Molecular detection of Histoplasma capsulatum in organ samples from bats randomly captured in urban areas of Araraquara, São Paulo state, Brazil.

The mycosis histoplasmosis is also considered a zoonosis that affects humans and other mammalian species worldwide. Among the wild mammals predisposed to be infected with the etiologic agent of histoplasmosis, bats are relevant because they are reservoir of Histoplasma species, and they play a fundamental role in maintaining and spreading fungal propagules in the environments since the infective mycelial phase of Histoplasma grows in their accumulated guano. In this study, we detected the fungal presence in organ samples of bats randomly captured in urban areas of Araraquara City, São Paulo, Brazil. Fungal detection was performed using a nested polymerase chain reaction to amplify a molecular marker (Hcp100) unique to H. capsulatum, which revealed the pathogen presence in organ samples from 15 out of 37 captured bats, indicating 40.5% of infection. Out of 22 Hcp100-amplicons generated, 41% corresponded to lung and trachea samples and 59% to spleen, liver, and kidney samples. Data from these last three organs suggest that bats develop disseminated infections. Considering that infected bats create environments with a high risk of infection, it is important to register the percentage of infected bats living in urban areas to avoid risks of infection to humans, domestic animals, and wildlife.

Targeted Anthocyanin Profiling of Fruits from Three Southern Highbush Blueberry Cultivars Propagated in Colombia.

The blueberry, a deciduous shrub in the Ericaceae family, is celebrated for its delightful flavor, sweetness, and abundance of anthocyanins and antioxidants, qualities that have garnered significant attention for their potential health benefits. Blueberries grown in diverse environments and exhibit varied anthocyanin profiles, often influenced by factors such as altitude and climate. Varietal groups worldwide have been bred and categorized based on their growth habits and specific cold requirements, particularly with southern highbush cultivars thriving in temperate climates, demonstrating tolerance to higher altitudes or cooler climates-a result of hybridizations involving various Vaccinium species. In the Colombian Andes, southern highbush blueberries thrive in unique high-altitude conditions, leading to exceptional quality due to the region's cool climate and specific soil characteristics. In this context, this study aimed to chemically characterize and differentiate three southern highbush blueberry cultivars (i.e., 'Biloxi,' 'Legacy' and 'Sharpblue') cultivated in a Colombian Andean plateau and compare them to three commercially available highbush blueberries. This comprehensive evaluation involved examining total phenols, flavonoids, anthocyanin content, and DPPH· free-radical scavenging capacity, as well as conducting anthocyanin-targeted profiling via HPLC-DAD-HRMS. Through supervised multivariate analyses such as sPLS-DA, this study delved into the pattern recognition of those anthocyanins that could potentially serve as markers for quality and cultivar-related chemical trait determination. These findings locate blueberry-derived anthocyanins in a metabolic context and afford some insights into southern highbush blueberry cultivar differentiation to be used for further purposes.

Recomendaciones basadas en guías de práctica clínica sobre diagnóstico, tratamiento y seguimiento de infección de tracto urinario en pacientes pediátricos en Colombia / Recommendations based on clinical practice guidelines on diagnosis, treatment and follow-up of urinary tract infection in pediatric patients in Colombia

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ABSTRACT Background: Urinary tract infection (UTI) is a common disease in childhood and one of the most common causes of consultation in the pediatric emergency department. Its incidence ranges between 5% and 10% in children under 2 years old. Objective: To generate recommendations on the diagnosis, treatment, and follow-up of UTI in pediatric patients in Colombia. Methods: 15 questions of clinical interest in the diagnosis, treatment, and follow-up of UTI in pediatric patients were formulated. A systematic review of the literature was carried out to identify the clinical practice guidelines (CPG) available in UTI, in order to use this evidence to answer the proposed questions and articulate the recommendations. Local and international tools were used to select and evaluate the CPGs. Information was retrieved from the selected guidelines, preliminary recommendations were compiled, and final recommendations were approved by expert consensus. Finally, the strength and direction of each recommendation was assessed. Results: A total of 4 CPGs were selected: American Academy of Pediatrics, Spanish Ministry of Health, McTaggart, and National Institute for Health and Care Excellence. Final recommendations for the diagnosis, treatment, and follow-up of UTI are presented in this paper. Conclusions: These recommendations will guide the teams to make clinical decisions regarding health care of pediatric patients with UTI in Colombia. This will help to improve health care and to generate policies for timely diagnosis, treatment, and follow-up in these patients.

A Pharmacogenetically Guided Acenocoumarol Dosing Algorithm for Chilean Patients: A Discovery Cohort Study.

BACKGROUND: Vitamin K antagonists (VKA) are used as prophylaxis for thromboembolic events in patients with cardiovascular diseases. The most common VKA are warfarin and acenocoumarol. These drugs have a narrow therapeutic margin and high inter-individual response variability due to clinical and pharmacogenetic variables. OBJECTIVE: The authors aim to develop an algorithm comprised of clinical and genetic factors to explain the variability in the therapeutic dose of acenocoumarol among Chilean patients. METHODOLOGY: DNA was obtained from 304 patients as a discovery cohort with an international normalized ratio (INR) range of 2.0-3.0. The non-genetic (demographic and clinical) variables were also recorded. Genotype analyses were performed using real-time PCR for VKORC1 (rs9923231), VKORC1 (rs7294), GGCx (rs11676382), CYP4F2 (rs2108622), ABCB1 (rs1045642), CYP2C9*2 (rs1799853), ApoE (rs429358), and CYP2C9*3 (rs1057910). RESULTS: The clinical variables that significantly influenced the weekly therapeutic dose of VKA were age, sex, body mass index (BMI), and initial INR, collectively accounting for 19% of the variability, and the genetic variables with a significant impact were VKORC1 (rs9923231), CYP2C9*2 (rs1799853), and CYP2C9*3 (rs1057910), explaining for another 37% of the variability. CONCLUSION: We developed an algorithm that explains 49.99% of the variability in therapeutic VKA dosage in the Chilean population studied. Factors that significantly affected the dosage included VKORC1, CYP2C9*2, and CYP2C9*3 polymorphisms, as well as age, sex, BMI, and initial INR.

Functionally Significant Coumarin-Related Variant Alleles and Time to Therapeutic Range in Chilean Cardiovascular Patients.

Despite the development of new oral agents over the last decade, vitamin K antagonists (VKAs) remain the most widely used anticoagulants for treating and preventing thromboembolism worldwide. In Chile, the Ministry of Health indicates that acenocoumarol should be used in preference to any other coumarin. Complications of inappropriate dosing are among the most frequently reported adverse events associated with this medication. It is well known that polymorphisms in pharmacokinetic and pharmacodynamic proteins related to coumarins (especially warfarin) influence response to these drugs. This work analyzed the impact of CYP2C19*2 (rs4244285), CYP1A2*1F (rs762551), GGCx (rs11676382), CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), CYP4F2 (rs2108622), VKORC1 (rs9923231), VKORC1 (rs7294), CYP3A4*1B (rs2740574), and ABCB1 (rs1045642) polymorphisms on time to therapeutic range for oral anticoagulants in 304 Chilean patients. CYP2C9*3 polymorphisms were associated with time to therapeutic range for acenocoumarol in Chilean patients, and the CYP4F2 TT genotype, MDR1 A allele, CYP1A2 A allele, and CYP3A4T allele are promising variants that merit further analysis. The presence of polymorphisms explained only 4.1% of time to therapeutic range for acenocoumarol in a multivariate linear model. These results improve our understanding of the basis of ethnic variations in drug metabolism and response to oral anticoagulant therapy. We hope that these findings will contribute to developing an algorithm for VKA dose adjustment in the Chilean population in the near future, decreasing the frequency of stroke, systemic embolism, and bleeding-related adverse events.

Estudio comparativo de equipos INR capilar "point of care" versus INR venoso, en pacientes en tratamiento con antagonistas de vitamina K / Comparison of point of care capillary international normalized ratio (INR) with INR measured in venous samples

Background: INR is used to monitor the treatment with vitamin K antagonists. A strategy to reduce waiting times for sampling is to measure INR in a capillary sample using a portable point of care (POC) type coagulometer. Aim: To evaluate the correlation of CoaguChek Pro II™, Xprecia™ and microINR™ with venous INR measured at the clinical laboratory and their ease of use. Materials and Methods: Patients provided capillary and venous blood samples for parallel tests comparing Xprecia™ Stride with CoaguChek Pro II™ and with venous INR, microINR™ with CoaguChek Pro IITM and with venous INR. The devices' ease of use was assessed surveying the sampling staff. Results: The three tested devices had good correlation coefficients with venous INR: CoaguChek Pro IITM 0.953 and 0.962; Xprecia™ of 0.912 and microINR™ of 0.932. The correlation coefficient of Xprecia™ with CoaguChek Pro IITM was 0.937 and microINR™ with CoaguChek Pro IITM was 0.976. Conclusions: CoaguChek Pro IITM, Xprecia™ and microINR™ results had a good correlation coefficient with INR measured at the laboratory. Our results indicate that, in the hands of trained users, POC-type coagulometers are reliable and acceptable for routine use in anticoagulant treatment control.

[Comparison of point of care capillary international normalized ratio (INR) with INR measured in venous samples]. / Estudio comparativo de equipos INR capilar "point of care" versus INR venoso, en pacientes en tratamiento con antagonistas de vitamina K.

BACKGROUND: INR is used to monitor the treatment with vitamin K antagonists. A strategy to reduce waiting times for sampling is to measure INR in a capillary sample using a portable point of care (POC) type coagulometer. AIM: To evaluate the correlation of CoaguChek Pro II™, Xprecia™ and microINR™ with venous INR measured at the clinical laboratory and their ease of use. MATERIALS AND METHODS: Patients provided capillary and venous blood samples for parallel tests comparing Xprecia™ Stride with CoaguChek Pro II™ and with venous INR, microINR™ with CoaguChek Pro IITM and with venous INR. The devices' ease of use was assessed surveying the sampling staff. RESULTS: The three tested devices had good correlation coefficients with venous INR: CoaguChek Pro IITM 0.953 and 0.962; Xprecia™ of 0.912 and microINR™ of 0.932. The correlation coefficient of Xprecia™ with CoaguChek Pro IITM was 0.937 and microINR™ with CoaguChek Pro IITM was 0.976. CONCLUSIONS: CoaguChek Pro IITM, Xprecia™ and microINR™ results had a good correlation coefficient with INR measured at the laboratory. Our results indicate that, in the hands of trained users, POC-type coagulometers are reliable and acceptable for routine use in anticoagulant treatment control.

Caracterización de muestras de cocaína inorgánica en una provincia ecuatoriana / Characterization of inorganic cocaine samples in an Ecuadorian province

El consumo de cocaína representa un problema de salud, por constituir un psicotrópico ilícito de elevado consumo, lo que ocasiona motivo de atención en los servicios de emergencia, adicción que genera riesgos relativos a los componentes asociados a la misma. Se realizó un estudio cuantitativo, de tipo descriptivo, cuyo objetivo fue caracterizar muestras inorgánicas de cocaína en el Laboratorio de Química Forense de una provincia del contexto ecuatoriano durante el período julio y diciembre de 2016. Se trabajó con la totalidad de la población, la que estuvo compuesta por 90 muestras. La cuantificación de los elementos químicos presen-tes en los ejemplares se realizó a través de una cromatografía de gases utilizando un detector de masas acoplado al equipo. Se determinó que de forma mayoritaria la mitad de las muestras contenían impurezas como cinamoilcocaína, metilecgonina, tropococaína, benzoilecgonina, kientras que solo el 11,1% de estas no tenía contaminaciones alcaloidales. En cuanto a la presencia de adulterantes en el material analizado, el almidón resultó ser el más utilizado por los comercializadores de la cocaína en el entorno estudiado; aunque también se pudo obser-var el uso de fenacetina, levamisol y aminopirina.

Consumption of cocaine represents an emerging health problem because it is an illicit psychotropic drug consumed among patients treated in emergency rooms, and it also genera-tes other risks related to the components that may be present in it. The study was carried out with a quantitative, descriptive approach. The research aimed to characterize the inorganic samples of cocaine in the Forensic Chemistry Laboratory of a province in the Ecuadorian context during the period July-December 2016. The whole population of 90 samples was taken into account. The quantification of the chemical elements presented in the specimens was carried out through gas chromatography using a mass detector coupled to the equipment. It was determined that half of the samples contained impurities sucah as cinnamoylcocaine, methylecgonine and tropococaine, benzoylecgonine and only 11.1% of the samples did not have alkaloidal impurities as results of the research. Regarding the presence of adulterants in the material analyzed, starch was the most used by cocaine drug dealers in the studied envi-ronment; the use of phenacetin, levamisole and aminopyrine could also be observed.