Direct PCR of lesions suggestive of sporotrichosis in felines / [PCR direta de lesões sugestivas de esporotricose em gatos]

A esporotricose é uma doença emergente e a incidência de esporotricose zoonótica tem aumentado, principalmente no Brasil; a maioria dos casos está relacionada à transmissão de gatos infectados. O diagnóstico definitivo da esporotricose felina é feito por cultura fúngica; no entanto, aguardar o longo período de cultura pode atrasar o início do tratamento. O objetivo deste estudo foi detectar e determinar as espécies de Sporothrix por PCR realizado diretamente das lesões de gatos, provenientes de área endêmica, nos quais a esporotricose fazia parte do diagnóstico diferencial. Um total de 87,1% dos casos foi positivo por PCR ou cultura fúngica para Sporothrix; 81,4% foram confirmados como S. brasiliensis por PCR, 71,4% por isolamento e 65,7% pelos dois métodos. Em conclusão, a análise direta por PCR de lesões sugestivas de esporotricose em gatos é um bom método para confirmar a infecção e determinar as espécies de Sporothrix, garantindo um diagnóstico rápido; esse método tem uma boa concordância com o isolamento fúngico.(AU)

Evaluación de la eficacia de dos prescripciones de cepillos dentales en la remoción de placa bacteriana en pacientes ortodóncicos / Evaluation of two toothbrushes prescriptions on the removal of plaque in patients with fixed orthodontic appliances

La aparatología empleada en los tratamientos de ortodoncia, favorece la retención de placa bacteriana y dificulta su eliminación por parte del paciente, aumentando el riesgo de desarrollar caries, manchas blancas y enfermedad periodontal. Diferentes cepillos dentales se han desarrollado para facilitar la mantención de una adecuada higiene oral en estos pacientes, sin embargo, se ha observado que los cepillos comunmente indicados (cepillo ortodóncico mas cepillo unipenacho), no siempre son bien manejados y difícilmente se usan ambos. El cepillo Cross Action Pro-Salud®, se ha presentado como una alternativa simple de usar y de transportar, por ser un único cepillo que combina las caracteristicas de los dos cepillos comunmente recomendados. Para evaluar la efectividad de este cepillo, en comparación con la prescripción convencional, se evaluaron 2 grupos, de 23 pacientes cada uno, portadores de aparatología fija. Un grupo utilizó la prescripción habitual y un segundo grupo utilizó cepillo Cross Action Pro-Salud®, por un período de 45 días. Los indices de higiene de O`leary, de placa en brackets y gingival modificado fueron registrados al inicio y 45 días después del uso diario de los cepillos antes mencionados. Se utilizó test-t para comparar los resultados obtenidos y se determinó que se produjo una disminución significativa en los tres indices de higiene, no existiendo diferencias en los resultados obtenidos entre ambas prescripciones. El cepillo Oral-B Cross-Action Pro-Salud® es una alternativa recomendable, ya que permite eliminar efectivamente la placa bacteriana en pacientes ortodónticos, y al ser un único cepillo, facilita y acorta el tiempo de cepillado.

Orthodontic fixed appliances include elements that allow the accumulation of bacterial plaque, making tooth brushing more difficult and increasing the risk of developing caries, white spot lesions, and periodontal disease. Several toothbrushes designs have been developed to facilitate oral hygiene in orthodontic patients; however, it has been observed that most patients do not take enough time to brush using adequately both commonly prescribed toothbrushes (Oral-B End-Tufted® and Oral-B Orthodontic® brushes). Oral B Cross Action Pro-Health® has been presented as an alternative, easier to use and to transport. To assess the effectiveness of Cross Action Pro-Health® versus commonly prescribed toothbrushes, two randomly assigned groups of 23 orthodontic patients each, were evaluated. One group of patients used commonly prescribed toothbrushes and the second group used Cross Action Pro-Health®. O`Leary, modified gingival and Bracket plaque index were measured before and 45 days after the daily use of the two mentioned toothbrushes prescriptions. T-test was used to detect statistically significant differences among the brushes for each index. The results demonstrated a significant reduction of the three indexes with the daily use of Cross Action Pro-Health® and no differences were found versus commonly used prescription. Orthodontic patients may benefit from the use of a single brush prescription (Cross Action Pro-Health®), because effective plaque removal can be achieved easier and faster.

Genotipificación y resistencia antibacteriana de cepas de Campylobacter spp aisladas en niños y en aves de corral / Genotyping and antibacterial resistance of Campylobacter spp strains isolated in children and in free range poultry

Poultry is a main reservoir and source of human infection in campylobacteriosis. Three hundred and forty one stool samples (291 human, 50 avian) were analyzed. In the human group, 220 samples were collected from children with acute diarrheal disease (183 inpatients, 37 outpatients) and 71 from healthy children. Erythromycin and ciprofloxacin agar dilution MIC tests, Penner serotyping and RAPD-PCR genotyping were performed on 23 strains isolated. C. jejuni was reported only in patients with acute diarrhea (5.4 percent inpatients, 2.2 percent outpatients). Campylobacter prevalence in poultry was 34 percent. Cross-resistance to nalidixic acid and ciprofloxacin was found in 33.3 percent of human samples and 11.8 percent of animal samples. Human samples could not be typed using the Penner method. F serotype was the most expressed in poultry. We obtained a total of 14 genotypes (4 / 5 human and 10/15 avian). In conclusion, the predominant species in poultry and humans was C. jejuni, a significant amount of quinolone-resistant human and avian samples were obtained, and avian genotypes and serotypes were not found in human samples. The latter would mean that another source of infection could exist; therefore other reservoirs must be studied.

Las aves de consumo constituyen uno de los principales reservorios y fuente de infección humana de la campilo-bacteriosis. Se analizaron 341 muestras de deposiciones, 291 humanas y 50 aviares. De las muestras, 220 de niños con síndrome diarreico agudo-SDA (183 hospitalizados y 37 consultantes ambulatorios) y 71 niños sanos. A las 23 cepas obtenidas se les realizó CIM por dilución en agar a eritromicina y ciprofloxacina, serotipificación de Penner y genotipiicación por RAPD-PCR. Se encontró Campylobacterjejuni sólo en pacientes con SDA, de ellos 5,4 por ciento ambulatorios y 2,2 por ciento hospitalizados. En aves, la prevalencia de Campylobacter spp., fue de 34 por ciento. Hubo resistencia cruzada a ácido nalidixico y ciprofloxacina en 33,3 por ciento cepas de origen humano y 11,8 por ciento animal. Las cepas humanas fueron no tipiicables por el método de Penner. Predominó entre las aves el serotipo F. Se obtuvo un total de 14 genotipos (4/5 humanos y 10/15 aviares). En conclusión, la especie predominante en aves de corral y en humanos fue C. jejuni, existiendo una alta prevalencia de cepas de origen humano y aviar resistentes a quinolonas. Los genotipos y serotipos aviares no fueron encontrados en cepas de origen humano, lo que indica que podría existir otra fuente de infección, por lo que se requiere estudiar otros reservorios.

Detección y tipificación de virus papiloma humano en adenocarcinoma de cuello uterino mediante reverse line blot, Región de La Araucanía, Chile / Detection and genotyping of human papillomavirus in biopsies of uterine cervical adenocarcinoma

Background: The genotyping of Human Papillomavirus (HPV) will improve knowledge about the local epidemiological association of this virus with adenocarcinoma. Aim: To determine the frequency of HPV genotypes in biopsies of women with uterine cervical adenocarcinoma in a geographic region of Chile. Materials and Methods: Forty-one cervical biopsies with a pathological diagnosis of adenocarcinoma, corresponding to all women diagnosed with this cancer between 2002 and 2004, were analyzed. Viral gene Ll was amplified by PCRfor viral detection. HPV genotyping was carried out by a Reverse Line Blot technique. Results: Seventy one percent of biopsies were positive for HPV. The most common genotypes found were HPV 16 (61 percent), followed by HPV 18 (19.5 percent). Eighty seven percent of biopsies had a single HPV infection. Three patients had a multiple HPV infection. All of the latter were infected by HPV 16, associated with other three viral genotypes (45, 52 and 66). No low-risk HPV genotypes were found. Conclusions: In this sample of biopsies, there was a high prevelence of HPV 16 and a low prevalence of HPV 18, which historically has been related to adenocarcinoma. The genotypes found correspond to those described in South America.

Genotipificación de aislados clínicos de Helicobacter pylori en base a genes asociados a virulencia cagA, vacA y babA2: Primer aislamiento de una cepa babA2 positiva en pacientes chilenos / Genotypying of clinical isolates of Helicobacter pylori by cagA, vacA and babA2 virulence associated genes: First detection of a babA2 positive strain in Chilean patients

Background: Helicobacter pylori-associated gastroduodenal diseases depends on host characteristics, environmental conditions and bacterial virulence factors, such as cagA, vacA y babA2 gene products. Moreover, peptic ulcer disease has been related with cagA+, vacAs1m1 strains, while metaplasia and gastric cancer has been associated to cagA+, vacAs1 and babA2+ H pylori strains. Gene babA2 has not yet been described in clinical isolates from Chilean patients. Aim: To investigate the presence of cagA, vacA (s and m) and babA2 genes in clinical isolates of H pylori from Chilean patients. Material and Methods: Sixty six isolates from 41 patients were genotyped by PCR, using primers for s1a, s1b, s2, m1, m2, cagA and babA2 genes as previously described. Results: cagA gene was detected in 16 isolates (24.2 percent) while vacAs1a, vacAs1b, vacAs2, vacAm1 and vacAm2 were detected in 28 (42.4 percent), 14 (21.2 percent), 17 (25.8 percent), 21 (31.8 percent) and 29 isolates (43.9 percent), respectively. One isolate (1.5 percent) was babA2 positive, being the first isolate with this genotype described in Chile. Besides the babA2+ genotype this clinical isolate also presented cagA+ and vacAs1a which has been related with metaplasia or gastric cancer. Five isolates showed an ulcerogenic profile cagA+, vacAs1m1. Conclusions: The results presented indicate the prevalence of vacAs1m1 genotype among the clinical isolates analyzed, and a low frequency of babA2 genotype.

Estudio comparativo de detección del virus papiloma humano (VPH) en muestras citológicas y biopsias de cuello uterino / Detection of human papilloma virus in cytologic samples or biopsies of the cervix

Background: The DNA quality for the detection and typification of Human Papilloma Virus (HPV) varies according to the type of sample in which it is studied. This may affect the sensitivity and specificity of the method employed. Aim: To study the yield and specificity of HPV detection and typification in uterine cervical samples obtained by cervical brushing fresh frozen and formalin fixed tissue. Material and methods: Cytological, fresh frozen and fixed tissue samples from 44 patients (nine with low grade lesions and 35 with high grade lesions) were studied. Nested polymerase chain reaction for genes E6/E7 was used to typify HPV groups as low risk or high risk. Results: Of all the cytological samples obtained by brushing 84% of fixed samples and 43% of fresh frozen samples were positive for HPV. The yields were significantly different when comparing brushing with fixed tissue or fresh frozen tissue and fixed tissue with fresh frozen tissue (p <0.05). The frequency of high risk HPV fluctuated from 41% in fresh frozen tissue to 98% in cytological samples. Low risk HPV was detected in 16% of fresh frozen tissue and 68% of cytological samples. A mixed infection was detected in 66%, 41% and 14% of cytological, fresh frozen and fixed tissue samples respectively. Conclusions: Cytological samples obtained by brushing had the highest yield for the detection of cervical infection with HPV.

Tipificación del virus papiloma humano (VPH) en lesiones preneoplásicas y carcinoma del cuello uterino en mujeres de la IX Región-Chile / Human papilloma virus (HPV) typing in preneoplastic and neoplastic lesions of the uterine cervix in the IX region-Chile

Background: Uterine cervical cancer (UCC) is an important public health problem in Chile. Although HPV infection has been established as the main cause of UCC, little is known of its frequency and distribution in our population. Aim: To determine the presence and frequency of viral genotypes in uterine cervical specimens with preneoplastic and neoplastic lesions. Material and Methods: Two nested consensus PCRs followed by identification of amplified product by dot-blot hybridization and restriction fragment length polymorphism (RFLP) were used to analyze 175 biopsies. Results: Detection of HPV was 40% in cases without histological lesion, 88% in low grade lesions, 89% in high grade lesions (HGL) and 93.5% in invasive carcinoma. Of all HPV positive cases, 89.5% were classified as high risk and only a 4.9% of HPV cases were of low risk type. Six percent of cases had multiple infections. Distribution of viral genotypes according to RFLP was: HPV33 (25.3%), 16 (18.7%), 52 (13.3%), 31 (12%), 35 (6.6%), 18 (2.7%). Conclusions: Most HPV found in biopsies with HGL and UCC were of high risk genotype. The elevated presence of high risk HPV in patients without cervical lesions may be a factor that explains the high percentage of UCC cases in our region. Most common viral types were: HPV16, 31, 33 and 52. Viral detection and typing may provide valuable information for patient selection and follow up and for allocation of resources (Rev Méd Chile 2003; 131: 1382-90).

Prevalencia de desórdenes psiquiátricos en población de 5 a 15 años que ingresa al servicio de cirugía del Hospital Roberto del Río / Prevalence of psychiatric disorders in population of 5 to 15 years of age admitted at the surgery service of the Roberto del Río Hospital

Se describen los resultados de una investigación llevada a cabo en el servicio de cirugía del Hospital Roberto del Río, con el objeto de determinar la presencia de sintomatología psiquiátrica en pacientes quirúrgicos que nunca habían sido derivados a atención de Salud Mental. Para la detección de casos potenciales se utilizó un encuesta que fue respondida por los adultos acompañantes de los ñiños hospitalizados, y los seleccionados a través de ésta fueron sometidos a evaluación psiquiátrica. Se encuestó a un total de 181 niños, 106 varones y 75 niñas, con edades comprendidas entre los 5 y 16 años, ingresados a cirugía en el período de un mes. Se estudiaron diversas variables, tales como edad, nivel socioeconómico y estado civil de los padres, procedencia rural-urbana, número de escolaridad de los pacientes, tipo de sintomatología pesquisada, duración de los síntomas previo a la detección de éstos, dinámica familiar, etc. En base a la evaluación psicosocial delos niños se obtuvo un aprevalencia de trastornos psiquiátricos de 38.7 por ciento en el grupo estudiado. La duración de la sintomatología en el 62.7 por ciento de estos niños, había sido pesquisada a nivel de la atención primaria y/o secundaria de salud

Actividad de la glucosa-6-fosfato deshidrogenasa en pacientes diabéticos tratados con pirofosfato de tiamina o cocarboxilasa / Activity of clucose-6-phosphate dehydrogenase on diabetic patients treated with thiramine pyrophosphate or cocarboxilase

Trabajos realizados con anterioridad tanto a nivel clínico como experimental en el Instituto de Investigaciones Cientificas Hans Selye, permiten proponer que la cocarboxilasa o pirofosfato de tiamina (PPT) estable en solución, al aplicarse a pacientes con hiperglucemia, mejora la incorporación de la glucosa a los tejidos. Con base en tales hechos, un posterior estudio pretende analizar si el PPT ejerce acción alguna sobre el ciclo de las pentosas. Para demostrar esto, se estudió la conducta de la glucosa-6-fosfato deshidrogenasa (G-6-PD) en el eritrocitos humanos, toda vez que su actividad se ha encontrado disminuida en los pacientes afectados por diabetes mellitus. Para comprobarlo se seleccionaron 10 pacientes de uno y otro sexo, de 45 a 70 años de edad y con diagnóstico de diabetes tipo II. De cada uno se tomó una muestra sanguínea antes de iniciar el traqtamiento con PPT y posteriormente a los 15, 30, 60, 90 y 120 días después de obtener la primera muestra, a fin de determinar la actividad de G-6-PD, así como las de glucosa, colesterol total, HDL, LDL, triglicériados y hemoglobina glucosilada. Los resultados obtenidos demuestran que la glucemia tiende a registrar niveles normales, alcanzando una recuperación física plena en 70 por ciento de los pacientes; en 100 por ciento de ellos también se normalizaron los niveles de colesterol y de triglicéridos. La hemoglobina glucosilada disminuye considerablemente en relación con los valores registrados antes de iniciar el tratamiento. Con respecto a la actividad de la G-6-PD, los autores observaron que ésta se incrementa, en promedio, de 3 a 5 U/g de hemoglobina en los pacientes hiperglucémicos: el máximo incremento de actividad se registra entre el segundo y tercer mes de tratamiento, lo cual indica que PPT participa en: 1) la incorporación de glucosa al interior de los eritrocitos, toda vez que dicha sustancia disminuye la glucosa sérica: 2) la utilización de la glucosa en el metabolismo de esta célilas, y 3) el ciclo de las pentosas, dado que la actividad de la G-6-PD aumenta en forma considerable.