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BACKGROUND: Sisal wool condition is a skin disease affecting Merino sheep in the Argentine Patagonia region. Corynebacterium spp. isolates have previously been isolated from skin swabs from lesions, while specific identification of the bacteria involved has not been reported. HYPOTHESIS/OBJECTIVES: The aim of this work was to characterize the bacterial agent isolated from sisal wool lesions and to develop a diagnostic method for field surveillance. MATERIALS AND METHODS: Molecular identification of a collection of 72 isolates obtained previously was performed using PCR and 16S rRNA and rpoB sequencing. A field survey was carried out on two farms in the Río Negro province of Argentine Patagonia. Swab samples from sheep with and without skin lesions were collected and analysed by PCR and culture. RESULTS: Isolates analysed were confirmed by sequencing as Corynebacterium bovis. Using a PCR test without culture step, all field samples from affected sheep were positive for C. bovis; samples from the healthy skin from the same animals or clinically healthy sheep all were negative. CONCLUSIONS AND CLINICAL RELEVANCE: Sisal wool skin disease was associated with C. bovis infection based on culture and PCR methods; the latter may be useful for helping to pursue a disease control strategy.

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One of the main intoxications to livestock in the Patagonia region of Argentina is the tremorgenic disease "Mal de Huecú", attributed to the consumption of the native grasses Poa huecu and/or Festuca argentina. In this report, five outbreaks of spontaneous intoxications were investigated. Several indole-diterpene alkaloids were identified in Poa huecu and Festuca argentina including the known tremorgen terpendole C and are likely the cause of "Mal de Huecú" disease.

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It is well known that several of the swainsonine-containing plant species found widespread around the world have a negative economic impact in each country. In Argentina, most of the information on the poisonous plant species that produce α-mannosidosis is published in Spanish and thus not available to most English-speaking researchers interested in toxic plants. Therefore, the aim of this review is to summarize the information about swainsonine-containing plants in Argentina, which are extensively distributed throughout different ecoregions of the country. To date, five species from three genera have been shown to induce α-mannosidosis in livestock in Argentina: Ipomoea carnea subsp. fistulosa, Ipomoea hieronymi subsp. calchaquina (Convolvulaceae), Astragalus garbancillo, Astragalus pehuenches (Fabaceae), and Sida rodrigoi (Malvaceae). These species contain the indolizidine alkaloid swainsonine, which inhibits the lysosomal enzyme α-mannosidase and consequently affects glycoprotein metabolism, resulting in partially metabolized sugars. The prolonged consumption of these poisonous plants produces progressive weight loss and clinical signs related to a nervous disorder, characterized by tremors of head and neck, abnormalities of gait, difficulty in standing, ataxia and wide-based stance. Histological lesions are mainly characterized by vacuolation of different cells, especially neurons of the central nervous system. The main animal model used to study α-mannosidosis is the guinea pig because, when experimentally poisoned, it exhibits many of the characteristics of naturally intoxicated livestock.

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INTRODUCTION: Although multiple neurologic manifestations associated with SARS-CoV-2 infection have been described in adults, there is little information about those presented in children. Here, we described neurologic manifestations associated with COVID-19 in the pediatric population. METHODS: Retrospective case series report. We included patients younger than 18 years, admitted with confirmed SARS-CoV-2 infection and neurologic manifestations at our hospital in Santiago, Chile. Demographics, clinical presentations, laboratory results, radiologic and neurophysiological studies, treatment, and outcome features were described. Cases were described based on whether they presented with predominantly central or peripheral neurologic involvement. RESULTS: Thirteen of 90 (14.4%) patients admitted with confirmed infection presented with new-onset neurologic symptoms and 4 patients showed epilepsy exacerbation. Neurologic manifestations ranged from mild (headache, muscle weakness, anosmia, ageusia), to severe (status epilepticus, Guillain-Barré syndrome, encephalopathy, demyelinating events). CONCLUSIONS: We found a wide range of neurologic manifestations in children with confirmed SARS-CoV-2 infection. In general, neurologic symptoms were resolved as the systemic presentation subsided. It is essential to recognize and report the main neurologic manifestations related to this new infectious disease in the pediatric population. More evidence is needed to establish the specific causality of nervous system involvement.

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The present study describes the spontaneous and experimental poisoning of goats by Festuca argentina in Argentine Patagonia. In April 2017, eight seven-month-old Creole male goats were accidentally introduced into a paddock that contained F. argentina. After four days, two of the goats were found dead and four out of the six remaining goats were clinically affected. Two of the latter had to be later euthanized in extremis. The main clinical signs were progressive nervous signs, starting with moderate muscle tremors, wide-based stance and ataxia. Postmortem examination was performed on the two euthanized goats. Epidermal fragments of F. argentina were found in the rumen samples from the necropsied goats and the fecal samples from the four affected goats. For the experimental poisoning, fresh sheaths of F. argentina collected from the paddock were offered to two goats at 10 g/kg body weight for 3 days. After 24-36 h, both animals exhibited severe muscle tremors, reluctance to move, tetanic convulsions, and opisthotonus. In both the spontaneously and experimentally poisoned goats, gross lesions were similar and consisted of dehydration, petechial hemorrhages in the epicardium and congestion. The main microscopic findings consisted of degeneration and loss of Purkinje cells and torpedoes in the granular layer of the cerebellum. The F. argentina sheaths collected from the pasture were found to contain tremorgenic indole-diterpene alkaloids. Taken together, the results of the present study suggest that the tremorgenic syndrome observed in the spontaneously poisoned goats was due to poisoning by F. argentina.

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Brucellosis in rams is caused by Brucella ovis or Brucella melitensis and it is considered one of the most important infectious diseases of males in sheep-raising countries. Molecular characterization of Brucella spp. achieved by multi-locus variable number of tandem repeats analysis (MLVA) is a powerful tool to genotype Brucella spp. However, data regarding B. ovis genotyping is scarce. Thus, the aim of this study was to characterize the molecular diversity of B. ovis field-strains in Argentina. A total of 115 isolates of B. ovis from Argentina and Uruguay were genotyped using MLVA-16 and analyzed altogether with 14 publicly available B. ovis genotypes from Brazil. The Discriminatory Power (D) was 0.996 for MLVA-16 and 0.0998 for MLVA-8 and MLVA-11. Analysis of MLVA-16 revealed 100 different genotypes, all of them novel, including 90 unique ones. There was no correlation between geographical distribution and genotype and results showed a higher diversity within provinces than between provinces. Clustering analysis of the strains from Argentina, Uruguay and Brazil revealed that the 129 isolates were grouped into two clades. Whole Genome Sequencing analysis of the 19 B. ovis genomes available in public databases, and including some of the Argentinian strains used in this study, revealed clustering of the Argentinian isolates and closer relationship with B. ovis from New Zealand and Australia. This work adds new data to the poorly understood distribution map of genotypes regionally and worldwide for B. ovis and it constitutes the largest study of B. ovis molecular genotyping until now.

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Resumen Los objetivos de este trabajo fueron estudiar la sensibilidad antibiótica de aislamientos de Corynebacterium pseudotuberculosis procedentes de pequeños rumiantes e investigar la presencia de integrones que contienen genes de resistencia. Se estudiaron 15 aislamientos de diferentes fuentes por los métodos de difusión y dilución. Por el método de difusión, amoxicilina-clavulánico, ampicilina, cefotaxima, cefoxitina, ciprofloxacina, cloranfenicol, eritromicina, estreptomicina, gentamicina, imipenem, kanamicina, norfloxacina, penicilina, rifampicina, tetraciclina, trimetroprima-sulfametoxazol y vancomicina fueron activos frente al 100% de los aislamientos, mientras que amicacina presentó resultados variables. En los aislamientos que desarrollaron frente a amicacina se investigó la presencia de integrones de clase 1. El resultado fue negativo, sugiriendo la ausencia del integrón. Utilizando el método de dilución, los antibióticos más activos correspondieron a los grupos de cefalosporinas, gluco-péptidos, macrólidos, quinolonas y tetraciclinas. Se demostró menor actividad de p-lactámicos y aminoglucósidos. No se registró variabilidad en los perfiles antibióticos en los aislamientos procedentes de diferentes fuentes.

Abstract The aims of this work were to study the antibiotic susceptibility in Corynebacterium pseudotuberculosis isolated from small ruminants and to determine the presence of integrons that contain resistance genes. Fifteen isolates of different sources were analysed using the diffusion and the dilution methods. When the diffusion method was performed, amoxicillin-clavulanic, ampicillin, cefotaxime, cefoxitin, ciprofloxacin, chloramphenicol, erythromycin, streptomycin, gentamicin, imipenem, kanamycin, norfloxacin, penicillin, rifampicin, tetracycline, trimethoprim-sulfamethoxazole and vancomycin were effective against the 100% of isolates, while amikacin showed variable results. The isolates that were able to grow with amikacin, were studied in relation to the presence of integron class 1. The result was negative, suggesting the absence of integron. Using dilution method, the antibiotics belonging to the cephalosporin, glycopeptide, macrolide, quinolone, and tetracycline groups were the most active ones for the C. pseudotuberculosis biovar ovis isolates. Less activity of p-lactam and aminoglycosides were observed. There was no observation of variability in the antibiotic patterns in the strains coming from different sources.

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OBJECTIVE: To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). METHODS: A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. RESULTS: Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101-259) vs. 574 (423-774) at the last checkup. The time of TTh administration was 34 months (12-72). An increase in triglyceride levels (200 (153-294) vs. 174 (134-233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2-10) vs. 7 (IQR 4-12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43-1.19) vs. 0.82 (0.45-1.4) ng/mL; p=0.02) was evidenced during TTh. CONCLUSION: TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.

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Swainsonine has been identified as the toxin in legumes belonging to the genera Astragalus and Oxytropis throughout the world including China, North America, and South America. Several South American Astragalus species have been reported to contain swainsonine; however, data is lacking to support the presence of a fungal symbiont in South American Astragalus species as has been shown for North American and Chinese Astragalus and Oxytropis species. The objective of this study was to investigate several South American species that have been reported to contain swainsonine for the presence of the fungal symbiont using culturing and PCR. Swainsonine was detected in field collections of A. pehuenches, A. illinii and A. chamissonis but not A. moyanoi, which is consistent with reports of toxicity regarding these species. The symbiont Alternaria section Undifilum was detected by PCR in all three species that contained swainsonine but not in A. moyanoi. A fungal symbiont was isolated from seeds of Astragalus pehuenches and A. illinii. The isolated symbiont from both respective species produced swainsonine in vitro, and was demonstrated to belong to the genus Alternaria section Undifilum by analysis of the nuclear ribosomal DNA. It is highly likely that Alternaria section Undifilum isolates will be associated with other South American Astragalus species that are reported to contain swainsonine.

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The aims of this work were to study the antibiotic susceptibility in Corynebacterium pseudotuberculosis isolated from small ruminants and to determine the presence of integrons that contain resistance genes. Fifteen isolates of different sources were analysed using the diffusion and the dilution methods. When the diffusion method was performed, amoxicillin-clavulanic, ampicillin, cefotaxime, cefoxitin, ciprofloxacin, chloramphenicol, erythromycin, streptomycin, gentamicin, imipenem, kanamycin, norfloxacin, penicillin, rifampicin, tetracycline, trimethoprim-sulfamethoxazole and vancomycin were effective against the 100% of isolates, while amikacin showed variable results. The isolates that were able to grow with amikacin, were studied in relation to the presence of integron class1. The result was negative, suggesting the absence of integron. Using dilution method, the antibiotics belonging to the cephalosporin, glycopeptide, macrolide, quinolone, and tetracycline groups were the most active ones for the C.pseudotuberculosis biovar ovis isolates. Less activity of ß-lactam and aminoglycosides were observed. There was no observation of variability in the antibiotic patterns in the strains coming from different sources.

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Fire modifies soil surface, and hence soil hydrological properties change after wildland fires. High fire severity causes partial or total removal of vegetation, reduction of soil aggregate stability and increased water repellency, which are associated with high runoff and erosion. The spatial connection among these runoff sources is an important factor to consider when evaluating fire-induced changes on hillslope and catchment hydrology, as fire generates connected areas of bare soil, which may increase hydrological connectivity and hence post-fire runoff and erosion. The aim of this study was to quantify changes in hydrological connectivity and efficiency in two burned areas in central Mexico. By integrating rainfall simulation and spatial analysis, an index of connectivity (IC) and the lateral hydrological efficiency index (LHEI) were computed based on land/cover use, fire severity and topography within 287 burned sub-basins. Post-fire IC and LHEI were compared with the pre-fire scenario, and the relationship between LHEI and the proportion of burned area was assessed at the sub-basin level. Thresholds of the burned area per fire severity needed to increase LHEI were determined by a classification tree. The index of connectivity and LHEI were higher after wildland fires. The burned area was positively related with LHEI, and at least 43.3% of area burned with high severity is sufficient to produce the highest LHEI. The results are evidence of the effect of fire on hydrological connectivity and efficiency which adds to the understanding of fire-hydrology relations and can be used for integrated catchment management, ecological restoration and risk assessment.

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This is the first report of a spontaneous outbreak of Astragalus pehuenches poisoning on a farm in Argentine Patagonia, where 63 out of 70 cattle died. The main clinical signs of affected animals were ataxia, balance loss and progressive emaciation. Purkinje cells presented vacuolation and marginalization of the nucleus. Astragalus pehuenches was detected in the paddock as well as in the ruminal content and fecal matter samples of the affected animals. Swainsonine concentrations in Astragalus specimens were found to be as high as 0.096%.

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Orf virus (ORFV) is the etiological agent of Contagious Ecthyma (CE) disease that mainly affects sheep, goats, wild ruminants, and humans with a worldwide distribution. To date, only two strains from Argentinian sheep have been characterized at the molecular level and there is little information on ORFV strains circulating in Argentina. Here we describe and analyze five outbreaks of CE in goats in three geographic regions of the country: Northwest, Center, and Southwest. The phylogenetic analysis based on four molecular markers of ORFV (orf011 partial sequence and orf020, orf109, and orf127 complete sequence genes) revealed that there are different strains circulating in Argentina and pointed out the importance of knowing the health status of animals traded between farms.

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Swainsonine is a toxic alkaloid found in several plant genera worldwide. The objective of this study was to screen several South American Astragalus species for the toxin swainsonine. Swainsonine was detected in 16 of 30 Astragalus species using liquid and gas chromatography coupled with mass spectrometry. Information in regard to the swainsonine content of these species may provide important information on the risk of grazing these toxic species.

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Dissections of extracranial arteries are estimated to account for only 2% of all ischemic strokes but for approximately 20% of strokes in patients younger than 45 years old. Most dissections of extracranial arteries involve some trauma stretch, mechanical stress, or connective tissue abnormalities. In the absence of these disorders, determining the etiology of recurrent extracranial dissections is quite challenging because the underlying nature of these cases is poorly understood. We report the case of a 44-year-old female with recurrent dissections of the vertebral and carotid arteries associated with a heterozygous mutation p.Pro2122Leu in the NOTCH 1 gene. Her mother with a thoracic aortic aneurysm was also positive for this variant.

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Vascular endothelial growth factor (VEGF) is important in the growth and metastasis of cancer cells. In 2001, another angiogenic factor, endocrine gland-derived VEGF (EG-VEGF), was characterized and sequenced. EG-VEGF activity appears to be restricted to endothelial cells derived from endocrine glands. At the molecular level, its expression is regulated by hypoxia and steroid hormones. Although VEGF and EG-VEGF are structurally different, they function in a coordinated fashion. Since the majority of mammary tumors are hormone-dependent, it was hypothesized that EG-VEGF would be expressed in these tumors, and therefore, represent a potential target for anti-angiogenic therapy. The aim of the present study was to assess the expression of VEGF, EG-VEGF and its receptor (prokineticin receptor-1), as well as that of breast cancer resistant protein, estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2, in 50 breast samples of infiltrating canalicular carcinoma (ICC) and their correlation with tumor staging. The samples were analyzed using reverse transcription-quantitative polymerase chain reaction and immunohistochemistry. Both angiogenic growth factors were identified in all samples. However, in 90% of the samples, the expression level of VEGF was significantly higher than that of EG-VEGF (P=0.024). There was no association between the expression of VEGF, EG-VEGF or its receptor with tumor stage. In ICC, the predominant angiogenic factor expressed was VEGF. The expression level of either factor was not correlated with the tumor-node-metastasis stage. Although ICC is derived from endothelial cells, EG-VEGF expression was not the predominant angiogenic/growth factor in ICC.

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Brucellosis caused by Brucella ovis is one of the most important infectious diseases of sheep. The aim of this study was to determine the presence of genes both inside and outside the specific B. ovis pathogenicity island 1 (BOPI-1) in a large collection of field isolates of B. ovis and other Brucella spp. from Argentina. The BOV_A0500 gene from B. ovis BOPI-1 was identified in all 104 B. ovis isolates studied. The BOPI-1 complete sequence was found to be conserved in 10 B. ovis strains from the collection, for which whole genome sequencing was performed. The BOV_0198 gene, which is outside BOPI-1 and considered exclusive to B. ovis, showed 90-100% identity with genomic regions of B. ovis, B. melitensis, B. abortus, B. canis, B. suis, B. microti, B. ceti and B. pinnipedialis. The results demonstrate that BOPI-1 is the only exclusive genetic region of B. ovis and marine Brucella spp. and that it is highly conserved in B. ovis field isolates from Argentina.

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Orf virus (ORFV) is the etiological agent of contagious ecthyma (CE), a pustular dermatitis of sheep and goats. Outbreaks of ORFV have been observed in all geographical regions of the world, including Argentina. The origin and identity of Argentinian ORFVs are unknown, and no comparative or phylogenetic studies of these viruses have been performed. In this study, we described the sequencing and analysis of five ORFV molecular markers: a partial B2L gene (ORF011), VIR (ORF020), an envelope mature protein (ORF109), vIL10 (ORF127), and GIF (ORF117) from two particular Argentinian outbreaks of CE.

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Necrotising fasciitis (NF) is a soft tissue bacterial-derived infection characterised clinically by fulminant tissue destruction of the poorly blood-supplied muscle fascia and overlying subcutaneous fat. Although these infections first appear as minor superficial manifestations, they are capricious in nature and often lead to sepsis, organ failure and high mortality. We report a case of type II necrotising fasciitis in a 39-year-old Caucasian female patient who presented to the emergency department with cellulitis of her right foot and lower leg that rapidly developed into tissue necrosis. The patient course is of unique interest due to progressive history over a 104 days time frame with complications following surgical treatments and outpatient follow-up. We highlight the importance of early detection and pertinent clinical awareness from a wide range of medical specialties that were involved in this case, and how this process is critical, in order to properly diagnose and treat NF-derived tissue infections.

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INTRODUCCIÓN: La no adherencia a la Terapia antirretroviral de gran actividad (TARGA) es la principal causa de fracaso en el tratamiento de pacientes con infección por VIH y depende de factores relacionados al individuo, a la enfermedad, a la medicación y al equipo asistencial. OBJETIVO: Identificar los factores asociados a falla en la adherencia de la TARGA en pacientes con infección por VIH que acuden a consulta ambulatoria de infectología en el Hospital Nacional Edgardo Rebagliati Martins en el periodo de diciembre de 2012 a febrero de 2013. HIPÓTESIS: Identificar los factores asociados a falla en la adherencia de la TARGA en pacientes con infección por VIH que acuden a consulta ambulatoria de infectología en el Hospital Nacional Edgardo Rebagliati Martins en el periodo de diciembre de 2012 a febrero de 2013. METODOLOGÍA: Estudio descriptivo, analítico transversal. A pacientes con infección por VIH que recibían TARGA en consulta externa se les aplicó el cuestionario SMAQ para valorar la adherencia y mediante una encuesta se evaluaron factores asociados a la adherencia. Para determinar la asociación, se empleó las pruebas de chi cuadrado se estableció un nivel de significación estadística p<0,05, y para calcular el riesgo se utilizó el OR, con intervalos de confianza de 95 por ciento. RESULTADOS: Se encuestó a 200 personas; la edad promedio fue de 38.8 años (22-80 a); 73 por ciento eran de sexo masculino. El 18 por ciento de los encuestados resulto no ser adherente. Los factores asociados a la no adherencia fueron: grado de instrucción no superior (OR: 8.44 IC: 95 por ciento 3.46 a 20.49), uso de drogas (OR: 11.9 lC: 95 por ciento 4.02 a 39.30), no percepción de utilidad de la TARGA (OR: 9.73 le: 95 por ciento 3.74 a 25.32) CD4 inferior de 200 cel (OR: 28.21 LC: 95 por ciento 10.97 a 72.51) carga viral detectable (OR: 169.4 lC: 95 por ciento 44.19 a 649.45), enfermedad definitoria de estadio SIDA (OR: 4.25 lC: 95 por ciento 1.76 a 10.24), cambios en el...

INTRODUCTION: Non-adherence to highly active antiretroviral therapy (HAART) is the leading cause of treatment failure in patients with HIV infection and depends on factors related to the individual, illness, medication and care team. OBJECTIVE: To identify factors associated with failure of HAART adherence in HIV- infected patients attending outpatient clinic of infectious diseases in the National Hospital Edgardo Rebagliati Martins in the period December 2012 to February 2013. HYPOTHESIS: To identify factors associated with failure of HAART adherence in HIV-infected patients attending outpatient clinic of infectious diseases in the National Hospital Edgardo Rebagliati Martins in the period December 2012 to February 2013. METHODOLOGY: A descriptive, cross-sectional analytical. In HIV-infected patients receiving HAART outpatient we applied the SMAQ questionnaire to assess adherence through a survey and evaluated factors associated with adherence. To determine the association, we used chi square tests established a level of statistical significance p<0.05, and to calculate the risk OR was used, with confidence intervals of 95 per cent. RESULTS: We surveyed 200 people, the average age was 38.8 years (22 - 80), 73 per cent were male. The 18 per cent of respondents turned out to be adherent. Factors associated with nonadherence were not higher education level (OR: 8.44 Cl 95 per cent 3.46 to 20.49), drug use (OR: 9.11 Cl 95 per cent 4.02 to 39.30), no perceived usefulness of HAART (OR: 9.73 Cl 95 per cent 3.74 to 25.32) CD4 less than 200 cells (OR 28.21 Cl 10.97 to 72.51 95 per cent) detectable viral load (OR: 169.4 el: 95 per cent 44.19 to 649.45), AIDS-defining illness stage (OR: 4.25 el 95 per cent 1.76 to 10.24), changes in the HAART (OR: 2.94 Cl 95 per cent 1.33 to 6.48) and psychiatric comorbidity (OR 22.43 Cl 95 per cent 8.25 to 68.97). CONCLUSIONS: We found high adherence to HAART in patients with HIV infection, similar to that found in other studies...

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