Significant heterogeneity in the diagnosis and long-term management of Wilson disease: Results from a large multicenter Spanish study / Elevada heterogeneidad en el diagnóstico y tratamiento a largo plazo en la enfermedad de Wilson: resultados de un estudio multicéntrico español

There is uncertainty regarding Wilson's disease (WD) management. Objectives: To assess, in a multicenter Spanish retrospective cohort study, whether the approach to WD is homogeneous among centers. Methods: Data on WD patients followed at 32 Spanish hospitals were collected. Results: 153 cases, 58% men, 20.6 years at diagnosis, 69.1% hepatic presentation, were followed for 15.5 years. Discordant results in non-invasive laboratory parameters were present in 39.8%. Intrahepatic copper concentration was pathologic in 82.4%. Genetic testing was only done in 56.6% with positive results in 83.9%. A definite WD diagnosis (Leipzig score ≥4) was retrospectively confirmed in 92.5% of cases. Chelating agents were standard initial therapy (75.2%) with frequent modifications (57%), particularly to maintenance zinc. Enzyme normalization was not achieved by one third, most commonly in the setting of poor compliance, lack of genetic mutations and/or presence of cardiometabolic risk factors. Although not statistically significant, there were trends for sex differences in number of diagnosed cases, age at diagnosis and biochemical response. Conclusions: Significant heterogeneity in diagnosis and management of WD patients emerges from this multicenter study that includes both small and large reference centers. The incorporation of genetic testing will likely improve diagnosis. Sex differences need to be further explored. (AU)

Existe incertidumbre con respecto al manejo de la enfermedad de Wilson (EW). Objetivos: Evaluar, en un estudio de cohorte retrospectivo español multicéntrico, si el abordaje de la EW es homogéneo entre los centros. Métodos: Se recogieron datos sobre pacientes con EW seguidos en 32 hospitales españoles. Resultados: Un total de 153 casos, 58% hombres, 20,6 años al diagnóstico, 69,1% presentación hepática, fueron seguidos durante 15,5 años. Se objetivaron resultados discordantes en parámetros de laboratorio no invasivos en el 39,8%. La concentración intrahepática de cobre fue patológica en el 82,4%. Las pruebas genéticas solo se realizaron en el 56,6% con resultados positivos en el 83,9%. Un diagnóstico definitivo de EW (puntuación de Leipzig ≥4) se confirmó retrospectivamente en el 92,5% de los casos. Los agentes quelantes fueron la terapia inicial estándar (75,2%) con modificaciones frecuentes (57%), particularmente hacia zinc de mantenimiento. La normalización enzimática no se logró en un tercio, más comúnmente en el contexto de un cumplimiento deficiente, ausencia de mutaciones genéticas y/o presencia de factores de riesgo cardiometabólicos. Aunque sin alcanzar significación estadística, observamos diferencias entre hombres y mujeres en el número de casos, edad en el momento del diagnóstico y la respuesta bioquímica. Conclusiones: De este estudio multicéntrico que incluye centros de referencia pequeños y grandes se desprende una heterogeneidad significativa en el diagnóstico y manejo de los pacientes con EW. La incorporación de pruebas genéticas ha mejorado el diagnóstico. Las diferencias de sexo deben explorarse más a fondo en estudios futuros. (AU)

Toxicidad del hipoclorito de sodio y compuestos de amonio cuaternario en seres humanos. Una revisión sistemática en época de COVID-19 / Toxicity of sodium hypochlorite and quaternary ammonium compounds in humans. A systematic review in the time of COVID-19

Los desinfectantes son productos que se utilizan de manera cotidiana, su uso se ha incrementado debido a los cambios en los hábitos de bioseguridad que incorporó la población desde el inicio de la pandemia por la COVID-19; en similar medida, han aumentado las intoxicaciones por la exposición a estas sustancias. Conocer los mecanismos a través de los cuales los productos de desinfección pueden causar una intoxicación es importante para desarrollar estrategias de prevención y manejo oportuno. Con este fin, se revisó la información de artículos científicos y reportes de caso, mediante la búsqueda sistemática en línea en PubMed, Medline, Google Scholar y EBSCO, relacionada a intoxicaciones con compuestos de amonio cuaternario e hipoclorito de sodio. El procedimiento utilizado implicó la búsqueda de palabras claves alusivas al tema mediante el uso de Descriptores en Ciencias en Salud y Medical Subject Headings, posteriormente se utilizó metodología “Preferred Reporting Items for Systematic reviews and Meta-Analyses”. Los resultados del estudio evidenciaron que el hipoclorito de sodio afecta a las células y tejidos, mediante sus propiedades oxidativas, provocando alteración de la membrana citoplasmática, desnaturalización y formación de agregados en las proteínas, daño al ADN e inflamación asociada a la lisis celular. Por otro lado, los compuestos de amonio cuaternario afectan principalmente a la membrana celular, ocasionando daño inflamatorio, fibrosis y alteraciones reproductivas. Los dos compuestos afectan la integridad de la célula de manera directa. Sin embargo, sus efectos se ven exacerbados por los cambios que ocurren en el entorno celular. (AU)

Disinfectants are products that are used on a daily basis, their use has increased due to changes in biosafety habits that the population has adopted since the beginning of COVID19. To a similar extent, poisoning from exposure to these substances has increased. Consequently, knowing the mechanisms through which disinfection products can cause poisoning is important to develop prevention strategies and timely management. To this end, the information related to poisoning with quaternary ammonium compounds and sodium hypochlorite was reviewed in scientific articles and study cases by a systematic online search in PubMed, Medline, Google Scholar and EBSCO. The procedure used involved the search for keywords alluding to the topic by using Descriptors in Health Sciences and Medical Subject Headings. Later the «Preferred Reporting Items for Systematic reviews and Meta-Analyses» methodology was used. The results of the study showed that sodium hypochlorite affects cells and tissues through its oxidative properties, causing alteration of the cytoplasmic membrane, denaturation and formation of protein aggregates, DNA damage and inflammation associated with cell lysis. On the other hand, quaternary ammonium compounds mainly affect the cell membrane, causing inflammatory damage, fibrosis and reproductive disorders. Both compounds directly affect the integrity of the cell. However, its effects are exacerbated by changes that occur in the cellular environment. (AU)

Significant heterogeneity in the diagnosis and long-term management of Wilson disease: Results from a large multicenter Spanish study.

There is uncertainty regarding Wilson's disease (WD) management. OBJECTIVES: To assess, in a multicenter Spanish retrospective cohort study, whether the approach to WD is homogeneous among centers. METHODS: Data on WD patients followed at 32 Spanish hospitals were collected. RESULTS: 153 cases, 58% men, 20.6 years at diagnosis, 69.1% hepatic presentation, were followed for 15.5 years. Discordant results in non-invasive laboratory parameters were present in 39.8%. Intrahepatic copper concentration was pathologic in 82.4%. Genetic testing was only done in 56.6% with positive results in 83.9%. A definite WD diagnosis (Leipzig score ≥4) was retrospectively confirmed in 92.5% of cases. Chelating agents were standard initial therapy (75.2%) with frequent modifications (57%), particularly to maintenance zinc. Enzyme normalization was not achieved by one third, most commonly in the setting of poor compliance, lack of genetic mutations and/or presence of cardiometabolic risk factors. Although not statistically significant, there were trends for sex differences in number of diagnosed cases, age at diagnosis and biochemical response. CONCLUSIONS: Significant heterogeneity in diagnosis and management of WD patients emerges from this multicenter study that includes both small and large reference centers. The incorporation of genetic testing will likely improve diagnosis. Sex differences need to be further explored.

Establecimiento de biofloc a tres relaciones carbono/nitrógeno, tendiente a la producción de zooplancton / Establishment of biofloc at three carbon/nitrogen ratios, tending to the production of zooplankton

RESUMEN El objetivo de esta investigación fue establecer el biofloc a tres relaciones carbono/ nitrógeno (C/N): 10/1, 15/1 y 20/1, determinando la secuencia de remoción de N, el perfil de sólidos y la caracterización del zooplancton, para tal fin se dispuso de tres tanques con volumen de 7000 L, incorporando oxígeno al agua a través de un aireador tipo soplador. Se utilizó como fuente de N balanceado, fuente de carbono melaza y bicarbonato de sodio como fuente alcalinizante. Al inicio se incrementó el nitrógeno amoniacal total NAT a 2 mg/L, la alcalinidad total (AT) a 120 mg/L y se adicionó como inóculo 10 litros/tanque de agua proveniente de un estanque de cultivo, al sexto y décimo días se adicionó balanceado incrementando teóricamente el NAT en 4 mg/L y a partir del día 12 en 1 mg/L. En las tres relaciones C/N se evidenciaron procesos de nitrificación durante la estabilización del biofloc, hasta llegar en el tiempo a concentraciones no letales de amonio y nitrito para peces, menores a 1 mg/L. En cuanto a los sólidos volátiles, se encontró una mayor concentración en la relación 20/1, lo cual puede atribuirse a la mayor adición de melaza, con la consecuente producción de SSV a partir de la dominancia de comunidades heterotróficas, en los tres macrocosmos se presentaron comunidades del zooplancton, no obstante, el T2 presentaron la mayor abundancia y riqueza de organismos. Las tres relaciones C/N en biofloc establecieron condiciones de calidad de agua y alimento vivo.

ABSTRACT The objective of this research was to establish the biofloc at three carbon/nitrogen (C/N) relationships: 10/1, 15/1 and 20/1, determining the N removal sequence, the solids profile and the characterization of the zooplankton, for this purpose three tanks with a volume of 7000 L were available, incorporating oxygen into the water through a blower-type aerator. It was used as a source of balanced N, a source of carbon molasses and sodium bicarbonate as an alkalizing source. At the beginning, the total ammoniacal nitrogen NAT was increased to 2 mg/L, the total alkalinity (AT) to 120 mg/L and 10 liters / tank of water from a culture pond was added as inoculum, on the sixth and tenth days it was he added balanced, theoretically increasing the NAT by 4 mg/L and from day 12 by 1 mg/L. In the three C / N relationships, nitrification processes were evidenced during the stabilization of the biofloc, until reaching non-lethal concentrations of ammonium and nitrite for fish, less than 1 mg/L in time. Regarding volatile solids, a higher concentration was found in the 20/1 ratio, which can be attributed to the greater addition of molasses, with the consequent production of SSV from the dominance of heterotrophic communities, in the three macrocosms there were Zooplankton communities, however, T2 presented the highest abundance and richness of organisms. The three C / N relationships in biofloc established conditions of water quality and live food.

Resistencia antimicrobiana y daño al medio ambiente, en el contexto COVID-19: Una revisión sistemática / Antimicrobial resistance and damage to the environment, in the context of COVID-19: A systematic review

Las pautas de abordaje de los pacientes con COVID-19, al inicio de la pandemia, se realizó por ensayo, ya que se desconocía la fisiopatología de esta nueva enfermedad, entre las acciones médicas se describió el uso de antiboticoterapias de manera indiscriminada, también se instó a realizar desinfección profundas, muchas veces, con sustancias químicas con impacto negativo en la salud ambiental, tanto a nivel de la microbiota encargada del equilibrio ecológico, como en la contaminación ambiental, principalmente del agua. Aunado a esto, debido a la emergencia sanitaria, se requirió usar en mayor cantidad equipos de protección personal de un solo uso y, como consecuencias el aumento de desechos sólidos peligrosos, cuya composición son de degradación tardía. Por tanto, la respuesta sanitaria ante la pandemia, probablemente fue escenario para acentuar la resistencia antimicrobiana y el riesgo de daño ambiental. En este, artículo se realizó una revisión sistemática de la literatura científicas en torno a estos tópicos, las evidencias demostraron el aumento de mecanismos de resistencias de bacterias, principalmente, patógenas del tracto respiratorio. De igual manera, el impacto negativo por uso irracional de desinfectantes químicos, traducido en bacterias resistentes especialmente a compuestos de amonio cuaternario. La bioacumulación y biomagnificación de estas sustancias ha provocado toxicidad, mutaciones, propagación de genes de resistencia. Por lo tanto, se sugiere que se priorice las estrategias que mitiguen el rastro que ha venido extendiéndose al paso de la pandemia por el SAR- CoV-2(AU)

The guidelines for the approach of patients with COVID-19, at the beginning of the pandemic, were carried out by trial, since the pathophysiology of this new disease was unknown, among the medical actions the use of antibiotic therapies indiscriminately was described, also the urged to carry out deep disinfection, many times, with chemical substances with a negative impact on environmental health, both at the level of the microbiota responsible for the ecological balance, and in environmental pollution, mainly of water. In addition to this, due to the health emergency, it was required to use more single-use personal protective equipment and, as a consequence, the increase in hazardous solid waste, whose composition is delayed degradation. Therefore, the health response to the pandemic was probably the setting to accentuate antimicrobial resistance and the risk of environmental damage. In this article, a systematic review of the scientific literature on these topics was carried out, the evidence demostrated the increase in resistance mechanisms of bacteria, mainly pathogens of the respiratory tract. Anyways, the negative impact due to the irrational use of chemical disinfectants, translated into resistant bacteria, especially to quaternary ammonium compounds. The bioaccumulation and biomagnification of these substances has caused toxicity, mutations, propagation of resistance genes. Therefore, it is suggested that strategies be prioritized that mitigate the trail that has been spreading as the pandemic passed by SAR-CoV-2(AU)

Use of ammonium chloride to prevent urolithiasis in sheep / [Utilização do cloreto de amônio na prevenção de urolitíase em ovinos]

Urolithiasis has a high incidence among confined sheep. It is multifactorial and may cause economic damage. Our aim was to determine the capacity of urinary acidification using ammonium chloride in sheep. Twenty-five 3-month-old male sheep were confined and randomly divided into three groups; the G200 and G500 groups received 200mg/kg/GW and 500mg/kg/GW of ammonium chloride daily for 56 consecutive days, respectively, whereas the CG group did not receive ammonium chloride. Sampling times and clinical evaluation were performed weekly, starting from the 14th day of confinement (M1 or immediately before administering ammonium chloride) until the 17th day (M9) of the feedlot. Hemogasometry, biochemical examination of serum urea and creatinine concentration and ultrasound evaluation of the urinary tract were performed. The urinalysis indicated a higher incidence of ammonium magnesium phosphate crystals at the beginning of the study, showing a migration to urate crystal formation, mainly in the G500 group because of urinary acidification. No hemogasometric, serum biochemistry, ruminal fluid, or ultrasonographic changes were observed. Urinary acidification was achieved and maintained after M7 during the administration of ammonium chloride in the G500 group, but not in the other study groups.(AU)

A urolitíase apresenta alta incidência em ovinos confinados, etiologia multifatorial, e pode causar prejuízo econômico. O objetivo do presente estudo foi determinar a capacidade da acidificação urinária mediante o uso de cloreto de amônio em ovinos. Foram utilizados 25 ovinos de três meses de idade, confinados e divididos aleatoriamente em três grupos: grupo CG (controle) não recebeu cloreto de amônio; grupo G200 (200mg/kg/PV) recebeu cloreto de amônio por 56 dias consecutivos; grupo G500 (500mg/kg/PV) recebeu cloreto de amônio por 56 dias consecutivos, administrados diariamente por via oral. Os momentos (M) de colheita de amostras e de avaliação clínica foram realizados com intervalo de sete dias, sendo M1 (imediatamente antes do cloreto de amônio), M2 (sete dias após) até M9, totalizando 70 dias de confinamento. Foram realizadas hemogasometria, concentração sérica de ureia e creatinina e avaliação ultrassonográfica do trato urinário. Na urinálise, houve uma maior incidência de cristais de fosfato amônio magnesiano no início do estudo, com migração para formação de cristais de urato, principalmente no G500, devido à acidificação urinária. Não houve alterações hemogasométricas, na bioquímica sérica, no líquido ruminal, ou alterações ultrassonográficas. A acidificação urinária foi obtida e mantida a partir do M7 durante a administração do cloreto de amônio no grupo G500, não ocorrendo nos outros grupos de estudo.(AU)

Polifluoruro de amonio como alternativa de acondicionamiento para laminados ultradelgados de disilicato de litio. Reporte de caso / Ammonium polyfluoride as an alternative for the surface conditioning of ultrathin lithium disilicate veneers. A case report

RESUMEN: Los laminados vitrocerámicos ultradelgados constituyen una alternativa conservadora para la resolución de alteraciones estéticas. Sin embargo, su acondicionamiento con ácido fluorhídrico suele no estar exento de complicaciones, por lo que el uso de un sistema autograbante en base a polifluoruro de amonio (Monobond Etch&Prime, MEP) permite disminuir el riesgo de sobregrabado, simplificando la técnica. El presente reporte presenta el seguimiento a dieciocho meses de un caso clínico resuelto mediante laminados vitrocerámicos acondicionados únicamente con MEP. Caso. Paciente joven con alteraciones estéticas en el sector anterosuperior. Se realizaron preparaciones conservadoras para la confección de laminados ultradelgados en disilicato de litio (e.maxPress). Las vitrocerámicas fueron acondicionadas sólo con MEP y se cementaron con Variolink Esthetic LC. Al año y medio las restauraciones se observaron indemnes, manteniendo un buen ajuste marginal y ausencia de tinciones. Conclusiones. MEP aparece como una alternativa prometedora para reemplazar al ácido fluorhídrico en la cementación de laminados vitrocerámicos.

ABSTRACT: Ultrathin glass-ceramic veneers are a conservative approach for the restorative treatment of aesthetic disorders in the anterior region. However, surface conditioning with hydrofluoric acid of the thin structures can be usually a challenging step. Therefore, the use of a self-etching ceramic primer containing ammonium polyfluoride (Monobond Etch&Prime, MEP) offers a simplified technique with a reduced risk of overetching. Here we present an 18-month follow-up of ultrathin glass-ceramic veneers conditioned with MEP only. Case. Young female patient with an aesthetic disorder in the front region. The four upper incisors were conservatively prepared for ultrathin lithium disilicate (e.maxPress) veneers. Pre-treatment of the glass-ceramics consisted only of MEP application, followed by adhesive cementation with Variolink Esthetic LC. At the 1.5-year recall, the restorations appeared undamaged, with no marginal gap or staining. Conclusions. MEP constitutes a promising alternative to hydrofluoric acid for the adhesive cementation of glass-ceramic veneers.

Varón de 30 años con hiperamonemia de 24 horas de evolución / 30-year-old man with Acute Hyperammonemia

La hiperamonemia es una de las complicaciones agudas más graves que se puede presentar en diversos trastornos congénitos del metabolismo como los defectos en el ciclo de la urea, las acidemias orgánicas o en las alteraciones en la oxidación de los ácidos grasos. Su reconocimiento y tratamiento es una emergencia clínica, dado que el efecto neurotóxico es directamente proporcional al tiempo de exposición a niveles elevados de amonio. Presentamos el caso clínico de un paciente de 30 años con deterioro del nivel de consciencia y elevación del amonio plasmático de 24 horas de evolución. (AU)

Hyperammonemia is one of the most severe acute complication that can occur in various congenital metabolic conditions such as the urea cycle disorders, organic acidemias or fatty acids oxidation defects. The prompt recognition and treatment is a clinical emergency, since the neurotoxic effect is directly proportional to the time of exposure to high levels of ammonia. We report the clinical case of a 30-year-old patient with a decreased level of consciousness and a 24-hour evolution of high plasma ammonia. (AU)

Prepartum anionic diet induces hyperchloremic acidosis in high-producing dairy cows without preventing subclinical hypocalcemia / Dieta aniônica pré-parto provoca acidose hiperclorêmica em vacas leiteiras de alta produção mas não evita a hipocalcemia subclínica

In this study we evaluated the effects of the prepartum anionic diet on the electrolyte balance and calcemia of high producing dairy cows in the first days of lactation, and investigated the impact on the frequency of subclinical hypocalcemia (SCH). Sixty healthy Holstein cows, producing 30 kg of milk/day, handled in intensive system (compost barn), were distributed in groups (n=15) according to lactation order: first, second, third, and fourth to sixth. In the last three weeks before calving they received a diet with negative DCAD (-6mEq/100g DM) and high chloride content. After calving, they received a diet with positive DCAD (18mEq/100g DM). Urine pH was measured before calving. Serum Na+, Cl-, K+, and total Ca concentrations, and the strong ion difference (SID3) were determined in samples taken soon after calving (0h), 24, 48, 72 and 96h after. The frequencies of SCH were determined considering the critical value of 2.125mmol/L (8.5mg/dL). Two-way repeated measures ANOVA and chi-square test were used for comparisons. The cows eliminated acidic urine before calving. Na+, K+, Cl-, and SID3 values did not differ between groups. Na+ and K+ did not vary between days; Cl- was elevated at calving and decreased until 72h; and SID3 was reduced at calving and increased up to 48h. The Ca levels were reduced until 24h and increased up to 72h. Cows of third and fourth to sixth lactations presented lower values up to 24h. SCH was observed in almost half of the cows (43.3% to 55%) until 48h. The maintenance of hypocalcemia for three or more consecutive days occurred in 53.3% of third and fourth to sixth lactations cows. Ingestion of a high chloride prepartum anionic diet led to hyperchloremic acidosis and this imbalance was reversed on the second postpartum day. The induced effects on electrolyte and acid-base balances were not able to prevent the occurrence of SCH in the first days of lactation.(AU)

Os objetivos do estudo foram avaliar os efeitos que a dieta aniônica pré-parto provoca sobre o equilíbrio eletrolítico e sobre a calcemia de vacas leiteiras de alta produção nos primeiros dias de lactação, e verificar o impacto sobre a frequência da hipocalcemia subclínica (HSC). Sessenta fêmeas hígidas HPB, com produção de 30 kg de leite/dia, manejadas em sistema intensivo (compost barn), foram distribuídas por grupos (n=15) de acordo com a ordem de lactação: primeira, segunda, terceira e quarta a sexta. Nas três semanas pré-parto receberam dieta com DCAD negativa (-6mEq/100g MS) e teor de cloreto elevado. Após o parto receberam dieta com DCAD positiva (18mEq/100g MS). O pH da urina foi mensurado antes do parto. As concentrações séricas de Na+, Cl-, K+ e Ca total e a diferença de íons fortes (SID3) foram determinadas em amostras colhidas ao parto (0h), 24, 48, 72 e 96h após. As frequências de HSC foram determinadas considerando-se o valor crítico de 2,125mmol/L (8,5mg/dL). ANOVA de medidas repetidas e teste de qui-quadrado foram empregados para as comparações. As vacas eliminavam urina ácida antes do parto. Os valores de Na+, K+, Cl- e SID3 não diferiram entre os grupos. Na+ e K+ não variaram entre os dias; Cl- era elevado ao parto e diminuiu até 72h; e SID3 era reduzida ao parto e aumentou até 48h. A calcemia era reduzida até 24h e se elevou até 72h. Vacas de terceira e de quarta a sexta lactações apresentaram valores mais baixos até 24h. A HSC foi observada em quase metade das vacas (43,3% a 55%) até 48h. A manutenção de hipocalcemia por três ou mais dias seguidos ocorreu em 53,3% das vacas de terceira e de quarta a sexta lactações. A ingestão de dieta aniônica pré-parto com alto teor de cloreto provocou acidose hiperclorêmica e este desequilíbrio se reverteu no segundo dia pós-parto. Os efeitos induzidos sobre os equilíbrios eletrolítico e ácido base não foram capazes de prevenir a ocorrência de HSC nos primeiros dias da lactação.(AU)

Crecimiento y metabolismo de Fischerella TB22 en medio de cultivo BG11 / Growth and metabolism of Fischerella TB22 in BG110 culture medium

Los microorganismos fijadores de nitrógeno de vida libre, abarcan una gama morfológica que va desde los organismos unicelulares como las bacterias y algunas cianobacterias, hasta multicelulares, filamentosas, por ello es importante conocer cómo se comportan y se puede saber haciendo una curva de crecimiento microbiano. Para este estudio se prepararon 4 fotobioreactores de columna burbujeada con inoculo de Fischerella TB22, se pusieron en aireación constante con 12 horas luz y 12 horas obscuridad durante 40 días con diferentes tratamientos de ajuste de volumen del medio de cultivo y ajuste del pH. El objetivo de este trabajo fue evaluar el crecimiento en biomasa por peso seco, densidad óptica, pH y amonio de Fischerella sp. en medio de cultivo BG110 durante 12 días. Las variables que se midieron de la curva de crecimiento de las cianobacterias, siguieron el patrón de una curva típica de crecimiento microbiano. (AU)

Free-living nitrogen-fixing microorganisms cover a morphological range that goes from unicellular organisms such as bacteria and some cyanobacteria, to multicellular, filamentous, therefore it is important to know how they behave and can be known by makinga microbial growth curve. For this study, 4 bubbled column photobioreactors with Fischerella TB22inoculum were prepared, they were placed in constant aeration with 12 hours of light and 12 hours of darkness for 40 days with different treatments of volumeadjustment of the culture medium and pH adjustment. The objective of this work was to evaluate the biomass growth by dry weight, optical density, pH, and ammonia of Fischerella sp. in the BG110 culture medium for 12 days. The variables that were measured from the growth curve of cyanobacteria followed the pattern of a typical microbial growth curve. (AU)

Glyphosate-resistant soybeans yield in function of glyphosate salts, doses and stadium phenological / Produtuvidade de cultivares de soja em função dos sais de glyphosate, doses e épocas de aplicação

Given the importance of soybean to the global economy and as a food source, improving crop management techniques is integral to obtaining higher yields. As such, this study aimed to assess the yield of soybean cultivars as a function of different glyphosate salt formulations, doses and application times. Two field experiments were conducted simultaneously using a randomized block design and 3x4x2 factorial scheme, with three repetitions. Factor A consisted of three glyphosate formulations: isopropylamine salt (Roundup Original®), ammonium salt (Roundup WG®), and potassium salt (Zapp Qi®), factor B four application times: 0, 14, 28, 42 days after planting (DAP), and factor C two doses: the recommended dose of 720 grams of acid equivalent per hectare and twice that (1440 grams of acid equivalent per hectare). There was no difference between the glyphosate salts for the BMX Ativa RR® cultivar, but yields of BMX Apolo RR® submitted to ammonium salt were 28% higher than those recorded for the other salts studied. Glyphosate potassium salt resulted in lower soybean yields. Potassium salt application between 14 and 28 DAP caused greater toxicity in both the soybean cultivars analyzed.

Diante da importância da cultura da soja tanto na economia mundial quanto para a alimentação, a melhoria das técnicas de cultivo torna-se um ponto fundamental na obtenção de maiores produtividades. Desta forma o objetivo do trabalho foi avaliar a produtividade de cultivares de soja sob a influência da aplicação de diferentes sais de glyphosate, doses e épocas de aplicação. Dois experimentos de campo foram realizados simultaneamente em delineamento de blocos casualizados com arranjo trifatorial (3x4x2) com três repetições. O fator A consistiu de três formulações de glyphosate: sal de isopropilamina (Roundup Original®), sal de amônio (Roundup WG®), sal de potássio (Zapp Qi®). O fator B consistiu de quatro épocas de aplicação: 0, 14, 28, 42 dias após a semeadura (DAS). O fator C consistiu em duas doses: a dose recomendada de 720 gramas de equivalente ácido por hectare e duas vezes a dose recomendada com 1440 gramas de equivalente ácido por hectare. Para a cultivar BMX Ativa RR® não se observou diferença quanto aos sais, porém a cultivar BMX Apolo RR® submetida a aplicação de sal de amônio demostrou uma produtividade 28% superior em relação aos demais sais. O glyphosate na formulação sal de potássio apresentou redução da produtividade da cultura da soja. Aplicações de glyphosate na formulação sal de potássio realizadas entre os 14 e 28 dias após a semeadura causam maior toxidez em ambas cultivares de soja utilizadas.

One-day protocol for 18F-FDG and 13N-ammonia PET/CT with uptake decoupling score in differentiating untreated low-grade glioma from inflammation. / Protocolo de un día para la PET/TC con 18F-FDG y 13N-amonio con escala de desacoplamiento de la captación para diferenciar el glioma de bajo grado no tratado de la inflamación.

PURPOSE: Accurate identification of low-grade gliomas (LGGs; World Health Organization grades I and II) and their differentiation from brain inflammation lesions (BILs) remains difficult; however, it is essential for treatment. This study assessed whether a one-day protocol for voxel-wise 18F-FDG and 13N-ammonia PET/CT with uptake decoupling analysis could differentiate LGGs from BILs. MATERIALS AND METHODS: Twenty-eight patients with LGGs and 16 patients with BILs underwent 18F-FDG and 13N-ammonia PET/CT on the same day before any type of therapy. The decoupling score and tumor-to-normal tissue (T/N) ratio of 18F-FDG and 13N-ammonia were calculated at each location. Student's t-test was used to compare values, and ROC curve analysis was used to establish a cut-off value for the T/N ratio and decoupling score. Area under the curve (AUC) was calculated to evaluate differential efficacy. RESULTS: Significant differences were observed in 13N-ammonia T/N ratio (p=0.018) and decoupling score (p=0.003) between LGGs and BILs; however, the 18F-FDG T/N ratio did not show any differences (p=0.413). Optimal cut-off values for 18F-FDG T/N ratio, 13N-ammonia T/N ratio, and decoupling score were 0.73, 0.97, and 2.31, respectively, with corresponding AUCs of 0.48, 0.68, and 0.77. The respective sensitivity, specificity, and accuracy parameters using these cut-off values were 53.6%, 62.5%, and 56.8%, respectively, for 18F-FDG; 50.0%, 75.0%, and 59.1%, respectively, for 13N-ammonia; and 60.7%, 93.8%, and 72.7%, respectively, for decoupling score. CONCLUSIONS: 18F-FDG/13N-ammonia uptake decoupling score can be used to discriminate between LGGs and BILs. Use of a decoupling map of these two tracers can improve visual analysis and diagnostic accuracy.

Correlación entre los microorganismos oxidantes del amonio y los factores ambientales durante el compostaje de estiércol de ganado / Correlation between ammonia-oxidizing microorganisms and environmental factors during cattle manure composting

Abstract Cattle manure composting was performed in an aerated vessel. Community structure and diversity of ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) were investigated using polymerase chain reaction and denaturing gradient gel electrophoresis (PCR-DGGE) techniques targeting the ammonia monooxygenase alpha subunit (amoA) gene and the correlation between AOB and AOA communities and environmental factors was explored. Thirteen (13) AOB sequences were obtained, which were closely related to Nitrosomonas spp., Nitrosomonas eutropha, and Nitrosospira spp. and uncultured bacteria, among which Nitrosomonas spp. were predominant. Excessively high temperature and high ammonium concentration were not favorable for AOB growth. Five AOA sequences, belonging to Candidatus Nitrososphaera gargensis and to an uncultured archaeon, were obtained. During composting, community diversity of AOB and AOA fluctuated, with AOA showing a higher Shannon-Wiener index. The AOB community changed more dramatically in the mesophilic stage and the early thermophilic stage, whereas the most obvious AOA community succession occurred in the late thermophilic stage, the cooling stage and the maturity stage. Water content, total nitrogen (TN) and ammonium concentration were more relevant to the AOB community structure, while higher correlations were observed between ammonia, nitrate and TN and the AOA community. AOB community diversity was negatively correlated with pH (r = -0.938, p < 0.01) and water content (r = -0.765, p < 0.05), while positively correlated with TN (r = 0.894, p < 0.01). AOA community diversity was negatively correlated with ammonium concentration (r = -0.901, p < 0.01). Ammonium concentration played an important role in the succession of AOB and AOA communities during composting.

Resumen Se llevó a cabo un compostaje de estiércol de ganado en un recipiente aireado. Se investigó la estructura de la comunidad y la diversidad de bacterias oxidantes del amoníaco (AOB) y las arqueas oxidantes del amoníaco (AOA) mediante el uso de las técnicas de reacción en cadena de la polimerasa y la electroforesis en gel con gradiente de desnaturalización (PCR-DGGE) dirigidas al gen de la subunidad alfa de la amonio monooxigenasa (amoA), y se exploró la correlación entre las comunidades AOB, AOA y los factores ambientales. Se obtuvieron 13 secuencias de AOB, las cuales se relacionaron estrechamente con Nitrosomonas spp., Nitrosomonas eutropha y Nitrosospira spp., y bacterias no cultivadas, entre las cuales fueron predominantes las Nitrosomonas spp. La temperatura excesivamente alta y la concentración de amonio elevada no fueron favorables para el crecimiento de las AOB. Se obtuvieron 5 secuencias de AOA, pertenecientes a Candidatus Nitrososphaera gargensis y un Archaeon no cultivado. Durante el compostaje, la diversidad de AOB y AOA fluctuó y las AOA mostraron un índice de Shannon-Wiener más alto. La comunidad de AOB cambió significativamente en la etapa mesofílica y la etapa termofílica temprana, mientras que la sucesión más obvia de la comunidad AOA ocurrió en la etapa termofílica tardía y las etapas de enfriamiento y de maduración. El contenido de agua, el nitrógeno total (TN) y la concentración de amonio fueron más relevantes para la estructura de la comunidad AOB, mientras que se observaron correlaciones mayores entre amoníaco, nitrato y TN, y la comunidad AOA. La diversidad de la comunidad AOB se correlacionó negativamente con el pH (r= -0,938; p < 0,01) y el contenido de agua (r = -0,765; p < 0,05), mientras que se relacionó positivamente con TN (r = 0,894; p < 0,01). La diversidad de la comunidad AOA se correlacionó negativamente con la concentración de amonio (r = -0,901; p < 0,01). La concentración de amonio desempenó un papel importante en la sucesión de las comunidades AOB y AOA durante el compostaje.

Modelo experimental de acidose metabólica crônica em ratos: respostas ventilatórias e gasometria / Experimental model of chronic metabolic acidosis in rats: ventilatory responses and gasometry / Modelo experimental de accidosis metabólica crónica en ratas: respuestas ventilatorias y gasometría

Introdução: Sob condições normais, o equilíbrio ácido-base no organismo é mantido pelo trabalho conjunto dos rins e pulmões. Objetivos: avaliar as respostas ventilatórias e a gasometria em ratos submetidos à acidose metabólica por cloreto de amônio durante diferentes intervalos de tempo. Material e Método: A acidose metabólica foi induzida por meio da ingesta ad libitum e gavagem de solução de cloreto de amônio (NH4Cl) 0,5M e 0,02M, respectivamente. Os animais foram divididos em sete grupos, submetidos, respectivamente a 1, 3, 4, 5, 7, 8 e 9 dias de acidose. Medidas das respostas ventilatórias (Vc, fR e VE), gasometria (PaO2, PaCO2, pHa e [HCO3-]pl) e creatinina e ureia plasmáticas e urinárias foram avaliadas. Somente foram considerados animais que apresentaram pH≤7,3 e [HCO-3]≤18mEq/L. Estatística: Média±EPM; ANOVA (one-way); p<0,05. Resultados: A ingestão de solução ácida promoveu redução significativa do pH e bicarbonato plasmáticos em todos os grupos. A ventilação apresentou tendência em aumentar no grupo com 1 dia de acidose e reduziu significativamente nos grupos com 4 e 9 dias nesta condição. A PaO2 reduziu significativamente nos grupos com 1, 3 e 4 dias de acidose e a PaCO2 permaneceu relativamente constante. Não houve alteração da ureia e creatinina plasmáticas e urinárias frente a acidose. Conclusões: O aumento apenas inicial da ventilação, adicionado ao perfil da gasometria frente à acidose metabólica, sugerem que ratos, em comparação com a espécie humana, apresentam limitações nas respostas em defesa do pH plasmático. Talvez o comprometimento de componentes importantes envolvidos na relação ventilação-perfusão possa explicar os resultados obtidos. No entanto, estudos mais aprofundados são necessários para fornecer maiores detalhes. (AU)

Introduction: Under normal conditions, the acid-base balance in the body is maintained by the joint work of the kidneys and lungs. Objetives: To evaluate ventilatory responses and blood gases in rats under metabolic acidosis induced by ammonium chloride during different periods of time. Material and Method: Metabolic acidosis was induced by ad libitum intake and gavage of 0.5M and 0.02M ammonium chloride solution (NH4Cl), respectively. The animals were allocated into seven groups, respectively submitted to 1, 3, 4, 5, 7, 8 and 9 days of acidosis. Measurements of ventilatory responses (Vc, fR and VE), blood gases (PaO2, PaCO2, pHa and [HCO3-] pl) and plasma and urinary creatinine and urea were performed. Only animals with pH≤7.3 and [HCO-3] ≤18mEq / L were considered. Statistics: Mean ± SEM; One-way ANOVA; p<0.05. Results: Acidic solution intake promoted significant decrease of plasma pH and bicarbonate in all groups. Ventilation showed a mild increase in the 1 day in acidosis groups and statistically significant decrease in the 4 and 9 day in acidosis groups. PaO2 decreased in the 1, 3, and 4-day in acidosis groups and PaCO2 remained unchanged. There was no change in plasma and urinary urea and creatinine during acidosis. Conclusions: The only transient increase in ventilation, associated to the blood gas profile in metabolic acidosis, suggests that rats, when compared to humans, have limitations in response to the defense of plasma pH. Perhaps the impairment of important components involved in the ventilation-perfusion relationship may explain the results obtained. However, further studies are necessary to provide details about the mechanism involved in this response.(AU)

Introducción: En condiciones normales, el equilibrio ácido-base en el cuerpo se mantiene mediante el trabajo conjunto de los riñones y los pulmones. Objetivos: Evaluar las respuestas ventilatorias y el análisis de gases en sangre en ratas sometidas a acidosis metabólica con cloruro de amonio durante diferentes intervalos de tiempo. Material y Método: La ingestión ad libitum y la ingestión de solución de cloruro de amonio 0.5M y 0.02M (NH4Cl) indujeron acidosis metabólica, respectivamente. Los animales se dividieron en siete grupos, sometidos respectivamente a 1, 3, 4, 5, 7, 8 y 9 días de acidosis. Se evaluaron las mediciones de respuestas ventilatorias (Vc, fR y VE), gases en sangre (PaO2, PaCO2, pHa y [HCO3-] pl) y creatinina y urea plasmática y urinaria. Solo se consideraron animales con pH≤7.3 y [HCO-3] ≤18mEq / L. Estadísticas: media ± SEM; ANOVA unidireccional; p <0,05. Resultados: La ingestión de solución ácida promovió una reducción significativa del pH plasmático y el bicarbonato en todos los grupos. La ventilación tendió a aumentar en el grupo de acidosis de 1 día y disminuyó significativamente en los grupos de 4 y 9 días en esta condición. PaO2 disminuyó significativamente en los grupos de acidosis de 1, 3 y 4 días y PaCO2 permaneció relativamente constante. No hubo cambios en el plasma y la urea urinaria y la creatinina durante la acidosis. Conclusiones: El único aumento inicial en la ventilación, agregado al perfil de gases en sangre frente a la acidosis metabólica, sugiere que las ratas, en comparación con los humanos, tienen limitaciones en la respuesta a la defensa del pH plasmático. Quizás el deterioro de componentes importantes involucrados en la relación ventilación-perfusión pueda explicar los resultados obtenidos. Sin embargo, se necesitan más estudios para proporcionar más detalles.(AU)

Modelagem de plumas de efluentes entre Praia Grande e Peruíbe, litoral do estado de São Paulo, Brasil / Modeling effluent plumes between Praia Grande and Peruíbe, São Paulo State's shore, Brazil

RESUMO O presente trabalho teve como objetivo monitorar a dispersão de plumas de efluentes provenientes dos emissários submarinos de Praia Grande e do Rio Itanhaém, por meio do processamento do modelo Delft3D (módulos hidrodinâmico e de qualidade da água) e do modelo Visual Plumes (módulo UM3). A modelagem de campo próximo indicou que as correntes geradas pelo vento foram mais eficientes do que as correntes de maré na diluição inicial das plumas dos emissários; e a modelagem de campo distante, validada qualitativamente, demonstrou que as concentrações dos potenciais poluentes de todas as plumas simuladas não ultrapassam os limites máximos estabelecidos pelo Conselho Nacional do Meio Ambiente quando essas plumas atingem as praias da região de estudo.

ABSTRACT This study's goal was to monitor the dispersion of effluent plumes from the Praia Grande's submarine outfalls and from the Itanhaém River by processing the Delft3D model (hydrodynamic and water quality modules) and the Visual Plumes model (UM3 module). The near field modeling indicated that wind-driven currents were more efficient than tidal currents in the initial dilution of the outfalls' plumes; and the far field modeling, qualitatively validated, demonstrated that the potential pollutants' concentrations in all the simulated plumes don't exceed the maximum limits established by the National Environmental Council when these plumes reach the study region's beaches.

Correlation between ammonia-oxidizing microorganisms and environmental factors during cattle manure composting.

Cattle manure composting was performed in an aerated vessel. Community structure and diversity of ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) were investigated using polymerase chain reaction and denaturing gradient gel electrophoresis (PCR-DGGE) techniques targeting the ammonia monooxygenase alpha subunit (amoA) gene and the correlation between AOB and AOA communities and environmental factors was explored. Thirteen (13) AOB sequences were obtained, which were closely related to Nitrosomonas spp., Nitrosomonas eutropha, and Nitrosospira spp. and uncultured bacteria, among which Nitrosomonas spp. were predominant. Excessively high temperature and high ammonium concentration were not favorable for AOB growth. Five AOA sequences, belonging to CandidatusNitrososphaera gargensis and to an uncultured archaeon, were obtained. During composting, community diversity of AOB and AOA fluctuated, with AOA showing a higher Shannon-Wiener index. The AOB community changed more dramatically in the mesophilic stage and the early thermophilic stage, whereas the most obvious AOA community succession occurred in the late thermophilic stage, the cooling stage and the maturity stage. Water content, total nitrogen (TN) and ammonium concentration were more relevant to the AOB community structure, while higher correlations were observed between ammonia, nitrate and TN and the AOA community. AOB community diversity was negatively correlated with pH (r = -0.938, p < 0.01) and water content (r = -0.765, p < 0.05), while positively correlated with TN (r = 0.894, p < 0.01). AOA community diversity was negatively correlated with ammonium concentration (r = -0.901, p < 0.01). Ammonium concentration played an important role in the succession of AOB and AOA communities during composting.

Resistência aos compostos de amônio quaternário (QACs) de uso doméstico e hospitalar em patógenos prioritários multirresistentes / Resistance to quaternary ammonium compounds (QACs) for domestic and hospital use in multiresistant priority pathogens

Compostos de amônio quaternário (QACs) têm sido amplamente utilizados como desinfetantes e antissépticos, sendo essenciais na prevenção e controle de infecções bacterianas na medicina humana e veterinária. Embora patógenos prioritários multirresistentes têm sido muito bem caracterizados quanto ao perfil de suscetibilidade e contexto genético da resistência aos antibióticos, dados de resistência aos QACs são limitados. Assim, o objetivo do presente estudo foi avaliar a atividade in vitro dos QACs de uso doméstico e hospitalar [cloreto de benzalcônio (BAC), cloreto de cetilpiridinio (CPC) e brometo de cetiltrimetilamônio (CTAB)], contra patógenos prioritários multirresistentes, identificando os principais genes de resistência associados. Foram estudadas 100 cepas multirresistentes previamente sequenciados usando as plataformas Illumina MiSeq e NextSeq representativas de diferentes hospedeiros (humanos e animais) e fontes (ambientes e alimentos). As cepas foram identificadas como Klebsiella pneumoniae (n= 24), Escherichia coli (n= 30); Pseudomonas aeruginosa (n= 10), Enterobacter spp, (n= 8), Acinetobacter baumannii (n= 11) e Salmonella spp. (n= 17). Genes de resistência aos QACs foram identificados in silico através do alinhamento dos contigs obtidos de cada cepa sequenciada com genes de referência obtidos do GenBank, utilizando o programa Geneious versão 8 (Biomatters Ltd). A identidade de cada gene foi analisada utilizando o programa BLASTx, no qual um critério baseado em ≥90% identidade resultou na identificação dos genes mdfA (77%), qacE (44%), qacEΔ1 (43%), sugE(c) (29%), emrE (21%), qacA (19%), sugE(p) (5%), qacF (7%), qacH (7%) e qacL (7%) em 85 cepas; enquanto que 15 cepas não possuíam nenhum gene de resistência aos QACs. A concentração inibitória mínima (CIM) dos QACs para as 100 cepas foi determinada pelo método de microdiluição em caldo. Os resultados sugeriram que a resistência em patógenos prioritários circulando na interface humano-ambiente-animal não é restrita aos antibióticos, uma vez que a elevada ocorrência de genes qacE, qacEΔ1 e mdfA poderia estar associada com uma redução da suscetibilidade para QACs. Consequentemente, a resistência aos QACs poderia também contribuir para a persistência e adaptação destes patógenos nos seres humanos e outros animais, assim como em ambientes impactados antropogenicamente

Quaternary ammonium compounds (QACs) have been widely used as disinfectants and antiseptics, being applied as essential compounds in the prevention and control of bacterial infections in human-and veterinary hospital medicine. Although multiresistant priority pathogens have been well characterized with respect to their susceptibility profile and their genetic context of resistance for antibiotics, studies of resistance to QACs are limited. Thus, the objective of the present study was to evaluate the in vitro activity of QACs [(benzalkonium chloride (BAC), cetylpyridinium chloride (CPC) and cetyltrimethylammonium bromide (CTAB)] for household and hospital use against multiresistant priority pathogens, identifying the main resistance genes associated. A hundred multiresistant isolates (previously sequenced using the Illumina MiSeq and NextSeq platforms), representative of different hosts (humans and animals) and sources (environment and food) were studied. Isolates were identified as Klebsiella pneumoniae (n=24), Escherichia coli (n=30), Pseudomonas aeruginosa (n=10), Enterobacter spp. (n=8), Acinetobacter baumannii (n=11) and Salmonella spp. (n=17). In silico analysis for identification of genes conferring resistance to QACs were performed by aligning the contigs obtained from the strains with reference genes deposited in GenBank, using the Geneious version program (Biomatters Ltd). Similarities were analyzed using the BLASTx online program, considering the alignment criteria based on ≥ 90% identity. The result of these analysis revealed the presence of the following QAC genes: mdfA (77%), qacE (44%), qacEΔ1 (43%), sugE(c) (29%), emrE (21%), qacA (19%), sugE (p) (5%), qacF (7%), qacH (7%) e qacL (7%); while 15 strains showed no resistance genes for QACs. Determination of QACs minimum inhibitory concentration (MIC) for the 100 isolates, by the broth microdilution method. These results suggest that resistance to QACs in priority pathogens, circulating at the human-environment-animal interface, is not restricted to antibiotics, since the high occurrence of genes qacE, qacEΔ1 and mdfA were associated with a reduced susceptibility to QACs. Consequently, resistance to QACs could also contribute to the persistence and adaptation of these pathogens in humans and othes animals, as well as in anthropogenically impacted environments

Eficácia do álcool etílico e quaternário de amônio na desinfecção de equipamentos médicos hospitalares / Efficacy of ethyl alcohol and quaternary ammonium in hospital medical equipment disinfection / Eficacia del alcohol etílico y cuaternario de amonio en la desinfección de equipos médicos hospitalarios

Justificativa e Objetivos: Os ambientes hospitalares podem albergar microrganismos patogênicos e oportunistas, sendo o processo de limpeza e desinfecção importante para o controle das Infecções relacionadas à Assistência à Saúde (IRAS). Assim, o objetivo deste trabalho foi avaliar a eficácia do álcool etílico e do quaternário de amônio no processo de desinfecção de equipamentos médicos hospitalares previamente contaminados com Staphylococcus aureus (S. aureus). Métodos: descontaminação de 10 equipamentos médicos hospitalares contaminados com uma suspensão de S. aureus ATCC 25923. A descontaminação ocorreu com álcool etílico nas concentrações de 46,2%, 70% e 99% e com o quaternário de amônio de 1ª e de 5ª geração. Após a descontaminação, foram colhidas amostras da superfície dos equipamentos para cultura bacteriana. Resultados: foi verificado crescimento bacteriano em 80% dos equipamentos descontaminados com álcool 46,2% e 99%. Não houve crescimento bacteriano na superfície dos equipamentos descontaminados com álcool 70% e quaternários de amônio. Conclusão: os processos de desinfecção com álcool 70% e quaternário de amônio de 1ª e 5ª geração foram eficazes no controle do S. aureus, comprovando a ação efetiva destes produtos na desinfecção dos equipamentos médicos hospitalares.(AU)

Background and Objectives: Hospital environments may harbor pathogenic and opportunistic microorganisms, and the cleaning and disinfection process is important for the control of Health Care Related Infections (IRAS). Thus, the objective of this work to evaluate compare the efficacy of ethyl alcohol and quaternary ammonium in the disinfection of hospital medical equipment against Staphylococcus aureus (S. aureus). Methods: decontamination of 10 hospital medical equipment contaminated with a suspension of S. aureus ATCC 25923. The decontamination occurred with ethyl alcohol at concentrations of 46.2%, 70% and 99% and with the quaternary ammonium of 1st generation and 5th generation. After the decontamination, samples were harvested from the surface of the equipment for bacterial culture. Results: bacterial growth was verified in 80% of the equipment decontaminated with alcohol 46.2% and 99%. There was no bacterial growth on the surface of equipment decontaminated with alcohol 70% and quaternary ammonium. Conclusions: the disinfection processes with alcohol 70% and quaternary ammonium 1st and 5th generation were effective in the control of S. aureus, proving the effectiveness of these products in the disinfection of hospital medical equipment.(AU)

Justificación y objetivos: Los ambientes hospitalarios pueden albergar microorganismos patógenos y oportunistas, siendo el proceso de limpieza y desinfección importante para el control de las Infecciones relacionadas a la Asistencia a la Salud (IRAS). Así, el objetivo de este trabajo evaluar comparar la eficacia del alcohol etílico y del cuaternario de amonio en el proceso de desinfección de equipos médicos hospitalarios previamente contaminados con Staphylococcus aureus (S. aureus). Métodos: la descontaminación de 10 equipos médicos hospitalarios contaminados con una suspensión de S. aureus ATCC 25923. La descontaminación ocurrió con alcohol etílico en las concentraciones de 46,2%, 70% y 99% y con el cuaternario de amonio de 1ª y de 5ª generación. Después de la descontaminación, se tomaron muestras de la superficie de los equipos para cultivo bacteriano. Resultados: se verificó crecimiento bacteriano en el 80% de los equipos descontaminados con alcohol 46,2% y 99%. No hubo crecimiento bacteriano en la superficie de los equipos descontaminados con alcohol 70% y cuaternarios de amonio. Conclusión: los procesos de desinfección con alcohol 70% y cuaternario de amonio de 1ª y 5ª generación fueron eficaces en el control del S. aureus, comprobando la acción efectiva de estos productos en la desinfección de los equipos médicos hospitalarios.(AU)

Excreção fracionada urinária de sódio, potássio e cloreto em cordeiros suplementados com cloreto de amônio para prevenção de urolitíase / Urinary fractional excretion of sodium, potassium and chloride in lambs supplemented with ammonium chloride to prevent urolithiasis

A urolitíase é uma doença importante de cordeiros confinados. A acidificação da urina, pela ingestão de cloreto de amônio, é o método preventivo mais frequentemente empregado. Devido à falta de informação específica em ovinos, este estudo foi realizado para avaliar as alterações que ocorrem nos eletrólitos urinários de cordeiros, que receberam cloreto de amônio na dieta. Foram utilizados 100 cordeiros, com 3 meses de idade, que foram mantidos em confinamento durante 56 dias, e distribuídos em 3 grupos: G1 (n=40) que receberam 400mg/kg de peso vivo (PV) de cloreto de amônio/dia, durante 21 dias; G2 (n=40) que receberam 400mg/kg de PV de cloreto de amônio/dia durante 42 dias; e G3 (n=20) que não receberam cloreto de amônio. Os cordeiros foram examinados e as amostras de sangue e urina foram colhidas a cada 7 dias: 0 (antes do início da ingestão de cloreto de amônio), 7, 14, 21, 28, 35, e 42 dias. As concentrações séricas e urinárias de sódio (Na+), potássio (K+), cloreto (Cl-), e de creatinina foram mensuradas em todos os momentos de colheita. A excreção fracionada urinária (EFu) de eletrólitos e a diferença de íons fortes (SID) na urina [(Na+ + K+) - Cl] foram calculadas. A EFu de Na+, K+ e Cl- não variou ao longo do tempo em G3, provando que a dieta de confinamento, por si só, não influenciou a excreção urinária destes eletrólitos. A ingestão de cloreto de amônio, pelo grupo G1 e G2, influenciou a EFu sobre o tempo de confinamento. A SID urinária foi mais precisa do que a EFu de Cl- para demonstrar que a concentração de Cl- aumentou na urina, o que destacou a relevância desta variável.(AU)

Urolithiasis is an important disease of lambs confined. The urine acidification, by ammonium chloride intake, is the preventive method most frequently employed. Due to the lack of specific information in sheep, this study was performed to evaluate the electrolyte changes that occur in the urine of lambs receiving ammonium chloride in the diet. One hundred male lambs, 3 months old, were kept in a feedlot during 56 days, and distributed in 3 groups: G1 (n=40) receiving 400mg/kg BW of ammonium chloride/day during 21 days; G2 (n=40) receiving 400mg/kg BW of ammonium chloride/day during 42 days; and G3 (n=20) that did not receive ammonium chloride. The lambs were examined and blood and urine samples were collected every 7 days: 0 (the beginning of ammonium chloride intake), 7, 14, 21, 28, 35, and 42 days. Serum and urine sodium (Na+), potassium (K+), chloride (Cl-), and creatinine concentrations were measured. The urinary fractional excretion (FE) of electrolytes and the urine strong ion difference [(Na+ + K+) - Cl-] were calculated. FEs of Na+, K+, and Cl- did not vary over time in G3, proving that the feedlot diet, by itself, did not influence the urinary excretion of these electrolytes. The ingestion of ammonium chloride, instead, influenced FEs over the time of feedlot. The urinary SID was more accurate than the FE of Cl- to demonstrate that the concentration of Cl- increased in the urine. It highlights the relevance of this variable.(AU)

Validación de una prueba de amonio en aliento para el diagnóstico de la infección por Helicobacter pylori en pacientes del Hospital Cayetano Heredia / Validation of an ammonia breath test for the diagnosis of Helicobacter pylori infection in patients with dyspepsia at Hospital Cayetano Heredia

Objetivo: Determinar la validez diagnóstica de una prueba de amonio en aire espirado para la infección por Helicobacter pylori en pacientes a los que se le realiza una endoscopía digestiva alta en el Hospital Cayetano Heredia. Material y métodos: De abril a diciembre del 2014 se evaluó a 155 pacientes con una prueba de amonio en aliento y la evaluación histopatológica de las biopsias de estómago (considerada como el patrón de oro) tomadas durante la endoscopía. Los datos fueron analizados en Microsoft Excel y STATA 14 para construir una curva ROC. Resultados: Los pacientes fueron predominantemente mujeres (71%), con una edad media de 53 años (18-84) y una prevalencia de Helicobacter pylori de 51,6%. Al comparar la prueba de amonio en aire espirado con la prueba histológica se obtiene una sensibilidad de 70%, especificidad de 36%, valor predictivo positivo de 53,8%, valor predictivo negativo de 36%, índice de probabilidad positivo de 1,15 e índice de probabilidad negativo de 0,75. De acuerdo a la curva ROC, no se encontró un punto de corte óptimo con adecuados valores de sensibilidad y especificidad y el área bajo la curva es de 0,5517. Conclusiones: Esta prueba de amonio en aliento (aire espirado) no presenta poder diagnóstico y no se recomienda como una herramienta para el diagnóstico de la infección por Helicobacter pylori.

Objetive: To determine the diagnostic validity of an ammonia breath test for Helicobacter pylori infection in patients who undergo an upper gastrointestinal endoscopy at Hospital Cayetano Heredia. Material and methods: From April to December 2014, 155 patients were evaluated with the ammonia breath test and compared with a histological evaluation of the gastric biopsies as the gold standard. Data were evaluated using Microsoft Excel and STATA 14 to build a ROC curve. Results: The patients were predominantly female (71%), with a median age of 53 years (18-84) and a Helicobacter pylori prevalence of 51.6%. The ammonia breath test, when compared to the gastric biopsy has a 70% sensitivity, 36% specificity, 53.8% positive predictive value, 36% negative predictive value, 1.15 positive likelihood ratio and 0.75 negative likelihood ratio. According to the ROC curve, there is not an optimal cut off value and the area under the curve was 0.5517. Conclusions: The ammonia breath test evaluated on this study does not have diagnostic accuracy and is not recommended as a diagnostic tool for Helicobacter pylori infection.