Vertical transmission: evidence of COVID-19 in a twin pregnancy.

This article reports the case of a 28-year-old female 31.6 weeks pregnant with twins diagnosed with SARS-CoV-2 infection, who delivered a boy and a girl. The newborns underwent RT-PCR testing for SARS-CoV-2; the male tested negative and the female newborn tested positive, in that the female placenta was SARS-CoV-2 positive and the male placenta negative. Clinical and laboratory findings evincing vertical transmission of SARS-CoV-2 were identified. Strict, multidisciplinary prenatal care is recommended for this group of patients. This case report alone does not provide statistical evidence of vertical transmission, but it is an account of a relevant matter.

Evaluation of the Anti-Müllerian Hormone and its Association with Embryo Quality in Advanced Reproductive Treatments in a Latin American Population.

OBJECTIVE: Serum anti-Müllerian hormone (AMH) presents a strong positive correlation with quantitative aspects of the ovarian reserve, while its correlation with embryo quality is unclear. This study assessed the association between serum AMH as a marker of ovarian reserve and embryo quality, in women undergoing in vitro fertilization. METHODS: This observational analytical retrospective study included patients seen between 2010 and 2018. In vitro fertilization patients with measured AMH levels were analyzed based on the following parameters: number of retrieved oocytes; number of metaphase II oocytes; embryo quality; and treatment outcome. Statistical analysis was performed using ANOVA, Mann-Whitney U test, linear regression, and Pearson and Spearman correlations. RESULTS: We found a positive correlation between AMH levels, number of retrieved oocytes and number of metaphase II oocytes (r 0.649, p=0.000). The numbers of retrieved and metaphase II oocytes were predicted in 42% (R2: 429) of the cases based on AMH levels (p=0.000). Serum AMH levels were not associated with embryo quality on Day 3 (p=0.151); an association was seen between AMH levels and embryo quality on Day 5 (p=0.006). The distribution of AMH levels was the same across patients, regardless of whether they were able to achieve pregnancy (p=0.767). CONCLUSIONS: AMH levels correlated with embryo quality on Day 5; no association was found between AMH levels and embryo quality on Day 3 or pregnancy rate. The use of AMH levels to predict embryo quality still requires further studies; therefore, AMH should be used to assess the ovarian reserve only.

Serum estradiol level on the day of trigger as a predictor of number of metaphase II oocytes from IVF antagonist cycles and subsequent impact on pregnancy rates.

OBJECTIVE: This study aimed to examine the association between serum estradiol levels and number of metaphase II oocytes harvested after in vitro fertilization cycles used in embryo transfers and the subsequent impact on pregnancy rates. METHODS: This observational analytical retrospective study was carried out in 2010-2018 at the Angeles del Pedregal Hospital. It included 181 cases and looked into the number of metaphase II oocytes to predict pregnancy rates. Statistical analysis was based on the calculation of correlations between variables and logistic regressions. RESULTS: Estradiol levels increased with the number of oocytes by a median correlation (r=0.482, p=0.000). On the day of trigger, estradiol levels predicted the number of retrieved oocytes with 23% reliability (R2=0.232, p=0.000); a linear trend correlation of r=0.489, p=0.000 was found between estradiol levels on the day of trigger and number of metaphase II oocytes. CONCLUSIONS: Serum estradiol on the day of trigger as a predictor of metaphase II oocytes in antagonist cycles encourages greater oocyte maturity and fertilization, whereas, in isolation, it does not determine the pregnancy achievement.

Prevalencia de hormona antimülleriana en mujeres latinas atendidas en un centro de fertilidad en México / Antimüllerian hormone prevalence in Latin women treated at a fertility center in Mexico

Resumen Antecedentes: La hormona antimüllleriana (HAM) ha sido utilizada como marcador de reserva ovárica, lo cual ayuda a predecir el éxito. Se desconoce si valores de otros países son apicables a México. Objetivo: Determinar los valores de HAM en nuestra población para graficarlas acorde a grupos de edad y evaluar su comportamiento. Metodología: Estudio observacional, descriptivo, retrospectivo y transversal de pacientes del 2008 al 2018, con reporte de nivel de HAM excluyendo a pacientes con enfermedades que alteran su nivel, analizando por grupos de edad en un laboratorio. Resultados: 450 pacientes de 36.93 años, el rango del valor de la HAM fue desde 0.003 ng/ml hasta 9.4 ng/ml, con una media de 1.5, con una disminución anual a partir de los 40 años (0.1-0.3). Correlación de Spearman de -436 (p < 0.000) con una asociación leve entre la edad y el nivel de HAM, pero sí lineal (p < 0.000). Conclusiones: La HAM es útil y sirve para dar recomendaciones personalizadas, así como base de estudios epidemiológicos en pro de una medicina individualizada.

Abstract Background: Antimüllerian hormone (AMH) has been used as a marker of ovarian reserve, which helps predict success. It is unknown if values from other countries are applicable to Mexico. Objective: To determine the AMH values in our population to graph them according to age groups and evaluate their behavior. Methodology: Observational, descriptive, retrospective, and cross-sectional study of patients from 2008 to 2018, with a AMH level report excluding patients with diseases that alter their level, analyzing by age groups in a laboratory. Results: 450 patients of 36.93 years old, the range of the AMH value was from 0.003 ng/ml to 9.4 ng/ml, with a mean of 1.5, with an annual decrease from 40 years of age (0.1-0.3). Spearman's correlation of -436 (p < 0.000) with a slight association between age and AMH level, but it was linear (p < 0.000). Conclusions: AMH is useful and serves to give personalized recommendations, as well as basis of epidemiological studies in favor of an individualized medicine.

Prognostic Role of 14F7 Mab Immunoreactivity against N-Glycolyl GM3 Ganglioside in Colon Cancer.

Purpose. To assess the prognostic role of 14F7 Mab immunoreactivity, against N-Glycolyl GM3 ganglioside, in patients with colon cancer (CC) and to evaluate the relationship between its expression and clinicopathological features. Methods. Paraffin-embedded specimens were retrospectively collected from 50 patients with CC operated between 2004 and 2008. 14F7 Mab staining was determined by immunohistochemistry technique and its relation with survival and clinicopathologic features was evaluated. Results. The reactivity of 14F7 Mab was detected in all cases. Most cases had high level of immunostaining (70%) that showed statistical correlation with TNM stage (P = 0.025). In univariate survival analysis, level of 14F7 Mab immunoreactivity (P = 0.0078), TNM Stage (P = 0.0007) and lymphovascular invasion (0.027) were significant prognostic factors for overall survival. Among these variables, level of 14F7 Mab immunoreactivity (HR = 0.268; 95% CI 0.078-0.920; P = 0.036) and TNM stage (HR = 0.249; 95% CI 0.066-0.932; P = 0.039) were independent prognostic factors on multivariate analysis. Conclusions. This study is the first approach on the prognostic significance of 14F7 Mab immunoreactivity in patients with colon adenocarcinoma and this assessment might be used in the prognostic estimate of CC, although further studies will be required to validate these findings.

Molecular epidemiology of human papillomavirus infections in cervical samples from cuban women older than 30 years.

OBJECTIVE: This study aimed to provide information about the molecular epidemiology of human papillomavirus (HPV) in a group of Cuban women. MATERIALS AND METHODS: DNA from cervical samples was analyzed using a quantitative real-time polymerase chain reaction (PCR), which detects 6 of the clinically most relevant high-risk HPV types. Furthermore, end point PCR and sequencing were performed. Three hundred twenty-two women (211 with positive and 111 with negative cytologic results) aged between 30 and 69 years were enrolled. Risk factors associated with HPV infections and premalignant lesions were also investigated. RESULTS: HPV DNA was detected in 76.1% (245/322) of the studied population, and 34 different genotypes were found. There was an association between HPV infection and low educational level, history of oral contraceptives, menopausal stage, as well as cigarette and/or alcohol consumption. Besides, in a multivariate analysis, previous positive Pap test result and positive colposcopy finding were both predictor variables for HPV infections and for premalignant lesions. Human papillomavirus infection was found in 94.3% of women (199/211) with positive cytologic result and in 41.4% (46/111) of those with negative results, being more likely that the first group was infected with any HPV (odds ratio = 23.43; 95% CI = 11.70-46.92; p = .000). The most common genotypes were HPV types 16, 18, 31, 58, 33, and 45. All the cases with HPV positive findings had at least 1 high-risk HPV genotype. CONCLUSIONS: This is the first report of the molecular epidemiology of HPV in Cuban women, based on results from a DNA sequence and quantitative PCR. Most individuals were infected with high-risk HPV types. These findings support the inclusion of HPV vaccine in Cuba.

Genital microsporidiosis in women with AIDS: a post-mortem study.

BACKGROUND: Microsporidiosis is a life threatening opportunistic infection of AIDS patients. The infection is usually restricted to specific anatomical areas, but could become systemic depending on the involved species. Genital microsporidiosis in female patients is rare. OBJECTIVE: To report genital microsporidiosis in female AIDS patients. METHODS: Tissues samples from the genital tract (ovary, fallopian tubes and uterus) of eight deceased women who died of wasting syndrome associated to AIDS and disseminated microsporidiosis at the Institute of Tropical Medicine Pedro Kourí were collected between 1997 and 2005. Using an indirect immunohistochemistry assay the microsporidia species involved in those cases were identified. RESULTS: We report several cases of microsporidial infection of the female genital tract. Six out of eight women with the disseminated form of the disease showed the presence of microsporidia in the genital tract. Encephalitozoon cuniculi and Encephalitozoon hellem were identified in the internal lining epithelium of the fallopian tubes and endometrium. CONCLUSIONS: Microsporidia species could disseminate to other organs and become systemic in severe immunocompromised cases. To our knowledge this is the greatest number of female genital tract microsporidiosis cases so far reported in humans.

Comparison of four DNA extraction methods from cerebrospinal fluid for the detection of Toxoplasma gondii by polymerase chain reaction in AIDS patients.

BACKGROUND: Toxoplasmosis is a serious and often life-threatening disease in immunodeficient patients. Polymerase chain reaction (PCR) assays allow a rapid diagnosis of Toxoplasma infection by direct detection of the parasite's DNA. To perform a sensitive, specific, and reliable PCR-based diagnostic test, the availability of pure DNA lacking PCR inhibitors as well as a rapid and easy-to-perform DNA extraction protocol are essential. The aim of the present study was to compare four DNA extraction methods for the detection of T. gondii on cerebrospinal fluid (CSF) using the PCR technology. MATERIAL/METHODS: Four DNA extraction methods (boiling, lysis + centrifugation, the miniMAG commercial system, and phenol-chloroform) were compared with respect to the time of completion, the manual labor involved, and PCR analytical sensitivity for the detection of T. gondii in CSF. The optimal DNA extraction method for the detection of the parasite was evaluated in CSF from 43 AIDS patients using the nest-PCR B1 assay. RESULTS: According to the time required for completion, labor, and PCR analytical sensitivity, the lysis + centrifugation protocol proved to be a simple, efficient, and economical in-house procedure to recover the T. gondii DNA present in the CSF. The diagnostic sensitivity of nest-PCR, according to Centers for Disease Control and Prevention (CDC) criteria, was 86.3% and the diagnostic specificity was 100%. CONCLUSIONS: We report a simple, rapid, reproducible, and economical in-house method for T. gondii DNA extraction from CSF. This method is recommended for diagnostic PCR of Toxoplasmic encephalitis (TE) in places with economical shortage.

Apoptosis in tissues from fatal dengue shock syndrome.

BACKGROUND: Apoptosis, or programmed cell death, has been implicated in dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS) pathogenesis. OBJECTIVES: To determine the in vivo apoptosis contribution to the pathogenesis of fatal DHF/DSS during a Cuban dengue epidemic. STUDY DESIGN: We detected apoptosis by the TdT-mediated dUTP Nick-End Labeling (TUNEL) technique and dengue virus (DENV) antigens by an immunohistochemical assay in different tissues from six individuals who died of DHF/DSS during the Santiago de Cuba DENV-2 epidemic in 1997. RESULTS: DENV antigens were immunolocalized mainly in hepatocytes. Apoptotic cells were found in five of the six cases studied. Apoptosis was demonstrated in liver, brain, intestinal and lung tissues. Severe brain hypoxia and ischemia in the studied subjects during DHF/DSS probably might induce apoptosis in cerebral cells. Apoptotic microvascular endothelial cells (ECs) in pulmonary and intestinal tissues, a finding only previously reported in vitro, are likely related to vascular plasma leakage manifested by the individuals. CONCLUSIONS: Apoptosis was demonstrated in cerebral cells, white blood cells, intestinal and pulmonary microvascular ECs from Cuban fatal cases of DHF/DSS. As far as we know, these findings have not been previously reported in DHF/DSS. Our results indicate there is very likely an in vivo contribution of apoptosis to the pathophysiological mechanisms of DHF/DSS.

El impacto de la muerte infantil en un grupo de profisionales de la salud / The impact of an infant's death on a health professiinal group

Este trabajo fue presentado ,en la III Jornada Anual Interna dle Centro Marplatense de Estudios Psicoanaliticos ("Diferentes Caminos del Pensamiento Psicoanalitico"), desarrollada en el mes de Diciembre de 1991, en la ciudad de Mar del Plata. Se trata de una experiencia de Grupo Reflexión que se realizó con el personal de enfermeria y médico de la Sala de Oncohematologia del Hospital Interzonal Especializado Materno Infantil de esta ciudad, por un espacio de siete meses. Su objetivo consistió en hacer más saludable la tarea, ya que la misma, por el tiempo de patologia que se asiste, expone al plantel, en forma casi permente, a situaciónes de un alto monto de angustia. La experiencia se ralizó gracias a la confluencia de una demanda de los profesionales del área, con el interés de Salud Mental del Hospital mencionado, de dar respuesta a dicha necesidad