Rapid Syphilis Tests as Catalysts for Health Systems Strengthening: A Case Study from Peru.

Objectives: Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening.

Composition of intraocular foreign bodies: experimental study of ultrasonographic presentation.

Purpose: To investigate the reliability of ultrasound in determining the size and identify the sonographic features and artifacts generated by intraocular foreign bodies of different materials.

Methods: Experimental study using 36 enucleated porcine eyes. Fragments of nine different compositions (wood, glass, plastic, cardboard, iron, aluminum, lead, powder and concrete) and similar dimensions (4 mm) were implanted via scleral incision into the vitreous cavity of 36 porcine eyes, four eyes were used for each material.

Salmonella enterica serovar Typhimurium virulence-resistance plasmids derived from the pSLT carrying nonconventional class 1 integrons with dfrA12 gene in their variable region and sul3 in the 3' conserved segment.

Drug-resistant derivatives of serovar-specific virulence plasmids, such as pSLT, in clinically-relevant Salmonella enterica serovar Typhimurium strains, represent a threat for human health. We have analysed 14 S. Typhimurium isolates recovered in Italy and the United Kingdom from swine and from cases of human infection for the presence of virulence-resistance (VR) plasmids.

Chronic exposure to volcanogenic air pollution as cause of lung injury.

Few studies were made regarding the pulmonary effects of exposure to volcanogenic air pollution, representing an unrecognized health risk for humans inhabiting non-eruptive volcanically active areas (10% of world human population). We tested the hypothesis whether chronic exposure to air pollution of volcanogenic origin causes lung injury, using wild mice (Mus musculus) as model. Lung injury was determined using histological morphometric parameters, inflammatory status (InfS) and the amount of black silver deposits (BSD).

Quantitative and qualitative spectral domain optical coherence tomography analysis of subretinal deposits in patients with acute central serous retinopathy.

Purpose: To perform qualitative and quantitative analyses of subretinal protein deposits (PDs), seen in acute central serous retinopathy (CSR) patients, using high-resolution spectral domain optical coherence tomography (SD-OCT), in order to investigate whether the present PDs have any significant impact on best corrected visual acuity (BCVA).

Methods: Patients diagnosed with acute CSR were included. Using SD-OCT, the following distances/heights were measured: central total retinal thickness, central neurosensory retinal thickness, the vertical and horizontal length of subfoveal subretinal fluid and subfoveal thickness of the PD layer, if present and could be measured.

Characterisation of plasmids implicated in the mobilisation of extended-spectrum and AmpC β-lactamase genes in clinical Salmonella enterica isolates and temporal stability of the resistance genotype.

Plasmids implicated in the mobilisation of β-lactamase genes in extended-spectrum β-lactamase (ESBL)- and AmpC-producing Salmonella enterica isolates recovered from three Spanish hospitals were characterised. The temporal stability of these plasmids and of the resistance phenotype without antimicrobial pressure was also assessed in the laboratory setting. The resistance determinants and their genetic environments were characterised by PCR sequencing, and their genomic location was analysed by S1 nuclease pulsed-field gel electrophoresis (PFGE) and I-CeuI PFGE, followed by Southern blot hybridisation.

[Impact of mass spectrometry by MALDI-TOF MS for the rapid identification of aerobic and anaerobic bacteria of clinical importance].

Background: MALDI-TOF MS (Matrix Assisted Laser Desorption Ionization -Time of Flight Mass Spectrometry) technology, recently introduced in the microbiology laboratory has proven to be a precise and rapid method for bacterial identification.

Objective: To evaluate the performance, costs associated and turnaround time of MALDI-TOF in a routine laboratory.

Material And Method: Five hundred and sixty one clinical isolates (281 aerobes and 280 anaerobes) previously identified by conventional methods were evaluated.

[Molecular analysis of fluoroquinolones and macrolides resistance in Campylobacter jejuni isolates from humans, bovine and chicken meat].

Background: Campylobacter sp.- one of the leading causes of bacterial food-borne gastrointestinal illness worldwide- is increasingly resistant to fluoroquinolone and macrolide antimicrobials, which has become a major concern for public health.

Objective: To describe the susceptibility patterns of Campylobacter jejuni strains to erythromycin and ciprofloxacin and to explore the origin of its resistance in human isolates.

[Reducing the incidence of ventilator-associated pneumonia following heart surgery: 13-year experience of epidemiologic surveillance in a teaching hospital].

Objectives: To report the results of 13 years worth of epidemiologic surveillance of ventilator-associated pneumonia (VAP) following heart surgery and the main interventions applied in order to reduce VAP incidence.

Methods: This is a retrospective and descriptive study of active epidemiologic surveillance of VAP. National diagnostic criteria were used.

Barriers to influenza vaccination among pregnant women.

Objective: Despite pregnant women's increased morbidity and mortality from influenza, vaccination rates remain low. This study intended to evaluate barriers to pregnant women's uptake of influenza vaccine.

Study Design: A survey was designed that assessed participant demographics, knowledge, beliefs, attitudes, and general experiences with seasonal and 2009 novel H1N1 influenza.

Urine toxicology screening in an urban stroke and TIA population.

Objective: We sought to determine the rate of urine toxicology screening, differences in testing, and outcomes among patients with stroke and TIA presenting to a tertiary care emergency department.

Methods: In this retrospective cohort study, patients admitted with stroke or TIA to a single tertiary care stroke center between June 2005 and January 2007 were identified through a stroke database. Factors that predicted urine toxicology screening of patients and a positive test, and discharge outcomes of patients based on toxicology result were analyzed.

The patient centered medical home as curricular model: perceived impact of the "education-centered medical home".

Background: The patient-centered medical home (PCMH) model aims to provide patient-centered care, lower costs, and improve health outcomes. Medical students have not been meaningfully integrated in this model.

Aim: To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educational objectives.

Inhibition of connective tissue growth factor (CTGF/CCN2) in gallbladder cancer cells leads to decreased growth in vitro.

Gallbladder cancer (GBC) is an aggressive neoplasm associated with late diagnosis, unsatisfactory treatment and poor prognosis. Previous work showed that connective tissue growth factor (CTGF) expression is increased in this malignancy. This matricellular protein plays an important role in various cellular processes and its involvement in the tumorigenesis of several human cancers has been demonstrated.

Immunohistochemical expression of phospho-mTOR is associated with poor prognosis in patients with gallbladder adenocarcinoma.

Context: Advanced gallbladder carcinoma (GBC) is a highly fatal disease with poor prognosis and few therapeutic alternatives. The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that plays a central role in cell growth and homeostasis. Its regulation is frequently altered in various tumors and is an attractive target for cancer therapy; however, its status in GBC remains unclear.

Cellular FLICE-like inhibitory protein long form (c-FLIPL) overexpression is related to cervical cancer progression.

Cervical cancer is a leading cause of cancer deaths in women worldwide and infection by high-risk human papillomavirus types is a precursor event. The cellular FLICE-like inhibitory protein (c-FLIP) has been found to be overexpressed in several types of cancers and could be associated with cervical cancer progression because of its ability to inhibit the apoptotic process. To detect c-FLIP expression in cervical cancer, an immunohistochemical staining was performed, using tissue microarrays, on a series of 536 archival biopsy samples, including normal cervical tissues, low-grade and high-grade squamous intraepithelial lesions, and squamous cervical carcinomas.

[Surveillance of carbapenem-resistant enterobacteria in stool cultures in a university hospital in Santiago, Chile].

Background: Clinical cultures detect only one-third of colonized patients with carbapenem-resistant Enterobacteriaceae. Early identification and contact precautions implementation would help to interrupt transmission. In our hospital no carbapenemase-producing enterobacteria infections have been described.

Antimicrobial susceptibility and genetic characteristics of Propionibacterium acnes isolated from patients with acne.

Background:   Propionibacterium acnes is an important target in acne management. Antibiotic resistance has increased, reducing its clinical efficiency.

Objective:   To study the prevalence, antimicrobial susceptibility patterns, and resistance mechanisms of P.

Possible mechanism by which zinc protects the testicular function of rats exposed to cigarette smoke.

Background: The aim of this study was to evaluate the changes in testicular function of rats due to cigarette smoke exposure and the possible mechanism by which zinc protects against these alterations.

Methods: Male Wistar rats (60 days old) were randomly divided into 3 groups: control (G1, n = 10); exposed to cigarette smoke (G2, n = 10; 20 cigarettes/day/9 weeks) and exposed to cigarette smoke and supplemented with zinc (G3, n = 8; 20 cigarettes/day/9 weeks; 20 mg/kg zinc chloride daily for 9 weeks, by gavage). After the treatment period, the animals were euthanized, and materials were collected for analyses.

Connective tissue growth factor immunohistochemical expression is associated with gallbladder cancer progression.

Context: Gallbladder cancer (GBC) is an aggressive neoplasia associated with late diagnosis, unsatisfactory treatment, and poor prognosis. Molecular mechanisms involved in GBC pathogenesis remain poorly understood. Connective tissue growth factor (CTGF) is thought to play a role in the pathologic processes and is overexpressed in several human cancers, including GBC.

Genetic types, gene repertoire, and evolution of isolates of the Salmonella enterica serovar 4,5,12:i:- Spanish clone assigned to different phage types.

Salmonella enterica subsp. enterica 4,[5],12:i:- is one of the most prevalent serovars associated with human infections worldwide. Two multidrug-resistant clones, designated Spanish and European clones, are recognized as having importance for public health and are subject to control measures in the European Union.

[Bacillary angiomatosis].

Bacillary angiomatosis is an unusual infectious disease, with angioproliferative lesions, typical of immunocompromised patients. It is caused by Bartonella quintana and Bartonella henselae, two infectious agents of the genus Bartonella, which trigger variable clinical manifestations, including cutaneous vascular and purpuric lesions, and regional lymphadenopathy, and even a systemic disease with visceral involvement. We report a 38-year-old HIV positive male presenting with a history of six months of cutaneous growing purple angiomatous lesions, located also in nasal fossae, rhi-nopharynx and larynx.

[Clinical and epidemiological profile of tuberculosis in a university hospital in Santiago, Chile].

Background: The incidence and epidemiological profile of tuberculosis (TB) has changed significantly in the recent years in Chile.

Aim: To evaluate the clinical and epidemiological characteristics of TB cases diagnosed in the last decade at a university hospital in Santiago.

Material And Methods: The Mycobacterium tuberculosis culture registry of the microbiology laboratory was reviewed.

[A comparative study for adenosine deaminase and anti-antigen A-60 antibodies detection for the diagnosis of tuberculous meningitis].

Background: Diagnosis of tuberculous meningitis (TBM) is hampered by the lack of rapid and accurate diagnostic tools. We evaluated the immunological response to Mycobacterium tuberculosis anti-A60 antibodies in cerebrospinal fluid (CSF) in comparison to adenosine deaminase (ADA) determination, for the diagnosis of TBM.

Methods: A total of 63 CSF samples were analyzed by indirect ELISA for the detection of anti- A60 IgG, IgM and IgA.

Abnormal fixation in individuals with age-related macular degeneration when viewing an image of a face.

Purpose: It has been reported that patients with macular disease have difficulties with face perception. Some of this difficulty may be caused by the sensory and perceptual consequences of using peripheral retina. However, strong correlations have not always been found between performance on face tasks and clinical measure of function.

Using species spectra to evaluate plant community conservation value along a gradient of anthropogenic disturbance.

The aim of this study was to assess the impact of anthropogenic disturbance on the partitioning of plant communities (species spectra) across a landcover gradient of community types, categorizing species on the basis of their biogeographic, ecological, and conservation status. We tested a multinomial model to generate species spectra and monitor changes in plant assemblages as anthropogenic disturbance rise, as well as the usefulness of this method to assess the conservation value of a given community. Herbaceous and arborescent communities were sampled in five Azorean islands.