Field-based molecular detection of Batrachochytrium dendrobatidis in critically endangered Atelopus toads and aquatic habitats in Ecuador.

Batrachochytrium dendrobatidis (Bd) is a lethal fungal species that parasitizes vertebrates and is associated with the worldwide decline of amphibian populations. The development of sensitive, rapid detection methods, particularly DNA-based techniques, is critical for effective management strategies. This study evaluates the efficacy of DNA extraction and a portable PCR device in a mountable field laboratory setup for detecting Bd near the habitats of three critically endangered Atelopus toad species in Ecuador. We collected skin swabs from Atelopus balios, A. nanay, and A. bomolochos, and environmental DNA (eDNA) samples from streams in Andean and coastal regions of Ecuador. For eDNA, a comparison was made with duplicates of the samples that were processed in the field and in a standard university laboratory. Our findings revealed Bd detection in eDNA and swabs from 6 of 12 water samples and 10 of 12 amphibian swab samples. The eDNA results obtained in the field laboratory were concordant with those obtained under campus laboratory conditions. These findings highlight the potential of field DNA-based monitoring techniques for detecting Bd in amphibian populations and their aquatic habitats, particularly in remote areas. Furthermore, this research aligns with the National Action Plan for the Conservation of Ecuadorian Amphibians and contributes to the global effort to control this invasive and deadly fungus.

The End of Wire Wrapping: A Technique to Avoid Intertwining Preloaded Guidewires for Endovascular Aortic Arch Repair.

PURPOSE: The purpose of this study was to present a new technique for endovascular aortic arch repair for 1, 2, or 3 vessels using preloaded wires and precannulated target vessels without wire wrapping. TECHNIQUE: This technique uses a prototype catheter with 2 parallel lumens to position through-and-through guidewires in the supra-aortic branches and an extra-stiff guidewire in the ascending aorta with no wrapping. This allows the introduction and advancement of the device with the already precannulated target vessels. The endograft is advanced to the aortic arch without twisting or wrapping. Covered stents are deployed to align the graft and target vessels. CONCLUSION: To our knowledge, a technique that avoids wire wrapping has not been previously described. This technique allows safer and faster endovascular arch procedures and opens up new possibilities by enabling multi-vessel endovascular aortic arch repair with all precannulated target vessels.

Altered regulation of DPF3, a member of the SWI/SNF complexes, underlies the 14q24 renal cancer susceptibility locus.

Our study investigated the underlying mechanism for the 14q24 renal cell carcinoma (RCC) susceptibility risk locus identified by a genome-wide association study (GWAS). The sentinel single-nucleotide polymorphism (SNP), rs4903064, at 14q24 confers an allele-specific effect on expression of the double PHD fingers 3 (DPF3) of the BAF SWI/SNF complex as assessed by massively parallel reporter assay, confirmatory luciferase assays, and eQTL analyses. Overexpression of DPF3 in renal cell lines increases growth rates and alters chromatin accessibility and gene expression, leading to inhibition of apoptosis and activation of oncogenic pathways. siRNA interference of multiple DPF3-deregulated genes reduces growth. Our results indicate that germline variation in DPF3, a component of the BAF complex, part of the SWI/SNF complexes, can lead to reduced apoptosis and activation of the STAT3 pathway, both critical in RCC carcinogenesis. In addition, we show that altered DPF3 expression in the 14q24 RCC locus could influence the effectiveness of immunotherapy treatment for RCC by regulating tumor cytokine secretion and immune cell activation.

Gut microbiome differences among Mexican Americans with and without type 2 diabetes mellitus.

PURPOSE: Type 2 diabetes mellitus (T2DM) is an urgent public health problem and disproportionately affects Mexican Americans. The gut microbiome contributes to the pathophysiology of diabetes; however, no studies have examined this association in Mexican-Americans. The objective of this study was to compare gut microbiome composition between Mexican-Americans with and without T2DM. METHODS: This was a cross-sectional study of volunteers from San Antonio, TX. Subjects were 18 years or older and self-identified as Mexican American. Subjects were grouped by prior T2DM diagnosis. Eligible subjects attended a clinic visit to provide demographic and medical information. Thereafter, subjects recorded their dietary intake for three days and collected a stool sample on the fourth day. Stool 16s rRNA sequences were classified into operational taxonomic units (OTUs) via the mothur bayesian classifier and referenced to the Greengenes database. Shannon diversity and bacterial taxa relative abundance were compared between groups using the Wilcoxon rank sum test. Beta diversity was estimated using Bray-Curtis indices and compared between groups using PERMANOVA. RESULTS: Thirty-seven subjects were included, 14 (38%) with diabetes and 23 (62%) without diabetes. Groups were well-matched by body mass index and comorbid conditions. Shannon diversity was not significantly different between those with and without T2DM (3.26 vs. 3.31; p = 0.341). Beta diversity was not significantly associated with T2DM diagnosis (p = 0.201). The relative abundance of the most common bacterial phyla and families did not significantly differ between groups; however, 16 OTUs were significantly different between groups. CONCLUSIONS: Although alpha diversity was not significantly different between diabetic and non-diabetic Mexican Americans, the abundance of certain bacterial taxa were significantly different between groups.

Rediscovery of Laura's glassfrog Nymphargus laurae (Anura: Centrolenidae) with new data on its morphology, colouration, phylogenetic position and conservation in Ecuador.

We report the rediscovery of Laura's Glassfrog, Nymphargus laurae Cisneros-Heredia & McDiarmid, 2007, based on two specimens collected at the Colonso-Chalupas Biological Reserve, province of Napo, Ecuador. The species was described and known from a single male specimen collected in 1955 at Loreto, north-eastern Andean foothills of Ecuador. Limited information was available about the colouration, systematics, ecology, and biogeography of N. laurae. We provide new data on the external morphology, colouration, distribution and comment on its conservation status and extinction risk. We discuss the phylogenetic relationships of N. laurae, which forms a clade together with N. siren and N. humboldti. The importance of research in unexplored areas must be a national priority to document the biodiversity associated, especially in protected areas.

Is the ADP ribose site of the Chikungunya virus NSP3 Macro domain a target for antiviral approaches?

Chikungunya virus (CHIKV) is a mosquito-transmitted virus of special concern as it causes Chikungunya fever, characterized by an acute febrile illness, rash, and arthralgia that can progress to chronic and debilitating arthritic symptoms. The effects of climate change on the geographic distribution of the mosquito vector has the potential to expose more of the globe to this virus. No antiviral agents or vaccines are currently available against CHIKV infection and the development of novel therapies that may lead to a future treatment is therefore necessary. In this context, the ADP-ribose binding site of the CHIKV nsP3 macro domain has been reported as a potential target for the development of antivirals. Mutations in the ADP-ribose binding site demonstrated decreased viral replication in cell culture and reduced virulence. In this study, 48,750 small molecules were screened in silico for their ability to bind to the ADP-ribose binding site of the CHIKV nsP3 macro domain. From this in silico analysis, 12 molecules were selected for in vitro analysis using a CHIKV subgenomic replicon in Huh-7 cells. Cell viability and CHIKV replication were evaluated and molecules C5 and C13 demonstrated 53 and 66% inhibition of CHIKV replication, respectively. By using a CHIKV-Dual luciferase replicon contain two reporter genes, we also demonstrated that the treatment with either compounds are probably interfering in the early replication rather than after RNA replication has occurred.

Progressive central puberty in a toddler with partial androgen insensitivity.

A male infant was diagnosed with partial androgen insensitivity caused by a novel mutation in the androgen receptor. At 3.5 months of age, he received 100 mg of testosterone intramuscularly over the course of 3 months to increase phallic size. He developed pubic hair after 5 months and signs of progressive central precocious puberty when re-examined at 17.5 months, which subsequently was suppressed with depot leuprolide.

Telehealth innovations in health education and training.

Telehealth applications are increasingly important in many areas of health education and training. In addition, they will play a vital role in biomedical research and research training by facilitating remote collaborations and providing access to expensive/remote instrumentation. In order to fulfill their true potential to leverage education, training, and research activities, innovations in telehealth applications should be fostered across a range of technology fronts, including online, on-demand computational models for simulation; simplified interfaces for software and hardware; software frameworks for simulations; portable telepresence systems; artificial intelligence applications to be applied when simulated human patients are not options; and the development of more simulator applications. This article presents the results of discussion on potential areas of future development, barries to overcome, and suggestions to translate the promise of telehealth applications into a transformed environment of training, education, and research in the health sciences.

Predictive value for malignancy in the finding of microcalcifications on ultrasonography of thyroid nodules.

BACKGROUND: The aim of this study was to determine the predictive value for malignancy of microcalcifications determined by ultrasonography in thyroid nodules. METHODS: One hundred seventy-seven nodules were prospectively studied by ultrasonography and compared with their fine-needle aspirative biopsy. The association between the presence and type of calcification and cytologic findings was verified through the chi-square test or likelihood ratio. RESULTS: Thirty nodules showed calcification, of which 17 had fine calcifications, 3 had fine and gross calcifications, and 10 had only coarse calcification. Seven (41.18%) of 17 fine calcified nodules were malignant on cytology, 8 (47.06%) were benign, 1 (5.88%) was indeterminate, and 1 was suspect for malignancy. We found statistical significance between the presence of fine calcifications and malignancy (p = .001) and, in the 13 malignant nodule group, 8 (61.50%) had fine calcifications. CONCLUSION: This study suggests that microcalcifications were highly specific for malignancy and were present in 61% of the malignant nodules.

A survey of the use of foreign-purchased medications in a border community emergency department patient population.

Many reports suggest that the use of imported medications in the United States continues to grow, fueled mostly by the rising price of prescription drugs. This trend may be problematic for several reasons, including the potential for counterfeit or impure products, a lack of pharmacist support outside of the United States, and the ability to purchase agents without a prescription from some countries. We performed a survey of Emergency Department (ED) patients in a border community to observe the magnitude of imported medication use, and to begin to determine the rationale behind the practice. A survey was conducted of 1008 ED patient encounters of individuals reporting at triage to be on any prescription or over-the-counter medication. Participants were queried on their use of imported medications and implications of such use through a questionnaire. A total of 966 patient encounter surveys were included in the analysis. Of this number, 7% reported the use of medications purchased outside of the United States. Most of these were purchased in person and in Mexico. The most commonly cited reason for importing medications was decreased cost, and almost a quarter of those importing medications stated that their physician had recommended it. The most common medications imported were antibiotics, and nearly a third of all of those buying foreign medications had done so without a prescription. Our study suggests that many patients in our community purchase medications outside of the United States.

Allozymic variation and differentiation in the chilean blue mussel, Mytilus chilensis, along its natural distribution

Genetic differentiation in the Chilean blue mussel Mytilus chilensis (Hupé 1854) was investigated based on the variation in the allozyme frequencies of Pgm, Gpi, Icd, Me, Gsr, Lap and Pep in eight samples collected along 1800 km from Arauco (VIII Region) to Punta Arenas (XII Region). Despite the large geographic separations, values of Neis unbiased genetic distance, D (0.004-0.048) and standardised genetic variation among populations, Fst (0.011-0.055) were small. The levels of gene flow (Nm = 8) found in this study prevent the effect of differentiation among populations by genetic drift. This findings indicate that its long-lived planktotrophic larvae provides this species with considerable dispersal ability throughout its range which is favoured by the ocean currents along the chilean coast. In terms of management of the M. chilensis fishery, the results provide no evidence for discrete stocks, with the possible exception of the Punta Arenas population. Considering the intensive aquaculture activities with this species the present study provide preliminary data which can be used as a baseline for further characterization and /or monitoring these mussel populations.

Peripheral macrophage depletion reduces central nervous system parasitism and damage in Trypanosoma cruzi-infected suckling rats.

We aim at investigating the role of blood born macrophages on the brain reaction to Trypanosoma cruzi infection in suckling rats. This infection provoked the appearance of numerous ED1(+) cells in the neural parenchyma and increased the amount of meningeal and perivascular ED2(+) macrophages. CD8(+) and NKR(+) cells also occurred. Parenchymal blood vessels showed strong ICAM-1 and decreased occludin immunoreactivities. Selective depletion of peripheral macrophages by clodronate liposomes decreased tissue parasitism, nodular lesions, ICAM-1 upregulation and leukocyte infiltration. Occludin immunoreactivity remained as in uninfected animals. Our results indicate a role for blood-born macrophages in both parasite invasion and brain reaction. Microglia activation cannot be discarded.

Sintomas respiratórios associados a distúrbios do sono em trabalhadores industriais do Rio Grande do Sul / Respiratory symptomas associated to sellep disorders in industrial workers in Rio Grande do Sul, Brazil

Os distúrbios do sono podem se apresentar como qualquer alteraçäo do padräo normal do ritmo do sono e vigilia. Por outro lado, sintomas respiratórios, como tosse e dispnéia, estäo associados a uma parcela das queixas do sono. Selecionou-se uma amostra de 1.027 trabalhadores do estado do Rio Grande do Sul, de sete ramos industriais, de 11 cidades. Aplicou-se um questionário de 26 perguntas de identificaçäo e história médica, 26 perguntas específicas sobre o sono e 12 sobre trabalho e hábitos pessoais. Foram avaliados sintomas respiratórios como tosse, ronco e apnéia e variáveis associadas a alteraçöes do sono: insônia, dificuldade para adormecer, despertares noturnos, sonolência excessiva diurna (SED) e satisfaçäo com o sono. A partir dos sintomas estimou-se a prevalência de síndrome das apnéias obstrutivas do sono (SAOS. Resultados: Roncar noturno foi mais freqüente nos homens (25,9 por cento) que nas mulheres (13,2 por cento), p = 0,00004); aproximadamente 8 por cento dos trabalhadores apresentavam tosse à noite; 21 pessoas (2,4 por cento) referiam interrupçöes na respiraçäo durante o sono; 14 por cento dos trabalhadores (n = 116) referiram ter insônia, sendo mais freqüente nas mulheres (18,3 por cento) que nos homens (12,3 por cento); a SED estava presente em 35,6 por cento (n = 68) dos roncadores e em 22,2 por cento (n = 15) dos näo-roncadores (p = 0,0002); prevalência de SAOS foi estimada em 0,9 por cento, sendo 1,2 por cento (n = 7) nos homens e 0,4 por cento (n = 1) nas mulheres; 11 homens e 9 mulheres referiram ter asma; 13 mulheres e 28 homens referiram ter bronquite crônica, tendo-se observado quase o dobro de sintomas associados a distúrbios do sono nesses pacientes. Conclusäo: Problemas de sono nesta amostra ocorrem em porcentagens semelhantes a de outras populaçöes já estudadas, säo freqüentes e podem trazer prejuízos à qualidade de vida dos trabalhadores. Uma parcela considerável dos distúrbios do sono está associada a sintomas e doenças respiratórias

Uma experiência multiprofissional na abordagem ao paciente hipertenso / An Interdistiplinarian Experience on Approaching Patients with Hypertension

Objetivo - Estudar o impacto das atividades educativas na abordagem ao paciente hipertenso, com equipe multiprofissional, num período mínimo de 5 e máximo de 9 meses, em aspectos relacionados à hipertensão arterial (HA). Métodos - Cinqüenta indivíduos constituindo dois grupos de 25 cada. O grupo A formado de pacientes que participavam das atividades educativas da Liga de Hipertensão Arterial (LHA) e o grupo B. também de pessoas matriculadas na LHA, mas não participantes. Os grupos eram comparáveis no tocante à idade, sexo, tipo e duração do tratamento. Foram estudados os grupos com relação à pressão arterial (PA), peso, tabagismo, ingestão alcoólica, exercícios físicos e freqüência às consultas. Resultados - Houve queda da PA em 84% dos pacientes do grupo A e 88% do grupo B. redução de peso em 60% do grupo A e 44% do grupo B e a prática de exercícios físicos foi hábito regular em 56% do grupo A e 36% do grupo B. No grupo A foi encontrado 4% de tabagistas e no grupo B 16%. A ingestão alcoólica esteve presente em 12% do grupo A e 24% do grupo B. Os pacientes do grupo A faltaram menos às consultas (30%) do que os do grupo B (44%). Conclusão - Apesar de não observarmos diferenças significativas entre as duas formas de abordagem, no que diz respeito ao controle da PA, observamos nítida vantagem a favor de uma abordagem educativa em grupo, com participação de equipe multiprofissional

Purpose - To evalvate the impact of the educational approach of activities on the approach of patients with hypertension, with an interdisciplinarian team. Methods - Fifty patients divided into two groups: A) with 25 patients who participated in educational activities in the Hipertension League (HL) and B) who were also registered and did not take part in the activities. They were studied regarding blood pressure (BP), weight control, smoking habits, alcoholic beverage consumption, physical activities and frequency of medical care. Results - There was a drop in BP of 84% of the patients in group A and 88% in group B. a drop in weight in 60% of group A and 44% of group B. We registered the presence of 4% of smokers in group A and 16% in group B. Physical activities were regular in 56% of group A and 36% in group B. Absenteeism to meetings was slighty higher among group B (44°/0) when compared with group A (30°/0). Conclusion - In spite of not having observed any significant differences between both approaches, regarding to strict BP control, we were able to observe a noticeable advantage in favor of the educational approach to the group, with participation of interdisciplinarian team

Tecnicas de enfermeria en tuberculosis

American Journal of Nursing, jun. 1951, p. 399 (English)