Rotura pancreática completa secundaria a traumatismo abdominal cerrado / Complete rupture of the pancreas due to blunt abdominal trauma

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Donantes fallecidos por criterios cardiocirculatorios (Maastricht 3) con hígados válidos para trasplante / Donors deceased according to cardiocirculatory criteria (Maastricht 3) with livers valid for transplantation

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Accessing indoor fungal contamination using conventional and molecular methods in Portuguese poultries.

Epidemiological studies showed increased prevalence of respiratory symptoms and adverse changes in pulmonary function parameters in poultry workers, corroborating the increased exposure to risk factors, such as fungal load and their metabolites. This study aimed to determine the occupational exposure threat due to fungal contamination caused by the toxigenic isolates belonging to the complex of the species of Aspergillus flavus and also isolates from Aspergillus fumigatus species complex. The study was carried out in seven Portuguese poultries, using cultural and molecular methodologies. For conventional/cultural methods, air, surfaces, and litter samples were collected by impaction method using the Millipore Air Sampler. For the molecular analysis, air samples were collected by impinger method using the Coriolis µ air sampler. After DNA extraction, samples were analyzed by real-time PCR using specific primers and probes for toxigenic strains of the Aspergillus flavus complex and for detection of isolates from Aspergillus fumigatus complex. Through conventional methods, and among the Aspergillus genus, different prevalences were detected regarding the presence of Aspergillus flavus and Aspergillus fumigatus species complexes, namely: 74.5 versus 1.0 % in the air samples, 24.0 versus 16.0 % in the surfaces, 0 versus 32.6 % in new litter, and 9.9 versus 15.9 % in used litter. Through molecular biology, we were able to detect the presence of aflatoxigenic strains in pavilions in which Aspergillus flavus did not grow in culture. Aspergillus fumigatus was only found in one indoor air sample by conventional methods. Using molecular methodologies, however, Aspergillus fumigatus complex was detected in seven indoor samples from three different poultry units. The characterization of fungal contamination caused by Aspergillus flavus and Aspergillus fumigatus raises the concern of occupational threat not only due to the detected fungal load but also because of the toxigenic potential of these species.

Fungal contamination of poultry litter: a public health problem.

Although numerous studies have been conducted on microbial contaminants associated with various stages related to poultry and meat products processing, only a few reported on fungal contamination of poultry litter. The goals of this study were to (1) characterize litter fungal contamination and (2) report the incidence of keratinophilic and toxigenic fungi presence. Seven fresh and 14 aged litter samples were collected from 7 poultry farms. In addition, 27 air samples of 25 litters were also collected through impaction method, and after laboratory processing and incubation of collected samples, quantitative colony-forming units (CFU/m³) and qualitative results were obtained. Twelve different fungal species were detected in fresh litter and Penicillium was the most frequent genus found (59.9%), followed by Alternaria (17.8%), Cladosporium (7.1%), and Aspergillus (5.7%). With respect to aged litter, 19 different fungal species were detected, with Penicillium sp. the most frequently isolated (42.3%), followed by Scopulariopsis sp. (38.3%), Trichosporon sp. (8.8%), and Aspergillus sp. (5.5%). A significant positive correlation was found between litter fungal contamination (CFU/g) and air fungal contamination (CFU/m³). Litter fungal quantification and species identification have important implications in the evaluation of potential adverse health risks to exposed workers and animals. Spreading of poultry litter in agricultural fields is a potential public health concern, since keratinophilic (Scopulariopsis and Fusarium genus) as well as toxigenic fungi (Aspergillus, Fusarium, and Penicillium genus) were isolated.

Fungal and microbial volatile organic compounds exposure assessment in a waste sorting plant.

In the management of solid waste, pollutants over a wide range are released with different routes of exposure for workers. The potential for synergism among the pollutants raises concerns about potential adverse health effects, and there are still many uncertainties involved in exposure assessment. In this study, conventional (culture-based) and molecular real-time polymerase chain reaction (RTPCR) methodologies were used to assess fungal air contamination in a waste-sorting plant which focused on the presence of three potential pathogenic/toxigenic fungal species: Aspergillus flavus, A. fumigatus, and Stachybotrys chartarum. In addition, microbial volatile organic compounds (MVOC) were measured by photoionization detection. For all analysis, samplings were performed at five different workstations inside the facilities and also outdoors as a reference. Penicillium sp. were the most common species found at all plant locations. Pathogenic/toxigenic species (A. fumigatus and S. chartarum) were detected at two different workstations by RTPCR but not by culture-based techniques. MVOC concentration indoors ranged between 0 and 8.9 ppm (average 5.3 ± 3.16 ppm). Our results illustrated the advantage of combining both conventional and molecular methodologies in fungal exposure assessment. Together with MVOC analyses in indoor air, data obtained allow for a more precise evaluation of potential health risks associated with bioaerosol exposure. Consequently, with this knowledge, strategies may be developed for effective protection of the workers.

[Musculoskeletal chronic pain: Latin-American expert panel review based on scientific evidence]. / Dolor musculoesquelético crónico: Opinión de un grupo de expertos latinoamericanos basada en la evidencia científica.

Based on the continual medical education, in the first trimester of 2010 an expert in pain meeting has being made at Mexico City. The priority of the research was on educate residents of medical school or at their post graduate years, and the priority was on investigate of how our residents use adequate pain medication. In that first meeting at Mexico City, from different countries, the agreement was on inadequate use of pain treatment caused from inadequate education of the proper indication of drugs and other therapies for muscle skeletal pain. We decided to make a Latin American expert recommendation in chronic muscle pain where we include: epidemiological and socioeconomic pain data, actual classification of NSAIDs, pharmacological and other treatment in pain, and side effects of most popular drugs with actual recommendations. We include Medline guides, reviews, randomized studies and meta-analysis from 2001 to 2010.

Síncope e hipotiroismo. Una relación razonable / Syncope and hypothryroidism. A reasonable relation

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Polyglycine expansions in eRF3/GSPT1 are associated with gastric cancer susceptibility.

Gastric cancer remains a major cause of death in the developed countries, and a large percentage is still genetically unexplained. Because of their major role in cell survival, mutations in translation factors and altered expression of these genes have been associated with cancer development. Apart from its role in translation termination, the eukaryotic translation release factor 3 (eRF3) is involved in several critical cellular processes, such as cell cycle regulation, cytoskeleton organization and apoptosis. The aim of this study was to evaluate eRF3/GSPT1 gene as a potential genetic susceptibility associated locus for gastric cancer, analysing a stable GGC expansion in exon 1 encoding a polyglycine tract in the N-terminal domain of the protein. DNA was obtained from 139 patients with gastric cancer and from 100 individuals of a healthy control population. The GGC expansion was amplified by PCR and the number of repeats determined by genotyping in an automatic sequencer. There are five known alleles encoding from 8 to 12 glycines. The most common allele encodes 10 glycines. The 12-Gly allele was detected exclusively in the cancer patients (allelic frequency = 5%). Regardless of the genotype, patients with the 12-Gly allele had a 20-fold increased risk for gastric cancer. We also detected a single-base alteration in the gene (G274T) although no correlation with cancer development has been found. Thus, our results show that the GGC expansion may have a potential role in regulating eRF3/GSPT1 expression and/or changing the protein function that can lead to gastric cancer development.

Differential expression of the eukaryotic release factor 3 (eRF3/GSPT1) according to gastric cancer histological types.

BACKGROUND: There are now several lines of evidence to suggest that protein synthesis and translation factors are involved in the regulation of cell proliferation and cancer development. AIMS: To investigate gene expression patterns of eukaryotic releasing factor 3 (eRF3) in gastric cancer. METHODS: RNA was prepared from 25 gastric tumour biopsies and adjacent non-neoplastic mucosa. Real time TaqMan reverse transcription polymerase chain reaction (RT-PCR) was performed to measure the relative gene expression levels. DNA was isolated from tumour and normal tissues and gene dosage was determined by a quantitative real time PCR using SYBR Green dye. RESULTS: Different histological types of gastric tumours were analysed and nine of the 25 tumours revealed eRF3/GSPT1 overexpression; moreover, eight of the 12 intestinal type carcinomas analysed overexpressed the gene, whereas eRF3/GSPT1 was overexpressed in only one of the 10 diffuse type carcinomas (Kruskal-Wallis Test; p < 0.05). No correlation was found between ploidy and transcript expression levels of eRF3/GSPT1. Overexpression of eRF3/GSPT1 was not associated with increased translation rates because the upregulation of eRF3/GSPT1 did not correlate with increased eRF1 levels. CONCLUSIONS: Overexpression of eRF3/GSPT1 in intestinal type gastric tumours may lead to an increase in the translation efficiency of specific oncogenic transcripts. Alternatively, eRF3/GSPT1 may be involved in tumorigenesis as a result of its non-translational roles, namely (dis)regulating the cell cycle, apoptosis, or transcription.

An island within an island: genetic differentiation of Anopheles gambiae in São Tomé, West Africa, and its relevance to malaria vector control.

Islands are choice settings for experimental studies of vector control strategies based on transgenic insects. Before considering this approach, knowledge of the population structure of the vector is essential. Genetic variation at 12 microsatellite loci was therefore studied in samples of the malaria vector Anopheles gambiae s.s., collected from six localities of São Tomé island (West Africa). The objectives were (i) to assess the demographic stability and effective population size of A. gambiae from these sites, (ii) to determine population differentiation and (iii) to relate the observed patterns of population structure with geographic, ecological and historical aspects of the vector on the island. Significant population differentiation, revealed by FST and RST statistics, was found between the southernmost site, Porto Alegre, and northern localities. The observed patterns of population substructure are probably a result of restrictions to gene flow in the less inhabited, more densely forested and mountainous south. In all localities surveyed, A. gambiae appeared to be experiencing a demographic expansion, consistent with a relatively recent (ca. 500 years) founder effect. The results are discussed with respect to current and future prospects of malaria vector control.

Evolución clínica y radiológica de la cifosis juvenil / Clinical and radiological evolution of juvenile kyphosis

Se realiza un estudio retrospectivo y longitudinal de 64 pacientes con cifosis juvenil. Se analizan las manifestaciones radiográficas y clínicas en el momento del diagnóstico y su evolución. Se concluye que la cifosis juvenil no está estadísticamente asociada a la presencia de dolor vertebral inicial ni tras el tratamiento ortopédico. Sólo la presencia de dolor inicial presenta asociación estadística con la existencia de dolor final. De igual modo, cada alteración radiográfica inicial muestra asociación estadística consigo misma con respecto a su presencia final. El grado de cifosis y de acuñamiento tras el tratamiento ortopédico guarda una relación directa con sus valores iniciales previos al tratamiento, por lo que es el grado de estas alteraciones las que deben determinar la posibilidad de instaurar tratamiento con corsé. La cifosis, el acuñamiento y la irregularidad vertebral son cambios potencialmente reversibles mientras las hernias de Schmorl y los pinzamientos discales tienden a permanecer. La evolución medida como la magnitud de regresión de las manifestaciones radiográficas y clínicas fue más favorable en aquellos pacientes con peor estado inicial, probablemente debido a que su potencialidad para la recuperación era mayor que en las lesiones leves. Esta evolución no depende de otros factores como la edad inicial de diagnóstico, del tiempo de permanencia del corsé o la diferencia entre la talla inicial y la talla adulta (AU)

[Viability of colonoscopy without analgesia and conscious sedation]. / Viabilidad de la colonoscopia sin analgesia y sedación consciente.

AIM: To study the need for analgesia and sedation before colonoscopy. PATIENTS AND STUDY DESIGN: Fifty consecutive outpatients were randomly assigned to receive meperidine (0.7 mg/kg) or midazolam (0-035 mg/kg) intravenously (n = 25) or to receive no medication (n = 25) before colonoscopy. Oxygen saturation (SaO2) and heart rate were monitored. Mean blood pressure (MBP) was recorded before and after endoscopy. Patients in the group receiving no medication who experienced marked abdominal pain received sedation and analgesia similar to the premedicated group. Twenty-four hours after the procedure, the patients evaluated the degree of abdominal pain experienced during colonoscopy on a scale from 0 to 9. RESULTS: Complete colonoscopy was performed in 92% of the patients. No significant changes in heart rate were registered in either group. However, in the premedicated group mean blood pressure fell significantly (97.6 +/- 2.6 vs. 89.5 +/- 2.7 mmHg) before and after colonoscopy, respectively (p < 0.05). Nine patients experienced clinically relevant oxygen desaturation (SaO2 > 90%). Of these, five were from the premedicated group and four were from the group receiving no medication. In two patients, both from the premedicated group, the decrease in SaO2 was severe (SaO2 < 85%). The degree of abdominal pain was similar in both groups: 3.64_0.47 (premedicated) vs. 3.92 +/- 0.5 (non-medicated). In the non-medicated group, two patients required analgesia and sedation to complete the colonoscopy and 20 (80%) preferred not to receive sedation in future colonoscopies. CONCLUSIONS: Colonoscopy may be well tolerated without systematic administration of sedation and analgesia, which could be administered selectively.

Desensitization of adenosine A1 receptor-mediated inhibition of adenylyl cyclase in cerebellar granule cells.

Agonist-induced desensitization of adenosine A1 receptor-mediated inhibition of adenylyl cyclase has been studied in cerebellar granule cells. Exposure of cells to the adenosine A1 receptor agonist R-phenylisopropyl adenosine (R-PIA) from 2 to 48 h brings about desensitization of this signal transduction pathway. Associated with the desensitization process, a decrease in radioligand binding performed in intact cells with the adenosine A1 receptor agonist [3H]cyclohexyladenosine (CHA) has been detected. Simultaneously, an increase of adenosine A1 radioligand binding has also been detected in microsomes. A decrease in the steady-state level of alpha-Gi in both, plasma membrane and microsomes also has been detected during the desensitization process. These data may account for the desensitization of the inhibitory pathway of the adenylyl cyclase in cerebellar granule cells described herein. After a transient increase in adenosine A1 receptor mRNA, no changes were observed in this parameter after 12 hr of treatment with the adenosine A1 agonist R-PIA, suggesting a post-transcriptional regulation of this receptor during long-term desensitization.