Evaluation of Microbiological Quality of Halal Beef Intended for Export from Khartoum State, Sudan

Aims: To evaluate halal criteria of beef microbiological quality intended for export in two slaughterhouses. Study Design: A cross-sectional study. Place and Duration of Study: Khartoum State, Sudan between August and November 2022. Methodology: Samples were collected by using the non-destructive dry swab method for microbiological quality sampling of beef and a standardized checklist to evaluate good manufacturing practices (GMPs) and good hygienic practices (GHPs). Restraining methods were categorized as “modern method” where the full inversion rotary casting box was used which resembled slaughterhouse “A” or “conventional method” where a large-sized hammer for blowing the skull was used and this resembled slaughterhouse “B”. A total of 80 male beef cattle were investigated after arrival in the lairages of the designated slaughterhouses. Forty carcasses from each slaughtering method were randomly chosen and swabbed. Results: The results revealed that halal criteria for the slaughtering methods in slaughterhouse (A) was 100%, while slaughterhouse (B) was 83.2%. Also, this study revealed poor personal hygiene as slaughterhouse A scored 53.2%, while slaughterhouse B scored 33.2% for personal hygiene evaluation. The mean total bacterial count (TBC) was found to be 4.556 x 10? cfu/ml and 5.53275 X 10? cfu/ml in slaughterhouses A and B, respectively with highly significant differences compared to the standard permissible limits (1x 10?cfu/ml) with p ?0.05, while there were no statistically significant differences (0.847) within slaughterhouses with p ?0.05. Furthermore, the mean total coliform count (TCC) was found to be 16.4795 X10²cfu/ml and 47.8670 X 10²cfu/ml in slaughterhouses A and B, respectively with a highly significant difference compared to the standard permissible limits (1x10²cfu/ml) with p ?0.05 and also with highly significant differences (0.000) between slaughterhouses themselves with p ?0.05. Conclusion: The study concluded that both slaughterhouses failed to meet the requirements of the various beef halal criteria.

Effects of Amarogentin on Residual Liver Cancer Stem Cells After Insufficient Thermal Ablation and Related Mechanism / 肿瘤防治研究

Objective To observe the effects of amarogentinon liver cancer stem cells (LCSCs) after insufficient thermal ablation and its mechanism. Methods A insufficient thermal ablation model of HepG2 cells was established by water bath method.The percentage of CD133-positive LCSCs and the mRNA and protein levels of CD133 were detected by flow cytometry, qRT-PCR and Western blot.The insufficient thermal ablation model of HepG2 cells was treated with variable doses of amarogentin for 24 h; the percentage of CD133-positive LCSCs, the proliferation and apoptosis of liver cancer cells, and the mRNA and protein levels of CD133, TBC1D15, and p53were detected by flow cytometry, qRT-PCR and Western blot. Results The percentage of CD133-positive HepG2 cells and the mRNA and protein levels of CD133 and TBC1D15in the insufficient thermal ablation model were significantly higher than those in the normal HepG2 cells.Amarogentin then markedly decreased the percentage of CD133-positive LCSCs, the proliferation rate of HepG2 cells, and the mRNA and protein levels of CD133 and TBC1D15 in the insufficient thermal ablationresidual model (all P < 0.05);inversely, the apoptosis rate of HepG2 cells and the phosphorylated levels of p53 in the insufficient thermal ablation model were significantly increased (all P < 0.05). Conclusion Amarogentin could reduce the proportion of LCSCs after insufficient thermal ablation, inhibit the proliferation, and promote the apoptosis of LCSCs, which maybe associated with increasing the phosphorylation of p53 and inhibiting the expression of TBC1D15.

TBC1D15 deficiency protects against doxorubicin cardiotoxicity via inhibiting DNA-PKcs cytosolic retention and DNA damage

Clinical application of doxorubicin (DOX) is heavily hindered by DOX cardiotoxicity. Several theories were postulated for DOX cardiotoxicity including DNA damage and DNA damage response (DDR), although the mechanism(s) involved remains to be elucidated. This study evaluated the potential role of TBC domain family member 15 (TBC1D15) in DOX cardiotoxicity. Tamoxifen-induced cardiac-specific Tbc1d15 knockout (Tbc1d15CKO) or Tbc1d15 knockin (Tbc1d15CKI) male mice were challenged with a single dose of DOX prior to cardiac assessment 1 week or 4 weeks following DOX challenge. Adenoviruses encoding TBC1D15 or containing shRNA targeting Tbc1d15 were used for Tbc1d15 overexpression or knockdown in isolated primary mouse cardiomyocytes. Our results revealed that DOX evoked upregulation of TBC1D15 with compromised myocardial function and overt mortality, the effects of which were ameliorated and accentuated by Tbc1d15 deletion and Tbc1d15 overexpression, respectively. DOX overtly evoked apoptotic cell death, the effect of which was alleviated and exacerbated by Tbc1d15 knockout and overexpression, respectively. Meanwhile, DOX provoked mitochondrial membrane potential collapse, oxidative stress and DNA damage, the effects of which were mitigated and exacerbated by Tbc1d15 knockdown and overexpression, respectively. Further scrutiny revealed that TBC1D15 fostered cytosolic accumulation of the cardinal DDR element DNA-dependent protein kinase catalytic subunit (DNA-PKcs). Liquid chromatography-tandem mass spectrometry and co-immunoprecipitation denoted an interaction between TBC1D15 and DNA-PKcs at the segment 594-624 of TBC1D15. Moreover, overexpression of TBC1D15 mutant (∆594-624, deletion of segment 594-624) failed to elicit accentuation of DOX-induced cytosolic retention of DNA-PKcs, DNA damage and cardiomyocyte apoptosis by TBC1D15 wild type. However, Tbc1d15 deletion ameliorated DOX-induced cardiomyocyte contractile anomalies, apoptosis, mitochondrial anomalies, DNA damage and cytosolic DNA-PKcs accumulation, which were canceled off by DNA-PKcs inhibition or ATM activation. Taken together, our findings denoted a pivotal role for TBC1D15 in DOX-induced DNA damage, mitochondrial injury, and apoptosis possibly through binding with DNA-PKcs and thus gate-keeping its cytosolic retention, a route to accentuation of cardiac contractile dysfunction in DOX-induced cardiotoxicity.

KIF2C: a novel link between Wnt/β-catenin and mTORC1 signaling in the pathogenesis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.

Does air pollution affect to the TB incidence? / Монголын Анагаах Ухаан

@#Tuberculosis remains a major global health problem with 10.4 million incident cases in 2016. Although Mycobacterium tuberculosis is the causative agent, many environmental factors play a role in disease progression. Several respiratory hazards including smoking and indoor air pollution were suggested to increase the risk of tuberculosis, but only fewer studies has been conducted on the association between ambient air pollution and tuberculosis. </br> Mongolia is a one of the seven TB high burden countries in the WHO Western Pacific Region. In 2017, there were 3779 TB cases in Mongolia. Most of them were smear positive pulmonary cases. Mongolia achieved the regional WHO targets for finding and curing TB. Currently, case detection and treatment success rates have reached 72% and 84.0%, respectively.</br> Air pollution is hard to escape no matter how rich an area you live in, it is all around us. Also, air pillution is incerasingly serious problem in Mongolia. Globally it is estimated that 9 out of 10 breathe polluted air and about 7 million deaths are attributed to air pollution. It is estimated that 91% of the world’s population lives in area where the World Health Organization (WHO) Air Quality Guidelines are not met. </br> In addition, children are highly affected by air pollution because their lungs are still developing and the air pollution can interfere with this biological process, their bodies are less able to metabolize, detoxify and excrete the toxins contained in the air pollution. Many epidemiological and ecological studies were done in Mongolia toward to air pollution and health. However, it is still not clear how much indoor and ambient air pollution can cause to TB incidence in Mongolia.

Tuberculosis verrucosa cutis en niños: Presentación de dos casos y revisión de la literatura / Tuberculosis verrucosa cutis in children: Two cases report and review

La tuberculosis cutánea (TBC) representa el 1.5% de todas las formas de TB extrapulmonares. Es una enfermedad proteiforme y su diagnóstico constituye un reto al clínico. La TB verrucosa cutis (TBVC) es una variante clínica paucibacilar, de TBC, donde es infrecuente aislar en medios de cultivos el Mycobacterium tuberculosis. Ocurre en niños previamente sensibilizados e inmunocompetentes que se reinfectan con este bacilo de una fuente exógena, algunas veces de un esputo o secreción de un paciente con TB activa, cuando juega en la tierra. La bacteria penetra a la piel a través de pequeñas abrasiones en zonas expuestas a traumas como lo son rodillas, tobillos o glúteos. La lesión se inicia como un papulonódulo verrucoso asintomático, parecido a una verruga común, que evoluciona a una placa verrucosa . Reportamos 2 casos de TBVC, una niña de 6 años de edad y el segundo, un niño de 10 años de edad ambos de la comarca Guna Yala, un área con alta prevalencia de TB en Panamá. En el segundo caso se logró aislar el M. Tuberculosis en medios de cultivo y demostrarse además por la reacción en cadena de la polimerasa (PCR). La respuesta a la terapia antituberculosa fue exitosa, en ambos casos, con completa regresión de las lesiones a los 2 meses de tratamiento

Cutaneous tuberculosis (CTB) comprises 1.5% of all extrapulmonary TB forms. It is a proteiform disease and its diagnosis represents a challenge to the clinician. TB verrucosa cutis (TBVC) a paucibacillary clinical manifestation of CTB, where routine cultures for Mycobacteriun tuberculosis, are commonly negative. Occurs in children previously sentitized with a moderate to high degree of immunity. It represents an exogenous reinfection of M. tuberculosis, sometimes from a contaminated sputum of a patient with active TB, at sites prone to minor abrasions, such as, knees, ankles or buttocks. The lesion begins as a solitary asymptomatic verrucous papulonodule, similar to a common wart, that evolves to a verrucous plaque. The author report 2 cases of TBVC, a 6 year old girl and the second one, a 10 year old boy, both from Guna Yala, an indigenous region, o the coast of Panama, an area with a high prevalence of TB. In the second case, M. tuberculosis was isolated in routine cultures and reported positive in Polimerase chain reaction (PCR). The antituberculous therapy was successfull in both patients, with complete regression of the lesions after 2 months of treatment

Parâmetros de qualidade do leite bovino em propriedades de agricultura familiar / Quality parameters of bovine milk from family farms

Propriedades da agricultura familiar tem contribuído para aumentar a produção leiteira, e podem ser considerados importantes para cadeia produtiva do leite. A higiene no processo produtivo deve ser o foco principal para garantir maior produção e qualidade do leite. Monitorou-se a qualidade do leite de vacas, em propriedades da agricultura familiar, no município de Bofete/SP, antes e após a adoção de medidas de controle. Avaliaram-se 21 propriedades, selecionadas por conveniência. Após período inicial de 13 coletas para monitoramento de CCS e CBT, os proprietários dos dois grupos (G1 e G2) receberam orientações técnicas sobre mastite e qualidade do leite, em atividade de dia de campo. Os proprietários do G1 além dessas atividades receberam intervenção no manejo utilizado, com visita técnica, e orientações individuais quanto à maneira adequada de ordenha e obtenção higiênica do leite. Posteriormente foram realizadas novas coletas quinzenais (n=12) como anteriormente, de amostras de leite de conjunto, de cada propriedade dos dois grupos, bem como do tanque comunitário. Foram consideradas variáveis climáticas como precipitação, temperatura e umidade relativa do ar. Observou-se uma variação dos resultados de cada coleta tanto para CCS/mL de leite quanto para CBT/mL de leite, nos dois períodos. Quanto a CCS no G1 houve uma diminuição significativa (P < 0,02), enquanto que para CBT houve um ligeiro aumento, bem menor, quando comparado ao valor mediano que foi de 381x103 UFC/mL de leite no G2. Os resultados medianos de CCS/mL de leite e de CBT/mL de leite do tanque comunitário foram mais elevados nas duas fases (períodos), entretanto muito superior para CBT. A análise das variáveis climáticas evidenciou aumento das medianas nos três parâmetros avaliados. A correlação entre essas variáveis e qualidade do leite, não mostrou diferenças para o Log10 da CCS e CBT. Pode-se concluir pela higiene precária no manejo de ordenha.(AU)

Family operated dairies have contributed to increase milk production and can be considered important in the milk production chain. Hygiene in the productive process must be the major focus to assure greater milk quality and production. The quality of milk from cows in family farms in the city of Bofete/SP was monitored before and after the establishment of control measures. Twenty-one dairy family farms, selected for convenience, were evaluated. After the initial period of 13 collections for SCC and TBC monitoring, farmers of the two groups (G1 and G2) received technical guidance about mastitis and milk quality during a day of field activity. G1 farmers, besides these activities, received intervention in the adopted management by means of technical visit and individual guidance as to adequate milking manner and hygienic milk production. Then, new fortnight collections (n=12) were performed, as previously, of a set of milk samples from each farm and both groups, as well as from the community tank. Climate variables were considered, such as rainfall, temperature and relative humidity. There was a variation in the results of each collection for both SCC/mL milk and TBC/mL milk in the two periods. As to SCC in G1, there was a statistically significant decrease (P < 0.02), while for TBC there was a slight increase, rather lower compared to the median value, which was 381x103 CFU/mL milk in G2. The median results of SCC/mL milk and TBC/mL milk from the community tank were greater in the two stages (periods), but much superior for TBC. Analysis of the climate variables evidenced an increase in the medians for all three evaluated parameters. The correlation between these variables and milk quality did not show differences for Log10 of SCC and TBC. It can be concluded that the milking management hygiene was precarious.(AU)

Clinical phenotypes of TBC1D24 gene related epilepsy / 中华儿科杂志

Objective@#To summarize the clinical features of TBC1D24 gene mutations associated with epilepsy.@*Methods@#All the patients with TBC1D24 gene compound heterozygous mutations were retrospectively collected at the Pediatric Department of Peking University First Hospital from March 2015 to July 2017, and the features of clinical manifestations, electroencephalogram, and neuroimaging were analyzed.@*Results@#Eighteen cases with TBC1D24 gene compound heterozygous mutations were included. The age of seizure onset was 1 day to 8 months, and the median age was 90 days. Seizure types included generalized tonic-clonic seizures (GTCS) in 3 cases, focal seizures in 18 cases, myoclonus in 18 cases, and 17 cases had focal myoclonus and myoclonus status. The focal myoclonus involving one or multiple muscle groups, sometimes migrating and alternating, lasting up to minutes to several days, and could be terminated by sleep or sedation drugs. In 11 cases, myoclonus was exacerbated by fever or infections, and 2 cases developed into myoclonic status during infection, in a severe case with the loss of consciousness. The magnetic resonance imaging (MRI) of seven patients was abnormal, including cerebral atrophy or cerebellar atrophy with abnormal signals. Segment myoclonus was captured in 10 patients, but without correlated epileptiform discharges. There were ten cases had varying degrees of developmental delay, 7 were normal, and one patient died of status epilepticus at the age of 4 months. Three cases had hearing disorders. In the 18 patients, the clinical phenotype of 4 cases consisted of epilepsy of infancy with migrating focal seizures, 2 with progressive myoclonus epilepsies, 1 with Dravet syndrome, 1 with DOORS syndrome, and 3 with unclassified epileptic encephalopathy.@*Conclusions@#The clinical feature of TBC1D24 gene mutation related epilepsy was focal myoclonus, and tended to develop into myoclonic status epilepticus, and could be aggravated by infections, and terminated by sleep or sedation drugs. Mental retardation involved or not, neuroimaging could present with cerebral atrophy or cerebellar atrophy with abnormal signals.

Poliarteritis nodosa cutánea / CUTANEOUS POLYARTERITIS NODOSA

La poliarteritis nodosa es una vasculitis de los vasos de mediano calibre que puede afectar solamente la piel o tener compromiso sistémico. Los signos cutáneos más frecuentes son livedo reticularis, nódulos y ulceras dolorosas. Se presenta un paciente masculino de 40 años de edad que consultó por nódulos eritematovioláceos dolorosos en miembros de un mes de evolución. Se realizó biopsia sugestiva de poliarteristis nodosa, se detectó serología para VIH positiva, cavitaciones pulmonares en TAC de tórax y lavado broncoalveolar con baciloscopía positiva para tuberculosis (TBC). Se inicia tratamiento antifímico y antiretroviral con mejoría de la clínica respiratoria y resolución a los 2 meses de las lesiones en piel

Polyarteritis nodosa is a vasculitis of medium sized vessels that can affect only skin or have systemic involvement. The most frequent cutaneous signs are livedo reticularis, nodules and painful ulcers. We present a 40 year-old male patient who consulted for painful erythematouspelvic nodules in a month of evolution. A biopsy suggestive of polyarteritis nodosa was detected, positive HIV serology, pulmonary cavitations in chest CT and bronchoalveolar lavage with tuberculosis-positive smear microscopy (TB). Antimicrobial and antiretroviral treatment with respiratory clinic improvement and resolution at 2 months of skin lesions are started

Perfil neuropsicológico en un paciente de 50 años con infección tuberculosis /VIH / Neuropsychological profile in a 50-year-old patient with Tuberculosis /HIV coinfection

Resumen El Virus de Inmunodeficiencia Humana (VIH) ataca al sistema inmunológico haciendo que este se debilite y no pueda defender al cuerpo de organismos infecciosos invasores; factor que es aprovechado por las enfermedades oportunistas, siendo la tuberculosis (TBC) una de las de mayor prevalencia en pacientes con VIH. La coinfección TBC/VIH, produce un deterioro progresivo del sistema inmune, secuelas neurológicas y alteraciones neuropsicológicas. El objetivo de este estudio es describir el perfil neuropsicológico de un hombre de 50 años con VIH y enfermedad oportunista (TBC). Para la evaluación neuropsicológica se utilizaron subpruebas del Test Barcelona, del proyecto NEURONORMA y de la BANFE 2. Los resultados sugirieron un síndrome prefrontal con mayor alteración de los circuitos dorsolaterales y orbitales. Este estudio estimula la realización de investigaciones que amplíen la información sobre las secuelas neuropsicológicas diferenciales del VIH y la TBC, así como las resultantes de su interacción.

Abstract The Human Immunodeficiency Virus (HIV) is a virus that invades the immune system causing it to weaken and unable to defend the body from invading infectious organisms. This factor is used by the opportunistic diseases, being tuberculosis (TBC), one of the most prevalent in patients with HIV. TBC/HIV coninfection causes a progressive deterioration of the immune system, neurological aftermath and neuropsychological alterations. The purpose of this study is to describe the neuropsychological profile of an 50 year old man with HIV and an opportunistic disease (TBC). For the neuropsychological evaluation were used subtests of the Test Barcelona, the NEURONORMA and the BANFE-2. The results suggested a prefrontal syndrome with greater alteration of the dorsolateral and orbital circuits. This study stimulates research that amplifies information about the differential neuropsychological aftermath of HIV and TBC, as well as those resulting from its interaction.

Legal standards of milk delivered for processing in Brazil / Adequação aos padrões legais de leite entregue para beneficiamento no Brasil

Thresholds for Somatic Cell Counts (SCC) and Total Bacterial Counts (TBC) in refrigerated raw milk have been stricter in Brazil since July 2014. We evaluated whether the composition of 11,051 milk samples delivered to processing plants in Paraná state, Brazil, by cooperative dairy farms, complies with government requirements and established changes. Milk quality was evaluated from June to August 2014, from dairy farms in three states. Data were obtained by infrared spectroscopy and flow cytometry. SCC was highest in June (p<0.05), when the highest number of samples and mean values was observed that did not comply with legal standards. No samples obtained in July complied with the requirements. The city in Mato Grosso do Sul state was the only one that met the legal requirements throughout the period studied. TBC did not vary (p>0.05) in the trimester, and none of the cities presented values below the maximum TBC allowed. Protein, fat and non-fat solids obtained complied with legal requirements. Total solids and lactose varied among the months (p<0.05), with highest values for total solids in June and for lactose in August. Milk samples did not comply with minimal requirements for SCC and TBC, and were not adjusted to more rigid quality standards.

Limites de contagem de células somáticas (CCS) e contagem bacteriana total (CBT) em leite cru refrigerado estão mais estritos no Brasil desde Julho de 2014. Foram avaliadas 11051 amostras de leite entregues para beneficiamento no Estado do Paraná, Brasil, por produtores de leite e cooperados e verificou-se se estas atendiam aos requisitos governamentais e às mudanças estabelecidas. A qualidade do leite foi avaliada de Junho a Agosto de 2014 em fazendas leiteiras de três estados. Os dados foram obtidos por espectroscopia em infravermelho e citometria de fluxo. CCS foi superior em Junho (p<0,05), quando foi observado maior número de amostras e valores médios que não estavam de acordo com os padrões legais. A cidade do Estado de Mato Grosso do Sul foi a única que cumpriu com os limites legais requeridos ao longo do período. CBT não apresentou variação (p>0,05) ao longo do trimestre, e nenhuma das cidades apresentou valores dentro do limite estabelecido para CBT. Proteína, gordura e sólidos não gordurosos estavam de acordo com os limites requeridos. Sólidos totais e lactose variaram ao longo dos meses (p<0,05), com valores elevados para sólidos totais em Junho e para lactose em Agosto. Amostras de leite não estavam de acordo com os requisitos mínimos de CCS e CBT, e não estão ajustadas aos padrões de qualidade mais rígidos.

Novel compound heterozygous TBC1D24 mutations in a boy with infantile focal myoclonic epilepsy and literature review / 中华儿科杂志

Objective@#To investigate the clinical features and genetic characteristics of patients with TBC1D24 gene mutations.@*Method@#The clinical data of a patient with novel TBC1D24 compound heterozygous mutations from Children′s Hospital of Fudan University were collected, the related literature was searched from China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, National Center from Biotechnology Information and Pubmed (up to April 2016) by using search terms "TBC1D24" "epilepsy" . The clinical features, electroencephalogram (EEG) and prognosis of the patients with TBC1D24 gene mutations were studied.@*Result@#The patient was a boy with non-consanguineous healthy parents.He had an acute episode of focal continuous myoclonus lasting a few hours with consciousness preserved at the age of 3 months.Myoclonic jerks alternatively affected the eyelids, either the right or left limbs, sometimes triggered by fever or fatigue.The frequency was once 3-7 days.At the age of 6 months he was found to have myoclonus seizures with onset from a unilateral eyes lid and limb lasting 10 more minutes and subsequently affected four extremities or the trunk.They occurred once 3-4 months with perserved consciousness and lasted from several hours to up to ten more hours.They mostly disappeared during sleep.He had ataxia and mild mental retarding.Paroxysmal anomalies were not found on ictal traces.A novel compound heterozygous mutation of TBC1D24 gene, c. 730G>A, p.A244T and c. 1571G>C, p.R524P were found in the patient.Further study showed that c. 730G>A mutation was inherited from his father and c. 1571G>C from his mother. These two were not reported in public databases and predicted deleterious by Mutation Taster and polyphen-2.Literature relevant to TBC1D24 published all around the world was reviewed, no Chinese cases with TBC1D24 gene mutations had been reported. The total of 24 cases including the present case with TBC1D24 gene mutation were reported.Among them, 11 cases had compound heterozygous mutations and 13 cases had homozygous mutations.Ten mutations were identified, including 1 termination mutation, 1 frameshift mutation and 8 missense mutations.@*Conclusion@#TBC1D24 gene mutational analysis should be performed on patients with early-onset focal continuous myoclonus, if the etiology was unclear.

TBC cutánea causada por Mycobacterium tuberculosis multidrogo resistente: reporte de un caso / Cutaneous TBC caused by multi-drug resistant Mycobacterium tuberculosis. case report

La TBC es una enfermedad causada por Mycobacterium tuberculosis y afecta usualmente el pulmón aunque un pequeño porcentaje se puede presentar en la forma cutánea. Se presenta el caso de un varón de 23 años, natural de la provincia de Madre de Dios, que desarrolló TBC pulmonar y cutánea causado por Mycobacterium tuberculosis MDR. El diagnóstico se hizo por Bk de secreción cutánea y Bk de esputo con resultado positivo en ambos casos; presentó además edema en hemicuerpo izquierdo, y ulceras a nivel esternal y a nivel clavicular. El paciente fue hospitalizado como enfermedad TBC pulmonar y extrapulmonar. El caso reportado pone en énfasis la TBC cutánea y el riesgo que esto significa aun en pacientes inmunocompetentes.

TBC caused by Mycobacterium tuberculosis and affects usually the lung, although a small percentage of patients present with skin involvement. We present the case of a 23-year-old male patient from Madre de Dios who developed both pulmonary and skin TBC caused by multi-drug resistant Mycobacterium tuberculosis. The diagnosis was made by detecting Mycobacterium using acid fast stains in sputum and skin samples. This case illustrates the risk that immunosuppressed patients has to get cutaneous tuberculosis.

Solitary Bone Cyst-A Case Report with Diagnostic Prospective

Solitary bone cyst is an uncommon non-epithelial lesion of the jaw bones. It was first defined by Lucas and Blum in 1929. It is classified as an intraosseous pseudocyst. They are asymptomatic and are usually seen during routine radiographical examination. According to the 2002 classification of the WHO, traumatic bone cysts are miscellaneous lesions. This report describes an 18-year-old female patient who had a solitary bone cyst in the posterior region of mandible associated with an impacted third molar.

Indicadores de qualidade e composição de leite informal comercializado na região Sudeste do Estado de São Paulo

Abstract:The informal milk is recognized as the product marketed without inspection. We evaluated the microbiological quality, nutritional ingredients and substances inhibiting bacterial growth in 100 informal samples from cows milk, marketed in the southwest region of the state of São Paulo, Brazil. It was found that 77% of Somatic Cell Count (SCC) and 86% of Total Bacterial Count (TBC) of the samples were at odds with the maximum values required by Instruction Rules 62 of the Ministry of Agriculture and Livestock Supply. It was identified to solids contents in disagreement (36%), protein (23%), fat (38%), nonfat dry extract (43%) and 73% urea nitrogen. In 59% of the samples was detected residues of the bacterial growth inhibitors. Were isolated 240 strains of micro-organisms with a prevalence of enterobacteria, streptococci, staphylococci and fungi. The informal milk is marketed in the region without the minimum hygienic conditions and present risks to public health, and represents serious socio-economic problem for the region.

Resumo:O leite informal é reconhecido como o produto comercializado sem inspeção. Avaliou-se a qualidade microbiológica, constituintes nutricionais e presença de substâncias inibidoras do crescimento bacteriano em 100 amostras informais de leite de vacas, comercializadas na região sudoeste do estado de São Paulo, Brasil. Verificou-se que 77% da Contagem de Células Somáticas (CCS) e 86% da Contagem Bacteriana Total (CBT) das amostras estavam em desacordo com os valores máximos exigidos pela Instrução Normativa 62 do MAPA. Identificaram-se teores em desacordo para sólidos totais (36%), proteína (23%), gordura (38%), extrato seco desengordurado (43%) e nitrogênio uréico (73%). Em 59% das amostras detectou-se a presença de resíduos de inibidores do crescimento bacteriano. Isolaram-se 240 linhagens de micro-organismos com predomínio de enterobactérias, estreptococos, estafilococos e fungos. O leite informal é comercializado na região sem as mínimas condições de higiene e oferece riscos a saúde pública, além de representar sério problema sócio-econômico para região.

Meningoencefalitis tuberculosa en niños: Experiencia en el Instituto Nacional de Salud del Niño de Lima, 2009 - 2013 / Meningial Tuberculosis in children: Experience in the Instituto Nacional de Salud del Niño from Lima, 2009-2013

Objetivos: Describir las características epidemiológicas, clínicas, de laboratorio y neuroimagen en los niños diagnosticados de meningoencefalitis tuberculosa (MEC TBC) en el Instituto Nacional de Salud del Niño de Lima - Perú. Material y métodos: Estudio retrospectivo y descriptivo de una serie de casos entre enero del 2009 a setiembre del 2013. Resultados: Se seleccionaron 31 casos con diagnóstico de MEC TBC, con una frecuencia de 7,4 casos por año, edad promedio de 7,3 años, la relación varón/ mujer fue 1,2. Los características más frecuentes fueron la desnutrición, el contacto TBC y la TBC pulmonar. Los síntomas más frecuentes fueron la fiebre, vómitos, y somnolencia. El trastorno de la conciencia y el síndrome meníngeo fueron los síndromes neurológicos más comunes. La mayoría ingresaron en estadio II (83,9 %) y egresaron con secuelas mayores (51,6%). Los hallazgos en el líquido cefalorraquídeo (LCR) fueron pleocitosis promedio de 275,6 células /mm3 y mediana de 184 células/mm3 (rango entre 15-1364 células/mm3), el Bacilo de Koch fue aislado por cultivo en el 19,5% de los casos. Los hallazgos más frecuentes de neuroimagen fueron la hidrocefalia (58%), infarto ygranuloma. Seis pacientes con hidrocefaliarequirieron derivación ventricular. Cinco de los pacientes desarrollaron reacción paradójica. La letalidad fue 12,9%.Conclusiones: La incidencia hospitalaria de MEC TBC fue 7,4 casos por año, la mayoría ingresó en estadio IIy egresó con secuelas mayores, en la neuro imagen la hidrocefalia fue el hallazgo más observado, la letalidad fue 12,9%.

Objectives: To describe clinical, epidemiological, laboratory and neuro imaging characteristics of children with Meningeal Tuberculosis (MEC TBC) at the Instituto Nacional de Salud del Niño, in Lima, Peru. Methods: Retrospective, descriptive case series from January 2009 to September 2013. Results: 31 cases with MEC TBC were included, with a frequency of 7.4 cases per year. The average age was7.3 years and boy/girl rate was 1.2. The more frequent characteristics were the malnutrition, a positive TBC contact and pulmonary TBC. The most common clinical findings were fever, vomits, altered consciousness and meningeal signs. Most cases were in the II clinical state of the disease (83.9%) and the majority evolved with severe complications (51.6%). The cerebrospinal fluid (CSF) findings showed an average 275.6 cells/mm3 cells and median of 184 cells/mm3 (15-1364 cells/mm3). The Koch bacillus was identified in 19.5 % of the CSF culture. The more frequent imaging findings were hydrocephalus (58%), cerebral infarct and granuloma. Six children with hydrocephalus needed a cerebral peritoneal shunt and five children evolved with a paradoxical reaction. The mortality was 12.9%. Conclusions: The hospital incidence was 7.4 cases per year, most of them came in stage II of the disease and left with major sequela, the hydrocephalus was the most frequent imaging finding and the mortality was 12.9%.

Qualidade do leite de vacas criadas no sistema silvipastoril no Vale do Cauca, Colômbia / Milk quality indicators from cows bred on silvopastoral system in Cauca Valley, Colombia

O sistema silvipastoril caracteriza-se por aumentar a produção de leite, com maior número de vacas por hectare devido ao maior aporte de proteína na dieta. Neste sistema as vacas são alimentadas, além do pasto, de pequenas árvores e arbustos. O objetivo do presente estudo foi determinar os principais indicadores de qualidade do leite e agentes causais de mastite em vacas criadas em sistema silvipastoril. Foram avaliadas a composição (teor de gordura, proteína total, lactose, extrato seco, extrato seco desengordurado e nitrogênio uréico), contagem de células somáticas (CCS), contagem bacteriana total (CBT), ocorrência de mastite clínica e subclínica, isolamento microbiológico, perfil de sensibilidade bacteriana "in vitro" e detecção de resíduos antimicrobianos no leite produzido por 100 vacas, bem como do tanque de expansão e latões em propriedades do Vale do Cauca, Colômbia. Os teores médios dos principais constituintes do leite foram 3,24% de gordura, 3,27% de proteína total, 4,40% de lactose, 10,62% de extrato seco, 8,57% de extrato seco desengordurado e 15,82mg/dL de nitrogênio uréico, enquanto do tanque de expansão e latões foi 3,51% de gordura, 3,20% de proteína total, 4,34% de lactose, 11,72% de extrato seco, 8,47% de extrato seco desengordurado e 14,57mg/dL de nitrogênio uréico. A celularidade média dos quartos mamários e do tanque de expansão foi 141.252,75 CS/mL e 363.078,05 CS/mL respectivamente. A CBT média dos quartos mamários e do tanque de expansão foi 4.466,84 UFC/mL e 24.547,01 UFC/mL. Os principais micro-organismos isolados dos quartos mamários foram Corynebacterium bovis, Staphylococcus aureus, Staphylococcus hyicus, Staphylococcus spp., Streptococcus dysgalatiae, enquanto do tanque de expansão foram identificados Streptococcus spp., Enterobacter cloacae, Hafnia alveii, Streptococcus hemolítico e Streptococcus spp., com maior frequência. A presença de resíduos de antimicrobianos em leite de vacas e do tanque ou latão foi detectada em 30% e 86% das amostras, respectivamente. O sistema silvipastoril mostrou ser uma boa alternativa para produção de leite em vacas. No entanto, são necessários cuidados no tratamento mamário para evitar resíduos no leite e a análise de todos os parâmetros de qualidade para garantir um produto diferenciado.

The silvopastoral system is characterized by increasing the production of milk with a greater number of cows per hectare due to the higher amount of protein in the diet. In silvopastoral system cows are fed in addition to pasture, small trees and shrubs. The aim of this study was determinate the main indicators of milk quality and mastitis causal agents in cows bred on silvopastoral system. We evaluated the composition (fat, total protein, lactose, solids, dry extract, nonfat dry and urea nitrogen), somatic cell count (SCC), total bacterial count (TBC), occurrence of clinical and subclinical mastitis, microbiological isolation, in vitro antimicrobial sensitivity profile and detection of antimicrobial residues in milk produced by 100 cows raised in silvopastoral systems, as well as the bulk tank and churns in farms of Cauca Valley, Colombia. The concentration of the major constituents of milk were 3.24% fat, 3.27% total protein, 4.40% lactose, 10.62% dry extract, 8.57% nonfat dry and 15.82mg/dL urea nitrogen, while the bulk tank and churns was 3.51% fat, 3.20% total protein, 4.34% lactose, 11.72% dry extract, 8.47% nonfat dry and 14.57mg/dL urea nitrogen. The cell count of the cows and the bulk tank was 141,252.75 CS/mL and 363,078.05 CS/mL respectively. The TBC mean in cows and the bulk tank was 4,466.84 CFU/mL and 24,547.01 CFU/mL respectively. The main microorganisms isolated from the udder cows were Corynebacterium bovis, Staphylococcus aureus, Staphylococcus hyicus, Staphylococcus spp., Streptococcus dysgalatiae, while the bulk tank were identified more often Streptococcus spp., Enterobacter cloacae, Hafnia alveii, hemolytic Streptococcus and Streptococcus spp. Antimicrobial residues in cow milk and bulk or churn were detected in 30% and 86% respectively. The silvopastoral system showed to be good alternative to milk production in cow. However is important the care with antimicrobial residues in milk and the analysis of all quality parameters to ensure a differentiated product.

Tuberculosis oral asociada al HIV: presentación de un caso clínico / HIV-related oral tuberculosis: report of a clinical case

La tuberculosis (TBC) es una enfermedad infecciosa causada principalmente por una bacteria, el Micobacterium tuberculosis. La estrecha vinculación entre TBC y VIH oermite hablar de una coepidemia dual. La localización oral de la TBC extrapulmon es rara, tanto en pacientes inmunocompetentes como VIH+. Las manifestaciones clínicas son inespecíficas, pudiendo presentarse como úlceras, fisuras, nódulos, granulomas o tumores. La falta de especificidad de las lesiones dificulta el diagnóstico. En este artículo se presenta un caso clínico de un paciente con TBC extrapulomonar en la cavidad oral asociado a HIV, atendido en el Servicio de Odontología del H.I.G.A. Gral. San Martín de la ciudad de La Plata.

Influence of somatic cell count and total bacterial counts of raw milk in cheese yield using small-scale methodology / Influência da contagem de células somáticas e da contagem bacteriana total do leite cru no rendimento da produção de queijos, utilizando metodologia em escala reduzida

The objectives of this study were to evaluate the influence of SCC and TBC of raw milk in cheese yield, using a reduced scale method, and to evaluate theoretical prediction of cheese yield. 270 samples of raw milk were split into three SCC levels (below 200,000; 200,000-750,000; above 750,000 SC/mL) and three TBC levels (below 100,000; 100,000-750,000; above 750,000 CFU/mL). Raw milk samples were submitted to compositional analysis (fat, protein, lactose, total solids and SNF content), SCC, TBC, freezing point and pH. The production of the small-scale cheese was conducted according to the method developed at Cornell University (Melilli et al., 2002). Cheese whey samples were submitted to compositional analysis (fat, total protein, true protein, lactose, total solids and SNF content) and SCC. The increase in the SCC of raw milk resulted in increased protein loss in cheese whey. High SCC (above 200,000 SC/mL) in milk samples was correlated to reduced dry matter yield. There was no effect of TBC in cheese yield in the experimental conditions used. There was a high correlation between the theoretical yield values and the yield values predicted by the small-scale method, indicating that this method is appropriate for cheese yield prediction.

Este trabalho teve como objetivos verificar a influência da CCS e CBT do leite cru no rendimento de queijos, utilizando método em escala reduzida, e avaliar a predição teórica do rendimento de queijos. Foram utilizadas 270 amostras de leite cru com três níveis de CCS (abaixo de 200.000; 200.000-750.000; acima de 750.000 CS/mL) e três níveis de CBT (abaixo de 100.000; 100.000-750.000; acima de 750.000 UFC/mL). As amostras de leite cru foram submetidas a análises de composição (gordura, proteína, lactose, EST e ESD), CCS, CBT, crioscopia e pH. A produção dos queijos em escala reduzida foi feita segundo o método desenvolvido na Universidade de Cornell, EUA (Melilli et al., 2002). As amostras de soro de queijo foram submetidas a análises de composição (gordura, proteína total, proteína verdadeira, lactose, EST e ESD) e CCS. O aumento da CCS no leite cru refletiu na maior perda de proteína no soro. CCS elevada (acima de 200.000 CS/mL) foi correlacionada ao menor rendimento de massa seca. Foi encontrada uma correlação alta entre os valores teóricos de rendimento e os valores de rendimento preditos pela metodologia em escala reduzida, indicando que esta metodologia pode ser utilizada para a predição do rendimento de queijos.

Paracoccidioidomicosis y TBC-MR en portador de VIH/VHC / Paracoccidioidomicosis and multidrug-resistant tuberculosis (TBC-MDR) in patient coinfected with HIV and hepatitis C

A case of an adult male patient diagnosed with HIV and Hepatitis C co infection is presented. He had granu-lomatuos hepatitis and blood smear positive to Paracoccidioides brasiliensis concomitant to the detection of MDR Mycobacterium tuberculosis in sputum further complicated with reactivation of cytomegalovirus (possible pancreatitis and retinitis). Difficulties in diagnostic and therapeutic approach in a patient with multiple infections are reviewed.

Reportamos el caso de un varón de 54 años portador de VHC y VIH estadio SIDA quien tuvo hepatitis granu-lomatosa y frotis de sangre positivo a Paracoccidioides brasiliensis concomitante al hallazgo de Mycobacterhim tuberculosis multiresistente en esputo, que evolucionó con reactivación de citomegalovirus (pancreatitis probable y retinitis). Se describen las dificultades diagnósticas y terapéuticas en un paciente con múltiples infecciones.