Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics / Diversidade bacteriana em solos de prados andinos elevados perturbados por culturas de Lepidium meyenii avaliadas por metagenômica

Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e pós colheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics

Abstract Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

Resumo A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e pós-colheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics / Diversidade bacteriana em solos de prados andinos elevados perturbados por culturas de Lepidium meyenii avaliadas por metagenômica

Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e póscolheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Hallazgos endoscópicos en pacientes con síntomas cardinales de enfermedad de reflujo gastroesofágico

La enfermedad de reflujo gastroesofágico (ERGE) es una enfermedad recurrente relacionada con el flujo retrógrado del contenido gástrico al esófago, con o sin daño tisular a dicho nivel. La Hernia Hiatal (HH) se asocia con ERGE, y se ha relacionado con grados severos de la enfermedad (Esofagitis Erosiva Severa y Esófago de Barrett). Objetivo: Describir la presencia y las alteraciones a nivel de la mucosa esofágica reportadas endoscópicamente en los pacientes que consultan con síntomas de ERGE al servicio de Gastroenterología del Hospital Vargas. Pacientes y métodos: estudio descriptivo de corte transversal, en el cual se evaluaron hallazgos endoscópicos de pacientes que acudieron con síntomas de ERGE a las consultas del servicio de gastroenteologia del Hospital Vargas entre enero-mayo de 2007. Resultados: de 674 pacientes encuestados, 204 pacientes (59 hombres y 145 mujeres)presentaron síntomas de ERGE, a 60 de ellos se les realizó videogastroscopia de manera aleatoria, reportando 23,33% (14 pacientes) con ERGE erosiva, 1,66% (1paciente) con tu submucoso de esófago, 6,66% con esófago Barret y 75% (45 pacientes) sin alteraciones esofágicas. 23 (38,33%) con hernia hiatal, 8 de ellos con esofagitis erosiva. Conclusiones: Nuestro trabajo confirma el valor de la endoscopia digestiva superior en la evaluación de pacientes con síntomas cardinales de ERGE.

Gastro-esophageal reflux disease (GERD) is a recurrent disease related with retrograde progression of gastric contents to the esophagus with or without mucosal damage at this level. Hiatal hernia is associated with GERD and it has been related with severe grades of the disease (severe erosive esophagitis and BarrettÊs esophagus). Aims: to describe the presence of endoscopic features in GERD patientss with cardinals symptoms attended at the Gastroenterology Division of the Vargas Hospital in Caracas. Patients and Methods: this was a descriptive, transversal cohort study in which endoscopic findings in patients with GERD symptoms were evaluated, at the Gastroenterology Service, between January and May 2007. Results: of 674 patients interviewed, 204 patients (59 men and 145 women) presented GERD symptoms; to 60 of them an upper endoscopy randomly was performed. 23,33% (14 patients) had erosive GERD, 1,66% (1 patient) a submucous esophageal tumor, 6,66 % with BarrettÊs esophagus and 75% (45 patients) without esophageal changes, 23 (38,33%) with hiatal hernia, 8 of them with erosive esophagitis. Conclusion: our study supports the importance of performing an upper endoscopy in patients with cardinals symptoms of GERD.

Experiencia en la colocación de prótesis endoscópica en patología biliopancreática

Desde hace dos décadas esta descrita la utilidad de las prótesis endoscópicas, en patología biliopancreática. Objetivo: Mostrar la experiencia del Servicio de Gastroenterología del Hospital Vargas de Caracas en la colocación de prótesis endoscópicas en la patología biliopancreática, describiendo características demográficas, patologías más frecuentes, tasa de éxito en su colocación y complicaciones. Pacientes y Métodos: Estudio descriptivo, retrospectivo. Se revisaron datos de los informes de CPRE de pacientes hospitalizados y ambulatorios evaluados en la institución desde enero 1998 hasta abril 2007. Resultados: Se incluyeron 248 procedimientos de 110 mujeres y 73 hombres, 242 correspondieron a colocación de prótesis biliares (234 de teflón o plástico y 8 autoexpansibles metálicas) y 6 prótesis pancreáticas. Las indicaciones mas frecuentes para la colocación de prótesis fueron: patologías neoplásicas (47%), lesiones de la vía biliar post-quirúrgicas o traumáticas (22%) y litiasis biliar (17%). El éxito de la colocación de la prótesis fue del 99,1%. Se reportaron complicaciones en 4% de los procedimientos, con mayor frecuencia la colangitis (2%) y una mortalidad del 0%. Conclusión: La colocación de prótesis endoscópicas en patologías biliopancreáticas es un procedimiento seguro, con un bajo porcentaje de complicaciones y mortalidad.

The utility of the endoscopic stent have been described for two decades in the biliopancreatic diseases. Aims: To show the Gastroenterology Division of the Hospital Vargas de Caracas experience in placing endoscopic stents in biliopancreatic diseases, describing demographic characteristics more frequent diseases, success rates and complications. Patients and Methods: descriptive and retrospective trial. Features of the reports of PEPR of hospitalized and ambulatory patients seen in the institution from January 1998 to april 2007 were reviewed. Results: 248 procedures from 110 women and 73 men were included, 242 had a biliar stent (234 of Teflon or plastic and 8 metallic selfexpanded) and 6 had pancreatic stents. The more frequent indications for placing the stents were: Tumoral disease, (47%), traumatic or post-surgical lesions of the biliary tract (22%) and biliary stones (17%). The success rate of the placing of stents was 99.1%. The procedureÊs complication rate reported was 4%, being colangitis the most frequent with 2% and a 0% mortality. Conclusion: the placing of endoscopic stents in biliopancreatic diseases is a safe procedure, with a low rate of complications and mortality.

Prevalencia de enfermedad por reflujo gastroesofágico en población adulta del área metropolitana de Caracas Venezuela

La enfermedad por reflujo gastroesofágico (ERGE) es uno de los trastornos gastrointestinales con mayor prevalencia; afecta del 10 a 15% de la población general constituyendo una causa frecuente de consulta. Sin embargo, existen pocos reportes acerca de la prevalencia de ERGE en la población general. Objetivos: Determinar la prevalencia de ERGE en la población general adulta del área metropolitana de Caracas y estudiar algunos factores asociados a esta enfermedad. Materiales y métodos: Estudio de corte transversal, realizado en la población general adulta del área metropolitana de Caracas en abril de 2007. Se utilizó una encuesta basada en criterios clínicos epidemiológicos de acuerdo a consensos latinoamericanos y europeos sobre la ERGE. Para el análisis de los resultados se calcularon promedios, medianas y porcentajes. Resultados: De 389 sujetos encuestados, 223 fueron mujeres (57,3%) y 166 hombres (42,7%). El promedio de edad fue 33,89 años. La prevalencia de síntomas cardinales en la ERGE fue 19,02%. En los sujetos con ERGE encontramos que 47,3% ingerían licor al menos un vez al mes, y 21,6% referían hábitos tabáquicos. Conclusión: Se determinó que la prevalencia de la ERGE en la población general adulta del área Metropolitana de Caracas fue de 19,02% encontrándose asociación con el hábito alcohólico.

Gastroesophageal reflux disease (GERD) is one of the gastrointestinals problems with higher prevalence; it affects 10 to 15% of the general population being a frequent cause of medical visit. Nevertheless, there is low number of reports about GERD prevalence. Objectives: to determine GERD prevalence in adult population of the Caracas Metropolitan Area and study some related factors to this disease. Materials and methods: Study of transversal cut, made in adult population in Caracas Metropolitan Area in April 2007. A poll based in clinical and epidemiological criteria in accordance with a Latin- American and European consensus about GERD was used. To analize the results averages, medians and percentages were calculated. Results: of 389 subjects surveyed, 223 were women (57,3%) and 166 were men (42,7%). The mean age of the patients was 33 years old. The cardinals symptoms prevalence was 19,02%. In subjects with GERD we found that 47,3% drank alcohol at least once a week, and 21,6% were smokers. In Conclusion, we found that GERD prevalence in adult population of the Caracas Metropolitan Area was 19, 02% finding a relationship with alcoholic habit.

Rendimiento diagnóstico de la cápsula endoscópica y enteroscopia doble balón en pacientes con hemorragia digestiva oscura

Introducción: los métodos descritos para el estudio del intestino delgado han sido de difícil realización y baja certeza diagnóstica. La cápsula endoscópica (CE) y enteroscopia doble balón (EDB), permiten obtener beneficio para el estudio y tratamiento del paciente con hemorragia digestiva oscura. Objetivo: determinar el rendimiento diagnóstico de la CE y EDB en pacientes con hemorragia digestiva oscura. Métodos y pacientes: se evaluaron 50 pacientes con hemorragia digestiva oscura, en 24 pacientes se realizó CE y en 26 pacientes EDB. Los hallazgos de las lesiones por cápsula endoscópica M2A Given Imaging y enteroscopia doble balón fueron comparados. Resultados: como causa de sangrado se encontraron lesiones en el 56,52% de los pacientes utilizando CE y en 42,30 % de los pacientes con EDB (p= 0,04). Ambos estudios fueron bien tolerados. No se reportó ningún efecto adverso. Biopsias (n: 1), coagulación con argón plasma (n: 7), esclerosis con adrenalina (n: 1) fueron realizados al utilizar EDB. Conclusión: el rendimiento diagnóstico de la CE y EDB fue similar para detectar las lesiones causantes de hemorragia oscura. La ventaja de la EDB es la posibilidad de aplicar procedimientos endoscópicos terapéuticos.

Introduction: The methods described for the study of the small bowel have been of difficult accomplishment and low diagnostic certainty. The Endoscopic Capsule (EC) and Double Balloon Enteroscopy (DBE), can be helpful in the study and treatment of the patient with occult digestive bleeding. Objective: To determine the diagnostic yield of EC and DBE in patients with occult digestive bleeding. Methods and patients: 50 patients with occult digestive bleeding were evaluated, in 24 patients EC was the method of choice and in 26 patients DBE. Findings by means of endoscopic capsule M2A Given Imaging and double balloon enteroscopy were compared. Results: A cause of bleeding was found in 56.52% of patients using EC and in 42, 30% of patients with DBE (p=0,04). Both studies were well tolerated. No adverse effects were reported. Biopsies (n: 1), argon plasma coagulation (n: 7), sclerosis with adrenalin (n: 1) were performed when using DBE. Conclusion: The diagnostic yield of EC and DBE was similar in detecting injuries causing occult bleeding. The advantage of DBE is the possibility of applying therapeutic endoscopic procedures.

Cápsula endoscópica y enteroscopia doble balón en pacientes con patología del intestino delgado

Introducción: La cápsula endoscópica (CE) y la enteroscopia de doble balón (EDB) fueron introducidas como nuevas modalidades endoscópicas para el estudio del intestino delgado. Objetivo: comparar el rendimiento diagnóstico de estos dos métodos en la evaluación de pacientes con patología del intestino delgado. Pacientes y métodos: estudio descriptivo de una muestra de 97 pacientes de ambos géneros mayores de 12 años, que acudieron al Servicio de Gastroenterología del Hospital Vargas de Caracas y Policlínica Metropolitana entre diciembre 2004 y mayo 2006, con indicación médica para evaluación del intestino delgado por cápsula endoscópica y/o enteroscopia doble balón. Resultados: a 30 pacientes se les realizó CE (12 mujeres, 18 hombres) edad promedio 58,95 años. Se encontraron hallazgos positivos en 72,41%. A 67 pacientes (36 mujeres, 31 hombres) se les realizó enteroscopia doble balón, edad promedio de 52,9 años. Hubo hallazgos positivos en 62,68%. Hubo 3 complicaciones menores (4,4%) tratadas médicamente. Conclusión: el rendimiento diagnóstico de la CE y EDB fue similar para detectar lesiones del intestino delgado. EDB permite realizar toma de biopsias y procedimientos terapéuticos.

Introduction: Endoscopic Capsule (EC) and Double Balloon Enteroscopy (DBE), are new endoscopic modalities for the study of the small bowel. Objective: To compare the diagnostic yield of these two methods in the evaluation of patients with pathology of the small bowel. Patients and methods: Comparative study of a sample of 97 patients of both genders that attended the Hospital Vargas de Caracas and Metropolitan Policlinic, between December 2004-May 2006, with clinical indication for evaluation of the small bowel by EC and/or DBE. Results: EC was performed to 30 patients (12 women, 18 men) age average 58,95 years, with findings in 72,41%: DBE was performed to 67 patients (36 women, 31 men), age average 52,9 years. Positive findings: 62,68%. There were 3 complications (4,4%).Conclusion: The diagnostic yield of EC y DBE was similar to detect lesions of the small bowel. With DBE is possible to take biopsy samples and perform therapeutic procedures.

Leishmaniasis in HIV infection.

Herein we review the particular aspects of leishmaniasis associated with HIV infection. The data in this review are mainly from papers identified from PubMed searches and from papers in reference lists of reviewed articles and from the authors' personal archives. Epidemiological data of HIV/Leishmania co-infection is discussed, with special focus on the influence of Highly Active Antiretroviral Therapy (HAART) on incidence of leishmaniasis and transmission modalities. Microbiological characteristics, pathogenesis, clinical presentation and specific treatment of the co-infection are also presented.

Diagnóstico y tratamiento de las complicaciones infecciosas de la pancreatitis necrotizante / Diagnostic and treatment of infectious complications of necrotizing pancreatitis

En las últimas décadas se ha logrado un consenso en el tratamiento de la pancreatitis aguda necrotizante (PAN); en caso de infección sobreagregada, el tratamiento médico debe ser complementado con la intervención quirúrgica de manera a suprimir el foco séptico retroperitoneal. El objetivo fue determinar la frecuencia relativa de la PAN y de las complicaciones infecciosas y analizar, al mismo tiempo, los resultados del tratamiento basado en un algoritmo. Entre abril de 1996 y marzo del 2001, 258 casos de pancreatitis aguda biliar fueron internados en la Primera Cátedra de Clínica Quirúrgica; los casos graves- según la escala de Glasgow- y con imágen tomográfica compatible con necrosis fueron seleccionados para realizar este estudio descriptivo retrospectivo. Este grupo de pacientes fue sometido al inicio a un tratamiento médico estándar incluyendo la antibioticoterapia de amplio espectro y el soporte nutricional enteral o parenteral; los que evolucionaron favorablemente continuaron con este manejo no operatorio, mientras que los cursaron con picos febriles y leucocitosis persistente, fueron sometidos a una punción percutánea e intervenidos quirúrgicamente conforme el resultado. La cirugía fue igualmente indicada ante la presencia de burbujas de aire en el retroperitoneo o septicemia. Del total de 258 pacientes, 53 (20 por ciento) eran portadores de PAN; 30 de ellos recibieron tratamiento médico exclusivo, mientras los restantes 23 fueron intervenidos por complicaciones infecciosas: 16 mecrosis infectadas difusas y 7 abscesos. La mortalidad global de la serie fue de 7,5 por ciento, 13 por ciento en los operados y 3 por ciento en los no operados

Pancreatitis aguda biliar: tendencias actuales en el manejo. Artículos / Acute pancreatitis biliary: current tendencies in the handling. Articles

El tratamiento de la Pancreatitis aguda de causa biliar, esencialmente médico, requiere en ocasiones de recursos endoscópicos y quirúrgicos, del apoyo nutricional, y de la administración de antibióticos de amplio espectro. En la actualidad, gracias al empleo de escalas pronósticas diversas, es posible reconocer precozmente los casos graves. La presencia de complicaciones, locales y sistémicas, contribuye también a establecer un pronóstico. La infección de la necrosis es el principal factor determinante del curso de la afección y de la oportunidad del manejo quirúrgico, modificando sustancialmente el curso de la enfermedad. También de debe realizar la intervención quirúrgica cuando hay un empeoramiento - a pesar de la terapia médica adecuada - especialmente si hay necrosis extensas, septicemia con sospechas de infección bacteriana peripancreática, o ante la posibilidad de un error diagnóstico. La indicación correcta y oportuna de la intervención quirúrgica permite una disminución de la mortalidad...

Vasovasostomías efectuadas en 60 casos, desde junio de 1990 a enero de 1994 / Vasovasostomies performed in 60 cases from June 1990 to January 1994

60 vasovasostomies were performed between june 1990 and january 1994, following the modified one layer technique, under microscopic magnification. All the patients who requested the surgical procedure were included in the present study despite their age or time after vasectomy, in order to have a non selected group. Follow up was given with sperm counts processed under similar standards and performed at 2, 4 and 6 months after the surgical procedure. Our overall experience seems to confirm that strong correlation does not exist between the surgical technique used (one layer vs two layer), but the lapse of time passed between the vasectomy and the reversal is critical. In our series a pregnancy rate of 56.6% was achieved, with a patency rate of 86.7%