Maternal alcohol drinking patterns predict offspring neurobehavioral outcomes.

The timing, rate, and quantity of gestational alcohol consumption, collectively referred to here as Maternal Drinking Patterns (MDPs), are of known importance to fetal developmental outcomes. However, few studies have directly evaluated the impact of MDPs on offspring behavior. To do so, we used specialized equipment to record the precise amount and timing of alcohol consumption in pregnant dams, and then characterized MDPs using Principle Component Analysis (PCA). We next tested offspring on behaviors we have previously identified as impacted by prenatal alcohol exposure, and evaluated them where possible in the context of MDPs. Male alcohol exposed mice exhibited longer latencies to fall on the rotarod compared to their controls, which we attribute to a delayed decrease in body weight-gain. This effect was mediated by MDPs within the first 15 min of alcohol access (i.e. alcohol frontloading), where the highest performing male offspring came from dams exhibiting the highest rate of alcohol frontloading. Female alcohol exposed mice displayed reduced locomotor activity in the open field compared to controls, which was mediated by MDPs encompassing the entire drinking session. Surprisingly, total gestational alcohol exposure alone was not associated with any behavioral outcomes. Finally, we observed allodynia in alcohol exposed mice that developed more quickly in males compared to females, and which was not observed in controls. To our knowledge, this report represents the highest resolution assessment of alcohol drinking throughout gestation in mice, and one of few to have identified relationships between specific alcohol MDPs and neurobehavioral outcomes in offspring.

Persistent pulmonary abnormalities after 18 months of SARS-CoV-2 pneumonia.

OBJECTIVE: To describe persistent pulmonary abnormalities detected on HRCT after 18 months of SARS-CoV-2 pneumonia, and to determine their extension and correlation with pulmonary function. PATIENTS AND METHODS: A prospective cross-sectional study with an initial cohort of 90 patients in follow-up due to persisting lung abnormalities on imaging, functional respiratory impairment and/or respiratory symptoms. Of these, 31 (34%) were selected for analysis due to the persistence of their lung abnormalities on HRCT at 18 months after infection. A double reading was performed for each HRCT (62 observations). RESULTS: Of the 31 patients included: 20 (65%) were men; mean age was 67 years; 17 (55%) were smokers/ex-smokers. The mean hospitalisation time was 38 days. Eighteen (58%) patients were admitted to intensive care units. Five patients (16%) suffered an acute pulmonary thromboembolism and three (9.7%) had a pneumothorax. The mean time between the onset of pneumonia and the follow-up HRCT was 20.34 months. Nineteen percent of patients suffered from total lung function abnormalities; and ground-glass opacities and reticulation were present in 12% and 4.5% respectively. The findings of the 62 readings were: ground-glass opacities (100%), reticulation (83%), subpleural curvilinear lines (62%), parenchymal bands (34%), traction bronchiectasis (69%), displacement of vessels/fissures (46%) and honeycombing (4.9%). Pulmonary function 18 months after the acute episode revealed a mean FVC of 92% of predicted value, with an FVC < 80% of predicted value in 11 patients (35.4%). Mean DLCO was 71% of predicted value, with a DLCO < 80% in 22 patients (70%). We observed a statistically significant relationship between total lung function abnormalities on HRCT and FVC (P < 0.05), and a trend towards statistical significance with DLCO (P = 0.051); there was a statistically significant relationship between the presence of ground-glass opacities and FEV1/FVC (P < 0.01). The relationships between reticulation and FVC, FVC%, FEV1, FEV1% and DLCO% were also considered statistically significant (P < 0.05). CONCLUSION: Persistent interstitial lung abnormalities are seen on HRCT for a subset of patients infected with SARS-CoV-2 pneumonia. Seventy percent of these patients suffered a slight decrease in DLCO.

Optogenetic stimulation of corticostriatal circuits improves behavioral flexibility in mice with prenatal alcohol exposure.

Fetal alcohol spectrum disorder (FASD) is the most common preventable form of developmental and neurobehavioral disability. Animal models have demonstrated that even low to moderate prenatal alcohol exposure (PAE) is sufficient to impair behavioral flexibility in multiple domains. Previously, utilizing a moderate limited access drinking in the dark paradigm, we have shown that PAE 1) impairs touchscreen pairwise visual reversal in male adult offspring 2) leads to small but significant decreases in orbitofrontal (OFC) firing rates 3) significantly increases dorsal striatum (dS) activity and 4) aberrantly sustains OFC-dS synchrony across early reversal. In the current study, we examined whether optogenetic stimulation of OFC-dS projection neurons would be sufficient to rescue the behavioral inflexibility induced by PAE in male C57BL/6J mice. Following discrimination learning, we targeted OFC-dS projections using a retrograde adeno-associated virus (AAV) delivered to the dS which expressed channel rhodopsin (ChR2). During the first four sessions of reversal learning, we delivered high frequency optogenetic stimulation to the OFC via optic fibers immediately following correct choice responses. Our results show that optogenetic stimulation significantly reduced the number of sessions, incorrect responses, and correction errors required to move past the early perseverative phase for both PAE and control mice. In addition, OFC-dS stimulation during early reversal learning reduced the increased sessions, correct and incorrect responding seen in PAE mice during the later learning phase of reversal but did not significantly alter later performance in control ChR2 mice. Taken together these results suggest that stimulation of OFC-dS projections can improve early reversal learning in PAE and control mice, and these improvements can persist even into later stages of the task days later. These studies provide an important foundation for future clinical approaches to improve executive control in those with FASD. This article is part of the Special Issue on "PFC circuit function in psychiatric disease and relevant models".

Preventable incidence cases from non-communicable diseases attributable to insufficient physical activity in Chile.

OBJECTIVES: Lack of sufficient physical activity (PA) has been associated with an increased risk of several non-communicable diseases (NCDs) and all-cause mortality. This study aimed to estimate the number of preventable incidence cases of NCDs attributable to insufficient PA in the Chilean population. STUDY DESIGN: Comparative risk assessment modelling study. METHODS: This study examined data from 5834 participants aged ≥20 years from the Chilean National Survey (2016-2017). PA was assessed by the Global Physical Activity Questionnaire (GPAQ), and metabolic equivalent of tasks (METs) were assigned according to PA intensity. Estimated incidence cases of NCDs in Chile in 2019 were obtained from the Global Burden of Disease study. Relative risks for breast cancer, colon cancer, ischaemic heart disease, diabetes and stroke were obtained from a published meta-analysis and applied to the prevalence of insufficient PA estimates through the potential impact fraction equation. RESULTS: High levels of PA (≥8000 MET-min/week) could potentially avoid more than 22,000 (64.6 %) incidence NCD cases, ranging from 498 (10.1 %) preventable cases of breast cancer to 5629 (14.7 %) cases of diabetes. Other modelled scenarios also showed to reduce the incidence cases of all five NCDs but to a lesser extent; where at least PA recommendation was achieved, preventable NCDs were reduced by 6522 cases (18.7 %), and where a 10 % relative reduction in insufficient PA level in the population was achieved, preventable NCDs were reduced by 651 (1.8 %) cases. CONCLUSIONS: The study results provide estimates for the incidence cases of preventable NCDs attributable to insufficient PA, highlighting the important role of PA in NCD prevention in Chile.

Recent breakthroughs in understanding the cerebellum's role in fetal alcohol spectrum disorder: A systematic review.

Exposure to alcohol during fetal development can lead to structural and functional abnormalities in the cerebellum, a brain region responsible for motor coordination, balance, and specific cognitive functions. In this systematic review, we comprehensively analyze a vast body of research conducted on vertebrate animals and humans over the past 13 years. We identified studies through PubMed and screened them following PRISMA guidelines. Data extraction and quality analysis were conducted using Covidence systematic review software. A total of 108 studies met our inclusion criteria, with the majority (79 studies) involving vertebrate animal models and 29 studies focusing on human subjects. Animal models included zebrafish, mice, rats, sheep, and non-human primates, investigating the impact of ethanol on cerebellar structure, gene/protein expression, physiology, and cerebellar-dependent behaviors. Additionally, some animal studies explored potential therapeutic interventions against ethanol-induced cerebellar damage. The human studies predominantly adopted cohort designs, exploring the effects of prenatal alcohol exposure on cerebellar structure and function. Certain human studies delved into innovative cerebellar-based diagnostic approaches for fetal alcohol spectrum disorder (FASD). The collective findings from these studies clearly indicate that the cerebellum is involved in various neurophysiological deficits associated with FASD, emphasizing the importance of evaluating both cerebellar structure and function in the diagnostic process for this condition. Moreover, this review sheds light into potential therapeutic strategies that can mitigate prenatal alcohol exposure-induced cerebellar damage.

Long-term effects of low prenatal alcohol exposure on GABAergic interneurons of the murine posterior parietal cortex.

BACKGROUND: Fetal alcohol spectrum disorders (FASDs) are characterized by a wide range of physical, cognitive, and behavioral impairments that occur throughout the lifespan. Prenatal alcohol exposure (PAE) can lead to adult impairments in cognitive control behaviors mediated by the posterior parietal cortex (PPC). The PPC plays a fundamental role in the performance of response tasks in both primates and rodents, specifically when choices between similar target and nontarget stimuli are required. Furthermore, the PPC is reciprocally connected with other cortical areas. Despite the extensive literature investigating the molecular mechanisms underlying PAE impairments in cognitive functions mediated by cortical areas, little is known regarding the long-term effects of PAE on PPC development and function. Here, we examined changes in the cellular organization of GABAergic interneurons and their function in PPC using behaviorally naïve control and PAE mice. METHODS: We used a limited access model of PAE in which C57BL/6J females were exposed to a solution of 10% (w/v) ethanol and 0.066% (w/V) saccharin for 4 h/day throughout gestation. Using high-throughput fluorescent microscopy, we quantified the levels of GABAergic interneurons in the PPC of adult PAE and control offspring. In a separate cohort, we recorded spontaneous inhibitory postsynaptic currents (sIPSCs) using whole-cell patch clamp recordings from PPC layer 5 pyramidal neurons. RESULTS: PAE led to a significant overall reduction of parvalbumin-expressing GABAergic interneurons in PAE mice regardless of sex. Somatostatin- and calretinin-expressing GABAergic interneurons were not affected. Interestingly, PAE did not modulate sIPSC amplitude or frequency. CONCLUSIONS: These results suggest that impairments in cognitive control observed in FASD may be due to the significant reduction of parvalbumin-expressing GABAergic interneurons in the PPC. PAE animals may show compensatory changes in GABAergic function following developmental reduction of these interneurons.

Prenatal alcohol exposure promotes NLRP3 inflammasome-dependent immune actions following morphine treatment and paradoxically prolongs nerve injury-induced pathological pain in female mice.

BACKGROUND: Neuroimmune dysregulation from prenatal alcohol exposure (PAE) may contribute to neurological deficits associated with fetal alcohol spectrum disorders (FASD). PAE is a risk factor for developing peripheral immune and spinal glial sensitization and release of the proinflammatory cytokine IL-1ß, which lead to neuropathic pain (allodynia) from minor nerve injury. Although morphine acts on µ-opioid receptors, it also activates immune receptors, TLR4, and the NLRP3 inflammasome that induces IL-1ß. We hypothesized that PAE induces NLRP3 sensitization by morphine following nerve injury in adult mice. METHODS: We used an established moderate PAE paradigm, in which adult PAE and non-PAE control female mice were exposed to a minor sciatic nerve injury, and subsequent allodynia was measured using the von Frey fiber test. In control mice with standard sciatic damage or PAE mice with minor sciatic damage, the effects of the NLRP3 inhibitor, MCC950, were examined during chronic allodynia. Additionally, minor nerve-injured mice were treated with morphine, with or without MCC950. In vitro studies examined the TLR4-NLRP3-dependent proinflammatory response of peripheral macrophages to morphine and/or lipopolysaccharide, with or without MCC950. RESULTS: Mice with standard sciatic damage or PAE mice with minor sciatic damage developed robust allodynia. Blocking NLRP3 activation fully reversed allodynia in both control and PAE mice. Morphine paradoxically prolonged allodynia in PAE mice, while control mice with minor nerve injury remained stably non-allodynic. Allodynia resolved sooner in nerve-injured PAE mice without morphine treatment than in morphine-treated mice. MCC950 treatment significantly shortened allodynia in morphine-treated PAE mice. Morphine potentiated IL-1ß release from TLR4-activated PAE immune cells, while MCC950 treatment greatly reduced it. CONCLUSIONS: In female mice, PAE prolongs allodynia following morphine treatment through NLRP3 activation. TLR4-activated PAE immune cells showed enhanced IL-1ß release with morphine via NLRP3 actions. Similar studies are needed to examine the adverse impact of morphine in males with PAE. These results are predictive of adverse responses to opioid pain therapeutics in individuals with FASD.

Binge-like ethanol exposure during the brain growth spurt disrupts the function of retrosplenial cortex-projecting anterior thalamic neurons in adolescent mice.

Ethanol (EtOH) exposure during late pregnancy leads to enduring impairments in learning and memory that may stem from damage to components of the posterior limbic memory system, including the retrosplenial cortex (RSC) and anterior thalamic nuclei (ATN). In rodents, binge-like EtOH exposure during the first week of life (equivalent to the third trimester of human pregnancy) triggers apoptosis in these brain regions. We hypothesized that this effect induces long-lasting alterations in the function of RSC-projecting ATN neurons. To test this hypothesis, vesicular GABA transporter-Venus mice (expressing fluorescently tagged GABAergic interneurons) were subjected to binge-like EtOH vapor exposure on postnatal day (P) 7. This paradigm activated caspase 3 in the anterodorsal (AD), anteroventral (AV), and reticular thalamic nuclei at P7 but did not reduce neuronal density in these areas at P60-70. At P40-60, we injected red retrobeads into the RSC and performed patch-clamp slice electrophysiological recordings from retrogradely labeled neurons in the AD and AV nuclei 3-4 days later. We found significant effects of treatment on instantaneous action potential (AP) frequency and AP overshoot, as well as sex × treatment interactions for AP threshold and overshoot in AD neurons. A sex × treatment interaction was detected for AP number in AV neurons. EtOH exposure also reduced the frequency and amplitude of spontaneous excitatory postsynaptic currents and increased the charge transfer of spontaneous inhibitory postsynaptic currents. These results highlight a novel cellular mechanism that could contribute to the lasting learning and memory deficits associated with developmental EtOH exposure.

Cut-off points for isometric handgrip and low limb explosive strength in relation to indicators of overweight/obesity in people with intellectual disabilities: analysis by age groups.

BACKGROUND: The prevalence of overweight/obesity has been increasing globally and in people with Intellectual Disabilities (IDs), this problem is exacerbated even more, which added to a low physical condition that contributes to the deterioration of functionality and increases the risk of developing chronic diseases in the course of life. Therefore, the aim of this study was to establish cut-off points for levels of isometric handgrip and low limb explosive strength in children, adolescents and adults, which identify overweight/obesity in people with IDs and their respective associations. METHODS: The sample was made up of 131 individuals with IDs, belonging to four special and community educational centres in the city of Santiago, Chile. Body mass index (BMI) and waist-to-height ratio (WHR) were used as indicators of overweight/obesity. Handgrip strength was used as a measure of isometric strength, and countermovement jump was used as a measure of low limb explosive strength. For the comparison of variables by age group, the analysis of Ancova, Kruskal-Wallis and chi-square tests were used. The total area under the receiver operating characteristic curve of isometric handgrip and low limb explosive strength was identified as an indicator of overweight/obesity according to age groups. A logistic regression model was used to quantify the effect that strength categories below the cut-off point have on the risk of overweight and obesity. RESULTS: Significant differences were observed between the age groups for body weight, height, BMI and WHR, as well as in the levels of absolute handgrip strength and vertical jump with countermovement (P ≤ 0.05). Children showed the lowest cut-off points for absolute and relative strength. The adolescent group showed the highest cut-off points for relative strength and countermovement jump and adults showed the highest value for absolute strength as indicators of overweight/obesity. Different associations between cut-off points with BMI and WHR were found. CONCLUSIONS: Adolescents showed the highest cut-off point for relative strength and countermovement jump, and adults showed the highest value for absolute strength, according to overweight/obesity indicators (BMI and WHR). It is suggested to adjust resistance training programmes according to age categories for the prevention of overweight/obesity in people with IDs.

Prenatal alcohol exposure alters mRNA expression for stress peptides, glucocorticoid receptor function and immune factors in acutely stressed neonatal brain.

Background: The amygdala, hippocampus and hypothalamus are critical stress regulatory areas that undergo functional maturation for stress responding initially established during gestational and early postnatal brain development. Fetal alcohol spectrum disorder (FASD), a consequence of prenatal alcohol exposure (PAE), results in cognitive, mood and behavioral disorders. Prenatal alcohol exposure negatively impacts components of the brain stress response system, including stress-associated brain neuropeptides and glucocorticoid receptors in the amygdala, hippocampus and hypothalamus. While PAE generates a unique brain cytokine expression pattern, little is known about the role of Toll-like receptor 4 (TLR4) and related proinflammatory signaling factors, as well as anti-inflammatory cytokines in PAE brain stress-responsive regions. We hypothesized that PAE sensitizes the early brain stress response system resulting in dysregulated neuroendocrine and neuroimmune activation. Methods: A single, 4-h exposure of maternal separation stress in male and female postnatal day 10 (PND10) C57Bl/6 offspring was utilized. Offspring were from either prenatal control exposure (saccharin) or a limited access (4 h) drinking-in-the-dark model of PAE. Immediately after stress on PND10, the hippocampus, amygdala and hypothalamus were collected, and mRNA expression was analyzed for stress-associated factors (CRH and AVP), glucocorticoid receptor signaling regulators (GAS5, FKBP51 and FKBP52), astrocyte and microglial activation, and factors associated with TLR4 activation including proinflammatory interleukin-1ß (IL-1ß), along with additional pro- and anti-inflammatory cytokines. Select protein expression analysis of CRH, FKBP and factors associated with the TLR4 signaling cascade from male and female amygdala was conducted. Results: The female amygdala revealed increased mRNA expression in stress-associated factors, glucocorticoid receptor signaling regulators and all of the factors critical in the TLR4 activation cascade, while the hypothalamus revealed blunted mRNA expression of all of these factors in PAE following stress. Conversely, far fewer mRNA changes were observed in males, notably in the hippocampus and hypothalamus, but not the amygdala. Statistically significant increases in CRH protein, and a strong trend in increased IL-1ß were observed in male offspring with PAE independent of stressor exposure. Conclusion: Prenatal alcohol exposure creates stress-related factors and TLR-4 neuroimmune pathway sensitization observed predominantly in females, that is unmasked in early postnatal life by a stress challenge.

Efecto del plomo y del arsénico en condiciones de laboratorio sobre la rana africana de uñas (Xenopus laevis) y la rana leopardo (Lithobates berlandieri) / Effect of lead and arsenic under laboratory conditions on African clawed frog (Xenopus laevis) and leopard frog (Lithobates berlandieri)

Actualmente, existe una creciente preocupación ya que algunas especies de anfibios han mostrado un declive en sus poblaciones por causa de diversos factores, entre ellos los metales pesados; por esta razón, es importante realizar estudios sobre esta problemática ambiental. El objetivo de este estudio fue determinar la cantidad del plomo y arsénico que se concentra en los tejidos de la rana Africana de uñas (Xenopus laevis) en etapa juvenil y de la rana Leopardo (Lithobates berlandieri) en etapa larvaria y en el agua después de 16 semanas expuestas a placas de plomo y arseniato de sodio, con la finalidad de determinar si esta acumulación de metales provoca eventualmente anomalías morfológicas en su desarrollo. Los individuos fueron puestos en contacto con placas de plomo, arseniato de sodio, agua de la red de abastecimiento de agua de consumo público (grupos experimentales) y con agua potable (grupo control). Los organismos fueron inspeccionados de manera externa para identificar anomalías macroscópicas, además de realizarles análisis morfométricos. Los análisis espectroquímicos (espectrofotometría de absorción atómica, con la técnica de horno de grafito) mostraron que hay un proceso de bioconcentración y bioacumulación de metales cuando los organismos están en contacto con estos metales y con agua de la red de abastecimiento público, la cual está contaminada también, pues se detectaron cantidades altas de metales en los tejidos de las larvas. Respecto a la morfometría hubo diferencias significativas en algunas estructuras entre el grupo control y los grupos experimentales en X. laevis. En L. berlandieri fueron detectadas anomalías macroscópicas como curvatura de la cola, problemas de pigmentación, protuberancias en el abdomen e inadecuada posición de los intestinos en aquellos individuos que estuvieron en contacto con estos metales pesados. (AU)

Currently, there is growing concern as some amphibian species have shown a decline in their populations due to various factors, including heavy metals; for this reason, it is important to carry out studies on this environmental problem. The objective of this study was to determine the amount of lead and arsenic concentrated in the tissues of the African clawed frog (Xenopus laevis) in the juvenile stage and the Leopard frog (Lithobates berlandieri) in the larval stage and in the water after 16 weeks exposed to lead plates and sodium arsenate, in order to determine if this accumulation of metals eventually causes morphological abnormalities in their development. The individuals were placed in contact with lead plates, sodium arsenate, water from the public water supply network (experimental groups) and with drinking water (control group). The organisms were externally inspected to identify macroscopic anomalies, in addition to performing morphometric analysis. The spectrochemical analyzes (atomic absorption spectrophotometry, with the graphite furnace technique) showed that there is a process of bioconcentration and bioaccumulation of metals when the organisms are in contact with these metals and with water from the public supply network, which is also contaminated, since high amounts of metals were detected in the tissues of the larvae. Regarding morphometry, there were significant differences in some structures between the control group and the experimental groups in X. laevis. In L. berlandieri, macroscopic abnormalities such as curvature of the tail, pigmentation problems, protuberances in the abdomen and inappropriate position of the intestines were detected in those individuals that were in contact with these heavy metals. (AU)

[Seroprevalence of Toxoplasma gondii in students with occupational risk]. / Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS: Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Experimental data on developmental elimination of retrosplenial cortex GABAergic interneurons in a mouse model of ethanol exposure during the last trimester of human pregnancy.

It has been previously shown that 40% of murine cortical interneurons are eliminated via apoptosis during the first two weeks of postnatal development [1], [2], [3]. Here, we report data on the effect of ethanol exposure on this process in a mouse model of binge-like alcohol exposure during last trimester of human pregnancy (equivalent to the first postnatal week in mice). We used transgenic mice that express the Venus fluorescent protein in GABAergic interneurons under the control of the vesicular GABA transporter promoter (VGAT-Venus mice) [4]. Mice were exposed to air (controls) or ethanol for 4 hr/day on postnatal days 4 to 9 using vapor inhalation chambers [5]. This exposure paradigm produces peak blood ethanol concentrations between 300 and 400 mg/dl. Transcardial perfusions were performed under anesthesia at postnatal days 5, 7, 10 and 30. Cryostat-prepared floating sections were stained with the fluorescent DNA dye, 4'6-diamidino-2-phenylindole (DAPI). We then quantified the density of Venus-positive GABAergic interneurons in layers I, II-IV and V of the retrosplenial cortex, which is part of the limbic memory system [6], and is sensitive to ethanol-induced apoptosis during the first postnatal week in mice [7], [8], [9], [10], [11]. The data show that density of interneurons decreases in the retrosplenial cortex layers during the first week of life and that ethanol exposure does not significantly alter this process. These data may be of interest to investigators who are studying the effect of ethanol and other teratogenic agents on developing interneurons in the cerebral cortex.

Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional / Seroprevalence of Toxoplasma gondii in students with occupational risk

INTRODUCCIÓN: La toxoplasmosis es una enfermedad zoonótica cuyo contagio se produce por vía oral por ingestión de quistes al consumir carne contaminada o al tener contacto con heces de felinos contaminadas con ooquistes. Con menor frecuencia, se adquiere por transmisión vertical o por trasplante de órganos infectados. En Chile, existen estudios serológicos en personas sanas e inmunodeprimidas, pero no en grupos de riesgo ocupacional, como son los estudiantes de Medicina Veterinaria. OBJETIVO: Determinar la seroprevalencia para T. gondii en estudiantes de Medicina Veterinaria de una universidad ubicada en el centro-sur del país, y ver su asociación con variable intrínsecas. MÉTODOS. Se tomaron muestras de sangre a 74 estudiantes de una universidad del centro-sur de Chile. Se determinó la presencia de anticuerpos específicos clase IgG contra Toxoplasma gondii mediante la técnica de inmunoanálisis por quimioluminiscencia en fase solida secuencial. RESULTADOS. Del total de alumnos, 16 fueron seropositivos lo que equivale a 21,6%, el mayor número de estudiantes seropositivos fue de sexo femenino (75%), se encontraban en el rango etario entre 24 y 26 años de edad (43,7%), todos consumían carne y verduras (100%) y realizaban la recolección de heces de gatos sin protección 50 (68,7%). CONCLUSIONES. Los resultados obtenidos demuestran la presencia de anticuerpos contra T. gondii en alumnos de Medicina Veterinaria. Según el conocimiento de los autores, es el primer estudio serológico para toxoplasmosis realizado en estudiantes universitarios de Medicina Veterinaria en Chile.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS. Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Caracterización clínica y microbiológica de pacientes con trazas en Xpert MTB/RIF Ultra / Clinical and microbiological characterization of patients with Xpert MTB/RIF Ultra traces

INTRODUCCIÓN: El Xpert MTB/RIF Ultra (Ultra) ha mejorado dramáticamente el diagnóstico de la tuberculosis (TBC). Con él ha nacido la categoría de trazas, que es la menor carga bacilar detectable por este examen. OBJETIVO: Describir las características clínicas de los pacientes con presencia de trazas en el Ultra y evaluar la confirmación de la TBC como diagnóstico clínico. MATERIALES Y MÉTODOS: Estudio descriptivo de serie de casos. Se extrajo la información de fichas clínicas de pacientes con positividad a trazas. Se confrontaron datos clínicos, microbiológicos e histopatológicos. RESULTADOS: Se analizaron 21 pacientes. La edad promedio fue de 52 años. Todos los casos presentaron baciloscopias negativas. Cuatro cultivos en medio líquido MGIT fueron positivos, dos en pleura parietal, uno en líquido pleural y otro en expectoración. En pleura parietal, tres casos presentaron granulomas con necrosis caseosa y un granuloma esbozos de necrosis. En tejido pulmonar se observaron dos casos con granulomas con esbozos de necrosis y dos con granulomas no necrotizantes. Tres pacientes tenían el antecedente de TBC previa, se interpretó la positividad de trazas en ellos como falsos positivos. Finalmente se diagnosticaron 13 casos como TBC activa, donde cinco de ellos fueron TBC pleurales. La mayor concordancia clínica, microbiológica e histopatológica fue en muestras de líquido y tejido pleural. DISCUSIÓN: Se debe interpretar con cautela los hallazgos de esta prueba en muestras de vía aérea; el análisis multidisciplinario (clínica, imágenes, microbiología, histología) es crucial en las decisiones de nuestras conductas clínicas futuras. El hallazgo de trazas en pleura tiene, a nuestro parecer, un alto valor diagnóstico en el estudio de la tuberculosis en esta localización.

INTRODUCTION: Xpert MTB/RIF Ultra has dramatically changed the diagnosis of tuberculosis. A new category called traces appeared, which is the smallest amount of bacillar load detectable. OBJECTIVE: Describe the clinical characteristics of patients that present traces in Xpert MTB/RIF Ultra test, and to evaluate the confirmation of tuberculosis as clinical diagnosis. METHODS: We perform a descriptive case series study. Information was recovered from clinical records of patients with positive test for traces. Clinical, histopathological and microbiological results were confronted. RESULTS: Twenty one patients were analyzed. The mean age was 52 years-old. All cases had negative smear microscopy and four MGIT cultures were positive, two in pleural fluid and another in sputum. In parietal pleura, three cases presented granulomas with caseous necrosis, and one showed granuloma with very little necrosis. In pleural tissue we observed two cases of granulomas with traces of necrosis and two with non-necrotizing granulomas. Three patients had history of previous tuberculosis and positive traces, the test was interpreted as a false positive result. Finally, active tuberculosis was diagnosed in 13 cases, and five of them were pleural tuberculosis. The highest clinical, microbiological and histopathological agreement was in fluid and pleural tissue samples. DISCUSSION: The findings of Xpert MTB/RIF Ultra in airway samples must be interpreted carefully. Multi-disciplinary analysis is crucial in future clinical decisions. The finding of traces in pleura has, in our opinion, a high diagnostic value in the study of tuberculosis in this location.

"A man without money getting a sexual partner? It doesn't exist in our community": male partners' perspectives on transactional sexual relationships in Uganda and Eswatini.

Research on transactional sexual relationships has largely focused on women's perspectives. Better understanding the men's views-especially regarding relationships with adolescent girls and young women-can inform HIV prevention efforts. In 2017, 134 in-depth interviews were conducted with the male partners of girls and young women aged 19-47 years, 94 in Uganda and 40 in Eswatini. Respondents were recruited at venues such as bars where men and potential partners meet and through other young women. Most respondents believed that providing money/gifts was the way to establish relationships with women in their communities, a context that some found undesirable. Young women were mainly perceived as actively pursuing transactional sex for material goods, but respondents also described economically impoverished women who were manipulated into relationships. Men described conflict with longer term partners as a driver to seeking younger partners, who were more compliant. Transaction dominates the male partners of adolescent girls and young women's understanding of sexual relationships, and inequitable power dynamics are reinforced by seeking younger partners. However, some respondents' discontent with this dynamic suggests an opportunity for change. HIV prevention programmes should directly address the underlying drivers of transactional relationships (e.g. gender norms) and work with men who question the practice.

Idiopathic granulomatous mastitis: experience at a New York hospital.

INTRODUCTION: Idiopathic granulomatous mastitis (IGM) often mimics breast cancer. Presentation includes pain, palpable mass, suppuration or suspicious imaging. Widely reported in Asia and the Middle East, IGM is diagnosed after excluding specific granulomatous mastitis (SGM). Aetiology remains unknown. Lactation, prolactinaemia, ethnicity, autoimmune disease and Corynebacteria are associated. Treatment is controversial and the prevalence rising. Surgery and non-operative treatments including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, methotrexate and observation have advocates. METHODS: A retrospective chart review of 63 patients with IGM from 2008 to 2018 was undertaken focusing on birthplace, age, clinical presentation, wound cultures, imaging, treatments and outcomes. RESULTS: Sixty-one of 63 patients were Hispanic; 53 were Mexican-born women aged 23-46. Clinical presentation included pain, painful mass, painless mass, suppuration and abnormal imaging. Some 31/61 ultrasound examinations and 17/33 mammograms were deemed Breast Imaging Reporting and Data System (BI-RADS) score 4 or 5. Management included antibiotics (43), incision and drainage (24), NSAIDs (29), steroids (8), lumpectomy (18) and observation (12). Some 12/20 patients with painless masses resolved with observation, 3 received NSAIDs, 2 received steroids and 3 underwent lumpectomies. Antibiotics resolved 8/43 cases, 5 needed incision and drainage, 26 received NSAIDs, 6 received steroids and 5 underwent lumpectomies. Nineteen patients had indolent disease or recurrence. CONCLUSIONS: Excluding malignancy is critical, treatment challenging and recurrence common in IGM. A preponderance of patients were Mexican-born, similar to other reports from the USA. Over 50% of IGM cases had suspicious BI-RADS scores. Best management remains a challenge and ranges from observation to lumpectomy.

Interstitial disease associated with connective tissue disease and vasculitis.

Systemic autoimmune diseases comprise a complex, heterogeneous group of entities. Noteworthy among the pulmonary complications of these entities is interstitial involvement, which manifests with the same radiopathologic patterns as in idiopathic interstitial pneumonia. High-resolution computed tomography is the gold-standard imaging technique; it enables us to identify and classify the disease and to determine its extent, providing useful information about the prognosis. In this group of processes, the most common pattern of presentation is nonspecific interstitial pneumonia. It is essential for radiologists to work together in collaboration with other specialists to reach the correct diagnosis and enable appropriate, integrated treatment.