Identificación de subtipos de blastocystis sp asociados a fuentes de transmisión en una zona rural del departamento del Quindío / Identification of blastocystis sp subtypes associated to transmission sources in a rural area of the department of Quindío

Introducción. Blastocystis sp es un protozoo parásito que se encuentra en el tracto intestinal del hombre y algunos animales, se estima que infecta a más de 1.000 millones de personas en el mundo. El presente trabajo tuvo como Objetivo determinar los genotipos de Blastocystis sp asociados a diferentes fuentes de transmisión en zona rural del departamento del Quindío. Materiales y Métodos. Se obtuvieron 42 muestras coprológicas de niños entre 0 y 14 años, 17 de heces de animales, 17 de alimentos, 28 de superficies inertes ,15 de suelo, 18 de agua de red domiciliaria y 3 de fuente hídrica. Se realizó extracción de ADN y amplificación por PCR para Blastocystis sp usando como blanco el gen SSADNr. Las secuencias fueron alineadas con ClustalW y se realizaron árboles filogenéticos el programa (MEGA11). Resultados. De las 140 muestras recolectadas entre coprológicos de población infantil y matrices ambientales, se encontró una prevalencia de Blastocystis sp del 23,5 % en alimentos, 22,2% en red domiciliaria y del 4,75 % en la población infantil, no hubo evidencia estadística que implicara una asociación entre la presencia de este protozoo y las variables sociodemográficas. Se encontró el subtipo 2 asociado a población infantil y el subtipo 3 asociado a matrices ambientales (agua y alimentos) y población infantil. Conclusiones: Se reporta la presencia de Blastocystis sp en tomate y zanahoria, en la red domiciliaria y población infantil en una zona rural del departamento del Quindío donde los subtipos asociados fueron el subtipo 2 y 3.

Introduction. Blastocystis sp is a parasitic protozoan found in the intestinal tract of man and some animals, and it is estimated that it infects more than 1,000 million people in the world. In the national parasitism survey, it was reported with a prevalence of 52% in the northern Andean region. The aim of this study was to determine the genotypes of Blastocystis sp associated with different sources of transmission in rural areas of the department of Quindío. Materials and Methods. Forty-two coprological samples were obtained from children between 0 and 14 years of age, 17 from animal feces, 17 from food, 28 from inert surfaces, 15 from soil, 18 from household water and 3 from water sources. DNA extraction and PCR amplification were performed for Blastocystis sp using the SSADNr gene as target. The sequences were aligned with ClustalW and phylogenetic trees were performed with the program (MEGA11). Results. Of the 140 samples collected between coprological samples of children and environmental matrices, we found a prevalence of Blastocystis sp of 23.5% in food, 22.2% in the home network and 4.75% in the child population, there was no statistical evidence implying an association between the presence of this protozoan and sociodemographic variables. Subtype 2 was found associated with infant population and subtype 3 associated with environmental matrices (water and food) and infant population. Conclusions: We report the presence of Blastocystis sp in tomato and carrot, in the home network and infant population in a rural area of the department of Quindío where the associated subtypes were subtype 2 and 3.

Surgery and Adjuvant Radiation for High-risk Skin Adnexal Carcinoma of the Head and Neck.

OBJECTIVES: Skin adnexal carcinoma (SAC) is a rare cutaneous malignancy that arises from sebaceous and sweat glands. These carcinomas are believed to behave more aggressively than cutaneous squamous cell carcinomas (SCC) with a propensity for local recurrence. The role of adjuvant radiotherapy in SAC is undefined. METHODS: We retrospectively reviewed all cases of head and neck SAC treated with surgery and adjuvant radiation from 2000 to 2012 at a single institution. RESULTS: Nine cases were identified. Median age was 67 (range, 52 to 88) years. The histologies were: adnexal carcinoma (n=1), adnexal carcinoma with sebaceous differentiation (n=1), adnexal carcinoma with squamous differentiation (n=1), skin appendage carcinoma (n=1), sclerosing sweat duct carcinoma (n=1), mucinous carcinoma (n=1), ductal eccrine adenocarcinoma (n=1), porocarcinoma (n=1), and trichilemmal carcinoma (n=1). All tumors were reviewed by a dermatopathologist to confirm the SAC diagnosis.All patients had undergone surgery. Indications for adjuvant radiation included involved lymph nodes (n=4), perineural invasion (n=2), nodal extracapsular extension (n=2), positive margin (n=1), high-grade histology (n=6), multifocal disease (n=2), and/or recurrent disease (n=5). Radiation was delivered to the primary site alone (n=3), to the draining lymphatics alone (n=2), or to both (n=4). One patient received concurrent cisplatin. Median dose to the primary site was 60 Gy and to the neck was 50 Gy.Median follow-up was 4.0 years (range, 0.6 to 11.4 y). Locoregional control was 100%. Five-year progression-free survival was 89%. There was 1 acute grade 3 toxicity and no greater than or equal to grade 2 late toxicities were recorded. CONCLUSIONS: Surgery and adjuvant radiation for high-risk SAC offers excellent locoregional control with acceptable toxicity.

Survival Impact of Increasing Time to Treatment Initiation for Patients With Head and Neck Cancer in the United States.

PURPOSE: To estimate the overall survival (OS) impact from increasing time to treatment initiation (TTI) for patients with head and neck squamous cell carcinoma (HNSCC). METHODS: Using the National Cancer Data Base (NCDB), we examined patients who received curative therapy for the following sites: oral tongue, oropharynx, larynx, and hypopharynx. TTI was the number of days from diagnosis to initiation of curative treatment. The effect of TTI on OS was determined by using Cox regression models (MVA). Recursive partitioning analysis (RPA) identified TTI thresholds via conditional inference trees to estimate the greatest differences in OS on the basis of randomly selected training and validation sets, and repeated this 1,000 times to ensure robustness of TTI thresholds. RESULTS: A total of 51,655 patients were included. On MVA, TTI of 61 to 90 days versus less than 30 days (hazard ratio [HR], 1.13; 95% CI, 1.08 to 1.19) independently increased mortality risk. TTI of 67 days appeared as the optimal threshold on the training RPA, statistical significance was confirmed in the validation set (P < .001), and the 67-day TTI was the optimal threshold in 54% of repeated simulations. Overall, 96% of simulations validated two optimal TTI thresholds, with ranges of 46 to 52 days and 62 to 67 days. The median OS for TTI of 46 to 52 days or fewer versus 53 to 67 days versus greater than 67 days was 71.9 months (95% CI, 70.3 to 73.5 months) versus 61 months (95% CI, 57 to 66.1 months) versus 46.6 months (95% CI, 42.8 to 50.7 months), respectively (P < .001). In the most recent year with available data (2011), 25% of patients had TTI of greater than 46 days. CONCLUSION: TTI independently affects survival. One in four patients experienced treatment delay. TTI of greater than 46 to 52 days introduced an increased risk of death that was most consistently detrimental beyond 60 days. Prolonged TTI is currently affecting survival.

Enhancement of sciatic nerve regeneration after vascular endothelial growth factor (VEGF) gene therapy.

AIMS: Recent studies have emphasized the beneficial effects of the vascular endothelial growth factor (VEGF) on neurone survival and Schwann cell proliferation. VEGF is a potent angiogenic factor, and angiogenesis has long been recognized as an important and necessary step during tissue repair. Here, we investigated the effects of VEGF on sciatic nerve regeneration. METHODS: Using light and electron microscopy, we evaluated sciatic nerve regeneration after transection and VEGF gene therapy. We examined the survival of the neurones in the dorsal root ganglia and in lumbar 4 segment of spinal cord. We also evaluated the functional recovery using the sciatic functional index and gastrocnemius muscle weight. In addition, we evaluated the VEGF expression by immunohistochemistry. RESULTS: Fluorescein isothiocyanate-dextran (FITC-dextran) fluorescence of nerves and muscles revealed intense staining in the VEGF-treated group. Quantitative analysis showed that the numbers of myelinated fibres and blood vessels were significantly higher in VEGF-treated animals. VEGF also increased the survival of neurone cell bodies in dorsal root ganglia and in spinal cord. The sciatic functional index and gastrocnemius muscle weight reached significantly higher values in VEGF-treated animals. CONCLUSION: We demonstrate a positive relationship between increased vascularization and enhanced nerve regeneration, indicating that VEGF administration can support and enhance the growth of regenerating nerve fibres, probably through a combination of angiogenic, neurotrophic and neuroprotective effects.

Peripheral nerve repair using a poly(organo)phosphazene tubular prosthesis.

Nerve regeneration experiments were carried out using tubular nerve guides of poly[(ethylalanato)1.4(imidazolyl)0.6phosphazene] (PEIP). By means of in vivo tests, this polymer was found to be biodegradable and transformed into harmless products. The tubular nerve guides were prepared by deposition of the dissolved polymer on a glass capillary tube, followed by evaporation of the solvent (methylene dichloride). After transectioning, rat sciatic nerve stumps were immediately sutured into the ends of 10-mm-long polymer tubes. On removal of the prosthesis, after implantation for 45 d, a tissue cable was found bridging the nerve stumps in all cases. Histological analysis revealed that the tissue cable was essentially composed of a regenerated nerve fibre bundle. A parallel series of experiments was undertaken to compare the use of silicone tubes that are not biodegradable and are most frequently used for studies of nerve regeneration with tubulization techniques. The advantages of biodegradable PEIP tubular nerve guides used for peripheral nerve repair are discussed.