Estudio preliminar sobre la evaluación del dolor mecánico a la presión y los mecanismos de modulación central del dolor mediante algometría en una unidad de anestesia / Preliminary study on the evaluation of mechanical pressure pain and central pain modulation mechanisms by algometry in an anesthesia unit

Introducción: La algometría de presión es un método válido para evaluar el sistema sensorial de transmisión del dolor en seres humanos, mediante pruebas como la sumación temporal y la modulación condicionada del dolor. El objetivo de este trabajo fue la realización de una experiencia preliminar en el Servicio de Anestesio­logía de nuestro Hospital Universitario, utilizando la algometría de presión como test sensorial cuantitativo. Metodología: En una primera etapa, se realizó un estudio transversal de caso y control, sin aleatorización, donde se midió el umbral de dolor a la presión por algometría de presión a 58 pacientes que consultaron en la policlínica preoperatoria. Dieciocho tenían algún tipo de dolor crónico (grupo con dolor) y 40 no tenían dolor (grupo sin dolor). En una segunda etapa, se realizó un estudio observacional a 36 voluntarios sanos, residentes de anestesiología. En 16 se estudió la sumación temporal y en 20 la modulación condicionada del dolor, en ambos casos utilizando la algometría de presión. La aplicación de presión con manguito en el brazo se utilizó como estímulo heterotópico. Ambas pruebas fueron medidas a nivel del músculo trapecio derecho. Resultados: En el grupo con dolor el valor del umbral de dolor a la presión fue menor que en el grupo sin dolor en todos los puntos evaluados. El valor del umbral de dolor a la presión promedio de las cuatro regiones analizadas en el grupo con dolor, resultó ser menor que en el grupo sin dolor, 32,7 ± 10 Newtons versus 42 ± 11,7 Newtons (p = 0,004). El umbral de dolor a la presión promedio resultó más bajo en pacientes de sexo femenino que en los de sexo masculino, 36,6 ± 9 Newtons versus 48 ± 11 Newtons (p = 0,001)...(AU)

Introduction: Pressure algometry is a valid method to evaluate the sensory system of pain transmission in humans, using tests such as temporal summation and conditioned modulation of pain. The objective of this work was to carry out a preliminary experience in the Anesthesiology Service of our University Hospital, using pressure algometry as a quantitative sensory test. Methodology: In a first stage, a cross-sectional case-control study was carried out, without randomization, where the pressure pain threshold was measured by pressure algometry in 58 patients who consulted in the preoperative evaluation visit. Eighteen had some type of chronic pain (pain group) and 40 had no pain (pain-free group). In a second stage, an observational study was carried out on 36 healthy volunteers, anesthesiology residents. Temporal summation was studied in 16 and conditioned modulation of pain in 20, in both cases using pressure algometry. The application of cuff pressure to the arm was used as a heterotopic stimulus. Both tests were measured at the level of the right trapezius muscle. Results: In the group with pain, the pressure pain threshold value was lower than in the group without pain in all the points evaluated. The pain threshold va­lue at the mean pressure of the four regions analyzed in the group with pain, turned out to be lower than in the group without pain, 32.7 ± 10 Newtons versus 42 ± 11.7 Newtons (p = 0.004). The mean pressu­re pain threshold was lower in female patients than in male patients, 36.6 ± 9 Newtons versus 48 ± 11 Newtons (p = 0.001). In the 20 healthy volunteers who underwent the conditioned modulation of pain test at the trapezius level, the pain threshold at the initial pressu­re was 63 ± 27 Newtons and the final pressure was 72 ± 28 Newtons, with an average increase of 9 Newtons (14.2 %)...(AU)

A conjoint analysis to consumer choice in Brazil: Defining device attributes for recognizing customized foods characteristics.

the availability of information about food products may be an essential factor in the consumer's value perception in their purchasing decision. As the food product becomes personalized, the customization of this information becomes complex due to the possible combinations of product components. The use of smart technology in devices is one way to provide customers with customized food information. In the following research five attributes were identified in the composition of these devices: (A) portability; (B) precision; (C) diet customization; (D) food quality analysis; and (E) price. This study aims to identify the appropriate combination of possible functionalities or attributes that must be present in a device in order to detect the food composition of customized foods and their relation to market characteristics. One experiment used fractional factorial project to present the attributes in the form of scenarios following the Choice-Based Conjoint Analysis (CBCA) method. The data collection was done using survey methodology, through online questionnaire, with some 303 Brazilian respondents. So, the Logistic Regression was applied to data analysis. The moderating variables-gender, age, gluten restriction, lactose restriction and other restrictions-were also added to verify potential interactions with the primary attributes. From the results obtained, it was possible to observe higher significance for the primary attributes of diet personalization and quality food analyzes function. Our study contributes to the literature by enhancing the understanding about what the attributes should be in a technological device that has the purpose of recognizing food characteristics and is capable of generating information about customized food products. Furthermore, this device can enabler the production of mass customized food with the nutritional labels for each possible combination.

Artificial neural network based identification of environmental bacteria by gas-chromatographic and electrophoretic data.

Chemotaxonomic identification techniques are powerful tools for environmental micro-organisms, for which poor diagnostic schemes are available. Whole cellular fatty acid methyl esters (FAME) content is a stable bacterial profile, the analysis method is rapid, cheap, simple to perform and highly automated. Whole-cell protein is an even more powerful tool because it yields information at or below the species level. The description of new species and genera and subsequent continuous rearrangement provide large amounts of data, resulting in large databases. In order to set up suitable software tools to work on such large databases artificial neural network (ANN) based programs have been used to classify and identify marine bacteria at genus and species levels, starting from the fatty acid profiles and protein profiles respectively. We analysed 50 certified strains belonging to Halomonas, Marinomonas, Marinospirillum, Oceanospirillum and Pseudoalteromonas genera. Both supervised and unsupervised ANNs provide a correct classification of the marine strains analyzed. Moreover, a set of 73 marine fresh isolates were used as an example of identification using ANNs. We propose supervised and unsupervised ANNs as a reliable tool for classification of bacteria by means of their FAME and of whole-protein analyses and as a sound basis for a comprehensive artificial intelligence based system for polyphasic taxonomy.

[Seroprevalence of T. cruzi infection in 6- and 12- year-old school children from three Uruguayan endemic departments]. / Seroprevalencia de la infección por Trypanosoma cruzi en escolares de seis y doce años de edad de tres departamentos endémicos de Uruguay.

The last national survey on seroprevalence of T. cruzi human infection in Uruguay, showed a 3.4% in adults from endemic areas. Since 1983, antivectorial actions of the control program have been carried out continually. In consequence, household infestation by Triatoma infestan, the main vector of T. cruzi in Uruguay, decreased in all endemic areas and was completely eliminated in some of them. The objectives of the present work are to evaluate the new seroepidemiological situation. A representative sampling of rural and urban population was undertaken, to include six and twelve year-old school children from three departments: Artigas, Rivera and Tacuarembo. The whole sample included 4,722 school children, evaluated by the indirect immunofluorescence (IFI) test for Chagas disease. The seroprevalence of T. cruzi infection in the six year-old group was 0.3% in Artigas, 0.6% in Rivera and 1.0% in Tacuarembo. The seropositive children with seropositive mothers support the possible congenital transmission.

An integration system to rapidly identify aquatic bacteria.

An identification system for aquatic bacteria which would be useful for aspects ranging from pollution monitoring to health care, is described. It contains relevant information concerning the nature, taxonomy and activity of aquatic bacteria and allows to identify fresh isolates by means of their chemotaxonomic profiles. The system is simple and user friendly, so that it can be used by people not familiar with computers and has a modular interface that allows an easy interaction with laboratory instruments. The system is also connected with artificial neural network based programs to identify strains starting from the considered chemotaxonomic features.

Artificial neural network identification of heterotrophic marine bacteria based on their fatty-acid composition.

The traditional approach to biochemical identification of marine fresh isolates requires considerably long culture preparation times and large quantities of expensive materials and reagents, and the results are not reliable. On the other hand, taxonomy tests based on DNA composition, although sensitive and reliable, require long execution time and high costs. A method is presented for the classification of fatty-acid profiles, extracted from marine bacteria strains, at genus level based on supervised artificial neural networks. The proposed method allows the correct identification of all patterns belonging to the test set. Moreover, a quantitative measure of the importance of each fatty acid for bacterial classification is also achieved. This measure allows the determination of a cluster of fatty acids to be controlled with greater care. The results show that the proposed method is reproducible and rapid, so that it can be routinely used in the marine microbiology laboratory to identify fresh isolates.

Automated systems for identification of heterotrophic marine bacteria on the basis of their Fatty Acid composition.

The fatty acid methyl ester composition of a total of 71 marine strains representing the genera Alteromonas, Deleya, Oceanospirillum, and Vibrio was determined by gas-liquid chromatographic analysis. Over 70 different fatty acids were found. The predominant fatty acids were 16:0, 16:1 cis 9, summed-in-feature (SIF) 4 (15:0 iso 2OH and/or 16:1 trans 9) and SIF 7 (18:1 cis 11, 18:1 trans 9, and/or 18:1 trans 6) for all the strains considered, but minor quantitative variations could be used to distinguish the different genera. In addition to a conventional statistical processing method to analyze the data and draw comparison between species and genera, an approach involving neutral network-based elaboration is applied. The statistical analysis and dendrogram representation gave a comparison of the species considered, while the neural network computation provided a more accurate assignment of species to their genera. Moreover, by using neural networks, it was possible to conclude that only 22 fatty acids were important for the identification of the marine genera considered. A database of Alteromonas, Deleya, Oceanospirillum, and Vibrio fatty acid methyl ester profiles was generated and is now routinely used to identify fresh marine isolates.

Ecology of Triatoma rubrovaria (Hemiptera, Triatominae) in wild and peridomestic environments of Uruguay.

This paper describes population structure, spatial distribution and habitat selection of wild and peridomestic populations of Triatoma rubrovaria (Blanchard, 1843). Field studies were carried out at Las Piedras and La Bolsa in the Northern Department of Artigas, Uruguay. A semicircular sampling area, divided in seven or eight triangular sectors was sequentially examined from October 1990 to November 1991. At Las Piedras (typical wild habitat) 1063 T. rubrovaria bugs were collected from 84% of the rocky outcroops ("pedregales"). Abundance varied by season peaking in October-November (spring). Throughout the year, most of the population was made up of third, fourth and fifth instar nymphs; adults were found from October to March. In the peridomestic environment of La Bolsa, however T. rubrovaria was less common and showed a more irregular instar distribution. Colonized ecotopes, were those close to houses. In both sites T. rubrovaria was mainly associated with the geckonid Homonota uruguayensis and the cockroach Blaptica dubia.

[Feeding pattern of Triatoma rubrovaria (Blanchard, 1843) (Hemiptera, Triatominae) in peridomiciliary habitats, of a rural area of Uruguay]. / Perfil alimentario de Triatoma rubrovaria (Blanchard, 1843) (Hemiptera, triatominae) en ámbitos peridomiciliarios, de una localidad rural de Uruguay.

It has been studied the feeding patterns of Triatoma rubrovaria (wild triatominae bug, and intradomiciliary secondary vector of T. cruzi) in a rural area of "La Bolsa" (Department of Artigas). Agar double diffusion test were used for analyze the blood meal, from 120 insects, which were confronted to 13 antisera. It has 251 identify blood meals, and the most frequently was mammalian host (73%), but it has a variable source of feeding (mammals, birds, reptiles and cockroach), including humans rate 8% of the total. The identify of haemolimphe as feed, place this triatominae bug as an intermediary vector between predator and haematophagous. The most usual mammals are dasypodides and bovines. The frequence of human blood meal near the dwellings, shows its potentiality as vectors. Therefore, the peridomicile is an area of interaction between, domestic, wild and sinantropic host. The trypanosomic infection's rate at peridomiciles was lesser those at wild areas.

Treatment of human cutaneous sporotrichosis with itraconazole.

Eighteen adult white male patients with cutaneous sporotrichosis were treated with itraconazole following different daily dose schemes. Cure was obtained in all cases after periods of 15-75 days (median 44 days) with total doses between 3.1 and 14.8 g (median 8.4 g). No serious side effects were observed and no relapses occurred in the follow-up period of between 1 and 26 months (median 14.7). These results show that itraconazole represents a safe and effective drug for the treatment of sporotrichosis. Comparison with other studies leads us to consider a daily dose of 200 mg as the most appropriate. A concomitant warming of the affected limbs should be recommended.

Serum dependent expression of Enterococcus faecalis adhesins involved in the colonization of heart cells.

Our previous studies have shown that the adhesive ability of Enterococcus faecalis is dependent on the strain and is further modified by growth in serum. The data reported here demonstrate that E. faecalis adherence is mediated by carbohydrate residues present on the bacterial cell surface. Some of these (D-mannose and D-glucose) are expressed by strains isolated from both urinary tract infections (UTI) and endocarditis (EN) when the cells are grown in brain-heart infusion broth (BHIB), and mediate adherence to either urinary tract epithelial cells or the Girardi Heart (GH) cell line. Other residues are present only on EN strains (D-galactose and L-fucose) and mainly mediate adherence to GH cells. These ligands can also be expressed by UTI isolates after growth in serum. D-galactose-bearing adhesins also seem to be involved in internalization of serum grown UTI strains and BHIB or serum grown EN isolates into GH cells.

Enterococcus faecalis: specific and non-specific interactions with human polymorphonuclear leukocytes.

In previous studies we have demonstrated that the ability of Enterococcus faecalis to adhere to and to be internalized in human urinary tract epithelial cells, Girardi Heart cells and human polymorphonuclear leukocytes (PMNs), was dependent on whether the strain had been isolated from urinary tract infections (UTI) or endocarditis (EN) respectively. These properties were further modified by growth of the organism in human serum. In the present report, using competition assays we show that adhesins containing a D-glucose moiety play a role in mediating the interactions between human PMNs and E. faecalis strains isolated from UTI and grown in brain-heart infusion broth (BHIB). On the other hand, adhesins containing both D-glucose and D-galactose moieties were involved in the interactions between PMNs and serum grown UTI isolates or EN isolates grown in either BHIB or human serum. Moreover, the impairment in the association between both UTI and EN strains after growth in serum appears to be at least partially related to a decrease in enterococcal surface hydrophobicity.

[Seroprevalence of antibodies against Trypanosoma cruzi in 13 departments of Uruguay]. / Seroprevalencia de anticuerpos contra Trypanosoma cruzi en 13 departamentos del Uruguay.

In 1985 a study was undertaken of the prevalence of Trypanosoma cruzi antibodies in 13 departments of Uruguay where transmission of the parasite by the vector Triatoma infestans persists. A total of 5,924 serum samples were selected using a probabilistic method--3,840 from individuals over the age of 12 (sample I) and 2,084 from subjects who were 12 years old (sample II). The population was classified according to place of residence (capital city, non-capital city, suburban area, and rural area). The percentage of positive sera detected by indirect immunofluorescence in the different departments ranged from 1 to 11%, and overall seroprevalence for the area was 3.4%. Based on the results obtained, it was possible to distinguish three areas: A, with seroprevalence from 6 to 11%; B, 2 to 3.2%, and C, 1 to 1.4%. In sample II from the Departments of Paysandú, Soriano, Flores, Florida, and Durazno, no cases of Chagas' disease were detected, which suggests that there is no active transmission of T. cruzi in this age group in the area studied. The number of persons estimated to have the disease was 36,952, or 1.3% of the total population of Uruguay and 4% of the population in the area surveyed. These seroprevalence figures are similar to those recorded in the province of Entre Ríos, Argentina, and in the neighboring municipalities of Rio Grande do Sul, Brazil.

Seroprevalencia de anticuerpos contra trypanosoma cruzi en 13 departamentos del Uruguay / Seroprevalence of trypanosoma cruzi in 13 deparments of Uruguay

In 1985 a study was undertaken of the prevalence of Trypanosoma cruzi antibodies in 13 departments of Uruguay where transmission of the parasite by the vector Triatoma infestans persists. A total of 5 924 serum samples were selected using a probabilistic method- 3 840 from individuals over the age of 12 (sample I) and 2 084 from subjects who where 12 years old (sample II). The population was classified acording to place of residence (capital city, non-capital city, suburban área, and rural área). The percentage of positive sera detected by indirect immunofluorescence in the different departments ranged from 1 to 11 percent, and overall seroprevalence for the área was 3.4 percent. Based on the results obtained, it was possible to distinguish three áreas: A, which seroprevalence from 6 to 11 percent; B, 2 to 3.2 percent, and C, 1 to 4 percent. In sample II from the Departments of Paysandu, Soriano, Flores, Florida, and Durazno, no cases of Chagas' disease were detected which suggests that there is no active transmission of T. cruzi in this age group in the área studied. The number of persons estimated to have the disease was 36 952, or 1.3 percent of the total population of Uruguay and 4 percent of the population in the área surveyed. These seroprevalence figures are similar to those recorded in the povince of Entre Rios, Argentina, and in the neighboring municipalities of Rio Grande do Sul, Brazil

Role of adherence in pathogenesis of Enterococcus faecalis urinary tract infection and endocarditis.

Enterococcus faecalis strains isolated from urinary tract infections (UTIs) and endocarditis were analyzed for their ability to adhere to urinary tract epithelial cells (ECs) and Girardi heart (GH) and human embryonic kidney (HEK) cell cultures. UTI isolates adhered to urinary tract ECs more efficiently than to the cultured cells, at the same time showing the least affinity for GH cells. In contrast, endocarditis isolates adhered to GH cell cultures more readily than to urinary tract ECs. Moreover, although strains isolated from endocarditis adhered to GH cells more efficiently than those derived from UTI, the latter strains adhered to urinary tract cells better than the former. Studies of the ability of GH and HEK cells to internalize E. faecalis showed that for UTI isolates, 9 to 74% of adhered bacteria were internalized, while for endocarditis isolates, the percentage varied from 76 to 82%. All strains were able to associate with human neutrophils; endocarditis strains, however, associated less efficiently than UTI isolates. Growth in serum raised the adherence of all tested strains by at least 1.5- to 3-fold, with the greatest increase being observed in UTI strain adherence to GH cells (8-fold). In contrast, the association of serum-grown cells with polymorphonuclear leukocytes was reduced by two- to fivefold. In both cases, the observed serum-dependent alterations were cancelled by a few subcultures in brain heart infusion broth. These results indicate that adhesive properties are important virulence factors in the pathogenesis of UTI and endocarditis and also suggest that UTI strains showing the highest invasion and adhesive potential invade the kidneys, cause bacteremia, and, after having expressed the serum-dependent surface modification, colonize the heart.

Impairment of phagocytosis by the Klebsiella pneumoniae mannose-inhibitable adhesin-T7 receptor.

It has been previously shown that Klebsiella pneumoniae K59 carrying the mannose-inhibitable adhesin-T7 receptor (MIAT) efficiently binds to polymorphonuclear leukocytes (PMNs) incubated at 4 degrees C but is not efficiently bound and internalized by phagocytes incubated at 37 degrees C. Pretreatment of K59 with compounds that bind the MIAT ligand (D-mannose, UV-inactivated T7 phages, and pepsin-digested anti-MIAT antibodies) enables PMNs to phagocytize and kill these bacteria. In this article, we show that the incubation temperature has no direct effect on expression of either the MIAT or the PMN receptors. These receptors were always expressed at 37 degrees C when PMNs were treated with substances that impaired their ability to rearrange their surfaces (glutaraldehyde and cytochalasins B and D). Pretreatment of inert PMNs with concanavalin A or succinyl concanavalin A drastically reduced binding of K59 to phagocytes at both 4 and 37 degrees C. The same pretreatment carried out with metabolically active PMNs enabled them to efficiently phagocytize the MIAT-positive strain. When phagocytes were treated with K59 bacteria, they became unable to ingest and kill a K59 mutant not expressing the MIAT which was sensitive to phagocytosis. If this pretreatment was performed in the presence of D-mannose, UV-inactivated T7 phages, and pepsin-digested anti-MIAT antibodies, PMNs maintained their phagocytic activity against the MIAT-negative strain. In the presence of K59 bacteria, a very low chemiluminescence response was generated; in contrast, a significant response was observed when bacteria were previously absorbed with UV-inactivated T7 phages and pepsin-digested anti-MIAT antibodies. These results support our previous suggestion that the MIAT adhesin triggers changes in the cell surface, inhibiting further binding and phagocytosis.

Cutaneous granuloma due to mycobacterium vaccae / Cutaneous granuloma due to mycobacterium vaccal

Se describe la primer observación de un granuloma cutáneo por Mycobacterium vaccae en el Uruguay, considerada como una micobacteria no patógena incluida en el grupo IV de Runyon. Es un paciente de 58 años de edad con dos lesiones de rodilla de 5 meses de evolución en el momento de suprimer consulta. Las mismas son secundarias a un mínimo traumatismo sobre tierra contaminada con excretas de vacuno. El diagnóstico fue realizado por el hallazgo de la bacteria en material contraído de la lesión, su aislamiento en cultivo, y la reproducción experimental de lesiones en la almohadilla plantar del hamster dorado. Se destaca su evolución regresiva favorable con la termoterapia local

Cutaneous granuloma due to mycobacterium vaccae / Cutaneous granuloma due to mycobacterium vaccal

Se describe la primer observación de un granuloma cutáneo por Mycobacterium vaccae en el Uruguay, considerada como una micobacteria no patógena incluida en el grupo IV de Runyon. Es un paciente de 58 años de edad con dos lesiones de rodilla de 5 meses de evolución en el momento de suprimer consulta. Las mismas son secundarias a un mínimo traumatismo sobre tierra contaminada con excretas de vacuno. El diagnóstico fue realizado por el hallazgo de la bacteria en material contraído de la lesión, su aislamiento en cultivo, y la reproducción experimental de lesiones en la almohadilla plantar del hamster dorado. Se destaca su evolución regresiva favorable con la termoterapia local (AU)