Actualización sobre la comorbilidad migraña-depresión / Update on migraine-depression comorbidity

Introducción: La migraña y el trastorno depresivo son patologías altamente prevalentes e incapacitantes, las cuales presentan relaciones bidireccionales de comorbilidad. En la literatura se han descrito factores de riesgo y mecanismos fisiopatológicos comunes para ambas enfermedades, así como asociaciones entre estas y su presentación clínica. Métodos: El presente texto es una revisión narrativa de la literatura. La búsqueda del material bibliográfico se hizo mediante distintas bases de datos especializadas en el área de la salud. Resultados: Algunos factores de riesgo están asociados con ambas patologías, y ambas comparten factores patogénicos, incluidos cambios funcionales, estructurales, genéticos, epigenéticos y hormonales, entre otros. Varios de los tratamientos preventivos que han demostrado eficacia en el tratamiento de la migraña son medicamentos o medidas con efecto antidepresivo. Discusión: Si se consideran las asociaciones y los factores comunes descritos en la literatura, se hace evidente que en el enfoque de pacientes diagnosticados con alguna de estas patologías es necesario tener en cuenta una posible comorbilidad entre migraña y depresión. Conclusión: Es importante promover el tamizaje de estas dos condiciones en pacientes diagnosticados con alguna de ellas, pues esto puede tener implicaciones terapéuticas e impacto en la calidad de vida.

Introduction: Migraine and depressive disorder are highly prevalent and disabling pathologies, which present bidirectional relationships of comorbidity. Common risk factors and pathophysiological mechanisms for both diseases have been described in the literature, as well as associations between them and their clinical presentation. Methods: This text is a narrative literature review. The bibliographical material was found through different databases specialized in health sciences. Results: Some risk factors are associated with both pathologies, and both share pathogenic factors, including functional, structural, genetic, epigenetic, hormonal changes, among others. Several of the preventive treatments that have shown efficacy in the treatment of migraine are medications or measures with an antidepressant effect. Discussion: Considering the associations and common factors described in the literature, it becomes evident that in the approach to patients diagnosed with any of these pathologies, it may be beneficial to consider a possible migraine-depression comorbidity. Conclusion: It is important to promote the screening of these two patients diagnosed with some, since it can have therapeutic implications and impact on quality of life.

Helminth and ectoparasitic faunas of the Harris's hawk, Parabuteo unicinctus (Accipitriformes: Accipitridae), in Chile: new data on host-parasite associations for Neotropical raptors / Helmintos e ectoparasitas do gavião-asa-de-telha (Accipitriformes: Parabuteo unicinctus) no Chile: novas associações parasita-hospedeiro para os rapinantes neotropicais

Abstract Birds of prey harbor a wide spectrum of various parasites, mostly with a heteroxenous life cycle. However, most reports on their parasites come from Europe. Although the Harris's hawk (Parabuteo unicinctus) is a widespread species in America, parasitological surveys on this hawk are mostly focused on coprological findings and ectoparasites, with poor attention paid to helminths. The aim of this study was to gather new and additional data on host-parasite associations for the Harris's hawk. Twenty-nine birds from central and southern Chile were necropsied. Further, nine birds from a rehabilitation center and 22 museum specimens were inspected for ectoparasites. Sixty-eight percent of birds hosted at least one parasite species. Four lice species, one mite species and eight helminth species (five nematodes, two platyhelminthes and one acanthocephalan) were recorded. Parasitic lice Colpocephalum nanum and Nosopon chanabense, and a nematode Cyathostoma (Hovorkonema) americana were recorded for the first time in raptors from the Neotropics. A feather mite, Pseudalloptinus sp., nematodes, Physaloptera alata and Microtetrameres sp., and a trematode Neodiplostomim travassosi, were recorded for the first time in Chile. The presence of diverse heteroxenous helminths reported here in the Harris's hawk could be explained by the generalist diet of this raptor.

Resumo As aves de rapina representam uma fonte importante de parasitas heteroxenos. Porém, a maioria dos relatos são da Europa. O gavião-asa-de-telha (Parabuteo unicinctus) é uma espécie amplamente distribuída no continente Americano, porém estudos parasitológicos nessas aves têm documentado achados coprológicos e ectoparasitas, com poucos relatos sobre endoparasitas como helmintos. Por essa razão, o objetivo deste estudo foi descrever novas associações parasita-hospedeiro para o gavião-asa-de-telha e rapinantes neotropicais. Vinte nove aves provenientes do centro e sul do Chile foram submetidas à necropsia. Por outro lado, nove aves de um centro de reabilitação e 22 espécimes de museu foram inspecionados em busca de ectoparasitas. Do total de aves, 68,3% foram identificadas como portadoras de pelo menos uma espécie de parasita. Quatro espécies de piolhos, um ácaro e oito helmintos (cinco nematoides, dois platelmintos e um acantocéfalo) foram registrados. Os piolhos Colpocephalum nanum, Nosopon chanabense e o nematóide Cyathostoma (Hovorkonema) americana são reportados pela primeira vez em rapinantes neotropicais. Colpocephalum nanum, N. chanabense, Pseudalloptinus sp., Physaloptera alata, Microtetrameres sp., C. (H.) americana e Neodiplostomim travassosi, são reportados pela primeira vez no Chile. A diversidade de helmintos heteróxenos, identificados neste trabalho, poderia ser explicada devido à dieta geralista do gavião-asa-de-telha.

Ectoparasites of Columbina passerina insularis (Columbiformes) in the National Zoological Park, Havana, Cuba / Ectoparasitas de Columbina passerina insularis (Columbiformes) no Parque Zoológico Nacional, Havana, Cuba

Abstract Ectoparasites of 18 free-living Cuban Ground Doves, Columbina passerina insularis (Columbiformes: Columbidae), captured in the National Zoological Park, Havana, Cuba, were identified. The collected ectoparasites included two species of lice (Phthiraptera: Ischnocera): Columbicola passerinae (77.1%), and Physconelloides eurysema (50%), as well as four species of feather mites (Astigmata: Falculiferidae): Pterophagus lomatus (83.3%), Byersalges talpacoti (50%), Byersalges phyllophorus (72.2%), and Hyperaspidacarus tridentatus (27.7%). Pterophagus lomatus, B. phyllophorus, and H. tridentatus represent new records for Cuba.

Resumo Foram identificados os ectoparasitas de 18 rolinhas-cinzentas de vida livre, Columbina passerina insularis (Columbiformes: Columbidae), capturadas no Parque Zoológico Nacional de Havana, Cuba. Os ectoparasitas coletados pertencem à duas espécies de piolhos (Phthiraptera: Ischnocera): Columbicola passerinae (77,1%) e Physconelloides eurysema (50%), bem como à quatro espé cies de ácaros de pena (Astigmata: Falculiferidae): Pterophagus lomatus (83,3%), Byersalges talpacoti (50%), Byersalges phyllophorus (72,2%) e Hyperaspidacarus tridentatus (27,7%). Pterophagus lomatus, B. phyllophorus e H. tridentatus representam novos registros para Cuba.

First record of Ornithonyssus bursa (Berlese, 1888) (Mesostigmata: Macronyssidae) parasitizing invasive monk parakeets in Santiago, Chile / Primeiro registro de Ornithonyssus bursa (Berlese, 1888) (Mesostigmata: Macronyssidae) parasitando caturritas invasoras em Santiago, Chile

Abstract Myiopsitta monachus is an invasive psittacine with wide distribution due to the pet trade. Its large communal nests and synanthropic nature contribute to its successful colonization of cities, from where it seems to be expanding in range and numbers. This is relevant with regard to pathogens that invasive species may harbor, especially when host populations thrive. We aimed to identify an abundant mite found in invasive monk parakeet chicks that had been collected in Santiago during 2017 and 2018. Through morphological and molecular identification of the 18S ribosomal RNA gene, we confirmed the presence of Ornithonyssus bursa. This was the first report of this mite in Chile. This mite is common in native and invasive monk parakeet populations and may affect other birds, including domestic fowl. Further, this mite bites people and can be a potential vector of pathogens such as bacteria or viruses. We conclude that this parasite was likely introduced with the parakeet and discuss possible ecological, health and economic consequences of this new potential pest.

Resumo Myiopsitta monachus é um psitacídeo invasor amplamente distribuído devido ao tráfico de animais selvagens. Os grandes ninhos comunitários construídos e sua condição de espécies sinantrópicas contribuem para a colonização bem-sucedida das cidades, onde parece estar expandindo sua distribuição e número de indivíduos. Isso é relevante, quando se trata de patógenos que os invasores podem abrigar, especialmente quando as populações hospedeiras prosperam. O objetivo deste trabalho foi identificar um ácaro abundante, encontrado em filhotes de periquitos-monge introduzidos em Santiago, Chile, coletados durante 2017 e 2018. Por meio da identificação morfológica e molecular do gene do RNA ribossômico 18S, foi confirmada a presença de Ornithonyssus bursa, sendo o primeiro registro para o Chile. Esse ácaro é comum em populações nativas e introduzidas de periquitos-monge e pode afetar outras aves, incluindo aves domésticas. Além disso, esse ácaro pode picar pessoas e pode ser um potencial vetor de patógenos, como bactérias ou vírus. Conclui-se que esse parasita provavelmente foi introduzido com o periquito e foram discutidas as possíveis consequências ecológicas de saúde e econômicas dessa nova praga em potencial.

Parasitic fauna of the invasive house sparrow (Passer domesticus) from Ñuble region, Chile: an example of co-introduced parasites / Fauna parasítica do pardal invasor (Passer domesticus) da região de Ñuble, Chile: um exemplo de parasitas co-introduzidos

Abstract Invasive species impact native wildlife in several ways, as they compete for resources and may transmit their specific pathogens. However, the potential consequences of co-introduced parasites are not fully understood. While the house sparrow (Passer domesticus) was introduced in Chile about a century ago, no data are available regarding its parasites. Thus, the aim of the present study was to determine the parasitic fauna of this avian invader and to determine whether there are co-introduced/co-invasive parasites shared with native birds. One hundred and eight birds were collected from three different localities in the Ñuble region of Chile, and a complete parasitic necropsy was performed in the laboratory. Twenty-three (21.3%) were parasitized by six arthropod species and four (3.7%) were parasitized by two helminth species. Four out of eight taxa are reported for the first time in Chile; among them, three arthropod parasites and the tapeworm, Anonchotaenia globate, are considered as co-introduced parasites. Only A. globata is a potential co-invasive parasite given its low degree specificity in terms of its definitive hosts. Future research should examine whether additional co-introduced/co-invasive parasites have been brought by the house sparrow, and what their potential consequences might be on the health of native birds in Chile.

Resumo As espécies invasoras de vertebrados competem com espécies nativas no uso de recursos e transmitem patógenos. Contudo as consequências da co-introdução de parasitos permanecem pouco estudadas. O pardal (Passer domesticus) foi introduzido há um século no Chile, porém não existem dados sobre seus parasitos. O objetivo do estudo foi investigar a fauna parasitária e avaliar se existem espécies co-introduzidas/co-invasivas compartilhadas com as espécies de aves nativas do Chile. Um total de 108 aves foram coletadas em diferentes localidades da região de Ñuble. Seis espécies de artrópodes parasitos foram coletadas de 23 (21,3%) aves. Quatro aves (3,7%) estavam parasitadas por duas espécies de helmintos. Quatro de um total de oito espécies de parasitos correspondem aos primeiros relatos para o Chile. Três artrópodes parasitos e o helminto Anonchotaenia globata são considerados parasitos co-introduzidos no país. Apenas A. globata possui potencial para ser considerada uma espécie co-invasiva, pois pode parasitar Passeriformes em geral. Pesquisas futuras devem investigar se os demais parasitos identificados neste estudo correspondem a espécies co-introduzidas ou co-invasoras e avaliar as possíveis consequências na saúde das aves nativas do país.

Trichinella spiralis in a cougar (Puma concolor) hunted by poachers in Chile / Trichinella spiralis em um puma (Puma concolor) caçado por caçadores furtivos no Chile

Abstract Trichinellosis is a zoonosis caused by nematodes of the Trichinella genus, of which 10 species have been described. Species identification when larvae is found is only possible using molecular tools. Meat from pigs and game animals not subjected to veterinary inspection are the main sources of human infections. The hunting of native carnivores is prohibited in Chile due to conservation issues and the fact that those animals favor pest control. The illegal hunting of a cougar (Puma concolor) occurred in September 2020. Herein, the molecular identification of Trichinella larvae, by analyzing nuclear (expansion segment V) and mitochondrial (cytochrome C oxidase subunit I) sequences are described. Both the amplification of the expansion segment V region and the phylogenetic analysis of a segment of a fragment of the cytochrome c-oxidase subunit I sequence confirmed that the larvae belonged to T. spiralis. The case described herein represents the first evidence of illegal hunting of a protected mammal infected with Trichinella in Chile, highlighting the 'One Health' perspective to face this disease in the rural-sylvatic interphase.

Resumo A triquinelose é uma doença causada por nematoides do gênero Trichinella. Dez espécies foram descritas. A identificação das espécies a partir das larvas só foi possível com ferramentas moleculares. O abate doméstico de suínos e o consumo de animais de caça, sem inspeção veterinária, são as principais fontes de infecção humana. A caça de carnívoros nativos é proibida no Chile por questões de conservação e pelo fato de que esses animais favorecem o controle de pragas. A caça ilegal de um puma (Puma concolor) aconteceu em setembro de 2020. No Chile, a identificação molecular de larvas de Trichinella, obtida pelo exame de sequências nucleares (segmento de expansão V) e mitocondriais (citocromo C oxidase subunidade I) são descritas. Tanto a amplificação da região do segmento de expansão V quanto a análise filogenética de um segmento de um fragmento da sequência da subunidade I da Citocromo c-oxidase, confirmaram que as larvas pertenciam a T. spiralis. O caso aqui descrito representa a primeira evidência de caça ilegal de um mamífero protegido infectado com Trichinella no Chile, destacando a perspectiva de "Saúde Única" para enfrentar esta doença na interfase rural-silvestre.

Prone Position in Non-intubated Patients with COVID-19, a Useful Maneuver to Avoid Mechanical Ventilation: A Literature Review

The spectrum of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to acute respiratory distress syndrome (ARDS). Prone position has been widely used in ARDS patients with mechanical ventilation and its benefits have been proven. This maneuver can be extrapolated to non-intubated patients with COVID-19, avoiding mechanical ventilation in some patients. Previous reports have demonstrated the benefits of this intervention.

External and gastrointestinal parasites of the Franklin's Gull, Leucophaeus pipixcan (Charadriiformes: Laridae), in Talcahuano, central Chile / Parasitas externos e gastrointestinais da gaivota de Franklin Leucophaeus pipixcan (Charadriiformes: Laridae) em Talcahuano, Chile central

Abstract Parasitological studies of the Franklin's gull, Leucophaeus pipixcan, are scarce, and knowledge about its endoparasites is quite limited. In order to describe its parasitic community, a total of 60 Franklin's gulls were captured in the coastal area in central Chile, using modified Bal-chatri traps. Ectoparasites were collected from all 60 live individuals through inspection of their plumage, while 30 were examined for endoparasites by standard parasitological necropsy. The prevalence of ectoparasites was 78.3%, including the feather mite Zachvatkinia larica (43.3%) and four species of lice: Actornithophilus piceus lari (15.0%), Austromenopon transversum (6.7%), Quadraceps punctatus (10.0%) and Saemundssonia lari (46.7%). Some 25 of 30 (83.3%) of birds necropsied were parasitized with the following helminths: Aporchis sp. (6.7%), Tetrabothrius cylindraceus (56.7%), Cyclophyllidea gen. sp. (3.3%), Profilicollis altmani (56.7%), Eucoleus contortus (10.0%), Cosmocephalus obvelatus (13.3%), Paracuaria adunca (10.0%), Stegophorus sp. (3.3%) and Tetrameres skrjabini (3.3%). To our knowledge, with the exception of P. altmani, these helminths are reported for first time in the Franklin's gull.

Resumo Existem escassos estudos de parasitismo em gaivota-de-Franklin Leucophaeus pipixcan, e o conhecimento sobre seus endoparasitas é ainda mais limitado. Com o objetivo de descrever sua comunidade parasitaria, um total de 60 gaivotas-de-Franklin foram capturadas usando-se armadilhas Bal-chatri numa zona costeira do centro do Chile. A pesquisa de ectoparasitas foi realizada em todos os indivíduos capturados e, para os endoparasitas, foram examinados 30 deles por necropsias. A prevalência de ectoparasitas foi de 78,3%, incluíndo o ácaro de pena Zachvatkinia larica (43,3%) e outras quatro espécies de piolhos, Actornithophilus piceus lari (15,0%), Austromenopon transversum (6,7%), Quadraceps punctatus (10,0%) e Saemundssonia lari (46,7%). Das aves necropsiadas, 83,3% estavam parasitadas por helmintos, sendo registrados Aporchis sp. (6,7%), Tetrabothrius cylindraceus (56,7%), Cyclophyllidea gen. sp. (3,3%), Profilicollis altmani (56,7%), Eucoleus contortus (10,0%), Cosmocephalus obvelatus (13,3%), Paracuaria adunca (10,0%), Stegophorus sp. (3,3%) e Tetrameres skrjabini (3,3%). Com exceção de P. altmani, este é o primeiro relato desses helmintos parasitando gaivotas-de-Franklin.

Endoparasitic fauna of two South American foxes in Chile: Lycalopex culpaeus and Lycalopex griseus / Fauna endoparasitária de duas raposas da América do Sul no Chile: Lycalopex culpaeus e Lycalopex griseus

Abstract Native foxes face serious threats related to anthropic activities and the uncontrolled pets. However, the transmission of several pathogens such as parasites by domestic dogs is an important conservation issue with limited attention in Chile. The lack of a proper identification of the helminths of wild canids in the country, based mostly in coprological studies, limited our knowledge in potential interspecific transmission. Thus, the aim of the present survey was to identify the parasitic fauna of two native canids, the Andean fox (Lycalopex culpaeus) (n=49) and Chilla (Lycalopex griseus) (n=17), from several localities in Chile through a complete parasitological survey. Sixteen different species were identified, 9 of which are new host records for Andean fox and two for Chilla fox in South America, and three are recorded for first time in Chile. Also, five of them are of zoonotic concern and six are known to use domestic dogs as their principal hosts. These findings have implications for public health and the conservation of canids whose interspecific transmission of parasites with domestic dogs is confirmed through these findings. The need for an exhaustive surveillance of wild carnivores is emphasized considering these hosts as important sources of micro- and macroparasites.

Resumo As raposas nativas enfrentam sérias ameaças devido às atividades antrópicas e contato com animais de estimação sem controle. Entretanto, a transmissão de patógenos, tais como parasitas de cães domésticos, é uma questão importante na conservação das raposas que têm sido pouco abordadas no Chile. A falta de uma identificação adequada dos helmintos de canídeos silvestres no país, que se baseia principalmente, em estudos coprológicos, limita o conhecimento sobre uma potencial transmissão interespecífica de parasitas. Assim, o objetivo do presente estudo foi identificar a fauna parasitária em dois canídeos nativos: a raposa andina (Lycalopex culpaeus) (n = 49) e a raposa chilla (Lycalopex griseus) (n = 17), provenientes de várias localidades do Chile, por meio de um levantamento parasitológico completo. Foram identificadas 16 espécies de parasitas, nove correspondem a novos registros de hospedeiros para a raposa andina e dois para a raposa chilla na América do Sul. Três espécies de parasitas são registrados pela primeira vez no Chile, cinco são motivo de preocupação zoonótica e seis são conhecidos por usar cães domésticos como seus principais hospedeiros. Esses achados têm implicações em saúde pública e na conservação de canídeos, pois confirmam a transmissão interespecífica de parasitas desde cães domésticos. A necessidade de vigilância exaustiva dos carnívoros selvagens é enfatizada considerando-se esses hospedeiros como importantes fontes de micro e macroparasitas.

Parasites of the Neotropic cormorant Nannopterum (Phalacrocorax) brasilianus (Aves, Phalacrocoracidae) in Chile / Parasitos da biguá Nannopterum (Phalacrocorax) brasilianus (Aves, Phalacrocoracidae) do Chile

Abstract The Neotropic cormorant Nannopterum (Phalacrocorax) brasilianus (Suliformes: Phalacrocoracidae) is widely distributed in Central and South America. In Chile, information about parasites for this species is limited to helminths and nematodes, and little is known about other parasite groups. This study documents the parasitic fauna present in 80 Neotropic cormorants' carcasses collected from 2001 to 2008 in Antofagasta, Biobío, and Ñuble regions. Birds were externally inspected for ectoparasites and necropsies were performed to examine digestive and respiratory organs in search of endoparasites. Ectoparasites collected were cleared and mounted for identification under a microscope. Fecal samples were also evaluated to determine the presence of protozoan parasites employing a flotation technique. A total of 44 (42.5%) of birds were infested with at least one ectoparasite species, while 77 (96.25%) were carrying endoparasites. No protozoan forms were found after examination. Most prevalent endoparasite species found were Contracaecum rudolphii s. l. (72/80, 90%), followed by Pectinopygus gyroceras (33/80, 41.25%), and Profilicollis altmani (26/80, 32.5%). This is the first report of P. altmani, Baruscapillaria carbonis, Avioserpens sp., Cyathostoma (Cyathostoma) phenisci, and Eidmaniella pelucida in the Neotropic cormorant. These findings also expand the distributional range of Andracantha phalacrocoracis, Paradilepis caballeroi, Hysteromorpha triloba, and P. gyroceras to Chile.

Resumo O Biguá Nannopterum (Phalacrocorax) brasilianus (Suliformes: Phalacrocoracidae) é amplamente distribuído na América Central e na do Sul. No Chile, as informações sobre parasitos para essa espécie são limitadas a helmintos e nematoides, e pouco se sabe sobre outros grupos de parasitos. Este estudo documenta a fauna parasitária presente em 80 biguás coletados de 2001 a 2008, nas regiões de Antofagasta, Biobío e Ñuble. As aves foram inspecionadas externamente em busca de ectoparasitas; adicionalmente, foram realizadas necropsias para examinar os órgãos digestivos e respiratórios em busca de endoparasitos. Os ectoparasitos coletados foram limpos e montados para identificação ao microscópio. As amostras de fezes também foram avaliadas para determinar a presença de parasitos protozoários, empregando-se uma técnica de flutuação. Um total de 44 (42,5%) aves estavam infectadas com pelo menos um ectoparasito, enquanto 77 (96,25%) estavam portando endoparasito. Nenhuma forma de protozoário foi encontrada após o exame. As espécies de endoparasitos mais prevalentes encontradas foram Contracaecum rudolphii (72/80, 90%), Pectinopygus gyroceras (33/80, 41.25%) e Profilicollis altmani (26/80, 32.5%). Este é o primeiro registro de P. altmani, Baruscapillaria carbonis, Avioserpens sp., Cyathostoma (Cyathostoma) phenisci e Eidmaniella pelucida no biguá. Esses resultados também expandem a distribuição de Andracantha phalacrocoracis, Paradilepis caballeroi, Ascocotyle felippei, Hysteromorpha triloba e P. gyroceras no Chile.

Morphological and molecular identification with frequency analysis of Calicophoron microbothrioides in central Chile / Identificação morfológica e molecular com análise de frequência de Calicophoron microbothrioides na região central do Chile

Abstract This research aimed to determine the presence of paramphistomids in cattle slaughtered in a slaughterhouse of the Ñuble Region of Chile, to identify flukes and to analyze the frequency of these parasites in the Maule, Ñuble, and Biobío administrative regions of Chile. Between October of 2016 and April of 2017, rumens of 494 cattle were examined for flukes in the forestomachs. Worms were identified morphologically and, in addition, molecular analysis of the internal transcriber spacer region 2 of the fluke's DNA was done and phylogenetic analyses were performed with Bayesian inference in 14 worms. The frequency was analyzed by locality (low- or highlands) and age. The overall frequency was 11.24%. The district with the highest frequency of presentation was Chillán Viejo (30.8%). Districts in the lowlands had similar frequencies to those in the mountain lands (p=0.1). The frequency of flukes was significantly higher in adult animals than in young ones (p<0.01). We obtained a 460 bp-length fragment of DNA that was identical to the sequences previously identified as Paramphistomum cervi and Calicophoron microbothrioides, and performed morphological analyses confirmed that our samples belonged to C. microbothrioides. This is the first published study of C. microbothrioides in Chile.

Resumo Este trabalho teve como objetivo determinar a presença de paramphistomídeos em bovinos abatidos em um matadouro da Região do Ñuble do Chile, para identificar parasitas e analisar a frequência desses parasitos nas regiões administrativas de Maule, Ñuble e Biobío, no Chile. Entre outubro de 2016 e abril de 2017, rúmens de 494 bovinos foram examinados à procura de vermes no pré-estômago. Os vermes foram identificados morfologicamente e, além disso, a análise molecular da região interna do espaçador do transcritor 2 do DNA e análises filogenéticas foram realizadas com inferência bayesiana em 14 vermes. A frequência foi analisada pela altitude da localidade (baixa ou alta) e idade. A frequência geral foi de 11,24%. O distrito com as maiores frequências de parasitismo foi Chillán Viejo (30,8%). Os distritos das terras baixas tinham frequências semelhantes às encontradas nas terras das montanhas (p=0,17). A frequência foi significativamente maior em animais adultos do que em jovens (p<0.01). Obtivemos um fragmento de DNA de 460 pb que era idêntico às sequências anteriores identificadas como Paramphistomum cervi e Calicophoron microbothrioides, e realizamos análises morfológicas que permitiram confirmar que nossas amostras pertenciam a C. microbothrioides. Este é o primeiro estudo publicado sobre C. microbothrioides no Chile.

Gastrointestinal helminths and related histopathological lesions in black-necked swans Cygnus melancoryphus from the Carlos Anwandter Nature Sanctuary, Southern Chile / Helmintos gastrintestinais e lesões histopatológicas relacionadas em cisnes de pescoço negro Cygnus melancoryphus do Santuário da Natureza Carlos Anwandter, Sul do Chile

Abstract Black-necked swans are distributed across South America and face conservation problems in Chile according to data of the State institution SAG. The aim of this study was to identify helminths and to assess associated tissue damage via histopathology. A total of 19,291 parasites were isolated from 21 examined birds; 17 species were identified, including nematodes, flukes, and tapeworms. Of these, 12 were new host records, 13 were reported for the first time in Chile, and 5 were new records for the Neotropical region. Further, the flukes Schistosomatidae gen. sp. and Echinostoma echinatum are of zoonotic concern. Regarding histopathology, an inflammatory response was found along the birds' entire digestive tract. Nevertheless, it is difficult to declare that there is a clear association between such lesions and isolated parasites, as other noxa could be responsible as well. Although in some cases there was an evident association, such inflammatory responses and necrosis were minimal, as occurred with Capillaria, Retinometra, Catatropis, Echinostoma, and Schistosomatidae gen. sp. Nevertheless, Epomidiostomum vogelsangi caused granulomatous injuries, an important inflammatory response, and necrosis, but it always circumscribed to superficial layers of the gizzard. Conversely, Paramonostomum was not associated with an inflammatory response despite a high parasitic load.

Resumo O cisne de pescoço negro é distribuído por toda a América do Sul, e enfrenta problemas de conservação no Chile, sendo protegido pela Lei Estadual de Caça. O objetivo deste estudo foi identificar helmintos em cisnes e avaliar o dano tecidual por meio de histopatologia. Um total de 19.291 parasitas foi isolado de 21 aves examinadas, sendo 17 espécies identificadas, entre nematóides, trematódeos e tênias. Destes, 12 são novos registros de hospedeiros, 13 são reportados pela primeira vez no Chile, e 5 são novos registros para a região Neotropical. Além disso, os trematódeos Schistosomatidae gen. sp. e Echinostoma echinatum detectados têm importância zoonótica. Em relação à histopatologia, uma resposta inflamatória foi encontrada em todo o trato digestivo. Entretanto, é difícil estabelecer uma associação estrita de tais lesões com parasitas isolados, porque outros fatores também poderiam ser responsáveis. Em alguns casos, houve uma associação óbvia entre parasitas e lesões, embora a resposta inflamatória e a necrose fossem mínimas, como foi o caso dos gêneros Capillaria, Retinometra, Catatropis, Echinostoma e Schistosomatidae gen. sp. Entretanto, Epomidiostomum vogelsangi causou lesões granulomatosas com importante resposta inflamatória e necrose, mas sempre circunscrita às camadas superficiais da moela. Por outro lado, Paramonostomum não foi associado com uma resposta inflamatória óbvia apesar da alta carga parasitária.

Histopathological findings of Fasciola hepatica infection in non-native European hare (Lepus europaeus) in Southern Chile / Achados histopatológicos da infecção por Fasciola hepatica em lebre europeia não-nativa (Lepus europaeus) no Sul do Chile

Abstract Fasciola hepatica is a parasite introduced in America from Europe, being considered of concern for public health and animal production, especially in countries with endemic areas as occur in Chile. In this country, the research has been focused mainly in domestic ruminants, with native and introduced wildlife being largely ignored. Thus, the aim of this study was to report the infection by Fasciola hepatica in an introduced mammal, the European hare, which is distributed along a vast area of the country. One in 42 hares hunted showed histological lesions compatible with F. hepatica, and harbored a parasitic load of 6 liver flukes. This is the first report of this lagomorph acting as host of this helminth in the country and the third in South America. Yet, we found no previous reports regard the pathology of this fluke in the species. Thus, we emphasize the importance of more studies regarding introduced mammals which could be acting as reservoirs for this important fluke.

Resumo Fasciola hepatica é um parasita de origem europeia introduzido na América, de importância em saúde pública e animais de produção, especialmente em países com áreas endêmicas, como ocorre no Chile. Neste país, a pesquisa foi focada principalmente em ruminantes domésticos, com a fauna nativa e introduzida sendo amplamente ignorada. O objetivo desse trabalho é relatar a infecção por Fasciola hepatica em lebre europeia, espécie distribuída em vasta extensão do país. Uma em 42 lebres caçadas, mostrou lesões histológicas compatíveis com infestação por F. hepatica, alojando 6 vermes hepáticos. Este é o primeiro relato deste lagomorfo apresentando este tipo de parasitismo no Chile, o terceiro na América do Sul. No entanto, não encontramos relatos anteriores sobre a patologia deste acaso na espécie. Este relato salienta a importância de mais estudos considerando espécies introduzidas, as quais podem ser reservatórios desse importante parasita.

Histopathological findings of Fasciola hepatica infection in non-native European hare (Lepus europaeus) in Southern Chile

Abstract Fasciola hepatica is a parasite introduced in America from Europe, being considered of concern for public health and animal production, especially in countries with endemic areas as occur in Chile. In this country, the research has been focused mainly in domestic ruminants, with native and introduced wildlife being largely ignored. Thus, the aim of this study was to report the infection by Fasciola hepatica in an introduced mammal, the European hare, which is distributed along a vast area of the country. One in 42 hares hunted showed histological lesions compatible with F. hepatica, and harbored a parasitic load of 6 liver flukes. This is the first report of this lagomorph acting as host of this helminth in the country and the third in South America. Yet, we found no previous reports regard the pathology of this fluke in the species. Thus, we emphasize the importance of more studies regarding introduced mammals which could be acting as reservoirs for this important fluke.

Resumo Fasciola hepatica é um parasita de origem europeia introduzido na América, de importância em saúde pública e animais de produção, especialmente em países com áreas endêmicas, como ocorre no Chile. Neste país, a pesquisa foi focada principalmente em ruminantes domésticos, com a fauna nativa e introduzida sendo amplamente ignorada. O objetivo desse trabalho é relatar a infecção por Fasciola hepatica em lebre europeia, espécie distribuída em vasta extensão do país. Uma em 42 lebres caçadas, mostrou lesões histológicas compatíveis com infestação por F. hepatica, alojando 6 vermes hepáticos. Este é o primeiro relato deste lagomorfo apresentando este tipo de parasitismo no Chile, o terceiro na América do Sul. No entanto, não encontramos relatos anteriores sobre a patologia deste acaso na espécie. Este relato salienta a importância de mais estudos considerando espécies introduzidas, as quais podem ser reservatórios desse importante parasita.

Opiniones de los inspectores médicos acerca de la distorsión clínica en la valoración de la incapacidad laboral en España / Opinions of medical inspectors about clinical distortion in assessment of work disability in Spain

El contexto médico-legal en el que se desarrolla la medicina evaluadora, permitiendo el acceso a prestaciones económicas, obliga a considerar la validez en las consultas de valoración médica de incapacidad para tratar de evitar el fraude por simulación. Por otra parte, en el ámbito médico asistencial son habituales los casos biomédicamente inexplicables que se acompañan de elevados niveles subjetivos de sufrimiento, para los que se ha propuesto el término MUPS (medically unexplained physical symptoms). Objetivos: Profundizar en el fenómeno de la distorsión clínica en la valoración médica de incapacidad, basado en los dos primeros criterios de Simulación del DSM-IV-TR, referido al marco teórico del Análisis de Conducta en Medicina. Métodos: Encuesta en línea dirigid el colectivo de los inspectores médicos evaluadores del Instituto Nacional de la Seguridad Social (INSS) de España para conocer sus opiniones acerca de estos casos, presentes en su práctica diaria, su manejo de los mismos y su grado de concordancia con respecto a la bibliografía de referencia. Resultados: Incluyen a una proporción representativa de dichos inspectores médicos (15 por ciento), que aparecen como un colectivo variado, por su distinta formación profesional, experiencia previa y práctica diaria en las diferentes Unidades Médicas. Conclusiones: Consideran la distorsión clínica y sus cuadros anexos como situaciones frecuentes y relevantes en sus consultas, principalmente el fraude por simulación. Pese a ello, los inspectores médicos no parecen contar actualmente con referencias específicas suficientes ni con un discurso científico común estructurado para estos casos, que son abordados según criterios individuales más o menos ajustados al estado actual del conocimiento.(AU)

The forensic context in which disability assessment medicine is practiced in Spain, allowing access to workers' compensation benefits, requires consideration of the validity of disability assessment examinations. On the other hand, in clinical medicine biomedically unexplained cases ­for which the term medically unexplained physical symptoms (MUPS) was proposed­ are common, often accompanied by high levels of subjective suffering. Aim: To deepen in the phenomenon of clinical distortion in disability assessment examinations, based on the first two criteria of Malingering in DSM-IV-TR, referring to the theoretical framework of the Behavior Analysis in Medicine. Methods: Online survey addressed to the group of medical examiners of the National Institute of Social Security (INSS) of Spain to know their opinions on these cases, present in their everyday practice, their management and the extent of agreement to the literature of reference. Results: Collected a representative proportion of medical examiners (15 percent), they appear as a miscellaneous group due to their different professional training, previous experience and everyday practice in their different Medical Units. Conclusions: medical examiners consider the clinical distortion and related cases as frequent and relevant situations in their practice, mainly malingering. Nonetheless, medical examiners do not seem to have sufficient specific references or a structured common scientific discourse for these cases, which are approached according to individual criteria more or less adjusted to the current state of knowledge. (AU)

Validación de la versión reducida del CECASDEP en usuarios de servicios deportivos / Validation of a short version of CECASDEP in sports services users

El objetivo planteado consistió en desarrollar una versión reducida del CECASDEP y obtener evidencias de su validez y fiabilidad en 2 muestras diferentes. Participaron 882 personas con un rango de edad que oscilaba entre 14 y 81 años (M = 34.89; DT = 12.57), de los que 432 eran hombres y 440 mujeres. Se examinó la estructura interna mediante análisis factorial confirmatorio y la validez cruzada mediante análisis multigrupo, obteniendo un buen ajuste en los distintosíndices. El modelo resultante está compuesto por 25 ítems y 5 dimensiones, con propiedades psicométricas que mostraron buena consistencia interna, validez convergente y discriminante. El análisis factorial confirmatorio mostró buen ajuste en los distintosíndices y el análisis multigrupo ofreció una estructura estable en 2 muestras independientes. Los resultados indican que el modelo propuesto supone una herramienta válida para evaluar la calidad percibida en servicios deportivos.

The aim of this study was to develop a short version of CECASDEP and to obtain evidence of its validity and reliability in two different samples. A total of 882 individuals, 432 male and 440 female aged 14 to 81 (M = 34.89; DT = 12.57) were included in the study. Internal structure was examined, using confirmatory factor analysis, and a good adjustment of the model to the data was obtained. Besides, cross-validity was evaluated through multi-group analysis. The resulting model is composed of 25 items and 5 dimensions, with psychometric properties reflecting good internal consistency, convergent validity and discriminant validity. Confirmatory factor analysis showed an acceptable adjustment of the model to the data and multi-group analysis reflected that the structure factor is stable in two independent samples. The results confirm that the proposed model is a valid tool to assess the perceived quality in sports services.

Obesidad y cáncer en Chile: estimación de las fracciones atribuibles poblacionales / Obesity and cancer in Chile: Estimation of population attributable fractions

Background: Obesity is a risk factor for the development of certain types of cancer. Aim: To estimate the proportion of cancers potentially attributable to obesity in men and women in Chile based on the calculation of population attributable fractions (PAF %). Material and Methods: Cancer sites studied were those where obesity is a known risk factor based on the updated World Cancer Research Fund (WCRF) analysis. Namely, colorectal, endometrium, esophagus, breast, pancreas, kidney and gallbladder cancers were analyzed. Overall and specific PAFs% were calculated for cancer sites and sex from known estimates of relative risk and national prevalence of overweight and obesity. Results: The overall estimates of cancer PAF% for obesity were approximately 20%, without differences between men and women. Highest cancer PAFs% were for endometrial (47%) in women, and esophageal (35%) and pancreatic (31%) in men. The largest sex differences in PAFs% were for gallbladder (higher in women) and colorectal (higher in men). Results are closer to those reported from developed countries (USA and United Kingdom) than those from developing countries (Brasil, China). Conclusions: In Chile about 20% of all cancers could be prevented by obesity prevention and control strategies.

Óxido nítrico exhalado, asma y atopia: análisis en un panel de niños en Santiago, Chile / Association of exhaled nitric oxide with asthma and atopy among children living in Santiago, Chile

Background: Chronic airway inflammation is a central process in asthma. Measurement of exhaled nitric oxide (eNO) is a non-invasive biomarker of eosinophilic airway inflammation. Aim: To measure eNO levels in a population of asthmatic and non-asthmatic children and to evaluate their relationship with asthma and atopy. Material and Methods: We studied 143 asthmatic and non-asthmatic children aged 6 to 14 years attended a hospital and primary health service. Participants were tested for allergies and followed during the winter months of 2010 and 2011. They were visited regularly at their homes and eNO levels were measured on each visit using a handheld equipment. Mean eNO distribution were compared by the presence of asthma or atopy using t-test and regression models. Results: No significant differences for mean eNO levels were detected, according to presence of asthma or atopy, by any ofthe statistical methods used. Regression models showed significant effects for age but not for sex. Conclusions: There were no differences in eNO levels in the studied children by the presence of asthma or atopy.

Enfermedad renal por depósito idiopático de cadenas livianas: Caso clínico / Kidney involvement in idiopathic light chain disease: Report of one case

Idiopathic Light Chain disease (ILCD) is a systemic disease characterized by a deposit in different organs of light chain monoclonal immunoglobulins, produced by an abnormal clone ofB cells. It is usually found in the course ofa plasma cell dyscrasia and in other lymphoproliferative alterations; however it may occur in absence of any hematologic disease and is denominated as idiopathic. We report a 51-year-old mole admitted to the hospital due to anasarca. Laboratory evaluation showed a serum creatinine of 1.4 mg/dl, a serum albumin of1.6 g/dl, a serum cholesterol of 687 mg/dl and a proteinuria of 5.3 g/day Light chains with a predominance of a monoclonal component were identified in urinary proteins by electrophoresis and kappa chains were identified by immunofixation. A renal biopsy showed a diffuse nodular glomerulopathy with a 35% tubular atrophy and interstitial sclerosis. Electrón microscopy confirmed light chain deposition. The bone marrow biopsy showed a myeloid hyperplasia. Thepatient was initially treated with methylprednisolone and plasmapheresis with a reduction in serum creatinine and disappearance of urinary kappa component. Albuminuriapersisted and a malnutrition-inflammatory complex syndrome was diagnosed. Hemodialysis with ultrafiltration was started along with cyclophosphamide. Thepatient receivedhemodialysisforsixmonths and continued with methylprednisolone.