Ex situ culture of coral species Porites lobata (Scleractinia: Poritidae) and Pocillopora damicornis (Scleractinia: Pocilloporidae), Costa Rica: first assessment and implications

Introduction: Coral reefs worldwide decline has prompted coral restoration as a viable strategy to rewild vulnerable, foundational coral species. Stony corals are now propagated by thousands in both in-water and ex situ (land-based) coral nurseries, the latter being unexplored in Costa Rica, despite their potential benefits as a reef management tool. Objective: To analyze the viability of ex situ culturing of the Pacific reef-building corals Porites lobata and Pocillopora damicornis at Parque Marino del Pacífico (PMP), Puntarenas, Costa Rica, aquaculture facilities. Methods: From May to October 2018 a total of 180 coral fragments were kept in an aquaculture recirculated system. Survival, growth, and fragment yield in relation to culture medium (physicochemical parameters) were recorded. Results: Survival and growth rate varied between species and culture tanks. On average, surviving P. lobata fragments (68.89 %) placed in Tank 1 (T1) grew 216 %, while fragments placed in Tank 2 (T2) had a survival rate of 71.11 % and an increase of 277 % in live tissue area. P. damicornis fragments survival, basal and crown area percentage increase were: 71.11 %, 980 % and 366 % in T1, and 100 %, 976 % and 287 % in T2. Although fragments survival and growth were net positive, the yield in terms of culture was low, due to culture conditions in the tanks not meeting coral culture optimal requirements. Conclusions: Survival and growth of both species varied depending on the tank in which they were placed. Survival was similar to that found in other ex situ studies and growth was similar to those reported in the wild, however culture performance in terms of yield was low. Aquaculture systems at PMP constitute a good base for the cultivation of corals, however for the culture effort to achieve maximum yield, current systems must be optimized according to the requirements of the target coral species.

Introducción: El declive mundial de los arrecifes de coral, ha impulsado a la restauración coralina como una estrategia viable para recuperar especies de coral fundacionales, en estado vulnerable. Los corales pétreos se propagan por miles, tanto en viveros subacuáticos como ex situ (en tierra). Siendo el segundo método poco explorado en Costa Rica, a pesar de sus potenciales beneficios como medida como herramienta de manejo arrecifal. Objetivo: Analizar la viabilidad del cultivo ex situ de las especies de coral constructoras de arrecifes Porites lobata y Pocillopora damicornis en el módulo de acuicultura del Parque Marino del Pacífico (PMP), Puntarenas, Costa Rica. Métodos: Desde el 17 de mayo hasta el 17 de octubre de 2018, se mantuvieron un total de 180 fragmentos de coral en un sistema de recirculación de acuicultura. Se registraron la supervivencia, el crecimiento y el rendimiento de los fragmentos en relación con el medio de cultivo (parámetros fisicoquímicos). Resultados: La tasa de supervivencia y crecimiento varió entre especies y tanques de cultivo. En promedio, los fragmentos de P. lobata supervivientes (68.89 %) colocados en el tanque 1 (T1) crecieron un 216 %. En contraste con los fragmentos colocados en el tanque 2 (T2) que mostraron una tasa de supervivencia del 71.11 % y un aumento del 277 % en el área de tejido vivo. En el caso de P. damicornis, los porcentajes de supervivencia, de aumento del área basal y del área de la corona fueron: 71.11 %, 980 %, y 366 %, y 100 %, 976 %, y 287 % para los fragmentos colocados en T1 y T2, respectivamente. Aunque la supervivencia y el crecimiento de los fragmentos fueron positivos, el rendimiento en términos de cultivo fue bajo, debido a que las condiciones en los tanques no cumplían con las condiciones ideales para el cultivo de corales. Conclusiones: La supervivencia y el crecimiento de ambas especies variaron en función del tanque en el que se colocaron. La supervivencia fue similar a la observada en otros estudios ex situ y el crecimiento fue similar al reportado en la naturaleza, pero el rendimiento del cultivo fue bajo. Los sistemas de acuicultura del PMP constituyen una buena base para el cultivo de corales, sin embargo, para que el esfuerzo de cultivo alcance un máximo de rendimiento, los sistemas actuales deben optimizarse en función de los requisitos de las especies de coral objetivo.

Entrenamiento de la musculatura intrínseca del pie para la prevención de caídas en personas mayores / Effect of a program of intrinsic musculature exercises of the foot in the prevention of risk of fall on the elderly

OBJETIVO Las personas mayores y particularmente las mujeres, son propensas a sufrir traumatismo por caídas. El objetivo de esta investigación fue mejorar la estabilidad y funcionalidad de la pisada en personas mayores, implementando un programa de entrenamiento de musculatura intrínseca del pie, y determinar sus efectos en el riesgo de caída como método de prevención. MATERIALES Y METODOS Participaron 33 personas mayores, de género femenino y autovalentes. En las participantes se evaluó el equilibrio y la velocidad de la marcha con la prueba Time up and Go (TUG), y el equilibrio dinámico se evaluó con la Escala de Tinetti (ET). La intervención constó de enteramiento de tipo short-foot de forma diaria, durante 4 semanas. RESULTADOS los tiempos del TUG disminuyeron de manera progresiva al final de la intervención, lo que indica una optimización en la velocidad de la marcha, por lo que, el entrenamiento tuvo resultados beneficios para la transferencia de carga corporal de una posición sedente a bípedo y de bípedo a marcha. En cambio, para el equilibrio y marcha según ET no se detectó una diferencia significativa. CONCLUSIONES Este entrenamiento presenta una mejoría en el ámbito funcional de cambio de posición, pero no reemplaza el ajuste postural de base de sustentación para mantener el centro de masa en su posición central.

OBJETIVE Seniors, particularly women, are at risk for suffering traumatisms from falls. The objective of this study was to improve the balance and walking functionality of seniors by implementing a program to training the intrinsic muscles of the foot. The impacts of this training on preventing fall risk were assessed. MATERIALS AND METHODS A total of 33 self sufficient, female seniors participated. Balance and the speed of walking were measured using the Timed Up and Go (TUG) test, while balance and gait were measured using the Tinetti Balance and Gait Assessment Tool (TT). Intervention consisted in four weeks of daily short foot exercises. RESULTS The TUG test times decreases progressively from the start to the end of the intervention period, indicating an optimization in walking speed. This translates into beneficial results for the transfer of body load from a sedentary to standing to walking position. In contrast, balance and gait evidenced no significant changes per the TT. CONCLUSIONS The implemented training program improved the functional sphere of position change, but this did not replace the postural adjustments needed in the base of support (i.e. the feet) to maintain a well-positioned center of mass

Detección de anticuerpos anti virus hepatitis E IgG e IgM utilizando un método automatizado: experiencia de un hospital universitario / Detection of anti-virus hepatitis e IgG and IgM antibodies using an automated method: experience of a university hospital

Resumen La determinación de anticuerpos anti virus hepatitis E (anti-VHE) tiene gran variabilidad dependiendo del ensayo utilizado. En 2015, con un método ELISA manual, publicamos una seroprevalencia de anti-VHE IgG de 32,6% en pacientes con estudio de hepatitis. Existen escasas publicaciones de anti-VHE IgM. Recientemente, se desarrolló el primer método automatizado y en el presente estudio comunicamos la experiencia obtenida. Se analizaron los resultados de 272 pacientes con estudio de anti-VHE IgG y/o IgM mediante técnica automatizada ELFA (VIDAS®), entre mayo de 2018 y agosto de 2020. Se encontró 25,8% (68/264) de positividad para anti-VHE IgG y 3,5% (9/259) para anti-VHE IgM. Cuatro muestras tuvieron ambos anticuerpos positivos. La seropositividad de anti-VHE IgG aumentó con la edad. En conclusión, la seroprevalencia de anti-VHE IgG obtenida fue similar a la publicada previamente. Considerando las ventajas de los ensayos IgM e IgG anti-VHE en el sistema VIDAS®, parecen ser nuevas herramientas valiosas en el estudio serológico de VHE.

Abstract The determination of anti-hepatitis E virus antibodies (anti-HEV) has a high variability depending on the assay used. In 2015, with a manual ELISA method, we reported anti-HEV IgG seroprevalence of 32.6% in patients under hepatitis study. There are few reports of anti-HEV IgM. Recently, it was developed the first automated method and in the present study, we report the experience using this new method. Between May 2018 and August 2020, the results of 272 patients with an anti-HEV IgG and/or IgM study were analyzed using the automated ELFA technique (VIDAS®). Seroprevalence was 25.8% (68/264) for anti-HEV IgG and 3.5% (9/259) for anti-HEV IgM. Four samples were positive for both antibodies. Anti-HEV IgG seropositivity increased with age. In conclusion, the seroprevalence of anti-HEV IgG obtained was similar to previously reported. Taking into account the advantages of these assays, anti-HEV IgM and IgG assays on VIDAS® system, seem to be valuable new tools in serological study of HEV.

Comparación entre Xpert® y COBAS®-TaqMan® para la medición de carga viral de virus hepatitis B y C / Comparison between Xpert® and COBAS® TaqMan® for the measuring of viral load of hepatitis B and C viruses

INTRODUCCIÓN: La medición de carga viral (CV) de virus hepatitis B (VHB) y C (VHC) es fundamental en el seguimiento de pacientes con terapia antiviral. La metodología más utilizada para su determinación es COBAS ®-TaqMan ®. Recientemente, se desarrolló la tecnología Xpert ®, que se debe evaluar. OBJETIVO: Comparar la medición de la CV de VHB y VHC por metodología Xpert® con COBAS®-TaqMan® como método de referencia. MATERIAL Y MÉTODOS: 39 muestras de suero de pacientes con VHB y 39 con VHC, previamente cuantificadas por COBAS ®-TaqMan ®, fueron analizadas mediante Xpert® y los resultados se compararon utilizando la regresión de Deming y gráfico Bland-Altman. RESULTADOS: Hubo una alta correlación entre Xpert® y COBAS®-TaqMan®. Para VHB, la ecuación de Deming fue XpertHBV = 0,44 + 0,99xCOBASTaqManHBV, con coeficiente de correlación de 0,94 y diferencia entre medias de -0,401 log10 (IC95%: -1,985 a 1,183). Para VHC, la ecuación de Deming fue XpertHCV = 0,36 + 0,87x COBASTaqManHCV, con coeficiente de correlación de 0,98 y diferencia entre medias de 0,328 log (IC95%: -0,449 a 1,105). CONCLUSIÓN: El nuevo sistema Xpert® muestra una buena correlación con COBAS ®-TaqMan ® para la medición de la CV de VHB y VHC, siendo una buena alternativa para el seguimiento de pacientes en tratamiento.

BACKGROUND: The measurement of viral load (VL) of hepatitis B (HBV) and C (HCV) viruses is essential in the follow-up of patients with antiviral therapy. The most widely used methodology for this determination is COBAS®-TaqMan®. Recently, the Xpert® technology was developed and needs to be evaluated. AIM: To compare the measurement of the VL of HBV and HCV by Xpert® methodology with COBAS®-TaqMan® as a reference method. MATERIAL AND METHODS: 39 serum samples from patients with HBV and 39 with HCV, previously quantified by COBAS®-TaqMan®, were analyzed using Xpert® and the results were compared using Deming regression and Bland-Altman plot. RESULTS: There was a high correlation between Xpert® and COBAS®-TaqMan®. For HBV, the Deming equation was XpertHBV = 0.44 + 0.99xCOBASTaqManHBV, with a correlation coefficient of 0.94 and a difference between means of -0.401 log (95% CI: -1.985 to 1.183). For HCV, the Deming equation was XpertHCV = 0.36 + 0.87x COBASTaqManHCV, with a correlation coefficient of 0.98 and a difference between means of0.328 log10 (95% CI: -0.449 to 1.105). CONCLUSION: The new Xpert® system shows a good correlation with COBAS®-TaqMan® for the measurement of the VL of HBV and HCV, being a good alternative for the follow-up of patients under treatment.

Condición del arrecife coralino de Playa Blanca, Punta Gorda, uno de los arrecifes más extensos de la costa Pacífica de Costa Rica

Introducción: Los arrecifes coralinos son afectados negativamente por diferentes causas antropogénicas y ambientales en el Golfo de Papagayo. Objetivo: En esta investigación, la condición del arrecife coralino de Playa Blanca fue evaluado. Métodos: Entre agosto de 2010 y setiembre de 2011 el porcentaje de coral vivo por especie y del alga Caulerpa sertularoides fue determinado; el crecimiento anual de P. damicornis y P. elegans fue medido y relacionado con variables ambientales. Resultados: Se encontraron 14 especies de corales, dos de ellas, F. curvata y L. papyracea, únicamente como esqueletos. La zona con la mayor cobertura fue en la zona media de la playa. La especie con mayor CCV en todos los ámbitos de profundidad fue P. damicornis, seguido de P. elegans. La CCV descendió de 29 % en septiembre 2010 a 1 % en octubre 2010. La mortalidad masiva fue causada por una Floración Algal Nociva (FAN). La tasa de crecimiento de P. damicornis (26.0 ± 8.9 mm año-1) y de P. elegans (27.9 ± 4.5 mm año-1), no mostraron diferencias significativas entre profundidades ni por ubicación en el arrecife. Conclusiones: El exuberante arrecife de coral de Playa Blanca experimentó una regresión repentina de la CCV similar a las descritas por Glynn et al. (1983). Esto sugiere que ocurren ciclos de mortalidad y recuperación natural de los arrecifes de coral, aunque las presiones antropogénicas reducen la capacidad de resiliencia de estos. El ordenamiento espacial, tanto en tierra como en el mar, es vital para un adecuado desarrollo humano, en el que se incorpore en el análisis el aumento de la capacidad de recuperación de los ecosistemas coralinos.

Introduction: Coral reefs are negatively affected by different anthropogenic and environmental causes in the Gulf of Papagayo, Costa Rican Pacific coast. Objective: The health status of the Playa Blanca coral reef was evaluated. Methods: Between August 2010 and September 2011, the percentage of live coral cover (LCC) per species and of the macroalgae Caulerpa sertularoides was determined in four sectors and at three depths of the coral reef; the annual growth of Pocillopora damicornis and P. elegans was measured and related to temperature, nutrients, wind, sun irradiation and rain. Results: 14 species of corals were found, two of them, Fungia curvata and Leptoseris papyracea, only as skeletons. The area with the highest LCC was offshore in the middle zone of Playa Blanca. The species with the highest coverage in all depth ranges was P. damicornis, followed by P. elegans. The LCC decreased from 29% in September 2010 to 1% in October 2010 due to a mass coral mortality caused by harmful algal blooms. The growth rate of P. damicornis (26.0 ± 8.9 mm year-1) and P. elegans (27.9 ± 4.5 mm year-1) did not show significant differences between depths or location in the reef. Conclusions: The exuberant Playa Blanca coral reef experienced a sudden drop in LCC similar to those described by Glynn et al. (1983). This suggests that cycles of mortality and natural recovery of coral reefs occur, although anthropogenic pressures reduce the resilience capacity of the reefs. Spatial planning, both on land and in the sea, is vital for adequate human development, in which the increase in the resilience of coral ecosystems is incorporated into the analysis.

Hepatitis aguda por virus C: reporte de siete casos en centro de referencia en Chile

Hepatitis C virus infection is a major global public health problem. Treatment with direct-acting antivirals is intended to eradicate the chronic form of this infection by 2030. Although uncommon, the acute form of presentation is increasingly recognized, especially in some high-risk populations, such as men who have sex with men without protection. Its virological and serological diagnosis is not standardized, so clinical suspicion is essential. Its early detection allows a timely treatment. We report seven cases of acute HCV hepatitis in a national reference center, its presentation, diagnosis and treatment. We discuss populations at risk and the change in therapeutics with the use of direct-acting antiviral drugs.

Seroprevalencia de virus hepatitis E en donantes de sangre en un hospital universitario en Chile / Hepatitis E virus seroprevalence in blood donors in a university hospital in Chile

Resumen En Chile, existen escasos estudios de seroprevalencia de anticuerpos IgG anti virus hepatitis E (VHE) en bancos de sangre, entre 4 y 8%. El desarrollo de nuevas técnicas con mayor sensibilidad y especificidad, dan cuenta de un aumento de la seroprevalencia de VHE en diversos países, siendo desconocido el estado actual en Chile. En el presente estudio, determinamos la seroprevalencia de IgG anti VHE en donantes de sangre del Hospital Clínico Universidad de Chile, con técnicas de ELISA de última generación. De un total de 186 muestras, recolectadas el año 2014, 56 (30,1%) resultaron positivas, sin diferencias de género, pero con un incremento significativo con la edad (p < 0,001). Estos resultados muestran un aumento en la seroprevalencia de VHE en donantes de sangre realizados con inmunoensayos de mayor sensibilidad.

In Chile, there are few studies about seroprevalence of IgG antibodies against hepatitis E virus (HEV) in blood banks, between 4 and 8%. The development of new techniques with greater sensitivity and specificity, account for an increase in the seroprevalence of HEV in various countries, the current status in Chile being unknown. In the present study, we determined the seroprevalence of anti-HEV IgG in blood donors of the Clinical Hospital University of Chile, with last generation ELISA techniques. Out of a total of 186 samples, collected in 2014, 56 (30.1%) were positive, without gender differences, but with a significant increase with age (p < 0.001). These results show an increase in the seroprevalence of HEV in blood donors performed with immunoassays of greater sensitivity.

El polimorfismo rs12979860 C> T en el gen Interferón lambda 4 no está asociado a riesgo de fibrosis hepática en pacientes chilenos con hepatitis crónica por virus C / Interferon Lambda 4 RS12979860 C> T polymorphism is not associated with liver fibrosis in patients with hepatitis C

Background. Host genetic predispositions may be important determinants of liver fibrosis in patients with chronic hepatitis C (CHC). The association between Interferon-L 4 (IFNL4) rs12979860 C>T polymorphism and risk of liver fibrosis in CHC is contradictory. Aim: To evaluate the impact of IFNL4 rs12979860 polymorphism on the risk of fibrosis in patients with CHC. Material and Methods: One hundred fifty patients with CHC aged 50 ± 11 years (89 females) were genotyped for IFNL4 rs12979860 using real time PCR. Fibrosis present in liver biopsies was assessed using the METAVIR score, comparing patients with either no fibrosis, mild fibrosis, or intermediate fibrosis (F0+F1+F2, n = 96), with patients with severe fibrosis or cirrhosis (F3+F4, n = 54). Results: In F0-F2 patients the distribution of rs12979860 genotypes was 22 CC, 57 CT and 17 TT, whereas in patients F3-F4 the distribution was 10, 29 and 15, respectively. No association between IFNL4 rs12979860 genotype and risk of fibrosis was observed in uni or multivariate analyses. Conclusions: IFNL4 rs12979860 C>T polymorphism is not associated with risk of liver fibrosis in this group of patients with CHC.

Eliminación espontánea de virus hepatitis C en trasplantado hepático: a propósito de dos casos / Spontaneous clearance of hepatitis C virus after liver transplantation: Report of two cases

The spontaneous clearance of hepatitis C virus infection is rare, especially after liver transplantation, condition in which recurrence is almost universal. We report two cases in which clearance of the virus was achieved after liver transplantation. We reviewed the literature and described possible mechanisms explaining this phenomenon, with emphasis on therapeutic implications.

Trasplante hepático en cirrosis por virus B: profilaxis con gammaglobulina antiHBs en dosis a "demanda" / Hepatitis B virus immunoglobulin on demand to prevent infection recurrence among liver allograft recipients: Report of three cases

Infection recurrence rates among hepatitis B virus infected liver allograft recipients, may be as high as 80%. Immunoprophylaxis with anti HBVgammaglobulin may reduce these rates and improve survival. The dose of anti HBV gammaglobulin that must be used is not clearly defined. The most commonly accepted protocol uses 10,000 units during the anhepatic phase and 10,000 units daily during one week, followed by weekly doses of 10,000 units during one month and maintenance with 10,000 units monthly, without measuring anti hepatitis B surface antigen antibodies (antiHBs). Some reports recommend the use of immunoglobulin on demand, to maintain antiHBs titers between 100 and 250 U/l. The infection recurrence rates among patients treated with immunoglobulin and Lamivudine fluctuates between 0 and 10%, during follow up periods of 13 to 30 months. We report three liver allograft recipients that received immunoglobulin on demand, using a mean of41,000 units, maintaining adequate antiHBs titers.

Resultados del tratamiento con peginterferón alfa-2a y ribavirina en pacientes con hepatitis crónica C / Results of treatment with peginterferon plus ribavirin in patients with chronic hepatitis C

Background: The current treatment recommendation for chronic hepatitis C virus infection is the combination of peginterferon and ribavirin for 24 or 48 weeks, depending on the viral genotype. The aim of the therapy is to obtain a sustained virological response. Aim: To report our experience in the treatment of chronic hepatitis C. Material and Methods: Analysis of 52 patients treated between September 2000 and June 2009. Patients with genotype 1 or 5 were treated with peginterferon alpha 2a (180 ug/week) and ribavirin (1000 mg/day for those weighing less than 75 kg and 1200 mg/day for those weighing more than 75 kg) during 48 weeks. Patients with genotypes 2 and 3 were treated for 24 weeks with the same dose of peginterferon and ribavirin 800 mg /day. Results: Viral genotypes 1, 2, 3 and 5 were present in 81, 4, 11 and 4 percent of patients, respectively. Twenty four patients (46 percent), 18 with genotype 1, achieved a sustained viral response. Age was the only variable that infl uenced the response to treatment. Conclusions: Approximately half of the patients with chronic hepatitis C, achieve a sustained viral response with peginterferon and ribavirin.