First detection of Omicron variant BA.4.1 lineage in dogs, Chile.

SARS-CoV-2's rapid global spread caused the declaration of COVID-19 as a pandemic in March 2020. Alongside humans, domestic dogs and cats are also susceptible to infection. However, limited reports on pet infections in Chile prompted a comprehensive study to address this knowledge gap. Between March 2021 and March 2023, the study assessed 65 pets (26 dogs and 39 cats) from 33 COVID-19+ households alongside 700 nasal swabs from animals in households with unknown COVID-19 status. Using RT-PCR, nasal, fecal, and environmental samples were analyzed for the virus. In COVID-19+ households, 6.06% tested positive for SARS-CoV-2, belonging to 3 dogs, indicating human-to-pet transmission. Pets from households with unknown COVID-19 status tested negative for the virus. We obtained 2 SARS-CoV-2 genomes from animals, that belonged to Omicron BA.4.1 variant, marking the first report of pets infected with this lineage globally. Phylogenetic analysis showed these sequences clustered with human sequences collected in Chile during the same period when the BA.4.1 variant was prevalent in the country. The prevalence of SARS-CoV-2 in Chilean pets was relatively low, likely due to the country's high human vaccination rate. Our study highlights the importance of upholding and strengthening human vaccination strategies to mitigate the risk of interspecies transmission. It underscores the critical role of the One Health approach in addressing emerging zoonotic diseases, calling for further research on infection dynamics and risk factors for a comprehensive understanding.

First report of porcine respirovirus 1 in South America.

Porcine respirovirus 1 (PRV1) is an emerging virus in pigs that has been previously described in the USA and China. There are no reports of its presence in the rest of the world. The objective of this study was to determine the occurrence of PRV1 in Chile and to determine its phylogeny. Thus, we collected samples (oral fluids, nasal swabs, and lungs) from a swine influenza A virus (IAV) surveillance program, most of which belonged to pigs with respiratory disease. The samples were analyzed by RT-PCR, and the viral sequencing was obtained using RNA whole-genome sequencing approach. Maximum likelihood phylogeny was constructed with the available references. Thirty-one of 164 samples (18.9 %) were RT-PCR positive for PRV1: 62.5 % oral fluids, 19.0 % nasal swabs, and 8.6 % lungs. All 6 farms in this study had at least one positive sample, with 6-40 % of positive results per farm, which suggests that PRV1 is disseminated in Chilean swine farms. Twenty-one of 31 (677%) PRV1-positive samples were also positive for IAV, so the role of PRV1 as secondary pathogen in respiratory disease needs to be further evaluated. Near to complete genome of two PRV1s were obtained from two farms. The phylogenies, in general, showed low bootstrap support, except the concatenated genome and the L gene trees which showed clustering of the Chilean PRV1 with Asian sequences, suggesting a close genetic relationship. This is the first report of PRV1 in the Southern Hemisphere. Further studies are necessary to determine the genetic diversity of this virus in Chile.

Síndrome de Austrian: reporte de caso / Austrian syndrome: report of one case

Austrian syndrome is a triad characterized by pneumonia, meningitis and endocarditis, as a result of a Streptococcus pneumoniae bacteremia. We report a previously healthy 49 year-old male, who consulted at the emergency care unit with a history of one week of pleuritic pain, fever leading to an altered level of consciousness and seizures. A diagnosis of community-acquired pneumonia and meningitis was reached, isolating Streptococcus pneumoniae in the cerebrospinal fluid and blood cultures. Antibiotic treatment was started but the patient had an unsatisfactory response. During hospitalization a new heart murmur was found in the physical examination. An echocardiography was performed and a massive aortic valve insufficiency was found along with vegetations and a perforation of the same valve. The valve was replaced by a prosthetic one and the patient responded satisfactorily to the surgical and antibiotic treatment, without complications.

Identification of a divergent genotype of equine arteritis virus from South American donkeys.

A novel equine arteritis virus (EAV) was isolated and sequenced from feral donkeys in Chile. Phylogenetic analysis indicates that the new virus and South African asinine strains diverged at least 100 years from equine EAV strains. The results indicate that asinine strains belonged to a different EAV genotype.

Pure 9p trisomy derived from a terminal balanced unreciprocal translocation.

The 9p trisomy is a relatively frequent disorder, while pure 9p trisomies are less frequent and usually derived from 9;22 translocations, duplications or 9p extra chromosomes. Here we report a patient with pure trisomy 9p derived from a terminal balanced unreciprocal translocation. The patient derived to the genetic service by psychomotor delay, presented at 2 years and 11 months: short stature, open anterior fontanelle, dysplastic ears, facial dysmorphisms, long and broad first toes with hypoplastic nails, central nervous system and skeletal alterations. The patient karyotype was: 46,XY,der(10)t(9;10) (p13.1;qter)mat while the mother karyotype was: 46,XX,t(9;10)(p13.1;qter). The presence of the subtelomeric region of 10q showed by FISH as well as the duplication of 9p subtelomere was further confirmed with multiplex ligation dependent probe amplification (MLPA) for the subtelomeric region of all chromosomes. The mechanism of formation seems to be due to a telomere break in 10q leading to loss of telomeric functions, permitting the 9p fusion; this has been supported with molecular probes showing telomere shortening in interstitial telomeric repeats, which are unable to prevent chromosome fusion. This is one of the few cases reported with terminal translocations (not jumping) preserving the subtelomeric region and highlights the importance of subtelomeric probes in terminal arrangements, and the utility of molecular probes, such as MLPA in defining this kind of abnormalities. In the clinical context, the patient presented a high proportion of 9p trisomy features which is expected considering the large 9p segment involved and the presence of the critical region 9p22.

[Achievement of cardiovascular prevention goals, pharmacologic prescription and major cardiovascular events among patients with coronary disease]. / Logro de metas de prevención secundaria, prescripción farmacológica y eventos cardiovasculares mayores en pacientes con enfermedad coronaria.

BACKGROUND: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. AIM: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. MATERIAL AND METHODS: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. RESULTS: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Of these, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two or more cardiovascular risk factors. A goal of HDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hg was achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using ß--blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. CONCLUSIONS: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.

Logro de metas de prevención secundaria, prescripción farmacológica y eventos cardiovasculares mayores en pacientes con enfermedad coronaria / Achievement of cardiovascular prevention goals, pharmacologic prescription and major cardiovascular events among patients with coronary disease

Background: Implementation of health programs to reduce cardiovascular risk, are needed for secondary prevention of cardiovascular diseases. Aim: To evalúate achievements of secondary prevention goals, pharmacologic prescription and major cardiovascular events in patients with coronary artery disease. Material and Methods: Patients who had a first event of acute coronary syndrome, angioplasty or revascularization surgery, between January 2008 and June 2010, were contacted for a clinical and laboratory evaluation between June and October 2011. Results: Seven hundred and two medical records were reviewed and 245 eligible patients were identified. Ofthese, we assessed 202 patients aged 64 ± 10 years (70% males). Sixty seven percent had two ormore cardiovascular riskfactors. A goal ofHDL cholesterol level over 40 mg/dL was achieved in 91 % of patients, smoking cessation in 84% and a total cholesterol < 200 mg/dL in 66%. A blood pressure below 130/85 mm Hgwas achieved in 30% of patients, a normal BMI in 19% and LDL cholesterol levels below 70 mg/dL in 18%. At the moment of assessment, 87%> were using aspirin, 78%> statins, 74% angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists and 66%o were using β - blockers. Twenty two percent of patients had a major cardiovascular event during the follow up, which lasted 28 ± 8 months. Conclusions: A low percentage of cardiovascular goals achievement was observed in this sample of patients, with a high prevalence of overweight and obesity. A high percentage quit smoking after their first cardiovascular event. Despite the high percentage of drug prescription, hypertension and dyslipidemia were not fully controlled.

A de novo sSMC(22) Characterized by High-Resolution Arrays in a Girl with Cat-Eye Syndrome without Coloboma.

Cat-eye syndrome (CES) results from trisomy or tetrasomy of proximal 22q originated by a small supernumerary marker chromosome (sSMC). Two critical regions for the major clinical features of CES (CESCRs) have been suggested; however, CES clinical presentation often does not correlate with the sSMC genetic content. We report here a CES girl without coloboma and carrier of a de novo type I sSMC(22) as determined by G- and C-banding, NOR staining and microarrays. This sSMC included 6 distal genes outside the original CESCR and led to a tetrasomy for 22q11.1-22q11.21. The patient's final karyotype was 47,XX,+psu dic(22)(q11.21).arr 22q11.1q11.21(15,250,000-17,035,860)×4 dn. The amplified region outside of CESCR included some genes that may be related to neurologic, heart and renal abnormalities. Conversely, even though the amplification included the CECR2 gene, a major candidate for eye features, there was no coloboma in the patient. The genetic delineation of the present sSMC further strengthens that the CES clinical presentation does not fit completely with the duplicated genetic content and that CES is actually a genomic disorder. Furthermore, since we observed no mosaicism, we believe that other mechanisms might be behind the variability of CES phenotypes as well, mainly those related with functional interactions among amplified genes.

Fibroadenoma en mama axilar supernumeraria: reporte de un caso / Fibroadenoma in supernumerary axilar breast: one case report

Se presenta el caso de una paciente de 41 años portadora de mamas axilares bilaterales que consulta por dolor más masa palpable en una de ellas. La paciente es sometida a resección quirúrgica que mostró que el tumor era un fibroadenoma.

This is a case report, of a 41 years old patient, with bilateral axillar fibroadenoma. The aim of the query was pain and a tangibly mass in one of it. A surgical resection was made, and it showed a fibroadenoma neoplasm.

Rotura de implante mamario: hallazgos en imágenes / Breast implant fracture: imaging findings

Se describe un caso de rotura intracapsular de implante en una paciente asintomática y su estudio diagnóstico con imágenes, analizándose el aporte de cada uno de los métodos incluyendo mamografía, ecografía y resonancia magnética, para el estudio de integridad del implante. Se enfatiza la mejor sensibilidad y especificidad de la resonancia magnética en el diagnóstico de rotura intracapsular.

A case of a fracture of an intracapsular implant in an asymptomatic patient is described, and the study of its diagnostic with images, analyzing the contribution of each one of the methods, including mammography, ultrasoundand magnetic resonance, fot the study on the integrity of the implant. It emphasizes the best sensitivity and specificity of the magnetic resonance in the diagnosis of intracapsular fracture.

Evaluation of the pathogenicity and transmissibility of a chilean isolate of porcine reproductive and respiratory syndrome virus.

The objective of this study was to determine clinical features, shedding and transmission of a Chilean Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) strain upon experimental inoculation of 4-week-old pigs. Six groups of five animals each were used. The G1 (donor) group was inoculated with PRRSV, maintained in an isolation unit for 35 days, and sampled daily to determine shedding in mucosal secretions and faeces, viraemia and seroconversion. An uninfected control group (G6) was equally maintained and sampled under strict isolation. Four other groups (G2 to G5) were exposed to PRRSV via direct contact with G1 for 5-day periods in a staggered manner, throughout the 35-day period, and were later placed in an independent isolation unit to monitor infection status for 7 days. All the animals in G1 and G6 were killed at 35 days post-inoculation (dpi) and the contact groups at 12 days post-contact (dpc). Samples were obtained from diverse organs for histopathological, immunohistochemical (IHC) and virological analysis. No clinical symptoms were evident in any group, except for a transient fever observed in G1. Histopathologically, all the animals of G1 had interstitial pneumonia, although scarce PRRSV-positive cells were detected in the lung using IHC. PRRSV-positive cells (IHC) were detected in the lymphoid tissue of all animals in infected groups, but especially in G3 and G4. Viraemia was detected in G1 (3-35 dpi) and in the all contact groups (5-12 dpc). Likewise, ranging from 3 to 19 dpi, PRRSV was detected in at least one animal from the tonsils and lungs in all infected groups, in nasal and ocular secretions, saliva or faeces. These results indicate that the donor group excreted infectious PRRSV and was able to transmit the infection to susceptible pigs. The critical shedding period was 7-19 dpi, during which, most likely, transmission took place.

Programa de mejoramiento continuo en mamografía / Mammography continuous improvement program

In different areas, the quality concept has been conceived like the fulfillment of "controls of quality" and standards defined in accreditation processes. This paradigm is being replaced by the one of "total quality", being based on cycles of continuous improvement and the use of tools of control for processes analysis. This paper shows the requirements in the implementation of the principles of "total quality" in the continuous quality of image improvement in the Mamography´s Unit of the "Centro de Imagenología, Hospital Clínico Universidad de Chile".

En distintas áreas, el concepto de calidad ha sido concebido como el cumplimiento de "controles de calidad" y estándares definidos en procesos de acreditación. Este paradigma está siendo reemplazado por el de "calidad total", basado en ciclos de mejora continua y el uso de herramientas de control para el análisis de los procesos. Este trabajo muestra los requerimientos en la implementación de los principios de "calidad total" en el mejoramiento continuo de la calidad de imagen en la Unidad de Mamografía del Centro de Imagenología del Hospital Clínico de la Universidad de Chile.

Estudio imagenológico en: nódulo sólido, microcalcificaciones y asimetría mamaria / Imaging study in: solid nodule, microcalcifications and breast asymmetry

Las presentaciones más frecuentes del cáncer mamario incluyen los nódulos, microcalcificaciones y asimetrías. Las microcalcificaciones sospechosas mamarias son el signo radiológico más frecuente de carcinoma mamario ductal in situ. Un detallado análisis de las microcalcificaciones en placas mamográficas magnificadas, que incluya los criterios de distribución, forma y densidad, nos ayudará a clasificarlas y determinar el posible proceso histológico que las produce. Los tipos de microcalcificaciones sospechosas, son las amorfas que son de bajo grado de sospecha, las heterogéneas, pleomórficas de moderado grado de sospecha y por último las lineales ramificadas que son de alto grado de sospecha. Los nódulos mamarios son un hallazgo frecuente, en su mayoría corresponden a lesiones benignas. Serán los criterios morfológicos en los distintos métodos de estudio imagenológicos los que orienten a su posible etiología maligna. Las densidades asimétricas deben ser evaluadas con proyecciones adicionales, para certificar su existencia, y poder caracterizarlas. Existen 4 tipos: tejido mamario asimétrico, densidades visibles en una proyección, densidad focal asimétrica y distorsión de la arquitectura, siendo esta última la que se asocia con mayor frecuencia a atípias.

Resonancia Magnetica Mamaria: Indicaciones Poco Habituales / Breast MR imaging: unusual indications

The indications of breast MRI are now clearly established and internationally accepted. They are also applied in Chile as was agreed in the last the National Consensus on the management of breast cancer. In our study the indications not mentioned in the consensus were classified as infrequent. We determined that a 9.2 percent of breast MRI performed in our study centers were due to infrequent indications, leading to a change in medical management in 71,4 percent of these patients, although this change sometimes had no scientific evidence availing it. These results suggest that MRI could be useful in specific situation and reveal a need for multicentric high quality studies in order to gather enough evidence to justify its use in indications other than the ones already established. In other situations MRI would not be recommended. In exceptional cases, where it seems useful to perform this type of exam it is suggested to make the advisable to make the decision after discussion in a interdisciplinary committee.

Las indicaciones de resonancia magnética mamaria están bien definidas e internacionalmente aceptadas. Se aplican también en Chile según lo establecido en el último Consenso Nacional sobre cáncer mamario, sin embargo observamos que un porcentaje no despreciable (9.2 por ciento) de las resonancias mamarias realizadas en nuestros centros de atención son por indicaciones distintas a las establecidas. En un 71.4 por ciento de estos casos generó un cambio en la conducta médica, situación que en algunos casos no contó con respaldo científico establecido. Estos resultados orientan a pensar que la resonancia sería de utilidad en casos específicos y demuestran la necesidad de estudios sistematizados, multicéntricos que lleven a reunir la evidencia suficiente para justificar su uso en indicaciones distintas a las ya aceptadas. En los casos en que parezca conveniente realizar este tipo de estudio, sería recomendable discutir su eventual utilidad e influencia en la conducta clínica, en el seno de equipos de especialistas multidisciplinarios.