Insects associated to ephemeral pools in Huentelauquén (29ºS Coquimbo Region, Chile)

Abstract In northern central Chile, ephemeral pools constitute shallow isolated water bodies with a favourable habitat for fauna adapted to seasonal changes. Based on the limited knowledge about the faunaparticularly insectsassociated to these ecosystems, the objective of this study was to characterize the richness, composition, structure and similarity of the insect communities associated with ephemeral pools in Huentelauquén (29º S, Coquimbo Region, Chile). By using pitfall traps, 10,762 individuals were captured, represented by 7 orders, 27 families, and 51 species. Coleoptera and Hymenoptera were the best represented orders, with Neuroptera, Orthoptera and Plecoptera being poorly represented groups. The non-parametric estimators evaluated showed wealth values above those observed for all the studied pools, and their accumulation curves suggest the existence of an incomplete species inventory in the studied community. Additionally, the hierarchical and ordering analysis showed groupings of pools located in the northwest and southeast of Huentelauquén. Preliminarily we found a negative correlation between the area of the pools and the richness (species) and abundance of insects. Additional studies (on other arthropod groups and other seasons of the year) could provide a better understanding of the local processes of extinction and colonization of the species inhabiting these fragile coastal environments.

Resumo No norte central do Chile, lagoas efêmeras constituem corpos de água isolados e pouco profundos, com um habitat favorável para a fauna adaptada as mudanças sazonais que as zonas úmidas estão sujeitas. Com relação a estes ecossistemas, sabe-se pouco sobre sua fauna, principalmente a de insetos. O objetivo do presente estudo foi caracterizar a riqueza, composição, estrutura e similaridade das comunidades de insetos que habitam as lagoas temporárias de Huentelauquén (29º S, Região de Coquimbo, Chile). Usando armadilhas de interceptação, se capturou um total de 10.762 indivíduos, pertencentes a 7 ordens, 27 famílias e 51 espécies. Coleoptera e Hymenoptera foram as ordens mais representativas, enquanto Neuroptera, Orthoptera e Plecoptera foram grupos pouco representativos. Os estimadores não paramétricos avaliados mostraram valores de riqueza superiores ao observados para todas as lagoas estudadas, e suas curvas de acumulação parecem indicar que o inventario da comunidade estudada está incompleto. A análise hierárquica e de ordenamento revelou agrupamentos de lagoas correspondentes a zona nordeste e sudeste de Huentelauquén. Preliminarmente encontramos uma correlação negativa entre a área de lagoas efêmeras e a riqueza (espécies) e abundância de insetos. É necessário realizar estudos adicionais (sobre outros grupos de artrópodes e em outras estações do ano) para melhor compreensão dos processos locais de extinção e colonização das espécies que habitam estes frágeis ambientes costeiros estudados.

Insects associated to ephemeral pools in Huentelauquén (29ºS Coquimbo Region, Chile) / Insetos associados a lagoas temporárias em Huentelauquén (29ºS Região de Coquimbo, Chile)

Abstract In northern central Chile, ephemeral pools constitute shallow isolated water bodies with a favourable habitat for fauna adapted to seasonal changes. Based on the limited knowledge about the fauna—particularly insects—associated to these ecosystems, the objective of this study was to characterize the richness, composition, structure and similarity of the insect communities associated with ephemeral pools in Huentelauquén (29º S, Coquimbo Region, Chile). By using pitfall traps, 10,762 individuals were captured, represented by 7 orders, 27 families, and 51 species. Coleoptera and Hymenoptera were the best represented orders, with Neuroptera, Orthoptera and Plecoptera being poorly represented groups. The non-parametric estimators evaluated showed wealth values above those observed for all the studied pools, and their accumulation curves suggest the existence of an incomplete species inventory in the studied community. Additionally, the hierarchical and ordering analysis showed groupings of pools located in the northwest and southeast of Huentelauquén. Preliminarily we found a negative correlation between the area of the pools and the richness (species) and abundance of insects. Additional studies (on other arthropod groups and other seasons of the year) could provide a better understanding of the local processes of extinction and colonization of the species inhabiting these fragile coastal environments.

Resumo No norte central do Chile, lagoas efêmeras constituem corpos de água isolados e pouco profundos, com um habitat favorável para a fauna adaptada as mudanças sazonais que as zonas úmidas estão sujeitas. Com relação a estes ecossistemas, sabe-se pouco sobre sua fauna, principalmente a de insetos. O objetivo do presente estudo foi caracterizar a riqueza, composição, estrutura e similaridade das comunidades de insetos que habitam as lagoas temporárias de Huentelauquén (29º S, Região de Coquimbo, Chile). Usando armadilhas de interceptação, se capturou um total de 10.762 indivíduos, pertencentes a 7 ordens, 27 famílias e 51 espécies. Coleoptera e Hymenoptera foram as ordens mais representativas, enquanto Neuroptera, Orthoptera e Plecoptera foram grupos pouco representativos. Os estimadores não paramétricos avaliados mostraram valores de riqueza superiores ao observados para todas as lagoas estudadas, e suas curvas de acumulação parecem indicar que o inventario da comunidade estudada está incompleto. A análise hierárquica e de ordenamento revelou agrupamentos de lagoas correspondentes a zona nordeste e sudeste de Huentelauquén. Preliminarmente encontramos uma correlação negativa entre a área de lagoas efêmeras e a riqueza (espécies) e abundância de insetos. É necessário realizar estudos adicionais (sobre outros grupos de artrópodes e em outras estações do ano) para melhor compreensão dos processos locais de extinção e colonização das espécies que habitam estes frágeis ambientes costeiros estudados.

Incontinencia urinaria de urgencia en mujeres adultas: ¿Qué tratamientos ofrecer en APS? / Emergency Urinary Incontinence in Adult Women: what treatments do we offer at PHC?

La incontinencia urinaria de urgencia corresponde a la pérdida involuntaria de orina, cuya causa es presumida multifactorial: hiperactividad del detrusor, hipersensibilidad vesical y distensibilidad reducida del detrusor. Esta patología es bastante frecuente tanto en Chile como en el mundo, con una prevalencia local entre 10% y 15%, a su vez genera un gran impacto en el bienestar físico, mental y socioeconómico del paciente. El diagnóstico es clínico, con apoyo en el uroanálisis y su tratamiento de primera línea puede ser realizado en APS. En cuanto al tratamiento existen tanto terapias no farmacológicas como farmacológicas; correspondiendo las técnicas de reentrenamiento vesical, los cambios de estilo de vida y los fármacos anticolinérgicos a tratamientos efectivos de primera línea. Existen, además, otros fármacos que pueden ser utilizados para el tratamiento de la IUU, cuya evidencia será igualmente revisada en este artículo.

Urge incontinence is defined as an involuntary leakage of urine, presumably with a multifactorial cause: detrusor overactivity, bladder hypersensibility and a reduced bladder compliance. It's a common disease worldwide, with local studies reporting a prevalence around 10-15%, causing a great impact in the physical, mental and socioeconomic well-being of the affected patients. Diagnosis is mainly based on the clinical history, supporting it with laboratory tests to rule out other conditions, and uncomplicated cases can be treated and followed in a primary care setting. There are pharmacologic and non-pharmacologic therapies, being healthy lifestyles changes, bladder retraining programs and anticholinergic drugs the first line of treatment. Additional pharmacologic treatments will be revised in this article.

Guía de recomendación ACCHED-SCHGE para el funcionamiento de las unidades de endoscopia durante el brote de coronavirus (COVID-19) / Guideline recommendations ACHED-SCHGE for the endoscopy units during the Coronavirus outbreak (COVID-19)

The outbreak of COVID-19 disease has recently spread from its original place in Wuhan, Hubei province, China, to the entire world, and has been declared to be a pandemic by the World Health Organization in March 2020. All countries in America, in particular Chile, show an important increase in COVID-19 cases and deaths. The clinical manifestations of COVID-19 are a broad spectrum, from asymptomatic mild disease, to severe respiratory failure, shock, multiorgan dysfunction and death. Thus, high clinical suspicion and appropriate structure risk stratification are needed. Health care teams in endoscopy units, are at an increased risk of infection by COVID-19 from inhalation of droplets, mucosae contact, probably contamination due to contact with stools. Endoscopic aerosolized associated infections have also been reported. Different societies' recommendations, have recently placed digestive endoscopy (especially upper) among the high risk aerosol generating procedures (AGPs). In addition, live virus has been found in patient stools. On top of this, the infected health professionals may transmit the infection to their patients. Health care infection prevention and control (HCIPC), has been shown to be effective in assuring the safety of both health care personnel and patients. This is not limited to the correct use of personal protective equipment (PPE), but is based on a clear, detailed and well communicated HCIPC strategy, risk stratification, use of PPE, and careful interventions in patients with moderate and high risk of COVID-19. A conscientious approach regarding limited resources is important, as the simultaneous outbreak in all countries heavily affects the availability of health supplies. The Chilean Gastroenterology Society (SChGE) and Digestive Endoscopy Association of Chile (ACHED) are joining to provide continued updated guidance in order to assure the highest level of protection against COVID-19, for both patients and health care workers. This guideline will be updated online as needed.

El brote de la enfermedad denominada COVID-19, se ha extendido desde su origen en Wuhan, provincia de Hubei, China, a todo el mundo. La Organización Mundial de la Salud lo declaró pandemia en marzo de 2020. Todos los países de América, en especial Chile, presentan incremento de casos y fallecidos. Las manifestaciones clínicas de COVID-19 van desde una enfermedad leve, hasta insuficiencia respiratoria severa, shock, disfunción orgánica y muerte. Se necesita una alta sospecha clínica y una adecuada estratificación del riesgo. El equipo de salud en las unidades de endoscopia, tiene un mayor riesgo de COVID-19 que otras unidades clínicas y de apoyo diagnóstico, dada la mayor exposición a inhalación de gotas, contacto posible con mucosas y contaminación por contacto con deposiciones. Recomendaciones de diferentes sociedades colocan la endoscopia digestiva (especialmente la esofagogastroscopia o endoscopia digestiva alta, EDA) entre los procedimientos generadores de aerosoles (PGA) de alto riesgo. Además, se han encontrado virus viables en las deposiciones de los pacientes. Potencialmente, los profesionales de la salud infectados podrían contagiar a los pacientes. Se ha demostrado que la prevención y control de infecciones asociadas a la atención de salud (IAAS), son efectivos para garantizar la seguridad tanto del personal de salud, como de los pacientes. Esto no es solamente el correcto uso del equipo de protección personal (EPP), sino que se basa en una clara estrategia de IAAS, bien comunicada, con estratificación de riesgo, uso de EPP e intervenciones correctas en pacientes con riesgo moderado y alto. Es relevante un enfoque sobre los limitados recursos, dado la simultaneidad del brote en todos los países, que afecta la disponibilidad de insumos. La Sociedad Chilena de Gastroenterología (SChGE) y la Asociación Chilena de Endoscopia Digestiva (ACHED) publican esta guía actualizada para apoyar las buenas prácticas contra COVID-19, tanto para pacientes como para el equipo de salud. Esta guía podrá tener actualizaciones según avance la información disponible.

Aspectos relevantes en la realización de la endoscopia digestiva: propuestas basadas en la evidencia. Curso ACHED 2013 / Relevant aspects of digestive endoscopy. Evidence-based suggestions. Chilean Association of Digestive Endoscopy (ACHED), Course 2013

Digestive endoscopy is a complex tool for diagnosis and treatment, with continuous development both in technical aspects and in their application for the different pathologies where this technique is required. Therefore, a continuous education program is necessary for the practitioner using this technique. With the purpose of reaching an agreement between different aspects of the performance of these procedures and also generating proposals for its application that are useful for the physicians of this area of expertise, during 2013 the Chilean Association of Digestive Endoscopy (ACHED) developed a workshop called ‘Relevant aspects of digestive endoscopy. Evidence-based suggestions’. This workshop was attended by gastroenterologists and trainee practitioners, who worked in groups during a period of two months where they reviewed available evidence to answer several questions relating to milestones and lesions that need to be described in upper gastrointestinal endoscopy, the preparation of the GI endoscopy report, technical aspects and quality measures in colonoscopy. This review resulted in proposals that were analyzed and agreed on in the form of recommendations presented for further analysis and discussion amongst endoscopic teams in our country.

La endoscopia digestiva es una herramienta de diagnóstico y tratamiento médico compleja, en continuo desarrollo tanto en lo técnico como en los conceptos de manejo de las patologías en las que se utiliza.Por lo tanto, es deseable una estrategia de formación continua del profesional que la realiza. Con el objetivode consensuar diferentes aspectos en la realización de estos procedimientos y generar propuestas de manejoque sean de utilidad para todos los médicos involucrados en esta especialidad, la Asociación Chilenade Endoscopia Digestiva (ACHED) realizó durante el año 2013 un curso taller denominado “Aspectosrelevantes en la realización de la endoscopia digestiva. Propuestas basadas en la evidencia”. Este cursoconvocó a gastroenterólogos y médicos en formación de la especialidad que conformaron grupos de trabajoque durante 2 meses revisaron la evidencia disponible para responder diversas preguntas en relación a los hitos y lesiones a describir en endoscopia digestiva alta (EDA), la realización del informe en EDA, aspectos técnicos y medidores de calidad en colonoscopia. La revisión les permitió generar propuestas que fuerondiscutidas y consensuadas en recomendaciones que se proponen para su discusión por los equipos endoscópicos de nuestro país.

Colitis ulcerosa corticorrefractaria en puerperio: reporte de un caso clínico / Corticorefractary ulcerative colitis in a puerperal woman: clinical report

For patients with bloody diarrhea, one of the possible diagnoses is ulcerative colitis. The case under analysis corresponds to a puerperal 19 year old woman, without any known medical record, presenting a fulminant pancolitis 40 days after delivery. The patient was admitted in the emergency room of “Hospital Militar” of Santiago, as a consequence of an important bloody diarrhea. She had hypotension, tachycardia and anemia, without fever so she was admitted into the Critical Care Unit. Abdominal CT showed that the colon was entirely dilated. Furthermore, the complete colonoscopy revealed pancolitis and pseudopolyps. There was no clinic improvement with the use of antibiotics, systemic steroids, oral 5-ASA, 5-ASA enemas and steroid enemas. The patient remained with bloody diarrhea; hence, infliximab treatment was started. She presented a satisfactory evolution, reducing the number of bowel movements and bleeding episodes. The biopsy confirmed ulcerative colitis. Treatment options for severe colitis that do not respond to steroids after 72 hours are: ciclosporin, anti-tumor necrosis factor therapy (infliximab) and surgery (colectomy). Anti-TNF, specifically infliximab, has shown response in 70 percent of fulminant colitis. For this purposes, the use of infliximab resulted in positive evolution with resolution of symptoms.

La colitis ulcerosa (CU) constituye parte del diagnóstico diferencial de diarrea con sangre. A continuaciónse presenta un caso de CU fulminante en una mujer de 19 años, puérpera de 40 días, sin antecedentes mórbidos conocidos. Inició diarrea con sangre porlo que consultó en el Hospital Militar de Santiago. Al momento de consultar se encontraba con hipotensión, taquicardia, anemia y sin fiebre por lo que ingresó a la Unidad de Paciente Crítico. En la Tomografía Computada de abdomen se informa dilatación pancolónica. En la colonoscopía se informa como pancolitis con presencia de pseudopólipos. Se inició terapiacon antibióticos, corticoides sistémicos, salicilatos (5 ASA) oral y en enemas, y esteroides en enemas; sin respuesta clínica, por lo que se decide iniciarinfliximab. Evolucionó con progresiva disminución de diarrea. Finalmente la biopsia fue compatible con colitis ulcerosa. Las alternativas terapéuticas frente a colitis grave que no responde a esteroides en 72 h son: ciclosporina, terapia con anticuerpos monoclonales(infliximab) y cirugía (colectomía). Específicamente, los anticuerpos contra factor de necrosis tumoral (anti-TNF) han mostrado una respuesta clínica de 70 por ciento de las colitis fulminantes. En este caso, el uso de infliximabpermitió una adecuada evolución con resolución de los síntomas.

Seguimiento de pólipos de colon / Surveillance of colorectal polyps

The colorectal cancer (CRC) is the second cause of death by digestive tumors. Colonic polyps can benon-neoplastic and neoplastic, where the adenomatous are premalignant lesions given their potential adenoma-carcinoma sequence and associated genetic factors that favor their occurrence. Most polyps are casual findings in: a colonoscopy performed due to nonspecific symptoms or signs, without a clear association with the presence of the polyps; as result of CRC screening programs; patients with positive fecal occult bleeding tests; individuals belonging to CRC risk groups such as inflammatory bowel disease or a family history of intestinal polyposis syndrome. For these reasons consensus guides and protocols have been developed for the follow-up of these injuries, being colonoscopy under quality parameters the recommended procedure, where polypectomy of the polyps encountered must be performed. This allows for histopathological study and depending on the results, the patients are referred to a monitoring program with variable periods of time, according to size, number, tubular or hairy adenoma (histological findings), degree of dysplasia or the existence or not of in situ or invasive carcinoma.

El cáncer colorrectal (CCR) es la segunda causa de muerte por tumores digestivos. Los pólipos colónicos pueden ser no neoplásicos y neoplásicos, donde los adenomatosos son lesiones premalignas, dada su potencial secuencia adenoma carcinoma y los factores genéticos asociados que lo favorecen. La mayoría de los pólipos son hallazgos casuales en: una colonos-copia efectuada por síntomas o signos inespecíficos sin relación clara con la presencia de los mismos; como resultado de programas de tamizaje (cribado o screening) para CCR; pacientes estudiados por test de hemorragias ocultas fecales positivas; individuos pertenecientes a grupos de riesgo para CCR como son las enfermedades inflamatorias intestinales; o por antecedentes familiares de síndromes de poliposis intestinal. Por tales motivos se han consensuado guías y protocolos de seguimiento de estas lesiones, siendo la colonoscopia bajo parámetros de calidad el procedimiento recomendado, donde siempre debe efectuarse la polipectomía del o los pólipos encontrados. Esto permite su estudio histopatológico y de acuerdo al resultado se integraran los pacientes a un programa de vigilancia con rangos o intervalos de tiempo variables, según tamaño, número, histología tubular o vellosa, grado de displasia o la existencia o no de carcinoma in situ o invasor.

Carcinoma verrucoso oral: reporte de un caso clínico y revisión de 20 casos del Instituto de Referencia en Patología Oral (IREPO), Chile / Oral verrucous carcinoma: a case report and review of 20 cases of the Oral Pathology Referral Institute (IREPO), Chile

El carcinoma verrucoso (CV) es una variante rara del carcinoma de células escamosas con características morfológicas y comportamiento específico. El presente estudio relata el caso de una paciente de género femenino, de 68 años de edad, que presenta un carcinoma verrucoso en lengua, indoloro y con 8 meses de evolución. Además, se realizó una breve revisión de casos clínicos del Instituto de Referencia en Patología Oral (IREPO) de la Facultad de Odontología de la Universidad de Chile, diagnosticados entre enero de 1984 y octubre de 2010, encontrándose 20 casos, con un promedio de edad de 70 años, localizados con mayor frecuencia en encía inferior y lengua.

Verrucous carcinoma (VC), a rare variant of squamous cell carcinoma is an established entity with distinctive morphology and specific clinical behavior. The present study describe a case report of a 68-year-old women who presented a tongue verrucous carcinoma, asymptomatic, that had about 8 months of evolution. A brief review of VC cases diagnosed in Oral Pathology Referral Institute (IREPO), Faculty of Odontology, University of Chile, between 1984 and 2010. It was found 20 cases of verrucous carcinoma with a median age of70-years-old, the most common places were lower gingiva and tongue.

Evaluación de la clasificación de Rockall como predictor de mortalidad en pacientes con hemorragia digestiva alta de origen no variceal / Assessment of Rockall score as a mortality predictor in patients with non-variceal upper gastrointestinal bleeding

Introduction: Upper gastrointestinal bleeding (UGIB), a high morbi-mortality disease, is a medical emergency with high incidence among the population. It also represents a significant health expense and its mortality rate is 4-12 percent. There are different systems to classify the risk for these patients; one of them is the Rockall Score. This system has been previously validated as mortality predictor. Objective: To evaluate the use in our environment of the Rockall Score as a mortality predictor, the need for surgery and hemoderivative requirements. Materials and Methods: Retrospective study in adult patients subjected to emergency upper digestive endoscopy due to potential non-variceal UGIB at Hospital Militar de Santiago. Many clinical and endoscopic variables were analyzed. Validation of Rockall Score was carried out by ROC curve analysis. Results: Ninety-one patients were studied: 2/3 male; 70 percent > 60 years; 68 percent with a related disease. The most frequent endoscopic diagnosis was stomach and duodenal lesions. Mortality rate of 8.8 percent. Rockall Score indicated an acceptable discrimination ratio as a predictor of mortality, need for surgery and red blood cell transfusion. The best sensitivity and specificity correlation score was >_ 5 to determine the high-risk group. Conclusion: Rockall Score proved to be a good mortality predictor in patients with non-variceal UGIB in our environment. The identification of high-risk UGIB patients will allow for an appropiate therapeutic approach.

Introducción: Hemorragia digestiva alta (HDA), patología de alta morbimortalidad, es una emergencia médica, presenta alta incidencia poblacional y demanda alto gasto en salud. Presenta una mortalidad entre 4-12 por ciento. Existen diferentes sistemas de clasificación de riesgo para estos pacientes, uno de los cuales es la clasificación de Rockall. Este sistema ha sido previamente validado como predictor de mortalidad. Objetivo: Evaluar en nuestro medio el uso de la clasificación de Rockall, para predecir mortalidad, necesidad de cirugía y requerimientos de hemoderivados. Materiales y Métodos: Estudio restrospectivo en pacientes adultos sometidos a endoscopia digestiva alta de urgencia por sospecha de HDA no variceal en el Hospital Militar de Santiago. Se analizaron diversas variables clínicas y endoscópicas. La validación de la clasificación de Rockall se realizó con el análisis de curva ROC. Resultados: Se estudiaron 91 pacientes: 2/3 de sexo masculino; 70 por ciento > 60 años; 68 por ciento presentaban alguna enfermedad asociada. El diagnóstico endoscópico mas frecuente fue lesiones en estómago y duodeno. Tasa de mortalidad de 8,8 por ciento. La clasificación de Rockall mostró un aceptable nivel de discriminación como predictor de mortalidad, requerimiento de cirugía y tranfusión de glóbulos rojos. El puntaje de mejor correlación de sensibilidad y especificidad fue > 5 para definir el grupo de alto riesgo. Conclusión: La clasificación de Rockall resultó ser un buen predictor de mortalidad en pacientes con HDA no variceal en nuestro medio. Identificar pacientes con HDA de alto riesgo, permitiría un adecuado enfrentamiento terapéutico.

Hematoma esofágico espontáneo: caso clínico / Spontaneous esophageal hematoma: case report

Hematoma of the esophagus is a rare condition. We report the case of an 86 year old man, treated with aspirin. He was admitted by hematemesis, hemodynamically stable. Upper digestive tract endoscopy revealed a big esophageal hematoma: Contrast enhanced computed tomography of the chest confirmed the diagnosis. Clinical outcome was good without complications, with conservative medical management.

El hematoma esofágico es una condición poco frecuente. Presentamos el caso de un hombre de 86 años, en tratamiento con aspirina, que ingresa por cuadro hematemesis, con hemodinamia estable. Se realiza endoscopia digestiva alta que revela gran hematoma esofágico; tomografía computada de tórax con contraste confirma el diagnóstico. La evolución clínica fue satisfactoria sin complicaciones, con manejo médico conservador.

Histological and functional organization in human testicle: expression of receptors c-kit and androgens / Organización histológica y funcional en el testículo humano: expresión de los receptores c-kit y andrógenos

The objective of this work was identify the presence of interstitial cells of Cajal, muscle cells, nerves and androgen receptor positive cells in adult human testicle, using immunohistochemical detection for c-kit/CD-117, actin smooth muscle specific (ASMS), neurofilament (N) and androgen receptor (AR), respectively. The samples were obtained from patients (n= 10) with diagnosis of prostate cancer, with surgery of orchiectomy. Subsequently were processed by histology and for immunohistochemistry using specific antibodies. It showed the presence of cells c-kit/CD-117, with diverse degrees of positivity, distributed mainly in the interstitial peritubular area of the human testicle. The peritubular myoides cells were positive to the presence of the actin smooth muscle and androgen receptor. The neurofilaments elements (+) only were observed in the vascular tunic. The specific immunohistochemistry describe the presence of the interstitial cells of Cajal in human testicular interstitium, opening a new perspective for the functional interpretation of the testicular cellularity and tubular motility. Possibly associated functionally to peribubulars cells of smooth muscle to regulate the mobility of the seminiferous tabules, whose integration and function would be androgen dependent. The cells that express the c-kit receptor, were found exclusively in the interstitial compartment. This cellular type in addition of the muscular cells of peritubules and the absence of nervous fibers to the interior of the testicle, could be responsible for the regulation of tubular mobility, as it happens in the gastrointestinal apparatus.

El objetivo de este trabajo fue identificar la presencia de células interticiales de Cajal, células musculares lisas, células nerviosas y células que expresan receptores de andrógeno en el testículo de humano adulto, usando inmunohistoquímica específica para: c-kit/CD-117, músculo liso actina específico (ASMS), neurofilamentos (N) y para receptores de andrógenos (AR). Las muestras fueron obtenidas de pacientes (n=10) con diagnóstico de cáncer prostático sometidos a cirugía de orquiectomía. Las biopsias se procesaron para histología e inmunohistoquímica usando anticuerpos específicos. Se muestra la presencia de células c-kit/CD-117, con diversos grados de positividad y distribuidas en el compartimento interticial del testículo. Las células peritubulares mioides fueron positivas para la presencia de músculo liso actina específico y para receptor de andrógenos. La marcación de neurofilamentos positivos, sólo fueron observados en la túnica vascular. Conclusiones: La inmunohistoquímica específica describe la presencia de células interticiales de Cajal en los interticios testiculares humanos, abriendo una nueva visión en la interpretación funcional de la celularidad testicular y la motilidad tubular. Lo anterior asociado a la funcionalidad de las células peritubulares (músculo liso) regularían la motilidad de los túbulos seminíferos. Este proceso posiblemente es andrógeno dependiente. Las células que expresan receptores c-kit se encuentran exclusivamente en los compartimentos interticiales, estas células en conjunto con las células musculares peritubulares agregado a la ausencia de fibras nerviosas al interior del testículo, podrían ser los responsables de la regulación de la motilidad tubular, similar a como se informa para el tracto gastrointestinal.

Patrón de metilación génico en el cáncer de mama / Promoter methylation profile in breast cancer

BACKGROUND: Genomic DNA methylation, mutations and allelic deletions explain the inactivation of genes involved in cell proliferation and cell cycle control mechanisms. AIM: To analyze the methylation pattern of important genes related to different carcinogenic mechanisms in patients with breast cancer and the relationship with its biological behavior. MATERIAL AND METHODS: Seventy fresh-frozen breast cancer samples were selected. The methylation specific PCR (MSP) test was used to analyze promoter methylation status for genes CDKN2A (p16), hMLH1, APC, CDH1 (Cadherin E) and FHIT. RESULTS: We found methylation in at least one of the genes studied in 88% of cases and in 3 or more genes in 40.5% of cases. The frequencies of promoter hypermethylation of CDKN2A, hMLH1, APC, CDH1 and FHT were 41.4%, 11.4%, 52.9%, 70% and 42.9%, respectively. We found a relationship between CDKN2A methylatlon and better survival (p=0.002). CDH1 methylation and poor histological differentiation (p=0.007), hMLH1 methylation and non-Mapuche ethnicity (p=-0.03), APC methylation and larger tumor size (p<0.05), FHIT methylatton and lack of estrogen rectptor IHC expression (p<0.05). CONCLUSIONS: The high frequency of promoter methylation in patients with breast cancer confirms its role in breast carcinogenesis. The finding of alterations in the methylation pattern of genes studied and its association with prognostic factors is a helpful tool in the search of new criteria for clinical and therapeutic decision making.

Fenotipos bioquímicos y fagotipos de cepas de Salmonella enteritidis aisladas en Antofagasta, 1997-2000 / Biochemical phenotypes and phage types of Salmonella enteriditis strains isolated in Antofagasta during the period 1997-2000

BACKGROUND: PhP-S48 (Phene Plate Techniques AB), a method based on biochemical phenotypes has been developed and used successfully to typify S enteritidis strains in epidemiological studies. AIM: To identify phenotypes of S enteritidis isolated from eggs, chicken meat and infected humans in Antofagasta during the period 1997-2000. MATERIAL AND METHODS: PhP-S48 and phage typing were used to identify phenotypes of 33 S enteritidis strains, sixteen isolated from poultry and 17 from clinical sources. S enteritidis ATCC17036 was used as control strain. RESULTS: Twelve biochemical phenotypes (BTs) including 4 common (C) and 8 single (S) were identified. BTs C1 y C3 containing 16 and 5 strains, respectively, accounted for 63.6 per cent of the isolates. BT C1 was found in poultry and human sources in the period 1997-2000, and BT C3 was isolated from humans, in the period 1999-2000. Using phage typing, 5 phage types (PT) and 3 strains could be not typed (NTs). PT1 and PT21 were the dominant phage types, with 14 and 13 strains respectively. Strains of PT1 were isolated from poultry and human sources in the period 1997-2000. PT21 was found in poultry samples in the period 1997-1998 and in clinical samples, in the period 1997-1998. Combination of biochemical phenotypes and phage typing divided the strains into 5 phenotypes (BT:PT). Two phenotypes were the most frequently isolated, phenotype C1:1 with 8 isolates found in eggs and humans in 1999, and phenotype C1:21 with 5 strains isolated in 1997-1999. CONCLUSIONS: These results indicate the presence of one persistent and one recently emerged phenotype among S enteritidis in Antofagasta, Chile. PhP-S48 also provided information about a relationship among the strains.

Desmina en túbulos seminíferos seniles humanos / Desmin intermediate filaments types in aging human testicle

El envejecimiento lleva implícito un deterioro generalizado, que se expresa de distinta manera en cada órgano o tejido corporal, afectando algunas funciones en forma progresiva, como es la disminución de la eficacia sexual. En la organización celular, los filamentos intermedios son elementos claves en la regulación de la forma y función. específicamente, a nivel testicular la organización histofisiológica del compartimento peritubular es clave para el desarrollo de una espermatogénesis normal, donde se describe a la desmina como uno de los principales filamentos intermedios. Muestra de tejido testicular de individuos seniles mayores de 70 años (3) y con diagnóstico de cáncer prostático, fueron fijadas durante 12 horas en formol tamponado al 10 por ciento e incluidas en parafina, procesadas por técnicas histológicas para H-E e imnunohistoquímica con anticuerpos antidesmina, las que fueron reveladas con complejo avidina-biotina. La microscopía permitió la identificación diferencial y cuantificación de las células negativas y positivas, expresándose los valores en porcentajes (por ciento). Las células mioides mostraron reactividad entre 10 a 15 por ciento para Desmina, con un 81 por ciento concentrada en la lámina celular interna (células de mayor carácter muscular) y un 19 po ciento en la periferia (células de mayor carácter conectivo, tipo fibroblastos). Por lo tanto, las células del compartimento peritubular, revelan su carácter mesenquimático, presentando características propias de células musculares, pero que también pudieran diferenciarse hacia células conectivas tipo fibroblastos.

Carcinoma subseroso de la vesícula biliar: expresión del complejo caderina-catenina / Subserous gallbladder carcinoma: expression of cadherine-catenine complex

BACKGROUND: Subserous gallbladder carcinoma is difficult to diagnose and treat. There are no tissue markers with prognostic value in this type of tumor. AIM: To study the immunohistochemical expression of E-cadherin alpha and beta catenin in subserous gallbladder carcinoma. PATIENTS AND METHODS: One hundred seventeen subjects (103 women and 14 men aged 62 and 69 years as a mean, respectively), were studied. Thirty five gallbladder samples without evidence of cancer were used as controls. Expression of markers was studied with standard immunohistochemical techniques for formalin fixed and paraffin embedded tissue. RESULTS: Ninety seven percent of tumors were adenocarcinoma. A lower or absent expression of E-cadherin, alpha catenin and beta catenin was observed in 26, 33 and 29 per cent, respectively. Actuarial five years survival was 37 per cent. No association between macroscopic features of the tumor and survival was observed. Well differentiated tumors had a 73 per cent survival, whereas less differentiated tumors had a 30 per cent survival. Tumors with a normal expression of the markers had a slightly better survival, although not significant (p = 0.06). CONCLUSIONS: Approximately 30 per cent of subserous gallbladder carcinoma have an abnormal expression of E-cadherin, alpha catenin and beta catenin. This abnormal expression has no relationship with prognosis and is probably secondary to the aberrant genic expression of the tumor.

Aplicación del anticuerpo c-kit (CD 117) para diferenciación inmunohistoquímica en tumores estromales gastrointestinales / C-kit (CD 117) antibody application for immunohistochemistry differentiation in gastrointestinal stromal tumours

La interpretación diagnóstica de las lesiones del estroma gastrointestinal, basada en los significativos avances de la inmunohistoquímica, parece indicar que estos tumores previamente considerados como leiomiomas o leiomiosarcomas, tienen un origen y expresión distinta que contrasta con los caracteres histopatológicos de estos. La incorporación del anticuerpo c-kit (CD-117) permitiría efectuar esa diferenciación y darles la designación de tumores estromales gastrointestinales (GIST). En el presente estudio se analizaron 5 casos de tumores gástricos y 3 de origen muscular de otras ubicaciones anatómicas, previamente diagnosticados, a los cuales se aplicaron anticuerpos primarios para Desmina, CD34, ENE y c-kit. Las muestras fueron posteriormente reveladas con complejo avidina-biotina y se evaluaron según su reacción a la inmunotinción como positivas o negativas. Los resultados obtenidos se expresan cualitativamente de acuerdo a la marcación e intensidad de la reacción con los distintos anticuerpos, observándose una manifiesta diferenciación entre los tumores que son de origen gástrico con aquellos provenientes de músculo liso. En consecuencia, la aplicación del anticuerpo c-kit(CD117) en procedimientos inmunohistoquímicos de rutina, es útil y recomendable para definir un diagnóstico diferencial