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We describe here the first isolation in Argentina of a lactose-fermenting and lysine decarboxylase-negative non-Typhi Salmonella enterica from a blood culture of a patient with systemic lupus erythematosus. The microorganism was identified as S. enterica (score: 2.148) by mass spectrometry, as "Salmonella group" (discrimination: 86%) by the VITEK® 2 system and as Citrobacter freundii complex by biochemical tests. The serological test using the OMA antiserum for the somatic antigen was positive. The identification was confirmed as Salmonella subsp. I 4,[5],12:i:- atypical at the National Reference Center ANLIS Dr. Carlos G. Malbrán. Mass spectrometry is especially useful in microbial identification in the presence of atypia, while biochemical tests can lead to misidentification in these cases. This study warns about the circulation of this strain in Argentina., (Copyright © 2024 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Salmonella spp. is one of the most important zoonotic pathogens that causes foodborne diseases. It is divided into two species (Salmonella bongori and Salmonella enterica) including around 2600 serovars, being S. enterica serovar Enteritidis one of the most frequent in Argentina. Serovar identification is generally conducted by somatic and flagellar agglutination sera assays, and molecular biology techniques can also be performed. As efforts are being made worldwide to differentiate Salmonella serovars, our aim was to evaluate the utility of two specific biomarkers, previously reported for differentiating S. Enteritidis with MALDI-TOF MS. A panel of 105 S. enterica local isolates, belonging to different serovars and characterized by sera agglutination and PCR, was included in this study. Two specific S. Enteritidis biomarkers, at m/z 3016±3Da and 6034±3Da, were visually detected showing a sensitivity of 54% and 98%, respectively, and a specificity of 100% for both peaks. Concordance between serotyping and identification by PCR of S. Enteritidis and the blind search of biomarkers in a subset of isolates was 98%. Visual detection of these S. Enteritidis biomarkers using MALDI-TOF MS can be used as a fast and easy screening method for serovars differentiation at the microbiology clinical laboratory., (Copyright © 2024 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To compare the effectiveness of the awake-prone position on relevant clinical outcomes in patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen between different waves in Argentina., Methods: This multicenter, prospective cohort study included adult patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen. The main exposure position was the awake-prone position (≥ 6 hours/day) compared to the non-prone position. The primary outcome was endotracheal intubation, and the secondary outcome was in-hospital mortality. The inverse probability weighting-propensity score was used to adjust the conditional probability of treatment assignment. We then adjusted for contextual variables that varied over time and compared the effectiveness between the first and second waves., Results: A total of 728 patients were included: 360 during the first wave and 368 during the second wave, of whom 195 (54%) and 227 (62%) remained awake-prone for a median (p25 - 75) of 12 (10 - 16) and 14 (8 - 17) hours/day, respectively (Awake-Prone Position Group). The ORs (95%CIs) for endotracheal intubation in the Awake-Prone Position Group were 0.25 (0.13 - 0.46) and 0.19 (0.09 - 0.31) for the first and second waves, respectively (p = 0.41 for comparison between waves). The ORs for in-hospital mortality in the awake-prone position were 0.35 (0.17 - 0.65) and 0.22 (0.12 - 0.43), respectively (p = 0.44 for comparison between waves)., Conclusion: The awake-prone position was associated with a reduction in the risk of endotracheal intubation and in-hospital mortality. These effects were independent of the context in which the intervention was applied, and no differences were observed between the different waves.

This study seeks to assess the accuracy of apical location using an augmented reality (AR) device with a free-hand method. Sixty (60) osteotomy site preparations were randomly assigned to one of two study groups: A. AR device (AR) ( n = 30), and B. conventional free-hand method (FHM) ( n = 30). Preoperative CBCT scans and intraoral scans were taken and uploaded to specialized implant-planning software to virtually plan preparations for the apical location osteotomy sites. The planning software was then used to automatically segment the teeth in each experimental model for their complete visualization using the AR device. A CBCT scan was carried out postoperatively after conducting the apical location procedures. The subsequent datasets were imported into therapeutic software to analyze the coronal, apical, and angular deviations. The Mann-Whitney non-parametric test was used. There were no statistically significant differences identified at the coronal ( p = 0.1335), apical ( p = 0.2401), and angular deviations ( p = 0.4849) between the AR and FHM study groups. The augmented reality technique did not show a statistically significant accuracy of osteotomies for apical location when compared with the conventional free-hand method.

Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients., (© 2022. The Author(s).)

In the last 10 years, Salmonella Heidelberg has been extensively isolated from poultry in several countries. In this context, molecular characterization is essential to understand whether the strains have entered the farms from a single or several sources. Thus, the aim of this study was to determine the genetic relationship and antimicrobial susceptibility of S. Heidelberg strains isolated between 2011 and 2012 from broiler farms belonging to three integrated poultry companies located in Argentina. The genetic relatedness of the S. Heidelberg isolates was determined by pulsed-field gel electrophoresis (PFGE), and resistance to 21 antimicrobials was determined by the disc diffusion method. The isolates were assigned to four PFGE patterns. Most of the strains showed 100% similarity and belonged to the same integrated poultry company. This PFGE pattern was also prevalent in S. Heidelberg strains isolated from humans in several provinces of Argentina, which suggests an epidemiological association between human and poultry strains. All the isolates were classified as multidrug-resistant (MDR), and no clear relationship was observed between PFGE and resistance patterns. S. Heidelberg strains may circulate among farms from the same integrated company due to common sources of contamination. To guarantee the safety of the poultry product for the consumers, holistic approaches including surveillance of Salmonella throughout the production chain together with control measures are crucial., (© 2021 Wiley-VCH GmbH.)

Introduction: Superimposition of digital models may be performed to assess tooth movement in three dimensions. Detailed analysis of changes in tooth position after treatment may be achieved by this method., Aim: This article describes the method of superimposing digital models with a clinical case. It emphasizes the difficult procedure of superimposing 3D models in the lower arch. A methodology for superimposing mandibular models acquired with a structured light 3D scanner is discussed., Conclusion: Superimposition of digital models is useful to analyse tooth movement in the three planes of space, presenting advantages over the method of cephalogram superimposition. It seems feasible to superimpose digital models in the lower arch in patients without growth by using a coordinate system based on the palatal rugae and occlusion. The described method aims to advance the difficult procedure of superimposing digital models in the mandibular arch, but further research is nonetheless required in this field., (Copyright © 2018 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Detailed description about occurrence of calcium oxalate (CaOx) crystals in the edible vine cactus species Hylocereus costaricensis and Selenicereus megalanthus is scarce. Therefore, we evaluated and characterized the presence, morphology and composition of CaOx crystals in both species. Crystals were isolated from greenhouse and in vitro vegetative stems, and from ripe fruit peels and pulp by enzymatic digestion and density centrifugation and quantified with a haemocytometer. Morphologies were studied using scanning electron microscopy, elemental composition with energy-dispersive X-ray spectroscopy and salt composition with X-ray powder diffraction. Analyses conducted confirmed that isolated crystals were exclusively composed by CaOx, both mono- and dihydrated. Highest crystal contents were measured in greenhouse stems, followed by the fruit peels. While very few crystals were quantified in in vitro plants, they were not detected in the fruit pulp at all, which is of advantage for its human consumption and could be linked to mechanisms of seed dispersal through animals. Different crystal morphologies were observed, sometimes varying between genotypes and tissues analysed. This is the first work known to the authors with a detailed characterization of CaOx crystals in vine cacti., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The aim of this study was to describe an outbreak of Shigella sonnei that occurred in the city of Lujan, Buenos Aires, Argentina, in July 2012. Five individuals were affected after eating a hand-made Viennese-style pastry at a family gathering. All of them presented with fever, joint pain, chills and non-bloody diarrhea containing mucus. Stool cultures were performed in all cases and the samples taken from the pastry ingredients were analyzed microbiologically. S.sonnei was isolated and identified in all the patients involved as well as in the almond cream filling. The isolates were analyzed for determining the antimicrobial susceptibility and genetic profiles by pulsed field gel electrophoresis (PFGE). The results showed the genetic relationship among the isolates, confirming that the cases occurred due to the patients' exposure to the same source of infection, i.e., the almond cream. Being the almond cream an industrially-manufactured ingredient, an initial contamination could have been unlikely; however contamination might have occurred as a result of manipulation in the bakery., (Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.)

The prevalence of Campylobacter spp. was investigated in 327 patients suffering from diarrhea and in 36 animals (dogs, cats and chickens) owned by the patients that presented infection by Campylobacter in Santa Rosa, La Pampa, Argentina. Campylobacter spp. was isolated in 50/327 patients and in 12/36 animals, being Campylobacter jejuni the most common species. Resistance to ciprofloxacin (65 %) and tetracycline (32 %) was found among 35 isolates of human origin studied. Seven genetic subtypes were observed among 13 C. jejuni isolates by pulsed field gel electrophoresis. Two subtypes grouped isolates belonging to patients and their respective dogs whereas another subtype grouped one isolate of human origin and two isolates from the patient's chickens. The results of this investigation highlight the need to strengthen surveillance of Campylobacter spp. not only in poultry, which is recognized as the main reservoir, but also in pets, which were shown to be asymptomatic carriers of the pathogen.

Background: Modern medical education is focused on students, and it is necessary to assess its level of satisfaction. A questionnaire was validated and we then conducted a study about the educational satisfaction level of medical residents of the Hospital General of Mexico., Methods: An observational, descriptive, cross-sectional and prospective study was conducted. A questionnaire of 21 items was validated and then applied to a representative sample of medical residents. Each item was evaluated with a scale from 0 to 10 and then gathered in groups: 0-5 = poor, 6-7 = average, 8 = good, 9 = very good, and 10 = excellent. Descriptive and inferential statistics were carried out using SPSS v.17.0., Results: The questionnaire had internal validity with Cronbach's alpha >0.91 by item. Included in the study were 355 medical residents representing 37 different specialties. The performance perception of the ìheadî professors showed a wide heterogeneity: excellent (23.7%), very good (20.6%), good (16.9%), average (23.1%), poor (15.8%). Fourth-year residents and upward valued the educational performance higher (p = 0.001) as well as medical/surgical residents (p = 0.02). Intermediate-level residents valued the professor higher (p = 0.001), similar to students who were married or living with a partner (p <0.001). Upon contrasting the evaluation of the teacher's performance with the overall course performance, a linear, direct and significant correlation was obtained with Spearman's correlation coefficient = 0.78 and regression coefficient (p <0.001)., Conclusions: We found a wide range of heterogeneity of results. Performance of the professors was the basic component to judge the quality of the residents' courses.

Objectives: To report a case of eosinophilic cystopathy associated to infiltrative transitional-cell carcino ma of the bladder in an adult., Methods: We describe the case of a 79-year-old wo man who complains of meso and hipogastric pain since several months before, and to whom a parietal thickening of the bladder was detected by means of abdominal CT scan during the diagnostic work up for a digestive disease indicated by the Internal Medicine Service. Cistoscopy confirmed that finding, together with areas of greater endoluminal protrusion. Cold biopsy showed an inflammatory in filtrate with eosinophilic component. Transurethral resection was indicated., Results: The pathological assessment was compatible with high-grade infiltrative transitional carcinoma of the bladder. The patient developed multiple lung metastases and died five months after surgery., Conclusions: Reports describing the coincidence of both entities are infrequent. We emphasize the importance of a correct filiation of apparently "pseudotumoral" endoluminallesions.