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Resumen: Se presenta el caso de un varón de 76 años con endocarditis precoz sobre una bioprótesis aórtica por Propionibacterium acnes. El diagnóstico se estableció con base en el cuadro clínico de fiebre y escalofríos, los hallazgos ecocardiográficos de vegetaciones y absceso periprotésico y el hemocultivo positivo. El paciente fue reintervenido, resecando la bioprótesis y administrando antibióticos durante seis semanas. La evolución postoperatoria fue satisfactoria. Nueve años después de la intervención, el sujeto se encuentra asintomático y sin signos de recidiva. Se comentan algunos aspectos relacionados con la patogenia, el diagnóstico y el tratamiento de esta enfermedad. Abstract: We report the case of a 76-year-old male patient who presented with early prosthetic aortic valve endocarditis due to Propionibacterium acnes. Diagnosis was established based on clinical picture of high temperature and positive blood cultures associated with echocardiographic findings of prosthetic valve vegetations and perivalvular abscess. Patient underwent redo sternotomy and re-replacement of the aortic valve bioprosthesis. He received a full course of antibiotics for six weeks and his postoperative course was uneventful. After follow-up for nine years, the patient has remained asymptomatic without any signs of recurrence. Some aspects related to the pathogenesis, diagnosis and treatment of this condition are discussed.

The management of Helicobacter pylori infection in children is a consistent problem in clinical practice. Over the years, many questions have been raised regarding symptoms associated with the infection, the diagnostic methods and type of treatment. What is most controversial is determining the criteria that enable us to initiate and carry out the study in children.In the last 10 years, pediatricians have followed the joint ESPGHAN/NASPGHAN guidelines published in 2011 and updated in 2017 in the management of H. pylori in children.This document aims to unify the study indication criteria as well as the diagnosis and treatment recommendations for H. pylori infection in children and adolescents, so they can be used in both Primary and Hospital care. Resumen: El manejo de la infección por Helicobacter pylori en los niños es un dilema permanente en la práctica clínica. A lo largo de los años se han ido creando multitud de interrogantes respecto a los síntomas ligados a la infección, los métodos diagnósticos y los modos de tratamiento, siendo la más controvertida la indicación diagnóstica.En los últimos 10 años el colectivo pediátrico ha dispuesto de una guía elaborada por expertos de las Sociedades de Gastroenterología Pediátrica de Europa (ESPGHAN) y Estados Unidos (NASPGHAN) publicada en 2011 y actualizada en 2017 que nos ha orientado en el manejo de la infección por H. pylori en la edad pediátrica.El presente documento pretende unificar los criterios de indicación de estudio así como las pautas de diagnóstico y tratamiento de la infección por H. pylori en los niños y adolescentes para que puedan ser utilizadas tanto en atención primaria como en la clínica hospitalaria.

Introduction: Pyogenic sacroiliitis (PSI) is a rare condition that accounts for 1–2% of all joint infections in the paediatric age group. Its diagnosis is often difficult and delayed due to its nonspecific signs, symptoms and physical findings. Also, the identification of the causative microorganism is frequently challenging due to a high rate of negative blood cultures and the risks involved in joint aspiration in this location. Patients and methods: We performed a retrospective review of the health records of all patients aged less than 18 years admitted to a tertiary children's hospital due to PSI between 2008 and 2016. Results: Six cases of paediatric PSI were identified. The blood cultures were negative, and identification of the causative agent required joint fluid aspiration in one case of Aggregatibacter aphrophilus infection and specific screening tests for other less frequent agents: Kingella kingae (n = 2), Brucella melitensis (n = 1) and Bartonella henselae (n = 1). The patients were treated with specific antimicrobial regimens, and all had favourable clinical outcomes and were free from sequelae during the follow-up. Conclusions: Despite the small sample size, our study emphasizes the low effectiveness of blood cultures for diagnosis of paediatric PSI. It also highlights the need for a high level of suspicion for atypical agents and the early use of adequate diagnostic methods, including imaging and serological testing or polymerase chain-reaction (PCR) analysis of blood samples, as well as the prescription of an effective antimicrobial therapy. Resumen: Introducción: La sacroileítis piógena (SIP) es una entidad infrecuente que representa del 1 al 2% del total de las infecciones articulares en la edad pediátrica. Su diagnóstico a menudo se complica y retrasa debido a la inespecificidad de sus síntomas, signos y exploración física. Además, la identificación microbiológica puede resultar difícil debido a la alta proporción de hemocultivos negativos y los riesgos implicados en la aspiración de líquido articular en esta localización. Pacientes y métodos: Revisión retrospectiva de las historias clínicas de todos los pacientes menores de 18 años ingresados en un hospital infantil terciario con SIP en el período 2008-2016. Resultados: Se identificaron 6 casos de SIP en niños. Los hemocultivos fueron negativos, y la identificación del agente etiológico requirió aspiración de líquido sinovial en un paciente con infección por Aggregatibacter aphrophilus y pruebas específicas para la detección de agentes menos frecuentes en los pacientes restantes: Kingella kingae (n = 2), Brucella melitensis (n = 1) y Bartonella henselae (n = 1). Los pacientes recibieron regímenes de antibioterapia específica, y todos presentaron una evolución favorable y libre de secuelas durante el seguimiento. Conclusiones: A pesar del reducido tamaño muestral, nuestro estudio puso de relieve la baja efectividad del hemocultivo en el diagnóstico de la SIP pediátrica. También evidenció la necesidad de mantener un elevado índice de sospecha de los agentes atípicos y de emplear precozmente métodos diagnósticos apropiados, como las pruebas de imagen y la reacción en cadena de la polimerasa (PCR) en muestras de sangre, así como la prescripción de antibioterapia efectiva.

A 54-year-old female patient with a history of acute myeloid leukaemia and receiving maintenance chemotherapy had a systemic relapse. She also had candidaemia caused by Candida tropicalis. Her blood cultures were negative after receiving antifungal treatment. Later, she had an ophthalmological assessment as part of the protocol, without ocular discomfort. In the fundoscopic examination, a whitish chorioretinal lesion was found in the left eye in relation to subretinal abscess, which correlated with retinal angiography and optical coherence tomography. The patient was treated with systemic antifungals with a favourable resolution of the lesion Paciente mujer de 54 años con historia de leucemia mieloide aguda, bajo quimioterapia de mantenimiento, cursa con recaída sistémica y candidemia por Candida tropicalis (C. tropicalis), tratada con antifúngico, con respuesta favorable es referida a oftalmológica como parte de protocolo. El examen fundoscópico en ojo izquierdo halló una lesión blanquecina, coriorretiniana en el cuadrante súpero temporal. Los exámenes de angiografía retinal y tomografía de coherencia óptica correlacionaron con absceso subretinal. La paciente fue tratada con antifúngicos sistémicos con resolución favorable de la lesión. Los abscesos subretinianos son una rara manifestación intraocular por C. tropicalis, este organismo es potencial agente causal de afección ocular en presencia de antecedente sistémico de inmunosupresión y factores de riesgo asociados.

A pesar de su importancia, el diagnóstico etiológico del aborto en bovinos representa un desafío técnico para los veterinarios clínicos y laboratoristas, en parte debido a la dificultad de recuperar los fetos abortados en condiciones extensivas de campo. Dicha dificultad limita la posibilidad de detectar tempranamente los vientres abortados y de efectuar la investigación patológica y microbiológica de los abortos. Neospora caninum es un protozoario cosmopolita identificado como uno de los principales agentes abortigénicos en bovinos. En este estudio proponemos una aproximación seroepidemiológica para diagnosticar abortos por N. caninum en bovinos lecheros usando kits de ELISA comerciales. Se procesaron muestras de entre 12 y 93 vacas y/o vaquillonas con (casos) y sin (controles) historia reciente de aborto en 4 tambos comerciales de Uruguay. La proporción controles:casos analizados varió entre 1:1 y 4,6:1. Las muestras (n=230) fueron analizadas mediante 3 kits comerciales para la detección de anticuerpos IgG anti-N. caninum. En los 4 tambos la proporción de vacas y/o vaquillonas seropositivas por cualquier kit fue significativamente mayor en los casos respecto de los controles (odds ratio=5,13 a 36; p=0,0002 a 0,0485). La concordancia entre los kits varió de débil a fuerte (coeficiente Kappa de Cohen=0,58 a 0,83). Concluimos que, a pesar de la imperfecta concordancia entre estos kits, el empleo de todos ellos permitió arribar a conclusiones similares respecto de la asociación estadísticamente significativa entre seropositividad a N. caninum y aborto, lo que demuestra la utilidad de estos kits para la aproximación diagnóstica del aborto a nivel poblacional en condiciones de campo. Bovine abortion causes considerable economic losses to the livestock industry worldwide and is of concern for public health and food safety, given that many abortigenic infectious agents of cattle are zoonotic. Despite its importance, the etiological diagnosis of abortion in cattle is challenging both for veterinary practitioners and laboratory technicians, partly due to the difficulty in recovering aborted fetuses under extensive field conditions for pathological and microbiological diagnostic investigation, and in the early identification of aborted dams. Neospora caninum is a cosmopolitan protozoon identified as one of the main abortigenic agents in cattle worldwide. In this study we propose a comparative seroepidemiological approach for the diagnosis of abortion by N. caninum in dairy cattle. Samples from 12 to 93 cows/heifers with and without recent history of abortion (cases and controls) in four commercial dairy farms were tested. The ratio of controls to cases tested varied from 1:1 to 4.6:1. All samples (n=230) were analyzed by three commercial ELISA kits for the detection of anti-N. caninum antibodies. In all four dairy farms, the proportion of seropositive cows and/or heifers per kit was significantly higher in the cases than in the controls (Odds Ratios=5.13 to 36, p=0.0002 to 0.0485). The agreement among the three kits varied from weak to strong (Coheńs kappa coefficients=0.58 to 0.83). We conclude that, despite the imperfect agreement between these kits, all of them allowed to arrive at similar conclusions regarding the statistical association between N. caninum seropositivity and abortion, thus representing a useful tool for the diagnostic approach at the population level under field conditions. EEA Balcarce Fil: da Silva Silveira, Caroline. Instituto Nacional de Investigación Agropecuaria. Estación Experimental La Estanzuela; Uruguay. Fil: Armendano, Joaquín Ignacio. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; Argentina. Fil: Moore, Dadín Prando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fil: Cantón, Germán José. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Macías Riosecoa, Melissa. Instituto Nacional de Investigación Agropecuaria. Estación Experimental La Estanzuela; Uruguay. Fil: Riet Correa, Franklin. Instituto Nacional de Investigación Agropecuaria. Estación Experimental La Estanzuela; Uruguay. Fil: Giannitti, Federico. Instituto Nacional de Investigación Agropecuaria. Estación Experimental La Estanzuela; Uruguay.

espanolIntroduccion: La radioterapia es uno de los tratamientos mas utilizados en los pacientes paliativos, siendo la radiodermatitis el efecto secundario mas frecuente de la radioterapia, afectando a un 85-95 % de los pacientes con cancer sometidos a este tratamiento. Objetivo: el proposito de esta revision es identificar aquellos productos con mayor eficacia en la prevencion de la radiodermatitis en los pacientes con cancer de mama. Metodologia: Revision sistematica de ensayos clinicos aleatorizados sobre la prevencion de la radiodermatitis en pacientes con cancer de mama en tratamiento radioterapico no concomitante, recopilados en las bases de datos PubMed, Lilacs, CINHAL, Trip Databases y Proquest Health & Medical Complete, publicados en los ultimos seis anos (2021 a 2018) en lengua inglesa y espanola. Resultados: Los productos que fueron efectivos en la prevencion de la radiodermatis son: la glutamina enteral, la curcumina oral, los apositos de fi lm transparente, la sulfadiazina de plata, la pelicula o la crema de barrera con polimeros, el furoato de mometasona, la crema con hidrocortisona al 1 %, la crema con melatonina y la crema con factor de crecimiento epidermico (EGF). Se desaconseja el uso del acido hialuronico y del aloe vera. No mejoro la radiodermatitis con el empleo de cremas hidratantes, calendula, boswellia, alantoina y el aceite de emu. Conclusiones: En la prevencion de la dermatitis por radioterapia, es efectivo el empleo de productos cuya finalidad sea la proteccion de la piel, como los apositos tipo fi lm y las cremas o peliculas con barrera de polimeros. Ademas de productos potenciadores del sistema inmunitario (glutamina enteral) y productos con propiedades antioxidantes (curcumila oral, la crema de melatonina o el factor de crecimiento epidermico), otros productos, como los corticoides y los antibioticos topicos, son efectivos pero su uso a largo plazo conlleva efectos secundarios. EnglishIntroduction: Radiotherapy is one of the most widely used treatments in palliative patients, with radiodermatitis being the most frequent side effect of radiation therapy, affecting 85-95 % of cancer patients undergoing this treatment. Objective: The purpose of this review was to identify the products with greater efficacy in the prevention of radiodermatitis in patients with breast cancer. Methodology: A systematic review of randomized clinical trials on the prevention of radiodermatitis in patients with breast cancer receiving non-concomitant radiotherapym was performed. The studies were collected from the PubMed, Lilacs, CINHAL, Trip, and Proquest Health & Medical Complete databases, and included those published in the last 6 years (2021 to 2018) either in English or Spanish. Results: Products effective in preventing radiodermatis included: enteral glutamine, oral curcumin, clear film dressings, silver sulfadiazine, polymer barrier film or cream, mometasone furoate, cream with 1 % hydrocortisone, melatonin cream, and epidermal growth factor (EGF) cream. The use of hyaluronic acid and aloe vera is not recommended. Radiodermatitis did not improve with the use of moisturizers, calendula, boswellia, allantoin, or emu oil. Conclusions: In the prevention of dermatitis by radiotherapy, the use of products whose purpose is to protect the skin, such as film-type dressings and creams, or films with polymer barriers, is effective. In addition to immune system enhancing products (enteral glutamine), and to products with antioxidant properties (oral curcumilla, melatonin cream or epidermal growth factor), other products such as corticosteroids and topical antibiotics are effective, but their long-term use is associated with side effects.

Introduction: Foetal abuse is that intentional or negligent act that causes a harmful effect to the foetus. It is a type of abuse difficult to diagnose and handle. Some indicators of suspicion are the absence of gestational control, the maternal consumption of toxic substances, or the problematic maternal social environment. Objective: To analyse the cases of foetal abuse registered in Catalonia between 2011 and 2014 to identify the risk profile. Methods: A cross-sectional descriptive study was conducted on a sample of 222 cases of prenatal abuse registered in Catalonia between 2011 and 2014. Results: The mean maternal age was 28.11 years, with 63% of Spanish nationality, 76% were unemployed, 60% had not followed correct gestational control, 76% had previous pregnancy interruptions, 20% reported to have been mistreated by the partner, had history of social problems (76% social intervention, 30.5% previous child retention, 13% custody of the mother by the administration, 7% deprivation of liberty), with high rates of mother-to-child transmission of infection (HIV 4.95%, HCV 9%, HIV + HCV co-infection 1.8%), and 73% reported toxic use (in order of frequency, cannabis, cocaine and heroin). In newborns, the rate of prematurity (26.3%) is highlighted, as well as the diagnosis of withdrawal syndrome in 34 cases. Just over half (51.6%) of the infants are currently with their mother. Conclusions: In our reference population with a diagnosis of prenatal abuse, there are high rates of maternal toxic consumption, HIV-HCV infection, unemployment, history of previous social intervention, and poor gestational control. Resumen: Introducción: El maltrato prenatal es aquel acto intencionado o negligente que causa un efecto nocivo al feto. Es un tipo de maltrato difícil de diagnosticar y manejar. Algunos indicadores de sospecha son la ausencia de control gestacional, el consumo materno de tóxicos o la problemática social del entorno materno. Objetivo: Analizar los casos de maltrato prenatal registrados en Cataluña entre 2011 y 2014 para identificar el perfil de riesgo. Métodos: Estudio descriptivo de corte transversal de una muestra de 222 casos de maltrato prenatal registrados en Cataluña entre 2011 y 2014. Resultados: La edad media materna fue de 28,11 años. El 63% de los casos eran de nacionalidad española, un 76% estaba sin trabajo, el 60% no había seguido un correcto control gestacional, un 76% tenía interrupciones de embarazo previas, un 20% manifestaba haber sido maltratada por la pareja. Fueron frecuente los antecedentes de problemática social (76% intervención social; 30,5% retenciones de hijos previos; 13% tutela de la madre por la administración; 7% privación de libertad), con tasas elevadas de infección por enfermedades de transmisión vertical (VIH 4,95%, VHC 9%, coinfección VIH + VHC 1,8%), el 73% manifestó consumo de tóxicos (por orden de frecuencia cannabis, cocaína y heroína). En los neonatos, destacó el alto índice de prematuridad (26,3%) y el diagnóstico de síndrome de abstinencia en 34 casos. En el 51,6% el hijo está en la actualidad con su madre. Conclusiones: En nuestra población de referencia con diagnóstico de maltrato prenatal destacan unos índices elevados de consumo materno de tóxicos, infección por VIH-VHC, desempleo, antecedentes de intervención social previa y mal control gestacional.

Objectives: To establish whether the duodenal mucosa microbiota of children with active coelic disease (CD) and healthy controls (HC) differ in composition and biodiversity. Material and methods: Samples of duodenal biopsies in 11 CD patients were obtained at diagnosis, and in 6 HC who were investigated for functional intestinal disorders of non-CD origin. Total duodenal microbiota and that belonging to the genus Lactobacillus using PCR-denaturing gradient gel electrophoresis (DGGE) were analyzed. The banding patterns obtained in the resulting gels were analyzed to determine the differences between the microbiota of CD patients and HC (FPQuest 4.5) while environmental indexes (richness, diversity and habitability) were calculated with the past version 2.17 program. Results: The intestinal microbiota of patients with Marsh 3c lesion showed similarity of 98% and differs from other CD patients with other type of histologic lesion as Marsh 3a, Marsh 3b and Marsh 2. The main differences were obtained in ecological indexes belonging to the genus Lactobacillus, with significant richness, diversity and habitability reduction in CD patients. In CD bands were categorized primarily with Streptococcus, Bacteroides and Escherichia coli species. In HC the predominant bands were Bifidobacterium, Lactobacillus and Acinetobacter, though the Streptococcus and Bacteroides were lower. Conclusions: The celiac patients with major histological affectation presented a similar microbiota duodenal. The ecological indexes applied to the genus Lactobacillus were significantly reduced in CD. Resumen: Objetivo: Comprobar diferencias en la microbiota duodenal al diagnóstico de la EC en relación con grupo control. Material y Métodos: Se obtuvieron muestras de biopsias duodenales en 11 pacientes con EC al diagnostico y en 6 controles. Se analizó la microbiota duodenal total así como la perteneciente al género Lactobacillus mediante la técnica molecular PCR-Electroforesis en gel con gradiente desnaturalizante (DGGE). Los patrones de bandas obtenidos en los geles resultantes fueron analizados para determinar las diferencias presentes entre la microbiota de pacientes con EC y controles (FPQuest 4.5) mientras que los índices ecológicos (riqueza, diversidad y habitabilidad) fueron calculados con el programa Past versión 2.17. Resultados: La microbiota intestinal de los individuos con histología Marsh 3c presentó similitud del 98% y fue diferente del resto de pacientes celiacos. Las principales diferencias se obtuvieron en los índices ecológicos pertenecientes al género Lactobacillus, con importante reducción de especies en los celiacos respecto al grupo control (riqueza, diversidad y habitabilidad). En los pacientes con EC las bandas principalmente fueron catalogadas con las especies Streptococcus, Bacteroides y E. coli. En los controles las bandas predominantes fueron Bifidobacterium, Acinetobacter y Lactobacillus, sin embargo los Streptococcus y Bacteroides fueron más bajos. Conclusiones: Los índices ecológicos aplicados al género Lactobacillus fueron significativamente reducidos en los pacientes celíacos. Los casos con mayor afectación histológica presentaron una microbiota duodenal similar.

19 páginas.-- 2 figuras.-- 2 tablas.-- 43 referencias, Two Gram-positive, catalase-positive, oxidase-negative, motile, endospore-forming, rod-shaped bacteria, designated as 0911MAR22V3T and 0911TES10J4, were isolated from air samples collected in two show caves, located in Andalusia, Southern Spain. Phylogenetic analysis based on 16S rRNA gene sequences indicated that both strains were indistinguishable and they were most closely related to Bacillus humi DSM 16318T (98%). DNA-DNA hybridization values of the strain 0911MAR22V3T with respect to strain 0911TES10J4 and B. humi DSM 16318T were 76.8% (73.9%, reciprocal) and 56.9% (63.3%, reciprocal analysis), respectively. Whole genome average nucleotide identity (ANI) values of both strains were in the threshold value for species delineation and less than 85% with B. humi. Strains 0911MAR22V3T and 0911TES10J4 grew at 10-47. °C (optimum 37. °C), at pH 6-9.5 and with 0-8% (w/v) NaCl (optimum 1%). In both strains the dominant isoprenoid quinone was MK-7, the major cellular polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, and two more phospholipids, the predominant fatty acids were iso-C15:0 and anteiso-C15:0 and the DNA G + C content was 38. mol%. On the basis of their phylogenetic relatedness and their phenotypic and genotypic features, the strains 0911MAR22V3T and 0911TES10J4 should be attributed to a novel species within the genus Bacillus, for which the name Bacillus onubensis sp. nov. is proposed. The type strain is 0911MAR22V3T (=LMG 27963T = CECT 8479T); and strain 0911TES10J4 (CECT 8478) is a reference strain., This study was supported by the project RNM 5137, Consejería de Innovación, Ciencia y Empresa, Junta de Andalucía, co-financed by 2007-2013 FEDER programme

Fluoroquinolones are a class of antibiotics widely prescribed in both human and veterinary medicine of high environmental concern and characterized as environmental micropollutants due to their ecotoxicity and persistence and antibacterial resistance potential. Ofloxacin and levofloxacin are chiral fluoroquinolones commercialized as racemate and in enantiomerically pure form, respectively. Since the pharmacological properties and toxicity of the enantiomers may be very different, understanding the stereochemistry of these compounds should be a priority in environmental monitoring. This work presents the biodegradation of racemic ofloxacin and its (S)-enantiomer levofloxacin by the bacterial strains Labrys portucalensis F11 and Rhodococcus sp. FP1 at a laboratory-scale microcosm following the removal and the behavior of the enantiomers. Strain F11 could degrade both antibiotics almost completely when acetate was supplied regularly to the cultures. Enrichment of the (R)-enantiomer was observed in FP1 and F11 cultures supplied with ofloxacin. Racemization was observed in the biodegradation of the pure (S)-ofloxacin (levofloxacin) by strain F11, which was confirmed by liquid chromatography - exact mass spectrometry. Biodegradation of ofloxacin at 450 µg L−1 by both bacterial strains expressed good linear fits (R2 > 0.98) according to the Rayleigh equation. The enantiomeric enrichment factors were comprised between − 22.5% to − 9.1%, and − 18.7% to − 9.0% in the biodegradation of ofloxacin by strains F11 and FP1, respectively, with no significant differences for the two bacteria under the same conditions. This is the first time that enantioselective biodegradation of ofloxacin and levofloxacin by single bacteria is reported.

Fil: Sarti, Simone. Universidad de Milán, Departamento de Ciencias Sociales y Políticas; Italia Fil: Rodríguez Espínola, Solange Sylvia. Pontificia Universidad Católica Argentina. Observatorio de la Deuda Social Argentina; Argentina Abstract: In the literature there is a lack of investigation on health inequalities in South America and their differences with respect to those in the developed countries. Since Italy has recorded similar economic trends in recent years and has some similarities with Argentina, we decided to use the Mediterranean country for comparative purposes. Our hypothesis was that, beyond structural differences, health inequalities present similar patterns in these two countries characterized by a capitalist economy. Social groups in advantaged educational and occupational positions exhibit better health than disadvantaged groups. We present some descriptive statistics on the overall situation in the two countries, and we then analyse data stemming from two surveys that collected individual information on social conditions and health statuses (OASD from 2010 to 2015, and “Multiscopo – Health condition and use of health services”, ISTAT 2013). The findings show that Argentina and Italy have different levels of wellbeing, mortality rates, and health services. But relative disparities in health seem very similar, confirming the hypothesis of Marmot (2017) about the general form of health inequalities. Manual and precarious workers (in particular unemployed persons) present systematically worse perceived health with respect to higher social classes.

El estornino pinto, Sturnus vulgaris, es un ave introducida en Argentina que nidifica en cavidades y puede desplazar a otras aves de sus nidos. Durante las temporadas reproductivas 2010 y 2011 observamos en el parque Pereyra Iraola 3 intentos de usurpación de nidos de aves nativas, hornero (Furnarius rufus), carpintero real (Colaptes melanochloros) y carpintero campestre (C. campestris). Además, en 2 ocasiones se observaron estorninos nidificando en cavidades que estaban construyendo carpinteros en días previos. Se observó también que el estornino pinto utiliza cavidades de chiripepé cabeza verde (Pyrrhura frontalis), calancate ala roja (Psittacara leucophtalmus) —especies traslocadas—, alilicucú común (Megascops choliba) y carpintero campestre —especies nativas —. Estas observaciones alertan sobre la posibilidad de competencia por el uso de este recurso entre el estornino pinto y aves nativas que nidifican en cavidades en Argentina. The European Starling, Sturnus vulgaris, is a hole-nesting bird introduced in Argentina that can displace other species from their nests. We recorded 3 attempts of nest usurpation of native birds, Rufous Hornero (Furnarius rufus), Golden-breasted Woodpecker (Colaptes melanochloros) and Field Flicker Woodpecker (C. campestris) during 2010 and 2011 breeding seasons in Pereyra Iraola Park. Additionally, we observed 2 pairs of starlings breeding in cavities that woodpeckers were building in the previous days. Starlings also used cavities of the Reddish-bellied Parakeet (Pyrrhura frontalis), the White-eyed Parakeet Psittacara leucophtalmus —traslocated species—, the Tropical Screech-owl (Megascops choliba) and the Field Flicker Woodpecker —native species—. These observations warn about the chance of competition for the use of this resource between the European starling and native hole-nesting birds of Argentina. Fil: Ibañez, Lucía Mariel. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Girini, Juan Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados; Argentina Fil: Palacio, Facundo Xavier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - Tucumán. Unidad Ejecutora Lillo; Argentina Fil: Fiorini, Vanina Dafne. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; Argentina Fil: Montalti, Diego. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. División Zoología de Vertebrados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

ResumenAntecedentes/ObjetivoLa severidad de la gastritis crónica asociada con la infección por Helicobacter pylori (GCAHpI) juega un papel importante en la evaluación del riesgo potencial de desarrollar cáncer gástrico. Nuestro objetivo fue estimar el riesgo de cáncer gástrico de acuerdo con criterios histopatológicos y mediante la aplicación del índice de riesgo de cáncer gástrico (GCRI).MétodosSe realizó análisis histopatológico de biopsias gástricas (cuerpo y antro) de pacientes adultos consecutivos que fueron sometidos a panendoscopia y el GCRI se aplicó en pacientes que presentaban evidencia de GCAHpI.ResultadosSe incluyeron 111 pacientes (77% mujeres) con una edad media de 38.6 ± 13.1. La infección activa por Helicobacter pylori (AHPI) se diagnosticó en 77 casos (69.40%). Del 45% de los casos con AHPI, 23% tuvieron pangastritis y 22% gastritis predominante en el cuerpo gástrico. Nueve casos fueron diagnosticados con metaplasia intestinal (8%), 7 de los cuales (77.70%) fueron del grupo AHPI. Veintiún por ciento de los pacientes con AHPI tenía un GCRI de 2 (18.10%) o 3 (2.50%) puntos (índice de riesgo alto), mientras que el 79.10% restante tuvieron un GCRI de 0 o 1 puntos (riesgo bajo índice). De los pacientes sin AHPI, ninguno de ellos tenía 3 puntos (p = 0.001). De los 18 pacientes que acumularon 2 o 3 puntos, 6 (33.30%) presentaron metaplasia intestinal (todos con pangastritis y gastritis en cuerpo), de los cuales 4 casos (66.60%) tenían AHPI.ConclusionesEl riesgo estimado de cáncer gástrico en pacientes con GCAHpI en el entorno clínico estudiado fue relativamente bajo y 5% de los pacientes tenían un fenotipo histopatológico asociado con un riesgo elevado de desarrollar cáncer gástrico.AbstractBackground/AimSeverity of chronic gastritis associated with Helicobacter pylori infection (CGAHpI) could play a role in evaluating the potential risk to develop gastric cancer. Our aim was to estimate the risk for gastric cancer in a clinical setting, according to histopathologic criteria, by applying the gastric cancer risk index (GCRI)MethodsHistopathologic study of the gastric biopsies (corpus-antrum) from consecutive adult patients that underwent gastroesophageal duodenoscopy was carried out, and the GCRI was applied in patients presenting with CGAHpI.ResultsOne hundred eleven patients (77% female) with a mean age of 38.6±13.1 years were included. Active Helicobacter pylori infection (aHpi) was diagnosed in 77 cases (69.40%). In 45% of the cases with aHpi, pangastritis (23%) or corpus-predominant gastritis (22%) was diagnosed. Nine cases were diagnosed with intestinal metaplasia (8%), 7 of which (77.70%) were in the aHpi group. Twenty one percent of the patients with aHpi had a GCRI of 2 (18.10%) or 3 (2.50%) points (high risk index), while 79.10% accumulated a GCRI of 0 or 1 points (low risk index). Of the patients with no aHpi, none of them had 3 points (p=0.001). Of the 18 patients that accumulated 2 or 3 points, 6 (33.30%) presented with intestinal metaplasia (all with pangastritis and corpus-predominant gastritis), of which 4 cases (66.60%) had aHpi.ConclusionsThe estimated gastric cancer risk in patients with CGAHpI in the clinical setting studied was relatively low and 5% of the patients had a histopathologic phenotype associated with an elevated risk for developing gastric cancer.

The human parechovirus (HPeV) are viruses of the recently described Picornaviridae family and are causing several infections in young children. The pathology associated with these viruses is beginning to emerge. The HPeV type 3 has been described particularly in association with sepsis-like febrile syndromes, meningitis and encephalitis in very young infants and neonates. We report the case of a 14-day-old girl with a fever and clinical sepsis that required hospitalisation and in which HPeV-3 was identified in the cerebrospinal fluid. The blood, urine and cerebrospinal fluid bacterial cultures were negative, and the patient improved.This case illustrates the usefulness of investigating parechovirus infection in neonates with fever or suspected sepsis. Resumen: Los parechovirus humanos (HPeV) son virus de la familia Picornaviridae recientemente descritos y causantes de numerosas infecciones en niños pequeños. La afección asociada a estos virus se está empezando a conocer. El HPeV tipo 3 se ha descrito especialmente asociado a síndromes febriles, sepsis-like, meningitis y encefalitis en lactantes muy pequeños y neonatos. Presentamos el caso de una niña de 14 días de vida con un cuadro de fiebre que precisó hospitalización por sospecha de sepsis y en la que se identificó en líquido cefalorraquídeo un HPeV-3. Las pruebas analíticas (leucocitos, fórmula diferencial y procalcitonina en sangre) fueron normales. Los cultivos bacterianos de sangre, orina y líquido cefalorraquídeo fueron estériles. La paciente evolucionó favorablemente.Este caso ilustra la utilidad de investigar la infección por parechovirus en los recién nacidos con fiebre o sospecha de sepsis.

Resumen: El citomegalovirus (CMV) es la causa más frecuente de infección congénita en los países desarrollados y aparece entre un 0,3 y un 0,6% de los recién nacidos en Europa. La primoinfección durante el embarazo ocurre entre el 1 y el 4% de las gestantes seronegativas. En este caso, el 40% de los fetos se infecta y un 10% presenta síntomas al nacimiento. La mitad de estos niños y el 13% de los que nacen asintomáticos desarrollan secuelas permanentes, especialmente hipoacusia neurosensorial y retraso mental. En la actualidad, la determinación de la avidez de los anticuerpos IgG maternos y la detección del virus en líquido amniótico por cultivo o reacción en cadena de la polimerasa (PCR) permiten el diagnóstico de la primoinfección en la embarazada y el diagnóstico de la infección en el feto. Además, existe cierta evidencia sobre la posibilidad de prevención de la infección sintomática en el recién nacido mediante el empleo en el embarazo de gammaglobulina hiperinmune frente a CMV.El diagnóstico de la infección congénita en el recién nacido debe realizarse mediante el cultivo del virus en shell vial o mediante la identificación del genoma viral por PCR en una muestra de orina recogida en las 2 primeras semanas de vida. La infección también puede diagnosticarse retrospectivamente mediante PCR para CMV en la sangre seca de papel de filtro (Guthrie card) que se utiliza para la prueba del talón en el recién nacido.Actualmente se dispone de 2 fármacos para el tratamiento del CMV congénito: ganciclovir y su profármaco valganciclovir. El tratamiento con ganciclovir intravenoso durante 6 semanas previene el desarrollo de hipoacusia progresiva en los niños con infección congénita sintomática por CMV y afectación del sistema nervioso central. El tratamiento con valganciclovir oral puede ser excelente alternativa debido a su buena biodisponibilidad, lo que le permite conseguir niveles plasmáticos similares a los alcanzados con ganciclovir intravenoso. Abstract: Cytomegalovirus (CMV) is the leading cause of congenital infection in developed countries, affecting 0.3 to 0.6% of all live births in Europe. Primary CMV infection occurs in 1 to 4% of seronegative women during pregnancy and may be transmitted to the fetus in 40% of cases. Up to 10% of intrauterine CMV infections result in symptomatic congenital disease at birth. Half of these children and 13% of those born with asymptomatic infection will develop long-term sequelae, especially neurosensory hearing loss and mental retardation. Accurate diagnosis of primary maternal and fetal infection is now possible using the avidity index of anti-CMV IgG and virological testing to detect the virus in amniotic fluid. Symptomatic congenital infection may be preventable using CMV hyperimmune globulin during pregnancy.The gold standard for diagnosis of congenital CMV infection is the detection of the virus in urine within the first 2 weeks of life by rapid cell culture techniques (shell vial) or nucleic acid amplification of viral DNA (PCR). Retrospective diagnosis can be achieved by detection of viral DNA by PCR in dried blood spots (Guthrie card) collected on filter paper in the first days of life.Currently available drugs for the treatment of congenital CMV include ganciclovir and its oral prodrug valganciclovir. Treatment with intravenous ganciclovir for six weeks may prevent hearing deterioration in children with symptomatic congenital CMV infection and central nervous system involvement. Valganciclovir may be an excellent alternative because of its good bio-availability, providing plasma concentrations similar to those achieved with intravenous ganciclovir.

Resumen: Tras una encefalitis herpética (EH), una cuarta parte de los pacientes con EH tiene una recaída de la enfermedad que, excepcionalmente, se manifiesta como un síndrome extrapiramidal de tipo coreoatetósico. La base fisiopatológica de este tipo de recaída es desconocida, pero se hipotetiza que puede ser un cuadro inmunitario mediado. Se presenta el caso de un niño de 8 meses con EH por virus del herpes simple tipo 1 que en la tercera semana de evolución tuvo una recaída caracterizada por un síndrome extrapiramidal con coreoatetosis y balismo. El cuadro se interpretó como postinfeccioso, inmunitario mediado. Se trató al paciente con corticoides en altas dosis e inmunoglobulinas, además de un nuevo ciclo de aciclovir. La coreoatetosis fue tan grave y resistente a los fármacos que obligó a sedorrelajar al paciente inicialmente. Posteriormente, se ensayó tratamiento con tetrabenazina.Se estudió a escala molecular una mutación en el receptor tipo Toll 3, que se ha relacionado con la susceptibilidad de presentar la enfermedad, que resultó ser negativa. Abstract: After Herpes simplex encephalitis, 25% of cases may have a relapse, rarely as a choreoathetosic movement disorder. The anatomic basis for herpes simplex virus encephalitis-associated movement disorders remains poorly understood, but the hypothesis is that it may be due to a post-infectious immune-mediated process. We report an 8-month-old boy, with herpes simplex encephalitis type 1, who started with an extrapyramidal Syndrome, presenting with choreoathetosis and ballistic movements, three weeks after onset. These new symptoms were attributed to a post-infectious immune-mediated process. We treated our patient with corticosteroids at high dose and gamma-globulins, in addition to a new course of Acyclovir. Sedation was required to control the intense choreoathetosic movements. Tetrabenazine was also tried, unsuccessfully. We studied a mutation on the toll like receptors (TLR3), which has been related to susceptibility for the disease, which was negative.

Resumen: La infección por citomegalovirus (CMV) es una causa frecuente de complicaciones en pacientes inmunodeprimidos. En huéspedes sanos, la infección por CMV cursa generalmente de forma asintomática. A continuación se presenta el caso de un paciente de 3 meses de edad inmunocompetente, en el que se desarrolló un cuadro de diarrea grave que precisó nutrición parenteral. El cuadro se resolvió sin secuelas tras tratamiento con ganciclovir. Abstract: Cytomegalovirus infection is a frequent cause of complications in immunodeficient patients. In healthy hosts, cytomegalovirus infection is usually asymptomatic. We describe a case of a 3 month old immunocompetent boy who suffered from protracted diarrhoea that required parenteral nutrition. After treatment with ganciclovir he recovered without any after effects.

Resumen: Introducción y objetivo: las consultas por consumo abusivo de alcohol se están volviendo habituales en los Servicios de Urgencias Pediátricas. El objetivo de este trabajo es determinar el perfil de los sujetos atendidos en Urgencias por intoxicación etílica aguda (IEA). Métodos: estudio descriptivo de los sujetos a los que se atendió por IEA en Urgencias durante el año 2007. Se excluyó a aquellos sujetos con intoxicación accidental o con enfermedad crónica asociada. Resultados: se incluyó a 104 sujetos (el 50% eran varones) con una media de edad de 16,2 años (desviación estándar [DE] de 1,2 años); el 95,8% era mayor de 14 años. A un sujeto se lo atendió en 2 ocasiones por el mismo motivo. El 72,4% de las consultas fueron en festivos; el 82,9% se realizaron de 20.00 a 8.00. El 81,9% de los sujetos acudió en ambulancia. No se detectó ningún caso de hipoglucemia y un 7,5% de los casos presentó hipotermia. Se determinó la concentración de etanol y tóxicos en orina en 66 consultas. La media de etanol en sangre fue de 186,1mg/dl (DE de 56,2mg/dl): el 21,2% presentó intoxicación leve, el 75,8% presentó intoxicación moderada y el 3% presentó intoxicación grave. Se detectó consumo de cannabis en 7 casos y consumo de anfetaminas en 3 casos. Tres sujetos requirieron ingreso. Conclusiones: el perfil del sujeto que acudió a Urgencias por IEA fue el de un adolescente que consulta las noches de festivos tras el consumo de una bebida alcohólica de alta graduación, que presenta una intoxicación moderada y que no requiere hospitalización. Abstract: Introduction and aim: Patients arriving in Paediatric Emergency Departments due to alcohol abuse is fairly common. The aim of this study is to determine the profile of the patients seen in the emergency room for acute ethanol intoxication. Material and method: A descriptive study was performed on all patients seen in the emergency department with an acute ethanol intoxication over a 12-month period (2007). Patients with accidental poisoning or with related chronic illness were excluded. Results: A total of 104 patients were included (50% males). Their mean age was 16.2 years (standar desviation [SD] 1.2 years); 95.8% were older than 14 years. There was on patient who was seen twice for the same reason. The majority, 72.4%, were seen on holiday days; 82.9%, from 8:00 pm to 8:00 am. A total of 81.9% of the patients were brought in by ambulance. No cases of hypoglycaemia were detected and 7.5% of the patients had hypothermia. Ethanol levels and urine toxicology were measured in 66 cases. The mean blood ethanol was 186.1mg/dl (SD 56.2mg/dl); 21.2% were slightly intoxicated, 75.8% moderate and 3% severe. Cannabis was detected in seven cases and amphetamines in three. Three patients needed hospital admission. Conclusions: The profile of the patient who arrives to emergency department with acute ethanol intoxication is a teenager who is seen on holiday nights, after a consumption of high proof alcoholic drinks, presents a moderate intoxication, and does not require hospitalisation.

El vértigo posicional paroxístico benigno (VPPB) se define como la aparición de episodios bruscos de vértigo de breve duración, provocados por cambios de posición, acompañados de nistagmo y que se reproducen al adoptar la posición desencadenante.La teoría fisiopatológica que mejor explica las características clínicas y del nistagmo en las maniobras de provocación del VPPB es la canalitiasis: partículas otolíticas desprendidas de la mácula del utrículo penetrarían en el interior de un conducto semicircular; su desplazamiento al realizar determinados movimientos en el plano de ese conducto produce una corriente endolinfática que estimularía la cúpula originando la aparición de vértigo y nistagmo.El diagnóstico se basa en una historia clínica típica, una exploración otoneurológica normal y una reproducción de la crisis con las maniobras de provocación. El tratamiento a través de las maniobras de reposición permite la resolución del cuadro de forma rápida y sencilla.Presentamos dos casos de mareo vistos en nuestro servicio de urgencias. La sospecha clínica y la realización de la maniobra de Dix-Hallpike confirmaron el diagnóstico de VPPB. La maniobra de Epley resolvió el cuadro de manera rápida y definitiva. : The benign paroxystic positional vertigo (BPPV) is defined by brief episodic vertigo attacks and accompanied by a rotary-linear nystagmus, triggered by head position changes and is always produced in that position.The theory that better explains the BPPV is canalithiasis: free- floating particles leave the utricular macula and enter one of the semicircular canals, producing an endolymphatic movement that stimulates the cupula and produces vertigo and nystagmus.The diagnosis is based on a typical clinical history, normal ear and neurological examination and provocation maneuvers, such as the Dix- Hallpike test, reproduce the vertigo attacks.The treatments are the liberatory maneuvers, such as the Epley maneuver which makes the vertigo disappear.We present two cases of vertigo with a compatible clinic history of BPPV, where the Dix-Hallpike maneuver confirmed the diagnosis. The treatment in both cases was the Epley maneuver.

EuroNeoStat is a European project, financed entirely by one million Euros from the European Commission Health and Consumer Protection Directorate General (DG Sanco), within the VI Research Framework Programme for 2006 to 2008. Neonatal units from 23 European countries work together on this project, which is led from our country. Its overall objective is to create a European information system that monitors the shortand long-term outcomes of extremely low birth-weight infants (ELBWI) attended at the units taking part, in order to improve the quality and safety of care provided and so improve their development. Currently, premature birth must be a health priority, given its high prevalence and its grave family, social, individual and health-care consequences, as well as its economic impact. These babies not only require long stays in neonatal intensive care units (NICUs), but often require rehospitalisation, along with multiple preventive, therapeutic and rehabilitatory interventions, which drain the always limited health-care resources available. All this means that this project is extremely relevant both for health-care delivery and in social and economic terms. Although the end aim of Perinatology is to avoid premature birth, this target has not been attainable. In fact, the same as in Europe as a whole1, premature birth rates have increased in our country, such that in three decades they have almost doubled (from 4-5 % to the current 7-8 %)2. In addition, ELBWI, under 1,500 grams at birth, though only accounting for 1-2% of all births, have high specific mortality (15-20 %) and morbidity (10-20 %), which means they contribute greatly both to neonatal and child mortality3 and to childhood disability. It should also not be forgotten that, although these rates depend on maternal health and the perinatal care received, specific morbi-mortality is the outcome, among other factors, of the quality of neonatal care. In NICUs, monitoring and life-support techniques have not only increased survival4, but have avoided some of these patients suffering injuries that would lead eventually to long-term disability. Despite this, an overall 10% of ELBWI are gravely disabled; and a further 10 %, moderately disabled5,6. In addition, 20-30% of the most immature babies have a cognitive or attention deficiency or delayed psycho-motor development7. If the outcomes are to be improved, then those factors of risk that can be modified must be identified, the care process needs to be analysed and the results for one unit, region or country need to be compared with reference populations. In addition to intra-institution analysis, as long as explicit and homogeneous indicators and criteria are followed, inter-institution comparisons can also be conducted8.

Resumen: Se describe el caso de un varón de 10 meses, inmunocompetente, que presentó artritis séptica por Candida albicans en el período neonatal. Durante el ingreso recibió tratamiento con anfotericina B liposómica y al alta se le administró fluconazol. La evolución ha sido favorable y tras un año de seguimiento se encuentra asintomático.La aparición de artritis por C. albicans en un lactante inmunocompetente, con el antecedente de candidiasis sistémica en el período neonatal, es excepcional. Abstract: We report the case of knee arthritis in an immunocompetent infant man, 10 month-old, caused by Candida albicans. He suffered in the past septic arthritis due to Candida albicans in the neonatal period. Initial management included treatment with liposomal amphotericin B and fluconazole at hospital discharge. Primary immunodeficiency was ruled out. Ongoing follow up during 1 year has been uneventful.

Dentro del amplio espectro clínico de la infección por Yersinia enterocolitica, en los lactantes y niños pequeños la manifestación más frecuente es la diarrea aguda que cursa sin complicaciones. En los niños mayores y adolescentes suele presentarse con más frecuencia como una ileítis terminal y/o adenitis mesentérica. Se presentan dos casos de ileítis terminal durante una infección por Y. enterocolitica en lactantes, hecho excepcional en la literatura médica, y se describen los datos clínicos y exámenes complementarios más relevantes, entre los que destaca la ecografía, prueba fiable y sencilla, que nos documenta dicha afectación. : Yersinia enterocolitica infection presents a wide clinical spectrum; in infants and young children it usually presents as uncomplicated acute diarrhea, while in older children and adolescents it more frequently presents as terminal ileitis and/or mesenteric adenitis. We describe two infants who developed terminal ileitis complicating Y. enterocolitica infection, which is exceptionally rare. The clinical, laboratory and radiologic findings are described and ultrasound study is emphasized as a simple and reliable tool for investigation of terminal ileitis.

Resumen: En los últimos años estamos asistiendo a un aumento de la inmigración, de los niños viajeros y de adopción internacional, lo cual ha favorecido el resurgimiento de la malaria. Dado que la mortalidad asociada no es despreciable, resultan esenciales tanto el diagnóstico como el tratamiento precoz. Por otra parte, se han producido cambios terapéuticos importantes (nuevos fármacos, desarrollo de resistencias…). En este artículo se realiza una puesta al día y se recogen las nuevas recomendaciones siguiendo las directrices de las principales guías disponibles (OMS, CDC). Abstract: An increase in the cases of malaria in our country has been observed due to immigration, and adopted children. Malaria management requires an integrate approach, including prompt diagnoses and treatment to avoid the associated morbidity and mortality. In the last years, new recommendations have been introduced due to the appearance of new resistant areas. In this article we aim to provide a summary of the key recommendations following the main malaria guidelines (WHO and CDC).

Endocrine disruptors (EDs) interfere with the development and functioning of the endocrine system, causing reproductive disturbance in aquatic wildlife. The aim of the present work was to determine the presence of EDs in sediments and to investigate possible exposure and effects of EDs in the estuary of the Urdaibai Biosphere Reserve (Gernika) in comparison with the Arriluze marina. For this, gonad histology, plasma vitellogenin (VTG) protein levels and mRNA levels of vitellogenin (vtg), cyp19 aromatases, estrogen receptor (er) and retinoid X receptor (rxr) were studied in Chelon labrosus. The presence of alkylphenols (APs) in fish bile was also assessed. In sediments, estrogenic hormones were below the detection limit and levels of bisphenol A were very low. In Gernika organotin compounds were low but in Arriluze levels of up to 12 μg/g were found. Moderate levels of APs and phthalate levels of up to 8 μg/g were found in sediments. In fish, a high prevalence up to 33% of intersex gonads was found in Gernika, whereas only one intersex was found in Arriluze. Accordingly, mullets from Gernika showed higher concentrations of APs in bile. VTG protein levels were detected not only in females but also in some undifferentiated, male and intersex fish. mRNA of vtg was detected in one male from Gernika. mRNA of er and rxr showed significant differences between seasons. In conclusion, the present study demonstrated that C. labrosus from the Urdaibai estuary were exposed to EDs and showed clear signs of endocrine disruption., This work was supported by Catedra UNESCO of the University of the Basque Country (UPV/EHU) through the project DERBiUr (UNESCO06/19), by the University of the Basque Country through a grant to the Unit of Formation and Research (UFI 11/37), by the Basque Government through the project ETORTEK-IMPRES and a grant to consolidated research groups (GIC07/26-IT-393-07), and by MICINN through the projects CEMAGUA (CGL2007-64551/HID) and SCARCE (Consolider-Ingenio 2010 CSD2009-00065). Denise Fernandes acknowledges a postdoctoral fellowship (SFRH/BPD/34289/2006) from the Portuguese Fundacao para a Ciencia e Tecnologia (FCT) of the Ministry of Science and Technology of Portugal. The help of Drs. T. Serrano and M.C. Barbero with the examination of gonad preparations is greatly acknowledged.

Malaria, one of the three most important life-threatening infectious diseases, is recommended to be treated with ACT (artemisinin combination therapy) against which Plasmodium falciparum already displayed resistance. Two artemisinin-4-amino-quinoline hybrid-dimers (1 and 2), previously synthesized, possessed low nanomolar in vitro antiplasmodial activity, while poorly toxic against mammalian cells. They are here investigated to ascertain whether this antimalarial activity would be carried on in vivo against Plasmodium vinckei. During the four day treatment, parasitemia of less than 1% were observed on day 5 after doses from 2.5 mg/kg ip and 50 mg/kg po for hybrid-dimer 1, and from 7.5 mg/kg ip and 25 mg/kg po for hybrid-dimer 2. Snapshot pharmacokinetic analysis demonstrated that the antiplasmodial activity of these C-10-acetal artemisinin dimers may be due to active metabolites, which were confirmed by in silico findings. Hybrid-dimer 1 also displayed potent in vitro activity against tumor cells and was found to be more active than etoposide against TK10, UACC62 and MCF7 cell lines (TGI values 3.45 vs. 43.33 μM, 2.21 vs. 45.52 μM and 2.99 vs. >100 μM, respectively). The 1,3-diaminopropane linker, present in hybrid-dimer 1, was therefore identified as the optimum linker. http://dx.doi.org/10.1016/j.ejps.2012.09.019

Seed shape in the model legumes Lotus japonicus and Medicago truncatula is described. Based on previous work with Arabidopsis, the longitudinal section of seeds is compared with a cardioid, the trajectory described by a point of a circle that rolls around another fixed circle with the same radius. Lotus japonicus seeds adjust well to an unmodified cardioid, whereas accurate adjustment in Medicago truncatula is obtained by the simple transformation of scaling the vertical axis by a factor of the Golden Ratio. Adjustment of seed shape with simple geometrical forms becomes an essential tool for the statistical analysis of variations in seed shape under different environmental or genetic (i.e., mutant) conditions. Seeds of ethylene insensitive mutants present differences in size and shape as well as altered responses to imbibition. The biological implication and meaning of these relationships are discussed.

Resumen: Las levaduras del género Candida son comensales ubicuos, que pueden causar infección oportunista en cualquier localización del organismo; la fuente de infección puede ser tanto endógena como exógena. La candidiasis invasiva engloba entidades distintas que van desde la candidemia o invasión limitada al torrente circulatorio a la candidiasis diseminada o infección multiorgánica. La candidemia constituye la tercera causa de infección del torrente circulatorio en la IN y la cuarta de todas las infecciones. También constituye la IFI más frecuente en el paciente crítico no neutropénico, habiendo sufrido un incremento muy notable en los últimos 20 años, debido tanto a una mayor supervivencia de los pacientes críticamente enfermos como a una mayor complejidad de los procedimientos diagnóstico-terapéuticos y quirúrgicos. Su incidencia en lactantes, según revisiones recientes, se sitúa en 38,8 casos/100.000 menores de 1 año. La especie más frecuentemente implicada en infecciones invasoras sigue siendo Candida albicans, aunque en los últimos años existe un incremento de infecciones causadas por especies distintas: es relevante la aparición de Candida krusei y Candida glabrata y el incremento de candidemia por Candida parapsilosis asociada principalmente al manejo de catéteres intravenosos centrales, especialmente en unidades neonatales.La mortalidad global de la candidiasis invasiva es elevada, llegando a cifras del 20 al 44% a los 30 días en determinadas series que incluyen a pacientes pediátricos.Este documento recoge una revisión actualizada sobre incidencia, epidemiología, diagnóstico, tratamiento y evolución, de la infección invasiva por Candida spp. en el paciente pediátrico. Abstract: Candida yeasts are ubiquitous commensals, which can cause opportunistic infection in any location of the body. The source of infection may be both endogenous and exogenous. Invasive candidiasis encompasses different entities ranging from invasive candidiasis to disseminated multiorgan infection. Invasive candidiasis is the third leading cause of nosocomial bloodstream infection and the fourth of all nosocomial infections. It is also the most common invasive fungal infection in non-neutropenic critically ill patients, with a remarkable increase in the last 20 years owing to the increased survival of these patients and to more complex diagnostic, therapeutic and surgical procedures. Its incidence in infants, according to recent reviews, stands at 38.8 cases/100,000 children younger than 1 year. Candida albicans remains the most frequent isolate in invasive infections, although infections caused by other species have risen in the last years, such as C. kruzsei, C. glabrata and C. parapsilosis; the latter causing invasive candidiasis mainly associated with central venous catheter management, especially in neonatal units. The overall mortality of invasive candidiasis is high, with 30-day mortality reaching 20-44% in some series involving paediatric patients.This report provides an update on incidence, epidemiology, clinical presentation, diagnosis, treatment and outcome of invasive infection by Candida spp. in the paediatric patient.

El pdf del artículo es la versión pre-print., The mould Aspergillus giganteus produces a basic, low molecular weight protein (AFP) showing in vitro and in vivo antifungal properties against important plant pathogens. AFP is secreted as an inactive precursor containing an amino-terminal extension of six amino acids (If-AFP) which is later removed to produce the active protein. The molecular basis to explain this behavior and the features that determine the fungal specificity of this protein are not completely solved. In this work, the mature AFP (AFP*) and a version of AFP with an extended amino-terminal (proAFP) have been cloned and produced in the yeast Pichia pastoris. The two proteins have been purified to homogeneity and characterized from structural and functional points of view. AFP* produced is practically indistinguishable from the natural fungal protein in terms of its spectroscopic and antifungal properties while proAFP is mostly inactive under identical assay conditions. The availability of an active AFP protein produced in P. pastoris will allow getting further insights into the mode of action and targeting specificity of AFP by using site-directed mutagenesis approaches., This work was supported by Grants BFU2006- 04404 and BIO2006-05583 from the Ministerio de Educación y Ciencia (MEC) (Spain) and within the center CONSOLIDER on Agrigenomics (MEC) and the Xarxa de referencia en Biotecnología (Generalitat de Catalunya).

El esclerocio del hongo Poria cocos forma parte, desde hace miles de años, de la farmacopea china. En esta revisión se presentan aspectos sobre la biología y nomenclatura de este hongo, y especialmente sobre su composición y aplicaciones terapéuticas., The sclerotium of Poria cocos has been used in the Chinese pharmacopoeia during thousands of years. In this note several aspects about the biology and nomenclature of this fungus are summarized, with emphasis on its composition and therapeutic applications.

Producción Científica, Extracts of seven medicinal plants used specifically against cutaneous leishmaniasis in the Madre de Dios region of Peru were evaluated in vitro against promastigote and axenic amastigote forms of Leishmania amazonensis. One of them showed interesting leishmanicidal activities (IC50 =5!g/ml in amastigotes). Bio-guided isolation of the stem bark’s ethanol extract of Himatanthus sucuuba (Spruce ex M¨ull. Arg.) Woodson (Apocynaceae) afforded the spirolactone iridoids isoplumericin and plumericin. The latter showed a reduction of macrophage infection similar to that of the reference drug Amphotericin B (IC50 = 0.9 and 1!M, respectively). These findings validate the traditional use of Himatanthus sucuuba in the treatment of cutaneous leishmaniasis (Uta) in Peru.