RESUMO
Clostridium difficile infection has gained importance in recent years as a result of the rapid spread of epidemic strains, including hypervirulent strains. This study reports the molecular epidemiology of C. difficile obtained from hospitalized patients in Chile. Seven hundred and nineteen isolates of toxigenic C. difficile from 45 hospitals across the country were characterized through toxin profile, pulsed-field gel electrophoresis (PFGE), and sequencing of the tcdC gene. In addition, polymerase chain reaction (PCR) ribotyping and multilocus sequence typing (MLST) were performed on a subset of selected strains. PFGE typing of 719 isolates of C. difficile produced 60 PFGE patterns (subtypes). Subtype 1 was predominant (79% of isolates) and related to the hypervirulent strain (NAP1). Subtype 1 showed 73% relatedness with nine other subtypes, which had a similar tcdC deletion. Subtype 1 corresponded to ribotype 027 and ST1. This report shows the wide dissemination of the hypervirulent strain NAP1/027/ST1 in Chile.
Assuntos
Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/epidemiologia , Infecções por Clostridium/microbiologia , Epidemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Toxinas Bacterianas/genética , Criança , Pré-Escolar , Chile/epidemiologia , Clostridioides difficile/classificação , Clostridioides difficile/genética , Análise por Conglomerados , Eletroforese em Gel de Campo Pulsado , Feminino , Genótipo , Hospitais , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Tipagem de Sequências Multilocus , Ribotipagem , Adulto JovemRESUMO
A recently discovered new species of diploglossine lizard is described from west-central Panama. The distinctiveness of the nominal genera Celestus and Diploglossus is confirmed; the new form represents the southernmost record for the genus Celestus. A summary of selected characteristics and general distribution is presented for all recent species of diploglossines, including members of the Antillean genera Saurisia and Wetmorea and the South American genus Ophiodes. A systematic key to mainland members of the genus Celestus is provided. Rev. Biol. Trop. 56 (2): 845-859. Epub 2008 June 30.
Se describe una especie nueva de lagarto diploglossino recientemente descubierta en el centro-oeste de Panamá. Confirmamos la peculiaridad de los géneros nominales Celestus y Diploglossus. La nueva especie representa el registro más al sur del género Celestus. Se presenta un resumen de características selectas y de la distribución general de todas las especies recientes de diploglossinos, incluyendo a los miembros de los géneros antillanos Saurisia y Wetmorea y del género suramericano Ophiodes. Se provee una clave sistemática para los miembros de tierra firme del género Celestus.
Assuntos
Animais , Lagartos/anatomia & histologia , Lagartos/classificação , Panamá , Especificidade da EspécieRESUMO
El embarazo localizado dentro de una cicatriz de cesárea previa es el menos frecuente de los embarazos ectópicos y no existe un tratamiento estándar. Se presenta el caso clínico de una paciente con embarazo ectópico ístmico-cervical sobre una cicatriz de cesárea. Se hospitaliza por el riesgo de ruptura uterina, evolucionó con invasión trofoblástica de la histerorrafia culminando en muerte embrionaria. No hubo complicaciones maternas. Se trató con metotrexato para evitar la progresión de la invasión trofoblástica, con buen resultado materno.
Assuntos
Feminino , Gravidez , Adulto , Humanos , Cesárea/efeitos adversos , Cicatriz/complicações , Gravidez Ectópica/etiologia , Gravidez Ectópica/tratamento farmacológico , Metotrexato/uso terapêutico , Abortivos não Esteroides/uso terapêuticoRESUMO
We describe morphological variation (scalation and coloration) observed among eight individuals of the Panamanian lizard species Anolis casildae. This variation was not observed in the holotype and aids in identification of this recently described species (originally described on the basis of a single, male specimen). This species occurs only in the Reserva Forestal Fortuna (ChiriquÝ Province) and the adjacent Bosque Protector Palo Seco (Bocas del Toro Province) in western Panama. Anolis casildae can be distinguished from all other Panamanian anole species via six features: (1) two enlarged superciliary scales (the first larger than the second); (2) an anterior nasal scale in contact with the rostral scale or separated from the rostral by one scale; (3) 6-8 sublabial scales to the center of the eye; (4) 3-4 scales between the supraobital semicircles; (5) unique coloration (4-6 oblique brown bands interspersed by blue-outlined yellow patches; dewlap is a dirty cream color with broad yellow scale rows irregularly interspersed with smaller emerald green scales) and (6) A. casildae occurs from 1,050 to 1,400 m in the Cordillera Central. We also compare our natural history observations of A. casildae to a similar large anole, A. frenatus, a species which we believe A. casildae to be closely related.
Assuntos
Animais , Feminino , Masculino , Lagartos , PanamáRESUMO
We describe morphological variation (scalation and coloration) observed among eight individuals of the Panamanian lizard species Anolis casildae. This variation was not observed in the holotype and aids in identification of this recently described species (originally described on the basis of a single, male specimen). This species occurs only in the Reserva Forestal Fortuna (Chiriquí Province) and the adjacent Bosque Protector Palo Seco (Bocas del Toro Province) in western Panama. Anolis casildae can be distinguished from all other Panamanian anole species via six features: (1) two enlarged superciliary scales (the first larger than the second); (2) an anterior nasal scale in contact with the rostral scale or separated from the rostral by one scale; (3) 6-8 sublabial scales to the center of the eye; (4) 3-4 scales between the supraobital semicircles; (5) unique coloration (4-6 oblique brown bands interspersed by blue-outlined yellow patches; dewlap is a dirty cream color with broad yellow scale rows irregularly interspersed with smaller emerald green scales) and (6) A. casildae occurs from 1,050 to 1,400 m in the Cordillera Central. We also compare our natural history observations of A. casildae to a similar large anole, A. frenatus, a species which we believe A. casildae to be closely related.
Assuntos
Lagartos/anatomia & histologia , Animais , Feminino , Lagartos/classificação , Masculino , PanamáRESUMO
We retrospectively reviewed the charts and radiographs of 38 patients with systemic-onset juvenile rheumatoid arthritis, attempting to identify early in the disease course the clinical and laboratory observations most predictive of the later development of destructive arthritis. In 12 of the patients, destructive arthritis developed within 2 years of disease onset. When first examined, these patients could not readily be differentiated from those in whom joint destruction did not develop, but they more commonly had hepatosplenomegaly (p less than 0.04), serositis (p less than 0.01), and a lower mean serum albumin concentration (26.7 vs 31.3 gm/L; p less than 0.02). However, by 6 months after onset, patients with destructive arthritis more frequently had persistent systemic symptoms (92% vs 12%; p less than 0.0001), polyarthritis (67% vs 19%; p less than 0.0005), a lower mean hemoglobin level (95 vs 114 gm/L; p less than 0.001), a higher mean leukocyte count (21.2 vs 10 x 10(9)/L; p less than 0.0003), a higher mean platelet count (794 vs 400 x 10(9)/L; p less than 0.0001), and a higher mean erythrocyte sedimentation rate (43 vs 24 mm/hr; p less than 0.05). Multivariate analysis of the results at 6 months revealed that persistent systemic symptoms and a platelet count greater than or equal to 600 x 10(9)/L were the variables most highly predictive of the later development of joint destruction. We conclude that patients at high risk for the development of destructive arthritis may be identified within 6 months of disease onset, thereby indicating the need for more aggressive early therapy.