Grand rounds to provide feedback on procurement activities.

INTRODUCTION: The Argentine Society of Transplants has set in motion an activity called Grand Rounds to Provide Feedback on Procurement Activities with the purpose of informing, training, and creating awareness by providing information about the evolution of transplanted patients. OBJECTIVE: To measure, describe and analyze the impact that the transplant results presented at the rounds had on participants. RESULTS: One hundred and fifty-eight surveys were conducted. The respondents' average age was 40.06 years (95% confidence interval [CI 95%] 38.39-41.73) including 52.08% women (CI 95%: 43.92%-60.24%); 77.14% physicians (CI 95%: 84.09%-70.18%); 7.85% nurses (CI 95%: 3.4%-12.31%;) and 4.28% surgical nurses and other professional (CI 95%: 0.93%-7.64). When asked how comforted they felt when they learnt about a transplantation, the score prior to the round was 4 (CI 95%: 3.79-4.20) and after it, 4.8 (CI 95%: 4.69-4.90; P < .05). When asked about the transparency of the donation process, the average score before the round was 4.16 (CI 95%: 3.96-4.36) and after it, 4.76 (CI 95%: 4.67-4.86; P < .05). When asked how proactive they considered themselves before, before the average score was 3.54 (CI 95% 3.30-3.78) and post-round, 4.53 (CI 95%: 4.38-4.67; P < .05). When asked if they thought that this activity might be useful for them to manage future donors, 97.41% (CI 95%: 89%-96.98%) of respondents answered affirmatively. The answers to the question whether they thought this activity might increase donation were affirmative in 92.99% of cases; "Don't know", 6.36%; and negative in less than 1%. When consulted about their feelings, the preferred one was "happiness" for 46.82% of respondents; followed by "satisfaction" for 29.36% and "emotion" for 23.80%. The analysis of the open-ended questions revealed that the rounds were perceived as closure of the procurement-transplantation process. CONCLUSIONS: This widely accepted tool was viewed as a vehicle to interconnect links in the work process from organ procurement to transplantation.

Trypanosoma cruzi discrete typing units in Chagas disease patients from endemic and non-endemic regions of Argentina.

Genetic diversity of Trypanosoma cruzi may play a role in pathogenesis of Chagas disease forms. Natural populations are classified into 6 Discrete Typing Units (DTUs) Tc I-VI with taxonomical status. This study aimed to identify T. cruzi DTUs in bloodstream and tissue samples of Argentinean patients with Chagas disease. PCR-based strategies allowed DTU identification in 256 clinical samples from 239 Argentinean patients. Tc V prevailed in blood from both asymptomatic and symptomatic cases and Tc I was more frequent in bloodstream, cardiac tissues and chagoma samples from immunosuppressed patients. Tc II and VI were identified in a minority of cases, while Tc III and Tc IV were not detected in the studied population. Interestingly, Tc I and Tc II/VI sequences were amplified from the same skin biopsy slice from a kidney transplant patient suffering Chagas disease reactivation. Further data also revealed the occurrence of mixed DTU populations in the human chronic infection. In conclusion, our findings provide evidence of the complexity of the dynamics of T. cruzi diversity in the natural history of human Chagas disease and allege the pathogenic role of DTUs I, II, V and VI in the studied population.

Hallazgos endoscópicos en poblaciones chilenas aisladas: Isla de Pascua y Chile Chico / Endoscopic findings in isolated chilean populations: Isla de Pascua (easter island) and Chile Chico

Chile is a country with high incidence of gastrointestinal diseases, but there are Chilean populations without access to an expeditious endoscopic diagnosis. Easter Island (3.791 inhabitants) and Chile Chico (3.042 inhabitants). Objective: To describe and compare the endoscopic findings in two subgroups of Chilean population of Easter Island (Isla de Pascua) and Chile Chico. Methods: Endoscopic procedures were performed on selected subgroups from Isla de Pascua and Chile Chico during October 2008 and March 2009, in the context of health operations conducted by our hospital. Results: Seventy two patients were evaluated in Isla de Pascua and 52 in Chile Chico. The most frequent endoscopic indications in Isla de Pascua were epigastric pain (22%), heartburn (18.2%), and gastroesophageal reflux (16.2%) and in Chile Chico: gastroesophageal reflux and pirosis (36,5%), epigastric pain (19,3%), and previous gastric ulcer (5.7%). Endoscopic findings in Isla de Pascua and Chile Chico were: gastritis, 26 patients (36.1%) and 5 (9.6%); peptic ulcer 2 (2.7%) and 9 (17.2%); esophagitis 10 (13.8%) and 6 (11.5%); hiatal hernia, 9 (12.5%) and 11 (21%); and endoscopy without lesions 20 (27%) and 13 (25%), respectively. Comparing the findings in both groups the occurrence of two advanced cancers stands out (gastric and esophageal) in the population of Chile Chico; no neoplastic diseases were found in Isla de Pascua. Conclusion: The endoscopic findings in a subgroup of Chileans belonging to isolated populations are described. Differences in the type of digestive diseases suggest that these are different populations despite sharing the same nationality. Future operations will provide a better understanding of these conditions.

Introducción: Chile es un país con alta incidencia de patología digestiva, sin embargo, existen poblaciones chilenas que por situación geográfica no cuentan con acceso expedito a un diagnóstico endoscópico. Objetivo: Describir los hallazgos endoscópicos en dos subgrupos de población chilena de Isla de Pascua y Chile Chico y compararlos entre sí. Métodos: Se realizaron procedimientos endoscópicos a subgrupos seleccionados en Isla de Pascua y Chile Chico en los meses de octubre de 2008 y marzo de 2009, en el marco de los operativos de salud realizados por nuestro Hospital. Resultados: Se evaluaron 72 pacientes en Isla de Pascua y 52 en Chile Chico. Las indicaciones endoscópicas más frecuentes en Isla de Pascua son epigastralgia (22%), pirosis (18,2%) y control de reflujo gastroesofágico (16,2%) y en Chile Chico: reflujo gastroesofágico y pirosis (36,5%), epigastralgia (19,3%) y antecedente de úlcera gástrica (5,7%). Los hallazgos endoscópicos en Isla de Pascua y Chile Chico respectivamente son: gastritis 26 pacientes (36,1%) y 5 (9,6%), úlcera péptica 2 (2,7%) y 9 (17,2%), esofagitis 10 (13,8%) y 6 (11,5%), hernia hiatal 9 (12,5%) y 11 (21%), sin lesiones 20 (27%) y 13 (25%). Al comparar los hallazgos en ambos grupos destaca la presencia de dos cánceres avanzados (gástrico y esofágico) en la población de Chile Chico, sin encontrarse patología neoplásica en Isla de Pascua. Conclusión: Se describen los hallazgos endoscópicos en un subgrupo de chilenos pertenecientes a poblaciones más aisladas. Las diferencias en el tipo de patologías pesquisadas sugiere que se trata de poblaciones diferentes pese a compartir una misma nacionalidad. La realización de futuros operativos permitirá obtener un mayor conocimiento de las patologías más prevalentes en dichas poblaciones y evaluar la influencia de las...

Combined cardiohepatic transplantation due to severe heterozygous familiar hypercholesteremia type II: first case in Argentina--a case report.

Heterozygous familial hypercholesteremia type II is a recessive autonomic disease with a population incidence

[Leishmaniasis outbreak in Cancha Larga, Chaco, Argentina]. / Brote de leishmaniosis en Cancha Larga, Chaco, Argentina.

A leishmanioasis outbreak is reported among the inhabitants of an endemic area for this disease located in Cancha Larga, Chaco in Argentina. Frotis and biopsy confirmed that 11.8% of the whole population was affected. They were all treated with meglumine antimonate.