Dissemination of blaIMP-8 among Enterobacteriaceae isolates from a Buenos Aires Hospital

Entre agosto de 2008 y diciembre de 2011 se detectaron en el Hospital Interzonal General de Agudos «Evita» de Lanús 6 aislamientos de enterobacterias productoras de metalo- β-lactamasas, distribuidos en tres especies: Enterobacter cloacae (4), Klebsiella oxytoca (1) y Citrobacter freundii (1). Los seis aislamientos presentaron un perfi l de multirresistencia y se confi rmó la presencia del gen blaIMP-8. Cinco aislamientos además expresaron la β-lactamasa de espectro extendido PER-2. El gen blaIMP-8 fue hallado como primer casete de un integrón de clase 1. Sin embargo, la secuencia 3´ conservada no pudo detectarse en tres aislamientos. En todos los casos, el gen blaIMP-8 fue transferido por conjugación a Escherichia coli resistente a azida. Mediante PFGE se observó que los cuatro aislamientos de E. cloacae no estuvieron genéticamente relacionados. Estos son los primeros hallazgos de metalo-β-lactamasas en la institución, que sugieren una posible diseminación horizontal del gen blaIMP-8 intra e interespecies.From August 2008 to December 2011, six metallo-β-lactamase-producing isolates, four Enterobacter cloacae, one Klebsiella oxytoca and one Citrobacter freundii, were detected at Hospital Interzonal General de Agudos “Evita” in Lanús. All six isolates showed multiresistant profi les and the presence of the blaIMP-8 gene. Five isolates also expressed PER-2 extended spectrum β-lactamase. The blaIMP-8 gene was found as the fi rst cassette in a class 1 integron. However, the 3´ conserved sequence could not be detected in three isolates. In all cases, blaIMP-8 was transferred by conjugation to azide-resistant Escherichia coli J53. PFGE analysis revealed that the four E. cloacae isolates were not genetically related. These are the fi rst metallo-β-lactamases detected in this institution and our results suggest a possible intra- and inter-species horizontal dissemination of blaIMP-8.Fil: Togneri, Ana M.. Hospital Interzonal General de Agudos Evita. Laboratorio de Bacteriología; ArgentinaFil: Gómez, Sonia Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Podestá, Laura B.. Hospital Interzonal General de Agudos Evita. Laboratorio de Bacteriología; ArgentinaFil: Pérez, Marcela P.. Hospital Interzonal General de Agudos Evita. Laboratorio de Bacteriología; ArgentinaFil: Faccone, Diego Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Ríos, Lidia E.. Hospital Interzonal General de Agudos Evita. Laboratorio de Bacteriología; ArgentinaFil: Gañete, Marcelo A.. Hospital Interzonal General de Agudos Evita. Laboratorio de Bacteriología; ArgentinaFil: Anchordoqui, María S. . Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; ArgentinaFil: Pasterán, Fernando G.. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Corso, Alejandra C.. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas. Area de Antimicrobianos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Assessment of a New ROS1 Immunohistochemistry Clone (SP384) for the Identification of ROS1 Rearrangements in Patients with Non–Small Cell Lung Carcinoma: the ROSING Study

Introduction: The ROS1 gene rearrangement has become an important biomarker in NSCLC. The College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology testing guidelines support the use of ROS1 immunohistochemistry (IHC) as a screening test, followed by confirmation with fluorescence in situ hybridization (FISH) or a molecular test in all positive results. We have evaluated a novel anti-ROS1 IHC antibody (SP384) in a large multicenter series to obtain real-world data. Methods: A total of 43 ROS1 FISH-positive and 193 ROS1 FISH-negative NSCLC samples were studied. All specimens were screened by using two antibodies (clone D4D6 from Cell Signaling Technology and clone SP384 from Ventana Medical Systems), and the different interpretation criteria were compared with break-apart FISH (Vysis). FISH-positive samples were also analyzed with next-generation sequencing (Oncomine Dx Target Test Panel, Thermo Fisher Scientific). Results: An H-score of 150 or higher or the presence of at least 70% of tumor cells with an intensity of staining of 2+ or higher by the SP384 clone was the optimal cutoff value (both with 93% sensitivity and 100% specificity). The D4D6 clone showed similar results, with an H-score of at least 100 (91% sensitivity and 100% specificity). ROS1 expression in normal lung was more frequent with use of the SP384 clone (p < 0.0001). The ezrin gene (EZR)-ROS1 variant was associated with membranous staining and an isolated green signal FISH pattern (p = 0.001 and p = 0.017, respectively). Conclusions: The new SP384 ROS1 IHC clone showed excellent sensitivity without compromising specificity, so it is another excellent analytical option for the proposed testing algorithm

Relationship between olive oil consumption and ankle-brachial pressure index in a population at high cardiovascular risk

The aim of this study was to ascertain the association between the consumption of different categories of edible olive oils (virgin olive oils and olive oil) and olive pomace oil and ankle-brachial pressure index (ABI) in participants in the PREDIMED-Plus study, a trial of lifestyle modification for weight and cardiovascular event reduction in individuals with overweight/obesity harboring the metabolic syndrome. Methods: We performed a cross-sectional analysis of the PREDIMED-Plus trial. Consumption of any category of olive oil and olive pomace oil was assessed through a validated food-frequency questionnaire. Multivariable linear regression models were fitted to assess associations between olive oil consumption and ABI. Additionally, ABI ≤1 was considered as the outcome in logistic models with different categories of olive oil and olive pomace oil as exposure. Results: Among 4330 participants, the highest quintile of total olive oil consumption (sum of all categories of olive oil and olive pomace oil) was associated with higher mean values of ABI (beta coefficient: 0.014, 95% confidence interval [CI]: 0.002, 0.027) (p for trend = 0.010). Logistic models comparing the consumption of different categories of olive oils, olive pomace oil and ABI ≤1 values revealed an inverse association between virgin olive oils consumption and the likelihood of a low ABI (odds ratio [OR] 0.73, 95% CI [0.56, 0.97]), while consumption of olive pomace oil was positively associated with a low ABI (OR 1.22 95% CI [1.00, 1.48]). Conclusions: In a Mediterranean population at high cardiovascular risk, total olive oil consumption was associated with a higher mean ABI. These results suggest that olive oil consumption may be beneficial for peripheral artery disease prevention, but longitudinal studies are needed

Costo anual per cápita en primer nivel de atención por género Cost per capita in outpatients by gender

El objetivo de este artículo es estimar el costo per cápita anual por género en primer nivel de atención. MÉTODOS: estudio de costo realizado en Unidades de Medicina Familiar en México. La información correspondió al año 2004 y el estudio se dividió en perfil de uso y costo de la atención. PERFIL DE USO DE LO SERVICIOS: se estudiaron los registros clínicos de 1,585 pacientes adscritos a unidades de medicina familiar. El perfil de uso se definió mediante el promedio y los motivos de atención por departamento, género y grupo de edad. COSTO DE LA ATENCIÓN: estimado en dólares estadounidenses incluyó costo unitario fijo (departamentalización ajustada por productividad), el costo unitario variable (técnica de microcosteo), costo unitario por departamento y motivo de atención, y costo unitario por departamento, quinquenio y género. La esperanza de vida fue de 73 años para los hombres y 78 para las mujeres. Se identificaron tres escenarios. RESULTADOS: el costo anual per capita es superior en la mujer US $73.24 (IC 95$11.38 - $197.49) que en el hombre$ 53.11 (IC 95% 2.51 - 207.71). CONCLUSIÓN: en primer nivel de atención el costo per cápita en las mujeres es mayor que en los hombres, información valiosa en el proceso de planeación de los servicios de salud.<br>The objective of this study is to identify the annual cost per capita by gender in first level of attention. It is a cost study in Family Physician Units in Mexico. The information corresponded to the year of 2004 and the study divided in the use profile and cost attention. USE PROFILE OF SERVICES: it was studied 1,585 clinical registries of patients, use profile defined by average and attention reasons by department, gender and age group. COST ATTENTION: considered in American dollars it included fixed unit cost (departmentalization adjusted by productivity), variable unit cost (micro cost technical), department unite cost by type attention, and department unit cost by age and gender. The life expectancy was of 73 years for men and 78 for women. Three scenes were identified. The annual cost per capita is superior among woman [US$73.24 (IC 95$11.38 - $197.49)] than in man [$ 53.11 (IC 95% 2.51 - 207.71)]. The conclusion found that in the first level of attention the cost per capita is greater in woman than in man

Composición química y actividad farmacológica del extracto etanólico de Satureja sericea (goyal)

We studied the aerial parts of Satureja sericea (goyal) of the Mallas community, Huari province, Ancash Region, used for diseases of the digestive tract due to its carminative and anti-inflammatory properties. The sample was dried under shade, powdered and the extract was obtained by maceration in ethanol. In solubility and phytochemical screening was observed large amount of phenolic compounds. It was confirmed the presence of four flavonoids by color reactions and precipitation; this flavonoids were isolated by thin layer chromatography to preparative-scale and their structures were elucidated by UV visible spectroscopy in ethanol and displacement reagents. The cytoprotective effect on the gastric mucosa was evaluated by oral administration of alcoholic extract in rats. It was also evaluated the gastric antisecretory effect of ethanol extract in rats subjected to pyloric ligation. Safety was evaluated in animals by oral acute toxicity, repeated dose for 28 days abd determining the DL50 . The lethal dose 50 of the ethanol extract was determined in mice; the hematological, biochemical and histopathological parameters were evaluated) using the model of repeated dose toxicity when given orally oral ethanol extract to normal rats according to OECD.Se estudiaron las partes aéreas de Satureja sericea (goyal) de la comunidad de Mallas, provincia de Huari, Región Ancash, usada para afecciones de las vías digestivas debido a sus propiedades carminativas y antiinflamatorias. La muestra se secó bajo sombra, se pulverizó y se obtuvo el extracto por maceración etanólica. Al realizar el ensayo de solubilidad y marcha fotoquímica se observó gran cantidad de compuestos fenólicos, comprobándose la presencia de cuatro flavonoides mediante reacciones de coloración y precipitación, los que fueron aislados por cromatografía en capa fina a escala preparativa, elucidándose sus estructuras mediante espectroscopía UV visible con reactivos de desplazamiento. El efecto citoprotector de la mucosa gástrica fue determinado por administración oral del extracto alcohólico en ratas y el efecto antisecretor gástrico en ratas sometidas a ligazón pilórica. La seguridad en animales fue evaluada mediante toxicidad aguda oral, a dosis repetidas durante 28 días, y por determinación de la DL50. La dosis letal 50 del extracto etanólico se determinó en ratones, mientras que los parámetros: hematológico, bioquímico e histopatológico, mediante el modelo de toxicidad a dosis repetidas al administrar por vía oral el extracto etanólico en ratas normales según la OECD

Diseminación de blaIMP-8 en enterobacterias aisladas en un hospital de Buenos Aires

Entre agosto de 2008 y diciembre de 2011 se detectaron en el Hospital Interzonal General de Agudos «Evita» de Lanús 6 aislamientos de enterobacterias productoras de metalo-ß-lactamasas, distribuidos en tres especies: Enterobacter cloacae (4), Klebsiella oxytoca (1) y Citrobacter freundii (1). Los seis aislamientos presentaron un perfil de multirresistencia y se confirmó la presencia del gen blaIMP-8. Cinco aislamientos además expresaron la ß-lactamasa de espectro extendido PER-2. El gen blaIMP-8 fue hallado como primer casete de un integrón de clase 1. Sin embargo, la secuencia 3´ conservada no pudo detectarse en tres aislamientos. En todos los casos, el gen blaIMP-8 fue transferido por conjugación a Escherichia coli resistente a azida. Mediante PFGE se observó que los cuatro aislamientos de E. cloacae no estuvieron genéticamente relacionados. Estos son los primeros hallazgos de metalo-ß-lactamasas en la institución, que sugieren una posible diseminación horizontal del gen blaIMP-8 intra e interespecies

Assessment of a New ROS1 Immunohistochemistry Clone (SP384) for the Identification of ROS1 Rearrangements in Patients with Non–Small Cell Lung Carcinoma: the ROSING Study

Introduction: The ROS1 gene rearrangement has become an important biomarker in NSCLC. The College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology testing guidelines support the use of ROS1 immunohistochemistry (IHC) as a screening test, followed by confirmation with fluorescence in situ hybridization (FISH) or a molecular test in all positive results. We have evaluated a novel anti-ROS1 IHC antibody (SP384) in a large multicenter series to obtain real-world data. Methods: A total of 43 ROS1 FISH-positive and 193 ROS1 FISH-negative NSCLC samples were studied. All specimens were screened by using two antibodies (clone D4D6 from Cell Signaling Technology and clone SP384 from Ventana Medical Systems), and the different interpretation criteria were compared with break-apart FISH (Vysis). FISH-positive samples were also analyzed with next-generation sequencing (Oncomine Dx Target Test Panel, Thermo Fisher Scientific). Results: An H-score of 150 or higher or the presence of at least 70% of tumor cells with an intensity of staining of 2+ or higher by the SP384 clone was the optimal cutoff value (both with 93% sensitivity and 100% specificity). The D4D6 clone showed similar results, with an H-score of at least 100 (91% sensitivity and 100% specificity). ROS1 expression in normal lung was more frequent with use of the SP384 clone (p < 0.0001). The ezrin gene (EZR)-ROS1 variant was associated with membranous staining and an isolated green signal FISH pattern (p = 0.001 and p = 0.017, respectively). Conclusions: The new SP384 ROS1 IHC clone showed excellent sensitivity without compromising specificity, so it is another excellent analytical option for the proposed testing algorithm

Relationship between olive oil consumption and ankle-brachial pressure index in a population at high cardiovascular risk

The aim of this study was to ascertain the association between the consumption of different categories of edible olive oils (virgin olive oils and olive oil) and olive pomace oil and ankle-brachial pressure index (ABI) in participants in the PREDIMED-Plus study, a trial of lifestyle modification for weight and cardiovascular event reduction in individuals with overweight/obesity harboring the metabolic syndrome. Methods: We performed a cross-sectional analysis of the PREDIMED-Plus trial. Consumption of any category of olive oil and olive pomace oil was assessed through a validated food-frequency questionnaire. Multivariable linear regression models were fitted to assess associations between olive oil consumption and ABI. Additionally, ABI ≤1 was considered as the outcome in logistic models with different categories of olive oil and olive pomace oil as exposure. Results: Among 4330 participants, the highest quintile of total olive oil consumption (sum of all categories of olive oil and olive pomace oil) was associated with higher mean values of ABI (beta coefficient: 0.014, 95% confidence interval [CI]: 0.002, 0.027) (p for trend = 0.010). Logistic models comparing the consumption of different categories of olive oils, olive pomace oil and ABI ≤1 values revealed an inverse association between virgin olive oils consumption and the likelihood of a low ABI (odds ratio [OR] 0.73, 95% CI [0.56, 0.97]), while consumption of olive pomace oil was positively associated with a low ABI (OR 1.22 95% CI [1.00, 1.48]). Conclusions: In a Mediterranean population at high cardiovascular risk, total olive oil consumption was associated with a higher mean ABI. These results suggest that olive oil consumption may be beneficial for peripheral artery disease prevention, but longitudinal studies are needed