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Enteric diseases affect poultry and cause important economic losses in many countries worldwide. Avian parvovirus has been linked to enteric conditions, such as malabsorption and runting-stunting syndrome (RSS), characterized by diarrhoea, and reduced weight gain and growth retardation. In 2013 and 2016, 79 samples were collected from different organs of chickens in Ecuador that exhibited signs of diarrhea and stunting syndrome, and analysed for the presence of chicken parvovirus (ChPV). The detection method of ChPV applied was Polymerase Chain Reaction (PCR), using primers designed from the conserved region of the viral genome that encodes the non-structural protein NS1. Out of the 79 samples, 50.6% (40/79) were positive for ChPV, and their nucleotide and amino acid sequences were analysed to determine their phylogenetic relationship with the sequences reported in the United States, Canada, China, South Korea, Croatia, Poland, Hungary, and Brazil. Strong similarity of nucleotide and amino acid sequences among all analyzed sequences and between the analysed and reference sequences was demonstrated, and the phylogenetic analysis clustered all the sequences within the same group, demonstrating a strong relation between the studied strains and the reference chicken parvovirus strains.

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Enteric diseases affect poultry and cause important economic losses in many countries worldwide. Avian parvovirus has been linked to enteric conditions, such as malabsorption and runting-stunting syndrome (RSS), characterized by diarrhoea, and reduced weight gain and growth retardation. In 2013 and 2016, 79 samples were collected from different organs of chickens in Ecuador that exhibited signs of diarrhea and stunting syndrome, and analysed for the presence of chicken parvovirus (ChPV). The detection method of ChPV applied was Polymerase Chain Reaction (PCR), using primers designed from the conserved region of the viral genome that encodes the non-structural protein NS1. Out of the 79 samples, 50.6% (40/79) were positive for ChPV, and their nucleotide and amino acid sequences were analysed to determine their phylogenetic relationship with the sequences reported in the United States, Canada, China, South Korea, Croatia, Poland, Hungary, and Brazil. Strong similarity of nucleotide and amino acid sequences among all analyzed sequences and between the analysed and reference sequences was demonstrated, and the phylogenetic analysis clustered all the sequences within the same group, demonstrating a strong relation between the studied strains and the reference chicken parvovirus strains.(AU)

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This study determined the presence of Tremovirus A as the possible agent related to Avian Encephalomyelitis in broiler chicks from the states of São Paulo (SP) Paraná (PR), Goiás (GO), Santa Catarina (SC) and Rio Grande do Sul (RS), between the years 2006 and 2015. Samples of the nervous, digestive, respiratory, immune, and renal systems, plus muscular organs from broiler chicks with neurological problems such as ataxia and muscle tremors, and four (4) commercial vaccines as positive control, were tested by reverse-transcriptase (RT-PCR) amplification and DNA sequencing. A highly conserved region (P1) of the viral genome, was used to amplify a segment which encodes a structural protein VP4. Out of 112 samples, 46 were positive (42%) for Tremovirus A, that was identified in the nervous, digestive, respiratory, renal and immune systems. The phylogenetic analysis clustered together the nucleotide sequences of the 46 samples, the four commercial vaccine strains and the reference sequence of Calnek strain obtained from the GenBank. According to these results, we conclude that the presence of Tremovirus A in these Brazilian chicken flocks distributed in all states was due to flaws in the biosecurity measurements.

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This study determined the presence of Tremovirus A as the possible agent related to Avian Encephalomyelitis in broiler chicks from the states of São Paulo (SP) Paraná (PR), Goiás (GO), Santa Catarina (SC) and Rio Grande do Sul (RS), between the years 2006 and 2015. Samples of the nervous, digestive, respiratory, immune, and renal systems, plus muscular organs from broiler chicks with neurological problems such as ataxia and muscle tremors, and four (4) commercial vaccines as positive control, were tested by reverse-transcriptase (RT-PCR) amplification and DNA sequencing. A highly conserved region (P1) of the viral genome, was used to amplify a segment which encodes a structural protein VP4. Out of 112 samples, 46 were positive (42%) for Tremovirus A, that was identified in the nervous, digestive, respiratory, renal and immune systems. The phylogenetic analysis clustered together the nucleotide sequences of the 46 samples, the four commercial vaccine strains and the reference sequence of Calnek strain obtained from the GenBank. According to these results, we conclude that the presence of Tremovirus A in these Brazilian chicken flocks distributed in all states was due to flaws in the biosecurity measurements.(AU)

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Resumen La endosonografía nació hace más de 30 años como parte de las modalidades diagnósticas de patologías benignas y malignas del tracto gastrointestinal. En los últimos años se ha demostrado la eficacia y seguridad superior de la biopsia con aguja fina de las glándulas suprarrenales por vía transgástrica (izquierda) o tranduodenal (derecha) guiadas por endosonografía, en comparación con los abordajes percutáneos guiados por tomografía axial computarizada (TAC) o ecografía. Uno de los diagnósticos diferenciales de insuficiencia suprarrenal con evidencia de masas en glándulas suprarrenales es la paracoccidioidomicosis, a pesar de ser una entidad de presentación exclusiva de las áreas geográficas de Latinoamérica, donde se encuentra su agente etiológico. Se presenta un caso de paciente con paracoccidioidomicosis con insuficiencia suprarrenal y engrosamiento adrenal bilateral, cuyo diagnóstico se logró mediante biopsia transgástrica de glándula suprarrenal izquierda guiada por endosonografía.

Abstract Endosonography, born more than 30 years ago, is one diagnostic modality for benign and malignant pathologies of the gastrointestinal tract. In recent years, transgastric (left) or transduodenal (right) fine needle biopsies of the adrenal glands guided by endosonography has been demonstrated to be safer and more efficacious than percutaneous approaches guided by CT or ultrasound. Differential diagnoses of adrenal insufficiency with evidence of masses in adrenal glands must consider paracoccidioidomycosis despite the fact that it is exclusively present in Latin America where its etiological agent is found. We present a case of paracoccidioidomycosis with adrenal insufficiency and bilateral adrenal thickening whose diagnosis was achieved by transgastric biopsy of the left adrenal gland guided by endosonography.

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SETTING: Mexico City, Mexico. OBJECTIVE: To identify proteins synthetised by Mycobacterium tuberculosis in hypoxic culture, which resemble more closely a granuloma environment than aerobic culture, and to determine if they are recognised by antibodies from patients with active pulmonary tuberculosis (PTB). DESIGN: Soluble extracts from M. tuberculosis H37Rv cultured under aerobic or hypoxic conditions were analysed using two-dimensional polyacrylamide gel electrophoresis, and proteins over-expressed under hypoxia were identified by mass spectrometry. The presence of immunoglobulin (Ig) G, IgA and IgM antibodies against these proteins was determined in the serum of 42 patients with active PTB and 42 healthy controls. RESULTS: We selected three M. tuberculosis H37Rv proteins (alpha-crystallin protein [Acr, Rv2031c], universal stress protein Rv2623 and isocitrate lyase [ICL, RV0467]) that were over-expressed under hypoxia. Titres of anti-Acr and anti-ICL IgA antibodies were higher in patients than in healthy controls, with an area under the receiver operating characteristic curve of 0.71 for anti-ICL IgA antibodies. CONCLUSION: ICL could be used in combination with other M. tuberculosis antigens to improve the sensitivity and specificity of current serological TB diagnostic methods.

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Folate is an essential nutrient because mammals lack biological activity to synthesize. It different factors generate folate deficiency. Recent studies have identified that the C677T variant of the enzyme methylene tetrahydrofolate reductase (MTHFR), can play a role in serum folate concentrations (SFC) and red cell folate (RCF). The aim of this rewiev was to actualice some generalities of folate metabolism, factors related to its deficiency biochemical indicators used to assess the nutritional status of folate and role of the C677T polymorphism of the MTHFR enzyme on the cycle of folate and methionine. It is necessary to design studies with representative samples corroborating the effect of polymorphisms on biochemical indicators of nutritional status of folate and determine the dose-response effect and contribute to modify the nutritional recommendations with the necessary scientific evidence.

El folato es un nutriente esencial porque los mamíferos carecen de actividad biológica para sintetizarlo. Diferentes factores generar deficiencia de folato. Estudios recientes han identificado que la variante C677T de la enzima metilen tetrahidrofolato reductasa (MTHFR), puede jugar un papel en las concentraciones de folato sérico (FS) y eritrocitario (FE). El objetivo de este trabajo fue revisar algunas generalidades del folato, su metabolismo, los factores relacionados con su deficiencia, los indicadores bioquímicos utilizados para evaluar el estado nutricional del folato y el papel del polimorfismo C677T de la enzima MTHFR sobre el ciclo del folato y de la metionina. Es necesario diseñar estudios con muestras representativas que corroboren el efecto de los polimorfismos sobre los indicadores bioquímicos del estado nutricional del folato y determinar el efecto dosis-respuesta y así contribuir con la evidencia científica necesaria para modificar las recomendaciones nutricionales.

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Avian Infectious laryngotracheitis (AILT) is a respiratory tract disease of great importance because it causes significant economic losses in the poultry industry around the world. It is caused by a Gallid herpesvirus type 1, a member of the genus Iltovirus. The target system for Avian Infectious Laryngotracheitis virus (AILTV) infections is the respiratory system, and the main organ in which the virus remains latent is the trigeminal ganglia. However, the virus has demonstrated tropism for other organs besides the respiratory tract. The main transmission routes are ocular and respiratory. Infected birds with clinical symptoms are main sources of transmission, but birds with latent infections, litter, and contaminated fomites may also transmit the virus. Clinical signs usually appear 6-12 days after natural exposure and may be moderate or severe. The causative agent of this disease can be propagated in chorioallantoic membrane (CAM) of developing chicken embryos and replicate in mature chicken kidney cells, as well as in a variety of epithelial chick embryo cells, such as kidneys, liver and lungs. There are several procedures for the diagnosis of ILT such as the observation of clinical signs, the detection of gross and histopathological lesions, and the use of molecular techniques, including RFLP, polymerase chain reaction (PCR), real-time PCR, and loop-mediated isothermal amplification. Vaccination with different types of vaccine provides a good expectation on disease control, such as vaccines produced in chicken-embryo-origin (CEO), tissue-culture-origin (TCO), and recombinant vaccines. However, in endemic areas, biosecurity measures and best management practices are important for the control of the disease. It is distributed worldwide and, in South America, it has been reported in Brazil, Peru, Ecuador, Bolivia, and Argentina causing great economic losses.

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Avian Infectious laryngotracheitis (AILT) is a respiratory tract disease of great importance because it causes significant economic losses in the poultry industry around the world. It is caused by a Gallid herpesvirus type 1, a member of the genus Iltovirus. The target system for Avian Infectious Laryngotracheitis virus (AILTV) infections is the respiratory system, and the main organ in which the virus remains latent is the trigeminal ganglia. However, the virus has demonstrated tropism for other organs besides the respiratory tract. The main transmission routes are ocular and respiratory. Infected birds with clinical symptoms are main sources of transmission, but birds with latent infections, litter, and contaminated fomites may also transmit the virus. Clinical signs usually appear 6-12 days after natural exposure and may be moderate or severe. The causative agent of this disease can be propagated in chorioallantoic membrane (CAM) of developing chicken embryos and replicate in mature chicken kidney cells, as well as in a variety of epithelial chick embryo cells, such as kidneys, liver and lungs. There are several procedures for the diagnosis of ILT such as the observation of clinical signs, the detection of gross and histopathological lesions, and the use of molecular techniques, including RFLP, polymerase chain reaction (PCR), real-time PCR, and loop-mediated isothermal amplification. Vaccination with different types of vaccine provides a good expectation on disease control, such as vaccines produced in chicken-embryo-origin (CEO), tissue-culture-origin (TCO), and recombinant vaccines. However, in endemic areas, biosecurity measures and best management practices are important for the control of the disease. It is distributed worldwide and, in South America, it has been reported in Brazil, Peru, Ecuador, Bolivia, and Argentina causing great economic losses.(AU)

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Chicken astrovirus (CAstV) is one of many viruses related to enteric diseases in poultry that are associated with Runting-Stunting Syndrome (RSS), which affects young chickens. CAstV was also recently associated with an unusual condition in chicks called "white chicks." Some hatcheries in certain states of Brazil have reported several incubation problems, mortality, and the presence of chicks with white plumages over the past several months. These chicks were termed locally as "white chicks." The present work investigated 30 chicks with this unusual condition using a multidisciplinary approach. Postmortem examination of each chick showed enlarged livers and intestines that were full of liquid and gas (30/30). The pancreas, kidneys, and spleen were pale (30/30). The other organs did not show any macroscopic alterations. CAstV, chicken parvovirus (ChPV), avian nephritis virus (ANV), avian rotavirus (ARtV), avian reovirus (AReoV), infectious bronchitis virus (IBV), and fowl adenovirus group I (FAdV-1) were tested in the intestines, pancreas, proventriculus, gizzard, liver, spleen, bursa, kidneys, thymus, lung, heart, brain, and yolk sac in each chick. All organs and yolk sacs were positive for CAstV in different titres and negative for the other tested viruses. The partial molecular characterization of the ORF 1b gene of CAstV using 28 sequences revealed a high similarity of the nucleotides and amino acids with sequences of CAstV from North America, Europe, and Asia, and our CAstV sequences clustered into a unique group that was separate from the other sequences. These results demonstrated that CAstV was associated with the white chick condition in Brazil. The virus was distributed in most organs, including the brain and yolk sac. These results suggest that the virus could be transmitted vertically. The molecular characterization also revealed that the CAstV associated with white chick condition was molecularly related to other CAstV sequences found worldwide.

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Enteric disorders are an important cause of economic losses in broiler chickens worldwide. Several agents have been associated with enteric problems, such as viruses, bacteria, and parasites. In this study, broiler chickens showing signs of enteric disorders were subjected to molecular diagnosis for several viral agents and also for pathological examination for elucidating this problem. Thus, the chickens were screened for avian nephritis virus (ANV), chicken astrovirus (CAstV), avian rotavirus (ArtV), avian reovirus (AReoV), infectious bronchitis virus (IBV), fowl adenovirus group I (FAdV-1), and chicken parvovirus (ChPV). Postmortem examinations revealed a curving of the duodenal loop (J-like appearance) and intestines filled with liquid and gaseous content. Histopathological analysis of the duodenal loop showed pancreatic atrophy, acute mesenteritis, and enteritis. PCR results showed that ChPV was the sole viral agent detected in samples with lesions such as the curved duodenal loop and pancreatic atrophy. Molecular characterization of the nucleotide and deduced amino acid sequences revealed a high similarity with other strains of ChPV from Brazil, Canada, United States, Europe, and Asia. These findings suggest an association between ChPV and the development of enteritis, pancreatitis, and pancreatic atrophy, which may lead to curling of the duodenal loop. Together, these alterations may disrupt the normal functioning of the digestive system, diminishing digestion and the absorption of dietary nutrients and consequently leading to reduced weight gain, flock impairment, dwarfism, and an elevated feed conversion rate.

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Iron deficiency is the most common type of nutritional deficiency in the world, and calcium intake is low in many populations. Developing a supplement that contains both micronutrients would be an excellent method to prevent iron deficiency and increase calcium intake. Human and cellular studies have shown that calcium inhibits iron absorption. Currently, the mechanisms underlying this inhibitory effect have not been elucidated. Because calcium is involved in cell signaling pathways, it may affect the regulation of the expression or localization of proteins involved in iron uptake and efflux in enterocytes. The aim of this review was to describe the processes involved in the absorption of dietary iron and the regulation of the expression and activity of proteins involved in this absorption. Additionally, the potential mechanisms by which calcium affects the expression and localization of these proteins are also discussed.

La deficiencia de hierro es la deficiencia nutricional más común en el mundo y la ingesta de calcio es baja en la mayoría de poblaciones. El desarrollo de un suplemento que contenga ambos micronutrientes sería una excelente estrategia para prevenir la deficiencia de hierro y aumentar la ingesta de calcio. Estudios en humanos y en células han demostrado que el calcio inhibe la absorción del hierro. Actualmente los mecanismos que explican este efecto inhibitorio no están claramente dilucidados. Dado que el calcio está implicado en la señalización celular, podría afectar la regulación de la expresión y localización de proteínas implicadas en la captación y eflujo de hierro en los enterocitos. El objetivo de esta revisión es describir los procesos implicados en la absorción del hierro dietario y la regulación de la expresión y actividad de las proteínas implicadas en esta absorción. Además, se discutirán los posibles mecanismos por los cuales el calcio afecta la expresión y localización de esas proteínas.

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Objective. To detect the presence of specific antibodies against Hepatitis E virus (HEV) in pigs slaughtered in Antioquia, the department where the greatest amount of pork is produced and consumed in Colombia. Materials and methods. Between September 2011 and May 2012, blood samples from pigs were obtained in five slaughterhouses of Antioquia, four of them located in the Aburrá Valley subregion and other located in northern subregión. Serum were evaluated with a commercial ELISA kit for diagnosing HEV in humans but adapted to detect IgG and IgM antibodies in pigs. Results. A 100.0% seropositivity for IgG antibodies was found in 1000 samples evaluated, and 82.06% for IgM antibodies were found in 740 samples. Conclusions. These results indicate that pigs in slaughter age in Antioquia, and possibly in Colombia, have been exposed to HEV at some point in their production process and a high percentage of them can arrive to slaughterhouses with recent infection.

Objetivo. Detectar la presencia de anticuerpos específicos contra el virus de la Hepatitis E (HEV) en cerdos faenados en Antioquia, departamento donde se produce y consume la mayor cantidad de carne de cerdo en Colombia. Materiales y métodos. Entre septiembre de 2011 y mayo de 2012, se obtuvieron muestras de sangre de cerdos en cinco plantas de faenado, cuatro de ellas ubicadas en el Valle de Aburrá y una en la subregión Norte del departamento de Antioquia, las cuales fueron evaluadas mediante un kit de ELISA comercial para diagnóstico de HEV en humanos pero adaptado para la detección de anticuerpos tipo IgG e IgM en cerdos. Resultados. Se encontró una seropositividad de 100.0% para anticuerpos tipo IgG en 1000 muestras evaluadas y de 82.06% para anticuerpos tipo IgM en 740 muestras. Una muestra de heces positiva para la detección del genoma HEV es similar al genotipo 3 encontrada en Estados Unidos. Conclusiones. Estos resultados indican que los cerdos en edad de faenado en Antioquia y posiblemente en Colombia, han tenido exposición a HEV del, un virus zoonótico emergente a nivel mundial, en algún momento de su proceso productivo.

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Objetivo: Identificar la situación que presentan las personas con factores de riesgo cardiovascular respecto a la adherencia terapéutica, y conocer la relación de esta conducta con el control de dichos factores. Método: Estudio de tipo cuantitativo y transversal. La muestra estuvo constituida por 257 personas con diagnóstico de hipertensión arterial, diabetes mellitus tipo 2 y dislipidemias. Para recolectar los datos se revisó la ficha clínica y se utilizó un cuestionario, y la Escala de Conductas en Salud, para medir adherencia terapéutica. Para procesar los datos se utilizó el programa SPSS v15.0; se usaron medidas de tendencia central y de dispersión; para evaluar la asociación entre variables se recurrió a la t de Student. Resultados: La Escala de Conductas en Salud reflejó la baja adherencia de la muestra, ya que solo 4 (1.5%) personas obtuvieron el puntaje máximo, es decir, que siempre siguen las indicaciones entregadas por el equipo de salud. Se encontró que solo el 22.6% tenía controlada la enfermedad. Se encontraron asociaciones estadísticamente significativas entre el control integral de los factores de riesgo estudiados con la escala global de la Escala de Conductas en Salud, y las subescalas Seguimiento de la dieta y Seguimiento de las actividades prescritas. Conclusiones: El control de los factores de riesgo cardiovascular constituye un complejo conjunto de interacciones, en el cual la adherencia terapéutica puede ser solamente uno de los factores relacionados con él, y por esta razón pueden existir otras variables que influyen en el control de estas enfermedades.

Objective: To identify the situation of persons with cardiovascular risks in relation to their therapeutic compliance, and establish the association of this conduct with the control of those risks. Method: Quantitative and transversal study. The sample included 257 persons diagnosed with arterial hypertension, diabetes mellitus type 2, and dyslipidemia. In order to estimate the therapeutic compliance, data were collected through the clinical history, a questionnaire, and a health behavior scale. Data were processed with SPSS v15.0. Central tendency and dispersion measures were used, and the Student's t test was used to estimate the variables association. Results: The health behaviors scale used showed an overall low-therapeutic-compliance level among the participants. Only 4 individuals (1.5%) obtained the maximum score (absolute compliance with the instructions given by the health team). It was also found that only 22.6% in the sample monitored their condition. Statistically significant associations were found between the control of the studied risk factors measured by the global health behaviors scale and the sub-scales of "following the diet" and "following prescribed activities". Conclusions: The control of cardiovascular risk factors implies a set of complex interactions of which therapeutic compliance is probably just one more. In other words, there could also be other variables which have an impact on the control of these illnesses.

Objetivo: Identificar a situação que apresentam as pessoas com fatores de risco cardiovascular referente à aderência terapêutica, e estabelecer a relação dessa conduta com o controle dos fatores. Método: Estudo de tipo quantitativo e transversal. A amostra foi constituída por 257 pessoas com diagnóstico de hipertensão arterial, diabetes mellitus tipo 2 e dislipidemias. Para a coleta de dados revisou-se a ficha clínica e utilizou-se um questionário, bem como a Escala de Condutas em saúde para medir a aderência terapêutica. Para o processamento de dados utilizou-se o programa SPSS v15.0, usaram-se medidas de tendência central e de dispersão, para avaliar a associação entre as variáveis, precisou-se da t de Student. Resultados: A Escala de Condutas em saúde e as subescalas "Continuação da dieta" e "continuação das atividades prescritas". Conclusões: O controlo dos fatores de risco cardiovascular constitui um complexo conjunto de interações no qual, a aderência terapêutica pode ser apenas um dos fatores relacionados com ele, e por esta razão podem existir outras variáveis que influenciam no controlo destas doenças.

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1. The presence of parvovirus in chickens with enteric disease was investigated in commercial flocks in Brazil. 2. The intestinal contents of chickens exhibiting clinical signs of diarrhoea, weight loss or mortality were examined, and chicken parvovirus (chPV) was identified using a polymerase chain reaction (PCR) assay. The samples were sequenced and inoculated into specific-pathogen-free (SPF) embryonated eggs to isolate the virus. 3. Necropsies showed that the embryos were dwarfish, haemorrhagic and oedematous. The presence of chPV was confirmed by PCR and DNA sequencing. 4. The molecular characterisation of chPV strains circulating in the Brazilian flocks showed that they were genetically related to sequences from North America, Europe and Asia. Phylogenetic analyses clustered the Brazilian chPV sequences with those from Europe (Croatia, Hungary) and Asia (South Korea). 5. This study is the first report of the molecular characterisation of chPV circulating in the commercial flocks in Brazil and indicates high genetic similarity with chPV sequences from around the world.

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Infectious laryngotracheitis is a very important respiratory disease because it causes significant economic losses in the poultry industry. The target of ILTV infections is the respiratory system, and the main organ in which the virus remains latent is the trigeminal ganglia. However, the virus has demonstrated tropism for other organs as well. The present study was conducted to determine the presence of Infectious Laryngotracheitis Virus (ILTV) in the state of São Paulo. Samples submitted to LABOR- USP during the last four years (2009-2013) analyzed by a nested/PCR technique. Out of the 682 samples from layers tested for LTIV, 12.46 % were positive, and derived from in both traditional (trachea and trigeminal ganglion) and untraditional (cecal tonsils, digestive tract and kidneys) organs utilized for ILTV diagnosis. The present work showed that ILTV is circulating in commercial layer flocks in São Paulo State, and that the LTIV is present in other organs in addition to the respiratory tract and trigeminal ganglion; however, it was not determined if the circulating virus is a vaccinal or field strain.

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Infectious laryngotracheitis is a very important respiratory disease because it causes significant economic losses in the poultry industry. The target of ILTV infections is the respiratory system, and the main organ in which the virus remains latent is the trigeminal ganglia. However, the virus has demonstrated tropism for other organs as well. The present study was conducted to determine the presence of Infectious Laryngotracheitis Virus (ILTV) in the state of São Paulo. Samples submitted to LABOR- USP during the last four years (2009-2013) analyzed by a nested/PCR technique. Out of the 682 samples from layers tested for LTIV, 12.46 % were positive, and derived from in both traditional (trachea and trigeminal ganglion) and untraditional (cecal tonsils, digestive tract and kidneys) organs utilized for ILTV diagnosis. The present work showed that ILTV is circulating in commercial layer flocks in São Paulo State, and that the LTIV is present in other organs in addition to the respiratory tract and trigeminal ganglion; however, it was not determined if the circulating virus is a vaccinal or field strain.(AU)

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This article aims to analyze, from a legal perspective, the boundaries of the obligation imposed on health care providers to inform the patient. This requirement originated and was developed as an ethical issue. However, with the newly approved law regulating the rights and duties of patients, the obligation to inform can be viewed from prisms and principles that differ from those governing medical ethics. With this purpose, we will focus on the comparative experience, which will allow us to evaluate the responsibility of health care providers when this duty is breached. We will try to answer the following questions: Which medical information must be informed to the patient? When should the doctor inform the patient? In which form should this information be provided?.

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Candida albicans causes opportunistic systemic infections with high mortality (30%-50%). Despite significant nephrotoxicity, amphotericin (AmB) is still used for the treatment of this serious fungal infection. Therefore, alternative treatments are urgently needed. Dialyzable leukocyte extracts have been used successfully to treat patients with mucocutaneous candidiasis, but their effectiveness in systemic candidiasis has not been evaluated. In this study, low-dose AmB (0.1 mg/kg) plus 10 pg of murine dialyzable spleen extracts (mDSE) were tested in a systemic candidiasis mouse model. Survival, tissue fungal burden, kidney damage, kidney cytokines, and serum levels of IL-6 and hepcidin were evaluated. Our results showed that the combined treatment of low-dose AmB plus mDSE improved survival and reduced kidney fungal burden and histopathology; these effects correlated with increased kidney concentration of IFN- γ and TGF- ß 1, decreased levels of TNF- α , IL-6, and IL-10, as well as high levels of systemic IL-6 and hepcidin. Low-dose AmB and mDSE synergized to clear the infectious agent and reduced tissue damage, confirming the efficacy of a low dose of AmB, which might decrease the risk of drug toxicity. Further studies are necessary to explore these findings and its implications in future therapeutic approaches.

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Background: treatments with lipopolysaccharide (LPS) from E. coli are an accepted way of inducing inflammation in immunological studies since they have the ability to activate a coordinate series of signs through the synthesis of pro-inflammatory cytokines such as interleukin 8 (IL-8), IL-18 and tumor necrosis factor alpha (TNF-α), which can cause significant changes in intestinal structure and functionality. Objective: the aim of this study was to evaluate the effect of adding LPS of E. coli on pro-inflammatory cytokine gene expression IL-8, IL-18 and TNF-α in early-weaned pigs. Methods: fieldwork was conducted at Centro San Pablo, belonging to the Universidad Nacional de Colombia with 32 pigs at 21 days of age, with 6.5 ± 0.5 kg of weight. Animals were fed with a basal diet supplemented with two levels of inclusion of LPS of E. coli serotype 0111:B4 (0 to 0.3 μg/mg of food). Pigs were slaughtered in stages on days 1, 5, 7 and 10 postweaning and complete extraction of small intestine was made. Gene expression was evaluated by qPCR. Blocks at random in a factorial arrangement 2 x 4 were used as statistical design. Results: the basal diet (without addition of LPS) presented increase in mRNA expression (p<0.01) of all the cytokines in jejunum for each post-weaning day, which suggests an inflammatory response and extensive tissue damage in pigs after early weaning. In diet 1 (with consumption of 0.3 μg LPS / mg diet) cytokines TNF-α, IL-8 and IL- 18 showed a significant increase in their levels of expression (p<0.01). All cytokines presented significant increase (p<0.01) in jejunum for each post-weaning day. Conclusion: The increase observed in the expression of TNF-α can be involved in the development of post-weaning diarrhea.

Antecedentes: los tratamientos con lipopolisacáridos (LPS) de E. coli son una forma aceptada para inducción de inflamación en estudios inmunológicos ya que tienen la capacidad de activar una gran variedad de rutas de señalización a través de la síntesis de citoquinas proinflamatorias, tales como interleuquina 8 (IL- 8), IL-18 y factor de necrosis tumoral alfa (TNF-α), las cuales pueden provocar cambios importantes en la estructura y funcionalidad intestinal. Objetivo: el presente estudio tuvo como objetivo evaluar el efecto de la adición de LPS de E. coli sobre la expresión génica de las citoquinas proinflamatorias IL-8, IL-18, y TNF-α en lechones recién destetados. Métodos: este trabajo se realizó con 32 lechones de 21 días de edad, con un peso de 6,5 ± 0,5 kg en el Centro San Pablo, perteneciente a la Universidad Nacional de Colombia. Los animales fueron alimentados con una dieta basal adicionada con dos niveles de inclusión de LPS de E. coli serotipo 0111:B4 (0 y 0,3 μg/mg de alimento). Los animales se sacrificaron escalonadamente los días 1, 5, 7 y 10 posdestete, y se realizó extracción completa del intestino delgado. Se evaluó la expresión génica por qPCR. El diseño estadístico empleado fue de bloques al azar en un arreglo factorial de 2X4. Resultados: la dieta basal (sin adición de LPS) presentó incremento en la expresión de mRNA (p<0,01) de todas las citoquinas en yeyuno para cada día posdestete, lo que sugiere una respuesta inflamatoria y grandes daños tisulares en el lechón luego del destete precoz. En la dieta 1 (con consumo de 0,3 µg LPS /mg dieta) las citoquinas TNF-α, IL-8, e IL-18 presentaron incrementos significativos en sus niveles de expresión (p<0,01). Todas las citoquinas presentaron incremento significativo (p<0,01) en yeyuno para cada uno de los días posdestete. Conclusión: el incremento observado en la expresión de TNF-α puede estar implicado en el desarrollo de diarreas posdestete.

Antecedentes: os tratamentos com lipopolissacarídeos (LPS) de E.coli são uma forma aceita de indução de inflamação para estudos imunológicos quanto que têm a capacidade de ativar uma grande variedade de vias de sinalização através da síntese de citocinas pró-inflamatórias tais como a interleucina 8 (IL-8), IL-18 e fator de necrose tumoral alfa (TNF-α), o que pode causar alterações importantes na estrutura e funcionalidade do intestino. Objetivo: o presente estudo teve como objetivo a adição de LPS de E. coli sobre a expressão génica das citocinas pró-inflamatórias IL-8, IL-18 e TNF-α em leitões desmamados. Métodos: este trabalho foi feito com 32 leitões de 21 dias de idade, com um peso de 6,5 ± 0,5 kg no Centro San Pablo, pertencente à Universidade Nacional de Colômbia. Os animais foram alimentados com uma dieta basal adicionada com dois níveis de inclusão de LPS de E. coli serotipo 0111:B4 (0 y 0,3 μg/mg de alimento). Os animais foram sacrificados nos dias 5, 7 e 10 após o desmame, e foi realizada a remoção completa do intestino delgado. A expressão do gene foi avaliada por qPCR. O desenho estatístico empregado foi de bloco ao acaso num fatorial de 2x4. Resultados: a dieta basal (sem LPS adicionado) mostrou aumento da expressão de mRNA (p<0,01) de todas as citocinas no jejuno para cada dia após o desmame, sugerindo uma resposta inflamatória e grande danos teciduais no porco após o desmame precoce. Na dieta 1 (com um consumo de 0,3 mg de LPS / mg dieta) citocinas TNF-a, IL-8 e IL-18 mostraram aumentos significativos nos níveis de expressão (p<0,01). Todas as citocinas mostraram aumento significativo (p<0,01) no jejuno, para cada um dos dias após o desmame. Conclusão: o aumento observado na expressão de TNF-α pode estar envolvido no desenvolvimento de diarreia pós-desmame.