New Piper species from the eastern slopes of the Andes in northern South America.

We describe four new species of Piper from the Amazonian slopes of the northern Andes. Piperhoyoscardozii is distinguished from similar climbing species, P.dryadum and P.flagellicuspe, by its longer peduncles. The Amazonian species Piperindiwasii is distinguished from P.scutilimbum from Panama and northern Colombia by the narrowly spatulate leaf base extension. Pipernokaidoyitau is characterised by the presence of larger leaves and longer spikes than similar species, P.anonifolium and P.hostmannianum. Finally, P.velae is characterised by cordulate leaf bases in all nodes, petioles 0.8-1.5 cm long and pubescent fruits, which easily distinguish it from the related species, P.holdridgeanum.

Effect of childhood rotavirus vaccination on community rotavirus prevalence in rural Ecuador, 2008-13.

BACKGROUND: Although live attenuated monovalent human rotavirus vaccine (Rotarix) efficacy has been characterized through randomized studies, its effectiveness, especially in non-clinical settings, is less clear. In this study, we estimate the impact of childhood Rotarix® vaccination on community rotavirus prevalence. METHODS: We analyse 10 years of serial population-based diarrhoea case-control study, which also included testing for rotavirus infection (n = 3430), and 29 months of all-cause diarrhoea active surveillance from a child cohort (n = 376) from rural Ecuador during a period in which Rotarix vaccination was introduced. We use weighted logistic regression from the case-control data to assess changes in community rotavirus prevalence (both symptomatic and asymptomatic) and all-cause diarrhoea after the vaccine was introduced. We also assess changes in all-cause diarrhoea rates in the child cohort (born 2008-13) using Cox regression, comparing time to first all-cause diarrhoea case by vaccine status. RESULTS: Overall, vaccine introduction among age-eligible children was associated with a 82.9% reduction [95% confidence interval (CI): 49.4%, 94.2%] in prevalence of rotavirus in participants without diarrhoea symptoms and a 46.0% reduction (95% CI: 6.2%, 68.9%) in prevalence of rotavirus infection among participants experiencing diarrhoea. Whereas all age groups benefited, this reduction was strongest among the youngest age groups. For young children, prevalence of symptomatic diarrhoea also decreased in the post-vaccine period in both the case-control study (reduction in prevalence for children <1 year of age = 69.3%, 95% CI: 8.7%, 89.7%) and the cohort study (reduction in hazard for receipt of two Rotarix doses among children aged 0.5-2 years = 57.1%, 95% CI: 16.6, 77.9%). CONCLUSIONS: Rotarix vaccination may suppress transmission, including asymptomatic transmission, in low- and middle-income settings. It was highly effective among children in a rural community setting and provides population-level benefits through indirect protection among adults.

Diagnóstico diferencial de leishmaniasis mucocutánea. A propósito de un caso de carcinoma basocelular de la piel / Differential diagnosis of mucocutaneous leishmaniasis. Report of a clinical case of basocellular carcinoma of the skin

Introducción. La leishmaniasis es una enfermedad parasitaria causada por aproximadamente veinte especies diferentes del protozoario Leishmania sp. y transmitida al hombre por la picadura de un mosquito hembra del género Phlebotomine sp. Las manifestaciones clínicas son variables y están relacionadas con la especie infectante; su relación con el ambiente y con la respuesta inmune del hospedero. La leishmaniasis mucocutánea (LMC), afecta a piel y mucosas de la estructura de vías respiratorias superiores; está presente en Latinoamérica donde es producida principalmente por la especie Leishmania (Vianna) braziliensis. Los signos iniciales son eritema y ulceraciones en los orificios nasales, seguidos por inflamación destructiva que puede extenderse hasta afectar el septo nasal y en algunos casos, la faringe o la laringe, desfigurando gravemente el rostro y comprometiendo la vida del paciente. Caso clínico. Varón de 90 años proveniente del Noroccidente de Pichincha, quien presenta varias lesiones ulcerativas localizadas en el puente nasal derecho, ángulo interno del ojo derecho y mejilla homolateral cubriendo un área aproximada de 4 cm. de diámetro. Inicialmente se sospechó de LMC y se aplicaron varias dosis de antimonio pentavalente (Glucantime©). Se realizaron exámenes diagnósticos para Leishmaniasis (frotis, cultivo y PCR) los cuales resultaron negativos. Resultados. La muestra de biopsia de piel determinó lesión compatible con carcinoma basocelular refiriéndose al paciente a SOLCA. Discusión. Existen algunos diagnósticos diferenciales de la LMC en zonas endémicas, siendo el carcinoma de piel uno de los cuales los médicos y laboratoristas deberían tener en cuental al momento del diagnóstico. Además deben confirmarse los diagnósticos de LMC con exámenes de laboratorio para evitar el mal uso de antimoniales. Conclusiones. En zonas endémicas de LMC, se debe realizar un adecuado diagnóstico diferencial de otras patologías que causan lesiones ulcerativas como este tipo de carcinoma basocelular de piel, evitando la administración de antimonio pentavalente de manera indiscriminada.

Introduction. Leishmaniasis is a parasitic disease caused about twenty differents species of the Leishmania protozoo.Transmitted to humans by the bite of a female midge of the genus Phlebotomine sp. The clinical manifestations are variable and are related to the infected species, their relationship with the environment and the host immune response. Mucocutaneous leishmaniasis (MCL), affect the skin and mucous membranes of the upper respiratory tract, is present in Latin America, produced mainly by Leishmania (Vianna) braziliensis. The initial signs first signs are erythema and ulcerations in the nostrils, followed by destructive inflammation that can spread to involve the nasal septum, in some cases, pharynx or larynx, severely disfiguring the face and compromise the patient's life. Clinical case. A 90 year old male from the Northwest of Pichincha province, who has several ulcerative lesions in the right nasal bridge, inner corner of the right eye and ipsilateral cheek covering an area of approximately 4 cm in diameter is presented. Multiple doses of pentavalent antimony (Glucantime©) were applied because it was suspected MCL. Diagnostic tests for Leishmaniasis (smear, culture and PCR) were negative. Histopathological examination determined that it was a basal cell skin carcinoma. Results. The skin biopsy sample determined a lesion with basal cell carcinoma, we have referred the patient to SOLCA. Discussion. There are some differential diagnoses of MCL in endemic areas, skin carcinoma being one of which doctors and laboratory technicians should take into account at the time of diagnosis. In addition, MCL diagnoses should be confirmed with laboratory tests to avoid misuse of antimonials. Conclusions. In endemic areas of MCL, a proper differential diagnosis must be performed for ulcerative lesions such as basal cell carcinoma of the skin, avoiding the indiscriminately administration of pentavalent antimony.

Psychometric Properties of the Revised Illness Perception Questionnaire for Oral Health.

AIMS: The aim of this study was to test the hypothesis that, for patients with dental caries, the Spanish version of the Revised Illness Perception Questionnaire for Oral Health (IPQ-R-OH) has 7 dimensions, including personal and treatment control, timeline-acute/chronic and timeline-cyclical, illness coherence, consequences, and emotional representations. METHODS: A Spanish adaptation of the IPQ-R, with a self-reported 38-item scale, was developed. Exploratory and confirmatory factor analyses were conducted using data from 520 patients with dental caries attending the Dental Clinic at Universidad Cooperativa de Colombia, Pasto, Colombia. RESULTS: Exploratory factor analysis revealed 7 dimensions with 36 items (2 items were removed because of poor factor loadings or discriminant ability). The internal consistency coefficients of each factor ranged from 0.72 to 0.91, and all item loadings were >0.52. Confirmatory factor analysis indicated that a 7-factor model with 36 items had superior fit compared to the 38-item original model: χ2 = 1,784.291 (df = 573, p < 0.001); nonnormal fit index = 0.941; comparative fit index = 0.946; root mean square error of approximation = 0.062 (90% CI = 0.057-0.066); standardized root mean square residual = 0.072; and Akaike information criterion = 638.291. Control (integrated by items from personal control, treatment control, and timeline-acute factors) and hopelessness (PC15 and PC17) were the 2 reconfigured factors that were identified. CONCLUSIONS: These findings suggest that the modified 36-item model has satisfactory reliability and construct factorial validity; therefore, it could be a valuable instrument in the screening of illness perceptions in oral health.

Composition of forage and grain from second-generation insect-protected corn MON 89034 is equivalent to that of conventional corn (Zea mays L.).

Insect-protected corn hybrids containing Cry insecticidal proteins derived from Bacillus thuringiensis have protection from target pests and provide effective management of insect resistance. MON 89034 hybrids have been developed that produce both the Cry1A.105 and Cry2Ab2 proteins, which provide two independent modes of insecticidal action against the European corn borer ( Ostrinia nubilalis ) and other lepidopteran insect pests of corn. The composition of MON 89034 corn was compared to conventional corn by measuring proximates, fiber, and minerals in forage and by measuring proximates, fiber, amino acids, fatty acids, vitamins, minerals, antinutrients, and secondary metabolites in grain collected from 10 replicated field sites across the United States and Argentina during the 2004-2005 growing seasons. Analyses established that the forage and grain from MON 89034 are compositionally comparable to the control corn hybrid and conventional corn reference hybrids. These findings support the conclusion that MON 89034 is compositionally equivalent to conventional corn hybrids.

Composition of grain, forage, and processed fractions from second-generation glyphosate-tolerant soybean, MON 89788, is equivalent to that of conventional soybean (Glycine max L.).

Developments in biotechnology and molecular-assisted breeding have led to the development of a second-generation glyphosate-tolerant soybean product, MON 89788. The MON 89788 event was produced by direct transformation of a cp4 epsps (5-enolpyruvylshikimate-3-phosphate synthase) gene cassette derived from Agrobacterium sp. strain CP4 into an elite soybean germplasm known for its superior agronomic characteristics and high yielding property. The purpose of this work was to assess whether the nutrient and antinutrient levels in seed and forage tissues of MON 89788 are comparable to those in the conventional soybean variety, A3244, which has background genetics similar to MON 89788 but does not contain the cp4 epsps gene cassette. Additional conventional soybean varieties currently in the marketplace were also included in the analysis to establish a range of natural variability for each analyte, where the range of variability is defined by a 99% tolerance interval for that particular analyte. Compositional analyses were conducted on forage, seed and four processed fractions from soybeans grown in ten sites across both the United States and Argentina during the 2004-2005 growing seasons. Forage samples were analyzed for levels of proximates (ash, fat, moisture, and protein) and fiber. Seed samples were analyzed for proximates, fiber, antinutrients, and vitamin E. Defatted, toasted (DT) meal was analyzed for proximates, fiber, amino acids, and antinutrients. Refined, bleached, and deodorized (RBD) oil was analyzed for fatty acids and vitamin E. Protein isolate was analyzed for amino acids and moisture. Crude Lecithin was analyzed for phosphatides. Results of the comparisons indicate that MON 89788 is compositionally and nutritionally equivalent to conventional soybean varieties currently in commerce.

Chemical composition of glyphosate-tolerant soybean 40-3-2 grown in Europe remains equivalent with that of conventional soybean (Glycine max L.).

The composition of glyphosate-tolerant (Roundup Ready) soybean 40-3-2 was compared with that of conventional soybean grown in Romania in 2005 as part of a comparative safety assessment program. Samples were collected from replicated field trials, and compositional analyses were performed to measure proximates (moisture, fat, ash, protein, and carbohydrates by calculation), fiber, amino acids, fatty acids, isoflavones, raffinose, stachyose, phytic acid, trypsin inhibitor, and lectin in grain as well as proximates and fiber in forage. The mean values for all biochemical components assessed for Roundup Ready soybean 40-30-2 were similar to those of the conventional control and were within the published range observed for commercial soybean. The compositional profile of Roundup Ready soybean 40-3-2 was also compared to that of conventional soybean varieties grown in Romania by calculating a 99% tolerance interval to describe compositional variability in the population of traditional soybean varieties already on the marketplace. These comparisons, together with the history of the safe use of soybean as a common component of animal feed and human food, lead to the conclusion that Roundup Ready soybean 40-3-2 is compositionally equivalent to and as safe and nutritious as conventional soybean varieties grown commercially.

Comparison of the forage and grain composition from insect-protected and glyphosate-tolerant MON 88017 corn to conventional corn (Zea mays L.).

The next generation of biotechnology-derived products with the combined benefit of herbicide tolerance and insect protection (MON 88017) was developed to withstand feeding damage caused by the coleopteran pest corn rootworm and over-the-top applications of glyphosate, the active ingredient in Roundup herbicides. As a part of a larger safety and characterization assessment, MON 88017 was grown under field conditions at geographically diverse locations within the United States and Argentina during the 2002 and 2003-2004 field seasons, respectively, along with a near-isogenic control and other conventional corn hybrids for compositional assessment. Field trials were conducted using a randomized complete block design with three replication blocks at each site. Corn forage samples were harvested at the late dough/early dent stage, ground, and analyzed for the concentration of proximate constituents, fibers, and minerals. Samples of mature grain were harvested, ground, and analyzed for the concentration of proximate constituents, fiber, minerals, amino acids, fatty acids, vitamins, antinutrients, and secondary metabolites. The results showed that the forage and grain from MON 88017 are compositionally equivalent to forage and grain from control and conventional corn hybrids.

Glyphosate-tolerant alfalfa is compositionally equivalent to conventional alfalfa (Medicago sativa L.).

Glyphosate-tolerant alfalfa (GTA) was developed to withstand over-the-top applications of glyphosate, the active ingredient in Roundup agricultural herbicides. As a part of the safety assessment, GTA (designated J101 x J163) was grown under controlled field conditions at geographically diverse locations within the United States during the 2001 and 2003 field seasons along with control and other conventional alfalfa varieties for compositional assessment. Field trials were conducted using a randomized complete block design with four replication blocks at each site. Alfalfa forage was harvested at the late bud to early bloom stage from each plot at five field sites in 2001 (establishment year) and from four field sites in 2003 (third year of stand). The concentration of proximate constituents, fibers, amino acids, coumestrol, and minerals in the forage was measured. The results showed that the forage from GTA J101 x J163 is compositionally equivalent to forage from the control and conventional alfalfa varieties.

Determination of aristolochic acid in botanicals and dietary supplements by liquid chromatography with ultraviolet detection and by liquid chromatography/mass spectrometry: single laboratory validation confirmation.

The presence of aristolochic acid in some dietary supplements is a concern to regulators and consumers. A method has been developed, by initially using a reference method as a guide, during single laboratory validation (SLV) for the determination of aristolochic acid I, also known as aristolochic acid A, in botanical species and dietary supplements at concentrations of approximately 2 to 32 microg/g. Higher levels were determined by dilution to fit the standard curve. Through the SLV, the method was optimized for quantification by liquid chromatography with ultraviolet detection (LC-UV) and LC/mass spectrometry (MS) confirmation. The test samples were extracted with organic solvent and water, then injected on a reverse phase LC column. Quantification was achieved with linear regression using a laboratory automation system. The SLV study included systematically optimizing the LC-UV method with regard to test sample size, fine grinding of solids, and solvent extraction efficiency. These parameters were varied in increments (and in separate optimization studies), in order to ensure that each parameter was individually studied; the test results include corresponding tables of parameter variations. In addition, the chromatographic conditions were optimized with respect to injection volume and detection wavelength. Precision studies produced overall relative standard deviation values from 2.44 up to 8.26% for aristolochic acid I. Mean recoveries were between 100 and 103% at the 2 microg/g level, between 102 and 103% at the 10 microg/g level, and 104% at the 30 microg/g level.

Comparison of various dilutions and solid-phase extraction cleanup on the determination of ephedrine-type alkaloids and internal standard recovery in ephedra botanical raw material and powdered extract.

A study was conducted to determine the effect of 3 dilution levels on the precision of the ephedra alkaloid method when used in conjunction with a solid-phase extraction (SPE) column. For the dilutions studied, SPE column cleanup is necessary because it promotes a greater recovery of the internal standard. However, overall, target precision values were not obtained on the test materials. It was determined that the SPE column is not the cause of the lower recovery in the more concentrated solutions. Significant signal suppression of the internal standard occurs in more concentrated solutions within the mass spectrometer. It is hypothesized that this lack of performance on the part of the SPE column may be linked to its inability to fully clean contaminants from the higher concentration solutions and/or a mass spectrometer overload, which resulted in the internal standard not fully correcting for signal suppression in more concentrated solutions. An internal standard is necessary, especially for accuracy, for the determination of all alkaloids, and only dilute solutions can be accurately analyzed. Due to the sensitivity of the mass spectrometer, it is recommended that the determination of ephedrine alkaloids in dietary supplements and botanicals should be studied using a standard graph at a level 10 x less than the current method. It is also recommended that the SPE column used should be evaluated on its need for the sample dilutions made to fit the newly recommended standard graph.

Glyphosate-tolerant soybeans remain compositionally equivalent to conventional soybeans (Glycine max L.) during three years of field testing.

Previous studies have shown that the composition of glyphosate-tolerant soybeans (GTS) and selected processed fractions was substantially equivalent to that of conventional soybeans over a wide range of analytes. This study was designed to determine if the composition of GTS remains substantially equivalent to conventional soybeans over the course of several years and when introduced into multiple genetic backgrounds. Soybean seed samples of both GTS and conventional varieties were harvested during 2000, 2001, and 2002 and analyzed for the levels of proximates, lectin, trypsin inhibitor, and isoflavones. The measured analytes are representative of the basic nutritional and biologically active components in soybeans. Results show a similar range of natural variability for the GTS soybeans as well as conventional soybeans. It was concluded that the composition of commercial GTS over the three years of breeding into multiple varieties remains equivalent to that of conventional soybeans.

The composition of grain and forage from glyphosate tolerant wheat MON 71800 is equivalent to that of conventional wheat (Triticum aestivum L.).

Glyphosate tolerant wheat MON 71800, simply referred to as MON 71800, contains a 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) protein from Agrobacterium sp. strain CP4 (CP4 EPSPS) that has a reduced affinity for glyphosate as compared to the endogenous plant EPSPS enzyme. The purpose of this work was to evaluate the compositional equivalence of MON 71800 to its nontransgenic parent as well as to conventional wheat varieties. The compositional assessment evaluated the levels of proximates, amino acids, fatty acids, minerals, vitamins, secondary metabolites, and antinutrients in wheat forage and grain grown during two field seasons across a total of eight sites in the United States and Canada. These data demonstrated that with respect to these important nutritional components, the forage and grain from MON 71800 were equivalent to those of its nontransgenic parent and commercial wheat varieties. These data, together with the previously established safety of the CP4 EPSPS protein, support the conclusion that glyphosate tolerant wheat MON 71800 is as safe and nutritious as commercial wheat varieties.

Determination of ephedrine alkaloids in human urine and plasma by liquid chromatography/tandem mass spectrometry: collaborative study.

A collaborative study was conducted to evaluate the accuracy and precision of a method for ephedrine-type alkaloids (i.e., norephedrine, norpseudoephedrine, ephedrine, pseudoephedrine, methylephedrine, and methylpseudoephedrine) in human urine and plasma. The amount of ephedrine-type alkaloids present was determined using liquid chromatography (LC) with tandem mass selective detection. The test samples were diluted to reflect a concentration of 5.00-100 ng/mL for each alkaloid. An internal standard was added and the alkaloids were separated using a 5 microm phenyl LC column with an ammonium acetate, glacial acetic acid, acetonitrile, and water mobile phase. Eight blind duplicates of human urine and eight blind duplicates of human plasma were analyzed by 10 collaborators. In addition to negative controls, test portions of urine and plasma were fortified at 3 different levels with each of the 6 ephedrine-type alkaloids at approximately 1, 2, and 5 microg/mL for urine and 100, 200, and 500 ng/mL for plasma. On the basis of the accuracy and precision results for this collaborative study, it is recommended that this method be adopted Official First Action for the determination of 6 different ephedrine-type alkaloids in human urine and plasma.

Determination of ephedrine alkaloids in dietary supplements and botanicals by liquid chromatography/tandem mass spectrometry: collaborative study.

An interlaboratory study was conducted to evaluate the accuracy and precision of a method for ephedrine-type alkaloids [i.e., norephedrine (NE), norpseudoephedrine (NPE), ephedrine (E), pseudoephedrine (PE), methylephedrine (ME), and methylpseudoephedrine (MPE)] in dietary supplements and botanicals. The amount of ephedrine-type alkaloids present was determined using liquid chromatography with tandem mass selective detection. The samples were diluted to reflect a concentration of 0.0200 to 1.00 microg/mL for each alkaloid. An internal standard was added and the alkaloids were separated using a 5 microm phenyl LC column with an ammonium acetate, glacial acetic acid, acetonitrile, and water mobile phase. Eight blind duplicates of dietary supplements or botanicals were analyzed by 10 collaborators. Included was a negative control, ephedra nevadensis, and negative controls fortified at 2 different levels with each of the 6 ephedrine-type alkaloids. The spike levels were approximately 100 and 1000 microg/g for NE, 100 and 600 microg/g for NPE, 6500 and 65000 microg/g for E, 1000 and 10 000 microg/g for PE, 300 and 3000 microg/g for ME, and 100 and 1000 microg/g for MPE. On the basis of the accuracy and precision results for this interlaboratory study, it is recommended that this method be adopted Official First Action for the determination of 6 different individual ephedrine-type alkaloids in dietary supplements and botanicals.

Malária: clínica, diagnóstico, tratamento, profilaxia e controle: parte 2 / Malaria: clinic, diagnostic, treatment, prophylaxis and control: part 2

No presente artigo são revistos os aspectos clínicos, diagnósticos, terapêuticos e profiláticos da malária

Epidemiología y control de la malaria: una experiencia brasileña / Epidemiology and control of malaria: brazilian experience

La malaria, ya por su prevalencia, ya por su re-emergencia, es la enfermedad parasitaria de mayor impacto en el mundo. En el presente artículo, son discutidos aspectos relativos al control de la malaria, dentro de una perspectiva brasileira