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In Chile, studies of parasites from the family Sarcocystidae (Apicomplexa) have mostly been related to domestic animals. We aimed to assess the presence of Sarcocystidae taxa in cricetid rodents from Central and Southern Chile. We studied 207 rodents, encompassing six species, from 13 localities. We isolated DNA from tissue samples, amplified the Sarcocystidae 18S rRNA gene with polymerase chain reaction, and performed phylogenetic analyses using maximum likelihood and Bayesian inferences. In addition, we examined blood smears and performed histological studies in organs from Sarcocystidae DNA-positive animals. Three specimens were DNA-positive and three genotypes were retrieved and named: Sarcocystis sp. P61, related to Sarcocystis strixi, was detected in two Abrothrix olivacea. Toxoplasmatinae gen. sp. P99 was retrieved from those same two specimens, and was related to Toxoplasma and other genera, although it branched independently. Besnoitia sp. R34 was detected in one Abrothrix hirta, and was clustered with congeneric species associated with rodents. No protozoa were found during microscopic studies; thus, it was not possible to confirm parasitic interactions rather than accidental encounters. However, the close relatedness of the retrieved genotypes to parasites of rodents supports the hypothesis of host-parasite associations. All three genotypes are suggested as potential new taxa, including a putative new genus.

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The aim of this study was to compare the effect of cognitive behavioral intervention (CBI) combined with the resilience model (CBI + R) vs CBI alone on depression symptoms, anxiety symptoms, and quality of life of end-stage renal disease (ESRD) patients undergoing hemodialysis replacement therapy. METHOD: Fifty-three subjects were randomly assigned to one of two treatment groups. The control group (n = 25) was provided with treatment strategies based on a cognitive behavioral approach, while the experimental group (n = 28) were given the same techniques plus resilience model strategies. Five psychological instruments were applied: Beck Depression Inventory, Beck Anxiety Inventory, Mexican Resilience Scale, cognitive distortions scale, and the Kidney Disease related Quality of Life questionnaire. Participants were assessed at baseline (before treatment), eight weeks later (end of treatment), and four weeks after the end of treatment (follow up). The results were analyzed by ANOVA for repeated measures with a Bonferroni-adjusted test method, with p < 0.05 considered significant. RESULTS: The experimental group had significant differences in total and somatic depression as well as differences in the dimensions of cognitive distortions and a significant increase in the dimensions of resilience. The control group had significant differences in all variables but showed lower scores in the evaluated times. CONCLUSIONS: The resilience model strengthens and enhances the effectiveness of the cognitive behavioral approach to reduce symptoms of depression and anxiety in patients with ESRD.

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El diagnóstico del síndrome de Alport supone un reto en la edadpediátrica, debido a la ausencia de fenotipos clínicos esperados de la enfermedad, su clásica caracterización de entidad rara y la práctica muy restringida de biopsias renales con análisis rutinario de la muestra por microscopía electrónica durante la infancia. Se presentan las características clínicas y genéticas de 6 pacientes pediátricos (4 mujeres) diagnosticados de síndromede Alport en dos centros hospitalarios entre 2018 y 2021. Todos los pacientes presentaron un debut clínico claramente diferente y ninguno presentó complicaciones auditivas nioftalmológicas. La mitad carecía de antecedentes familiares de enfermedad renal crónica. Ninguna biopsia renal realizada confirmó el diagnóstico. Todos los pacientes fueron confirmadosgenéticamente y fueron el caso índice del estudio familiar. Esta serie ilustra la presencia de fenotipos clínicos inesperados en el síndrome de Alport y refleja la necesidad de incorporar el estudio genético para su diagnóstico.

The diagnosis of Alport syndrome is a challenge in the pediatric age, due to the absence of expected clinical phenotypes of the disease, its classic characterization of a rare disease and the very restricted practice of renal biopsies with routine analysis of the sample by electron microscopy during infancy. The clinical and genetic characteristics of 6 pediatric patients (4 women) diagnosed with Alport syndrome in two hospital centers between 2018 and 2021 are reported. All patients presented a clearly different clinical debut and none presented auditory or ophthalmological complications. Half had no family history of chronic kidney disease. No kidney biopsy performed confirmed the diagnosis. All patients were genetically confirmed and were the index case in the family study. This series illustrates the presence of unexpected clinical phenotypes in Alport syndrome and reflects the need for the incorporation of the genetic study for its diagnosis.

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The diagnosis of Alport syndrome is a challenge in the pediatric age, due to the absence of expected clinical phenotypes of the disease, its classic characterization of a rare disease and the very restricted practice of renal biopsies with routine analysis of the sample by electron microscopy during infancy. The clinical and genetic characteristics of 6 pediatric patients (4 women) diagnosed with Alport syndrome in two hospital centers between 2018 and 2021 are reported. All patients presented a clearly different clinical debut and none presented auditory or ophthalmological complications. Half had no family history of chronic kidney disease. No kidney biopsy performed confirmed the diagnosis. All patients were genetically confirmed and were the index case in the family study. This series illustrates the presence of unexpected clinical phenotypes in Alport syndrome and reflects the need for the incorporation of the genetic study for its diagnosis.

El diagnóstico del síndrome de Alport supone un reto en la edad pediátrica, debido a la ausencia de fenotipos clínicos esperados de la enfermedad, su clásica caracterización de entidad rara y la práctica muy restringida de biopsias renales con análisis rutinario de la muestra por microscopía electrónica durante la infancia. Se presentan las características clínicas y genéticas de 6 pacientes pediátricos (4 mujeres) diagnosticados de síndrome de Alport en dos centros hospitalarios entre 2018 y 2021. Todos los pacientes presentaron un debut clínico claramente diferente y ninguno presentó complicaciones auditivas ni oftalmológicas. La mitad carecía de antecedentes familiares de enfermedad renal crónica. Ninguna biopsia renal realizada confirmó el diagnóstico. Todos los pacientes fueron confirmados genéticamente y fueron el caso índice del estudio familiar. Esta serie ilustra la presencia de fenotipos clínicos inesperados en el síndrome de Alport y refleja la necesidad de incorporar el estudio genético para su diagnóstico.

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BACKGROUND: Portal vein occlusion shortly before extended hepatic resections has hepatoprotective properties, but its molecular effects have not been elucidated. We characterized the impact of regenerative preconditioning by portal vein embolization (PVE) on hepatic energy metabolism and cytokine expression. MATERIALS AND METHODS: About 90% hepatectomies were performed in normal pigs (Control) and in pigs that underwent a PVE 24 h before the surgery (n = 10/group). Blood biochemistry and coagulation, liver damage, liver function (ICG), hepatic content of adenine nucleotides, and hepatic expression of inflammatory mediators (RT-PCR and WB) were determined before the hepatectomy, 15 min, and 24 h later. RESULTS: All PVE and hepatectomies were successfully accomplished. The 90% hepatectomy resulted in: Immediate reduction of ATP, leading to persistent decreases of energy load and ATP/ADP ratio up to the 24-h time-point; and pro-inflammatory expression profile of cytokines in the remnant liver. Prior performance of PVE attenuated the bioenergetic alterations and prevented many of the changes in hepatic cytokine expression. CONCLUSIONS: Regenerative preconditioning by PVE improved hepatic energy metabolism and modulated inflammatory mediators in the remnant liver in pigs undergoing major hepatectomies, potentially contributing to its hepatoprotective effects.

INTRODUCCIÓN: la oclusión de la vena porta precoz antes de hepatectomías extendidas tiene propiedades hepatoprotectoras, pero sus efectos moleculares no se han aclarado. Caracterizamos el impacto del preacondicionamiento regenerativo por embolización de la vena porta (PVE) sobre el metabolismo energético hepático y la expresión de citocinas. MATERIALES Y MÉTODOS: Realizamos hepatectomías del 90% en cerdos (Control) y en cerdos sometidos a PVE 24 horas antes de la cirugía (n = 10/grupo). La bioquímica y la coagulación, el daño hepático, la función hepática (ICG), los nucleótidos de adenina y la expresión de mediadores inflamatorios (RT-PCR y WB) fueron determinado antes de la hepatectomía, quince minutos y 24 horas después. RESULTADOS: Las PVE y las hepatectomías se realizaron con éxito. La hepatectomía del 90% resultó en: una reducción del ATP, lo que disminuye la carga energética y la relación ATP/ADP a las 24 horas; y en la expresión de citocinas proinflamatorias. La realización previa de PVE atenuó las alteraciones bioenergéticas y evitó muchos de los cambios en la expresión de citocinas. CONCLUSIONES: El preacondicionamiento regenerativo con PVE mejoró el metabolismo energético y moduló los mediadores inflamatorios en el hígado remanente en cerdos sometidos a hepatectomías subtotales, contribuyendo potencialmente a sus efectos hepatoprotectores.

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Depression and anxiety are highly prevalent psychological disorders in end-stage renal disease (ESRD) that have a negative clinical impact. The purpose of our study was to identify factors associated with the presence of depression and anxiety, in a sample of ESRD patients treated with hemodialysis. We included 187 patients from two dialysis facilities, age 18-65 years. Beck's depression and anxiety inventories, KDQOL36 questionnaire, the cognitive distortion scale and the Mexican scale of resilience were used. Socio-demographic and clinical information was obtained from medical records. Depression was present in 143 (76.4%) patients. Patient with depression were older (33 (26-52) years vs. 30 (24.43) years, p = 0.025), had a lower education level (36% vs. 9%, p = 0.001), used more medications (67% vs. 36%, p = 0.001), had a comorbidity (75% vs. 41%, p = 0.001), and a higher proportion were waiting for a kidney transplant. Anxiety was present in 112 (59.8%) cases. By multivariate analysis, depression was independently associated with lower education, absence of previous kidney transplant, anxiety, higher cognitive distortion, lower psychological resilience, and lower quality of life scores. In conclusion, lower psychological resilience, lower education level, and higher cognitive distortions are factors associated with depression and anxiety in ESRD patients.

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BACKGROUND: The Surveillance, Epidemiology, and End Results (SEER) database and National Cancer Database (NCDB) show improved overall survival (OS) in patients with multiple myeloma (MM) over the last 15 years. This analysis evaluated the validity of the largely community-based Connect MM Registry as a national reference for MM. METHODS: Baseline disease characteristics and survival in US newly diagnosed MM patients were examined using the Connect MM Registry as well as SEER and NCDB databases. Baseline characteristics predictive of longer survival in Connect MM were also identified. RESULTS: As of February 2017, 3011 patients were enrolled in the Connect MM Registry; 2912 were treated. Median age at time of MM diagnosis and age range were numerically similar from 2010 to 2015 across all 3 registries; SEER had a higher representation of nonwhite racial groups than that in the other 2 registries. OS rates suggest proportionate improvement with year of diagnosis among the 3 registries. A Cox proportional hazards model suggests that younger age (<65 years) is associated with longer survival (vs ≥75; HR, 0.39; 95% confidence interval, 0.34-0.46) in the Connect MM Registry. However, sex (HR, 0.91; P = .15) and race (black vs white; HR, 0.88; P = .21) were not associated with longer OS. CONCLUSIONS: Data from the Connect MM Registry appear to be largely representative of national trends, comprehensive, and reliable representations of the national MM population. Baseline characteristics were comparable, and survival similarly improved over time among the 3 registries. CLINICALTRIALS. GOV, IDENTIFIER: NCT01081028.

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Bovine viral diarrhea virus (BVDV) is a major pathogen worldwide, causing significant economic losses to the livestock sector. In Uruguay, BVDV seroprevalence at the farm level is >80%. In this work, 2546 serum, blood or tissue samples collected from animals suspected of being affected by BVD between 2015 and 2017 were analyzed by reverse transcription PCR and sequencing. Analysis of the BVDV genomic regions 5'UTR/Npro, Npro and E2 revealed that BVDV-1a, 1i and 2b circulate in the country, with BVDV-1a being the most prevalent subtype. Population dynamics studies revealed that BVDV-1a has been circulating in our herds since ~1990. This subtype began to spread and evolve, accumulating point mutations at a rate of 3.48 × 10-3 substitutions/site/year, acquiring specific genetic characteristics that gave rise to two local genetic lineages of BVDV-1a. These lineages are divergent from those circulating worldwide, as well as the vaccine strain currently used in Uruguay. The most notable differences between field and vaccine strains were found in the E2 glycoprotein, suggesting that the amino acid substitutions could result in failure of cross-protection/neutralization after vaccination. This is the first study that compares Uruguayan BVDV field and vaccine strains with other BVDV strains from throughout the world. The results obtained in this study will be very useful for developing a suitable immunization program for BVDV in Uruguay by identifying local field strains as candidates for vaccine development.

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ABSTRACT Introduction: The present work evaluated the possible alterations in different hemogram parameters as: total erythrocyte count, hematocrit, leukocyte, and platelet count, against different times of sample storage at refrigerated and room temperature towards the effects of anticoagulants that can affect the variation of laboratory results. Objective: Compare variations in automated hemogram analysis, with blood collected in tubes containing dipotassium ethylenediaminetetraacetic acid (K2EDTA) and tripotassium ethylenediaminetetraacetic acid (K3EDTA). Material and methods: A comparative study was carried out on differential leukocyte count and absolute leukocyte count, hemoglobin determination and red blood cell count and platelet count. Therefore, it researches the anticoagulant that brings less interferences in hemogram analysis according to storage, at temperatures from 2°C to 8°C and 25°C (room temperature), and the time window between collection and analysis (4, 6, and 8 hours). These determinations were carried out after homogenization from five to eight inversions using the automated device Sysmex XN-1000TM. Eighteen biological samples of venous blood were collected, used as control, from patients aged 18 and over that did not have any hematologic disease. Results: The results were evaluated through descriptive statistical analysis, and comparison of mean values through the analysis of variance (Anova). In accordance with the results presented, there were not changes in the parameters by refrigerating the sample in the period of 8 hours, except for the platelet count, presenting oscillations when stored under refrigeration from 2°C to 8°C. Conclusion: At room temperature, the parameters mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), and hematocrit presented significant statistical differences.

RESUMEN Introducción: Este trabajo evaluó los posibles cambios en diferentes parámetros del hemograma, como conteo de eritrocitos totales, leucocitos, hematocrito y plaquetas, con respecto a diferentes tiempos de almacenamiento de la muestra en ambiente refrigerado y temperatura ambiente en cuanto a los efectos de los anticoagulantes, que pueden afectar los resultados del análisis de laboratorio. Objetivo: Comparar los cambios presentes en el análisis del hemograma automatizado, recogido en tubos que contienen ácido etilendiaminotetraacético dipotásico (K2EDTA) y tripotásico (K3EDTA). Material y método: Estudio comparativo realizado para conteo diferencial/absoluto de leucocitos, determinación de hemoglobina y conteo de eritrocitos y plaquetas, a fin de investigar el anticoagulante que trae menos interferencia en el análisis del hemograma según su almacenamiento - temperatura de 2°C a 8°C y 25°C (temperatura ambiente) y ventana de tiempo entre recuento y análisis de 4, 6, y 8 horas. Se realizaron las determinaciones luego de homogeneizar las muestras con cinco a ocho inversiones en el analizador automatizado Sysmex XN-1000TM. Dieciocho muestras de sangre venosa de pacientes mayores de 18 años, sin enfermedades hematológicas, fueron recogidas y usadas como control. Resultados: Se evaluaron los resultados mediante un análisis descriptivo, con comparación de medias por análisis de la varianza (Anova). De acuerdo con los resultados, no hubo cambios en los parámetros enfriándose la muestra en el período de 8 horas, a excepción del recuento de plaquetas, que presentó oscilaciones bajo refrigeración (2°C-8°C). Conclusión: A temperatura ambiente, los parámetros volumen corpuscular medio (VCM), concentración de hemoglobina corpuscular media (CHCM) y hematocrito presentan diferencia estadísticamente significativa.

RESUMO Introdução: O presente trabalho avaliou as possíveis alterações em diferentes parâmetros do hemograma, como contagem de eritrócitos totais, leucócitos, hematócrito e plaquetas, em relação a diferentes tempos de armazenamento da amostra em ambiente refrigerado e em temperatura ambiente quanto aos efeitos dos anticoagulantes, que podem afetar a variabilidade de seus resultados laboratoriais. Objetivo: Comparar as variações presentes na análise do hemograma automatizado, colhido nos tubos contendo ácido etilenodiamino tetra-acético dipotássico (K2EDTA) e tripotássico (K3EDTA). Material e métodos: Estudo comparativo realizado para contagem diferencial/absoluta dos leucócitos, determinação de hemoglobina e contagem de hemácias e plaquetas, com o intuito de investigar o anticoagulante que traz menos interferentes na análise do hemograma de acordo com sua estocagem - temperatura de 2°C a 8°C e 25°C (temperatura ambiente) e janela de tempo entre a coleta e a análise de 4, 6 e 8 horas. Essas determinações foram realizadas após homogeneização de cinco a oito inversões pelo aparelho automatizado Sysmex XN-1000TM. Dezoito amostras biológicas de sangue venoso de pacientes com idade superior a 18 anos, sem doenças hematológicas, foram coletadas e utilizadas como controle. Resultados: Os resultados foram avaliados por meio de uma análise estatística descritiva, com comparação de médias através da análise de variância (Anova). De acordo com os resultados apresentados, não ocorreram alterações nos parâmetros ao refrigerar a amostra no período de 8 horas, com exceção da contagem de plaquetas, que apresentou oscilações quando armazenadas sob refrigeração de 2°C a 8°C. Conclusão: Na temperatura ambiente, os parâmetros volume corpuscular médio (VCM), concentração de hemoglobina corpuscular média (CHCM) e hematócrito apresentaram diferença estatística significante.

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BACKGROUND AND OBJECTIVES: Tumor deposits (TDs) are associated with adverse prognostic factors and decreased survival in colorectal cancer. However, controversy exists regarding their definition, evaluation, and staging categories. This study aimed to determine the survival and recurrence impact of the TD in colon adenocarcinomas; and to determine if TD patients behave similarly to stage IV patients. METHODS: Cross-section study from 392 patients with colon adenocarcinoma from 2005 to 2012. We performed survival analysis and further stratified patients considering TD patients as a "stage IV-TD" to demonstrate if they behave similarly than stage IV patients. RESULTS: From 392 patients, 204 (52%) were men, the mean age was 57.4 ± 13.9 years and 11.5% of cases had TD. In a multivariate analysis, TD failed to predict mortality and recurrence. Considering cases with TD as stage IV-TD, their mean survival was similar to stage IV patients (69.3 and 64.6 months, respectively) and different to those in stage III (110.5 months), II (135.7 months), and I (114.9 months) (P < 0.001). CONCLUSIONS: TD failed to predict mortality and recurrence. Patients with TD in stage I-III shows similar mortality than stage IV patients; then, we suggest putting them into a substage IV category instead of the N1c category.

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