The spawning method affects the reproductive efficiency of piracanjuba fish (Brycon orbignyanus) in restocking programs / El método de desove afecta la eficiencia reproductiva de piracanjuba (Brycon orbignyanus) en programas de repoblación / O método de desova afeta a eficiência reprodutiva de piracanjuba (Brycon orbignyanus) em programas de repovoamento

Abstract Background: Preserving the genetic diversity of wild fish is an important consideration for restocking programs, as inbreeding can compromise progeny survival as well as impact the resilience of natural populations. Objective: To evaluate the influence of spawning method: semi-natural (SN) or strip-spawning (ST), and the number of breeders (1♀:3♂ and 2♀:6♂) on the reproductive efficiency and genetic diversity of B. orbignyanus progeny destined for restoration of wild stocks. Methods: Rates of fertilization, hatching and broodfish mortality were recorded. For genetic evaluations (allele frequency, observed and expected heterozygosity, Shannon index, inbreeding coefficient, molecular variance analysis, and genetic differentiation), breeders (n=24), and their progenies (90 larvae/treatment) were sampled and analyzed using eight microsatellite markers. Results: Higher fertilization and hatching rates, and lower broodfish mortality were observed for the SN method (p<0.05), whereas the number of breeders did not affect these parameters (p>0.05). Interaction between spawning method and number of breeders was not significant (p>0.05). The amplified microsatellite loci produced a total of 30 alleles, with sizes between 80 and 225 bp and their frequencies indicated an increase (p<0.05) of genetic diversity in the progenies, but low genetic differentiation between treatments (p>0.05). Conclusion: The spawning methods and number of breeders tested increased equally the genetic diversity of the progeny, with low genetic differentiation between treatments. In contrast, rates of fertilization, hatching and brood fish mortality revealed that the SN method resulted in the best reproductive efficiency due to the handling stress and injuries caused by ST. Thus, SN proves to be the most suitable spawning-method for B. orbignyanus in restocking programs.

Resumen Antecedentes: Mantener la diversidad genética de los peces salvajes es una consideración importante para los programas de repoblación, ya que la endogamia puede comprometer la supervivencia de la progenie y afectar la supervivencia de las poblaciones naturales. Objetivo: Evaluar la influencia del método de desove (seminatural - SN o en franjas - ST) y el número de reproductores (1♀:3♂ y 2♀:6♂) sobre la eficiencia reproductiva y la diversidad genética de progenies de B. orbignyanus destinados a la restauración de poblaciones silvestres. Métodos: Se monitorearon las tasas de fertilización, eclosión y mortalidad de reproductores. Para las evaluaciones genéticas (frecuencias alélicas, heterocigosidad observada y esperada, índice de Shannon, coeficiente de endogamia, análisis de varianza molecular y diferenciación genética) los reproductores (n=24) y su progenie (90 larvas/tratamiento) se muestrearon y analizaron utilizando ocho marcadores microsatélites. Resultados: La interacción entre el método de desove y el número de reproductores no fue significativa (p>0,05). Se obtuvieron mejores tasas de fecundación y eclosión (p<0,05), y una menor mortalidad de reproductores (p<0,05) con el método SN, mientras que el número de reproductores no tuvo efecto (p>0,05). Los loci de microsatélites amplificados produjeron un total de 30 alelos con tamaños entre 80 y 225 pb, y sus frecuencias indicaron un aumento (p<0,05) en la diversidad genética de las progenies, pero una baja diferenciación genética entre tratamientos (p>0,05). Conclusión: Los métodos de desove y el número de reproductores evaluados aumentaron de la misma manera la diversidad genética de las progenies, con baja diferenciación genética entre tratamientos. En contraste, las tasas de fecundación, eclosión y mortalidad de peces reproductores revelaron que el SN tuvo la mejor eficiencia reproductiva, un hecho relacionado con el estrés del manejo y las lesiones causadas por el ST. Por lo tanto, el SN demuestra ser el método de desove más adecuado para B. orbignyanus en los programas de repoblación.

Resumo Antecedentes: A manutenção da diversidade genética dos peixes selvagens é uma importante consideração para programas de repovoamento, já que a endogamia pode comprometer a sobrevivência da progênie, além de impactar na resiliência das populações naturais. Objetivo: Avaliar a influência do método de desova (semi-natural - SN ou por extrusão - ST) e número de reprodutores (1♀:3♂ e 2♀:6♂) na eficiência reprodutiva e na diversidade genética de progênie de B. orbignyanus destinados à recuperação de estoques selvagens. Métodos: Taxas de fertilização, eclosão e mortalidade de reprodutores foram monitorados. Para avaliações genéticas (frequências alélicas, heterozigosidade observada e esperada, índice de Shannon, coeficiente de endogamia, análise de variância molecular e diferenciação genética), reprodutores (n=24) e sua progênie (90 larvas/tratamento) foram amostrados e analisados utilizando oito marcadores microssatélites. Resultados: Interação entre método de desova e número de reprodutores não foi significante (p>0,05). Melhores taxas de fertilização e eclosão (p<0,05), e menor (p<0,05) mortalidade de reprodutores foram observados para o método SN, enquanto que o número de reprodutores não afetou esses parâmetros (p>0,05). Os loci microssatélites amplificados produziram um total de 30 alelos, com tamanhos entre 80 e 225 pb e suas frequências indicaram aumento (p<0,05) da diversidade genética nas progênies, mas baixa diferenciação genética entre os tratamentos (p>0,05). Conclusão: Os métodos de desova e números de reprodutores avaliados aumentaram igualmente a diversidade genética das progênies, com baixa diferenciação genética entre tratamentos. Em contraste, as taxas de fecundação, eclosão e mortalidade de reprodutores revelaram que SN obteve a melhor eficiência reprodutiva, fato relacionado com o estresse de manipulação e injurias causadas por ST. Por isso, SN se mostrou como o método de desova mais adequado para B. orbignyanus em programas de repovoamento.

NOD1 rs2075820 (p.E266K) polymorphism is associated with gastric cancer among individuals infected with cagPAI-positive H. pylori

BACKGROUND: Helicobacter pylori is detected by pathogen recognition receptors including toll-like receptors (TLR) and nucleotide-binding oligomerization domain (NOD)-like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. RESULTS: A case-control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal-type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41-5.13, p = 0.0026). The association was not statistically significant in diffuse-type gastric cancer cases (OR = 1.26, 95% CI 0.63-2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80-3.36, p = 0.0019), in particular for intestinal-type gastric cancer cases (OR = 7.16, 95% CI 2.40-21.33, p = 4.1 × 10- 4) but not among diffuse-type gastric cancer cases (OR = 3.39, 95% CI 1.13-0.10, p = 0.03). CONCLUSIONS: NOD1 rs2075820 increases the risk of intestinal-type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.

Uso de plasma convaleciente en pacientes con COVID-19 / Use of convalescent Plasma in COVID-19 patients

La enfermedad por coronavirus 2019 (COVID-19) representa una de las mayores pandemias a las que el mundo se enfrenta y está produciendo una crisis sanitaria global. Hasta la fecha no se disponen de terapias o vacunas aprobadas para esta enfermedad. Se están estudiando varias opciones terapéuticas y desarrollando vacunas. El plasma convaleciente constituye una opción terapéutica interesante contra COVID-19, ya que sutilizó con éxito en otros brotes virales en el pasado. Esta terapia se consiste en la recolección de plasma de individuos recuperados de la enfermedad viral que desarrollaron anticuerpos. Es considerada la única estrategia a corto plazo, para conferir inmunidad inmediata a individuos susceptibles. En esta revisión se aborda los posibles mecanismos de acción del plasma convaleciente, damos una vista panorámica de los primeros estudios realizados en COVID-19, así como como los procedimientos necesarios para implementar esta terapia.

Coronavirus 2019 disease (COVID-19) represents one of the largest pandemics the world is facing and is producing a global health crisis. To date, there are no approved therapies or vaccines for this disease. Various therapeutic options are being explored and vaccines are being developed. Convalescent plasma is an interesting therapeutic option against COVID-19, as it has been successfully used in other viral outbreaks in the past. This therapy consists of collecting plasma from individuals recovered from the viral disease who developed antibodies. It is considered the only short-term strategy to confer immediate immunity to susceptible individuals. This review addresses the possible mechanisms of action of convalescent plasma, we give a panoramic view of the first studies carried out on COVID-19, as well as the necessary procedures to implement this therapy.

Sepsis por Lactobacillus reuteri en un recién nacido pretérmino: reporte de un caso / Sepsis due to Lactobacillus reuteri in an extreme preterm newborn: case report

La utilización de probióticos en la población neonatal ha contribuido a una disminución de la morbilidad y mortalidad en esta población a través de la reducción en la incidencia de entidades como enterocolitis necrosante, infecciones asociadas al cuidado de la salud y sepsis neonatal. A pesar de los múltiples efectos beneficiosos descritos, este tipo de medicamentos debe ser administrado con precaución en los pacientes de alto riesgo, debido a que se han documentado reportes de casos de sepsis neonatal por Lactobacillus rhamnosus, Saccharomyces boulardii y Bifidobacterium, entre otros. Se presenta un caso atípico de sepsis neonatal por Lactobacillus reuteri en un recién nacido pretérmino extremo en una institución de alta complejidad en la ciudad de Bogotá D. C., Colombia. El desenlace, en nuestro caso, fue fatal, pese al manejo médico establecido.

The use of probiotics in the neonatal population has contributed to a decrease in morbidity and mortality in this population through the reduction in the incidence of entities such as necrotizing enterocolitis, infections associated with health care and neonatal sepsis. Despite the multiple beneficial effects described due to the use of probiotics, this type of medication should be administered with caution in high-risk patients because reports of cases of neonatal sepsis by Lactobacillus rhamnosus, Saccharomyces boulardii and Bifidobacterium, among others, have been documented. We present an atypical case of neonatal sepsis due to Lactobacillus reuteri in an extreme preterm newborn in a highly complex institution in the city of Bogotá D. C., Colombia. The outcome in our case was fatal despite the established medical management.

Genetic diversity of Piracanjuba populations in fish stocking programs in the Tietê River, Brazil / Diversidad genética de poblaciones de Piracanjuba del programa de repoblamiento del Río Tietê, Brasil / Diversidade genética de populações de Piracanjuba do programa de repovoamento do Rio Tietê, Brasil

Abstract Background: Piracanjuba (Brycon orbignyanus) is a fish species highly affected by anthropogenic actions such as overfishing, water pollution, and hydroelectric developments. This species is currently considered in danger of extinction. Objective: To analyze the genetic diversity of a natural population (NP) and two captive broodstocks (SA and SB) of B. orbignyanus. Methods: Samples of caudal fins (NP: 24, SA: 30, and SB: 30) were collected. DNA was extracted and amplified for six RAPD primers and four microsatellite loci. Results: Sixty polymorphic fragments and 17 microsatellite alleles were detected. High intrapopulation heterozygosity (NP: 0.692, SA: 0.724, and SB: 0.686) was observed. Thirty-eight fragments and six alleles were shared among NP, SA, and SB. The FIS and Shannon's Index of diversity revealed a lack of inbreeding within groups. AMOVA analyses and FST indicated very high (NP vs SA and SB) and small (SA vs SB) genetic differentiation, confirmed by genetic distance and identity, number of migrants and a dendrogram, which revealed the formation of two genetic groups. Conclusions: The two marker types showed similar variability. The groups have adequate genetic variability, with high differentiation between NP and SA-SB, and similarity between broodstocks.

Resumen Antecedentes: Piracanjuba (Brycon orbignyanus) es una especie de pez fuertemente impactada por acciones antrópicas como sobrepesca, contaminación del agua y proyectos hidroeléctricos. Esta especie está considerada en peligro de extinción. Objetivo: Analizar la diversidad genética de una población natural (NP) y de dos lotes de reproductores (SA y SB) de B. orbignyanus en cautiverio. Métodos: Se colectaron 84 muestras de aleta caudal (NP: 24, SA: 30 y SB: 30). El ADN fue extraído y amplificado para seis cebadores RAPD y cuatro loci microsatélites. Resultados: Se obtuvieron 60 fragmentos polimórficos y 17 alelos microsatélites. Se observó alta heterocigosidad intra-poblacional (NP: 0,692; SA: 0,724 y SB: 0,686). Treinta y ocho fragmentos y seis alelos fueron compartidos entre NP, SA y SB. Los valores de FIS e índice de Shannon mostraron ausencia de endogamia entre los grupos. Los análisis de ANOVA y FST indicaron alta (NP vs SA y SB) y pequeña (SA vs SB) diferenciación genética; resultados confirmados por la distancia e identidad genética, número de migrantes y dendograma, evidenciando la formación de dos grupos genéticos. Conclusiones: Los grupos poseen adecuada variabilidad genética, con alta diferenciación entre NP vs SA-SB y similitud entre los lotes de reproductores.

Resumo Antecedentes: Piracanjuba (Brycon orbignyanus) é uma espécie peixe fortemente impactada por ações antrópicas como sobrepesca, poluição e construção de hidrelétricas. Atualmente, essa espécie engloba a lista de peixes que correm perigo de extinção. Objetivo: Analisar a diversidade genética de uma população natural (NP) e de dois estoques de reprodutores em cativeiro (SA e SB) de B. orbignyanus. Métodos: Foram coletadas amostras de nadadeira caudal de 84 indivíduos (NP: 24, SA: 30 e SB: 30). O DNA foi extraido e amplificado para seis primers RAPD e quatro loci microssatélites. Resultados: Foram obtidos 60 fragmentos polimórficos e 17 alelos microssatélites. Foi observada uma alta heterozigosidade intra-populacional (NP: 0,692; SA: 0,724 e SB: 0,686). Trinta e oito fragmentos e seis alelos foram compartilhados entre NP, SA e SB. Os valores de FIS e índice de Shannon demonstraram ausência de endogamia entre os grupos. As análises de AMOVA e FST indicaram alta (NP vs SA e SB) e pequena (SA vs SB) diferenciação genética, resultados confirmados pela distância e identidade genética, número de migrantes e dendrograma, que evidenciaram a formação de dois grupamentos genéticos. Conclusões: Os grupos possuem adequada variabilidade genética, com alta diferenciação entre NP e SA-SB e similaridade entre os estoques de reprodutores.

Resultados de la inducción en niños con leucemia linfoblástica aguda en el Hospital del Niño Ovidio Aliaga Uria, periodo 2013-2015: serie de casos / Induction outcomes in children with acute lymphoblastic leukemia in the Hospital del Niño Ovidio Aliaga Uria, Period 2013-2015: case series

INTRODUCCIÓN: La leucemia linfoblástica aguda es la neoplasia más común en pediatría. Hasta la fecha no se estudiaron los aspectos clínicos y resultados del tratamiento de este trastorno en Bolivia. OBJETIVO: Describir los resultados de la inducción a la remisión en un grupo de niños con leucemia linfoblástica aguda. MÉTODOS: Estudio descriptivo de una serie de casos tratados en el Hospital del Niño "Ovidio Aliaga Uría", durante el periodo 2013-2015. RESULTADOS: Se incluyeron en el análisis 25 casos, con una edad promedio de 5,8 años, el 60% correspondía al sexo femenino. Las manifestaciones clínicas frecuentes al diagnóstico fueron la palidez, fiebre y la anorexia con 68%, 64% y 60% respectivamente. El 100% de los casos correspondía al fenotipo B, con un 96% para subtipo B común. Al finalizar la inducción con el protocolo institucional (Total Therapy XV modificado) el 92% alcanzó remisión completa, la mortalidad durante la inducción fue del 4%. La complicación más frecuente durante la inducción fue la toxicidad hematológica, seguida de la morbilidad infecciosa. El 92% requirió apoyo transfusional durante el tratamiento. La SG y la SLE estimada a los 2 años fue del 95% y 56% respectivamente. CONCLUSIÓN: La respuesta terapéutica a la inducción a la remisión con el protocolo institucional es comparable a estudios previos. La SLE es menor a datos reportados previamente, siendo el abandono de tratamiento un factor clave asociado a este hallazgo.

INTRODUCTION: Acute lymphoblastic leukemia is the most common neoplasm in pediatrics. To date, the clinical aspects and results of the treatment of this disorder in Bolivia have not been studied. OBJECTIVE: To describe the results of induction to remission in a group of children with acute lymphoblastic leukemia. METHODS: Descriptive, cross-sectional and analytical study of a case series treated at Hospital del Niño "Ovidio Aliaga Uría" during the period 2013-2015. RESULTS: Twenty-five cases, with an average age of 5.8 years, were included in the analysis, 60% of which were female. The common clinical manifestations at the diagnosis were pallor, fever and anorexia with 68%, 64% and 60% respectively. 100% of the cases corresponded to phenotype B, with 96% for common B subtype. At the end of the induction with the institutional protocol (Total Therapy XV modified), 92% achieved complete remission, the mortality during induction was 4%. The most frequent complication during induction was haematological toxicity, followed by infectious morbidity. 92% required transfusion support during treatment. The OS and EFS estimated at 2 years was 95% and 56%, respectively. CONCLUSION: Therapeutic response to induction of remission with the institutional protocol is comparable to previous studies. SLE is lower than previously reported data, with treatment abandonment being a key factor associated with this finding.

Interactive effects of genotype x environment on the live weight of GIFT Nile tilapias

ABSTRACT In this paper, the existence of a genotype x environment interaction for the average daily weight in GIFT Nile tilapia (Oreochromis niloticus) in different regions in the state of Paraná (Brazil) was analyzed. The heritability results were high in the uni-characteristic analysis: 0.71, 0.72 and 0.67 for the cities of Palotina (PL), Floriano (FL) and Diamond North (DN), respectively. Genetic correlations estimated in bivariate analyzes were weak with values between 0.12 for PL-FL, 0.06 for PL and 0.23 for DN-FL-DN. The Spearman correlation values were low, which indicated a change in ranking in the selection of animals in different environments in the study. There was heterogeneity in the phenotypic variance among the three regions and heterogeneity in the residual variance between PL and DN. The direct genetic gain was greater for the region with a DN value gain of 198.24 g/generation, followed by FL (98.73 g/generation) and finally PL (98.73 g/generation). The indirect genetic gains were lower than 0.37 and greater than 0.02 g/generation. The evidence of the genotype x environment interaction was verified, which indicated the phenotypic heterogeneity of the variances among the three regions, weak genetic correlation and modified rankings in the different environments.

Triterpenes and sterols from Hoya diversifolia Blume.

Chemical investigation of the dichloromethane extracts of Hoya diversifolia Blume led to the isolation of β-amyrin cinnamate (1), squalene (2), β-sitosterol (3), a mixture of β-amyrin (4a), α-amyrin (4b) and lupeol (4c) in a 4:2:1 ratio and saturated hydrocarbons from the leaves; and 2, taraxerol (5), lupeol cinnamate (6), and a mixture of 3 and stigmasterol (7) in a 2:1 ratio from the stems. The structures of 1-7 were identified by comparison of their NMR data with those reported in the literature.

Trastornos del sueño asociados a la hipertensión arterial / Sleeping Disorders associated to High Blood Pressure

Se realizó un estudio transversal con el objetivo de establecer la relación existente entre los trastornos del sueño y la Hipertensión Arterial. La muestra estuvo formada por el total de pacientes hipertensos pertenecientes a tres consultorios médicos del Policlínico Universitario Turcios Lima en el municipio de Pinar del Río, en el periodo comprendido de enero 2006 a diciembre de 2006. Para dicho estudio se aplicó una encuesta donde se recogen datos relacionados con los trastornos del sueño más frecuentes que presentaban los pacientes. Se utilizó el método estadístico de la prueba de hipótesis de comparación de proporciones para los niveles de significación hasta 1%. Se obtuvo como resultado un elevado por ciento (81,07%) de pacientes con trastornos del sueño, el insomnio y el ronquido resultaron los trastornos más frecuentes, un tercio de los pacientes refirió síntomas subjetivos de apnea obstructiva del sueño y la mitad de los pacientes ingerían psicofármacos para dormir.

A cross-sectional study was aimed at establishing the relationship between the sleeping disorders and the high blood pressure. The sample was comprised of the total of hypertensive patients attending to three medical offices belonging to"Turcios Lima" Teaching Policlinic in Pinar del Rio municipality between January- December 2006. A survey was applied for compiling the data related to the most frequent sleeping disorders in patients .The statistical method of the hypothesis testing of comparison of proportions was used with significant levels up 1%.It was obtained a high percentage of patients with sleeping disorders (81, 07) being insomnia and snore the most frequent disorders presented, a third of patients had subjective symptoms of obstructive sleeping apnea and the half of patients used sleeping drugs.

Gota tofácea crónica: presentación de caso, servicio de medicina interna / Chronic Tophaceous Gout: A case presentation, Internal Medicine Service

El siguiente trabajo es la presentación de un caso ingresado en el servicio de Medicina Interna del Hospital Provincial Abel Santamaría Cuadrado, provincia Pinar del Río, en septiembre del 2007, con el diagnóstico de Gota Tofácea crónica. Este paciente presentaba una artritis invalidante y la presencia de tofos con grandes dimensiones que han provocado la anquilosis articular y deformaciones significativas. Considerando que es de gran interés semiológico para estudiantes de pre y postgrado, así como personal médico en general, pues en la actualidad es difícil encontrar pacientes con las manifestaciones encontradas al examen físico de este caso, debido a la prontitud del diagnóstico, la sistematicidad del tratamiento que se realiza en estos momentos.

The present study is a case presentation admitted at Internal Medicine Service in Abel Santamaría Cuadrado Provincial Hospital in September 2007 with a diagnosis of chronic tophaceous gout. This patient presented an invalid arthritis and the presence of tophos with large dimensions provoking the articular ankylosis and significant malformations being interesting semiologically to pregraduate and postgraduate students as well as the medical staff in general because it is hard to find out patients with manifestations found in the physical examination at present due to the quickness of diagnosis and systematicity of the treatment.

Carcinoma hepatocelular. Presentación de dos casos interesantes / Two interesting cases of Hepatocellular Carcinoma

Se presentaron dos pacientes con el diagnóstico de Carcinoma hepatocelular ingresados en el servicio de Medicina Interna del Hospital Central De Maputo, Mozambique, los cuales se comportaron evolutivamente diferente a lo observado en Cuba. Encontramos en el examen físico de estos casos hepatomegalias de grandes dimensiones, anemia, ertrosedimentación elevada, de los marcadores hepáticos la fosfatasa alcalina también elevada y la negatividad del HBS Ag. El estudio Ecográfico y tomográfico además de la Biopsia Aspirativa hepática concluyó el diagnóstico de certeza. A pesar de lo avanzado de la enfermedad, los pacientes lograban cierta tolerancia con las manifestaciones clínicas que presentaban por la neoplasia.

Two patients suffering from hepatocellular carcinoma are presented. They were admitted at Internal Medicine Service at Maputo Central Hospital. Mozambique. They had a different evolutive behaviour in relation to what was observed in Cuba. At physical examination it was found large hepatomegalia, anaemia, high erithrosedimentation rate, hepatic markers, alkaline phosphates and non-positive HBS Ag. Diagnosis was confirmed by the echocardiography, tomography and hepatic aspiration biopsy. In spite of the progressive disease, patients presented some tolerance to clinical manifestations due to neoplasm.

VARIABILIDAD GENÉTICA DE LOTES DE Brycon orbignyanus UTILIZADOS EN PROGRAMAS DE REPOBLAMIENTO: MANEJO Y CONSERVACIÓN / Genetic Variability in Brycon orbignyanus Stocks Used in Stocking Programs: Management and Conservation

Alteraciones ambientales causadas por el calentamiento global y principalmente causa-das por la acción del hombre, han reducido poblaciones naturales de peces. Como forma de conservación, programas de repoblamiento han sido utilizados; sin embargo, sin una debida orientación científica, estas medidas pueden generar disturbios genéticos sobre la diversidad genética de poblaciones de peces naturales y sobre el ecosistema. El objetivo de este estudio fue estimar y analizar la variabilidad genética de dos lotes y una progenie de Brycon orbignyanus utilizados en programas de repoblamiento, utilizando el marcador molecular RAPD (Random Amplified Polymorphic DNA). Cincuenta y ocho reproductores de dos lotes (A y C) y 30 larvas de la progenie del lote A (B) pertenecientes a la Estação de Aqüicultura e Hidrologia da Duke Energy Internacional (Geração Parana-panema; São Paulo, Brasil) fueron analizados. Los resultados de variabilidad genética estimados por el índice de diversidad de Shannon (A: 0,3184; B: 0,3433 y C: 0,3687) y por el porcentaje de fragmentos polimórficos (A: 54,02%; B: 57,47% y C: 58,62%) mostraron que la variabilidad genética fue mantenida en la progenie, debido posiblemente al adecuado manejo reproductivo y al efecto fundador. Por el contrario, la variabilidad encontrada entre los dos lotes de reproductores indica una similaridad genética, a pesar de ser originarios de diferentes pisciculturas. Este resultado es comprobado en el valor moderado de diferenciación genética encontrado (0,0968), en el alto Nm (4,67) y en el dendrograma, que sugieren que los lotes poseen un pool genético similar.

Environmental alterations caused by the global heating and mainly caused by man's action, have reduced natural fish populations. As a conservation measure, stocking programs have been used; however, without scientific orientation these measures can generate genetic disturbances on the genetic diversity of natural fish populations and the ecosystem. The objective of this study was to estimate and analyze the genetic variability of Brycon orbignyanus stocks and offspring used in stocking programs, using the molecular marker RAPD (Random Amplified Polymorphic DNA). Fifty eight broodstocks of two stocks (A and C) and thirty offspring larvae of the stock A (B) belonging to the Estação de Aqüiicultura e Hidrologia da Duke Energy International (Geração Paranapanema; São Paulo, Brazil ) were analyzed. The results of genetic variability estimated by the Shannon Index diversity (A: 0.3184; B: 0.3433 and C: 0.3687) and for the percentage of polymorphic fragments (A: 54.02%; B: 57.47% and C: 58.62%) showed that the genetic variability was maintained in the offspring, due possibly to the appropriate reproductive management and the founder effect. On the contrary, the variability found among the two broodstocks indicates a genetic similarity, in spite of being natives of different fish farming's. This result is verified in the moderate value of genetic differentiation found (0.0968), in the high Nm (4.67) and the dendrogram, which suggests that the stocks hold a similar genetic pool.

Study of Cytochrome P450 2E1 and its allele Variants in Liver Injury of Nondiabetic, Nonalcoholic Steatohepatitis Obese Women

CYP2E1 enzyme is related to nonalcoholic steatohepatitis (NASH) due to its ability for reactive oxygen species production, which can be influenced by polymorphisms in the gene. The aim of this study was to investigate hepatic levels, activity, and polymorphisms of the CYP2E1 gene to correlate it with clinical and histological features in 48 female obese NASH patients. Subjects were divided into three groups: (i) normal; (ii) steatosis; and (iii) steatohepatitis. CYP2E1 protein level was assayed in microsomes from liver biopsies, and in vivo chlorzoxazone hydroxylation was determined by HPLC. Genomic DNA was isolated for genotype analysis through PCR. The results showed that liver CYP2E1 content was significantly higher in the steatohepatitis (45 percent; p=0.024) and steatosis (22 percent; p=0.032) group compared with normal group. Chlorzoxazone hydroxylase activity showed significant enhancement in the steatohepatitis group (15 percent, p=0.027) compared with the normal group. c2 rare allele of RsallPstl polymorphisms but no C allele of Dral polymorphism was positively associated with CHZ hydroxylation, which in turn is correlated with liver CYP2E1 content (r=0.59; p=0.026). In conclusion, c2 allele is positively associated with liver injury in NASH. This allele may determine a higher transcriptional activity of the gene, with consequent enhancement in pro-oxidant activity of CYP2E1 thus affording liver toxicity.

Microbial isolates from patients in an intensive care unit, and associated risk factors / Aislados microbianos de pacientes en una unidad de cuidados intensivos, y factores de riesgos asociados

A retrospective one-year analysis of blood, sputum and urine samples taken from all patients admitted for more than 48 hours to the Intensive Care Unit at the University Hospital of the West Indies (UHWI) was undertaken. Positive trapped sputum cultures were found in 50of patients, positive blood cultures in 32.7and positive urine cultures in 23.1. Gram-negative organisms predominated especially Pseudomonas aeruginosa (41.3) and Acinetobacter spp (33.5). Coagulase-negative staphylococcus (20) and streptococcus group D (18.7) were the most common gram-positive organisms. The Acinetobacter spp showed marked resistance to most antibiotics except for meropenem (82.7susceptibility) while P. aeruginosa was most susceptible to ceftazidime (84.4) and amikacin (89.1). Both the coagulase-negative staphylococcus and streptococcus group D were relatively sensitive to amoxycillin/clavulanate (80.6and 79.3respectively). There was a high incidence of yeast found in sputum (27.1) and urine (16.8). Mechanical ventilation was a significant risk factor for developing a positive sputum culture (p = 0.01), this effect being particularly prominent in those ventilated for > 5 days. Central venous pressure lines significantly increased the risk of a positive blood culture (p = 0.005). This increase was seen particularly in those with CVP lines for > 7 days. Other risk factors for developing positive cultures included preadmission infection, antibiotic use just prior to ICU admission, increasing APACHE II score and increasing age.

Un análisis retrospectivo de muestras de sangre, esputo y orina tomadas a todos los pacientes ingresados por más de 48 horas en la Unidad de Cuidados Intensivos del Hospital Universitario de West Indies (HUWI) fue realizado por espacio de un año. Se hallaron cultivos de esputo positivos en 50% de los pacientes, cultivos de sangre positivos en el 32.7%, y cultivos de orina positivos en el 23.1%. Hubo predominio de organismos gram-negativos, en especial Pseudomonas aeruginosa (41.3%) y Acinetobacter spp (33.5%). Los estafilococos coagulasa-negativos (20%) y los estreptococos del grupo D (18.7%) fueron los organismos gram-positivos más comunes. Los Acinetobacter spp mostraron marcada resistencia a la mayoría de los antibióticos, salvo al meropenem (82.7% susceptibilidad), mientras P aeruginosa fue muy susceptible a la ceftazidima (84.4%) y a la amikacina (89.1%). Tanto el estafilococo coagulasa-negativo como el estreptococo del grupo D fueron relativamente sensibles a la amoxicilina/clavulanato (80.6% y 79.3% respectivamente). Se halló una alta incidencia de levadura en el esputo (27.1%) y la orina (16.8%). La ventilación mecánica fue un factor de riesgo importante para desarrollar un cultivo de esputo positivo (p = 0.01), siendo este efecto particularmente prominente en los ventilados por > 5 días. Las líneas de la presión venosa central aumentaron significativamente el riesgo de un cultivo de sangre positivo (p = 0.005), haciéndose este incremento particularmente evidente en aquellos con líneas de PVC por > 7 días. Otros factores de riesgo para el desarrollo de cultivos positivos incluyeron las infecciones previas a la admisión, el uso de antibióticos justo antes del ingreso a la UCI, el aumento de la puntuación APACHE II cuenta, y la edad avanzada.

Massas abdominais volumosas em pediatria: ensaio iconográfico / Bulky abdominal masses in pediatrics: iconographic essay

Os autores apresentam os achados de exames de imagem de 19 pacientes pediátricos com massas abdominais volumosas. Foram selecionadas imagens de ultra-sonografia (US), tomografia computadorizada (TC) e ressonância magnética (RM). Nos 19 pacientes estudados os diagnósticos foram: hidronefrose, tumor de WiIms, neuroblastoma, carcinoma de adrenal, sarcoma, hemangioendotelioma, hepatoblastoma, hamartoma mesenquimal, carcinoma hepatocelular, cisto de colédoco, cisto esplênico, linfoma, cisto de mesentério, teratoma, hidrometrocolpos, lipoma. Os exames de imagem (US, TC e RM) são importantes ferramentas na avaliação de massas abdominais pediátricas e podem contribuir para o diagnóstico e avaliação da extensão dessas entidades.

Anaesthesia for operative deliveries at the University Hospital of the West Indies: a change of practice / La Anestesia en los Partos Operativos en el Hospital Universitario de West Indies Un Cambio de Práctica

There has been an increasing trend worldwide to use regional anaesthesia for operative deliveries. The Confidential Enquiry into Maternal Deaths in the United Kingdom has demonstrated a steady decline in the anaesthesia-related deaths since the introduction of regional anaesthesia. There are lower morbidity profiles in mothers delivering under regional anaesthesia as well as better infant Apgar scores. In 1997, a decision was taken to have at least 60% of all elective Caesarean sections done at the University Hospital of the West Indies (UHWI) performed under spinal anaesthesia. This is a review of the anaesthetic technique for Caesarean sections at the UHWI since 1996. The Deliveries and Anaesthetic Books on the labour ward were reviewed and the type of anaesthesia for elective and emergency Caesarean sections recorded for the period January 1996 to December 2001. At the beginning of the period under study, more than 90% of the Caesarean sections were being done under general anaesthesia. By the middle of 1998, spinal anaesthesia was more commonly employed than general anaesthesia for Caesarean sections and by December 2001, more than eight out of every ten Caesarean sections were being done under spinal anaesthesia. The main reasons for the successful change of practice were that it was consultant-led, there was good communication between relevant departments, the junior staff were properly trained, there was a consistent supply of appropriate drugs and there was a high level of patient satisfaction

Ha habido una tendencia creciente mundial a usar la anestesia regional en los partos operativos. La Encuesta Confidencial sobre las causas de las muertes maternas en el Reino Unido, ha demostrado un descenso constante de los casos de muertes relacionadas con la anestesia, a partir de la introducción de la anestesia regional. Los perfiles de morbosidad son más bajos en las madres que dan a luz con anestesia regional, en tanto que los infantes presentan una mejor puntuación Apgar. En 1997, se toma la decisión de que al menos el 60% de todas las secciones cesáreas electivas en el Hospital Universitario de West Indies (UHWI) fueran realizadas bajo anestesia espinal. El presente trabajo constituye un resumen que examina la técnica anestésica aplicada en las cesáreas practicadas en el UHWI desde 1996. Se examinaron los Registros de Partos y Anestesia del salón de partos, tomándose nota del tipo de anestesia usado en las cesáreas electivas y de emergencia en el período de enero de 1996 a diciembre de 2001. A principios del periodo bajo estudio, más del 90% de las secciones cesáreas se hacían con anestesia general. A mediados de 1998, la anestesia espinal se empleaba más comúnmente que la anestesia general en las cesáreas. Y para diciembre de 2001 más de ocho de cada diez cesáreas se realizaban con anestesia espinal. Las razones principales para el cambio exitoso de práctica consistieron en que se llevo a cabo bajo la dirección de un consultante, hubo buena comunicación entre los departamentos pertinentes, el personal subalterno estaba debidamente entrenado, hubo un suministro consistente de los medicamentos apropiados, y finalmente un alto nivel de satisfacción de los pacientes.

Vomiting post tonsillectomy at the University Hospital of the West Indies / Vómitos Post Tonsilectomía en el Hospital Universitario de West Indies

A three-year observational study of patients undergoing tonsillectomy at the University Hospital of the West Indies was conducted to determine the incidence of postoperative vomiting. Data were collected to assess possible risk factors for vomiting as well as possible alleviating agents. Two hundred and fifty-two patients were included in the study and a thirteen per cent incidence of postoperative vomiting was found. This is significantly less than that quoted in other studies (40-73). Results also showed that steroids significantly reduced the incidence of postoperative vomiting in the study population. Muscle relaxants reversal agents and antibiotics particularly co-trimoxazole and ceftriaxone significantly increased its incidence. Usual antiemetic agents including dimenhydrinate (gravol) and promethazine (phenergan), as well as drugs known to possess antiemetic properties such as midazolam and propofol, lacked any significant protective effect against emesis. Opioid analgesia, inhalational induction and blood loss of greater than 10 of estimated blood volume appeared to increase emesis but failed to achieve statistical significance

Un estudio de observación a pacientes de tonsilectomía en el Hospital Universitario de West Indies, fue realizado durante tres años, a fin de determinar la incidencia de vómitos post-operatorios. Se recogieron datos con el propósito de evaluar los posibles factores de riesgo por vómitos así como los posibles agentes para aliviarlos. Doscientos cincuenta y dos pacientes fueron incluidos en el estudio y se halló una incidencia de trece por ciento de vómitos post-operatorios. Esta cifra es significativamente menor que las citadas en otros estudios (40-73%). Los resultados también mostraron que los esteroides redujeron significativamente la incidencia de vómitos post-operatorios en la población del estudio. Los agentes de reversión de los relajantes musculares y los antibióticos co-trimoxazol y ceftriaxona aumentaron significativamente la incidencia. Los agentes antieméticos usuales, incluyendo incluso el dimenhidrinato (gravol) y la prometazina (fenergan), así como drogas conocidas por sus propiedades antieméticas, tales como el midazolam y el propofol, no mostraron efecto significativo alguno de protección contra la émesis. La analgesia opioide, la inducción por inhalación, y la pérdida de sangre mayor al 10% del volumen de sangre estimada, parecían aumentar la émesis, pero no alcanzaron a tener importancia estadística.

A national survey on preoperative fasting policies and practices in Jamaican hospitals

Controversy has arisen regarding the length and nature of the preoperative fast that should be required of patients with normal gastric emptying time undergoing elective surgery. Various studies and editorials have indicated that the traditional preoperative fasting policy of [quot ]NPO after midnight[quot ] may be illogical as it makes no distinction between solid foods and clear fluids. Successive National Surveys conducted in the United States of America (USA) have shown an increasing number of Ambulatory Surgery Hospitals adopting more liberal preoperative fasting guidelines. Jamaican practitioners have also begun implementing some of these new liberal practices, even in institutions where [quot ]NPO after midnight[quot ] remain the official policy of the institution in which they practice. This has created a discordance between individual practice and institutional policy. In view of the fact that the extent of this discrepancy has not yet been studied and documented in Jamaica, and in an effort to better characterize the nature of the changes taking place in preoperative fasting practices in Jamaican hospitals, including those related to knowledge and attitude of practitioners, we embarked on this National Survey. The survey consisted of a questionnaire comprised of 13 questions which were to be completed by all surgeons and anaesthetists practising in a wide cross-section of public hospitals throughout Jamaica, providing an initial sample size of 201 subjects. We had a response rate of 74, or 148 responses. At all the hospitals surveyed, the traditional NPO policy continued to be the official institutional policy. However, at the individual level, 37 of respondents had already revised their policy, and were allowing their patients to have clear fluids up to three hours before the induction of anaesthesia. Also, 66, 68, and 73 of respondents stated that, in the future, they were prepared to allow their patients a solid meal up to eight hours, light breakfast up to six hours, and clear fluids up to three hours, respectively. We concluded that, whilst the traditional NPO policy remained firmly entrenched at the institutional level, many anaesthetists and surgeons show a positive inclination towards more liberal fasting practices. We recommend the formation of a local task force to determine what aspects of the new liberal guidelines may be safely and effectively adopted, taking account of local circumstances