Granular cell tumor of soft tissues: MR findings.

Granular cell tumors (GrCT) are histologically unique neoplasms that often manifest as painless solitary nodules located in the dermis or submucosal tissue. In this article we analyze the radiologic features of this type of tumor in five patients by magnetic resonance imaging (MRI), analyzing morphologic and signal characteristics. MR imaging findings were similar to other publications and we demonstrate low ADC values in our series.

Marcadores de selección en cerdos Pampa Rocha: comparación con razas autóctonas de España y Portugal / Selection markers in Pampa Rocha piqs: a comparison with autochthonous breeds of Spain and Portugal

RESUMEN Objetivo. El análisis de marcadores de selección permite obtener datos de la vida evolutiva de una raza o línea y permite también evaluar la conveniencia o no de su uso en programas de mejora genética. Hemos evaluado SNPs en cuatro genes (IGF2, MC4R, PRKAG3 y PEPCK-C), que tienen importantes efectos fenotípicos, en cerdos de la raza Pampa Rocha, una raza criolla, y hemos comparado sus frecuencias alélicas con cerdos de diversas razas autóctonas y líneas de España y Portugal no sometidas a selección así como con jabalíes y cerdos de la raza Piétrain. Materiales y métodos. Los SNPs fueron analizados mediante diversas técnicas de RT-PCR. Resultados. Los resultados de los análisis muestran una similitud de frecuencias alélicas entre los cerdos de la raza Pampa Rocha y los cerdos autóctonos de la península ibérica sobre todo en el gen IGF2 y, en menor medida en el gen PEPCK-C. Sin embargo difieren considerablemente en el caso del marcador MC4R y, también en menor medida, en PRKAG3. En el trabajo se discute el uso potencial de los resultados obtenidos para orientar la selección genética de cerdos de la raza Pampa Rocha. Conclusiones. Nuestros resultados demuestran la peculiaridad de la raza Pampa Rocha con respecto a los marcadores estudiados.

ABSTRACT Objective. The analysis of selection markers allows to obtain information about the evolutive story of a particular breed or line and allows also to evaluate the usefulness of those markers for breeding programs. We have analyzed SNPs in four genes of the creole pig breed Pampa Rocha and we have compared their allelic frequencies with the allelic frequencies of diverse autochthonous breeds of Spain and Portugal and also with Piétrain pigs and wild boars. Materials and methods. The SNPs were analyzed using diverse RT-PCR methods. Results. The results of the analysis show that Pampa Rocha pigs have similar allelic frequencies with the autochthonous breeds of Spain and Portugal especially in the case of IGF2 and also, but not so coincident, in the case of PEPCK-C. However, they differ considerably for MC4R, and also, but in a lower extent, for PRKAG3. We discuss in this work the usefulness of our results for breeding of Pampa Rocha pigs. Conclusions. Our results demonstrate the peculiarity of the Pampa Rocha breed regarding the markers studied.

Histopathological changes in the liver and stomach of Didelphis virginiana (Didelphimorphia: Didelphidae) during natural infection with Gnathostoma turgidum (Nematoda: Gnathostomidae).

Gnathostoma turgidum is a nematode parasite that exploits the stomach of Virginian opossums, Didelphis virginiana, in Latin America. The opossum is the definitive host of G. turgidum in the wild. Intrahepatic growth and maturation of the parasite, subsequent migration to the stomach and spontaneous expulsion are common. However, the histopathological lesions caused by G. turgidum are poorly described. A better understanding of the life cycle of this parasite and the pathological changes in natural host-parasite interactions could help to clarify the progression of human infections caused by Gnathostoma binucleatum. The aim of this work was to study morphological changes in the liver and stomach of D. virginiana during natural infection and adult worm expulsion. Three opossums naturally infected with G. turgidum were captured from an endemic area of gnathostomosis. Three uninfected opossums captured from a non-endemic area were used as controls. The opossums were sacrificed at different stages of infection (March, May and December), and a histopathological study of their livers and stomachs was conducted. Injuries in livers were observed by histopathology - areas of necrosis and collagen septa were identified. Parasites caused nodules with necrosis on the periphery of lesions, and collagen fibres were also observed in stomachs. Collagen septa may be caused by antigenic remains of the parasite. Further immunological studies are necessary to verify that stimulation is caused by these factors.

Vendaje neuromuscular en músculo tibial anterior durante la marcha en niños con parálisis cerebral tipo hemiparesia espástica: estudio de casos / Kinesiotape in tibialis anterior muscle during gait in children with spastic hemiparetic cerebral palsy: case reports

Introduction: Kinesiotape (Kt) is a therapeutic technique producing somatosensory stimulation when placed on the skin, and has shown improvement in dynamic activities in neuropediatric field; however, there are limited studies on its effect during gait. Objective: To assess the effect of KT in children with spastic hemiparetic cerebral palsy (CP) during gait, when applied on tibialis anterior muscle of the affected side. Method: Study carried out with 9 children with spastic hemiparetic cerebral palsy and Gross Motor Function Classification System (GMFCS) I & II, between 4 and 10 years old, male and female, at Instituto teletón Antofagasta. Gait was recorded in video in 3 instances: before Kt, immediately after application of Kt, and 5 days post application. Recordings were assessed using the Edinburgh Visual Gait Score (EVGS) and range of motion (RoM) of the ankle during gait. Results: None of the subjects showed significant improvement in RoM of the ankle during gait or in the EVGS. Conclusion: Kt did not change ROM of the ankle during gait in the studied cases, nor as an immediate effect or 5 days after application. only 2 out of 9 children showed a 1 point improvement during the swing phase during EVGS. It is suggested to consider other exclusion criteria and extend the duration of Kt therapy.

El vendaje neuromuscular (VN) es una herramienta terapéutica que estimula el nivel somatosensitivo al ubicarlo sobre la piel, que ha demostrado mejoras en actividades dinámicas en el ámbito neuroinfantil; sin embargo, existen escasos estudios sobre su efecto durante la marcha. Objetivo: Evaluar el efecto del VN sobre la marcha de niños con parálisis cerebral (PC) hemiparética espástica, aplicado en músculo tibial anterior del lado afectado. Método: Estudio de 9 niños con PC y Gross Motor Function Classification System (GMFCS) I y II tipo hemiparesia espástica entre 4 y 10 años de edad, de ambos sexos en el Instituto Teletón Antofagasta. Se filmó marcha en 3 instancias: antes del VN, inmediato con VN y a los 5 días post aplicación. Las grabaciones fueron valoradas con la Edinburgh Visual Gait Score (EVGS) y rango de movimiento (RoM) de tobillo durante la marcha. Resultados: Ninguno de los 9 niños presentó mejoría significativa en su ROM del tobillo durante la marcha ni en la EVGS. Conclusión: El vendaje neuromuscular no produjo cambios del RoM del tobillo durante la marcha en los casos presentados, ni como efecto inmediato ni a los 5 días post aplicación. Sólo 2 de 9 mejoraron en 1 punto durante la fase de balanceo en la EVGS. Se sugiere considerar otros criterios de exclusión y ampliar el tiempo de aplicación del VN.

Pioglitazone Enhances the Beneficial Effects of Glucocorticoids in Experimental Nephrotic Syndrome.

Glucocorticoids are the primary therapy for nephrotic syndrome (NS), but have serious side effects and are ineffective in ~20-50% of patients. Thiazolidinediones have recently been suggested to be renoprotective, and to modulate podocyte glucocorticoid-mediated nuclear receptor signaling. We hypothesized that thiazolidinediones could enhance glucocorticoid efficacy in NS. We found that puromycin aminonucleoside-induced proteinuria in rats was significantly reduced by both high-dose glucocorticoids (79%) and pioglitazone (61%), but not low-dose glucocorticoids (25%). Remarkably, pioglitazone + low-dose glucocorticoids also reduced proteinuria (63%) comparably to high-dose glucocorticoids, whereas pioglitazone + high-dose glucocorticoids reduced proteinuria to almost control levels (97%). Molecular analysis revealed that both glucocorticoids and pioglitazone enhanced glomerular synaptopodin and nephrin expression, and reduced COX-2 expression, after injury. Furthermore, the glomerular phosphorylation of glucocorticoid receptor and Akt, but not PPARγ, correlated with treatment-induced reductions in proteinuria. Notably, clinical translation of these findings to a child with refractory NS by the addition of pioglitazone to the treatment correlated with marked reductions in both proteinuria (80%) and overall immunosuppression (64%). These findings together suggest that repurposing pioglitazone could potentially enhance the proteinuria-reducing effects of glucocorticoids during NS treatment.

Influence of Quaternary Benzophenantridine and Protopine Alkaloids on Growth Performance, Dietary Energy, Carcass Traits, Visceral Mass, and Rumen Health in Finishing Ewes under Conditions of Severe Temperature-humidity Index.

Twenty Pelibuey×Katahdin ewes (35±2.3 kg) were used to determine the effects of the consumption of standardized plant extract containing a mixture of quaternary benzophenanthridine alkaloids and protopine alkaloids (QBA+PA) on growth performance, dietary energetics, visceral mass, and ruminal epithelial health in heat-stressed ewes fed with a high-energy corn-based diet. The basal diet (13.9% crude protein and 2.09 Mcal of net energy [NE] of maintenance/kg of dry matter) contained 49.7% starch and 15.3% neutral detergent fiber. Source of QBA+PA was Sangrovit RS (SANG) which contains 3 g of quaternary benzophenathridine and protopine alkaloids per kg of product. Treatments consisted of a daily consumption of 0 or 0.5 g SANG/ewe. Ewes were grouped by weight and assigned to 10 pens (5 pens/treatment), with two ewes per pen. The experimental period lasted 70 days. The mean temperature humidity index during the course of this experiment was 81.7±1.0 (severe heat stress). There were no treatment effects on water intake. Dry matter intake was not affected (p = 0.70) by treatments, but the group fed SANG had a numerically (11.2%) higher gain in comparison to the control group, SANG improved gain efficiency (8.3%, p = 0.04), dietary NE (5.2%, p<0.01) and the observed-to-expected NE (5.9%, p<0.01). Supplemental SANG did not affect (p≥0.12) carcass characteristics, chemical composition of shoulder, and organ weights (g/kg empty body weight) of stomach complex, intestines, and heart/lung. Supplemental SANG decreased liver weight (10.3%, p = 0.02) and increased visceral fat (16.9%, p = 0.02). Rumen epithelium of ewes fed SANG had lower scores for cellular dropsical degeneration (2.08 vs 2.34, p = 0.02), parakeratosis (1.30 vs 1.82, p = 0.03) and neutrophil infiltration (2.08 vs 2.86, p = 0.05) than controls. It is concluded that SANG supplementation helped ameliorate the negative effects of severe heat on growth performance of feedlot ewes fed high-energy corn-based diets. Improvement in energetic efficiency may have been mediated, in part, by anti-inflammatory effects of supplemental SANG and corresponding enhancement of nutrient uptake.

The nutrition transition in the Venezuelan Amazonia: increased overweight and obesity with transculturation.

OBJECTIVES: Amerindians have a particularly high propensity to overweight and obesity as they change lifestyle and experience a nutrition transition. The aim of this study was to evaluate the effects of transculturation on nutritional status in three Amazonian Amerindian villages. METHODS: Nutritional status was assessed in 232 volunteers: 65 Yanomami from an isolated village and 167 Guahibo subjects from villages with intermediate and high levels of transculturation. RESULTS: There was a significant pattern of decreasing stunting and increasing overweight and obesity across the gradient of transculturation. From the jungle Yanomami to the intermediate and transculturated Guahibo, stunting was respectively 72, 55, and 39%, and children /adult overweight was 0, 3/44, and 15/89%. These anthropometric-based patterns were confirmed by bioimpedance vector analysis. CONCLUSIONS: Transculturation in these Amerindian populations is associated with an increase in overweight and obesity coexisting with undernourished children.

[In vitro emergence of ertapenem resistance in Escherichia coli producing extended-spectrum ß-lactamase]. / Rápida adquisición de resistencia in vitro al ertapenem en Escherichia coli productora de betalactamasa de espectro extendido.

INTRODUCTION: The occurrence of community-associated infections due to extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. These organisms are frequently resistant to many of the antimicrobial agents but remain susceptible to carbapenems. We investigated the in vitro emergence of carbapenem resistance in a collection of clinical isolates of ESBL -producing E. coli. MATERIAL AND METHODS: First and second-step resistant mutants were obtained from E. coli with ESBL. Aliquots of 50 µl containing > 109 CFU were applied to Mueller-Hinton plates containing meropenem, imipenem or ertapenem. MICs for native strains and mutants were determined using the epsilometric test (E-test). RESULTS: Resistant mutants were not selected with imipenem or meropenem. E. coli growth was observed on ertapenem (0.5 mg/L)-containing plates in 13 of 57 clinical isolates (22.8 %).The ertapenem MIC for these first-step mutants were ≥ 1 mg/L, remaining susceptible to imipenem and meropenem. The first-step mutants were used as native strains. Six second-step resistant mutants were selected with ertapenem. All were fully resistant (CMI ≥ 8 mg/L) to ertapenem, three were resistant to meropenem and one to imipenem. Four second-step resistant mutants were selected with meropenem. All were resistant to ertapenem, meropenem, and two of them were resistant to imipenem. CONCLUSIONS: Stable resistant mutants were easy to select with ertapenem among ESBL-producing E. coli. Two steps were necessary to select resistant mutants to meropenem or imipenem. The use of ertapenem in high-inoculum infections or in undrained focus of infection should be monitored to reduce the risk on selection of resistance.

Amiotrofia neurálgica bilateral. A propósito de un caso y revisión bibliográfica / Bilateral neuralgic amiotrophy. Case report and literature review

Se presenta un caso atípico de amiotrofia neurálgica bilateral que debutó con dolor de intensidad leve-moderada y que evolucionó desfavorablemente hacia una amiotrofia de ambos deltoides que incapacitó permanente y totalmente al paciente para el desempeño de su trabajo habitual (AU)

The following case is an atypical bilateral neuralgyc amiotrophy which started with mild to moderate pain and evolved unfavourably towards atrophy of both Deltoid muscles, leading to a permanent incapacity for the patient´s job (AU)

Niño quemado gran secuelado. Perfil clínico y calidad de vida / Child burned great aftermath. Clinical profile and quality of life

Burns are an important cause of morbidity in children. The medical advances in acute trauma care have led to an increase in the number of children with extense area of burned skin, whose sequelaes are cause of complications along their growth. Objective. To characterize population with over 25% of sequelae burn skin at the COANIQUEM Rehabilitation Center, Santiago. Additionally to measure their quality of life and suggest interventions to improve medical attention. Methods. Quantitative, non experimental, descriptive, comparative study. Results. A sample of 59 children were identified as having post-traumatic burned on more than 25% of total body surface. 47% of them were men and 53% female. Most them (64%) were patients who lived outside the capital city, Santiago. 54% was burned during the ages between to 2 to 6 years old. 42% was burned with fire and 56% by scalding. Half the patients were admitted to rehabilitation before 2 month after injury. 64% has good adherence to treatment and a regular follow-up. A group of 29 KIDSCREEN-27 survey was analyzed. There were no significant differences between gender, age, residence or visibility scars. Conclusions. Epidemiology found in children with severe burn sequelae is consistent with findings from literature. Quality of life outcomes are similar to general population. The concept of pediatric major burn sequela is established for future research in this area. (AU)

Prurito neuropático / Neuropathic pruritus

El prurito neuropático es una forma patológica de prurito, donde la curva estímulo-respuesta que rige la sensación normal se ha distorsionado y la sensación de prurito está fuera de proporción o incluso completamente independiente de los estímulos pruritogénicos. Al igual que el dolor neuropático, el prurito neuropático aún es poco conocido, a pesar de los avances en la comprensión de los mecanismos de éste. La causa del prurito neuropático puede ser extremadamente difícil de precisar. El tratamiento eficaz requiere de la identificación anatómica y etiológica del problema neurológico y la instauración de un tratamiento modificador de la enfermedad. En algunos casos, esto puede ser neuroquirúrgico. El prurito neuropático no suele responder a antihistamínicos, esteroides tópicos u otros medicamentos eficaces para tratar el prurito convencional. Por otra parte, al igual que otros síntomas neurológicos, el prurito puede indicar un problema neurológico potencialmente grave que puede necesitar tratamiento rehabilitador.

Neuropathic Pruritus is a pathological form of itching, where stimulus-response curve governing normal sensation, has been distorted and itching sensation is out of proportion or even completely independent pruritogenic stimuli. As neuropathic pain, neuropathic pruritus is still poorly understood, despite advances in understanding the mechanisms thereof. The cause of neuropathic itch can be extremely difficult to pinpoint. Effective treatment requires identification of anatomical and etiological neurological problem, and the establishment of a disease-modifying treatment. In some cases, this may be neurosurgical. The neuropathic pruritus not usually respond to antihistamines, topical steroids or other effective drugs to treat itching conventional. Moreover, like other neurological symptoms, pruritus may indicate a potentially serious neurological problem that may need rehabilitation treatment.

Non-typhi Salmonella serovars found in Mexican zoo animals.

The aim of the present study was to determine the bacteriological prevalence of subclinical non-typhi Salmonella infections in zoo animals and to determine the most frequently isolated serovars of the bacteria. A total of 267 samples were analyzed, including fecal samples from zoo animals and rodents, insects (Musca domestica and Periplaneta americana) and samples of the zoo animal's food. Salmonella was detected in 11.6% of the samples analyzed. Characterization of the isolates was performed with serotyping and pulsed-field gel electrophoresis. The following serovars were isolated: S. San Diego, S. Oranienburg, S. Weltevreden, S. Braenderup, S. Derby, S. 6,7, H:en x:- and S. 3,10, H:r:-. The isolates showed seven pulsed-field gel electrophoresis patterns with a Jaccard coefficient≥0.75 indicating a possible common origin. The prevalence of asymptomatic infections caused by Salmonella spp. in zoo animals was high. These findings demonstrate the diversity of Salmonella serovars in several captive wild animal species.

Solución del caso 36. Divertículo gigante de sigma / Solution to case 36. Giant diverticulum of the sigmoid colon

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