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Type of feeding during early life influences growth trajectory and metabolic risk at later ages. Modifications in infant formula composition have led to evaluate their effects on growth and energetic efficiency (EE) compared with breast-feeding. Main goal was to analyse type of feeding potential effects during first months of life, plus its EE, on growth patterns in healthy formula fed (standard infant formula (SF) vs. experimental infant formula enriched with bioactive nutrients (EF)) and breastfed (BF) infants participating in the COGNIS RCT (http://www.ClinicalTrials.gov, Identifier: NCT02094547) up to 18 months of age. Infants follow-up to 18 months of age (n 141) fed with a SF (n 48), EF(n 56), or BF (n 37), were assessed for growth parameters using WHO standards. Growth velocity (GV) and catch-up were calculated to identify growth patterns. EE of breast milk/infant formula was also estimated. Infants' growth at 6 months showed higher length and lower head circumference gains in SF and EF infants than BF infants. Both weight-for-length and weight-for-age catch-up growth showed significant differences in formula fed groups compared with the BF. No significant differences in GV or catch-up were found at 6-12 and 12-18 months. Regarding EE, infant formula groups showed significantly lower weight and length gains/g of milk protein, and higher weight and length gains/g of milk lipids, than the BF infants. GV during first 6 months, which may be influenced by feeding, seems to be the main predictor of subsequent growth trajectory. Breast-feeding may have positive effects on growth programming due to its nutrients' EE.

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BACKGROUND: Hemoglobin is a rich source of biologically active peptides, some of which are potent antimicrobials (hemocidins). A few hemocidins have been purified from the midgut contents of ticks. Nonetheless, how antimicrobials are generated in the tick midgut and their role in immunity is still poorly understood. Here we report, for the first time, the contribution of two midgut proteinases to the generation of hemocidins. RESULTS: An aspartic proteinase, designated BmAP, was isolated from the midgut of Rhipicephalus (Boophilus) microplus using three chromatographic steps. Reverse transcription-quantitative polymerase chain reaction revealed that BmAP is restricted to the midgut. The other enzyme is a previously characterized midgut cathepsin L-like cysteine proteinase designated BmCL1. Substrate specificities of native BmAP and recombinant BmCL1 were mapped using a synthetic combinatorial peptide library and bovine hemoglobin. BmCL1 preferred substrates containing non-polar residues at P2 subsite and polar residues at P1, whereas BmAP hydrolysed substrates containing non-polar amino acids at P1 and P1'. CONCLUSIONS: BmAP and BmCL1 generate hemocidins from hemoglobin alpha and beta chains in vitro. We postulate that hemocidins may be important for the control of tick pathogens and midgut flora.

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INTRODUCTION: Sacral fractures are uncommon injuries; published cases constitute less than 1% of all the spinal fractures. The vertical sacral fractures are more common. Based on Denis's classification for sacral fractures, those that present on area III, transverse, are still the less frequent ones and they are associated in 57% to a neurological deficit. They are link with high energy trauma. A delay in diagnosis and treatment can lead to neurologic deterioration and pain. CASE PRESENTATION: A 16-years-old boy fell from a moving vehicle, and suffered direct trauma to the dorsal and sacral region. He was initially assisteed in a second level hospital unit for lumbar pain, inability to walk and was unable to urinate; 4 days later to the accident he was transferred to our institution where we carried out diagnostic protocol finding a high transverse displaced fracture at S2 level with associated neurological deficit. We carried out surgical procedure, which consisted on open reduction, with a posterior approach, descompressive laminectomy and fixation with dynamic compression plate (D.C.P.) 4.5 mm in diameter. Six weeks after the surgical procedure the patient was able to walk with partial support, clear improvement in strength and sphincter control. DISCUSSION: Transverse fractures of the sacrum are uncommon fractures; still in trauma centers the experience is limited. At the moment there is no consensus between conservative or surgical tretment modalities according the type of sacral fracture. CONCLUSION: Today's evidence suggests that consideration must be taken on the risk of a neurological lesion associated through the surgical stabilization in comparison to the stability of the fracture site.

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Background: The prevalence of Chlamydia pneumoniae infection varies according to the population and geografic area studied. Aim: To evaluate the incidence of Chlamydia pneumoniae infection in Chilean subjects with community acquired pneumonia. Patients and methods: Between 1995 and 1997, patients with community acquired pneumonia attending two emergency rooms in Santiago, were studied. The diagnosis of Chlamydia pneumoniae infection was based on the detection of Chlamydia pneumoniae specific IgG antibody in samples from both the acute and convalescent phase, using an indirect microimmunofluorescent technique. Evidence of present infection was defined as seroconversion, a significant increase in the titer of the second sample and an initial titer equal or greater than 1/512. Results: During the study period, 160 patients consulted and seven (six male), aged 54ñ27 years old, complied with the diagnostic criteria of present Chlamydia pneumoniae infection. These patients had no special clinical or radiological features. Five of seven patients improved without any specific treatment. Conclusions: Eight percent of this sample of patients with community acquired pneumonia had Chlamydia pneumoniae infection. This agent should be included in the design of empiric treatment schemes, although our results cast doubt on the pathogenic role of Chlamydia pneumoniae in pneumonia

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Investigamos retrospectivamente la presencia de Legionella pneumonophila mediante la técnica de inmunofluorescencia directa (IFD) para detección de antígenos polivalentes (Organon Teknika) en 50 muestras almacenadas de lavado broncoalveolar (LBA). La IFD fue realizada ignorando los datos clínicos de los pacientes, 64 porciento de los cuales habían tenido una neumonía, de acuerdo a criterios clínicos, radiológicos y microbiológicos. La IFD fue positiva en dos muestras. El primero fue un varon de 44 años, con un cuadro clínico de neumonía adquirida en la comunidad, tratada por tres días con penicilina sódica sin resultados. El estudio corriente de LBA no fue diagnóstico. Se trató con roxitromicina, con buena respuesta clínica y radiográfica. El segundo corresponde a un varón de 45 años, con rechazo agudo de transplante renal que desarrolló una neumonía fulminante que lo llevó a la muerte, pese a un tratamiento antimicrobiano de amplio espectro, que incluía eritromicina. Concluímos que en nuestro medio existen neumonías graves por L. pneumophila que pueden ser detectadas mediante IFD de LBA, método que es altamente específico

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Torulopsis glabrata representa al 5,5% de las levaduras aisladas de muestras clínicas en el laboratorio de microbiología del Centro Diagnóstico de la Pontificia Universidad Católica de Chile. Ocupa el segundo lugar después de Candida albicans. Se localiza preferentemente a nivel del tracto genitourinario, pero en ocasiones, puede ser agente de septicemias, en especial en pacientes inmunocomprometidos. El estudio de sensibilidad muestra excelente actividad de nistatina (S=100%) y anfotericin B (S=96,6%), buena acción de la 5-fluocitosina (S=90%) y alta resistencia del clotrimazol (S=16%)

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