Pan-azole- and multi-fungicide-resistant Aspergillus fumigatus is widespread in the United States.

Aspergillus fumigatus is an important global fungal pathogen of humans. Azole drugs are among the most effective treatments for A. fumigatus infection. Azoles are also widely used in agriculture as fungicides against fungal pathogens of crops. Azole-resistant A. fumigatus has been increasing in Europe and Asia for two decades where clinical resistance is thought to be driven by agricultural use of azole fungicides. The most prevalent mechanisms of azole resistance in A. fumigatus are tandem repeats (TR) in the cyp51A promoter coupled with mutations in the coding region which result in resistance to multiple azole drugs (pan-azole resistance). Azole-resistant A. fumigatus has been isolated from patients in the United States (U.S.), but little is known about its environmental distribution. To better understand the distribution of azole-resistant A. fumigatus in the U.S., we collected isolates from agricultural sites in eight states and tested 202 isolates for sensitivity to azoles. We found azole-resistant A. fumigatus in agricultural environments in seven states showing that it is widespread in the U.S. We sequenced environmental isolates representing the range of U.S. sample sites and compared them with publicly available environmental worldwide isolates in phylogenetic, principal component, and ADMIXTURE analyses. We found worldwide isolates fell into three clades, and TR-based pan-azole resistance was largely in a single clade that was strongly associated with resistance to multiple agricultural fungicides. We also found high levels of gene flow indicating recombination between clades highlighting the potential for azole-resistance to continue spreading in the U.S.IMPORTANCEAspergillus fumigatus is a fungal pathogen of humans that causes over 250,000 invasive infections each year. It is found in soils, plant debris, and compost. Azoles are the first line of defense antifungal drugs against A. fumigatus. Azoles are also used as agricultural fungicides to combat other fungi that attack plants. Azole-resistant A. fumigatus has been a problem in Europe and Asia for 20 years and has recently been reported in patients in the United States (U.S.). Until this study, we did not know much about azole-resistant A. fumigatus in agricultural settings in the U.S. In this study, we isolated azole-resistant A. fumigatus from multiple states and compared it to isolates from around the world. We show that A. fumigatus which is resistant to azoles and to other strictly agricultural fungicides is widespread in the U.S.

Evaluation of chemical silage on egg quality parameters in ISA Brown line laying hens (Gallus gallus domesticus) / Evaluación del ensilado químico sobre los parámetros de calidad del huevo en gallinas ponedoras de la línea ISA Brown (Gallus gallus domesticus)

ABSTRACT In this study we evaluated the inclusion of chemical silage from red tilapia viscera (Oreochromis sp.) in diets for ISA Brown line laying hens (Gallus gallus domesticus) and its influence on nutritional parameters and egg quality. A total of 56 16-week-old laying hens were randomly divided into two groups (one per diet), which in turn were subdivided into 7 groups, each with 4 birds. Eggs were collected during the first 13 weeks of laying. During this period the egg quality parameters were evaluated until week 11; the bromatological characterization of the egg was carried out in the 2nd and 4th week of laying. The results indicated that the inclusion of chemical silage in 17,18% dry matter does not result in statistically significant differences in egg quality parameters or in their bromatological composition, with respect to the control. This led to the conclusion that chemical silage can be used as an alternative to protein inputs such as fish meal and soybean cake in the diet of laying hens, without modifying the quality of the final product.

RESUMEN En este trabajo se evaluó la inclusion de ensilado químico de vísceras de tilapia roja (Oreochromis sp.) en dietas para gallinas ponedoras (Gallus gallus domesticus) de la raza Isa-Brown, y su influencia sobre parámetros nutricionales y la calidad del huevo. Se utilizó un total de 56 gallinas ponedoras de 16 semanas de edad divididas al azar en dos grupos (uno por dieta), los cuales a su vez se subdividieron en 7 grupos de 4 aves cada uno. Se les recolectó huevos durante las primeras 13 semanas de postura. Durante este periodo se realizó la evaluación de los parámetros de calidad del huevo hasta la semana 11. La caracterización bromatológica del huevo se realizo en las semanas 2 y 4, luego de haber sido puestos. Los resultados indicaron que la inclusion de ensilado químico en un 17,18% materia seca, no genera diferencias estadísticamente significativas (p < 0,05) en los parámetros de calidad del huevo ni en su composición bromatológica, con respecto al control. Esto permitió concluir que el ensilado químico puede ser usado como alternativa a insumos proteicos como harina de pescado y torta de soya en la alimentación de gallinas ponedoras, sin modificar la calidad del producto final.

Clinicopathological factors associated with the presence of hypercapnia at admission in hospitalised cats with decompensated chronic kidney disease.

AIMS: To evaluate associations between clinicopathological variables and hypercapnia measured in cats with decompensated chronic kidney disease (CKD) on admission to a veterinary hospital. METHODS: This is a retrospective, cross-sectional study of cats (n = 39) that presented to a tertiary veterinary hospital in Argentina between June 2015 and December 2017 with blood creatinine concentrations >140 µmol/L, and abdominal ultrasound results consistent with CKD. Data recorded included venous partial pressure of CO2 (PvCO2), blood pH, haematocrit and concentrations of glucose, potassium, sodium, corrected sodium (Na+c), and ionised calcium in blood. A logistic regression model was used to assess associations between the presence of hypercapnia (PvCO2 ≥ 44.7 mmHg) and the other clinicopathologic variables. The duration of hospitalisation was compared in cats with and without hypercapnia using the Wilcoxon Rank Sum test. RESULTS: The final study population comprised 39 cats. Eleven cats (28.2%) had hypercapnia. In the logistic regression model, two independent variables were associated with the presence of hypercapnia at admission in cats with CKD: the concentration of creatinine in blood (OR = 1.06 (95% CI = 1.016-1.108); p = 0.007) and Na+c (OR = 1.33 (95% CI = 1.08-1.63); p = 0.005). There were no statistically significant differences in the length of hospital stay between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE: There appears to be an association between elevated concentrations of creatinine and Na+c in blood, and hypercapnia in cats with CKD, suggesting careful assessment of blood gas and electrolyte parameters during hospitalisation is required. Further prospective studies are needed to evaluate the mechanisms behind this association and the association of hypercapnia with disease outcome including mortality.

Retrospective study of gross and histopathologic lesions associated with closed chest cardiopulmonary resuscitation in dogs.

OBJECTIVES: To investigate and characterise the incidence of iatrogenic complications secondary to closed chest cardiopulmonary resuscitation in dogs. MATERIALS AND METHODS: Necropsy reports and histologic sections of tissues were retrospectively examined from 180 dogs that had received closed chest cardiopulmonary resuscitation to determine lesions associated with resuscitation. RESULTS: The most common complication was pulmonary haemorrhage (81/163, 49.7%, 95% confidence interval: 42.1 to 57.3), although only nine dogs had pulmonary haemorrhage of at least moderate severity. Liver fractures occurred in 16 of 180 cases (8.9%, 95% confidence interval: 5.5 to 14.0). Blood loss of >15% of blood volume into the abdomen and/or thorax occurred in 13 of 180 cases (7.2%, 95% confidence interval: 4.2 to 12.1). CLINICAL SIGNIFICANCE: Significant haemorrhage secondary to cardiopulmonary resuscitation may decrease the chances of achieving the return of spontaneous circulation or may cause or compound ischemic damage to critical organs if the return of spontaneous circulation is achieved. Following successful cardiopulmonary resuscitation, animals should be screened for cavitary or pulmonary haemorrhage, as significant haemorrhage could be a factor in recurrence of cardiac arrest.

Hipertrofia del proceso coronoideo / Hipertrophy of the coronoid process

Entre las principales causas de la reducción progresiva y sin dolor de la apertura bucal en pacientes jóvenes, se encuentra la denominada hipertrofia del proceso coronoideo. Se trata de una patología secundaria a la elongación anormal del proceso coronoideo por el crecimiento del hueso que provoca una alteración mecánica al abrir la boca. Presentamos nuestra experiencia con la recogida de 5 casos clínicos (AU)

Among the causes of reduction in mouth opening gradually and without pain in young patients, we find the hypertrophy of the coronoid process. It is a disease due to abnormal elongation of the bone growth process, which causes a mechanical disruption when the patient opens the mouth. We present our experience with a casuistic of 5 clinical cases (AU)

Colgajo miocutáneo de trapecio bilateral para reconstrucción de región cervical posterior / Bilateral trapezius miocutaneous flap for reconstruction of posterior cervical and occipital regions

La cirugía reconstructiva para la resolución de defectos en la región cervical posterior y occipital muchas veces puede ser un verdadero desafío para los cirujanos plásticos. El colgajo miocutáneo de trapecio es una de las alternativas más utilizadas. En este artículo describimos una variante técnica del colgajo miocutáneo de trapecio basada en un diseño cutáneo bilateral en V-Y, para reconstruir defectos producidos por dehiscencia de heridas con fístula de líquido cefalorraquídeo en región cervical posterior de 2 pacientes de 52 y 72 años, intervenidos quirúrgicamente por hernia discal cervical. Logramos una cobertura total del defecto en ambos casos, con un exitoso aislamiento biológico proporcionado por la importante superficie y volumen brindados por el tercio medio de ambos músculos trapecios. No hubo sufrimiento de los colgajos ni se manifestaron alteraciones en la funcionalidad de los hombros en ambos casos. El cierre del avance en V-Y se hizo sin tensión. En conclusión, si bien existen distintas opciones para reconstruir la región posterior cervical y occipital, este nuevo diseño de colgajo miocutáneo de trapecio es una herramienta segura, de fácil ejecución, reproducible y que conserva la funcionalidad del hombro

Reconstructive surgery for the resolution of defects in posterior cervical and occipital region can often be a challenge for plastic surgeons. The trapezius myocutaneous flap is one of the most used alternatives. This article describes a technical variation of the trapezius myocutaneous flap based on a bilateral cutaneous VY design to reconstruct the defect caused by wound dehiscence with cerebrospinal fluid fistula in the posterior cervical region of 52 and 72 years old patients. Total coverage was achieved with a successful defect biological isolation given by the major surface and volume provided by the middle third of the two trapezoids. There was no suffering of the flaps and no problems with the functions. The closure of V-Y advance was without tension. No changes were manifested in the functionality of the shoulders. In conclusion, although there are different options to reconstruct the posterior cervical and occipital region, this new design trapezius myocutaneous flap is a secure, easy to perform, reproducible and functional conservation of the shoulder

Estudio de los cambios de la actividad antioxidante en bebidas de café durante su periodo de vida útil usando métodos in vitro y ex vivo / Study of the antioxidant activity changes of coffee beverages during its shelf life using in-vitro and ex-vivo methods

Antecedentes: Los antioxidantes se han convertido en uno de los conceptos comerciales de mayor impactoen el mercado de los alimentos funcionales; sin embargo, su declaración resulta ser un tema controvertidoentre los entes regulatorios a nivel global debido a la complejidad que comprende demostrar la presencia ybioactividad de éstos en un alimento. En este contexto, investigaciones recientes en el café han atribuidopropiedades antioxidantes a su bebida. Objetivo: El objetivo de este estudio fue determinar por métodosin-vitro que las bebidas de café contienen sustancias fenólicas, las cuales pueden actuar como antioxidantes,y evaluar cómo su bioactividad puede variar en el tiempo. Métodos: Se evaluaron 48 productos de caféen dos tiempos de almacenamiento, a saber, al inicio y al final de la vida útil del producto, determinandosu contenido de fenoles totales y la actividad antioxidante por captura de los radicales ABTS (2,2’ -azino-bis-(3-etil benzotiazolin -6- sulfonato de amonio) y DPPH (2,2-difenil-1-picrilhidracilo); además,se determinó por FRAP la actividad reductora del hierro férrico con el fin de establecer el contenido defenoles antioxidantes a declarar en la etiqueta. Resultados: El contenido de polifenoles antioxidantes fuediferente según el tipo de café, los cafés tostados presentaron 328,61 ± 31.35 mg Equivalentes de ÁcidoGálico por cada 100 mL de bebida y los cafés solubles 297,17 ± 68.48. Los resultados obtenidos por losmétodos de ABTS, DPPH y FRAP mostraron, por medio de un análisis de componentes principales,que éstos se correlacionan entre sí y que el tiempo de almacenamiento tiene efecto sobre la actividadantioxidante de los productos. Se evaluó la actividad antioxidante ex-vivo en una bebida de café tostado yen otra de café soluble mediante el ensayo de peroxidación lipídica de la Lipoproteína de Baja Densidad(LDL), lográndose evidenciar que estas evitaron la oxidación de la LDL, conforme los contenidos anteriores...

Los jugos de cítricos inhiben la oxidación de lipoproteínas de baja densidad: relación entre actividad captadora de radicales libres y movilidad electroforética / Citrus juice inhibits low density lipoprotein oxidation: relationship between free radical scavenger activity and electrophoretic mobility

Epidemiological studies have shown that consumption of fruits and vegetables are associated with beneficial effects on human health including the reduction of coronary artery disease (CAD) risk. Fruits and their juices contain phytochemicals that inhibit in vitro the low-density lipoprotein (LDL) oxidation, a key process involved in the generation of arterial lessions. We developed an study to examine the phenolics compound content of citrus juice cultivated in the southwest of Antioquia, Colombia, its free radical scavenger activity and in vitro effect on LDL oxidation. Five citrus varieties were analyzed: Citrus sinensis valencia, Citrus reticulata clementina, Citrus reticulata oneco, Tangelo Orlando and Tangelo mineola. The results showed that no correlation exists between phenolic compounds content and free radical scavenger activity in the citrus juices analyzed. However a high inhibitory capacity of LDL oxidation was found.

Estudios epidemiológicos han demostrado que el consumo de frutas y vegetales se asocia con efectos beneficiosos sobre la salud humana, incluyendo reducción del riesgo de enfermedades cardiovasculares (ECV). Las frutas y sus jugos contienen compuestos que inhiben la oxidación de Lipoproteínas de Baja Densidad (LDL), un proceso clave en el desarrollo de la lesión arterial. Se ha desarrollado un estudio para determinar el contenido de compuestos fenólicos, la actividad captadora de radicales libres y el efecto sobre la oxidación de LDL, de jugos de cítricos cultivados en el suroeste de Antioquia (Colombia). Cinco variedades de cítricos fueron analizadas: Citrus sinensis valencia, Citrus reticulata clementina, Citrus reticulata oneco, Tangelo orlando, Tangelo mineola. Se demostró que en estos jugos no existe correlación entre el contenido de compuestos fenólicos y la actividad captadora de radicales libres (ACRL), sin embargo, se encontró una alta capacidad para inhibir la oxidación de LDL.

Estado nutricional y complicaciones posquirurgicas en cirugia mayor gastrointestinal / Nutritional state and posoperative complications in gastrointestinal surgery

Un estudio descriptivo para evaluar estado nutricional preoperatorio, complicaciones, tiempo y costo de hospitalización en 45 pacientes sometidos a cirugía electiva mayor del tracto gastrointestinal entre Julio/1998 y mayo/2000 en el Hospital Universitario San Vicente de Paúl- HUSVP. Una evaluación nutricional al ingreso, consideró: edad, sexo, enfermedad de base, etiopatogenia quirúrgica, peso, talla, perímetro de carpo, pliegue de grasa tricipital, circunferencia muscular del brazo, área muscular del brazo, albúmina, recuento linfocitos. Se observaron las complicaciones durante la estancia hospitalaria y en el control a los 15 días del egreso, 21 pacientes fueron hombres y 24 mujeres, entre los 22 y 83 años, con patología en tubo digestivo 84 por ciento, seguido de vía biliar 11 por ciento y páncreas 5 por ciento. El 42-2 por ciento desnutridos; 28.9 por ciento lene y 13.3 por ciento moderadamente. Un 24.4 por ciento exceso de peso; 13.3 por ciento sobrepeso y 11.1 por ciento obesidad. 33.3 por ciento estado nutricional adecuado. Se encontró mayor frecuencia de complicaciones estancia hospitalaria y costo de hospitalización en pacientes con exceso de peso

Actualización en liquen plano oral / Update in oral lichen planus

El liquen plano LP es un desorden inflamatorio del epitelio escamoso estratificado relativamente común. Las lesiones pueden afectar la piel y membranas mucosas. El Liquen Plano Oral LPO, usualmente, presenta una morfología y distribución característica, pudiendo mostrar una disposición confusa de patrones y formas de tal manera que otros desórdenes pueden simularlo clínicamente. El LP es probablemente de origen multifactorial, algunas veces es inducido por drogas o materiales dentales, a menudo idiopático y con una inmunopatogénesis que involucra a las células T en particular. La etiopatogénesis parece ser compleja con interaccioes entre factores genéticos, ambientales y de estilo de vida, aunque en la actualidad se han aclarado varios aspectros acerca de los mecanismos involucrados y han surgido nuevas asociaciones interesantes con otras enfermedades. El manejo del LP aún no es satisfactorio, pues hasta ahora no existe un tratamiento definitivo y aunque no hay método curativo disponible, la inmunomodulación puede controlar la condición. Clásicamente se ha considerado como una entidad premaligna, pero estudios recientes sugieren que existe una condición conocida como displasia liquenoide que requiere diagnóstico diferencial con el LP. Se precisa más investigación en los aspectos genéticos, ambientales, potencial maligno, asociación con otros desórdenes y más estudios clínicos acerca de su terapia

Characterisation of Candida albicans infections of haematogenous and mucosal origin in mice lacking the interferon gamma receptor protein.

Mice harbouring a null deletion mutation in the IFNgamma receptor gene were used to study the role of IFNgamma responsiveness during experimental systemic candidiasis of mucosal or haematogenous origin. After intravenous (i.v.) or intranasal (i.n.) challenge with Candida albicans the progression of infection and concomitant cellular and antibody anti-C. albicans immune responses were analysed. During the week following i.v. challenge, the rate of C. albicans multiplication in kidneys, liver and spleen was faster in IFNgammaR (-/-) than IFNgammaR (+/+) mice. As a result, IFNgammaR (-/-) mice perished earlier than IFNgammaR (+/+) mice when challenged with equal numbers of live yeast cells. However, the overall susceptibility of the two mouse strains, in terms of survival against different C. albicans challenge doses over a 60-day period, was similar. No differences were found in the cellular anti-C. albicans response generated by i.v. challenge in both mouse strains. In contrast the kinetics and strength of the serum anti-C. albicans antibody responses were markedly different. Significantly stronger, predominantly IgG2a antibody responses accompanied the eventual control of C. albicans infection in IFNgammaR (-/-) mice. Following intranasal challenge, there was no difference in the rate of C. albicans clearance from the lungs of IFNgammaR (-/-) and IFNgammaR (+/+) mice. However, 48 h after challenge, large, conspicuous abscesses appeared in the lungs, liver, kidneys and spleen of IFNgammaR (-/-) mice. These abscesses were characterised by the presence of C. albicans and abundant neutrophilic infiltrates, but very few macrophages. No such abscesses developed in i.n. challenged IFNgammaR (+/+) mice. In both mouse strains, i.n. challenge induced strong systemic anti-C. albicans cellular responses, but relatively low titre systemic antibody responses. Mucosal anti-C. albicans antibody responses were detected in IFNgammaR (+/+), but not IFNgammaR (-/-) mice. Splenic adherent macrophages obtained from IFNgammaR (-/-) mice exhibited a significantly lower candidacidal activity than those of IFNgammaR (+/+) mice, and as expected, were not responsive to IFNgamma. In summary, these data suggest that IFNgamma has a role in limiting C. albicans multiplication during the early stages of infection, as well as in preventing the development of C. albicans-associated abscesses. Activation of macrophages by IFNgamma might be pivotal in mediating this role.

Immunisation of mice using Salmonella typhimurium expressing human papillomavirus type 16 E7 epitopes inserted into hepatitis B virus core antigen.

Live vaccines based on BRD509, an attenuated S. typhimurium (aroA, aroD) strain, were constructed that directed the expression of hepatitis B core antigen particles (HBcAg) (BRD969) or HBcAg harbouring human papillomavirus type 16 E7 protein sequences (BRD974), under the control of the in vivo inducible nirB promoter. These strains were used to orally or intravenously immunise different inbred mouse strains and humoral, secretory and cellular anti-E7 and anti-HBcAg responses were monitored. Both BRD969 and BRD974 induced anti-HBcAg humoral IgG responses following oral or intravenous immunisation of B10 mice, although responses were higher in BRD969 immunised animals. IgG subclass analysis revealed a predominantly IgG2a response in these animals. BRD974, but not BRD969, induced anti-E7 humoral IgG responses. Anti-HBcAg (BRD969 and BRD974) and anti-E7 (BRD974) IgA responses were detected in the intestines of orally immunised mice. Anti-Salmonella but not anti-HBcAg or anti-E7 T helper cell responses were detected in mice immunised with BRD509, BRD969 and BRD974. Thus Salmonella vaccine strains can be used to efficiently deliver HBcAg and E7 epitopes to the mucosal and systemic immune systems.

Development of Attenuated Salmonella Strains that Express Heterologous Antigens.

The ability of attenuated strains of Salmonella to induce humoral, secretory, and cellular immune responses following oral ingestion has made them attractive as a system for delivering foreign antigens to the mammalian immune system. DNA capable of driving the expression of heterologous antigens can be introduced into Salmonella vaccine strains using a variety of approaches. In general, there are two common methods of expressing a foreign antigen in salmonellae: from plasmid vectors or from the bacterial chromosome. Since there are many similarities in the cellular and molecular biology of Escherichia coli and Salmonella, most of the genetic manipulations required to construct expression cassettes can be carried out in E. coli. The resulting constructs can then be introduced into the vaccine strains using simple transformatron or other similar techniques. However, the laboratory manipulation of Salmonella strains should be undertaken using techniques that do not lead to the accumulation of undefined genetic lesions, which may compromise the immunogenicity of Salmonella growing in vivo. With this in mind, we will describe appropriate techniques for manipulating Salmonella with the aim of constructing effective oral vaccines.

Restriction fragment length polymorphism (RFLP) analysis and tuberculosis epidemiology.

In order to study polymorphisms of the DNA insertion sequence 6110 (IS6110) in Mycobacterium tuberculosis strains isolated from Colombian patients, together with resistance to antituberculous medications in the Department of Quindío, Colombia, a prospective study was conducted using a consecutive sample of 59 patients with symptomatic pulmonary tuberculosis whose cases had been confirmed by bacilloscopy, both with and without a history of treatment. The patients, who were participating in the Tuberculosis Control Program of the Regional Health Institute of Quindío in Armenia, included all individuals attending local health centers and hospitals between March and July 1993 who were referred to the regional institute. Sputum specimens from each patient were cultured and subjected to drug sensitivity tests. Subsequently, restriction fragment length polymorphisms (RFLP) of IS6110 from 27 patients were analyzed. The patients' treatment histories were used to classify their cases according to WHO criteria. Forty-five cultures were found positive, 44 for M. tuberculosis and 1 for M. africanum. Initial drug resistance was observed in 4 of 42 new cases, or 9.5% (95% CI: 0.6, 18), 2 showing resistance to isoniazid (INH) and 2 to isoniazid plus streptomycin (INH-SM). Acquired resistance was observed in 2 of the 3 chronic cases and relapses, the bacteria being resistant to isoniazid, rifampicin, and streptomycin (INH-RM-SM) in one case and to isoniazid, ethambutol, rifampicin, and streptomycin (INH-EMB-RM-SM) in the other. In those 27 strains subjected to RFLP analysis, the number of copies of IS6110 ranged from 6 to 17. Similarity coefficients revealed five distinct groups of strains. Overall, the RFLP analysis permitted most of the strains to be distinguished from one another, implying that the polymorphisms involved are sufficient to permit effective employment of this technique, which appears to have considerable potential for use in epidemiologic studies and in work designed to provide a basis for tuberculosis control program decision-making.

[Analysis of restriction fragment length polymorphism (RFLP) in epidemiology of tuberculosis]. / Análisis de polimorfismos de los fragmentos de restricción (RFLP) y epidemiología de la tuberculosis.

The purpose of this study was to determine the polymorphism of insertion segment 6110 (IS6110) in strains of Mycobacterium tuberculosis isolated from Colombian patients as well as the current status of resistance to antituberculosis drugs in the department of Quindío, Colombia. To this end, a prospective study was performed with a consecutive sample of 59 patients who sought care at local health centers and hospitals in rural and urban areas of Quindío from March to July 1993. The patients in the sample had symptomatic pulmonary tuberculosis confirmed by bacteriologic inspection of sputum, with and without a history of treatment, and were participants in the Tuberculosis Control Program of the Sectional Health Institute of Quindío in Armenia, Colombia. Sputum cultures and drug sensitivity tests were done. Later, restriction fragment length polymorphisms (RFLP) of IS6110 were analyzed in accordance with the protocols of van Soolingen et al. (1992). Cases were classified by treatment history, applying the criteria of WHO (1991). The results showed 44 cultures positive for M. tuberculosis and one positive for M. africanum. Primary drug resistance was found in 4 of 42 cultures, or 9.5% (CI 95%: 0.6 to 18); 4.8% were resistant to isoniazid (INH) and 4.8% to isoniazid and streptomycin (INH-SM). Acquired resistance was found in two of three cultures, or 66% (to isoniazid, rifampicin, and streptomycin [INH-RM-SM] and to isoniazid, ethambutol, rifampicin, and streptomycin [INH-EMB-RM-SM]). In 27 strains submitted to RFLP analysis, the number of copies of IS6110 varied from 6 to 17. Similarity coefficients revealed five distinct groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation, characterization, and molecular cloning of a specific Mycobacterium tuberculosis antigen gene: identification of a species-specific sequence.

A rabbit polyclonal antiserum exhibiting a specific recognition pattern for Mycobacterium tuberculosis proteins was used to screen an M. tuberculosis genomic library constructed in the expression vector lambda gt11. One clone, denominated C1:10, expressed M. tuberculosis-specific determinants as part of a large fusion protein with beta-galactosidase. The gene for this protein has been sequenced, and it encodes a protein of 134 amino acids (13.8 kDa) which did not display significant homology with any of the previously reported proteins in the data bases. Hybridization studies with restriction fragments of the cloned sequence revealed that it was not present in the genomes of related mycobacteria, namely, M. bovis, M. bovis BCG, M. flavescens, M. fortuitum, M. phlei, and M. vaccae. These findings suggest that we have detected a gene, or a fragment therefrom, unique for M. tuberculosis whose nucleotide and amino acid sequences could be useful tools in the design of an improved vaccine or a diagnostic method of greater accuracy for tuberculosis.

Prevalencia de epilepsia en Medellin, Colombia, 1983 / Prevalence of epilepsy in Medellin, Colombia, 1982

In 1983 a study was done on the prevalence of epilepsy and some of its associated risk factors using a randon representative sample stratified by economic level. The research was carried our in two stages. The first stage consisted of a survey, conducted in July of that year, during which 4 549 persons responded to a questionnaire containing a series of questions on the signs and symptoms of epilepsy and its associated risk factors. Based on the responses and a set of conventional criteria, 441 individuals were identified as suspected epileptics. In the second stage, diagnosis of the disorder was confirmed in 77 of them: in 21 (27.3 percent), through the clinical record or the report of the attending physician, and in 56 (72.7 percent), through the neurological examination that was done as part of the study. Ninety-two persons (20.9 percent) did not report for the examination. A systematic description was drawn up of the clinical characteristics of epilepsy that were identified in the 56 individuals who underwent the neurological examination. Since the probability of confirming the diagnosis was considered to be the same for the persons who reported for the examination and for those who did not, the calculation of prevalence was designed to compensate for the latter