Retrospective study of risk markers for developing high-grade anal intraepithelial neoplasm in men who have sex with men living with HIV. / Estudio retrospectivo que evalúa marcadores de riesgo de desarrollar lesión escamosa intraepitelial anal de alto grado en hombres que tiene sexo con hombres y viven con el virus de inmunodeficiencia humana.

High-grade anal intraepithelial squamous lesion is significantly prevalent among men who have sex with men and are infected with the human immunodeficiency virus. This condition-the precursor to anal cancer-significantly increases the risk of developing it. Conversely, low-grade anal intraepithelial squamous typically follow a benign course and usually regress spontaneously. MATERIALS AND METHODS: To describe a population of men who have sex with men living with human immunodeficiency virus followed in a specialized anal cancer screening unit we conducted an observational, retrospective, and single-center study was. RESULTS: Ninety-four patients were analyzed, with a mean age of 39 ± 9 years, and a 87% positivity rate for high-risk human papillomavirus (HR-HPV). At the initial visit, 47% presented with low-grade squamous intraepithelial lesions. The progression rate to high-grade squamous intraepithelial lesion was 37.2 per 100,000 patients/year. None of the patients developed anal cancer. Tobacco and alcohol consumption were associated with this progression. DISCUSSION: In this series, longer duration of HIV infection, tobacco and alcohol use and the presence of HR-HPV were significantly associated with the occurrence of high-grade intraepithelial lesions. A lower risk of progression was seen in patients with higher education. CONCLUSION: In men who have sex with men living with HIV, the association of factors such as smoking, alcohol, the presence of HR-HPV and an increased burden of human papillomavirus disease makes these patients more susceptible to develop high-grade anal squamous lesions.

Batmanacarus robini, n. gen., n. sp. (Trombidiformes: Trombiculidae) collected parasitizing a ghost-faced bat (Chiroptera: Mormoopidae) from a cave in Trinidad and Tobago.

Trinidad and Tobago, a neotropical country, has 38 reported chigger species. Of these species, 18 were parasitizing bats. Here, we describe a new genus and species parasitizing a ghost-faced bat in this country.

Notes on the Occurrence of Oligonychus milleri (McGregor) and Oligonychus ununguis (Jacobi) (Acari: Tetranychidae) in Brazil.

We verified infestation of Oligonychus milleri (McGregor) on plantations of Pinus caribaea (Pinaceae) and of Oligonychus ununguis (Jacobi) on plantations of Eucalyptus urophylla x Eucalyptus grandis (Myrtaceae) in State of Rondônia, Northern region of Brazil. This represents the first record of O. milleri in Brazil. Oligonychus ununguis was recorded previously, on cypress. The damage caused by these two spider mites in the plantations is described herein.

Treatment of Refractory Gastrointestinal Bleeding in Patients With Portal Hypertension: A Case Series and Treatment Algorithm.

In patients with portal hypertension, ectopic varices can develop at any site along the gastrointestinal tract outside the classically described gastroesophageal location. Like esophageal variceal hemorrhage, bleeding from ectopic varices can be life-threatening. Diagnosis and treatment of ectopic varices can be challenging; to date, no effective treatment algorithm has been described. A systematic teamwork approach to diagnosing and treatment of ectopic varices is required to successfully manage hemorrhage from ectopic varices.

Morfología de la placenta en recién nacidos con defecto congénito / Morphology of the placenta in newborns with congenital defects

El objetivo del estudio fue comparar el índice de madurez placentaria y las alteraciones histopatológicas en placentas de recién nacidos/óbitos con y sin defecto congénito (DC). Se realizó un estudio tipo casos y controles. Se incluyeron n=25 casos yn=50 controles sin DC. Los casos se clasificaron de acuerdo a la presencia de DC aislado (n=17) omúltiple (n=8). Se incluyeron recién nacidos/óbitos (RN) con una edad gestacional (EG) > 20 semanas. Se excluyeron embarazos gemelares. Se recolectó información sobre las características clínicas del producto y de la madre, antropometría del RN y su evaluación de APGAR. Se examinó la placenta, macroscópica y microscópicamente, para determinar la presencia y extensión de alteraciones histopatológicas. Se determinó el índice de madurez placentaria (IMP), calculado dividiendo el número de membranas vásculo sinciciales en 1 mm2 entre el grosor de las mismas (µ). El IMP (media ±DE) fue de 27.77±14 en el grupo de controles, 30.31±12 en el grupo de casos aislados y 16.76± 1 en el grupo de DC múltiple (p<0.05).El resto de las variables evaluadas no mostraron diferencias significativas entre grupos. En conclusión este trabajo muestra una menor madurez placentaria asociada con la presencia de DC múltiple.

The objective of the study was to compare the placental maturity index (PMI) and pathohistological alterations of placentas from newborn/stillborns (NB) with or without congenital defects (CD). A case control study was carried out. N=25 CD cases and n=50 controls without CD were included. Cases were classified according to the presence of simple (n=17) or multiple (n=8) CD. Newborn/stillborns with gestational age >20 weeks were included. Twin pregnancies were excluded. We collected information on clinical characteristics of the NB and the mother, NB anthropometry and APGAR score. The placenta was macro and microscopically examined to determine the presence and extension of histological alterations. The PMI was obtained by dividing the number of vasculo-syncytial membranes in 1 mm2, by their thickness (µ). The PMI (Mean ± SD) was 27.77 ± 14 in the control group, 30.31 ± 12 in the group diagnosed with simple CD, and 16.76 ± 1 in the group diagnosed with multiple CD (p<0.05. The rest of the assessed variables did not show significant difference between groups. In conclusion, this work shows a lower placental maturity associated with the presence of multiple CD.

Frequency of cattle farms with ivermectin resistant gastrointestinal nematodes in Veracruz, Mexico.

This study reports the percentage of cattle farms with ivermectin (IVM) resistant gastrointestinal nematodes (GINs) in Veracruz, Mexico, and identifies the GIN genera involved in the resistances. It also describes management practices of anthelmintic (AH) use on the surveyed farms. Twenty-one farms were assessed by means of the faecal egg count reduction test using the McMaster technique. Only two farms had GIN populations susceptible to IVM (9.5%). The proportion of farms with IVM resistant GIN was 71.4% (15/21). Seven of these farms had less than 80% egg count reductions. Haemonchus and Cooperia were the genera most commonly found in the resistant populations, followed by Oesophagostomum. Inappropriate AH treatment practices were identified from the completed questionnaires. Further management practices such as selective treatment and quarantine treatments are proposed to further reduce the spread of IVM resistance between farms.

Antígenos HLA de clase ii en pacientes con artritis reumatoide ecuatorianos y asociación con el factor reumatoide, anticuerpos anti-citrulinados y nódulos reumatoides / HLA antigens class ii in patients with ecuadorian rheumatoid arthritis and association with the rheumatoid factor, anti-citrulinated antibodies and rheumatoid nodules

Objetivo Determinar los antígenos de Clase II en 52 pacientes con artritis reumatoide (AR) y 52 controles, y establecer la asociación de los antígenos de Clase II DRB1* con el factor reumatoide (FR), anticuerpos anti-péptido cíclico citrulinados (anti-CCP) y nódulos reumatoides. Material y Métodos Estudio de casos y controles, realizado en pacientes del Hospital Vicente Corral Moscoso y José Carrasco Arteaga de la ciudad de Cuenca-Ecuador; se incluyeron 52 pacientes con AR que cumplen los criterios del Colegio Americano de Reumatología (ACR) y 52 controles. Se identificaron a través de la Reacción en Cadena de la Polimerasa (PCR), los diferentes tipos de HLA que tienen cada uno de los 52 pacientes con AR y controles. Se buscó asociación de los HLA-DR1* con la AR y las pruebas de laboratorio: FR, anticuerpos anti-CCP y con nódulos reumatoides. El análisis estadístico se realizó con el cálculo de OR (IC 95%) y 2 de Pearson con corrección de Fisher y la información se procesó en SPSS v15. Resultados Los alelos más frecuentes fueron HLA-DRB1*09 (17,3%) OR 3,42 (IC95% 1,21 ­ 10,14) y HLADRB1*04 (32,7%) OR 1,81 (IC95% 0,93 ­ 3,55). Tanto el factor reumatoide como los anticuerpos anti-péptido cíclico citrulinados estuvieron presentes en el 82,7% de pacientes con artritis reumatoide y los nódulos reumatoides se detectaron en el 19,2% de pacientes con AR. Se encontró asociación entre los nódulos reumatoides con valores altos de FR y anti-CCP y estos a su vez con los alelos HLA-DRB1*14 y HLADRB1*04. La mayoría de pacientes con alelos HLA-DRB1*09 con predominio heterocigoto tuvieron anticuerpos anti-CCP y FR positivo. Conclusión La presencia de los alelos HLA-DRB1*04 y HLADRB1*09 está relacionada con la susceptibilidad de presentar AR en pacientes ecuatorianos, además se relaciona con valores elevados de factor reumatoide y anticuerpos anti-péptido cíclico citrulinados.

Objective To determine Class II antigens in 52 patients with rheumatoid arthritis (RA) and 52 controls and establish the association of Class II antigens DRB1* with rheumatoid anti- cyclic citrullinated peptide (anti-CCP) rheumatoid factor (RF), and antibodies rheumatoid nodules. Methods and Materials Case and control study in patients from the Hospital Vicente Corral Moscoso and José Carrasco Arteaga of Cuenca-Ecuador; 52 patients with rheumatoid arthritis who satisfy the criteria of ACR-American College of Rheumatology and 52 healthy patients. The different types of HLA from each 52 patients with rheumatoid arthritis and controls were identified through PCR - Polymerase Chain Reaction. Association of HLA-DR1* with rheumatoid arthritis and rheumatoid factor, anti-citrullinated and rheumatoid nodules. The statistical analysis was done by the OR (IC 95%) and 2 of Pearson with Fisher correction and the information was processed in SPSS v15. Results The most frequency alleles were HLA-DRB1*09 (17,3%) OR 3,42 (IC95% 1,21 ­ 10,14) and HLADRB1*04 (32,7%) OR 1,81 (IC95% 0,93 ­ 3,55). The rheumatoid factor and anti-cyclic citrullinated peptide antibodies were presented in 82,7% of patients with rheumatoid arthritis and rheumatoid nodules was detected in the 19.2% of patients with rheumatoid arthritis . An association between rheumatoid nodules with high values of rheumatoid factor and anti-ccp and these in turn with HLA-DRB1*14 y HLA-DRB1*04 alleles were found. The majority of patients with HLA-DRB1*09 alleles with heterozygote predomination had positive anti-ccp and rheumatoid factor. Conclusion The presence of HLA-DRB1*04 and HLA-DRB1*09 alleles is related with the susceptibility of present rheumatoid arthritis in Ecuadorian patients, and it is related with higher values of rheumatoid factor and anti-cyclic citrullinated peptide.

Gelsolin levels are decreased in ankylosing spondylitis patients undergoing anti-TNF-alpha therapy.

OBJECTIVES: To determine whether circulating gelsolin (GSN) levels in patients with ankylosing spondylitis (AS) undergoing TNF-α antagonist-infliximab-therapy are altered compared with controls and to establish whether disease activity, systemic inflammation and metabolic syndrome are potential determinants of circulating GSN levels in these patients. METHODS: We assessed GSN serum concentrations in a series of 30 non-diabetic AS patients without cardiovascular (CV) disease undergoing TNF-α antagonist-infliximab therapy and 48 matched controls. GSN levels were measured immediately before and after an infliximab infusion. Correlations of GSN serum levels with disease activity, systemic inflammation and metabolic syndrome were assessed. Potential changes in GSN concentration following an infusion of anti-TNF-α monoclonal antibody-infliximab were also analysed. RESULTS: Although at the time of the study AS patients undergoing anti-TNF-α therapy had adequate control of the disease (mean BASDAI 2.94), they showed lower GSN serum levels than healthy controls (mean±SD: 38660.42±23624.6 ng/ml versus 68975.43±31246.79 ng/ml; p<0.0001). When AS patients were stratified according to sex, we observed that GSN levels were significantly lower in men than in women (p=0.032). However, no differences in GSN levels according to the specific clinical features of the disease were seen. No association was found between GSN concentration and adipokines or biomarkers of endothelial cell activation. However, correlation between basal GSN levels and insulin resistance was observed. A single infliximab infusion did not lead to significant changes in GSN levels. CONCLUSIONS: GSN concentration is reduced in AS patients undergoing periodical anti-TNF-α therapy and low disease activity. Potential association with some metabolic syndrome features seems to exist.

Correlation between two biomarkers of atherosclerosis, osteopontin and angiopoietin-2, in non-diabetic ankylosing spondylitis patients undergoing TNF-α antagonist therapy.

OBJECTIVES: To determine whether circulating osteopontin (OPN) levels in patients with ankylosing spondylitis (AS) undergoing TNF-α antagonist-infliximab-therapy are increased compared with controls and to establish whether disease activity, systemic inflammation, metabolic syndrome, adipokines and biomarkers of atherosclerosis are potential determinants of circulating OPN levels in these patients. METHODS: We assessed OPN serum concentrations in a series of 30 non-diabetic AS patients without cardiovascular disease undergoing TNF-α antagonist-infliximab therapy and 48 matched controls. OPN levels were measured immediately before and after an infliximab infusion, at time 0 and at time 120 minutes respectively. Correlations of OPN serum levels with clinical features, disease activity, systemic inflammation, metabolic syndrome and several biomarkers of atherosclerosis were assessed. Potential changes in OPN concentration following an infusion of anti-TNF-α monoclonal antibody-infliximab were also analysed. RESULTS: At the time of the study AS patients undergoing anti-TNF-α therapy had low disease activity (mean BASDAI 2.94) and they showed similar OPN serum levels to healthy controls. No differences in OPN levels according to the specific clinical features of the disease were seen. Also, no correlation between OPN concentration and insulin resistance and adipokines was observed. However, a positive correlation between OPN and angiopoietin-2 (Angpt-2) serum levels was found (r=0.397; p=0.04). In addition, a single infliximab infusion led to a marginal statistically significant reduction in OPN levels (24112.19±14608.73 pg/ml at time 0 versus 21806.62±11390.83 pg/ml at time 120'; p=0.05). CONCLUSIONS: OPN and Angpt-2 serum levels are correlated in non-diabetic AS patients undergoing TNF-α antagonist therapy.

No evidence of association between functional polymorphisms located within IL6R and IL6ST genes and Henoch-Schönlein purpura.

Henoch-Schönlein purpura (HSP) is the most common type of primary small-sized blood vessel vasculitis in children and an uncommon condition in adults. Interleukin (IL)-6 is a proinflammatory cytokine whose effect is controlled by the IL-6 receptor (IL-6R). IL-6 transducer (IL-6ST/gp130) is the signal-transducing subunit of the IL-6R. Two hundred and eighty five Spanish HSP patients and 877 sex and ethnically matched controls were genotyped for the IL6R rs2228145 and IL6ST/gp130 rs2228044 functional polymorphisms. No significant differences in the genotype and allele frequencies between HSP patients and controls were observed. Moreover, there were no differences between HSP patients according to the age at disease onset, presence of nephritis or gastrointestinal manifestations. Our results do not confirm association of IL6R rs2228145 and IL6ST/gp130 rs2228044 polymorphisms with HSP.

Travelling with tea: a Tuckerella's tale.

Tuckerella japonica Ehara appears strongly associated with tea (Camellia sinensis (L.) Kuntze, Theaceae) and, due to certain cultural practices in tea production, has in fact become a world traveller, accompanying the greatly coveted tea plant as it spread across the planet. The history of tea production and culture, and its arrival in the USA, provides the backdrop for this traveller's tale. Tuckerella japonica is morphologically similar to T. flabellifera Miller, described from Tasmania in Australia from Bedfordia salicina (Labill.) D.G. (Asteraceae). These two species have historically been misidentified as each other, creating inaccuracies in the collection records. The implications of this in terms of host plant lists and world distribution are discussed further, along with their morphological separation. The male and immature stages of T. japonica are described for the first time. Tuckerella xinglongensis Lin and Fu, from tea in China, is considered a junior synonym of T. japonica. The loss of the ancestral prostigmatan condition of three nymphal stages during ontogeny is confirmed for males of T. flabellifera, which do not retain a tritonymphal stage.

External mouthpart morphology in the Tenuipalpidae (Tetranychoidea): Raoiella a case study.

The use of low-temperature scanning electron microscopy (LTSEM) to study external mouthpart morphology in the Tenuipalpidae, in particular the genus Raoiella, has brought some aspects of the mechanics of feeding in this group into question. In addition, an LTSEM study on the specialized feeding behaviour of Raoiella indica Hirst (Tetranychoidea: Tenuipalpidae) revealed host plant use in this species could be affected by stomatal complex morphology.

Phylogenetic investigation of the genus Raoiella (Prostigmata: Tenuipalpidae): diversity, distribution, and world invasions.

The genus Raoiella is best known because of the red palm mite, R. indica, a major pest of palms spreading aggressively throughout the Americas. Not much was known about the biology, geographic origins, or evolutionary history of the genus when R. indica emerged as a major invasive pest. This paper attempts to address some of the basic historical questions regarding the palm mite as well as the genus. Molecular characters from COI and 28S regions were used to produce a phylogenetic hypothesis for the genus in an effort to understand its geographic origin. It also uses COI barcode data to delimit several potentially new species discovered by the authors in Australia. Results show a basal split between R. indica and all other Raoiella species, which indicates Africa or the Middle East as the most probable origin of the genus. Additionally, COI data suggests that at least eight new species are represented among the 20 Australian populations included in this study.

Interaction of the mite Aceria mangiferae with Fusarium mangiferae, the causal agent of mango malformation disease.

The role of the mango bud mite, Aceria mangiferae, in carrying conidia of Fusarium mangiferae, vectoring them into potential infection sites, and assisting fungal infection and dissemination was studied. Following the mite's exposure to a green fluorescent protein-marked isolate, conidia were observed clinging to the mite's body. Agar plugs bearing either bud mites or the pathogen were placed on leaves near the apical buds of potted mango plants. Conidia were found in bud bracts only when both mites and conidia were co-inoculated on the plant, demonstrating that the mite vectored the conidia into the apical bud. Potted mango plants were inoculated with conidia in the presence or absence of mites. Frequency and severity of infected buds were significantly higher in the presence of mites, revealing their significant role in the fungal infection process. Conidia and mite presence were monitored with traps in a diseased orchard over a 2-year period. No windborne bud mites bearing conidia were found; however, high numbers of windborne conidia were detected in the traps. These results suggest that A. mangiferae can carry and vector conidia between buds and assist in fungal penetration but does not play a role in the aerial dissemination of conidia between trees.

Haplotype frequencies of the PowerPlex Y system in a Mexican-Mestizo population sample from Mexico City.

The PowerPlex Y system including 11 Y-STRs (DYS19, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS385, DYS437, DYS438 and DYS439) was analyzed by capillary electrophoresis in 357 males from Mexico City. Haplotype frequency for this system was reported. The haplotype diversity was 99.56+/-0.04%, and gene diversity ranged from 51.4% for DYS393 to 92.5% for DYS385. AMOVA tests including previous reports from Mexico (Chihuahua and Jalisco States), demonstrated significant genetic heterogeneity between north and western populations regarding Mexico City, justifying the establishment of local databases in this country for male-identification purposes.

Púrpura trombocitopénica inmune en la infancia: 20 años de experiencia: 1985-2005 estado Cojedes-Venezuela / Autoimmune thrombocytopenic purpura in infancy: 20 years of experience: 1985-2005 Cojedes state-Venezuela

La púrpura trombocitopénica idiopática (PTI) es un síndrome caracterizado por diátesis hemorrágica consecuencia de la excesiva destrucción periférica de plaquetas, globalmente es considerada la trombocitopenia inmune más frecuente en niños. Describir el comportamiento clínico-epidemiológico de la PTI en el estado Cojedes, Venezuela. Se realizó un estudio descriptivo, prospectivo en niños con clínica de PTI que acudieron entre 1985 y 2005 al Hospital "Dr. Egor Nucete" de referencia del estado Cojedes, Venezuela. Las variables estudiadas fueron: época del año, procedencia, edad, género, antecedentes, manifestaciones clínicas, signos hematológicos, variedad clínica y tratamiento. Se realizó análisis estadístico descriptivo con distribuciones de frecuencia, porcentajes y gráficos de segmentos. 112 niños con PTI, incidencia acumulada promedio anual de 4,4/100.000 menores de 12 años; marzo, junio, julio y agosto mostraron el mayor número de casos y también los municipios San Carlos (30,36%), Falcón (18,75%) y Rómulo Gallegos (17,86%). Hubo mayor incidencia de PTI entre los 5 y 8 años (39%), sin diferencia entre géneros, pero con antecedentes de afección respiratoria superior en 82%; en lugar de predominó la forma aguda (91%), trombocitopenia menor de 50.000 plaquetas/mm3, sólo el 9% no recibió tratamiento terapéutico. La PTI es una patología de importante morbilidad en el estado Cojedes, de comportamiento epidemiológico similar al resto de América Latina y el mundo, su aparición está influenciada por factores ambientales, se resalta el predomino de la enfermedad entre los 2-8 años, sin distingo de género, con antecedentes infecciosos como factor de riesgo en la génesis del cuadro clínico y evolución satisfactoria aún sin tratamiento.

The immune thrombocytopenic purpura (ITP) it is a syndrome characterized by hemorrhagic, diathesis consequence of the excessive peripheric destruction of platelets, widely spread in the world and considered the most frequent thrombocytopenia in children. To description the clinic-epidemic behavior of the ITP in Cojedes state, Venezuela. It was done a descriptive prospective study with children with clinic of ITP who request medical assistance at the Hospital "Dr. Egor Nucete" of Cojedes state in a 20 years period. The variables studied were: time of the year, origin, age, gender, antecedents, clinical features, hematological signs, clinical variety and treatment. It was carried out statistical analysis. 112 children with ITP, cumulative annual average incidence of 4.4 for each 100.000 children less 12 years old; March, June, July and August showed most cases and also the municipalities of San Carlos (30.36%), Falcón (18.75%) and Rómulo Gallegos(17.86%). There was higher incidence of ITP among 5-8 years (39%), without difference among gender, but with antecedents of respiratory upper tract infection in 82% of the cases; The acute disease was predominant (91%), thrombocytopenia lower than 50.000 platelets/mm³, only 9% didn't receive treatment. The ITP is a disease of important morbility in the Cojedes state, with similar epidemic behavior than the rest of Latin America and the world, being its occurrence influenced by environmental factors, prevalence of the illness among the 2-8 years, without distinguish of gender, with infection antecedents as factor of risk in the genesis of the clinical features and satisfactory evolution without treatment.

[Mortality related with alcohol in Spain and the different Autonomous Communities of Spain in 2004]. / Mortalidad relacionada con el consumo de alcohol en España y en las comunidades autónomas en el año 2004.

INTRODUCTION: Alcohol consumption is associated with great morbidity-mortality rate. The aim of this study is to analyze the mortality that can be attributed to alcohol consumption in Spain and in its different Autonomous Communities during 2004. METHOD: The records of deaths by cause of death were used, grouped by age, gender and 60 diagnostic categories. The number of deaths attributable to alcohol consumption according to gender and age group in 2004 for Spain and the different Autonomous Communities was calculated by means of the alcohol attributable fractions proposed by the Centers for Disease Control and Prevention for calculating the mortality rates in the U.S.A. in 2001. The raw and adjusted mortality rates attributable to alcohol per 100,000 inhabitants were calculated with respect to the European population standard. RESULTS: Alcohol-related mortality in Spain was 2.3%; 3.2% for men and 1.2% for women. The Community of Murcia, with a mortality rate of 2.9%, together with those of Andalusia, the Canary Islands, the Basque Country and Asturias, had the highest rates of mortality attributable to alcohol in 2004. The highest adjusted mortality rates attributable to alcohol were found in Asturias, Murcia, Galicia and the Basque Country. CONCLUSIONS: In the different Autonomous Communities of Spain, alcohol consumption is an important cause of death. This information is of use for identifying priorities and to evaluate intervention programs. Chronic causes, in general, have a greater weight in mortality rates than acute causes, disease of the digestive system having the highest rate of contribution.