Identificación presuntiva de Candida spp. y de otras levaduras de importancia clínica: utilidad de Brilliance Candida Agar

Fungal infections caused by yeasts have increased during the last decades and invasive forms represent a serious problem for human health. Candida albicans is the species most frequently isolated from clinical samples. However, other emerging yeast pathogens are increasingly responsible for mycotic infections, and some of them are resistant to some antifungal drugs. Consequently, it is necessary to have methods that can provide a rapid presumptive identification at species level.Numerous chromogenic agar media have been shown to be of value as diagnostic tools. We have compared a chromogenic medium, Brilliance Candida Agar, with CHROMagar Candida, the chromogenic medium most used in our country. A multicentre study was conducted in 16 Hospitals belonging to the Mycology Net of Buenos Aires City Government. A total of 240 yeast isolates were included in this research.The new chromogenic agar showed results very similar to those obtained with CHROMagar Candida.     

Determinación de perfiles de producción de metabolitos secundarios característicos de especies del género Alternaria aisladas de tomate

BackgroundMany Alternaria species have been studied for their ability to produce bioactive secondary metabolites, such as tentoxin (TEN), some of which have toxic properties. The main food contaminant toxins are tenuazonic acid, alternariol (AOH), alternariol monomethyl ether (AME), altenuene, and altertoxins i, ii and iii.AimsTo determine the profiles of secondary metabolites characteristic of Alternaria strains isolated from tomato for their chemotaxonomic classification.MethodsThe profiles of secondary metabolites were determined by HPLC MS.ResultsThe Alternaria isolates obtained from spoiled tomatoes belong, according to their morphological characteristics, to the species groups Alternaria alternata, Alternaria tenuissima and Alternaria arborescens, with A. tenuissima being the most frequent. The most frequent profiles of secondary metabolites belonging to the species groups A. alternata (AOH, AME, TEN), A. tenuissima (AOH, AME, TEN, tenuazonic acid) and A. arborescens (AOH, AME, TEN, tenuazonic acid) were determined, with some isolates of the latter being able to synthesize AAL toxins.ConclusionsSecondary metabolite profiles are a useful tool for the differentiation of small spored Alternaria isolates not easily identifiable by their morphological characteristics.     

Primer registro del género Corytoplectus (Gesneriaceae: Episcieae) en México, con descripción de una nueva especie

Corytoplectus (Gesneriaceae) is a neotropical genus of 11 species from South America. Collections recently made in Oaxaca indicate, for the first time, the presence of the genus in Mexico, and a newly described endemic species, C. oaxacensis. This species is most closely resembles C. schlimii which is from Colombia and Venezuela. Geographical distribution of the genus is briefly discussed.     

Evolución del estado de nutrición de yodo en los escolares de la Comunidad Autónoma del País Vasco

BackgroundAn epidemiologic survey showed in 1992 iodine deficiency and endemic goiter in schoolchildren from the Basque Country.Objectives1) To determine the percentage of homes of schoolchildren where iodized salt (IS) is used; 2) to assess iodine nutrition status in schoolchildren and to compare the data collected to those available from previous epidemiological studies.Design and MethodsA cross-sectional study in 720 randomly selected schoolchildren. Urinary iodine concentration (UIC) was measured using high-performance liquid chromatography(HPLC) with electrochemical detection.ResultsIS was used at 53.0% of the homes (95% confidence interval [CI], 49.2-56.7%). Median UIC has increased by 226%, from 65 μg/L in 1992 to 147 μg/L (percentile [P], P₂₅, 99 μg/L; P₇₅, 233 μg/L) today. Both schoolchildren consuming IS and those using unfortified salt at their homes had UICs corresponding to adequate iodine intakes (165 and 132 μg/L respectively). UICs experienced great seasonal fluctuations, being 55% higher during the November-February period than in June-September period (191 μg/L vs 123 μg/L; p < 0.001)ConclusionsSchoolchildren from the Basque Country have normalized their iodine nutrition status. The strong seasonal pattern of UICs suggests that consumption of milk and iodine-rich dairy products coming from cows feed iodized fodder is one of the most significant factors involved in the increase in iodine intake since 1992.     

Valoración de niveles de testosterona mediante diferentes métodos analíticos en varones sanos

Plasma testosterone concentrations are essential for the diagnosis of several causes of hypogonadism, including late-onset hypogonadism. Defining the normal range for testosterone concentrations poses certain difficulties due to the changes that occur with age and the variability of the different analytical methods used.ObjectivesTo study normal ranges of testosterone in healthy young men and to compare the results of distinct analytical methods.Material and methodsWe recruited 20 healthy men with a mean age of 24.5 years (standard deviation (SD): 5.04) and a mean body mass index (BMI) of 23.8% (SD: 3.3). Total testosterone (TT) was measured by immunochemiluminescence (ICLA) and free testosterone (FT) by radioimmunoassay (RIA). Calculated free testosterone (FTc) and bioavailable testosterone (BT) were calculated using Vermeulen's formula. Serum lutropin (LH), follitropin (FSH) and sex hormone binding globulin (SHBG) were measured by immunoradiometric assays (IRMA).ResultsThe mean concentrations were 20 nmol/l (SD: 4.96) for TT, 0.054 nmol/L (SD: 0.01) for FT, 0.3834 nmol/L (SD: 0.09) for FTc and 9.9 nmol/L (SD: 2.8) for BT. There was no correlation between testosterone measured by different methods other than an association between FT and FTc (r=0.662, p<0.003) and between FTc and BT (r=0.979, p<0.0001). An inverse correlation was found between BMI and TT concentrations (r: ?0.52, p<0.017).ConclusionsThe normal range for testosterone in healthy young men should be established in each laboratory based on the analytical method used.     

Evaluación de la realización del cribado del pie diabético en Atención Primaria

AimTo ascertain whether patients with type 2 diabetes are screened for diabetic foot, and to analyze the factors related to patients and centers associated to performance of such screening.Material and methodsA multicenter, epidemiological, cross-sectional study was conducted. The clinical records of 443 patients with type 2 diabetes monitored at Primary Care for at least 12 months were reviewed. Demographic and healthcare variables and characteristics of the primary care center were recorded.ResultsIn the previous year, 51.2% of patients had been trained on foot self-care, 56.4% had undergone foot inspection, 39.5% had been examined with a monofilament, and palpation of peripheral pulses and measurement of the ankle-brachial index were performed in 45.8 and 10.1% of patients, respectively. Diabetic foot screening (inspection, monofilament testing, and palpation of peripheral pulses) was performed in 37% of study patients. Ulcer risk stratification was done in 12.4% of patients. A significant association was found between diabetic foot screening and presence of foot deformities (P < .001), history of neuropathy (P = .005), and history of peripheral artery disease (P < .05). Screening was also associated to some characteristics of the center, such as reception of information about goal achievement (P < .001) and economic incentives for goal attainment (P < .001).ConclusionsCompliance with diabetic foot screening and ulcer risk stratification in patients with type 2 diabetes in Primary Care was poor.     

Especie nueva del género Megastigma (Rutaceae), del estado de Guerrero,México

Megastigma balsense, from the Río Balsas basin, in Guerrero, Mexico, is described as new and illustrated. It is related to M. galeottii.     

Evolución del microprolactinoma a largo plazo con tratamiento médico

IntroductionProlactinoma is the most frequent functioning pituitary adenoma. Most commonly occurs as microprolactinoma (less than 1 cm in size), which may be cured with medical therapy, but few long-term studies are available about optimal duration of treatment with dopamine agonists to ensure cure after drug discontinuation and its withdrawal without recurrence are do not report consistent results.ObjectiveTo establish criteria for cure of microprolactinoma with medical treatment and to analyze the potential predictors involved.PatientsA retrospective study was conducted on 47 adult women with microprolactinoma followed up between 1975 and 2010; none of them had undergone prior surgery or radiotherapy, and all of them received treatment with a dopamine agonist for at least 4 years. They were divided into two groups for analysis: cured patients with at least 4 years with normal prolactin levels after drug discontinuation, and not cured patients.ResultsCure was achieved in 57.4% of patients. Only age at diagnosis was a significant predictor: there were more young patients in the cured group and youngest patients needed less time to cure. Development of empty sella turcica or normal MRI were similar regarding time to cure.ConclusionsMicroprolactinoma may be cured with dopamine agonists, and life-long treatment is not required, although more than 10 years may be required to achieve cure, 11,6 ± 5,3 years in our experience.     

La medición de la dependencia a partir del tiempo de cuidado y del baremo de valoración de dependencia

AimsTo assign care time to the activities collected in the Dependency Assessment Scale (BVD) and to analyse the relationship between care time and the score received on the BVD.MethodsA cross-sectional observational study of 148 dependent persons was carried out. Socioeconomic and clinical data, the BVD, the 6-dimensional dependency indicator (DEP-6D), as well as data from a diary with the time of care received, were collected. The median time needed to carry out the activities included in the BVD was estimated from the diary. Following the BVD methodology, those who had their mental functions affected were separated. Each person was assigned two scores, one based on BVD and the other based on the time that the caregivers spent to care for them. The correlation between the two was estimated, and a regression was performed to identify the main explanatory factors for the disparity between the two indicators.ResultsBVD and hours of care show a moderate positive correlation. The mental impairment of the dependent person increased the time of care in most activities. The regression analysis suggests that while mental impairment is the main explanatory factor of obtaining a higher assessment with care time than with BVD, being bedridden is the main predictor of having a higher sore with the BVD.ConclusionsThe construct that underlies BVD is moderately related to care time. Future research must contrast the robustness of these results and address whether the normative criteria that underlie the BVD is aligned with the weights that characterise it.     

Distributión de avifauna en los distintos ‘Habitats’ del Estuario Andalién,Bahia de Conceptión,Conception, Chile

In a first survey a total of 70 species of birds was found in the area of the Andalien river estuary in Chile during the years 1979 to 1981. There are four major types of habitat: the marine coastal zone, the vegetation covered coastal plain, the brackish coastal lagoons, and the mud flats aiong the river. The distribution of adaptive types of birds across these different kinds of habitat is shown qualitatively in the figs. 2 to 5. Twelve of the 70 species are migrants from North America and distant regions of South America, the remaining 58 are residents of Central Chile.