High-throughput characterization and phenotyping of resistance and tolerance to virus infection in sweetpotato.

Breeders have made important efforts to develop genotypes able to resist virus attacks in sweetpotato, a major crop providing food security and poverty alleviation to smallholder farmers in many regions of Sub-Saharan Africa, Asia and Latin America. However, a lack of accurate objective quantitative methods for this selection target in sweetpotato prevents a consistent and extensive assessment of large breeding populations. In this study, an approach to characterize and classify resistance in sweetpotato was established by assessing total yield loss and virus load after the infection of the three most common viruses (SPFMV, SPCSV, SPLCV). Twelve sweetpotato genotypes with contrasting reactions to virus infection were grown in the field under three different treatments: pre-infected by the three viruses, un-infected and protected from re-infection, and un-infected but exposed to natural infection. Virus loads were assessed using ELISA, (RT-)qPCR, and loop-mediated isothermal amplification (LAMP) methods, and also through multispectral reflectance and canopy temperature collected using an unmanned aerial vehicle. Total yield reduction compared to control and the arithmetic sum of (RT-)qPCR relative expression ratios were used to classify genotypes into four categories: resistant, tolerant, susceptible, and sensitives. Using 14 remote sensing predictors, machine learning algorithms were trained to classify all plots under the said categories. The study found that remotely sensed predictors were effective in discriminating the different virus response categories. The results suggest that using machine learning and remotely sensed data, further complemented by fast and sensitive LAMP assays to confirm results of predicted classifications could be used as a high throughput approach to support virus resistance phenotyping in sweetpotato breeding.

Early-Stage Phenotyping of Sweet Potato Virus Disease Caused by Sweet Potato Chlorotic Stunt Virus and Sweet Potato Virus C to Support Breeding.

Sweet potato virus disease (SPVD) is a global constraint to sweetpotato (Ipomoea batatas) production, especially under intensive cultivation in the humid tropics such as East Africa. The objectives of this study were to develop a precision SPVD phenotyping protocol, to find new SPVD-resistant genotypes, and to standardize the first stages of screening for SPVD resistance. The first part of the protocol was based on enzyme-linked immunosorbent assay results for sweet potato chlorotic stunt virus (SPCSV) and sweet potato virus C (SPVC) with adjustments to a negative control (uninfected clone Tanzania) and was performed on a prebreeding population (VZ08) comprising 455 clones and 27 check clones graft inoculated under screenhouse conditions. The second part included field studies with 52 selected clones for SPCSV resistance from VZ08 and 8 checks. In screenhouse conditions, the resistant and susceptible check clones performed as expected; 63 clones from VZ08 exhibited lower relative absorbance values for SPCSV and SPVC than inoculated check Tanzania. Field experiments confirmed SPVD resistance of several clones selected by relative absorbance values (nine resistant clones in two locations; that is, 17.3% of the screenhouse selection), supporting the reliability of our method for SPVD-resistance selection. Two clones were promising, exhibiting high storage root yields of 28.7 to 34.9 t ha-1 and SPVD resistance, based on the proposed selection procedure. This modified serological analysis for SPVD-resistance phenotyping might lead to more efficient development of resistant varieties by reducing costs and time at early stages, and provide solid data for marker-assisted selection with a quantitative tool for classifying resistance.[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Heterosis and Responses to Selection in Orange-Fleshed Sweetpotato (Ipomoea batatas L.) Improved Using Reciprocal Recurrent Selection.

Sweetpotato is a highly heterozygous hybrid, and populations of orange-fleshed sweetpotato (OFSP) have a considerable importance for food security and health. The objectives were to estimate heterosis increments and response to selection in three OFSP hybrid populations (H1) developed in Peru for different product profiles after one reciprocal recurrent selection cycle, namely, H1 for wide adaptation and earliness (O-WAE), H1 for no sweetness after cooking (O-NSSP), and H1 for high iron (O-HIFE). The H1 populations were evaluated at two contrasting locations together with parents, foundation (parents in H0), and two widely adapted checks. Additionally, O-WAE was tested under two environmental conditions of 90-day and a normal 120-day harvest. In each H1, the yield and selected quality traits were recorded. The data were analyzed using linear mixed models. The storage root yield traits exhibited population average heterosis increments of up to 43.5%. The quality traits examined have exhibited no heterosis increments that are worth exploiting. The storage root yield genetic gain relative to the foundation was remarkable: 118.8% for H1-O-WAE for early harvest time, 81.5% for H1-O-WAE for normal harvest time, 132.4% for H1-O-NSSP, and 97.1% for H1-O-HIFE. Population hybrid breeding is a tool to achieve large genetic gains in sweetpotato yield via more efficient population improvement and allows a rapid dissemination of globally true seed that is generated from reproducible elite crosses, thus, avoiding costly and time-consuming virus cleaning of elite clones typically transferred as vegetative plantlets. The population hybrid breeding approach is probably applicable to other clonally propagated crops, where potential for true seed production exists.

Multiple QTL Mapping in Autopolyploids: A Random-Effect Model Approach with Application in a Hexaploid Sweetpotato Full-Sib Population.

In developing countries, the sweetpotato, Ipomoea batatas (L.) Lam. [Formula: see text], is an important autopolyploid species, both socially and economically. However, quantitative trait loci (QTL) mapping has remained limited due to its genetic complexity. Current fixed-effect models can fit only a single QTL and are generally hard to interpret. Here, we report the use of a random-effect model approach to map multiple QTL based on score statistics in a sweetpotato biparental population ('Beauregard' × 'Tanzania') with 315 full-sibs. Phenotypic data were collected for eight yield component traits in six environments in Peru, and jointly adjusted means were obtained using mixed-effect models. An integrated linkage map consisting of 30,684 markers distributed along 15 linkage groups (LGs) was used to obtain the genotype conditional probabilities of putative QTL at every centiMorgan position. Multiple interval mapping was performed using our R package QTLpoly and detected a total of 13 QTL, ranging from none to four QTL per trait, which explained up to 55% of the total variance. Some regions, such as those on LGs 3 and 15, were consistently detected among root number and yield traits, and provided a basis for candidate gene search. In addition, some QTL were found to affect commercial and noncommercial root traits distinctly. Further best linear unbiased predictions were decomposed into additive allele effects and were used to compute multiple QTL-based breeding values for selection. Together with quantitative genotyping and its appropriate usage in linkage analyses, this QTL mapping methodology will facilitate the use of genomic tools in sweetpotato breeding as well as in other autopolyploids.

Quantitative trait loci and differential gene expression analyses reveal the genetic basis for negatively associated ß-carotene and starch content in hexaploid sweetpotato [Ipomoea batatas (L.) Lam.].

KEY MESSAGE: ß-Carotene content in sweetpotato is associated with the Orange and phytoene synthase genes; due to physical linkage of phytoene synthase with sucrose synthase, ß-carotene and starch content are negatively correlated. In populations depending on sweetpotato for food security, starch is an important source of calories, while ß-carotene is an important source of provitamin A. The negative association between the two traits contributes to the low nutritional quality of sweetpotato consumed, especially in sub-Saharan Africa. Using a biparental mapping population of 315 F1 progeny generated from a cross between an orange-fleshed and a non-orange-fleshed sweetpotato variety, we identified two major quantitative trait loci (QTL) on linkage group (LG) three (LG3) and twelve (LG12) affecting starch, ß-carotene, and their correlated traits, dry matter and flesh color. Analysis of parental haplotypes indicated that these two regions acted pleiotropically to reduce starch content and increase ß-carotene in genotypes carrying the orange-fleshed parental haplotype at the LG3 locus. Phytoene synthase and sucrose synthase, the rate-limiting and linked genes located within the QTL on LG3 involved in the carotenoid and starch biosynthesis, respectively, were differentially expressed in Beauregard versus Tanzania storage roots. The Orange gene, the molecular switch for chromoplast biogenesis, located within the QTL on LG12 while not differentially expressed was expressed in developing roots of the parental genotypes. We conclude that these two QTL regions act together in a cis and trans manner to inhibit starch biosynthesis in amyloplasts and enhance chromoplast biogenesis, carotenoid biosynthesis, and accumulation in orange-fleshed sweetpotato. Understanding the genetic basis of this negative association between starch and ß-carotene will inform future sweetpotato breeding strategies targeting sweetpotato for food and nutritional security.

Guía de práctica clínico-quirúrgica para hemorragia digestiva baja / Clinical practice guide in lower gastrointestinal bleeding

El objetivo de esta guía clínico-quirúrgica es homogeneizar conceptos y conductas para el manejo de la hemorragia digestiva baja (HDB), con el fin de protocolizar y unificar el tratamiento multidisciplinario de dicha patología. Durante el manejo inicial del paciente con HDB, resulta prioritario determinar la estabilidad hemodinámica. Cuando el paciente se presenta hemodinámicamente estable, la videocolonoscopia (VCC) es el método diagnóstico de elección, la cual debe realizarse con preparación colónica y dentro de las 48 horas, mientras que si se trata de un paciente inestable que no responde a la reanimación debe realizarse, de ser posible, angiotomografía para localizar el sitio de sangrado y posteriormente angiografía. Si las condiciones no lo permiten, se procede directamente a la cirugía de urgencia. Si se logra reanimar al paciente, el método diagnóstico de elección es la videoendoscopia digestiva alta (VEDA). Si la VEDA es negativa y el paciente permanece estable, se prosigue con VCC. Por el contrario, si continúa sangrando, el paso siguiente es la angio-TC. En caso de localizar el sitio de sangrado, se realiza angiografía terapéutica. Si falla o la angio-TC es negativa, tiene indicación de cirugía. Esta guía fue consensuada a partir de la bibliografía, guías internacionales y la experiencia de los Servicios de Cirugía General, Coloproctología, Gastroenterología, Diagnóstico por Imágenes y Hemodinamia.(AU)

Debilidad adquirida en la Unidad de Cuidados Intensivos / Weakness acquired in the Intensive Care Unit

La debilidad adquirida en la unidad de cuidados intensivos (DAUCI) es una patología frecuente en el paciente crítico, la cual lleva consecuentemente al aumento de la morbimortalidad, días de internación y de ventilación mecánica. La utilización de sedación profunda y la aparición de diversas intercurrencias tales como sepsis y delirio son considerados factores de riesgo que llevan a la inmovilización. La aparición de nuevo métodos de prevención, como la movilización precoz y la utilización de estimulación neuromuscular eléctrica, parecen ser la clave para evitar la presencia de DAUCI.(AU)

Use of radiotherapy in patients with palliative double bypass for locally advanced pancreatic adenocarcinoma.

PURPOSE: Pancreatic cancer (PC) has not changed overall survival in recent years despite therapeutic efforts. Surgery with curative intent has shown the best long-term oncological results. However, 80%-85% of patients with these tumors are unresectable at the time of diagnosis. In those patients, first therapeutic attempts are minimally invasive or surgical procedures to alleviate symptoms. The addition of radiotherapy (RT) to standard chemotherapy, ergo chemoradiation, in patients with locally advanced pancreatic cancer (LAPC) is still controversial. The study aims to compare outcomes in patients with a double bypass surgery due to LAPC treated or not with RT. MATERIALS AND METHODS: A retrospective cohort study of patients with double bypass for LAPC were registered and divided into two groups: treated or not with postoperative RT. Baseline characteristics, postoperative complications, those related to RT and their relation to the main event (mortality) were compared. RESULTS: Seventy-four patients were included. Surgical complications between the groups did not offer significant differences. Complications related to RT were mostly mild, and 86% of patients completed the treatment. Overall survival at 1 and 2 years for patients in the exposed group was 64% and 35% vs. 50% and 28% in the non-exposed group, respectively (p = 0.11; power 72%; hazard ratio = 0.53; 95% confidence interval, 0.24-1.18). CONCLUSION: We observed a tendency for survival improvement in patients with postoperative RT. However, we've not had enough power to demonstrate this difference, possibly due to the small sample size. It is indispensable to develop randomized and prospective trials to guide more specific treatment lines in this patients.

Gene Pool Subdivision of East African Sweetpotato Parental Material.

Sweetpotato [Ipomoea batatas (L.) Lam] breeding is important for food security and health in East Africa (EA), and a breeding platform in Uganda provides national researchers and breeders in EA with true seed. Our objectives were to characterize genetic relationships among parental material used at the EA breeding platform. There were 135 parents and six check clones analyzed using 31 simple sequence repeat primers. An average of 7.13 alleles per primer was found, and Jaccard similarity coefficients were in the range of 0.298 to 1.00 with a mean of 0.542. Unweighted pair group cluster analysis placed most African parents in two main subclusters showing no association with morphology or geographical origin. The subclusters were also supported by principal coordinate analysis, derivative analysis of principal components, and population structure simulations. The analyzed breeding material from EA was highly genetically variable, grouped in two distinct genetic pools, and suitable to study heterosis exploiting breeding schemes.

Atlas-based segmentation in breast cancer radiotherapy: Evaluation of specific and generic-purpose atlases.

OBJECTIVES: Atlas-based automatic segmentation (ABAS) addresses the challenges of accuracy and reliability in manual segmentation. We aim to evaluate the contribution of specific-purpose in ABAS of breast cancer (BC) patients with respect to generic-purpose libraries. MATERIALS AND METHODS: One generic-purpose and 9 specific-purpose libraries, stratified according to type of surgery and size of thorax circumference, were obtained from the computed tomography of 200 BC patients. Keywords about contralateral breast volume and presence of breast expander/prostheses were recorded. ABAS was validated on 47 independent patients, considering manual segmentation from scratch as reference. Five ABAS datasets were obtained, testing single-ABAS and multi-ABAS with simultaneous truth and performance level estimation (STAPLE). Center of mass distance (CMD), average Hausdorff distance (AHD) and Dice similarity coefficient (DSC) between corresponding ABAS and manual structures were evaluated and statistically significant differences between different surgeries, structures and ABAS strategies were investigated. RESULTS: Statistically significant differences between patients who underwent different surgery were found, with superior results for conservative-surgery group, and between different structures were observed: ABAS of heart, lungs, kidneys and liver was satisfactory (median values: CMD<2 mm, DSC≥0.80, AHD<1.5 mm), whereas chest wall, breast and spinal cord obtained moderate performance (median values: 2 mm ≤ CMD<5 mm, 0.60 ≤ DSC<0.80, 1.5 mm ≤ AHD<4 mm) and esophagus, stomach, brachial plexus and supraclavicular nodes obtained poor performance (median CMD≥5 mm, DSC<0.60, AHD≥4 mm). The application of STAPLE algorithm generally yields higher performance and the use of keywords improves results for breast ABAS. CONCLUSION: The homogeneity in the selection of atlases based on multiple anatomical and clinical features and the use of specific-purpose libraries can improve ABAS performance with respect to generic-purpose libraries.

Development of the vertebral column and caudal skeleton in Prochilodus lineatus larvae under laboratory conditions / Desarrollo de la columna vertebral y del esqueleto caudal en larvas de Prochilodus lineatus en condiciones de larvicultura intensiva

For successful fish larviculture thorough studies describing the development of fish in different morphological aspects are required, as they are crucial for larval survival and growth. The present study described in Prochilodus lineatus larvae the osteological development of the vertebral column and caudal skeleton 30 days after hatching (dah). Larvae were obtained by artificial induction of adults. The beginning of formation of the spine occurs between 10 to 12 dah (8.3 mm standard length, SL) simultaneously to the first neural and hemal processes and the pre-caudal vertebral bodies. The ossification of the vertebral column occurred in cranio-caudal direction and was completed at 28 dah (22.6 mm SL). The development of the caudal skeleton elements started between 6 and 8 dah with the formation of the hypurals (H), the parahipural (PH) and the primary and secondary caudal rays. H 1 to H 3 were formed as cartilaginous primordia on the ventral side of the distal portion of the notochord, while the PH and H 4 to H 6 were formed subsequently. The first rays of the caudal fin were observed in correspondence with the formation of H 2 and H 3, while complete formation of the caudal fin was observed at 28 dah. The epurals, three in number, were evident as cartilaginous elements located both dorsal and distal in the notochord. Central ural complex (CUC) was formed by the fusion of three structures, the center preural 1 and urals 1 and 2. Development of the vertebral column and the caudal skeleton in P. lineatus larvae showed similar patterns to those described for other teleosts.

Se describe el desarrollo osteológico de la columna vertebral y del esqueleto caudal en larvas de sábalo (Prochilodus lineatus) bajo condiciones controladas hasta los 30 días posteriores a la eclosión (dpe). El inicio de la formación de la columna vertebral fue observado entre los 10-12 dpe (8,3 mm de longitud estándar, LE) con la aparición de los primeros procesos neurales, hemales y cuerpos vertebrales pre-caudales. La osificación de la columna vertebral ocurrió en sentido cráneo-caudal y fue completa a los 28 dpe (22,6 mm LE). El esqueleto caudal inició su desarrollo entre los 6 y 8 dpe con la formación de los hipurales (H), parahipural (PH) y los radios caudales principales y secundarios. Los H 1 al 3 se formaron como primordios cartilaginosos en la cara ventral de la porción distal de la notocorda, mientras que posteriormente se formaron los H 4 al 6 y el PH. Los primeros radios de la aleta caudal fueron observados en correspondencia con la formación de los H 2 y 3, mientras que a los 28 dpe se observó la completa formación de los mismos, existiendo 10 radios en el lóbulo dorsal y 9 en el lóbulo ventral. Los epurales, en número de tres, fueron evidentes como elementos cartilaginosos en dorsal de la notocorda y distalmente a los arcos neurales, permaneciendo sin osificarse hasta los 25 dpe. El complejo centro ural se constituyó por la fusión de tres estructuras, el centro preural 1, el ural 1 y 2. El desarrollo de la columna vertebral y del esqueleto caudal muestran patrones similares a los descriptos en otros teleósteos.

Osteomesopyknosis--a benign axial hyperostosis that can mimic metastatic disease.

We report two cases of an axial osteosclerosis with histopathologic findings of osteomesopyknosis in siblings. Osteomesopyknosis is a benign hereditary osteosclerosis that can show a radiologic pattern similar to blastic metastatic disease. The aim of this article is to inform radiologists about the existence of this benign condition and its various radiologic manifestations. Therefore, we discuss the principal differential diagnosis and point out the key imaging findings of osteomesopyknosis in order to avoid overdiagnosis in future cases.

Influence of sociodemographic factors upon pain intensity in patients with temporomandibular joint disorders seen in the primary care setting

Objective: A study is made of the influence of gender, educational level, marital status, income, social support, and perceived general and oral health upon pain intensity in a sample of patients with temporomandibular joint disorders (TMJD) explored in primary care (AP).Design: A review was made of 899 patients from Córdoba Healthcare District (Spain) referred to the primary care TMJD Unit by their primary care physician and/or dentist. Of these subjects, 151 failed to meet the inclusion criteria. The remaining 748 subjects were explored according to the corresponding research diagnostic criteria (RDC/TMJD). A bivariate analysis was made the association of pain intensity to the demographic and psychological characteristics of the patients, and to perceived general and oral health, followed by a multivariate linear regression analysis to explain pain intensity as a function of the rest of the variables. The SPSS version 19.0 statistical package was used.Results: The patient age ranged from 18-86 years, with a mean of 45.8 years (± 15.8), and a female predominance of 5:1. The characteristic pain intensity (CPI) score was almost 15 points higher on average in women than in men (p<0.05). A lower educational level, and separation or divorce, were correlated to an increased intensity of pain. Social support, depression and general and oral health also explained part of pain intensity. The regression model established with these variables accounted for 13.3% of the variability of pain (R2 = 0.133).Conclusions: Women suffer more intense pain than men. Perceived health partially explains the variability of the CPI score. However, it is empirically seen that the variables gender, educational level and marital status exert an important and independent influence upon pain intensity (AU)

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Influence of sociodemographic factors upon pain intensity in patients with temporomandibular joint disorders seen in the primary care setting.

OBJECTIVE: A study is made of the influence of gender, educational level, marital status, income, social support, and perceived general and oral health upon pain intensity in a sample of patients with temporomandibular joint disorders (TMJD) explored in primary care (AP). DESIGN: A review was made of 899 patients from Córdoba Healthcare District (Spain) referred to the primary care TMJD Unit by their primary care physician and/or dentist. Of these subjects, 151 failed to meet the inclusion criteria. The remaining 748 subjects were explored according to the corresponding research diagnostic criteria (RDC/TMJD). A bivariate analysis was made the association of pain intensity to the demographic and psychological characteristics of the patients, and to perceived general and oral health, followed by a multivariate linear regression analysis to explain pain intensity as a function of the rest of the variables. The SPSS version 19.0 statistical package was used. RESULTS: The patient age ranged from 18-86 years, with a mean of 45.8 years (± 15.8), and a female predominance of 5:1. The characteristic pain intensity (CPI) score was almost 15 points higher on average in women than in men (p<0.05). A lower educational level, and separation or divorce, were correlated to an increased intensity of pain. Social support, depression and general and oral health also explained part of pain intensity. The regression model established with these variables accounted for 13.3% of the variability of pain (R2 = 0.133). CONCLUSIONS: Women suffer more intense pain than men. Perceived health partially explains the variability of the CPI score. However, it is empirically seen that the variables gender, educational level and marital status exert an important and independent influence upon pain intensity.

¿Qué opinan los residentes de reumatología sobre su formación? Una encuesta de la Comisión Nacional de Reumatología / What do rheumatology residents think of their training? A survey of the National Rheumatology Commission

La Comisión Nacional de Reumatología ha elaborado una encuesta sobre la satisfacción de los residentes respecto a su periodo formativo. Contestaron un 37% de los 176 invitados a participar. Un 71% manifestó que estaba satisfecho o muy satisfecho de la influencia de la actividad asistencial en su formación. El 38% estaba insatisfecho o muy insatisfecho de la supervisión por parte de la plantilla. El 39% estaba insatisfecho o muy insatisfecho del adiestramiento en microscopía de luz polarizada. El 52% contestó que no existían reuniones periódicas estructuradas de monitorización de su formación. El 66% declaró que no había existido ningún tipo de evaluación efectiva de su formación. El 39% se mostró insatisfecho o muy insatisfecho respecto a las facilidades para publicar que le brindó su unidad docente. La satisfacción global sobre la formación asistencial de los residentes de reumatología es elevada. Existen oportunidades de mejora referentes al entrenamiento en determinadas técnicas, la monitorización y evaluación del periodo formativo y la formación en habilidades de investigación (AU)

The National Commission of Rheumatology has developed a satisfaction survey for residents concerning their training period. 37% of the 176 invited to participate answered the survey. 71% said they were satisfied or very satisfied with the influence of the assistance activities during their training. 38% were dissatisfied or very dissatisfied with supervision by staff. 39% were dissatisfied or very dissatisfied with their training in polarized light microscopy. 52% said no regular meetings were structured to monitor their training. 66% said that there had been no effective evaluation of their training. 39% were dissatisfied or very dissatisfied on the tools they were given to publish at their teaching unit. Overall satisfaction on classroom training for residents of Rheumatology is high. There are opportunities for improvement relating to training in certain techniques, monitoring and evaluation of the training period and training in research skills (AU)

[What do rheumatology residents think of their training? A survey of the National Rheumatology Commission]. / ¿Qué opinan los residentes de reumatología sobre su formación? Una encuesta de la Comisión Nacional de Reumatología.

The National Commission of Rheumatology has developed a satisfaction survey for residents concerning their training period. 37% of the 176 invited to participate answered the survey. 71% said they were satisfied or very satisfied with the influence of the assistance activities during their training. 38% were dissatisfied or very dissatisfied with supervision by staff. 39% were dissatisfied or very dissatisfied with their training in polarized light microscopy. 52% said no regular meetings were structured to monitor their training. 66% said that there had been no effective evaluation of their training. 39% were dissatisfied or very dissatisfied on the tools they were given to publish at their teaching unit. Overall satisfaction on classroom training for residents of Rheumatology is high. There are opportunities for improvement relating to training in certain techniques, monitoring and evaluation of the training period and training in research skills.

Criterios de acreditación para la formación de especialistas de reumatología / Formation of specialists in rheumatology: accreditation criteria

La Comisión Nacional de Reumatología es el garante de la formación postgrado en reumatología. Se presentan a continuación los criterios de acreditación de unidades docentes. Estos criterios tienen en cuenta 4 dominios, a saber: la estructura, la asistencia, la docencia y la investigación. Cada dominio se subdivide en subdominios e ítems. Algunos de ellos son de obligado cumplimiento. Este documento es el marco de referencia para las evaluaciones de las solicitudes de acreditación. Es un documento que puede ser revisado en un futuro (AU)

The National Rheumatology Board is responsible for postgraduate formation in rheumatology. Herein we present the new criteria for accreditation of teaching units. These criterion contemplate four domains, namely: structure, clinical work, teaching and research. Each domain is divided in subdomains and items. Some of them are of an obligatory nature. This document serves as reference for future applications. The document may be reviewed in the future (AU)

[Formation of specialists in rheumatology: Accreditation criteria]. / Criterios de acreditación para la formación de especialistas de reumatología.

The National Rheumatology Board is responsible for postgraduate formation in rheumatology. Herein we present the new criteria for accreditation of teaching units. These criterion contemplate four domains, namely: structure, clinical work, teaching and research. Each domain is divided in subdomains and items. Some of them are of an obligatory nature. This document serves as reference for future applications. The document may be reviewed in the future.

Frecuencia de Haemophilus ducreyi en la etiología de la úlcera genital y papel de la coloración de Gram en el diagnóstico de chancroide

Objetivo: determinar la frecuencia de H. ducreyi en la úlcera genital (UG) y definir la importancia de la coloración de Gram en el diagnóstico de chancroide. Material y métodos: se trata de un estudio prospectivo, longitudinal. Con todos los pacientes se siguió un protocolo de laboratorio para el estudio de la UG que incluyó: coloración de Gram, prueba de Tzanck, campo oscuro, VDRL, FTA-ABS, aislamiento en línea celular para Herpes simplex y cultivo de H. ducreyi utilizando un medio bifásico. Resultados: se studiaron 79 pacientes con predominio del sexo masculino. En 35 pacientes (44.3 por ciento) se encontró uno o más agentes de transmisión sexual y en 44 (55.6 por ciento) no se encontró agente etiológico. En los 35 pacientes con UG los agentes encontrados fueron: H. ducreyi en 11 (13.9 por ciento), Herpes simplex en 10 (12.7 por ciento), Treponema pallidum en tres (3.8 por ciento), Calymatabacterium granulomatis en dos (2.5 por ciento) y en nueve (11.4 por ciento) la etiología fue mixta. Al comparar el cultivo de H. ducreyi con la coloración de Gram se encontró en esta última una sensibilidad de 87.5 por ciento, especificidad de 94.2 por ciento y valores predictivos positivos y negativos de 82.3 por ciento y 96.0 por ciento respectivamente, con un intervalo de confianza de 95 por ciento. Conclusiones: H. ducreyi es la primera causa de UG en este estudio; el encontrar etiologías mixtas en la UG hace necesario establecer protocolos que permitan buscar la mayoría de los agentes etiológicos de la UG. La coloración de Gram continúa siendo de mucha utilidad para sostener el diagnóstico de H. ducreyi

Frecuencia de infección por chlamydia trachomatis en el endocervix y el endometrio de un grupo de mujeres infertiles comparadas con un grupo fértil

Se compararon 60 pacientes con problemas de infertilidad con 120 mujeres multíparas : se investigó la presencia de Chlamydia trachomatis tanto en el endometrio como en el endocervix, utilizando, la inmunofluorescencia directa (MICROTRAK). Los controles tenían significativamente mayor de edad, más años de vida sexual y mayor número de abortos. Con relación a la presencia de C. trachomatis se encontró mayor positividad en el grupo control tanto en el endocervix (33 por ciento Vs. 12 por ciento no significativamente), como el endometrio (38 por ciento Vs. 17 por ciento), como también mayor positividad simultánea en ambos sitios anatómicos, sin embargo sólo se encontró diferencia significativa (p 0.005 ) en cuanto a la muestra endometrial en favor del grupo control. Se llama la atención hacia la alta prevalencia de infección por C. trachomatis en la población de mujeres fértiles