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Drought is widely recognized as one of the most significant agricultural constraints worldwide. A strategy to avoid the adverse effects of drought on crops is to cultivate high-yielding varieties by grafting them onto drought-tolerant rootstocks with a differentiated root system. Thus, the objective of this study was to evaluate fruit yield and quality, root system architecture, and water productivity of watermelon grafted onto Lagenaria siceraria rootstocks. To do so, a commercial watermelon cultivar "Santa Amelia" [Citrullus lanatus (Thunb.)] was grafted onto five L. siceraria rootstocks: 'Illapel', 'Osorno', 'BG-48', 'GC', and 'Philippines', which were grown under three irrigation treatments (100%, 75%, and 50% of evapotranspiration). The comparison of the L. siceraria rootstocks in the irrigation treatments demonstrated no significant effect on watermelon fruit quality parameters. The rootstocks 'Illapel', 'Osorno', and 'GC' significantly improved the fruit number and yield (total fruit weight) under water deficit. Similarly, 'Illapel', 'Osorno', and 'GC' consistently showed statistical differences for root system architecture traits compared to 'BG-48' and 'Philippines'. Based on these results, we concluded that the used L. siceraria rootstocks did not affect the fruit yield and quality of grafted watermelon under water deficit. This study may help adjust the amount of applied water for watermelon production where L. siceraria rootstocks are utilized.

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In many agricultural areas, crop production has decreased due to a lack of water availability, which is having a negative impact on sustainability and putting food security at risk. In plants, the plasticity of the root system architecture (RSA) is considered to be a key trait driving the modification of the growth and structure of roots in response to water deficits. The purpose of this study was to examine the plasticity of the RSA traits (mean root diameter, MRD; root volume, RV; root length, RL; and root surface area, SA) associated with drought tolerance in eight Lagenaria siceraria (Mol. Standl) genotypes, representing three different geographical origins: South Africa (BG-58, BG-78, and GC), Asia (Philippines and South Korea), and Chile (Illapel, Chepica, and Osorno). The RSA changes were evaluated at four substrate depths (from 0 to 40 cm). Bottle gourd genotypes were grown in 20 L capacity pots under two contrasting levels of irrigation (well-watered and water-deficit conditions). The results showed that the water productivity (WP) had a significant effect on plasticity values, with the Chilean accessions having the highest values. Furthermore, Illapel and Chepica genotypes presented the highest WP, MRD, and RV values under water-deficit conditions, in which MRD and RV were significant in the deeper layers (20-30 and 30-40 cm). Biplot analysis showed that the Illapel and Chepica genotypes presented a high WP, MRD, and RV, which confirmed that these may be promising drought-tolerant genotypes. Consequently, increased root diameter and volume in bottle gourd may constitute a response to a water deficit. The RSA traits studied here can be used as selection criteria in bottle gourd breeding programs under water-deficit conditions.

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Genomic selection models were investigated to predict several complex traits in breeding populations of Zea mays L. and Eucalyptus globulus Labill. For this, the following methods of Machine Learning (ML) were implemented: (i) Deep Learning (DL) and (ii) Bayesian Regularized Neural Network (BRNN) both in combination with different hyperparameters. These ML methods were also compared with Genomic Best Linear Unbiased Prediction (GBLUP) and different Bayesian regression models [Bayes A, Bayes B, Bayes Cπ, Bayesian Ridge Regression, Bayesian LASSO, and Reproducing Kernel Hilbert Space (RKHS)]. DL models, using Rectified Linear Units (as the activation function), had higher predictive ability values, which varied from 0.27 (pilodyn penetration of 6 years old eucalypt trees) to 0.78 (flowering-related traits of maize). Moreover, the larger mini-batch size (100%) had a significantly higher predictive ability for wood-related traits than the smaller mini-batch size (10%). On the other hand, in the BRNN method, the architectures of one and two layers that used only the pureline function showed better results of prediction, with values ranging from 0.21 (pilodyn penetration) to 0.71 (flowering traits). A significant increase in the prediction ability was observed for DL in comparison with other methods of genomic prediction (Bayesian alphabet models, GBLUP, RKHS, and BRNN). Another important finding was the usefulness of DL models (through an iterative algorithm) as an SNP detection strategy for genome-wide association studies. The results of this study confirm the importance of DL for genome-wide analyses and crop/tree improvement strategies, which holds promise for accelerating breeding progress.

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The evaluation of root system architecture (RSA) development and the physiological responses of crop plants grown under water-limited conditions are of great importance. The purpose of this study was to examine the short-term variation of the morphological and physiological plasticity of Lagenaria siceraria genotypes under water deficit, evaluating the changes in the relationship between the root system architecture and leaf physiological responses. Bottle gourd genotypes were grown in rhizoboxes under well-watered and water deficit conditions. Significant genotype-water regime interactions were observed for several RSA traits and physiological parameters. Biplot analyses confirmed that the drought-tolerant genotypes (BG-48 and GC) showed a high net CO2 assimilation rate, stomatal conductance, transpiration rates with a smaller length, and a reduced root length density of second-order lateral roots, whereas the genotypes BG-67 and Osorno were identified as drought-sensitive and showed greater values for average root length and the density of second-order lateral roots. Consequently, a reduced length and density of lateral roots in bottle gourd should constitute a response to water deficit. The root traits studied here can be used to evaluate bottle gourd performance under novel water management strategies and as criteria for breeding selection.

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BACKGROUND: Tuberculosis (TB) control programs face the challenges of decreasing incidence, mortality rates, and drug resistance while increasing treatment adherence. The Brazilian TB control program recommended the decentralization of patient care as a strategy for combating the disease. This study evaluated the performance of this policy in an area with high default rates, comparing epidemiological and operational indicators between two similar municipalities. METHODS: This study analyzed epidemiological and operational indicators on new cases of pulmonary tuberculosis reported in the Brazilian Notifiable Diseases Information System between 2006 and 2015. In addition, to characterize differences between the populations of the two studied municipalities, a prospective cohort study was conducted between 2014 and 2015, in which patients with new cases of culture-confirmed pulmonary tuberculosis were interviewed and monitored until the disease outcome. A descriptive analysis, the chi-square test, and a Poisson regression model were employed to compare TB treatment outcomes and health care indicators between the municipalities. RESULTS: Two thousand three hundred nine cases were evaluated, of which 207 patients were interviewed. Over the 2006-2015 period, TB incidence per 100,000 population in the municipality with decentralized care was significantly higher (39%, 95% CI 27-49%) in comparison to that of the municipality with centralized care. TB treatment default rate (45%, 95% CI 12-90%) was also higher in the municipality with decentralized care. During the two-year follow-up, significant differences were found between patients in centralized care and those in decentralized care regarding treatment success (84.5 vs. 66.1%), treatment default (10.7 vs. 25.8%), illicit drug use (27.7 vs. 45.9%), and homelessness (3.6 vs. 12.9%). The operational indicators revealed that the proportion of control smear tests, medical imaging, and HIV tests were all significantly higher in the centralized care. However, a significantly higher proportion of patients started treatment in the early stages of the disease in the municipality with decentralized care. CONCLUSIONS: These data showed a low success rate in TB treatment in both municipalities. Decentralization of TB care, alone, did not improve the main epidemiological and operational indicators related to disease control when compared to centralized care. Full implementation of strategies already recommended is needed to improve TB treatment success rates.

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Downy mildew caused by Plasmopara viticola is a major disease of grapes in Paraná State, Brazil and other wine-producing regions. The seedless table grape BRS Vitória stands out for its tolerance to this disease and is a viable alternative to reduce fungicide applications. The objectives of this study were to analyze the influence of weather-related factors, such as temperature and rainfall on disease progress and to evaluate the efficacy of fungicide spray programs for controlling downy mildew of grapes during the summer-fall and winter-spring crop seasons in northern Paraná, Brazil. Field trials were conducted in Marialva, Paraná, during the winter-spring crop seasons (August to December) in 2013 and 2014 and the summer-fall crop seasons (January to May) in 2014 and 2015. The experimental design used was completely randomized with repeated measurements over the phenological periods, with five treatments and 10 replicates. The following treatments were compared: (1) conventional, in which fungicides were applied according to conventional standards; (2) preventive fungicide sprays every seven days; (3) preventive fungicide sprays every 14 days; (4) fungicide sprays after observing the first downy mildew symptoms; and (5) no fungicide sprays. In the conventional fungicide program, sprays were performed two or three times per week. Treatments 2 and 3 received sprayings between...

O míldio da videira causado pelo fungo Plasmopara viticola é a principal doença da videira no Paraná e em outras regiões vitícolas do país. A cultivar de uva sem sementes BRS Vitória destaca-se pela tolerância a esta doença e constitui uma alternativa viável para a produção de uva de mesa com menor emprego de fungicidas. Os objetivos deste trabalho foram analisar a influência de fatores climáticos sobre o progresso da doença e avaliar a eficácia dos programas de pulverização de fungicidas para controlar o míldio da videira durante as safras normal e temporã no norte do Paraná, Brasil. Os ensaios de campo foram conduzidos em Marialva, Paraná, durante as safras normal (agosto a dezembro) em 2013 e 2014 e safra temporã (janeiro a maio) em 2014 e 2015. O delineamento experimental utilizado foi inteiramente casualizado com medidas repetidas ao longo dos períodos fenológicos, com cinco tratamentos e 10 repetições. Os seguintes tratamentos foram comparados: (1) convencional, em que os fungicidas foram aplicados de acordo com padrões convencionais; (2) pulverizações a cada sete dias; (3) pulverizações a cada 14 dias; (4) pulverizações de fungicidas após observar os primeiros sintomas do míldio; e (5) controle. No programa convencional, as pulverizações foram realizadas duas ou três vezes por semana. Os tratamentos 2 e 3 receberam pulverizações entre o início da brotação e a maturação...

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Downy mildew caused by Plasmopara viticola is a major disease of grapes in Paraná State, Brazil and other wine-producing regions. The seedless table grape BRS Vitória stands out for its tolerance to this disease and is a viable alternative to reduce fungicide applications. The objectives of this study were to analyze the influence of weather-related factors, such as temperature and rainfall on disease progress and to evaluate the efficacy of fungicide spray programs for controlling downy mildew of grapes during the summer-fall and winter-spring crop seasons in northern Paraná, Brazil. Field trials were conducted in Marialva, Paraná, during the winter-spring crop seasons (August to December) in 2013 and 2014 and the summer-fall crop seasons (January to May) in 2014 and 2015. The experimental design used was completely randomized with repeated measurements over the phenological periods, with five treatments and 10 replicates. The following treatments were compared: (1) conventional, in which fungicides were applied according to conventional standards; (2) preventive fungicide sprays every seven days; (3) preventive fungicide sprays every 14 days; (4) fungicide sprays after observing the first downy mildew symptoms; and (5) no fungicide sprays. In the conventional fungicide program, sprays were performed two or three times per week. Treatments 2 and 3 received sprayings between...(AU)

O míldio da videira causado pelo fungo Plasmopara viticola é a principal doença da videira no Paraná e em outras regiões vitícolas do país. A cultivar de uva sem sementes BRS Vitória destaca-se pela tolerância a esta doença e constitui uma alternativa viável para a produção de uva de mesa com menor emprego de fungicidas. Os objetivos deste trabalho foram analisar a influência de fatores climáticos sobre o progresso da doença e avaliar a eficácia dos programas de pulverização de fungicidas para controlar o míldio da videira durante as safras normal e temporã no norte do Paraná, Brasil. Os ensaios de campo foram conduzidos em Marialva, Paraná, durante as safras normal (agosto a dezembro) em 2013 e 2014 e safra temporã (janeiro a maio) em 2014 e 2015. O delineamento experimental utilizado foi inteiramente casualizado com medidas repetidas ao longo dos períodos fenológicos, com cinco tratamentos e 10 repetições. Os seguintes tratamentos foram comparados: (1) convencional, em que os fungicidas foram aplicados de acordo com padrões convencionais; (2) pulverizações a cada sete dias; (3) pulverizações a cada 14 dias; (4) pulverizações de fungicidas após observar os primeiros sintomas do míldio; e (5) controle. No programa convencional, as pulverizações foram realizadas duas ou três vezes por semana. Os tratamentos 2 e 3 receberam pulverizações entre o início da brotação e a maturação...(AU)

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The Tuberculosis (TB) notification rates are 5 to 81 times higher in prisons worldwide when compared to the general population. The state of Santa Catarina (SC) has few epidemiological data regarding TB in prisons. The aim of this study was to evaluate the molecular epidemiology of circulating strains in prisons of SC. The study comprised 95 clinical samples from six prisons. Among the cases included, all subjects were male, predominantly caucasians, and young adults, with low education level. The positive smear in the TB diagnosis comprised 62.0% of cases. About 50% of subjects had some condition associated with TB. The Spoligotyping results showed that the most frequent lineages were LAM (50.7%), T (22.2%) and S (11.6%). The 12-loci MIRU generated 62 different genotypes. The MSTs showed evolutionary relationships between Mycobacterium tuberculosis spoligotypes from SC and evolutionary relationships between the prison isolates and studied parameters. This first study on TB in prison units of SC highlighted the predominance of SIT216/LAM5, and SIT34/S. Interestingly, his profile was found to be different from that observed in a previous study performed with the state's general population. This data shows the need for continued surveillance of episodes of TB occurring among prison inmates in an emerging country like Brazil.

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This study aimed to evaluate the inbreeding depression and average genetic components in seven hybrids and two open pollinated cultivars for green corn production, as well as to select the best genotypes in order to obtain base populations for inbred lines extraction. The experiment was carried out in a randomized complete block design with four replications, in a split plot design, with inbreeding levels arranged in the plots and the different genotypes distributed over the subplots, in the municipality of Sabáudia - PR, during the 2014/15 crop season. Higher values of dominance and inbreeding depression were observed for yield of both unhusked and commercial ears. Higher additive effects were detected on length and diameter of commercial ears. The genotypes AM811, Cativerde 02 and AG4051 showed greater probability of obtaining highly productive and higher quality green corn inbred lines.

O trabalho teve por objetivo avaliar a depressão por endogamia e os componentes genéticos de médias em sete híbridos e em duas variedades de polinização aberta para uso como milho verde, para seleção de genótipos visando à formação de populações-base para a extração de linhagens. Para a realização do estudo, foi instalado um experimento no município de Sabáudia - PR, no ano agrícola de 2014/15. O experimento foi delineado em blocos completos ao acaso, com quatro repetições, em arranjo de parcelas subdivididas, com as gerações de endogamia e os diferentes genótipos ocupando as parcelas e as subparcelas, respectivamente. As maiores estimativas de dominância e de depressão endogâmica foram observadas na produtividade de espigas empalhadas e comerciais. Os efeitos aditivos foram mais expressivos na herança do comprimento e do diâmetro de espigas comerciais. Os genótipos AM811, Cativerde 02 e AG4051 apresentaram maiores probabilidades no sucesso de extração de linhagens destinadas à produtividade e qualidade de milho verde.

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This study aimed to evaluate the inbreeding depression and average genetic components in seven hybrids and two open pollinated cultivars for green corn production, as well as to select the best genotypes in order to obtain base populations for inbred lines extraction. The experiment was carried out in a randomized complete block design with four replications, in a split plot design, with inbreeding levels arranged in the plots and the different genotypes distributed over the subplots, in the municipality of Sabáudia - PR, during the 2014/15 crop season. Higher values of dominance and inbreeding depression were observed for yield of both unhusked and commercial ears. Higher additive effects were detected on length and diameter of commercial ears. The genotypes AM811, Cativerde 02 and AG4051 showed greater probability of obtaining highly productive and higher quality green corn inbred lines.(AU)

O trabalho teve por objetivo avaliar a depressão por endogamia e os componentes genéticos de médias em sete híbridos e em duas variedades de polinização aberta para uso como milho verde, para seleção de genótipos visando à formação de populações-base para a extração de linhagens. Para a realização do estudo, foi instalado um experimento no município de Sabáudia - PR, no ano agrícola de 2014/15. O experimento foi delineado em blocos completos ao acaso, com quatro repetições, em arranjo de parcelas subdivididas, com as gerações de endogamia e os diferentes genótipos ocupando as parcelas e as subparcelas, respectivamente. As maiores estimativas de dominância e de depressão endogâmica foram observadas na produtividade de espigas empalhadas e comerciais. Os efeitos aditivos foram mais expressivos na herança do comprimento e do diâmetro de espigas comerciais. Os genótipos AM811, Cativerde 02 e AG4051 apresentaram maiores probabilidades no sucesso de extração de linhagens destinadas à produtividade e qualidade de milho verde.(AU)

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Mapping quantitative trait loci through the use of linkage disequilibrium (LD) in populations of unrelated individuals provides a valuable approach for dissecting the genetic basis of complex traits in soybean (Glycine max). The haplotype-based genome-wide association study (GWAS) has now been proposed as a complementary approach to intensify benefits from LD, which enable to assess the genetic determinants of agronomic traits. In this study a GWAS was undertaken to identify genomic regions that control 100-seed weight (SW), plant height (PH) and seed yield (SY) in a soybean association mapping panel using single nucleotide polymorphism (SNP) markers and haplotype information. The soybean cultivars (N = 169) were field-evaluated across four locations of southern Brazil. The genome-wide haplotype association analysis (941 haplotypes) identified eleven, seventeen and fifty-nine SNP-based haplotypes significantly associated with SY, SW and PH, respectively. Although most marker-trait associations were environment and trait specific, stable haplotype associations were identified for SY and SW across environments (i.e., haplotypes Gm12_Hap12). The haplotype block 42 on Chr19 (Gm19_Hap42) was confirmed to be associated with PH in two environments. These findings enable us to refine the breeding strategy for tropical soybean, which confirm that haplotype-based GWAS can provide new insights on the genetic determinants that are not captured by the single-marker approach.

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Knowledge of the genetic architecture of flowering and maturity is needed to develop effective breeding strategies in tropical soybean. The aim of this study was to identify haplotypes across multiple environments that contribute to flowering time and maturity, with the purpose of selecting desired alleles, but maintaining a minimal impact on yield-related traits. For this purpose, a genome-wide association study (GWAS) was undertaken to identify genomic regions that control days to flowering (DTF) and maturity (DTM) using a soybean association mapping panel genotyped for single nucleotide polymorphism (SNP) markers. Complementarily, yield-related traits were also assessed to discuss the implications for breeding strategies. To detect either stable or specific associations, the soybean cultivars (N = 141) were field-evaluated across eight tropical environments of Brazil. Seventy-two and forty associations were significant at the genome-wide level relating respectively to DTM and DTF, in two or more environments. Haplotype-based GWAS identified three haplotypes (Gm12_Hap12; Gm19_Hap42 and Gm20_Hap32) significantly co-associated with DTF, DTM and yield-related traits in single and multiple environments. These results indicate that these genomic regions may contain genes that have pleiotropic effects on time to flowering, maturity and yield-related traits, which are tightly linked with multiple other genes with high rates of linkage disequilibrium.

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ABSTRACT: This study aimed to evaluate the inbreeding depression and average genetic components in seven hybrids and two open pollinated cultivars for green corn production, as well as to select the best genotypes in order to obtain base populations for inbred lines extraction. The experiment was carried out in a randomized complete block design with four replications, in a split plot design, with inbreeding levels arranged in the plots and the different genotypes distributed over the subplots, in the municipality of Sabáudia - PR, during the 2014/15 crop season. Higher values of dominance and inbreeding depression were observed for yield of both unhusked and commercial ears. Higher additive effects were detected on length and diameter of commercial ears. The genotypes AM811, Cativerde 02 and AG4051 showed greater probability of obtaining highly productive and higher quality green corn inbred lines.

RESUMO: O trabalho teve por objetivo avaliar a depressão por endogamia e os componentes genéticos de médias em sete híbridos e em duas variedades de polinização aberta para uso como milho verde, para seleção de genótipos visando à formação de populações-base para a extração de linhagens. Para a realização do estudo, foi instalado um experimento no município de Sabáudia - PR, no ano agrícola de 2014/15. O experimento foi delineado em blocos completos ao acaso, com quatro repetições, em arranjo de parcelas subdivididas, com as gerações de endogamia e os diferentes genótipos ocupando as parcelas e as subparcelas, respectivamente. As maiores estimativas de dominância e de depressão endogâmica foram observadas na produtividade de espigas empalhadas e comerciais. Os efeitos aditivos foram mais expressivos na herança do comprimento e do diâmetro de espigas comerciais. Os genótipos AM811, Cativerde 02 e AG4051 apresentaram maiores probabilidades no sucesso de extração de linhagens destinadas à produtividade e qualidade de milho verde.

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Molecular epidemiology of Mycobacterium tuberculosis is useful for understanding disease transmission dynamics, and to establish strategic measures for TB control and prevention. The aim of this study was to analyze clinical, epidemiological and molecular characteristics of MTBC clinical isolates from Santa Catarina state, southern Brazil. During one-year period, 406 clinical isolates of MTBC were collected from Central Laboratory of Public Health and typed by spoligotyping. Demographic and clinical data were collected from the Brazilian National Mandatory Disease Reporting System. The majority of cases occurred in highest population densities regions and about 50% had some condition associated with TB. Among all isolates, 5.7% were MDR, which showed association with drug addiction. LAM was the most predominant lineage with 47.5%, followed by the T superfamily with 25.9% and Haarlem with 12.3%. The MST showed two major groups: the first was formed mainly by the LAM lineage and the second was mainly formed by the T and Haarlem lineages. Others lineages were distributed in peripheral positions. This study provides the first insight into the population structure of M. tuberculosis in SC State. Spoligotyping and other genotyping analyses are important to establish strategic measures for TB control and prevention.

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Drug resistance is a global threat and one of the main contributing factors to tuberculosis (TB) outbreaks. The goal of this study was to analyse the molecular profile of multidrug-resistant TB (MDR-TB) in the state of Santa Catarina in southern Brazil. Fifty-three MDR Mycobacterium tuberculosisclinical isolates were analysed by spoligotyping and a partial region of therpoB gene, which is associated with rifampicin resistance (RMP-R), was sequenced. Some isolates were also distinguished by their mycobacterial interspersed repetitive units (MIRU). S531L was the most prevalent mutation found within rpoBin RMP-R isolates (58.5%), followed by S531W (20.8%). Only two MDR isolates showed no mutations withinrpoB. Isolates of the Latin American Mediterranean (LAM) family were the most prevalent (45.3%) found by spoligotyping, followed by Haarlem (9.4%) and T (7.5%) families. SIT106 was found in 26.4% of isolates and all SIT106 isolates typed by MIRU-12 (5 out of 14) belong to MIT251. There was a high correlation between the S531W mutation and the LAM family mainly because all SIT2263 (LAM9) isolates carry this mutation. Among isolates with the S531W mutation in rpoB MIRU demonstrates a cluster formed by four isolates (SIT2263 and MIT163) and very similar profiles were observed between eight of the nine isolates. Better characterisation of TB isolates may lead to new ways in which to control and treat TB in this region of Brazil.

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Drug resistance is a global threat and one of the main contributing factors to tuberculosis (TB) outbreaks. The goal of this study was to analyse the molecular profile of multidrug-resistant TB (MDR-TB) in the state of Santa Catarina in southern Brazil. Fifty-three MDR Mycobacterium tuberculosis clinical isolates were analysed by spoligotyping and a partial region of the rpoB gene, which is associated with rifampicin resistance (RMP-R), was sequenced. Some isolates were also distinguished by their mycobacterial interspersed repetitive units (MIRU). S531L was the most prevalent mutation found within rpoB in RMP-R isolates (58.5%), followed by S531W (20.8%). Only two MDR isolates showed no mutations within rpoB. Isolates of the Latin American Mediterranean (LAM) family were the most prevalent (45.3%) found by spoligotyping, followed by Haarlem (9.4%) and T (7.5%) families. SIT106 was found in 26.4% of isolates and all SIT106 isolates typed by MIRU-12 (5 out of 14) belong to MIT251. There was a high correlation between the S531W mutation and the LAM family mainly because all SIT2263 (LAM9) isolates carry this mutation. Among isolates with the S531W mutation in rpoB MIRU demonstrates a cluster formed by four isolates (SIT2263 and MIT163) and very similar profiles were observed between eight of the nine isolates. Better characterisation of TB isolates may lead to new ways in which to control and treat TB in this region of Brazil.

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Introducción: La melanosis adquirida primaria es una lesión pigmentaria conjuntival considerada premaligna, que puede llegar a convertirse en melanoma. Resumen clínico: Se informa el caso de una mujer de 95 años de edad quien inició con hiperpigmentación conjuntival multicéntrica en ojo izquierdo. La lesión de mayor tamaño fue resecada con diagnóstico histopatológico de melanosis adquirida primaria con atipia. Veinticuatro años después desarrolló una masa conjuntival, la cual se originó en el limbo superior, con invasión del fórnix y de la conjuntiva tarsal. Fue sometida a resección, obteniéndose el diagnóstico histopatológico de melanoma conjuntival. Discusión: Se enfatiza acerca del seguimiento a largo plazo de aquellos pacientes con melanosis adquirida primaria con atipia, por su alto porcentaje de transformación maligna hacia melanoma.

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Introducción: La infección por Helicobacter pylori (HP) tiene una alta prevalencia mundialmente y ha sido asociada a la presencia de úlcera duodenal, úlcera gástrica y gastritis crónica activa. Además se especula que pueda tener un papel en el desarrollo del cáncer gástrico. Hoy en día se ha definido que la terapia con tres drogas es la más eficaz para combatir al HP. Sin embargo, elevadas tasas de resistencia a algunos de los antibióticos, así como lo costosos del tratamiento, afectan su eficacia. El objetivo del presente estudio es evaluar la eficacia de la combinación de tetraciclina, furazolidona y bismuto en la erradicación del HP, así como los cambios en el aptrón histológico. Material y Métodos : Se reclutó pacientes con diagnóstico de infección por HP obtenido en biopsias de antro gástrico coloreadas con hematoxilina-eosina (H-E). Se les administró el siguiente esquema terapéutico por 10 días: tetraciclina 500 mg 4 veces/día, furazolidona 100 mg 4 veces/día y subcitrato de bismuto coloidal 120 mg 4 veces/día. Se indicó a los pacientes que volvieran para su control 6 a 8 semanas luego de iniciado el tratamiento. En la visita de control se realizó una endoscopía en la que se tomó un promedio de tres biopsias de antro gástrico. Las biopsias fueron coloreadas con H-E y leídas por patólogos experimentados. Tanto en la biopsia previa al tratamiento como en la de control se evaluó los siguientes parámetros: presencia y densidad del HP; presencia, profundidad y grado de la gastritis crónica (infiltrado linfoplasmocitario (LMN)); presencia y grado de la actividad inflamatoria (infiltrado de polimorfonucleares (PMN)); presencia de atrofia glandular; presencia, grado y extensión del daño mucinoso; presencia de metaplasia intestinal y presencia de folículos linfoides. Resultados : Cincuenta y nueve pacientes, 30 hombres y 29 mujeres, completaron el estudio. La edad media fue de 43 ñ 18 años (rango de 14 a 73). En 54 de los 59 pacientes se erradicó la infección por HP (91.5 por ciento) (p<0.001). Las biopsias de control mostraron una mejoría estadísticamente significativa en los siguientes parámetros: presencia y densidad del HP (p<0.001); presencia, profundidad y grado de la gastritis crónica (p<0.001); presencia y grado de la actividad inflamatoria (p<0.001); presencia, grado y extensión del daño mucinoso (p<0.001); y presencia de folículos linfoides (p<0.001)...

Assuntos

RESUMO

BACKGROUND: Helicobacter pylori (HP) infection is very prevalent worldwide, and has been associated with the presence of duodenal ulcer, gastric ulcer and chronic active gastritis. It is also speculated that HP may have a role in gastric cancer development. Triple drug schemes have been shown to be the most effective approach to erradicate HP infection. Nevetheless, high rates of resistance against some antibiotics as well as high costs affect the effectiveness of these therapies. The goal of the present study is to assess the effectiveness of the combination of tetracycline, furazolidone and bismuth in erradicating HP, as well as the changes in the histology.METHODS: Patients with diagnosis of HP infection, found in their antral gastric biopsies (hematoxylin and eosin staining (H-E)), were included. They received the following scheme for 10 days: tetracycline 500 mg qid., furazolidone 100 mg qid., and colloidal bismuth subcitrate 120 mg qid. Patients were instructed to come back for follow-up 6 to 8 weeks after starting the therapy. At that time a control upper endoscopy was performed and 3 antral biopsies were taken. Biopsies were stained with H-E and read by experienced pathologists. In both, the biopsy before treatment and the control biopsy, the following parameters were looked for: presence and density of HP; presence, depth and grade of chronic gastritis (lymphoplasmocytic infiltrate); presence and grade of inflammatory activity (polymorphonuclear inflitrate); presence of glandular atrophy; presence, grade (partial or total) and extent (focal or multifocal) of mucinous damage (epithelial damage); presence of intestinal metaplasia; and presence of lymphoid follicles.RESULTS: Fifty-nine patients (30 men and 29 women) completed per protocol. Mean age was 43 +/- 18 (range: 14-73). HP erradication was achieved in 54 patients (91.5%). Control biopsies showed improvement in the following parameters: presence and density of HP (p<0.001); presence, depth and grade of chronic gastritis (p<0.001); presence and grade of inflammatory activity (p<0.001); presence, grade and extent of mucinous damage (p<0.001); and presence of lymphoid follicles (p<0.001). Neither the presence of glandular atrophy nor the presence of intestinal metaplasia showed any significant change. Patients who did not erradicate HP showed no significant difference in any of the parameters.CONCLUSIONS: The triple drug scheme including tetracycline, furazolidone and bismuth is effective in HP erradication. Erradication of HP is followed by an improvement in the following histologic parameters: presence, depth and grade of chronic gastritis (LMN infiltrate); presence and grade of inflammatory activity (PMN infiltrate); presence, grade and extent of mucinous damage; and presence of lymphoid follicles. This scheme is a cost-effective alternative for the therapy of HP infection in low income populations with a high prevalence of infection with this bacteria.

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