Morphological Description of the Early Events during the Invasion of Acanthamoeba castellanii Trophozoites in a Murine Model of Skin Irradiated under UV-B Light.

Skin infections have been associated with Acanthamoeba, nevertheless the events during skin invasion and UV-B light effects on it are unknown. The early morphological events of Acanthamoeba castellanii skin invasion are shown in SKH-1 mice that were chronically UV-B light irradiated. Mice that developed skin lesions (group 1) were topical and intradermally inoculated with A. castellanii trophozoites and sacrificed 48 h or 18 days later. Mice that showed no skin lesions (group 2) were intradermally inoculated and sacrificed 24, 48 or 72 h later. Mice ventral areas were considered controls with and without trophozoites intradermally inoculated. Skin samples were processed by histological and immunohistochemistry techniques. In group 1, trophozoites were immunolocalized in dermal areas, hair cysts, sebaceous glands, and blood vessels, and collagen degradation was observed. One of these mice shown trophozoites in the spleen, liver, and brain. In group 2, few trophozoites nearby collagenolytic activity zones were observed. In control samples, nor histological damage and no trophozoites were observed. Adherence and collagenolytic activity by A. castellanii were corroborated in vitro. We can infer that UV-B light irradiated skin could favor A. castellanii invasiveness causing damage in sites as far away as the brain, confirming the invasive capacity and pathogenic potential of these amphizoic amoebae.

Langerhans Cells From Mice at Birth Express Endocytic- and Pattern Recognition-Receptors, Migrate to Draining Lymph Nodes Ferrying Antigen and Activate Neonatal T Cells in vivo.

Antigen capturing at the periphery is one of the earliest, crucial functions of antigen-presenting cells (APCs) to initiate immune responses. Langerhans cells (LCs), the epidermal APCs migrate to draining lymph nodes (DLNs) upon acquiring antigens. An arsenal of endocytic molecules is available to this end, including lectins and pathogen recognition receptors (PRRs). However, cutaneous LCs are poorly defined in the early neonatal period. We assessed endocytic molecules expression in situ: Mannose (CD206)-, Scavenger (SRA/CD204)-, Complement (CD2l, CDllb)-, and Fc-Receptors (CD16/32, CD23) as well as CD1d, CD14, CD205, Langerin (CD207), MHCII, and TLR4 in unperturbed epidermal LCs from both adult and early neonatal mice. As most of these markers were negative at birth (day 0), LC presence was revealed with the conspicuous, epidermal LC-restricted ADPase (and confirmed with CD45) staining detecting that they were as numerous as adult ones. Unexpectedly, most LCs at day 0 expressed CD14 and CD204 while very few were MHCII+ and TLR4+. In contrast, adult LCs lacked all these markers except Langerin, CD205, CD11b, MHCII and TLR4. Intriguingly, the CD204+ and CD14+ LCs predominant at day 0, apparently disappeared by day 4. Upon cutaneous FITC application, LCs were reduced in the skin and a CD204+MHCII+FITC+ population with high levels of CD86 subsequently appeared in DLNs, with a concomitant increased percentage of CD3+CD69+ T cells, strongly suggesting that neonatal LCs were able both to ferry the cutaneous antigen into DLNs and to activate neonatal T cells in vivo. Cell cycle analysis indicated that neonatal T cells in DLNs responded with proliferation. Our study reveals that epidermal LCs are present at birth, but their repertoire of endocytic molecules and PRRs differs to that of adult ones. We believe this to be the first description of CDl4, CD204 and TLR4 in neonatal epidermal LCs in situ. Newborns' LCs express molecules to detect antigens during early postnatal periods, are able to take up local antigens and to ferry them into DLNs conveying the information to responsive neonatal T cells.

Immunization of Newborn Mice Accelerates the Architectural Maturation of Lymph Nodes, But AID-Dependent IgG Responses Are Still Delayed Compared to the Adult.

Lymph nodes (LNs) have evolved to maximize antigen (Ag) collection and presentation as well as lymphocyte proliferation and differentiation-processes that are spatially regulated by stromal cell subsets, including fibroblastic reticular cells (FRCs) and follicular dendritic cells (FDCs). Here, we showed that naïve neonatal mice have poorly organized LNs with few B and T cells and undetectable FDCs, whereas adult LNs have numerous B cells and large FDC networks. Interestingly, immunization on the day of birth accelerated B cell accumulation and T cell recruitment into follicles as well as FDC maturation and FRC organization in neonatal LNs. However, compared to adults, the formation of germinal centers was both delayed and reduced following immunization of neonatal mice. Although immunized neonates poorly expressed activation-induced cytidine deaminase (AID), they were able to produce Ag-specific IgGs, but with lower titers than adults. Interestingly, the Ag-specific IgM response in neonates was similar to that in adults. These results suggest that despite an accelerated structural maturation of LNs in neonates following vaccination, the B cell response is still delayed and reduced in its ability to isotype switch most likely due to poor AID expression. Of note, naïve pups born to Ag-immunized mothers had high titers of Ag-specific IgGs from day 0 (at birth). These transferred antibodies confirm a mother-derived coverage to neonates for Ags to which mothers (and most likely neonates) are exposed, thus protecting the neonates while they produce their own antibodies. Finally, the type of Ag used in this study and the results obtained also indicate that T cell help would be operating at this stage of life. Thus, neonatal immune system might not be intrinsically immature but rather evolutionary adapted to cope with Ags at birth.

Performance of Spanish speakers on the Mattis dementia rating scale (MDRS).

This paper examined whether education-, age-, and gender-matched Spanish- and English-speaking normals (n=30 pairs) had comparable scores on the Mattis dementia rating scale (MDRS). It provides preliminary normative data on Spanish-speaking volunteers aged 55-89 years old (n=54). It also compared the MDRS total score with its memory subscale score and the mini-mental state examination (MMSE) score on sensitivity and specificity for distinguishing normals from patients with dementia (n=61). Spanish-speaking normals scored significantly lower than English-speaking normals on MDRS total and its attention, conceptualization, and memory subscales. The area under the receiver operating characteristic curve distinguishing normals from patients with dementia was not significantly different among the MDRS total, its memory subscale, and the MMSE. We conclude that (a) the norms based on English-speaking individuals are not appropriate for use with Spanish-speaking individuals, and (b) to screen for dementia, the shorter MDRS Memory subscale and the MMSE are as good as the entire MDRS.

Relación entre condición nutricional, deterioro neurocognitivo, dependencia funcional y depresión en adultos mayores, Ilama, Honduras / Relationship between nutritional condition, neurocognitive impairment, functional dependence, and depression in elderly people, Ilama, Honduras

l virus SARS-CoV-2, es responsable de la enfermedad COVID-19; para su detección indirecta se utilizan inmunoensayos que cuantifican anticuerpos séricos contra algunas de sus proteínas. Objetivo: documentar resultados de la técnica ELISA, para la identificación cualitativa de anticuerpos contra SARS-CoV-2 en sujetos de Tegucigalpa y Comayagüela y la determinación de relevancia epidemiológica y clínica que presenta esta prueba. Material y Métodos: estudio correlacional transversal de 596 sujetos, a quienes se les practicó ELISA para la determinación de anticuerpos contra el SARS-CoV-2. Se recolectó datos epidemiológicos y clínicos del 13 de mayo al 31 de agosto 2020. Resultados: se analizó datos de 492 sujetos, 271 mujeres y 221 hombres, 313 de Tegucigalpa y 179 de Comayagüela. La edad media fue de 42.1 años; 253 tuvieron nexo epidemiológico negativo y 239 fueron positivos, se identificaron 88 profesiones, con base en la clasificación del Departamento de Trabajo de Estados Unidos y se categorizaron en grupos de riesgo bajo, medio y alto. Se encontraron 12 síntomas clínicos y 2 enfermedades concomitantes. De acuerdo al resultado de la prueba ELISA, los resultados se estructuraron en cuatro grupos: IgM e IgG negativos, IgM positivos, IgM e IgG positivos e IgG positivos, los que se asociaron con las variables epidemiológicas y clínicas. Los habitantes de Comayagüela presentaron mayor número de casos de ELISA positiva en comparación con los de Tegucigalpa. 1Facultad de Ciencias Médicas, UNAH. 2 Laboratorios Molina, Tegucigalpa, Honduras. 3 Western International School, San Pedro Sula. 4 Grupo de Investigación Historia. 5 Dirección General de Documentos Normativos, SESAL. 6 Grupo de Investigación Historia. 7 Departamento de Ciencias Fisiológicas, UNAH. Autor corresponsal: Mayra Gabriela Handal Lorenzana. mayr_gt@hotmail.com Recibido: 15/04/2021 Aceptado: 28/06/2021 Conclusiones: no hubo difer encia entr e edad (p=0.528) y sexo (p=0.245) en cuanto a los resultados del ELISA. Un tercio de los sujetos a los que se detectó algún anticuerpo no refirieron nexo epidemiológico. Las profesiones u ocupaciones más afectadas fueron las de riesgo medio y los síntomas identificados más frecuentes fueron fiebre, cefalea y odinofagia...(AU)

The neurophysiological effects of single-dose theophylline in patients with chronic stroke: A double-blind, placebo-controlled, randomized cross-over study.

BACKGROUND: Reducing inhibitory neurotransmission with pharmacological agents is a potential approach for augmenting plasticity after stroke. Previous work in healthy subjects showed diminished intracortical inhibition after administration of theophylline. OBJECTIVE: We assessed the effect of single-dose theophylline on intracortical and interhemispheric inhibition in patients with chronic stroke, in a double-blind, placebo-controlled, cross-over study. METHODS: Eighteen subjects were randomly administered 300 mg of extended-release theophylline or placebo. Immediately and 5 hours following administration, transcranial magnetic stimulation was used to assess bihemispheric resting motor threshold, short-interval intracortical inhibition, long-interval intracortical inhibition, and interhemispheric inhibition. Adverse effects on cardiovascular, neurological, and motor performance outcomes were also surveilled. Change between morning and afternoon sessions were compared across conditions. One week later, patients underwent the same assessments after crossing over to the opposite experimental condition. Subjects and investigators were blinded to the experimental condition during data acquisition and analysis. RESULTS: For both hemispheres, changes in intracortical or interhemispheric neurophysiology were comparable under theophylline and placebo conditions. Theophylline induced no adverse neurological, cardiovascular, or motor performance effects. For both conditions and hemipsheres, the baseline level of inhibition inversely correlated with its change between sessions: less baseline inhibition (i.e. disinhibition) was associated with a strengthening in inhibition over the day, and vice versa. CONCLUSION: A single dose of theophylline is well-tolerated by patients with chronic stroke, but does not alter cortical excitability. The inverse relationship between baseline inhibition and its change suggests the existence of a homeostatic process. The lack of effect on cortical inhibition may be related to an insufficiently long exposure to theophylline, or to differential responsiveness of disinhibited neural circuitry in patients with stroke.

The reliability of repeated TMS measures in older adults and in patients with subacute and chronic stroke.

The reliability of transcranial magnetic stimulation (TMS) measures in healthy older adults and stroke patients has been insufficiently characterized. We determined whether common TMS measures could reliably evaluate change in individuals and in groups using the smallest detectable change (SDC), or could tell subjects apart using the intraclass correlation coefficient (ICC). We used a single-rater test-retest design in older healthy, subacute stroke, and chronic stroke subjects. At twice daily sessions on two consecutive days, we recorded resting motor threshold, test stimulus intensity, recruitment curves, short-interval intracortical inhibition, and facilitation, and long-interval intracortical inhibition. Using variances estimated from a random effects model, we calculated the SDC and ICC for each TMS measure. For all TMS measures in all groups, SDCs for single subjects were large; only with modest group sizes did the SDCs become low. Thus, while these TMS measures cannot be reliably used as a biomarker to detect individual change, they can reliably detect change exceeding measurement noise in moderate-sized groups. For several of the TMS measures, ICCs were universally high, suggesting that they can reliably discriminate between subjects. TMS measures should be used based on their reliability in particular contexts. More work establishing their validity, responsiveness, and clinical relevance is still needed.

Necesidad de tratamiento estomatológico en niños de la Escuela Especial Jardín de La Alegría, 2016 / Need for stomatological treatment in children of the Special School Jardín de La Alegría, 2016

RESUMEN Introducción: La salud bucal del paciente discapacitado intelectual ha sido una gran preocupación a nivel mundial. Cuba no se escapa de ello, por lo que ha implementado programas que priorizan a este tipo de individuos. Objetivo: Determinar la necesidad de tratamiento estomatológico de los pacientes con discapacidad intelectual según la categoría diagnóstica de la Escuela Especial Jardín de la Alegría. Métodos: Estudio descriptivo transversal realizado en el período comprendido entre 2016-2017. El universo de estudio estuvo constituido por 105 niños que representa la matrícula total de la escuela. El examen clínico de los escolares se realizó en el sillón dental. Para la recolección de la información se confeccionó una planilla encuesta teniendo en cuenta las características del grupo objeto de estudio: edad, sexo, categoría diagnóstica, índice COP-D y ceo-d, índice de necesidad de tratamiento periodontal comunitario, y la higiene bucal mediante el índice de higiene bucal simplificado de Greene y Vermillon. Resultados: La categoría diagnóstica que prevaleció fue el discapacitado intelectual leve con 82,8 por ciento. El 68,6 por ciento de la población estudiada presentó higiene bucal regular. El 67,6 por ciento de los niños presentó enfermedad periodontal, el 59,0 por ciento maloclusión y el 54,2 por ciento caries dental. Según necesidad de tratamiento, el 67,0 por ciento requiere tratamiento periodontal, el 59,0 por ciento tratamiento ortodóncico y el 45,7 por ciento tratamiento conservador. Conclusiones: Existió una alta necesidad de tratamiento periodontal en los individuos con discapacidad intelectual leve(AU)

ABSTRACT Introduction: The oral health of the intellectually disabled patient has been a great concern worldwide. Cuba does not escape this concern by implementing programs that prioritize this type of individuals. Objective: To determine the need for stomatological treatment of patients with intellectual disability according to the diagnostic category of the Jardín de la Alegría Special School. Methods: a cross-sectional descriptive study conducted in the period 2016-2017. The clinical examination of the students was carried out in the dental chair. For the collection of the information a survey form was made taking into account the characteristics of the group under study: age, sex, diagnostic category, COP-D index and ceo-d, index of need for community periodontal treatment, and oral hygiene using the simplified oral hygiene index of Greene and Vermillon. The universe of study was constituted by 105 children that represents the total enrollment of the school. Results: the diagnostic category that prevailed was the mild intellectual disability with 82.8. 68.6 percent of the studied population presented regular oral hygiene. 67.6 percent of the children presented periodontal disease, 59.0 percent malocclusion and 54.2 percent dental caries. According to need of treatment, 67 percent need periodontal treatment, 59.0 percent orthodontic treatment and 45.7 percent need conservative treatment. Conclusions: there was a high need for periodontal treatment in individuals with mild intellectual disability(AU)

Prevalencia de embarazo de adolescentes, Hospital Leonardo Martínez Valenzuela / Prevalence teen pregnancy, Hospital Leonardo Martinez Valenzuela

El embarazo en adolescentes es un estado fisiológico de alto riesgo para la madre e hijo, se presenta entre los 10 hasta los 19 años de edad. Objetivo: Determinar la prevalencia y características clínicas de las adolescentes embarazadas atendidas en el Hospital Leonardo Martínez Valenzuela (HLMV) durante el período del 1 de enero hasta el 31 de diciembre del 2014. Pacien- tes y Métodos: Estudio con enfoque cuantitativo, de corte transversal y alcance descriptivo, realizado en la Sala de Maternidad del Hospital Leonardo Martínez Valenzuela durante el período descrito. El método de recolección de datos fue a través de datos secundarios obtenidos directamente de los libros de registros de ingreso de labor y parto, área quirúrgica y puerperio del Depar-tamento de Estadística del hospital ya mencionado. Los datos fueron tabulados con el programa de computación Excel 2010. Resultados: Un total de 14,008 nacimientos fueron atendidos en la Sala de Maternidad durante el año 2014, de los cuales 4,035 correspondían a madres adolescentes, con una prevalencia de 28.8%. De las adolescentes embarazadas, 113 (2.80%) no asistieron control prenatal y 916 (22.70%) asistieron a 5 controles. La vía del parto fue: vaginal 3,409 (85%) y cesárea 626 (15%). Se encontró que 298 (7.39%) eran quinceañeras y el método anticonceptivo hormonal (inyección de Acetato de medroxiprogesterona) fue utilizado por 2,686 (75%) madres. Conclusiones: Existe alta prevalencia de embarazos en adolescentes que se atienden en el HLMV, muchas jóvenes son madres al cumplir apenas quince años...(AU)

Nefropatía lúpica. caso clínico y revisión bibliográfica / Nephropaty lupus. clinical case and literature review

El Lupus Eritematoso Sistémico (LES) es una enfermedad de carácter autoinmune sistémica, de etiología desconocida, sin embargo se estima que factores genéticos y ambientales contribuyen a la aparición de la enfermedad. Su incidencia es mayor en mujeres en edad reproductiva. Una de sus complicaciones es la Nefropatía Lúpica, la cual puede ser mortal para el paciente, por lo que se requiere un diagnóstico oportuno y tratamiento eficaz para mejorar su calidad de vida. Un ejemplo de dicha complicación es el caso clínico desarrollado en el presente artículo. Paciente femenina de 18 años de edad, con LES diagnosticada hace un año, ingresó a la sala de Nefrología del Hospital Mario Catarino Rivas (HMCR) con historia de 7 días de evolución de ascitis progresiva acompañado de dolor epigástrico y disnea progresiva. Laboratorialmente con: C3: 62.4mg/dl, C4: 5.0mg/dl, anticuerpos antinucleares (ANA): positivo, nitrógeno ureico en sangre (BUN) 91.6 mg/dl, creatinina 5.5 mg/dl. No se realizó biopsia renal por falta de insumos en el hospital. La paciente fallece a los 7 días de su hospitalización. Discusión Se puede sospechar nefritis en paciente que padece lupus, si hay hematuria u orina de apariencia espumosa, asimismo si sufre de hipertensión arterial o muestra signos de edema, características presentes en la paciente de nuestro caso clínico...(AU)