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Introducción. Blastocystis sp es un protozoo parásito que se encuentra en el tracto intestinal del hombre y algunos animales, se estima que infecta a más de 1.000 millones de personas en el mundo. El presente trabajo tuvo como Objetivo determinar los genotipos de Blastocystis sp asociados a diferentes fuentes de transmisión en zona rural del departamento del Quindío. Materiales y Métodos. Se obtuvieron 42 muestras coprológicas de niños entre 0 y 14 años, 17 de heces de animales, 17 de alimentos, 28 de superficies inertes ,15 de suelo, 18 de agua de red domiciliaria y 3 de fuente hídrica. Se realizó extracción de ADN y amplificación por PCR para Blastocystis sp usando como blanco el gen SSADNr. Las secuencias fueron alineadas con ClustalW y se realizaron árboles filogenéticos el programa (MEGA11). Resultados. De las 140 muestras recolectadas entre coprológicos de población infantil y matrices ambientales, se encontró una prevalencia de Blastocystis sp del 23,5 % en alimentos, 22,2% en red domiciliaria y del 4,75 % en la población infantil, no hubo evidencia estadística que implicara una asociación entre la presencia de este protozoo y las variables sociodemográficas. Se encontró el subtipo 2 asociado a población infantil y el subtipo 3 asociado a matrices ambientales (agua y alimentos) y población infantil. Conclusiones: Se reporta la presencia de Blastocystis sp en tomate y zanahoria, en la red domiciliaria y población infantil en una zona rural del departamento del Quindío donde los subtipos asociados fueron el subtipo 2 y 3.

Introduction. Blastocystis sp is a parasitic protozoan found in the intestinal tract of man and some animals, and it is estimated that it infects more than 1,000 million people in the world. In the national parasitism survey, it was reported with a prevalence of 52% in the northern Andean region. The aim of this study was to determine the genotypes of Blastocystis sp associated with different sources of transmission in rural areas of the department of Quindío. Materials and Methods. Forty-two coprological samples were obtained from children between 0 and 14 years of age, 17 from animal feces, 17 from food, 28 from inert surfaces, 15 from soil, 18 from household water and 3 from water sources. DNA extraction and PCR amplification were performed for Blastocystis sp using the SSADNr gene as target. The sequences were aligned with ClustalW and phylogenetic trees were performed with the program (MEGA11). Results. Of the 140 samples collected between coprological samples of children and environmental matrices, we found a prevalence of Blastocystis sp of 23.5% in food, 22.2% in the home network and 4.75% in the child population, there was no statistical evidence implying an association between the presence of this protozoan and sociodemographic variables. Subtype 2 was found associated with infant population and subtype 3 associated with environmental matrices (water and food) and infant population. Conclusions: We report the presence of Blastocystis sp in tomato and carrot, in the home network and infant population in a rural area of the department of Quindío where the associated subtypes were subtype 2 and 3.

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Fascioliasis is a zoonotic disease caused by liver flukes transmitted by freshwater lymnaeid snails. Donkey and horse reservoir roles have been highlighted in human endemic areas. Liver fluke infection in mules has received very limited research. Their role in disease transmission, epidemiological importance and Fasciola hepatica pathogenicity are studied for the first time. Prevalence was 39.5% in 81 mules from Aconcagua, and 24.4% in 127 from Uspallata, in high-altitude areas of Mendoza province, Argentina. A mean amount of 101,242 eggs/mule/day is estimated. Lymnaeids from Uspallata proved to belong to ribosomal DNA internal transcribed spacer (ITS) markers ITS-1 and ITS-2 combined haplotype 3C of Galba truncatula. These lymnaeids were experimentally susceptible to infection by egg miracidia from mules. Infectivity, number of cercariae/snail and shedding period fit the enhanced F. hepatica/G. truncatula transmission pattern at very high altitude. This indicates that the mule is able to maintain the F. hepatica cycle independently. Individual burdens of 20 and 97 flukes were found. Mule infection susceptibility is intermediate between donkey and horse, although closer to the latter. Anatomo-pathology and histopathology indicate that massive infection may cause mule death. Haematological value decreases of red blood cells, haemoglobin, leucocytes and lymphocytes indicate anaemia and strong immunosuppression. Strongly increased biochemical marker values indicate liver function alterations. The mule probably played a role in the past exchanges with Chile and Bolivia through Mendoza province. Evidence suggests that mules could contribute to the spread of both F. hepatica and G. truncatula to human fascioliasis-endemic areas in these countries.

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Laccases are ligninolytic enzymes produced by different microorganisms, especially by fungi such as the white-rot fungus Pleurotus ostreatus. Chemical inductors have been used to promote laccase secretion due to the application of these enzymes in lignocellulosic biomass pretreatment. Cordyceps nidus ANDES-F1080 was previously described as a source of bioactive compounds that could influence the enzymatic production system of other fungi. For that reason, this study evaluates the effect of C. nidus' ANDES-F1080 extracts on the laccase activity of P. ostreatus ANDES-F515. To achieve this objective, C. nidus ANDES-F1080 was grown in four different substrates: two artificial-based and two natural-based culture media. Metabolites were extracted from C. nidus ANDES-F1080 using water and methanol as solvents. Biochemical characterization of these extracts was performed to complement the analysis of their effect on laccase activity. Our results revealed an enhancement on the laccase activity of P. ostreatus ANDES-F515 grown in natural-based cultures when C. nidus' ANDES-F1080 extracts were supplemented. The best laccase activities registered values around 10,575 ±â€¯813 U·L-1.

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"Titanium dioxide (TiO2) is a semiconductor material that exhibits antibacterial activity due to its photocatalytic properties under ultraviolet light. On the other hand, silver also exhibits strong antibacterial activity towards a wide range of microorganisms and TiO2 with silver addition exhibits more efficient photocatalytic properties than unmodified TiO2. In this work, TiO2 nanoparticles were synthesized by the hydrothermal method and modified with silver by two different methods: wet impregnation (Ex situ) and In situ incorporation. The antimicrobial activity of TiO2 nanoparticles synthesized and modified by both methods was evaluated against Escherichia coli and Staphylococcus aureus. The results showed that TiO2 nanoparticles have anatase phase. Also, spherical morphology with a mean particle size around 10.6 nm was obtained. The presence of silver in the modified TiO2 nanoparticles was confirmed by EDS and XPS. TiO2 particles modified by the Ex situ method, showed a better bactericidal activity compared to the particles modified by In situ incorporation method and TiO2 unmodified nanoparticles. This study demonstrated that both methods used to modify the titanium dioxide nanoparticles are effective as bactericidal materials and better results were found for the Ex situ method."

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INTRODUCTION: Chronic kidney disease (CKD) is a priority problem due to its high prevalence. According to the modalities of renal replacement therapy, kidney transplantation (TR) offers to be the best alternative. TR presents multiple factors of dependence of success; among them is the management of the anatomical variants of the graft and the surgical decision on the basis of these. Therefore, the objective of this study is to determine the frequency of variants in the graft, its surgical management, and the impact on the functionality of the transplanted kidney. MATERIAL AND METHODS: This was an observational, retrospective study of patients in the renal transplant unit of the Siglo XXI National Medical Center from 2002-2016. The analysis begins in the description of the population doing bivariate analysis to establish relative risks. For variables with a central tendency, the parametric tests analysis of variance, Student t paired, and unpaired will be used. In the case of nominal variables, the proportion's difference will be estimated using the chi-square test, establishing significance when P is ≤ .05. SPSS 21 software was used. RESULTS: There were a total of 773 patients, with 576 transplants from living donors and 197 from deceased donors. In the case of the artery, a greater number of variants is observed-27.8% being alive versus 17.3% of the variants found in deceased donors. For the renal vein, 12.7% of the kidneys were taken from living donor vs 6.1% from deceased donors. This required one more day of hospitalization (6 vs 7 days of single vs multiple vessels); likewise, increases in immediate post-transplant infections were 5% for single vessels vs 8% in the case of multiple variants. CONCLUSIONS: The importance of knowing the anatomical variants prior to the TR allows them to plan the potential surgical maneuvers, decreasing the times aimed at improving the immediate functionality of the renal graft, while also considering the increase in hospital expenses due to the greater number of days of hospitalization.

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El conocimiento de las especies de ectoparásitos presentes en los animales de compañía tiene implicancias tanto en medicina veterinaria como en salud humana, ya que varios agentes tienen la potencialidad de transmitirse del animal al humano y viceversa. Se revisaron 466 garrapatas remitidas al Centro de Investigación en Parasitología Regional (CIPaR) durante los años 2010 y 2013, recolectadas en 217 perros de zonas urbanas de la provincia de Mendoza. El 83,5% (n=385) fueron identificadas como Rhipicephalus sanguineus sensu lato (84 machos y 199 hembras - relación 1:2,37 -, 65 ninfas y 37 larvas), mientras que el 16,5% (n=76) fue identificado como Amblyomma tigrinum (10 machos y 61 hembras - relación 1:6,1 -, y cinco ejemplares adultos en mal estado, imposibilitando su sexado). Adicionalmente, cinco ejemplares adultos sólo se identificaron como pertenecientes al género Amblyomma, ya que por encontrarse ingurgitados no se pudo realizar la determinación de especie. Éste registro es un importante aporte al conocimiento de las especies de garrapatas presentes en perros (Canis familiaris) en la provincia de Mendoza.

Knowledge of the ectoparasitic agents of pets has implications both in veterinary medicine and public health since several agents have the potential to spread from animal to human and vice versa. Ticks sent to the Centro de Investigación en Parasitología Regional (CIPaR) during 2010 to 2013 were analysed. 466 adult ticks were collected from 217 dog in urban areas from Mendoza province, Argentina. Of these, 83.5% (n=385) specimens were identified as Rhipicephalus sanguineus s.l. (84 male and 199 female - ratio 1:2.37 -, 65 nymphs and 37 larvae), while 16.5% (n = 76) were identified as Amblyomma tigrinum (10 males and 61 females - ratio 1:6.1 -, and five adults in bad condition, which precluded their sexing). In addition, five adult specimens, identified as Amblyomma, were not identified to the species level since they were fully engorged. This report is an important contribution to the knowledge of the species of ticks in dogs (Canis familiaris) in the province of Mendoza.

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PURPOSE: To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. MATERIALS AND METHODS: Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. RESULTS: Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 L. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism: Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. CONCLUSIONS: Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or age of initial treatment exerts no definite effect on testicular volume improvement r hormonal levels at 18 years of age.

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Purpose To evaluate the relationship between unilateral or bilateral criptorchidism, patient age, primary location of the gonad and modality of treatment with testicular volume and hormonal status at 18 years in patients diagnosed and treated for cryptorchidism during childhood. Materials and Methods Testicular volume, LH, FSH, and testosterone were evaluated in 143 young men at 18 years treated in childhood for unilateral (n=103) or bilateral (n=40) cryptorchidism. Results Unilateral cryptorchidism: Location of testis was prescrotal in 36 patients, inguinal in 52 and non-palpable in 15. The mean volume was 9.7 mL compared to 16.2 mL. for the spontaneously descended testicle in unilateral cryptorchidism. However, 22 patients who received HCG had a significantly bigger testis (11.8 mL.) than those treated with primary surgery (9.2 mL). The results showed a significant positive correlation between testicular volume and patient age at treatment. Bilateral cryptorchidism Location of testis was prescrotal in 34 cases, inguinal in 40 and 6 patients with non-palpable testicles. Mean volume at 18 years was 12.9 mL, greater than unilateral cryptorchid testis (9.7 mL) but smaller than healthy contralateral in unilateral cases (16.2 mL). There were significant differences in the testicular growth for bilateral patients with testicular descent after being treated with HCG (14.4 mL) in respect with those untreated (11.1 mL) or those who underwent primary surgery (11.4 mL). There was a significant positive correlation between the testicular volume and palpable (12.4 mL) or non-palpable testis (10.4 mL). There was a correlation between unilateral or bilateral cryptorchidism and levels of FSH. Conclusions Testicular volume and hormonal function at 18 years for patients diagnosed and treated for cryptorchidism during childhood are strongly influenced by whether the undescended testis was unilateral or bilateral. Location of the testes at diagnosis or ...

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We analyzed 17 strains of Pseudomonas aeruginosa resistant to carbapenems isolated in four hospitals in eastern and southern Venezuela collected between 2007 and 2010. Combined disk method showed production of metallo־β־lactamases (MBLs) in all strains. PCR and sequencing of genes encoding IMP, VIM and SPM metallo־β־lactamase families confirmed the presence of VIM-2 MMBL in all strains. Pulsed field gel electrophoresis classified the strains into three similarity groups. The largest group, group A included 13 strains with over 83% similarity between them and was found in four hospitals. Two strains of Cumana hospital formed the group B and other two the Group C with similitary of 73% and 65% respectively with Group A. These results confirmed that hospitals in eastern and southern Venezuela, circulating strains of P. aeruginosa producing VIM-2 type MBLs with a common clonal origin. On the other hand, carbapenem-resistant P. aeruginosa circulating in Cumana city hospital had polyclonal origin.

Se analizaron 17 cepas de Pseudomonas aeruginosa resistentes a carbapenémicos aisladas en cuatro hospitales del oriente y sur de Venezuela colectadas entre los años 2007 y 2010. En todas las cepas se demostró la producción de metalo-β-lactamasas (MBLs) por el método de discos combinados. Mediante la amplificación por la reacción de polimerasa en cadena (RPC) de los genes que codifican para las metalo-β-lactamasas de las familias IMP, VIM y SPM, y su posterior secuenciación, se confirmó la presencia de MBLs de tipo VIM-2 en todas las cepas. Mediante la electroforesis de campos pulsantes (ECP), las cepas se clasificaron en tres grupos de similaridad. El grupo dominante (A) estuvo constituido por 13 cepas provenientes de los cuatro hospitales, con similaridad superior al 83% entre ellas. Dos cepas del hospital de Cumaná conformaron el Grupo B y otras dos el Grupo C con similaridad de 73 y 65%, respectivamente, con el Grupo A. Estos resultados confirmaron que en los hospitales del oriente y sur de Venezuela, circulan cepas de P. aeruginosa productoras de MBLs de tipo VIM-2, con un origen clonal común. Asimismo, en el hospital de Cumaná circulan cepas de origen policlonal.

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We analyzed 17 strains of Pseudomonas aeruginosa resistant to carbapenems isolated in four hospitals in eastern and southern Venezuela collected between 2007 and 2010. Combined disk method showed production of metalloÖ¾ßÖ¾lactamases (MBLs) in all strains. PCR and sequencing of genes encoding IMP, VIM and SPM metalloÖ¾ßÖ¾lactamase families confirmed the presence of VIM-2 MMBL in all strains. Pulsed field gel electrophoresis classified the strains into three similarity groups. The largest group, group A included 13 strains with over 83% similarity between them and was found in four hospitals. Two strains of Cumana hospital formed the group B and other two the Group C with similitary of 73% and 65% respectively with Group A. These results confirmed that hospitals in eastern and southern Venezuela, circulating strains of P. aeruginosa producing VIM-2 type MBLs with a common clonal origin. On the other hand, carbapenem-resistant P. aeruginosa circulating in Cumana city hospital had polyclonal origin.

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AIMS: Cape gooseberries (Physalis peruviana) have become increasingly important in Colombia for both domestic consumption and the international export market. Vascular wilting caused by Fusarium oxysporum is the most damaging disease to P. peruviana crops in Colombia. The control of this pathogen is mainly carried out by chemical and cultural practices, increasing production costs and generating resistance. Therefore, the objectives of this study were to test rhizobacteria isolates from P. peruviana rhizosphere against F. oxysporum under in vitro and in vivo conditions. METHODS AND RESULTS: Over 120 strains were isolated, and five were selected for their high inhibition of F. oxysporum growth and conidia production under in vitro conditions. These strains inhibited growth by 41-58% and reduced three- to fivefold conidia production. In the in vivo assays, all the tested isolates significantly reduced fungal pathogenicity in terms of virulence. Isolate B-3.4 was the most efficient in delaying the onset of the first symptoms. All isolates were identified as belonging to the genus Pseudomonas except for A-19 (Bacillus sp.). CONCLUSIONS: Our results confirmed that there are prospective rhizobacteria strains that can be used as biological control agents; some of them being able to inhibit in vitro F. oxysporum growth and sporulation. SIGNIFICANCE AND IMPACT OF THE STUDY: Incorporating these bacteria into biological control strategies for the disease that causes high economical losses in the second most exported fruit from Colombia would result in a reduced impact on environment and economy.

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Pseudomonas aeruginosa es un bacilo gramnegativo, capaz de adquirir genes que codifican la producción de metalo-β-lactamasas (MBL) haciéndose multirresistente, lo cual dificulta el tratamiento de las infecciones causadas por este microorganismo. Se evaluó la actividad in vitro de piperacilina-tazobactam, en combinación con aminoglucósidos y fluoroquinolonas, en 8 aislamientos de P. aeruginosa productoras de MBL, provenientes de cuatro hospitales del oriente y sur de Venezuela mediante el método epsilométrico. Las combinaciones de antimicrobianos que presentaron mayor efecto sinérgico fueron piperacilina-tazobactam/gentamicina y piperacilina-tazobactam/ciprofloxacina en 5/8 aislamientos. La combinación de piperacilina-tazobactam/amikacina presentó sinergia en 4 de los casos y adición en los otros 4, manifestando el menor índice de concentración inhibitoria fraccionada promedio. No hubo antagonismo en ninguna combinación de antimicrobianos. Los resultados de este estudio sugieren que piperacilina-tazobactam en combinación con gentamicina, amikacina o ciprofloxacina podrían ser utilizadas como alternativas terapéuticas en las infecciones por P. aeruginosa multirresistentes productoras de MBL en los hospitales del estado Bolívar, mientras que en los hospitales del oriente de Venezuela se sugiere la combinación piperacilina-tazobactam/amikacina.

Pseudomonas aeruginosa is a gram negative bacillus able to acquire genes which codify for production of metallo-β-lactamases (MBL) becoming multiresistant, which difficults the treatment of infections produced by this microorganism. The in vitro activity of piperacilline-tazobactam, in combination with aminoglycosides and fluoroquinonolones was evaluated in 8 P. aeruginosa MBL producers obtained at four hospitals of the west and south areas of Venezuela through an epsilometric method. The antimicrobial combinations which showed the greatest synergic effect were piperacillin-tazobactam/gentamicin and piperacillin-tazobactam/amikacin in 5/8 isolates. The piperacilline-tazobactam/amikacin combination showed synergy in 4 cases and addition in the other 4, with the lowest index of mean fractionated inhibitory concentration. There was no antagonism in any of the antimicrobial combinations. The results of this study suggest that piperacilline-tazobactam in combination with gentamicin, amikacin or ciprofloxacin, could be used as therapeutic alternatives in multiresistant P. aeruginosa MBL producers at all the hospitals of Bolivar State, while in hospitals located in the west of Venezuela, the piperacilline-tazobactan/amikacin combination is suggested.

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Papaya ringspot virus (PRSV) is the most important virus affecting papaya and cucurbit plants in tropical and subtropical areas. PRSV isolates are divided into biotypes P and W: both the P and W types naturally infect plants in the family Cucurbitaceae, whereas the P type naturally infects papaya (Carica papaya). Understanding the origin and nature of the PRSV genetic diversity and evolution is critical for the implementation of control strategies based on cross-protection and the deployment of transgenic plants that show resistance to virus isolates highly similar to the transgene. The molecular epidemiology of PRSV was evaluated by analyzing the nucleotide sequence of the capsid protein (CP) and helper component-proteinase (HC-Pro) genes of isolates from around the world, including newly characterized ones from Colombia and Venezuela, using a relaxed molecular clock-based approach and a phylogeographic study. Our results confirm previous estimates on the origin of PRSV around 400 years ago and suggest distinct dispersion events from the Indian Peninsula to the rest of Asia, via Thailand, and subsequently to the Americas. A historical reconstruction of the P- and W-type characters in the phylogenetic study supports the need to revise the hypothesis that PRSV-P derives from PRSV-W since our results suggest that the ancestral state could be either of the two biotypes. Moreover, estimates of epidemic growth predict an increasing genetic diversity of the virus over time that has direct implications for control strategies of PRSV based on cross-protection and the use of transgenic plants.

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The species constituting the genus Malassezia are considered to be emergent opportunistic yeasts of great importance. Characterized as lipophilic yeasts, they are found in normal human skin flora and sometimes are associated with different dermatological pathologies. We have isolated seven Malassezia species strains that have a different Tween assimilation pattern from the one typically used to differentiate M. furfur, M. sympodialis, and M. slooffiae from other Malassezia species. In order to characterize these isolates of Malassezia spp., we studied their physiological features and conducted morphological and molecular characterization by PCR-restriction fragment length polymorphism and sequencing of the 26S and 5.8S ribosomal DNA-internal transcribed spacer 2 regions in three strains from healthy individuals, four clinical strains, and eight reference strains. The sequence analysis of the ribosomal region was based on the Blastn algorithm and revealed that the sequences of our isolates were homologous to M. furfur sequences. To support these findings, we carried out phylogenetic analyses to establish the relationship of the isolates to M. furfur and other reported species. All of our results confirm that all seven strains are M. furfur; the atypical assimilation of Tween 80 was found to be a new physiological pattern characteristic of some strains isolated in Colombia.

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OBJECTIVE: To clarify the role of peritoneography in assessing the patency of processus vaginalis (PV) in pediatric patients diagnosed with cryptorchidism. MATERIALS AND METHODS: We designed a prospective clinical trial to evaluate the patency of PV in boys presenting cryptorchidism. Herniography was performed in 310 prepubertal boys. Data about the morphology of PV was compared with operative findings in those surgically treated patients. Retractile and ectopic testes were excluded from the study. RESULTS: Of the 376 undescended testes (310 patients), 281 cases were associated with an obliterated PV. Herniography revealed 95 cases of open PV in cryptorchid boys. The 244 normally descended testes had associated patent processus vaginalis in only 31 cases. CONCLUSIONS: Herniography is the most relevant procedure for accurate diagnosis of persistent PV. The persistence of PV was significantly more frequent when the position of the testes is more cranial. The incidence of an open PV decreases with age.

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OBJECTIVE: To clarify the role of peritoneography in assessing the patency of processus vaginalis (PV) in pediatric patients diagnosed with cryptorchidism. MATERIALS AND METHODS: We designed a prospective clinical trial to evaluate the patency of PV in boys presenting cryptorchidism. Herniography was performed in 310 prepubertal boys. Data about the morphology of PV was compared with operative findings in those surgically treated patients. Retractile and ectopic testes were excluded from the study. RESULTS: Of the 376 undescended testes (310 patients), 281 cases were associated with an obliterated PV. Herniography revealed 95 cases of open PV in cryptorchid boys. The 244 normally descended testes had associated patent processus vaginalis in only 31 cases. CONCLUSIONS: Herniography is the most relevant procedure for accurate diagnosis of persistent PV. The persistence of PV was significantly more frequent when the position of the testes is more cranial. The incidence of an open PV decreases with age.

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X-ray screening of gastric cancer is broadly used in Japan, although no controlled trial has proved its effectiveness. This study evaluates the impact of an X-ray screening demonstrative intervention to reduce gastric cancer mortality in a Costa Rican region. The evaluation follows a quasi-experimental, community-controlled design, with measures before and after. About 7000 individuals participated by invitation in the two-wave screening programme. X-ray screening was followed by videoendoscopy and gastric biopsies. Treatment included resection with or without lymph node dissection. Comparisons with two control groups estimate that gastric cancer mortality was halved in the period from 2 to 7 years after the first screening visit. Validity of X-rays as used in this intervention had 88% sensitivity, 80% specificity, and 3% predictive value for individuals with two screening visits. Incidence in the screened group increased up to four times. Case survival was 85% in the intervention group after 5 years, compared to 12% among the controls before the intervention and 35% among the controls in the same region after the intervention. Although X-ray mass screening seems able to reduce stomach cancer mortality, its high cost may be an obstacle for scaling up this intervention in a non-rich country like Costa Rica.

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Although, in the endemic areas throughout the world, human fascioliasis presents varying patterns in its epidemiology, the species of lymnaeid snail that act as intermediate hosts and vectors are always crucial in the transmission of the causative parasites. Species in the Galba/Fossaria group of snails, such as Lymnaea cubensis, L. viatrix var. A ventricosa, L. viatrix var. B elongata and Galba truncatula, appear to be frequently involved in the transmission of Fasciola hepatica in Central and South America, although specific classification within this morphologically and anatomically confusing group is often very difficult. To explore the potential use of molecular analyses in the identification of vector snails, regions of the ribosomal DNA - the small subunit (18S) gene and internal transcribed spacers (ITS-2 and ITS-1) - and of the mitochondrial DNA - the cytochrome c oxidase subunit I (COI) - of wild-caught lymnaeid snails of L. cubensis, L. viatrix var. A ventricosa, L. viatrix var. B elongata and G. truncatula have been sequenced. The samples of the Latin American species included specimens from the respective type localities. The genetic distances observed and the results of phylogenetic analyses demonstrate that two different species exist within L. viatrix. Lymnaea neotropica n. sp. (=L. viatrix var. B elongata) is here proposed for specimens from Lima, Peru, and is differentiated from L. viatrix (=L. viatrix var. A ventricosa), L. cubensis and G. truncatula. The data collected on the 18S ribosomal-RNA gene indicate that the snails investigated may cover more than one supraspecific taxon. The ITS-2, ITS-1 and COI nucleotide sequences are clearly useful markers for the differentiation of these morpho-anatomically similar lymnaeid species. The numerous microsatellite repeats found within ITS-2 are potential tools for differentiation at population level.

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En las unidades de cuidados intensivos se ingresan pacientes críticamente enfermos que requieren ventilación artificial mecánica. Entre las opciones de esta se incluye la ventilación artificial mecánica no invasiva. Actualmente es una preocupación de los líderes de la medicina intensiva saber cómo y en qué tipo de pacientes se prescribe este tipo de ventilación. El propósito de este estudio es ofrecer referentes relacionados con el uso de la ventilación artificial mecánica no invasiva en pacientes con enfermedad pulmonar obstructiva en nuestra unidad de cuidados intensivos del Hospital General Docente “Dr. Agostinho Neto”, de la provincia Guantánamo durante el año 2005 (AU)

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Se realiza un estudio en la Unidad de Cuidados Intensivos Polivalente del Hospital Dr. Agostinho Neto de Guantánamo, con el objetivo de precisar el comportamiento de los pacientes con infarto agudo del miocardio tratado con ventilación artificial mecánica, durante los años 1992-2004. Se realiza una investigación aplicada y prospectiva. El universo se conforma por los pacientes con infarto agudo del miocardio egresados de la citada unidad durante los años citados (n=1156). Se precisa edad, sexo, localización y extensión del infarto, índice pronóstico de Peel. Se identifica causa de prescripción de la ventilación artificial mecánica, modalidad utilizada y evolución. Mediante análisis univariante se establecen las variables fundamentales que determinan la necesidad de esta terapéutica. En los fallecidos se precisa la causa directa de la muerte. Entre las conclusiones se encuentra que el 10.6 por ciento de los pacientes ingresados en la unidad de cuidados intensivos con diagnóstico de infarto agudo del miocardio necesitó de ventilación artificial mecánica. El subgrupo de pacientes infartados tratados con esta ventilación se caracterizó por tener más edad que los pacientes que no necesitaron de esta terapéutica (p<0,01), y en ellos fue más común el sexo masculino (p>0,05). En el subgrupo de pacientes ventilados fue más frecuente el infarto agudo del miocardio con localización anterior (p<0,05). La principal causa directa de la muerte fue el fallo de múltiples órganos (AU)

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