Normalized difference vegetation index for desiccation evaluation with glyphosate + 2, 4-D in magnetized spray solution / Índice de vegetação por diferença normalizada para avaliação de dessecação com glyphosate + 2, 4-D em calda magnetizada

Water magnetization and geoprocessing are increasingly utilized tools in weed management. Our objective was to study the influence of water magnetization on herbicide efficiency and to verify whether there is a relationship between control scores and the normalized difference vegetation index (NDVI). In the laboratory experiment, water was subjected to magnetization and evaluated with respect to four characteristics. In the field experiment, plots of Brachiaria grass were subjected to treatments in a factorial scheme (6 × 2 + 1). Six herbicidal factors (doses of glyphosate and glyphosate + 2,4-D) and the magnetization or absence of magnetization of the spray solution were evaluated and compared against the control treatment (without spraying). Weed control assessments were carried out six times. Images were obtained using an embedded multispectral camera to determine the NDVI values. Data related to water characteristics were analyzed using the t test. Weed control and NDVI data were subjected to analysis of variance and are presented in regression graphs. Dispersion analysis of NDVI data was performed according to the control scores. The magnetization process decreased the pH of the water and increased the surface tension, but it did not influence the control scores or the NDVI. As the glyphosate dose was increased, the control scores were higher and the NDVI values were lower. Magnetized water did not affect the biological efficiency of the herbicides, and there was a strong correlation between the control scores and the NDVI values.

A magnetização da água e o geoprocessamento são ferramentas cada vez mais utilizadas no manejo de ervas daninhas. Nosso objetivo foi estudar a influência da magnetização da água na eficiência do herbicida e verificar se existe uma relação entre os escores de controle e o índice de vegetação por diferença normalizada (NDVI). No experimento de laboratório, a água foi submetida à magnetização e avaliada em relação a quatro características. No experimento de campo, parcelas de capim-braquiária foram submetidas a tratamentos em esquema fatorial (6 × 2 + 1). Seis fatores herbicidas (doses de glyphosate e glyphosate + 2,4-D) e a magnetização ou ausência de magnetização da calda foram avaliados e comparados com o tratamento controle (sem pulverização). Avaliações de controle de plantas daninhas foram realizadas seis vezes. As imagens foram obtidas usando uma câmera multiespectral incorporada para determinar os valores de NDVI. Os dados relacionados às características da água foram analisados por meio do teste t. O controle de plantas daninhas e os dados de NDVI foram submetidos à análise de variância e são apresentados em gráficos de regressão. A análise de dispersão dos dados NDVI foi realizada de acordo com os escores de controle. O processo de magnetização diminuiu o pH da água e aumentou a tensão superficial, mas não influenciou nos escores de controle ou no NDVI. Conforme a dose de glyphosate foi aumentada, os escores de controle foram maiores e os valores de NDVI foram menores. A água magnetizada não afetou a eficiência biológica dos herbicidas, e houve uma forte correlação entre os escores de controle e os valores de NDVI.

Normalized difference vegetation index for desiccation evaluation with glyphosate + 2,4-D in magnetized spray solution

Abstract Water magnetization and geoprocessing are increasingly utilized tools in weed management. Our objective was to study the influence of water magnetization on herbicide efficiency and to verify whether there is a relationship between control scores and the normalized difference vegetation index (NDVI). In the laboratory experiment, water was subjected to magnetization and evaluated with respect to four characteristics. In the field experiment, plots of Brachiaria grass were subjected to treatments in a factorial scheme (6 × 2 + 1). Six herbicidal factors (doses of glyphosate and glyphosate + 2,4-D) and the magnetization or absence of magnetization of the spray solution were evaluated and compared against the control treatment (without spraying). Weed control assessments were carried out six times. Images were obtained using an embedded multispectral camera to determine the NDVI values. Data related to water characteristics were analyzed using the t test. Weed control and NDVI data were subjected to analysis of variance and are presented in regression graphs. Dispersion analysis of NDVI data was performed according to the control scores. The magnetization process decreased the pH of the water and increased the surface tension, but it did not influence the control scores or the NDVI. As the glyphosate dose was increased, the control scores were higher and the NDVI values were lower. Magnetized water did not affect the biological efficiency of the herbicides, and there was a strong correlation between the control scores and the NDVI values.

Resumo A magnetização da água e o geoprocessamento são ferramentas cada vez mais utilizadas no manejo de ervas daninhas. Nosso objetivo foi estudar a influência da magnetização da água na eficiência do herbicida e verificar se existe uma relação entre os escores de controle e o índice de vegetação por diferença normalizada (NDVI). No experimento de laboratório, a água foi submetida à magnetização e avaliada em relação a quatro características. No experimento de campo, parcelas de capim-braquiária foram submetidas a tratamentos em esquema fatorial (6 × 2 + 1). Seis fatores herbicidas (doses de glyphosate e glyphosate + 2,4-D) e a magnetização ou ausência de magnetização da calda foram avaliados e comparados com o tratamento controle (sem pulverização). Avaliações de controle de plantas daninhas foram realizadas seis vezes. As imagens foram obtidas usando uma câmera multiespectral incorporada para determinar os valores de NDVI. Os dados relacionados às características da água foram analisados por meio do teste t. O controle de plantas daninhas e os dados de NDVI foram submetidos à análise de variância e são apresentados em gráficos de regressão. A análise de dispersão dos dados NDVI foi realizada de acordo com os escores de controle. O processo de magnetização diminuiu o pH da água e aumentou a tensão superficial, mas não influenciou nos escores de controle ou no NDVI. Conforme a dose de glyphosate foi aumentada, os escores de controle foram maiores e os valores de NDVI foram menores. A água magnetizada não afetou a eficiência biológica dos herbicidas, e houve uma forte correlação entre os escores de controle e os valores de NDVI.

Normalized difference vegetation index for desiccation evaluation with glyphosate + 2, 4-D in magnetized spray solution / Índice de vegetação por diferença normalizada para avaliação de dessecação com glyphosate + 2, 4-D em calda magnetizada

Abstract Water magnetization and geoprocessing are increasingly utilized tools in weed management. Our objective was to study the influence of water magnetization on herbicide efficiency and to verify whether there is a relationship between control scores and the normalized difference vegetation index (NDVI). In the laboratory experiment, water was subjected to magnetization and evaluated with respect to four characteristics. In the field experiment, plots of Brachiaria grass were subjected to treatments in a factorial scheme (6 × 2 + 1). Six herbicidal factors (doses of glyphosate and glyphosate + 2,4-D) and the magnetization or absence of magnetization of the spray solution were evaluated and compared against the control treatment (without spraying). Weed control assessments were carried out six times. Images were obtained using an embedded multispectral camera to determine the NDVI values. Data related to water characteristics were analyzed using the t test. Weed control and NDVI data were subjected to analysis of variance and are presented in regression graphs. Dispersion analysis of NDVI data was performed according to the control scores. The magnetization process decreased the pH of the water and increased the surface tension, but it did not influence the control scores or the NDVI. As the glyphosate dose was increased, the control scores were higher and the NDVI values were lower. Magnetized water did not affect the biological efficiency of the herbicides, and there was a strong correlation between the control scores and the NDVI values.

Resumo A magnetização da água e o geoprocessamento são ferramentas cada vez mais utilizadas no manejo de ervas daninhas. Nosso objetivo foi estudar a influência da magnetização da água na eficiência do herbicida e verificar se existe uma relação entre os escores de controle e o índice de vegetação por diferença normalizada (NDVI). No experimento de laboratório, a água foi submetida à magnetização e avaliada em relação a quatro características. No experimento de campo, parcelas de capim-braquiária foram submetidas a tratamentos em esquema fatorial (6 × 2 + 1). Seis fatores herbicidas (doses de glyphosate e glyphosate + 2,4-D) e a magnetização ou ausência de magnetização da calda foram avaliados e comparados com o tratamento controle (sem pulverização). Avaliações de controle de plantas daninhas foram realizadas seis vezes. As imagens foram obtidas usando uma câmera multiespectral incorporada para determinar os valores de NDVI. Os dados relacionados às características da água foram analisados ​​por meio do teste t. O controle de plantas daninhas e os dados de NDVI foram submetidos à análise de variância e são apresentados em gráficos de regressão. A análise de dispersão dos dados NDVI foi realizada de acordo com os escores de controle. O processo de magnetização diminuiu o pH da água e aumentou a tensão superficial, mas não influenciou nos escores de controle ou no NDVI. Conforme a dose de glyphosate foi aumentada, os escores de controle foram maiores e os valores de NDVI foram menores. A água magnetizada não afetou a eficiência biológica dos herbicidas, e houve uma forte correlação entre os escores de controle e os valores de NDVI.

Manejo laparoscópico multidisciplinario de la endometriosis profunda del 2010 al 2017: estudio de cohorte retrospectivo / Multidisciplinary laparoscopic management of deep infiltrating endometriosis from 2010 to 2017: A retrospective cohort study

INTRODUCCIÓN La laparoscopía es actualmente el estándar en el manejo de la endometriosis profunda. Sin embargo, requiere de un entrenamiento específico e involucra la realización de procedimientos complejos y asociados a una alta tasa de complicaciones. Por lo anterior en Chile y Latinoamérica, la endometriosis profunda es frecuentemente manejada de manera inadecuada. OBJETIVO Describir nuestra experiencia en el enfrentamiento clínico y manejo quirúrgico laparoscópico de la endometriosis profunda, durante los últimos siete años. MÉTODOS Estudio de cohorte retrospectivo de 137 pacientes consecutivas operadas y con confirmación histológica de endometriosis profunda. Se recolectaron los datos demográficos, datos quirúrgicos, complicaciones, resultados reproductivos y seguimiento. RESULTADOS Todas las cirugías fueron completadas por laparoscopía, sin conversión. La dismenorrea y la dispareunia fueron los síntomas más frecuentes en 85,4 y 56,9%, respectivamente. La localización más frecuente de endometriosis profunda fueron los ligamentos úterosacros, coexistiendo un endometrioma en 48,9% de los casos. La mediana de tiempo operatorio fue de 140 minutos, siendo significativamente más prolongado en casos con compromiso intestinal (p < 0,0001). Quince pacientes (10,9%) presentaron complicaciones. El seguimiento medio fue de 24,5 meses. La tasa de embarazo fue de 58,1% y 90% de las pacientes reportó una mejoría significativa de su sintomatología. CONCLUSIONES El manejo laparoscópico de la endometriosis profunda es efectivo y seguro, pero debe reservarse a centros especializados y con disponibilidad de equipo multidisciplinario.

BACKGROUND Laparoscopy has become the standard of care in the surgical management of deep infiltrating endometriosis (DIE). However, it is a challenging procedure with a high complication rate. Despite the benefits of the minimally invasive approach, DIE resection is often performed by surgeons without adequate training, especially in developing countries like Chile. OBJECTIVE To asses our experience in the diagnosis and laparoscopic management of DIE during seven years. METHODS A retrospective cohort study of data including 137 patients with pathology-proven DIE. Surgical and fertility outcomes were evaluated. RESULTS All procedures were performed laparoscopically without conversion. Dysmenorrhea and dyspareunia were the most common symptoms in 85.4% and 56.9%, respectively. Uterosacral ligaments were the most common DIE location. Endometrioma was present in 48.9% of cases. Median operative time was 140 minutes; however, it was longer in cases requiring bowel surgery (p < 0.0001). The complication rate was 10.9%. Median follow-up was 24.5 months. The pregnancy rate was 58.1% and 90% of patients reported significant symptom relief after surgery. CONCLUSION Laparoscopic surgical management of DIE is effective and safe but it must be performed in tertiary centers with the availability of multidisciplinary teams.

Efecto de inoculantes bacterianos edáficos mixtos en el desarrollo temprano de cultivares mejorados de cacao (Theobroma cacao L.) en un sistema agroforestal tradicional del norte de Oaxaca, México / Effect of mixed edaphic bacterial inoculants in the early development of improved cocoa cultivars (Theobroma cacao L.) in a traditional agroforestry system of Oaxaca, Mexico

El cacao (Theobroma cacao L.) es nativo de América del Sur y representa uno de los recursos «bioculturales¼ más significativos de Mesoamérica, ya que es una región donde se domesticó y tuvo relevancia como bebida ritual y como moneda en muchas culturas prehispánicas hasta la llegada de los españoles, quienes difundieron su uso en el mundo y lo convirtieron en una de las mercancías «commodity¼ más consumidas. Mediante este trabajo se propone una alternativa para atender la problemática de las plantaciones a través de la introducción de una diversidad amplia de cultivares de cacao en sistemas agroforestales tradicionales, en sinergia con la inoculación de bacterias edáficas fijadoras de nitrógeno y solubilizadoras de fósforo insoluble. En una parcela agroforestal tradicional se introdujeron plantas de cacao injertadas de cuatro cultivares y se dispusieron 3 tratamientos: aplicación de biofertilizante, aplicación de fertilizante químico y testigo. Se registraron la altura, el diámetro basal, el número de hojas y el número de ramas a los 2 y 12 meses, y se caracterizó la población de microorganismos asociada alrededor del tallo bajo la copa de las plantas. Los resultados de crecimiento muestran un buen potencial para los 4 cultivares estudiados y se observó que la biofertilización generó efectos significativos en algunos de los indicadores de crecimiento de las plantas de cacao. Así, las asociaciones vegetales en un sistema agroforestal podrían ser favorables para potenciar el desarrollo de frutos y resistencia a plagas y enfermedades.

Cocoa plant (Theobroma cacao L.) is native from South America and it represents one of the most significant "bio-cultural" resources of Mesoamerica, since it is a region where it was domesticated and had a relevance as ritual drink and as currency in many pre-hispanic cultures until the arrival of the Spaniards who spread its use worldwide, and became it one of the most consumed commodity goods. Through this research, an alternative is proposed to address the problem of cultivars through the introduction of a wide variety of cocoa plants in traditional agroforestry systems, in synergy with the inoculation of nitrogen-fixing and insoluble phosphor solubilizing edaphic bacterial consortia. Four cultivars of improved grafted cocoa plants were introduced in a traditional agroforestry plot and three fertilization treatments were applied: application of biofertilizer, application of chemical fertilizer and control. Measurements of height, stem diameter, number of leaves and branches were recorded at 2 and 12 months after planting and rhizosphere microbial populations were characterized. Growth results showed good potential for all studied cultivars and it was observed that biofertilization foresees significant effects in some of the growth indicators of cocoa plant. Thereby, plant associations in an agroforestry system could be favorable to promote fruit development and resistance to pests and diseases.

Diseño y evaluación de las propiedades antibacterianas de un prototipo de molde de audífono que incorpora cobre en su manufactura / Design and evaluation of antibacterial properties of a prototype of earmold with copper incorporated in the manufacture

Introducción: La otitis externa infecciosa es una consulta otorrinolaringológica frecuente en usuarios de audífonos. Las propiedades antibacterianas descritas del cobre, han motivado el desarrollo de aplicaciones clínicas de este metal. Objetivo: Evaluar la capacidad antibacteriana de moldes de audífonos manufacturados con polímeros sensible a luz UV, silicona y acrílico que incorporan cobre metálico, en un sistema experimental in vitro. Material y método: Se diseñaron moldes de audífonos con y sin cobre, que fueron inoculados con distintas concentraciones de microorganismos (S aureus y P aeruginosa), para luego determinar el porcentaje de adherencia bacteriana a distintos tiempos de contacto (4, 8 y12 horas). Resultados: Existió reducción significativa en la adhesión bacteriana a los moldes con cobre respecto a aquellos sin cobre, independiente del material, del tipo de microorganismo y del inóculo bacteriano. Discusión: La disminución en la adherencia bacteriana en los prototipos con cobre, puede atribuirse a su actividad inhibitoria sobre los microorganismos en función de su concentración y el tiempo de contacto, ejerciendo su efecto por difusión a través de los distintos materiales. Conclusión: Con estos resultados, se hace necesario el desarrollo de estudios clínicos enfocados en comprobar si el uso de audífonos con cobre disminuyen las otitis externas de origen infeccioso.

Introduction: External otitis of infectious etiology among hearing aid users is a common motive of otolaryngology consultation. Antibacterial properties described copper, they have motivated the development of clinical applications of this metal. Aim: Evaluate the antibacterial capacity of copper-based ear molds manufactured with different materials such UV sensitive polymers, silicone and acrylic incorporating metallic copper, in an experimental system in vitro. Material and method: Ear molds with and without copper, were inoculated with different concentrations of microorganisms (S aureus and P aeruginosa) and determine the percentage of bacterial adherence to different contact times (4-8 and 12 hours). Results: There was significant reduction in bacterial adhesion to copper molds than those without copper, independent of the material, the type of microorganism and the bacterial inoculum. Discussion: The decrease in bacterial adherence on prototypes with copper, can be attributed to inhibitory activity on microorganisms depending on their concentration and contact time, exerting its effect by diffusion through the various materials. Conclusion: With these results, is necessary the development of clinical studies focused on checking whether the use of hearing aids with copper decreases external otitis of infectious origin.

Biologia reprodutiva e ausência de frutificação de Aloe saponaria (Aiton) Haw. (Xanthorrhoeaceae) fora do local de origem / Reproductive biology and absence of fruiting of Aloe saponaria (Aiton) Haw. (Xanthorrhoeaceae) outside its place of origin

RESUMO O gênero Aloe, originário principalmente da África, tem atualmente uma ampla distribuição no mundo. No entanto, são poucas as regiões que têm realizado estudos quanto ao sistema reprodutivo. O objetivo do presente trabalho foi analisar as características e o comportamento reprodutivo de Aloe saponaria em Florianópolis, Santa Catarina. Foram conduzidos estudos sobre sua morfologia e biologia floral, visitantes florais e sistema reprodutivo. Esta espécie apresentou uma inflorescência por planta, com um comprimento de 105 ± 0,1 cm e 267 ± 92,7 flores. A razão pólen/óvulo sugere que a espécie é xenogâmica. O volume e concentração de sólidos solúveis totais do néctar potencial foi 16,6 ± 6,3 μL e 22 ± 2,4 °Brix respectivamente. O néctar instantâneo não apresentou diferenças significativas nos períodos avaliados (9:00h e 15:00h) e o estigma permaneceu receptivo até o segundo dia após a antese. Foram coletados 110 insetos visitantes florais, dos quais 61,8% foram indivíduos de Trigona spinipes. Entretanto, nos testes de polinização não foi observada frutificação efetiva, indicando que a propagação vegetativa é o principal tipo de reprodução usado nessa população. Isto pode estar relacionado a um mecanismo de autoincompatibilidade esporofítica, a anormalidades cromossômicas durante a formação do pólen, as condições climáticas, e a escassa variabilidade genética no local de estudo.

ABSTRACT The Aloe genus, originating mainly from Africa, currently has a wide distribution in the world. However, in few regions studies about the reproductive system have been carried on. The aim e of this study was to analyze the characteristics and reproductive performance of the Aloesaponaria in Florianópolis, Santa Catarina. The morphology, floral biology, flower visitors and the reproductive system were determined. The plants presented an inflorescence per plant, with 105 ± 0,1 cm in length and 267 ± 92.7 flowers. The pollen/ovule ratio suggested that the species is xenogamic. The volume and concentration of total soluble solids in the potential nectar were 16.6 ± 6.3 μL and 22 ± 2.4°Brix, respectively. The instant nectar showed no significant differences between the evaluated periods (9:00h and 15:00h) and the stigma remained receptive until the second day the after anthesis. 110 insects were collected, from which 61.8% were from theTrigona spinipesspecies. However, in the pollination tests the fruit set was not observation, indicating that vegetative propagation is the main type of reproduction used by this population. This may be related to a mechanism of sporophytic self-incompatibility, to chromosomal abnormalities during the formation of pollen, to weather conditions, and to the low genetic variability at the study site.

Diagnóstico y tratamiento temprano de la maloclusión clase III / Early diagnosis and treatment of class III malocclusion

El objetivo del presente artículo es hacer una revisión de un tema muy importante como es el diagnóstico y tratamiento de la mal oclusión clase III en etapas tempranas, para lograr este objetivo se reunió a un grupo de residentes de Odontopediatría de diferentes universidades durante 6 meses, el cual realizó una búsqueda de información en las principales revistas y textos llegando a la conclusión de que la mal oclusión clase III es un síndrome dentofacial que genera mucha controversia en la odontología actual debido básicamente a la pregunta constante de los clínicos de cuándo será el momento oportuno para iniciar el tratamiento. La respuesta a esta interrogante dependerá de la gravedad de la mal oclusión y del estadío de crecimiento óseo en el que se encuentre el paciente; pero existen otras dimensiones a considerar como: las características clínicas, el correcto diagnóstico y las alternativas posibles de tratamiento (que serán necesarias para poder decidir acertadamente cuándo y cómo será el tratamiento de nuestro paciente). El objetivo de esta revisión bibliográfica es orientar al clínico sobre diversos aspectos; de esta maloclusión, existentes en la literatura...

The aim of this article is to make a review of a very important theme as is the diagnosis and treatment of Class III malocclusion in early stages. To achieve this goal, we gather a group of residents in pediatric dentistry from different universities during six months, this group per formed a search for information in the most important journals and texts, coming to the conclusion that Class III malocclusion is a dentofacial syndrome that generates a lot of controversy in dentistry today, basically due to the constant question of clinicians about when is the correct time to treat this malocclusion. The answer to this question will depend on the severity of the malocclusion and on the bone growth stage of the patient; but there are other dimensions to consider such as: clinical characteristics, the correct diagnosis and possible treatment alternatives (that will be necessary to take into consideration in order to correctly choose when and how the treatment of our patient will be). The aim of this review is to guide clinicians through all the different aspects of this malocclusion that may exist in literature...

Actividad bactericida de superficies de cobre frente a bacterias asociadas a infecciones nosocomiales, en un modelo in vitro de adherencia y sobrevivencia / Adherence to copper and stainless steel metal coupons of common nosocomial bacterial strains

Background: Copper has a bactericidal activity against a series of bacterial strains. Aim: To measure resistance to bacterial adherence of copper (Cu) and stainless steel (SS) metal coupons. Material and Methods: Bacterial strains causing nosocomial infections in Chile were analyzed. Bacterial adherence was studied using apreviously described method based on a system of metal coupons that are immersed in culture media containing the bacteria ofinterest at room temperature. Results: Adherence to Cu and SS coupons was differentfor Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae and Acinetobacter baumannii strains. For these strains, no adherence to Cu coupons occurred during the 48 h observation period compared to a rapidly increasing adherence to SS coupons, with a final colony count of 1.00E + 07 cfu/mL. For two different Pseudomonas aeruginosa clinical strains, inhibition of adherence was not observed on Cu coupons, and colony counts were similar for Cu and SS using the standard inoculum (2-3 xlO7 cfu).Apartial decrease in adherence was observed for Cu but not for SS coupons, when a lower inoculum was used. Conclusions: Copper surfaces represent an interesting option to reduce bacterial contamination in the hospital environment due to its resistance to bacterial adhesión ofmost ofthe common nosocomial bacterial strains.

Aplicación de la capacidad bactericida del cobre en la práctica médica / Application of copper bactericidal properties in medical practice

Background: Copper is essential for cell metabolism in animals and plants and thus for life. Along centuries, copper has been identified as a metal containing antimicrobial properties. In recent years, laboratory assays and clinical studies have revealed that surfaces of metallic copper or its alloys, containing at least 70% copper, eliminate in a few hours several pathogenic organisms including bacterial strains associated with nosocomial infections, influenza virus, HIV, and fungi such as Candida albicans. In March 2008, the American Environmental Protection Agency (EPA), supported by scientific evidence gathered to date, registered copper as the first and only metal with antimicrobial properties. We herein review certain mechanisms proposed for the antibacterial, antiviral and antifungal activity of copper. We also discuss in vitro and clinical efficacy studies developed world wide and in Chile, focusing on bactericidal activity of copper surface areas in comparison to materials typically used in hospital environments such as stainless steel and polymers. Scientific evidence gathered to date, consistently shows that the use of copper surface areas in high contact critical points in hospitals, significantly reduces environmental bacterial load. This is associated with a decreased risk of pathogen transmission to patients and represents therefore an interesting complement to infection control programs.

Síndrome hemolítico urémico asociado a infección intestinal por Escherichia coli productora de shigatoxina (STEC) en pacientes chilenos: aspectos clínicos y epidemiológicos / Hemolytic uremic syndrome associated to shigatoxin producing Escherichia coli in Chilean children: clinical and epidemiological aspects

Clinical and epidemiological aspects of shigatoxin producing E. coli (STEC) infections and hemolytic uremic syndrome (HUS) are reviewed. Surveillance results from 14 sentinel centers during 2000-2002 showed a mean incidence rate of 3.4 HUS cases per 100.000 children, with the highest incidence in the 6 to 28 month age group. Disease is endemic with summer peaks. Between 1988 and 2002 we obtained the clinical characteristics of a group of 119 HUS children with the following results: mean age 16 months, bloody diarrhea 57.8 percent, no previous diarrhea 9 percent, 60 percent received antibiotics, 72 percent had oligoanuria, 53 percent required dialysis, 15 percent had seizures and 31 percent had dizziness; mortality was 3 percent. Four foodborne outbreaks have been detected in Santiago, two outbreaks occurred in household settings, one in a Day Care Center and one in a Neonatal Unit. Recommendations for diagnosis, treatment and prevention of STEC infections, including potential vaccines are discussed.

Se revisan y actualizan aspectos clínicos y epidemiológicos de las infecciones por Escherichia coli productora de shigatoxina (STEC), y el síndrome hemolítico urémico (SHU). Se incluyen resultados de una vigilancia de SHU en 14 centros centinelas (2000-2002), que mostró una incidencia promedio de 3,4 casos por 100.000 niños, 78 por ciento) en el grupo de 6 a 48 meses. Esta vigilancia reflejó una situación endémica, con aumento en verano. Se analiza la observación clínica protocolizada de 119 pacientes con SHU hospitalizados en la Región Metropolitana (RM) (1988 y 2002). Edad promedio: 16 meses. El 578 por ciento> tenía diarrea con sangre, 9 por ciento> no tenía diarrea previa, 60 por ciento> recibió antibacterianos, 72 por ciento> presentó oligoanuria y 53 por ciento> necesitó diálisis. El 31 por cientoo tuvo compromiso de conciencia y 15 por cientoo presentó convulsiones. Letalidad 3 por ciento. Se analizan brotes de STEC asociados a alimentos ocurridos en la RM en el hogar (2), un jardín infantil (1) y en un servicio de neonatología (1). Finalmente, se entregar recomendaciones para el manejo clínico y prevención, se revisan los criterios diagnósticos, nuevas estrategias terapéuticas y progresos en el desarrollo de vacunas.

Diseño y evaluación de una reacción de polimerasa en cadena (RPC) múltiple, para la identificación de bacterias causantes de meningitis aguda en líquido cefalorraquídeo de niños chilenos / Multiplex PCR assay in spinal fluid to identify simultaneously bacterial pathogens associated to acute bacterial meningitis in Chilean children

Background: Acute bacterial meningitis (ABM) is a serious disease that needs rapid diagnosis for an accurate treatment. The most important etiological agents are: Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type b. Overall pathogen detection rate in patients with ABM in Chile is 83 percent. Aim: To evaluate a Polymerase Chain Reaction (PCR) protocol for simultaneous detection of several pathogens in patients with ABM. Material and methods: We designed and evaluated a multiplex PCR protocol for simultaneous specific genes identifications of S pneumoniae (¡ytA and ply genes), N meningitidis (ctrA, crgA) and H influenzae (bexA) in cerebrospinal fluid (CSF) samples from pediatric patients with suspected diagnosis of ABM. Sensitivity, specificity and minimum detection levels of DNA were determined. Amplifications ofrDNA 16S gene was done to confirm extraction of bacterial DNA. Results: Ninety nine CSF samples were studied, 90 from children with fever and negative CSF culture, and 9 from ABM and positive culture patients. The PCR protocol had a sensitivity of 89 percent, specificity of 100 percent, positive predictive value 100 percent and negative predictive value 99 percent. Conclusions: We observed a high concordance (89 percent) between bacteriological cultures and the PCR protocol results. This diagnostic tool could increase identification of agents in specific settings such as patients previously treated with antibiotics.

Epidemiología clínica y molecular de las infecciones por Shigella spp en niños de la Región Metropolitana durante el verano 2004-2005 / Shigella spp Infections In children living In the Metropolitan RegionChile, during summer of 2004-2005

Background: Shigella spp is a frequent cause of diarrhea in children. Antimicrobials decrease the duration of diarrhea and pathogen excretion. However, the increasing resistance limits their therapeutic value. Aim: To study Shigella serotype distribution in the Metropolitan Region in Chile, and its relationship with severity of disease, antimicrobial resistance pattern and clonality. Material and methods: During summer 2004-2005, stool samples from children with diarrhea were collected in Cary Blair transpon medium and cultured. Shigella isolates were serotyped using monoclonal and polyclonal commercial antibodies. In vitro activity of ampicillin, amoxicillin/clavulanic acid, chloramphenicol, cotrimoxazol, nalidixic acid, ciprofloxacin, ceftriaxone and azythromycin was determined by minimal inhibitory concentration (MIC). Clonality was studied by pulsed-field gel electrophoresis (PFGE) using Xbal as restriction enzyme. Results: One hundred thirty nine Shigella strains were isolated (77 S sonnei and 62 S flexneri). S sonnei and S flexneri 2a serotypes were responsible for 95 percent of episodes. Children aged 2-4 years, showed a greater incidence of Shigella infections and 77 percent of episodes were treated on an ambulatory basis. High resistance levels were observed for ampicillin, cotrimoxazole, amoxicillin-clavulanic acid and chloramphenicol (67 percent, 60 percent, 56 percent and 45 percent, respectively). We found 11 resistance patterns and 61,2 percent of strains were multiresistant. There were multiple clones without a strict relationship with resistance patterns. Conclusions: Shigella infections in Metropolitan Region in Chile are associated to a restricted number of serotypes, representing a clonal expansion associated to different antimicrobial resistant patterns.

Detección del tipo de papilomavirus humano por el método de PCR-RFLP en uncaso con neoplasia intraepitelial de alto grado y captura híbrida II negativa / Detection of human papillomavirus by PCR RFLP assay in a case with negative hybrid capture II result and high grade intraepithelial neoplasia Pap smear result

La infección persistente del virus del papiloma humano (HPV) es un factor necesario para eldesarrollo del cáncer de cuello uterino. Este caso reporta una mujer de 43 años, con imágenescitológicas persistentes de neoplasia intraepitelial de grado III (CIN III) y resultados negativos paraestudios colposcópicos y anatomopatológicos, como también, para HR-HPV analizado por el métodode Captura Híbrida II. Una evaluación histopatológica posteriormente confirmó la existencia de CINIII en mucosa cervical. A fin de detectar otros tipos de HPV no incluidos en la Captura Híbrida II, lamuestra fue analizada por el método de PCR-RFLP obteniendo un resultado positivo para HPV 73.En este caso, el uso del método de PCR-RFLP permitió detectar una infección por un tipo específicode HPV, brindando una información útil que puede ayudar en el manejo clínico de mujeres condiagnóstico citológico de CIN III y resultado de Captura Híbrida II negativo

Actividad comparativa in vitro de cefpodoxima en relación a otros antibióticos de uso frecuente, frente a patógenos respiratorios, urinarios y de infecciones de partes blandas / Activity of cefpodoxime against pathogens causing respiratory, urinary or soft tissue infections

Background: Cefpodoxime is a new antimicrobial in the Chilean market, recommended for treatment of respiratory and urinary tract infections. Aim: To study the susceptibility of common pathogens isolated from Chilean patients to cefpodoxime and other antimicrobials. Material and methods: The in vitro activity of cefpodoxime, expressed as Minimal Inhibitory Concentration, was studied in 331 S pneumoniae, H influenzae, M catarrhalis, E coli, S aureus and S pyogenes strains, isolated between 2000 and 2004 from respiratory, urinary and soft tissue infections, respectively. Results: Eleven percent of S pneumoniae isolates were resistant to penicillin, 11% were resistant to cefuroxime and 10% to cefpodoxime. All H influenzae isolates were susceptible to cefpodoxime. No H influenzae isolates were resistant to second or third generation cephalosporines. Four percent of H influenzae isolates were resistant to ampicillin by ß-lactamase production. In contrast 81% of M catarrhalis strains were resistant to ampicillin. Six percent of E coli isolates were resistant to cefpodoxime, 9% to cefuroxime, 11% to cefadroxile and 50% to ampicillin or trimethoprim/sulphamethoxazole. Cefpodoxime was the most active antimicrobial against S pyogenes. Conclusions: Cefpodoxime, recently introduced in Chile, is a good alternative for the treatment of common respiratory and urinary tract infections.

Estudio de la actividad comparativa in vitro de telitromicina en patógenos respiratorios adquiridos en la comunidad en 13 centros clínicos chilenos / In vitro activity of telithromycin against community acquired respiratory pathogens

Background: Telithromycin is a new ketolide antimicrobial, that can be useful for the treatment of respiratory infections. Aim: To compare in vitro activity of telithromycin against respiratory pathogens, isolated in outpatient clinics. Material and methods: Two hundred eighty strains isolated from patients with respiratory infections, were studied. The strains studied were S pneumoniae, penicillin sensitive (SPNS:57); intermediate (SPNI:35), resistant (SPNR:25); S pyogenes (SP:57); H influenzae (HIN 51); M catarrhalis (MC:25) and S aureus meticillin sensitive (SAUS:30). Minimal inhibitory concentration (MIC) by broth microdilution was studied for telitrhomycin and levofloxacin in all strains. Other antimicrobials studied, but not in all strains were erythromycin, clindamycin, trimetoprim sulphamethoxazole, oxacillin, amoxicillin-clavulanic acid and cefuroxime. Results: All strains were sensible to telithromycin at a concentration ¡4 µg/ml. MIC 90 and its range for SPNS was 0.03 µg/ml (¡0.004-0.12), for SPNI was 0.03 µg/ml (¡0.004-025), for SPNR was 0.06 µg/ml (¡0.004-0.25), for HIN was 2 µg/ml (0.12-4), for SP was 0.5 µg/ml (¡0.004-2), for MC was 0.5 µg/ml (0.06-2) and for SAU was 0.25 µg/ml (0.06-0.25). Conclusions: All studied pathogens were sensible to telithromycin in vitro. This antimicrobial is an alternative for the treatment of community acquired respiratory infections.

Perfil de susceptibilidad a los antimicrobianos en cepas de E coli productoras de Shiga toxina (STEC) aisladas de infecciones humanas y de alimentos / Antimicrobial susceptibility of shiga toxin producing E coli (STEC) strains isolated from human infections and food

BACKGROUND: Shiga toxin-producing E coli (STEC) are zoonotic pathogens associated to sporadic episodes of bloody diarrhea, foodborne outbreaks, and Hemolytic Uremic Syndrome (HUS), with worldwide public health impact. Antibiotic use in STEC infections is controversial because of the potential to increase production and secretion of Shiga toxins. AIM: To study the in vitro antimicrobial susceptibility profile of STEC. MATERIAL AND METHODS: The in vitro susceptibility profile against 10 antimicrobials of STEC strains isolated from 29 meat products, 20 patients with diarrhea and 9 HUS patients was studied. Minimal Inhibitory Concentrations (microg/ml) by agar dilution method for ampicillin, cloramphenicol, ciprofloxacin, amikacin, gentamycin, cotrimoxazol, ceftriaxone, tetracycline, fonsfomycin and azihromycin were measured according to NCCLS recommendations. RESULTS: Strains from patients with diarrhea or HUS were all susceptible to the 10 antimicrobials and only 13.7% had intermediate resistance to cloramphenicol. Strains from meat products had a similar susceptibility profile, with only 3.5% resistance to tetracycline, 3.5% intermediate resistance to cloramphenicol and 7% to fosfomycin. All 58 strains were considered resistant to azithromycin (MIC >32 microg/ml). CONCLUSIONS: Similarity of susceptibility profiles between STEC strains from human and food origin suggests a role of food chain in transmission to humans.

Evaluación pre-analítica de dos métodos de extracción de ADN para la amplificación del gen de la pneumolisina (PLY) de Streptococcus pneumoniae, en muestras de hemocultivo / Assessment of two DNA extraction methods to amplify the pneumolysin gene (PLY) from blood culture samples of Streptococcus pneumoniae

Background: Streptococcus pneumoniae is a common etiologic agent of invasive respiratory infections among children under 5 years of age and older adults. Isolation rates of S. pneumoniae by traditional culture techniques are low. Aim: To study the sensitivity and specificity of two different DNA extraction methods to amplify the ply gene, applied to three different types of blood culture broths, experimentally inoculated with S. pneumoniae. Material and methods: DNA was extracted from the cultures using an organic method or a technique that consists in dilution, washing with NaOH and concentration of the sample. This was followed by PCR amplification of a 355 pb fragment of the pneumolysin gene (ply). Results: The organic DNA extraction method inhibited the PCR reaction at all concetrations studied (0.6 to 10(6) colony forming units/mL). Using the NaOH extraction, ply gene amplification was positive in all three blood culture broths, but only at concentrations of 10 colony forming units/mL or higher. Using the same DNA extraction method, PCR was negative when the broths were inoculated with seven other related bacterial species, which results in a 100 percent specificity. Conclusions: Detection of S. pneumoniae by amplification of ply gene from blood cultures using the protocol of NaOH for DNA extraction is specific and provides results in a short lapse. However, the diagnostic sensitivity is not optimal, wich limits its clinical use.

Estrogen and progesterone receptors in human papilloma virus-related cervical neoplasia

Estrogen (ER) and progesterone (PR) receptors in the normal uterine cervix, cervical intraepithelial neoplasia and invasive carcinoma were studied in consecutive samples from Hospital do Câncer, São Paulo, between 1996 and 1997. Tissue was collected by removing a fragment of the tumoral area using a 5-mm diameter biopsy punch, followed by removal of a macroscopically normal area as close as possible from the tumor. Histopathological confirmation was obtained for all specimens analyzed. A total of 24 normal tissues, 17 cases of cervical intraepithelial neoplasia and 7 of invasive carcinomas were studied. The ER/PR ratio was determined by immunohistochemistry using monoclonal antibodies specific for each receptor. Adjacent tissue slides were submitted to generic PCR for human papillomavirus (HPV) DNA detection followed by typing by dot blot hybridization. About half (45.8 percent) of the tumors were HPV DNA positive while 29.1 percent of the patients were also HPV positive in their respective normal tissue. ER was negative in the tumoral epithelium of 11 HPV-positive patients (P = 0.04). There was a trend in the ER distribution in normal tissue that was opposite to that from lesions, but it was not statistically significant (P = 0.069). No difference in ER distribution in stromal tissues was observed between HPV-positive and HPV-negative tissues. PR staining was negative in the epithelium of all cases studied. The results obtained from this small number of cases cannot be considered to be conclusive but do suggest that factors related to viral infection affect the expression of these ER/PR cervix receptors.

Implementación de una red nacional para la vigilancia de resistencia de agentes patógenos a antimicrobianos según sÝndromes clÝnicos / Starting a national surveillance network on antibiotic resistance

El Instituto de Salud Pública de Chile y la Sociedad Chilena de InfectologÝa han aunado sus esfuerzos para coordinar y co-dirigir una red nacional para la vigilancia de resistencia de agentes patógenos a antimicrobianos según sÝndromes clÝnicos. El objetivo de esta red es establecer un sistema nacional de vigilancia de la resistencia a antimicrobianos, estandarizado y coordinado, que proporcione información actualizada acerca de los agentes infecciosos mßs relevantes por sÝndromes clÝnicos bien definidos, por edad y por lugar de origen: hospitalaria o de la comunidad. Nos parece fundamental la participación de todos los Servicios de Salud del paÝs en esta red, para obtener datos de calidad, representativos de nuestra realidad nacional, que sean de real utilidad en el manejo de los pacientes.