Original article: novelty of Canadian manufacture nasopharyngeal swabs for collection of samples being tested for SARS-CoV-2 in a pandemic setting.

Objectives: The COVID-19 pandemic caused a global shortage of nasopharyngeal (NP) swabs, required for RT-PCR testing. Canadian manufacturers were contacted to share NP swab innovations. The primary objective was to determine whether novel NP test swabs were comparable to commercially available swabs regarding user characteristics, ability to collect a specimen, and diagnostic performance using RT-PCR testing. Methods: Participants were randomized by swab (test/control) and nostril (left/right). A calculated positive percent agreement ≥90% was considered successful. Mean Ct values of viral genes and housekeeping gene (RNase P) were considered similar if a Ct difference ≤ 2 between control and test group was obtained. There also was a qualitative assessment of swabs usability. Results: 647 participants were enrolled from Huaycan Hospital in Lima, Peru, distributed over 8 NP swabs brands. Seven brands agreed to share their results. There were no statistically significant differences between the test swabs of these 7 brands and control swabs. Conclusion: All the seven brands are comparable to the commercially available flocked swabs used for SARS-CoV-2 regarding test results agreement, ability to collect a specimen, and user characteristics.

Tuberculosis and comorbidities: treatment challenges in patients with comorbid diabetes mellitus and depression.

Tuberculosis is one of the leading causes of death worldwide, primarily affecting low- and middle income countries and individuals with limited-resources within fractured health care systems. Unfortunately, the COVID-19 pandemic has only served to aggravate the already existing diagnostic gap, decreasing the number of people who get diagnosed and thereby complete successful treatment. In addition to this, comorbidities act as an external component that when added to the TB management equation, renders it even more complex. Among the various comorbidities that interact with TB disease, diabetes mellitus and depression are two of the most prevalent among non-communicable diseases within the TB population and merits a thoughtful consideration when the healthcare system provides care for them. TB patients with diabetes mellitus (TB-DM) or depression both have an increased risk of mortality, relapse and recurrence. Both of these diseases when in presence of TB present a 'vicious-circle-like' mechanism, meaning that the effect of each disease can negatively add up, in a synergistic manner, complicating the patient's health state. Among TB-DM patients, high glucose blood levels can decrease the effectiveness of anti-tuberculosis drugs; however, higher doses of anti-tuberculous drugs could potentially decrease the effects of DM drugs. Among the TB-depression patients, not only do we have the adherence to treatment problems, but depression itself can biologically shift the immunological profile responsible for TB containment, and the other way around, TB itself can alter the hormonal balance of several neurotransmitters responsible for depression. In this paper, we review these and other important aspects such as the pharmacological interactions found in the treatment of TB-DM and TB-depression patients and the implication on TB care and pharmacological considerations.

Efecto Antibacteriano del Aceite Esencial de Rosmarinus Officinalis "Romero" frente a Cepas de Escherichia Coli ATCC25922 comparado con Ciprofloxacino / Antibacterial Effect of Essential Oil of Rosmarinus Officinalis "Rosemary" against Strains of Escherichia Coli ATCC25922 compared to Ciprofloxacin

El objetivo principal de la presente investigación fue evaluar si el aceite esencial de la hoja de Rosmarinus officinalis "romero" tenía efecto antimicrobiano frente a cepas de Escherichia coli ATCC25922 comparado con ciprofloxacino a dosis de 30 ug, en un estudio in vitro. Se utilizaron diluciones del aceite esencial de Rosmarinus officinalis al 25%, 50%, 75% y 100%, se consideró un control negativo con agua destilada. Se realizaron 11 repeticiones por cada grupo estudiado. Encontrándose efecto inhibitorio a la dilución del 100% (17.36mm, DS: 1.027 ± 0.310; IC 95%; 16.67-18.05) valores considerados como eficacia intermedia según la denominación CLSI (>21mm), no superando los valores alcanzados por el control positivo ciprofloxacino (29.82mm, DS: 0.982 ± 0.296; IC 95%; 29.16-30.48mm). Al 75% el efecto inhibitorio fue (12.64mm, DS: 1.027 ± 0.310; IC 95%; 11.95-13.33), al 50% fue (9.55mm, DS: 0.522 ± 0.157; IC 95%; 9.19-9.9mm), mientras que al 25% no se observó efecto antibacteriano. El análisis ANOVA fue altamente significativo (0.000) asimismo los grupos estudiados fueron homogéneos según la prueba de Tukey. Se concluye que se presentó cierto grado de inhibición sobre Escherichia coli ATCC25922, no superando el halo de inhibición del ciprofloxacino.

Synaptic localization of acylpeptide hydrolase in adult rat telencephalon.

Acylpeptide hydrolase (ACPH), a serine protease present in the central nervous system (CNS), is believed to have a function in modulating synaptic plasticity, cleavage of beta amyloid peptide and degradation of aggregated oxidized proteins. In this report, we demonstrate for the first time the presence of ACPH in the synapse and its preferential localization at the pre-synaptic side. We isolated subcellular fractions from the rat telencephalon enriched in pre- versus post-synaptic components by using differential centrifugation steps to evaluate ACPH catalytic activity and expression level. Relative ACPH levels were determined by Western blot techniques while antibodies against synaptophysin and PSD-95 were used as positive pre- and post-synaptic markers, respectively. Our results show that ACPH protein levels are significantly increased at the synapse, which correlates with a 56% increase in ACPH activity. Furthermore, Western blot experiments show that ACPH is preferentially located at the pre-synaptic side and this is consistent with the increase of its enzymatic activity in fractions enriched in pre-synaptic components. These results give new insights regarding the localization and a putative role of ACPH in the CNS.

Simultaneous pancreas-kidney transplant: a single-center long-term outcome.

BACKGROUND: In patients with type 1 diabetes mellitus and end-stage renal disease, simultaneous pancreas-kidney transplantation is associated with increased survival when compared with solitary deceased kidney transplant or dialysis. We consider that the analysis of our long-term program (based in a single center) of simultaneous pancreas-kidney transplantation would provide valuable information for this therapeutic approach regarding patient and organ survival. METHODS: The outcome of 57 consecutive pancreas-kidney transplants patients was analyzed. The analysis included characteristics of the donor and recipient and survival rates of patients and both grafts. We also analyzed age and modality of renal replacement treatment as possible mortality risk factors. RESULTS: Ten-year patient, kidney and pancreas graft survival rates were 75.8%, 57.2% and 42.7%, respectively. Censoring for patient death, the results for 10-year kidney and pancreas survival were 78.5% and 58%, respectively. CONCLUSION: Our results add evidence to support the notion that the double and simultaneous pancreas-kidney transplantation is in fact the treatment of choice in selected patients with end-stage renal failure due to type 1 diabetes mellitus.

Antagonistic effects of TrkB and p75(NTR) on NMDA receptor currents in post-synaptic densities transplanted into Xenopus oocytes.

Brain-derived neurotrophic factor (BDNF) and its receptor TrkB are essential regulators of synaptic function in the adult CNS. A TrkB-mediated effect at excitatory synapses is enhancement of NMDA receptor (NMDA-R)-mediated currents. Recently, opposing effects of TrkB and the pan-neurotrophin receptor p75(NTR) on long-term synaptic depression and long-term potentiation have been reported in the hippocampus. To further study the regulation of NMDA-Rs by neurotrophin receptors in their native protein environment, we micro-transplanted rat forebrain post-synaptic densities (PSDs) into Xenopus oocytes. One-minute incubations of oocytes with BDNF led to dual effects on NMDA-R currents: either TrkB-dependent potentiation or TrkB-independent inhibition were observed. Pro-nerve growth factor, a ligand for p75(NTR) but not for TrkB, produced a reversible, dose-dependent, TrkB-independent and p75(NTR)-dependent inhibition of NMDA-Rs. Fractionation experiments showed that p75(NTR) is highly enriched in the PSD protein fraction. Immunoprecipitation and pull-down experiments further revealed that p75(NTR) is a core component of the PSD, where it interacts with the PDZ3 domain of the scaffolding protein SAP90/PSD-95. Our data provide striking evidence for a rapid inhibitory effect of p75(NTR) on NMDA-R currents that antagonizes TrkB-mediated NMDA-R potentiation. These opposing mechanisms might be present in a large proportion of forebrain synapses and may contribute importantly to synaptic plasticity.

Differences in perceptions of what constitutes having "had sex" in a population of people living with HIV/AIDS.

The reduction of high-risk sexual behavior among HIV-infected individuals is a major aspect of prevention strategies to reduce HIV infection in the United States. These prevention efforts assume a common understanding between clinicians and HIV-infected individuals of the terms "sex" and what constitutes having "had sex." The purpose of this study was to determine what sexual behaviors HIV-infected individuals perceive as having had sex and to examine the variability of these perceptions. Surveys were done of 279 HIV-positive adults receiving services at an HIV-focused community health center in Dallas, TX. Responses from participants about whether they perceived a given behavior as constituting having had sex were analyzed by Chi-squared analysis. Overall, only 80.9% of respondents perceived penile-vaginal intercourse as "sex," while 76.9% said they "had sex" if someone had oral contact with their genitals. There were gender and ethnicity differences in what was perceived as having had sex. Females were significantly less likely than males to perceive anal intercourse as having had sex. Variability exists among HIV-positive individuals regarding what they perceive as having had sex. Results support the need for clinicians to more precisely ascertain sexual perceptions and risks to achieve HIV prevention goals.

Chronic helminth infection induces alternatively activated macrophages expressing high levels of CCR5 with low interleukin-12 production and Th2-biasing ability.

Helminth infections induce Th2-type biased immune responses. Although the mechanisms involved in this phenomenon are not yet clearly defined, antigen-presenting cells (APC) could play an important role in this process. Here, we have used peritoneal macrophages (F4/80+) recruited at different times after challenge with Taenia crassiceps as APC and tested their ability to regulate Th1/Th2 differentiation. Macrophages from acute infections produced high levels of interleukin-12 (IL-12) and nitric oxide (NO), paralleled with low levels of IL-6 and prostaglandin E(2) (PGE(2)) and with the ability to induce strong antigen-specific CD4+ T-cell proliferation in response to nonrelated antigens. In contrast, macrophages from chronic infections produced higher levels of IL-6 and PGE(2) and had suppressed production of IL-12 and NO, associated with a poor ability to induce antigen-specific proliferation in CD4+ T cells. Failure to induce proliferation was not due to a deficient expression of accessory molecules, since major histocompatibility complex class II, CD40, and B7-2 were up-regulated, together with CD23 and CCR5 as infection progressed. These macrophages from chronic infections were able to bias CD4+ T cells to produce IL-4 but not gamma interferon (IFN-gamma), contrary to macrophages from acute infections. Blockade of B7-2 and IL-6 and inhibition of PGE(2) failed to restore the proliferative response in CD4+ T cells. Furthermore, studies using STAT6(-/-) mice revealed that STAT6-mediated signaling was essential for the expansion of these alternatively activated macrophages. These data demonstrate that helminth infections can induce different macrophage populations that have Th2-biasing properties.

Leptospirosis: una grave enfermedad que debemos conocer / Leptospirosis: a severe disease that we must know

Se presenta caso de paciente visto en interconsulta en el Area de Cuidados Intensivos del Hospital Clínico de la Universidad de Chile, con diagnóstico probable: reacción adversa a drogas. Al examen físico llamaban la atención la ictericia inyección conjuntival, alza térmica, cefalea, rijidez de nuca, mialgias y coluria. En piel se apreciaban máculas eritematosas, urticariales en cuello, axilas, brazo y zona inguinal. Se realiza serología para leptospira, la que confirma el diagnóstico de Leptospirosis. Se realiza extensa revisión bibliográfica de la enfermedad, con la finalidad de considerar esta patología entre los diagnósticos al ser interconsultados en servicios de mayor complejidad

Aspergilosis una micosis cutánea que debemos tener presente: a propósito de un caso / Aspergillosis a skin mycosis that we must have present: a propos of one case

Se presenta el caso de una paciente que fue vista en interconsulta por presentar lesiones en piel, acompañadas, según ecografía, de mixoma cardiaco, y además, con problemas neurológicos, por lo que fue hospitalizada. La biopsia y los resultados del cultivo de piel confirman el diagnóstico de Aspergilosis, por lo que fue tratada con anfotericina B, presentando una mejoría significativa de sus lesiones dermatológicas y de su estado general, pero luego sufre recaída de su sistema neurológico, especialmente por diseminación del Aspergillus a nivel sistémico. La paciente fallece un mes después de su hospitalización. Junto con presentar este interesante caso clínico se realiza una exhaustiva revisión bibliográfica de este tema

Escleroterapia percutánea de linfoceles con povidona yodada / Percutaneous sclerotherapy of a lymphocele with povidone iodine

Objetivo: Evaluar la efectividad de la esclerosis percutánea de linfoceles con povidona yodada.Material y Métodos: Estudio retrospectivo de ocho pacientes con una edad media de 49 años a los que se les ha realizado una esclerosis percutánea de linfoceles con povidona yodada. Seis linfoceles aparecieron tras trasplante renal, un linfocele tras intervención por adenocarcinoma de endometrio y otro linfocele tras trasplante de pulmón que requirió múltiples cateterismos femorales.Tras colocar un catéter pig-tail 8F en la colección se aspiró todo el líquido posible enviando muestras a bioquímica, citología y bacteriología; tras confirmación de que el líquido aspirado era linfa se procedió a la instilación de povidona yodada introduciendo cada 12 horas la mitad del volumen aspirado inicialmente, dejándolo en el interior de la colección durante 30 minutos. El catéter se retiró tras evidencia ecográfica de desaparición de la colección. A todos los pacientes se realizó ecografía de seguimiento.Resultados: Todos los linfoceles fueron sintomáticos y estériles y aparecieron tras un tiempo medio de 125 días tras la cirugía. El tamaño medio inicial de los linfoceles fue de 10,6 × 8,1 cm y volumen medio inicial de linfa aspirada fue de 161 ml. El tiempo medio de permanencia del catéter fue de 17 días y no hubo sobreinfección de la colección.En seis pacientes se consiguió una esclerosis completa (sin posterior recidiva) tras un tiempo medio de seguimiento de 23 meses. En un paciente hubo una colección residual de 2 × 2 cm que ha permanecido estable y asintomática durante 11 meses. En una paciente con esclerosis inicial se produjo una colección recidivante de 12 × 4 cm a los ocho meses.Conclusión: La escleroterapia percutánea de linfoceles con povidona yodada es un tratamiento efectivo (AU)

Consumo de drogas ilícitas en Chile por zonas geográficas censales: resultados del estudio nacional de 1994 / Illicit drug comsumption in Chile by geographic areas: results of the national study, 1994

Mediante una encuesta probabilística tri-etápica, el Consejo Nacional para el Control de Estupefacientesllevó a cabo el primer estudio nacional en 1994, con el objeto de evaluar el consumo de drogas a nivel nacional, como tanmbién a nivel de las zonas geográficas del país. El 13,4 por ciento de la población chilena que vive en ciudades de 50.000 y más habitantes ha consumido droga alguna vez en la vida, el 4,45 por ciento lo ha hecho en el último año, y el 2 por ciento en el último mes, considerando cualquiera de las tres drogas ilícitas de mayor consumo en el país (marihuana, pasta base y clorhidrato de cocaína). En las zonas geográficas censales en que se subdivide el territorio nacional, las mayores tasas de prevalencia de consumo en el último año, se concentran en la Zona Norte Chico, con un 5,8 por ciento y en la Región Metropolitana con un 5 por ciento, observándose la menor tasa en la Zona Austral con un 2,3 por ciento. En cuanto a género, los hombres superan a las mujeres en más de 3 veces el consumo de estas drogas ilícitas. En el género femenino, la razón entre estas prevalencias entre la Región Metropolitana y la Zona Austral es casi 7 veces. El consumo de drogas ilícitas en el último año es mayor en el caso de la marihuana, casi 7 veces los consumos declaradosde pasta base y clorhidrato de cocaína; es mayor en el grupo entre los 19 y 25 años y en los niveles socioeconómicos alto y medio-alto

Consumo de drogas en Chile: resultados del estudio nacional 1994 / Drug comsumption in Chile: national study results, 1994

Con el objeto de evaluar el consumo de drogas en Chile, se realizó un estudio descriptivo en la población de 12 a 64 años. La muestra está referida a la población de las ciudades de al menos 50.000 habitantes en las 12 regiones de Chile. El muestreo fue probabilístico trietápico. El 13.42 por ciento declaró haber consumido alguna droga ilícita en su vida. Este porcentaje está fuertemente marcado por el consumo de marihuana. Por otra parte, el 3.12 por ciento declaró haber iniciado el consumo durante el último año. El consumo de drogas ilícitas es bastante más frecuente en hombres que en mujeres, en razón de 3 a 1. Sin embargo, dicha razón baja a 2 a 1 en el caso de los jóvenes entre 12 y 18 años. El consumo de alcohol y tabaco muestra prevalencias, en el último mes, de aproximadamente 40 por ciento en cada caso