Search

An in vitro model for the formation of an Enterococcus faecalis endodontic biofilm under nutritional restriction was established, simulating clinical conditions for the evaluation of antimicrobial substances. Biofilm formation in dentin was standardized using root quarters incubated with E. faecalis ATCC 29212 at 37°C without nutritional changes. Biofilms were evaluated at 7, 14, and 30 days, counting bacterial colony-forming units using conventional culture and verified scanning electron microscopy. Bacterial viability and biovolume were determined with confocal laser microscopy. Colonization of E. faecalis and biofilm formation on the dentinal surface was confirmed after 7 and 14 days, respectively. Microorganism colonization was homogeneous over the entire root surface at each time point, without significant differences in the viability percentage and biovolume. On the contrary, a decrease in viability and an increase in biovolume were observed when the time was increased. Compared with other incubation times, 14 days was found to be the best time for the establishment of the biofilm in terms of biovolume and bacterial viability. This in vitro model for the formation of endodontic biofilm will allow future evaluation of the efficacy of antimicrobial substances with a more adequate clinical approach., (© 2021 Wiley-VCH GmbH.)

Coenzyme Q (CoQ or ubiquinone) serves as an essential redox-active lipid in respiratory electron and proton transport during cellular energy metabolism. CoQ also functions as a membrane-localized antioxidant protecting cells against lipid peroxidation. CoQ deficiency is associated with multiple human diseases; CoQ 10 supplementation in particular has noted cardioprotective benefits. In Saccharomyces cerevisiae , Coq10, a putative START domain protein, is believed to chaperone CoQ to sites where it functions. Yeast coq10 deletion mutants ( coq10Δ ) synthesize CoQ inefficiently during log phase growth and are respiratory defective and sensitive to oxidative stress. Humans have two orthologs of yeast COQ10 , COQ10A and COQ10B Here, we tested the human co-orthologs for their ability to rescue the yeast mutant. We showed that expression of either human ortholog, COQ10A or COQ10B, rescues yeast coq10Δ mutant phenotypes, restoring the function of respiratory-dependent growth on a nonfermentable carbon source and sensitivity to oxidative stress induced by treatment with PUFAs. These effects indicate a strong functional conservation of Coq10 across different organisms. However, neither COQ10A nor COQ10B restored CoQ biosynthesis when expressed in the yeast coq10Δ mutant. The involvement of yeast Coq10 in CoQ biosynthesis may rely on its interactions with another protein, possibly Coq11, which is not found in humans. Coexpression analyses of yeast COQ10 and human COQ10A and COQ10B provide additional insights to functions of these START domain proteins and their potential roles in other biologic pathways.

Acute leukemia is a heterogeneous set of diseases affecting children and adults. Current prognostic factors are not accurate predictors of the clinical outcome of adult patients and the stratification of risk groups remains insufficient. For that reason, this study proposes a multifactorial analysis which integrates clinical parameters, ex vivo tumor characterization and behavioral in vivo analysis in zebrafish. This model represents a new approach to understand leukemic primary cells behavior and features associated with aggressiveness and metastatic potential. Xenotransplantation of primary samples from patients newly diagnosed with acute leukemia in zebrafish embryos at 48 hpf was used to asses survival rate, dissemination pattern, and metastatic potential. Seven samples from young adults classified in adverse, favorable or intermediate risk group were characterized. Tumor heterogeneity defined by Leukemic stem cell (LSC) proportion, was performed by metabolic and cell membrane biomarkers characterization. Thus, our work combines all these parameters with a robust quantification strategy that provides important information about leukemia biology, their relationship with specific niches and the existent inter and intra-tumor heterogeneity in acute leukemia. In regard to prognostic factors, leukemic stem cell proportion and Patient-derived xenografts (PDX) migration into zebrafish were the variables with highest weights for the prediction analysis. Higher ALDH activity, less differentiated cells and a broader and random migration pattern are related with worse clinical outcome after induction chemotherapy. This model also recapitulates multiple aspects of human acute leukemia and therefore is a promising tool to be employed not only for preclinical studies but also supposes a new tool with a higher resolution compared to traditional methods for an accurate stratification of patients into worse or favorable clinical outcome.

Over the past few years, symptoms akin to late blight disease have been reported on a variety of crop plants in South America. Despite the economic importance of these crops, the causal agents of the diseases belonging to the genus Phytophthora have not been completely characterized. In this study, a new Phytophthora species was described in Colombia from tree tomato ( Solanum betaceum ), a semi-domesticated fruit grown in northern South America. Comprehensive phylogenetic, morphological, population genetic analyses, and infection assays to characterize this new species, were conducted. All data support the description of the new species, Phytophthora betacei sp. nov. Phylogenetic analyses suggest that this new species belongs to clade 1c of the genus Phytophthora and is a close relative of the potato late blight pathogen, P. infestans . Furthermore, it appeared as the sister group of the P. andina strains collected from wild Solanaceae (clonal lineage EC-2). Analyses of morphological and physiological characters as well as host specificity showed high support for the differentiation of these species. Based on these results, a complete description of the new species is provided and the species boundaries within Phytophthora clade 1c in northern South America are discussed.

Power struggles surrounding the increasing economic development of gold mining give rise to severe environmental and social problems. Two new strains of Lysinibacillus sphaericus were isolated from an area of active alluvial gold mining exploitation at El Bagre, Antioquia. The absorption capacity of these strains and some of the L. sphaericus Microbiological Research Center (CIMIC) collection (CBAM5, OT4b.31, III(3)7) were evaluated by spectrophotometry according to a calibration gold curve of HAuCl₄ - with concentrations between 0 µg/mL and 100 µg/mL. Bioassays with living biomass were carried out with an initial gold concentration of 60 µg/mL. Their sorption capacity was evident, reaching percentages of gold removal between 25% and 85% in the first 2 h and 75% to 95% after 48 h. Biosynthesis of possible gold nanoparticles (AuNPs) in assays with living biomass was also observed. Metal sorption was evaluated using scanning electron microscopy and energy-dispersive X-ray spectroscopy (EDS) analysis. The sorption and fabrication capacity exhibited by the evaluated strains of L. sphaericus converts this microorganism into a potential alternative for biomining processes, especially those related to gold extraction., Competing Interests: The authors declare no conflicts of interest.

Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs)). .

Background: In Chile, residency training programs (RTP) take place in a stimulating academic environment for the promotion of clinical research skills. However, research is not a frequent curricular outcome. Accreditation of these programs by the National Accreditation Commission is an opportunity to improve the trainee's research competences., Aim: To analyze in the RTP curricula, the explicit intention to carry out clinical research and its correlation with the scientific productivity of professors and residents., Material and Methods: Fifty six training study programs corresponding to six primary specialties and six derived specialties, offered by seven universities holding accreditation tenure for RTP from the Chilean Association of Medicine Faculties (ASOFAMECH) up to 2005, were analyzed. The analysis included each academic program, courses and/or rotations and professors and residents' productivity, measured as publications accredited in the Institute for Scientific Information (ISI), between 1999 and 2007., Results: RTP are based on a tutorial educational model, where the close relationship between professors and residents is essential for the expected final outcome. Simultaneously, the programs' curricula revealed a high intentionality towards clinical research. However, professors' publications of ISI indexed articles showed a low and irregular scientific productivity., Conclusions: The gap between the declared training in clinical research and the effective ISI productivity is an awareness call with respect to the contribution that RTP could provide to accreditation, to professors and residents, and in general to health improvement in the country.

We assessed the immunogenicity of the paediatric dose of Epaxal(®) (0.25 mL) and the degrees of seroprotection achieved with the standard dose (0.5 mL) of Epaxal(®) or a dose of Havrix(®) Junior, in children in an open, randomised, controlled, multi-centre, parallel-group study conducted at 2 Chilean study centres. 360 healthy children and adolescents 12 months to <17 years of age not previously vaccinated against hepatitis A were enrolled. Subjects were randomised 2:2:1 to be vaccinated with either Epaxal(®) 0.25 mL [n=146], Epaxal(®) 0.5 mL [n=142] or Havrix(®) Junior [n=72] intramuscularly on Day 1 and after 6 months (26 weeks±14 days). Primary end point was the proportion of subjects seroprotected (anti-HAV antibody concentration ≥10 mIU/mL) in the ATP population at Month 1. All vaccines elicited high seroprotection rates at Month 1: 95.7% with Epaxal(®) 0.25 mL, 99.3% with Epaxal(®) 0.5 mL and 94.0% with Havrix(®) Junior. After the booster vaccination, all subjects demonstrated 100% seroprotection with all vaccines. Antibody concentrations were similarly high in all age groups. The paediatric presentation achieved antibody concentrations similar to those achieved with the 0.5 mL dose across the entire age range, and there were no differences across the range of body weights from 9.0 kg to 82.7 kg. All study vaccines were well tolerated and there were no AEs leading to discontinuation. Thus, the paediatric 0.25 mL dose of Epaxal(®) fulfilled the primary objective of showing non-inferiority to the adult 0.5 mL dose and to Havrix(®) Junior, in terms of seroprotection rates achieved. The results show the paediatric dose of Epaxal(®) to be an attractive option when conducting childhood-vaccination programmes., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Social media and technologies have put connectivity on steroids and made collaboration more integral to business than ever. But without the right leadership, collaboration can go astray. Employees who try to collaborate on everything may wind up stuck in endless meetings, struggling to reach agreement. On the other side of the coin, executives who came of age during the heyday of "command and control" management can have trouble adjusting their style to fit the new realities. In their research on top-performing CEOs, Insead professors Ibarra and Hansen have examined what it takes to be a collaborative leader. They've found that it requires connecting people and ideas outside an organization to those inside it, leveraging diverse talent, modeling collaborative behavior at the top, and showing a strong hand to keep teams from getting mired in debate. In this article, they describe tactics that executives from Akamai, GE, Reckitt Benckiser, and other firms use in those four areas and how they foster high-performance collaborative cultures in their organizations.

Though companies now invest heavily in mentoring and developing their best female talent, all that attention doesn't translate into promotions. A Catalyst survey of over 4000 high potentials shows that more women than men have mentors-yet women are paid $4600 less in their first post-MBA jobs, hold lower-level positions, and feel less career satisfaction. To better understand why, the authors conducted in-depth interviews with 40 participants in a mentoring program at a large multinational. All mentoring is not created equal, they discovered. Only sponsorship involves advocacy for advancement. The interviews and survey alike indicate that, compared with their male peers, high-potential women are overmentored, undersponsored, and not advancing in their organizations. Without sponsorship, women not only are less likely than men to be appointed to top roles but may also be more reluctant to go for them. Organizations such as Deutsche Bank, Unilever, Sodexo, and IBM Europe have established sponsorship programs to facilitate the promotion of high-potential women. Programs that get results clarify and communicate their goals, match sponsors and mentees on the basis of those goals, coordinate corporate and regional efforts, train sponsors, and hold those sponsors accountable.

Abdominoscrotal hydrocele (ASH) is an unusual condition characterized by a large scrotal hydrocele which communicates in an hourglass fashion with an abdominal component through the inguinal canal. Based on previous clinical observations, we believed that ASH is a condition that begins as a large scrotal hydrocele during the neonatal period and later expands first into the inguinal canal and finally into the abdominal cavity during the next few months of life. We report a case series of ASH and point out its distinctive characteristics.

Are women rated lower than men in evaluations of their leadership capabilities because of lingering gender bias? No, according to an analysis of thousands of 360-degree assessments collected by Insead's executive education program. That analysis showed that women tend to outshine men in all areas but one: vision. Unfortunately, that exception is a big one. At the top tiers of management, the ability to see opportunities, craft strategy based on a broad view of the business, and inspire others is a must-have. To explore the nature of the deficit, and whether it is a perception or reality, Insead professor Ibarra and doctoral candidate Obodaru interviewed female executives and studied the evaluation data. They developed three possible explanations. First, women may do just as much as men to shape the future but go about it in a different way; a leader who is less directive, includes more people, and shares credit might not fit people's mental model of a visionary. Second, women may believe they have less license to go out on a limb. Those who have built careers on detail-focused, shoulder-to-the-wheel execution may hesitate to stray from facts into unprovable assertions about the future. Third, women may choose not to cultivate reputations as big visionaries. Having seen bluster passed off as vision, they may dismiss the importance of selling visions. The top two candidates for the Democratic nomination for U.S. president in 2008 offer an instructive parallel. The runner-up, Hillary Clinton, was viewed as a get-it-done type with an impressive, if uninspiring, grasp of policy detail. The winner, Barack Obama, was seen as a charismatic visionary offering a hopeful, if undetailed, future. The good news is that every dimension of leadership is learned, not inborn. As more women become skilled at, and known for, envisioning the future, nothing will hold them back.

Background: Swine hepatitis E virus (HEV) has a cross-reaction with human anti-HEV antibodies. Therefore, pigs could be an animal reservoir, rendering hepatitis E as a zoonosis. The spread of this infection among infected pigs across countries would be possible through trading. Previously, using an anti-human conjugate, we detected anti-HEV antobodies in adult pigs in Chile., Aim: To detect anti-HEV (ELISA) in a cohort of swine at different ages., Material and Methods: Two hundred pigs aged 42 to 360 days, divided in 20 groups of 10 animals were tested. Anti-HEV was detected by ELISA using anti-pig IgG horseradish peroxidase instead of anti-human conjugates., Results: Anti-HEV were detected in one animal aged 90 days, two animals aged 120 days, one animal aged 260 days and 2 animals aged 360 days, five pregnant sows and two old hogs. This represents a total of 14 animals or 7% of the sample., Conclusions: There is a significant prevalence of anti-HEV in pigs from 90 days of birth, suggesting that these swine are a probable reservoir.

The social and sanitary changes that Chile is experiencing will change the epidemiologic profile of viral hepatitis. Virus A hepatitis will displace to older ages, and immunization plans with specific vaccines should be considered. The real prevalence of hepatitis B may be higher, due to an underreporting of the disease. The education and vaccination of high risk groups should be reinforced. E virus hepatitis requires more research in risk groups and in certain animal species consumed by humans. C virus hepatitis is the greatest challenge as it causes chronic liver disease and is the main cause for liver transplantation.

Most people acknowledge that networking-creating a fabric of personal contacts to provide support, feedback, insight, and resources--is an essential activity for an ambitious manager. Indeed, it's a requirement even for those focused simply on doing their current jobs well. For some, this is a distasteful reality. Working through networks, they believe,means relying on "who you know" rather than "what you know"--a hypocritical, possibly unethical, way to get things done. But even people who understand that networking is a legitimate and necessary part of their jobs can be discouraged by the payoff--because they are doing it in too limited a fashion. On the basis of a close study of 30 emerging leaders, the authors outline three distinct forms of networking. Operational networking is geared toward doing one's assigned tasks more effectively. It involves cultivating stronger relationships with colleagues whose membership in the network is clear; their roles define them as stakeholders. Personal networking engages kindred spirits from outside an organization in an individual's efforts to learn and find opportunities for personal advancement. Strategic networking puts the tools of networking in the service of business goals. At this level, a manager creates the kind of network that will help uncover and capitalize on new opportunities for the company. The ability to move to this level of networking turns out to be a key test of leadership. Companies often recognize that networks are valuable, andthey create explicit programs to support them. But typically these programs facilitate only operational networking. Likewise, industry associations provide formal contexts for personal networking. The unfortunate effect is to give managers the impression that they know how to network and are doing so sufficiently. A sidebar notes the implication for companies' leadership development initiatives: that teaching strategic networking skills will serve their aspiring leaders and their business goals well.

Background: The seroprevalence of antibodies against hepatitis A virus (HAV) is decreasing in many Latin American countries, along with improvements in sanitary standards. However, there is no information available about low socioeconomic status (LSE) populations., Aim: To assess the evolution of hepatitis A and E virus antibodies in a cohort of LSE Chilean children., Material and Methods: One hundred sixty eight children aged four years, 97 males, coming from public primary care clinics, were studied. Two blood samples were obtained with an interval of one year. Anti-HAV and anti-hepatitis E virus (HEV) antibodies, were detected by ELISA using Abbott kits., Results: Anti-HAV was positive in 19 children (11.3%). After one year of follow-up, only 10 children had sustained reactivity (52.6%). Fourteen children, initially negative, became positive during the follow up (9.4%). Antibody titers to HAV were significantly higher in samples that remained positive, compared with those that lost reactivity. Anti-HEV was found positive in two children (1.2%). One remained positive and the other became negative., Conclusions: In this cohort of LSE Chilean children, the prevalence to antibodies against HAV and HEV is low. Follow-up detected loss of reactivity to HAV in nearly one half of the children, probably related to lower antibody levels.

When you're in the midst of a major career change, telling stories about your professional self can inspire others' belief in your character and in your capacity to take a leap and land on your feet. It also can help you believe in yourself. A narrative thread will give meaning to your career history; it will assure you that, in moving on to something new, you are not discarding everything you've worked so hard to accomplish. Unfortunately, the authors explain in this article, most of us fail to use the power of storytelling in pursuit of our professional goals, or we do it badly. Tales of transition are especially challenging. Not knowing how to reconcile the built-in discontinuities in our work lives, we often relay just the facts. We present ourselves as safe--and dull and unremarkable. That's not a necessary compromise. A transition story has inherent dramatic appeal. The protagonist is you, of course, and what's at stake is your career. Perhaps you've come to an event or insight that represents a point of no return. It's this kind of break with the past that will force you to discover and reveal who you really are. Discontinuity and tension are part of the experience. If these elements are missing from your career story, the tale will fall flat. With all these twists and turns, how do you demonstrate stability and earn listeners' trust? By emphasizing continuity and causality--in other words, by showing that your past is related to the present and, from that trajectory, conveying that a solid future is in sight. If you can make your story of transition cohere, you will have gone far in convincing the listener--and reassuring yourself--that the change makes sense for you and is likely to bring success.

Unlabelled: In this open study, 20 toddlers and 80 schoolchildren received an intramuscular dose of Epaxal and a booster dose 12 mo later to assess the efficacy and safety of this aluminium-free, virosomal hepatitis A vaccine. Four weeks after primary vaccination, 94% of toddlers and 99% of schoolchildren had seroconverted, and all toddlers and 94% of schoolchildren remained seroprotected for 12 mo., Conclusion: After vaccination with Epaxal and booster, all subjects were seroprotected. Epaxal was very well tolerated by both age groups.

Everyone knows a story about a talented business person who has lost his passion for work, or a person who ditched a 20-year career to pursue something completely different and is the happier for it. "Am I doing what is right for me, or should I change direction?" is one of the most pressing questions for today's midcareer professional. A true change of direction is hard to swing. Many academics and career counselors contend that the problem lies in basic human behavior: We fear change and don't want to make sacrifices. But author Herminia Ibarra suggests another explanation. People most often fail, she says, because they take the wrong approach to finding new careers. Indeed, the conventional wisdom on how to change careers is a prescription for how to stay put. Most of us have heard that the key to a successful career change is figuring out what we want to do next, then acting on that knowledge. But change actually happens the other way around. Doing comes first, knowing second, because changing careers means redefining our working identity--our sense of self in our professional roles, what we convey about ourselves to others and, ultimately, how we live our working lives. Who we are and what we do are tightly connected, the result of years of action. And to change that connection, we must first resort to action--exactly what the conventional wisdom cautions us against. Many successful career changers use a test-and-learn model of change, putting their possible identities into practice and then working and crafting them until the identities are sufficiently grounded in experience to guide more decisive steps. To make a break with the past, we must venture into the unknown.

Background: Sanitary and socioeconomic changes and the identification of new causative virus, have changed the epidemiology of hepatitis in Chile., Aim: To study the natural history of acute hepatitis caused by virus A, E and non A-E in Chilean adults., Patients and Methods: A special study protocol was followed for patients with a clinical picture of acute hepatitis. Anti HAV IgM, anti HBc IgM, anti HEV IgG and IgM and Anti HCV antibodies were determined by ELISA., Results: Fifty nine patients (30 male), aged 15 to 58 years old were studied. Eighty nine percent had jaundice and 50 to 70% had malaise and abdominal pain. Virus A was positive in 80%, virus E in 7%. In 14% of patients, all viral markers were negative. The evolution was typical in 78%, biphasic in 14% and cholestatic in 5%. One patient had a prolonged and one a fulminant course. Mean ALT was 1148 U/l and mean total bilirubin was 5.5 mg/dl. Seventy three percent of cases occurred during early winter and spring and 27% during summer and early autumn., Conclusions: The main etiology of acute viral hepatitis in Chile is virus A and most cases occur during the rainy season. Clinical features of hepatitis non A-E are similar to enteral transmission forms.

Background: Little information is available in Chile about hepatitis C virus (HCV) in hematological and oncohematological patients., Aim: To evaluate the prevalence of hepatitis C virus markers in a group of hematological and oncohematological pediatric patients seen at Valdivia Regional Hospital., Patients and Methods: Antibodies against virus C, determined by ELISA and viral RNA, determined using RT-polymerase chain reaction, were measured in 54 blood samples from children with hematological diseases (34 with Acute Lymphoblastic Leukaemia, 4 with Hodgkin Diseases, 4 with Haemolytic Anemia, 5 with Sarcomas, 2 with Non-Hodgkin Lymphoma, 2 with Thrombocytopenic Purpura, 1 with an Ependimoma, one with a Wilms Tumor and 1 with a Von Willebrand Disease)., Results: All samples were negative for antibodies against hepatitis C virus. Viral RNA was found in four children, all with a diagnosis of acute lymphoblastic leukemia and who received chemotherapy and multiple transfusions., Conclusions: The prevalence of Viral RNA for hepatitis C virus in oncohematological patients in our study is high and associated with the use of chemotherapy and multiple transfusions.

Background: As sanitary and economic conditions improve, the prevalence of antibodies to hepatitis A is now significantly lower., Aim: To evaluate the prevalence of hepatitis A virus antibodies in healthy Chilean adults., Material and Methods: Antibodies to hepatitis A virus were measured, using a commercial ELISA assay, in 215 voluntary blood donors (163 male, aged 19 to 30 years old) and 295 medical students and health personnel (156 male, aged 19 to 39 years old), residing in Valdivia, Chile., Results: Antibodies against hepatitis A virus were found in 68.2% of the total sample (351/510). Ninety percent of flood donors and 54% of health personnel and students were positive (p < 0.01). Age specific prevalence in blood donors 19 to 22, 23 to 29 and 27 to 30 years old was 81.0%, 95.2% and 95.6% respectively. Among the same age groups in medical students, the prevalence was 47.9%, 53.2% and 61.9% respectively (p < 0.01)., Conclusions: This study indicates a reduction in the prevalence of hepatitis A virus antibodies among adults in Valdivia (Chile). Differences detected between individuals are probably related to different socioeconomic levels. Medical students have an increased risk for hepatitis A infections than the general population.

Background: As sanitary conditions of a population improve, hepatitis A virus infection occurs at higher ages, thus decreasing the prevalence of antibodies against the virus. In the eighties, the prevalence of antibodies among children was 97% and depended on the socioeconomic level., Aim: To assess the prevalence of antibodies against hepatitis A virus in school age children living in Valdivia., Subjects and Methods: Two thousand three hundred thirty three school age children were studied. Total antibodies against hepatitis A virus were detected using an ELISA kit from Abbott. Children were stratified in age groups and school were classified as private, subsidized, municipal or foster homes., Results: Antibodies were positive in 65% of children (59% in children aged 6 to 8 years old, 66% in children aged 9 to 11 years and 69% in children aged 12 to 15 years. In private schools, the prevalence was 26%, in subsidized schools the figure was 54%, in municipal schools 73% and in foster homes 91%., Conclusions: The general prevalence of antibodies against hepatitis A virus is higher in low socioeconomic level children. There is a global decrease in the prevalence of these antibodies in the last years.

Little is known about hepatitis E virus (HEV) prevalence in South American countries. Anti-HEV was studied in 1,773 subjects from 1,360 blood donors of 3 cities in Chile, 72 in health care workers, 241 inmates in state jails, and in 100 Araucanian indians. Anti-HEV was detected in 109 out of 1,360 (8.0%) total donors (6.3%, 6.1%, and 18.8% from the cities of Valdivia, Osorno and Puerto Montt respectively); 9 out of 72 (12.5%) health care workers; 18 out of 241 (7.5%) inmates, and 17 out of 100 (17%) Araucanian indians. Prevalence of anti-HEV was not related to age and sex. Hepatitis E is an endemic infection in some population groups of Southern Chile, associated to environmental pollution, crowding and low socioeconomic level.

The aim of this study was to determine the prevalence of hepatitis C virus antibodies in high risk patients coming from Valdivia, Osorno and Puerto Montt. Fifty-six patients in hemodialysis, 51 renal graft recipients, 42 cirrhotics and 14 patients with acute non A non B hepatitis were studied. Antibodies were detected with a second generation ELISA technique and positive cases were confirmed with RIBA. All hemodialysis patients and renal graft recipients were negative for hepatitis C virus antibodies. In one non alcoholic patient with cirrhosis, a positive ELISA was confirmed with RIBA. Six patients with acute hepatitis had positive ELISA tests but none was confirmed with RIBA. It is concluded that the prevalence of hepatitis C virus antibodies in this region of Chile is very low.

The aim of this work was to study the prevalence of bacterial infections in hospitalized patients with liver cirrhosis and to compare clinical, bacteriological and evolution features of patients with (group 1) and without bacterial infections (group 2). One hundred thirty two hospitalized patients with liver cirrhosis were prospectively studied and 61 episodes of bacterial infections were diagnosed in 52 (27 spontaneous bacterial peritonitis (44.3%), 16 urinary tract infections (26.2%), 10 pneumonias (16.4%), 3 spontaneous bacteremias (4.9%9, and 5 miscellaneous infections (8.2%)). Twenty six percent of infections were nosocomial. Child-Pugh score was 12 +/- 2 in group 1 vs 10 +/- 2 in group 2 (p = 0.047). Sixty five percent of identified microorganisms were gram negative and 61.5% of these were E. coli. Hospital mortality of group 1 was 29% and that of group 2 was 9% (p = 0.002). It is concluded that there is a high prevalence of bacterial infections in hospitalized cirrhotic patients, that is associated to a high mortality.

A 53 year old female nurse presenting with malaise, jaundice and pruritus is reported. Physical examination only disclosed jaundice and laboratory values showed an ALT of 445 U/l, ASAT of 179 U/l, alkaline phosphatases of 455 U/l and a total bilirubin of 7.7 mg/dl. Serological markers for hepatitis virus E were positive and negative for hepatitis virus A, B and C, cytomegalovirus and Epstein Barr virus. The patient recovered fully in 10 weeks and is asymptomatic after 5 years of follow up. Health care workers probably have a higher risk for hepatitis E than the general population and this is the first acute sporadic case described in Chile.

In many countries, Hepatitis is mainly due to virus. A. When improving life condition in a given population, initially there is a tendency to increase the number of cases in adults. We report clinical and laboratory findings in 87 adults with acute viral Hepatitis A in Chile. The rate man/woman was 1.55/1. Mean age: 23.8 years. Clinical forms: icteric classical (77.01%), cholestatic (10.34%), anicteric (8.05%), biphasic (2.30%) and fulminant (2.30%). From 87 patients in consult 1, 64 were controlled at day 15 (consult 2) and 35 one year later (consult 3). Laboratory (means): ALT (UI/L): 856.8, 111.6 and 20.8 in consult 1, 2 and 3 respectively. Correlation between values of ALT and AST (p < 0.0001). Mean total bilirubin (mg%): 6.6, 2.5 and 0.8 respectively. The evolution of Hepatitis A was favorable with a rapid decrease of clinical signs and normalization of laboratory values within the 3 first weeks of disease.

A placebo-controlled, double-blind study on the efficacy of a hepatitis A vaccine (SmithKline Beecham Biologicals) was started in a region of Chile in September 1990, using hepatitis B vaccine as control. A total of 260 healthy children, 6-15 years of age, negative for antibody to hepatitis A virus (anti-HAV), antibody to HAV immunoglobulin M (IgM), hepatitis B surface antigen, and antibody to hepatitis B surface and core antigens by ELISA tests within 7 days before vaccination, were randomly assigned to two study groups: 128 children received the vaccine with a yellow label (group 1), and 132 children the vaccine with an orange label (group 2) at months 0, 1 and 6. Blood for serology and transaminase determination was drawn at months 1, 2, 6, 7 and 12. Both vaccines were tolerated equally well and no serious side effects were seen. In group 1 (presumed hepatitis A vaccine group), anti-HAV was detected (20% inhibition was used as the cut-off level) in 122 of 128 children (95.5%) tested at month 1, in 126 of 127 (99.2%) at month 2, in 126 of 127 (99.2%) at month 6 and in 126 of 126 (100%) at month 7. One anti-HAV seroconversion seen at month 1 was associated with presence of anti-HAV IgM and therefore probably represents HAV infection. Geometric mean anti-HAV concentration of the other children was 128, 342, 214 and 2301 mIU/ml at months 1, 2, 6 and 7, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Most cases of post-transfusion hepatitis correspond to infection by non-A non-B virus. Indirect test (ALT elevation, anti-HBc titers) have been used to detect the presence of this virus. We screened 692 blood donors and health personnel, measuring anti-HBc (n = 572), HBs antigen (340), and ALT serum levels (190). Positive results were obtained for anti-HBc in 1.7% and HBs in 0%. ALT levels were 25 +/- 12 u/l in males and 18 +/- 14 in females (p < 0.01). ALT levels above 45 u/l were found in 6% of subjects. ALT levels were not related to anti-HBc positiveness nor to alcohol intake. The possible risk of posttransfusion hepatitis related to increased ALT levels remains to be clarified by specific markers.

A 23-year-old man developed thrombocytopenic purpura at the end of the second week of the clinical evolution of hepatitis A confirmed by viral markers. The bone marrow of this patient showed megakaryocytic hyperplasia. Circulating in his serum immune complexes were demonstrated by solid phase conglutinin enzymo-immunoassay. Platelet-reactive serum factors were also detected by an indirect immunofluorescence test using fresh donor platelets as targets. The evolution of both the hepatitis and the purpura were benign with no therapy other than bedrest. Platelet count normalized within five weeks of the onset of purpura, and IgM antibodies against hepatitis A virus as well as circulating immune complexes dropped to normal levels. It is postulated that the thrombocytopenia of this case was caused by nonspecific deposition of immune complexes at the platelet surface.