Common Iliac Artery Aneurysm Repair with Hypogastric Preservation via Balloon-Expandable Covered Stents Using the Eyelet Technique-Iliac Branched Devices Still Inappropriate in Many Patients.

BACKGROUND: Common iliac artery aneurysms (CIAAs) are seen in 20-40% of patients with abdominal aortic aneurysms. Historically treated with sacrifice of the hypogastric artery, which can result in significant morbidity related to pelvic ischemia, new devices have made hypogastric artery preservation more feasible but are only applicable to a small subset of aneurysm anatomy. We sought to assess the safety and efficacy or a novel technique for hypogastric artery preservation applicable to a wider variety of patients with CIAAs. METHODS: We conducted a retrospective review of a prospectively maintained database of all patients with CIAAs treated with a novel endovascular technique at the UC San Diego Sulpizio Cardiovascular Center or the San Diego Veterans Affairs Hospital between March 2016 and December 2017. The endovascular technique involved stent placement in both the internal and external iliac arteries, with balloon expansion to minimize gutters between the endografts. Primary end points included technical success, limb patency, and presence of endoleaks (ELs). RESULTS: A total of 14 limbs (12 patients) were treated for CIAAs with 100% technical success and limb patency at an average of 6.8 months of follow-up. No patients experienced type I or type III ELs or evidence of pelvic ischemia. Two patients required reintervention, and one patient died of causes unrelated to the procedure. CONCLUSIONS: This technique was performed with excellent short- and mid-term safety in patients with varying aneurysm anatomy. The high rates of technical success and low rate pelvic ischemia represent improvement over conventional techniques that sacrifice the hypogastric artery and warrant further testing in a larger patient series with longer term follow-up.

Serologic evidence of rickettsial diseases associated with tick bites in workers of urban veterinary clinics.

BACKGROUND & OBJECTIVES: Rickettsial and other zoonotic diseases are a latent risk for workers of veterinary clinics. The objective of this study was to evaluate the prevalence and the associated risk factors of parasitosis caused by Rhipicephalus sanguineus, and to estimate the seroprevalence of rickettsial diseases in workers of urban veterinary clinics of Juárez city, México. METHODS: The participants of the study were recruited from 63 private veterinary clinics and hospitals. The serological analysis of the blood samples collected was carried out using immunofluorescence assay (IFA). The statistical analysis for prevalences, risk factors, and correlation was performed with the SAS program. RESULTS: In total, 167 veterinary workers were included in the study. The prevalence of tick bites was 40% (67/167), and the risk factors associated with the occurrence of bites included the activities performed in the clinic and the number of labour hours spent per week. About 21% (35/167) of participants were seropositive to R. rickettsii, 28% (47/167) to Ehrlichia chaffeensis, and 24% (40/167) to Anaplasma phagocytophilum. A correlation was observed between: the number of workers in the clinics and the proportion of tick bites (r2 = 0.865); the prevalence of bites and the seropositivity of the participants to at least one pathogen (r2 = 0.924); and the number of bites per individual and infection to pathogens (r2 = 0.838). INTERPRETATION & CONCLUSION: Workers in urban veterinary clinics are highly exposed to tick bites and, therefore, to the diseases they transmit. Hence, it is important to implement prevention measures and perform constant monitoring of these diseases.

Genomic Analysis of Aedes aegypti in the Northern Chihuahuan Desert of Texas and Mexico.

Background: Aedes aegypti, is the primary vector of dengue, Chikungunya, Zika, and yellow fever viruses. Both natural and human-impacted landscapes have selective pressures on Ae. aegypti, resulting in strong genomic structure even within close geographical distances. Materials and Methods: We assess the genetic structure of this medically important mosquito species at the northern leading edge of their distribution in Southwestern USA. Ae. aegypti were collected during 2017 in the urban communities of El Paso and Sparks, Texas (USA) and in the city of Ciudad Juárez, Mexico. Results: Thousands of nuclear loci were sequenced across 260 captured Ae. aegypti. First, we recovered the genetic structure of Ae. aegypti following geography, with all four major collection communities being genetically distinct. Importantly, we found population structure and genetic diversity that suggest rapid expansion through active-short distance dispersals, with Anapra being the likely source for the others. Next, tests of selection recovered eight functional genes across six outliers: calmodulin with olfactory receptor function; the protein superfamily C-type lectin with function in mosquito immune system and development; and TATA box binding protein with function in gene regulation. Conclusion: Despite these populations being documented in the early 2000s, we find that selective pressures on specific genes have already occurred and likely facilitate Ae. aegypti range expansion.

Clinical and pathological factors associated with Ehrlichia canis in companion dogs.

INTRODUCTION: Canine monocytic ehrlichiosis (CME) is a disease caused by the Gram-negative bacteria Ehrlichia canis, a bacterium that affects domestic dogs but can also infect humans. The diagnosis implies a challenge due to its diversity in clinical manifestations. METHODOLOGY: The frequency of E. canis infection, risk factors, and clinical-pathological parameters associated with seropositivity were calculated with the PROC FREQ TABLES and PROC LOGISTIC procedures of the SAS statistical software. RESULTS: The study showed a seroprevalence of 26.62% (156/586). Association between seropositivity and risk factors was found. The age and the presence of ticks including clinical signs such as anorexia, seizures, cough, petechiae, epistaxis, and hematochezia, as well as multiple blood and biochemical alterations were analyzed. The logistic regression analysis showed a high predictive power (c = 0.98) for CME for thrombocytopenia, leukopenia, and anemia. CONCLUSIONS: The high prevalence of E. canis in endemic areas makes its diagnosis difficult. Thus, clinical signs must be considered, along with blood and biochemical alterations, as a possible predictor of the disease.

Characterization of a Dengue Virus Serotype 1 Isolated from a Patient in Ciudad Juarez, Mexico.

Dengue (DEN) is the most important human arboviral disease worldwide. Sporadic outbreaks of DEN have been reported since 1980 in urban communities located along the border in southeast Texas and northern Mexico. Other than the Rio Grande Valley region of TX, autochthonous transmission of DENV has not been reported from any other US border communities. As part of a surveillance program for arthropod-borne viruses in Ciudad Juarez, Mexico, during November 2015, a blood sample was obtained from a female patient who experienced an undifferentiated fever and arthralgia. The plasma of the sample was tested for virus in Vero-76 and C6/36 cells. DENV serotype 1 (DENV-1) was isolated in the C6/36 cells, and nucleotide sequencing of the envelope gene and full genome grouped the DENV-1 isolate in the Central America clade. The patient had not traveled outside of Ciudad Juarez, Mexico, thus suggesting DENV-1 infection was acquired in this community.

[Geospatial distribution and detection of dengue virus in Aedes (Stegomyia) aegypti mosquitos in Ciudad Juárez, Chihuahua, Mexico]. / Distribución geoespacial y detección del virus del dengue en mosquitos Aedes (Stegomyia) aegypti de Ciudad Juárez, Chihuahua, México.

OBJECTIVE: To determine the distribution of Aedes aegypti in Ciudad Juárez, Mexico and evaluate it as a carrier of the dengue virus. MATERIAL AND METHODS: Mosquitoes were collected using CDC minitraps. Nearest neighbor and K-function were used as geospatial tools. The chi-square test was utilized to evaluate the association between the presence of the vector and sociodemographic variables. Evidence of infection was detected by RT-PCR. RESULTS: A total of 122 female mosquitoes were captured. A tendency in the cluster distribution (R= -1.2995, p= 0.05) of the mosquito was shown up to 4000 m but none of the sociodemographic variables showed significant associations. Seven of the pools tested were positive for DEN-2, ten were positive for DEN- 3, and seven for both serotypes. CONCLUSIONS: This is the first report on the presence of Aedes aegypti mosquitoes infected with dengue in the region, which will enable the promotion of monitoring in order to reduce the probability of occurrence of the disease among the border population.

Serological Evidence of Dengue and West Nile Virus Human Infection in Juarez City, Mexico.

Arboviruses are significant causes of human and animal diseases, globally. In the Rio Grande Valley of the United States-Mexico border region, endemic transmission of Dengue (DENV), Zika (ZIKV), and West Nile (WNV) viruses have been documented as a cause of human disease. Otherwise, very little is known about the distribution of arboviruses and their possible cause of human disease in other areas of the United States-Mexico border region. Therefore, a pilot serosurvey was conducted to determine if there was evidence of DENV and WNV infection among a human cohort in Anapra, Ciudad Juarez, Mexico. Baseline blood samples were obtained from 78 participants during May-June, 2015 and from 60 of the same participants again during November-December, 2015, and all the samples were tested for DENV and WNV indirect immunoglobulin G antibodies by an enzyme-linked immunosorbent assay and plaque reduction neutralization test (PRNT). The results showed that 14.1% (n = 11) of the 78 participants had neutralizing antibody to DENV and 5.13% (n = 4) had WNV-neutralizing antibody. Among 48 of 60 participants who were negative for DENV and WNV antibody during the baseline survey, 10.4% (n = 5) had acquired antibody to DENV (n = 4) and WNV (n = 1) by the second survey during November-December, 2015. These data support the local transmission of DENV and WNV in the Anapra, Ciudad Juarez community and therefore warrant further epidemiological studies to better understand the dynamics of transmission of these viruses in this United States-Mexico border city.

Occupational risk for personnel working in veterinary clinics through exposure to vectors of rickettsial pathogens.

Workers at veterinary clinics are exposed to zoonotic pathogens, which, though infrequently, can lead to serious consequences. The aim of the present study was to estimate the seroprevalence for rickettsial pathogens in veterinary clinic personnel in Ciudad Juárez, Chihuahua, Mexico. Voluntary participants included 106 veterinarians, 19 pet groomers, 36 veterinary assistants and 6 administrative workers who supplied blood samples taken by venipuncture. Detection of Rickettsia rickettsii, Ehrlichia spp. and Anaplasma phagocytophilum was conducted by indirect immunofluorescence assay (IFA) and polymerase chain reaction (PCR) techniques. To determine risk factors for the seroprevalence, the study considered social, demographic and occupational variables as well as the clinical signs and symptoms of the participants. Logistic regression procedures were performed, and the odds ratio (OR) was calculated with confidence intervals corresponding to a probability of 95%. The results indicate that 54% of the participants had a positive seroreaction to at least one of the pathogens evaluated and 2% were positive to all. The coexposure was as follows: 3% to R. rickettsii and A. phagocytophilum, 9% to Ehrlichia spp. and A. phagocytophilum, and 2% to Ehrlichia spp. and R. rickettsii. It was established that grooming posed the highest risk for R. rickettsii exposure. The implementation of appropriate management practices for zoonotic diseases is recommended to avoid health problems that may be life threatening to personnel in veterinary clinics.

Detection and phylogenetic analysis of bovine papillomavirus in cutaneous warts in cattle in Tamaulipas, Mexico.

Papillomas occur more frequently in cattle than other domestic animals. The causal agent of bovine papillomatosis is a virus that belongs to the family Papillomaviridae. In Tamaulipas, Mexico, the virus is considered a serious problem and has impeded the export of cattle to the United States, resulting in serious economic losses. Owing to the lack of information regarding the subtypes of papillomaviruses that infect cattle in Mexico, the aim of this study was to determine the subtypes in Tamaulipas. Fifty-two warts were analyzed with the use of polymerase chain reaction (PCR) involving primers that amplify the E7 gene of bovine papillomavirus (BPV). The PCR products were sequenced to differentiate the BPV-1 and BPV-2 subtypes. The sequencing quality was determined with the use of MEGA 6.0 software. Comparison of the Tamaulipas sequences with those of known BPV types by means of the MUSCLE algorithm showed that 53% of the former were BPV-1 and 47% were BPV-2. The distribution of the 2 subtypes in the cattle was homogeneous. This study demonstrated the presence of BPV-1 and BPV-2 in cattle from Tamaulipas and constitutes the first molecular characterization of papillomas in Mexico.

Les papillomes sont rencontrés plus fréquemment chez les bovins que chez n'importe quelle autre espèce domestiques. L'agent causal de la papillomatose bovine est un virus appartenant à la famille Papillomaviridae. Dans l'état mexicain de Tamaulipas le virus est considéré comme un problème sérieux et a empêché l'exportation de bovin vers les États-Unis d'Amérique, causant ainsi des pertes économiques importantes. Étant donné le manque d'information concernant les sous-types de papillomavirus qui infectent les bovins au Mexique, l'objectif de l'étude était de déterminer les sous-types présents dans l'état de Tamaulipas. Cinquante-deux verrues ont été analysées par réaction d'amplification en chaine par la polymérase (ACP) à l'aide d'amorces amplifiant le gène E7 du papillomavirus bovin (PVB). Les produits de l'ACP ont été séquencés afin de différencier les sous-types PVB-1 et PVB-2. La qualité du séquençage fut déterminée à l'aide du logiciel MEGA 6.0. La comparaison des séquences obtenues pour l'état de Tamaulipas avec celles des types connus de PVB par l'algorithme MUSCLE a permis de démontrer que 53 % étaient des PVB-1 et 47 % de PVB-2. La distribution des deux sous-types chez les bovins était homogène. La présente étude démontre la présence de PVB-1 et PVB-2 chez les bovins de Tamaulipas et constitue le premier rapport sur la caractérisation moléculaire des papillomes au Mexique.(Traduit par Docteur Serge Messier).

[Not Available]. / Deficiencia de micronutrientes en la dieta del paciente con lesiones precancerosas del cérvix de una clínica de colposcopía en Ciudad Juárez, México.

Introducción: las lesiones intraepiteliales escamosas (LIE) son un estado de transición hacia el cáncer cervicouterino (CaCu) y un déficit de micronutrientes puede acelerar este proceso. Por ello, determinar la existencia de este déficit y conocer qué factores se asocian permitiría una posible prevención en esta población de riesgo.Objetivo: determinar la presencia de alguna deficiencia de micronutrientes involucrados en el proceso anticancerígeno y asociar este déficit con hábitos y factores demográficos en pacientes con LIE de Ciudad Juárez, Chihuahua, México.Métodos:en un estudio transversal analítico fueron seleccionadas 102 pacientes con LIE. Se realizó una encuesta dietaría (recordatorio de 24 horas) para estimar la ingesta de micronutrientes. La deficiencia fue determinada con un consumo < 75% de la ingesta diaria recomendada o sugerida (IDR o IDS) en México. Algunos hábitos y factores demográficos fueron obtenidos mediante la entrevista con la paciente. Se realizó un modelo de regresión logística para asociar la presencia de deficiencia con factores que afectan a la ingesta o incrementan el requerimiento de micronutrientes.Resultados:el retinol, ácido fólico, zinc, vitaminas C y E, considerados como micronutrientes en el proceso anticancerígeno del CaCu, se encontraron por debajo del 75% de la IDR. Aquellas mujeres con sobrepeso, obesidad y amas de casa se asociaron significativamente con la deficiencia de micronutrientes.Conclusión: el sobrepeso, la obesidad y la ocupación han sido asociados para presentar deficiencias de micronutrientes en este estudio. Estas variables convergen en una posible inseguridad alimentaria, la cual podría asociarse al incremento de incidencia de CaCu en México.

DNA Methylation of Cellular Retinoic Acid-Binding Proteins in Cervical Cancer.

This study determined the methylation status of cellular retinoic acid-binding protein (CRABP) gene promoters and associated them with demographic characteristics, habits, and the presence of human papilloma virus (HPV) in patients with cervical cancer (CC), low and high squamous intraepithelial lesions, and no intraepithelial lesion. Women (n = 158) were selected from the Colposcopy Clinic of Sanitary Jurisdiction II in Ciudad Juarez, Chihuahua, Mexico. Demographic characteristics and habit information were collected. Cervical biopsy and endocervical scraping were used to determine methylation in promoter regions by methylation-specific polymerase chain reaction technique. We found hemi-methylation patterns in the promoter regions of CRABP1 and CRABP2; there was 28.5% hemi-methylation in CRABP1 and 7.0% in that of CRABP2. Methylation in CRABP1 was associated with age (≥35 years, P = 0.002), family history of cancer (P = 0.032), the presence of HPV-16 (P = 0.013), and no alcohol intake (P = 0.035). These epigenetic changes could be involved in the CC process, and CRABP1 has the potential to be a predictive molecular marker of retinoid therapy response.

Nilgai antelope in northern Mexico as a possible carrier for cattle fever ticks and Babesia bovis and Babesia bigemina.

Of 20 blood samples from nilgais from México, five were polymerase chain reaction-positive for Babesia bigemina and one for Babesia bovis. Positive samples had the expected 170 (B. bigemina) and 291 (B. bovis) base pairs and were identical to Gen-Bank B. bigemina accession S45366 and B. bovis M38218.

Distribución geoespacial y detección del virus del dengue en mosquitos Aedes (Stegomyia) aegypti de Ciudad Juárez, Chihuahua, México / Geospatial distribution and detection of dengue virus in Aedes (Stegomyia) aegypti mosquitos in Ciudad Juárez, Chihuahua, Mexico

OBJETIVO: Determinar la distribución de Aedes aegypti en Ciudad Juárez, México, y evaluarlo como portador del virus del dengue. MATERIAL Y MÉTODOS: Se colectaron mosquitos empleando minitrampas CDC. Se aplicaron técnicas geoespaciales del vecino más próximo y función K. Para evaluar la asociación entre la presencia del vector y variables sociodemográficas se aplicó la prueba de ji². Las pruebas de infección fueron mediante RT-PCR. RESULTADOS: Se capturaron 122 mosquitos hembra. Se demostró la tendencia de distribución en conglomerado (R=-1.2995 p=0.05) del mosquito a los 4000 m pero ninguna de las variables sociodemográficas mostró asociación significativa. Siete lotes evaluados fueron positivos para DEN-2, diez para DEN-3 y siete para ambos serotipos. CONCLUSIONES: Es el primer reporte de la presencia de mosquitos Aedes aegypti infectados con dengue en la región, lo que permitirá promover su vigilancia con el fin de disminuir la probabilidad de ocurrencia de la enfermedad entre la población fronteriza.

OBJECTIVE: To determine the distribution of Aedes aegypti in Ciudad Juárez, Mexico and evaluate it as a carrier of the dengue virus. MATERIAL AND METHODS: Mosquitoes were collected using CDC minitraps. Nearest neighbor and K-function were used as geospatial tools. The chi-square test was utilized to evaluate the association between the presence of the vector and sociodemographic variables. Evidence of infection was detected by RT-PCR. RESULTS: A total of 122 female mosquitoes were captured. A tendency in the cluster distribution (R= -1.2995, p= 0.05) of the mosquito was shown up to 4000 m but none of the sociodemographic variables showed significant associations. Seven of the pools tested were positive for DEN-2, ten were positive for DEN- 3, and seven for both serotypes. CONCLUSIONS: This is the first report on the presence of Aedes aegypti mosquitoes infected with dengue in the region, which will enable the promotion of monitoring in order to reduce the probability of occurrence of the disease among the border population.

Manejo anestésico de fisura de labio-paladar. Revisión de 3 años en el Hospital ABC / A review of the anesthetic management of the cleft lip in ABC Hospital, Mexico: Experience

La frecuencia de fisura de labio es de 1:1000; mientras que la de paladar es de 1:2500. Nosotros presentamos un estudio retrospectivo analizando la técnica utilizada, la evolución y las complicaciones, durante los últimos 3 años en el Hospital ABC. Material y Métodos: se revisaron 327 expedientes del programa de "Operación Sonrisa" de Brimex del Hospital ABC de enero de 1994 a diciembre de 1996. Se incluyeron expedientes completos de pacientes de 3 meses hasta 21 años, analizando únicamente 84 expedientes. Resultados: la edad promedio para la cirugía de fisura de labio es a los 45.11 meses, mientras que para la de paladar es a los 52.25 meses. Se realiza una comparación de las diferentes técnicas anestésicas utilizadas en los últimos tres años. Conclusión: la técnica anestésica ha mejorado, la vigilancia perioperatoria es la clave para evitar complicaciones y la valoración preanestésica es de suma importancia para detectar cualquier anomalía asociada