Antiplatelet therapy in patients with conservatively managed spontaneous coronary artery dissection from the multicentre DISCO registry.

AIMS: The role of antiplatelet therapy in patients with spontaneous coronary artery dissection (SCAD) undergoing initial conservative management is still a matter of debate, with theoretical arguments in favour and against its use. The aims of this article are to assess the use of antiplatelet drugs in medically treated SCAD patients and to investigate the relationship between single (SAPT) and dual (DAPT) antiplatelet regimens and 1-year patient outcomes. METHODS AND RESULTS: We investigated the 1-year outcome of patients with SCAD managed with initial conservative treatment included in the DIssezioni Spontanee COronariche (DISCO) multicentre international registry. Patients were divided into two groups according to SAPT or DAPT prescription. Primary endpoint was 12-month incidence of major adverse cardiovascular events (MACE) defined as the composite of all-cause death, non-fatal myocardial infarction (MI), and any unplanned percutaneous coronary intervention (PCI). Out of 314 patients included in the DISCO registry, we investigated 199 patients in whom SCAD was managed conservatively. Most patients were female (89%), presented with acute coronary syndrome (92%) and mean age was 52.3 ± 9.3 years. Sixty-seven (33.7%) were given SAPT whereas 132 (66.3%) with DAPT. Aspirin plus either clopidogrel or ticagrelor were prescribed in 62.9% and 36.4% of DAPT patients, respectively. Overall, a 14.6% MACE rate was observed at 12 months of follow-up. Patients treated with DAPT had a significantly higher MACE rate than those with SAPT [18.9% vs. 6.0% hazard ratios (HR) 2.62; 95% confidence intervals (CI) 1.22-5.61; P = 0.013], driven by an early excess of non-fatal MI or unplanned PCI. At multiple regression analysis, type 2a SCAD (OR: 3.69; 95% CI 1.41-9.61; P = 0.007) and DAPT regimen (OR: 4.54; 95% CI 1.31-14.28; P = 0.016) resulted independently associated with a higher risk of 12-month MACE. CONCLUSIONS: In this European registry, most patients with SCAD undergoing initial conservative management received DAPT. Yet, at 1-year follow-up, DAPT, as compared with SAPT, was independently associated with a higher rate of adverse cardiovascular events (ClinicalTrial.gov id: NCT04415762).

The influence of increased water temperature on the duration of spermatogenesis in a neotropical fish, Astyanax altiparanae (Characiformes, Characidae).

In view of the established climate change scenario and the consequent changes in global temperature, it is essential to study its effects on animal spermatogenesis. Therefore, the aim of this study was to verify the duration of spermatogenesis at different temperatures. For this purpose, 96 male and adult specimens of Astyanax altiparanae were kept in a closed circulation system with water temperature stabilized at 27 °C and 32 °C. Subsequently, the specimens received pulses of BrdU (bromodeoxyuridine) at a concentration of 100 mg/kg/day for 2 consecutive days, and the samples were collected daily for a period of 15 days. Their testes were removed, fixed, processed in historesin, and sectioned in 3 µm, submitted to hematoxylin/eosin staining and to bromodeoxyuridine immunodetection. Partial results of the optimum temperature experiments allowed the classification of A. altiparanae spermatogenic cells in Aund, Adiff, and type B spermatogonia, spermatocytes, spermatids, and spermatozoa. The duration of spermatogenesis was determined as approximately 6 days for animals at a temperature of 27 °C and 1 day for animals at 32 °C. The elevated temperature was also responsible for increasing cell proliferation, resulting in an increase in the number of spermatocytes, spermatids, spermatozoa, and cell death (cell pyknotic). The duration of spermatogenesis in A. altiparanae was directly affected by the elevated water temperature, causing a reduction in the estimated time of spermatogenesis.

Myocardium Arrangement and Coronary Vessel Distribution in the Ventricle of Three Neotropical Freshwater Teleosts.

The ventricle of the fish heart is a chamber that exhibits great morphological and vascular variability among species. However, although the Neotropical region has the greatest taxonomic and functional diversity in freshwater fish, many considerations have been formed without previous knowledge of the ventricular morphology of these fishes. Thus, the purpose of the present study was to describe the anatomy, myoarchitecture, and distribution of coronary vessels in the ventricle of three species belonging to two representative groups from this geographical area, Leporinus elongatus, Hoplias malabaricus (Characiformes) and Pterodoras granulosus (Siluriformes), using gross anatomy and light microscopy. The species L. elongatus and H. malabaricus presented a pyramidal ventricle associated to a mixed myocardium, formed by compact and spongy layers. The mixed myocardium was also observed in P. granulosus, but associated with a sac-like ventricle. The compact layer of the species studied was formed by muscular bundles in longitudinal and circular disposition. The spongy layer constituted most of the ventricular myocardium and was formed by a complex network of trabecular sheets presenting muscle fibers also in longitudinal and circular disposition. Coronary vessels were present in the three species and were observed primarily on the surface of the bulbus arteriosus, later branching on the ventricular surface and penetrating the myocardium only at the compact layer level. These characteristics allow classification of the ventricles studied as type II. Although the type I ventricle is the most common type in teleosts, it is important to emphasize that this type has not been observed in any Neotropical freshwater teleosts studied to date.

Effect of an homeopathic complex on fatty acids in muscle and performance of the Nile tilapia (Oreochromis niloticus).

BACKGROUND: The homeopathic complex HomeoAqua Mega 3(®) was designed to stimulate fish liver function resulting in enhanced lipid metabolism and improved overall performance. The effect of the complex in fatty acid compounds in the muscle tissues and the performance of Nile tilapia (O. niloticus) were evaluated. METHODS: A control diet with 40 mL of alcohol solution (30° Gay Lussac (GL) alcohol) per kg of feed and another diet with 40 mL/kg of the homeopathic complex were analysed in sex-reversed juvenile male Nile tilapia with mean initial weights of 89.54 g (±7.97) and 89.74 g (±8.83) and initial total mean lengths of 16.93 cm (±0.56) and 16.85 cm (±0.56) for the control and homeopathy-treated fish, respectively. Overall, 200 fish were distributed into 10 water tanks, with 20 specimens in each 600 L tank, they were kept for 63 days. Monitoring of the water's physical and chemical parameters was performed. Additionally, the percentage chemical composition and the composition of the muscle tissue fatty acids were determined, and fish performance was evaluated. RESULTS: No significant differences (p > 0.05) were found between treatments with regard to the water's physical and chemical parameters, moisture, ashes, proteins of the Nile tilapia muscular tissue and mean rates of total weight and length of the animals in the final period of the assay. The total lipid (TL) rates of the tilapia muscle tissue were 1.133 ± 0.2% at the start (control and homeopathy) and 0.908 ± 0.14% (control) and 0.688 ± 0.14% (homeopathy) at the end of the experiment (p < 0.06). The sum total of the SFAs (saturated fatty acids) was 338.50 ± 0.15 at the start (control and homeopathy) and 271.49 ± 0.34 mg/g of the TLs for the control and 226.12 ± 0.77 mg/g of TL for the homeopathy at the end of the experiment (p < 0.05). The n-6/n-3 ratio was also lower for the homeopathy-treated fish (8.45 ± 0.40) compared with the control fish (9.60 ± 0.14), (p < 0.05) at the end of the 63-day period. CONCLUSION: Nile tilapia juveniles that received the HomeoAqua Mega-3(®) in their diets had a decrease in the TL rates, mainly for the SFAs, and the n-6/n-3 ratio, compared with the control group, without any changes in the animal performance during the experimental period.

Morpho-functional response of Nile tilapia (Oreochromis niloticus) to a homeopathic complex.

BACKGROUND: This study evaluated the performance, prevalence of ectoparasites and morpho-functional response of the liver and the branchiae of Nile tilapia (Oreochromis niloticus) raised on fish meal with added of the homeopathic complex Homeopatila 100(®) at different concentrations. METHODS: Post-reversed juvenile Nile tilapia (O. niloticus) of the GIFT (Genetic Improvement of Farmed Tilapia) strain were used in this study. The performance, ectoparasite prevalence and parasite load in the branchiae and skin as well as the liver and branchial histology. Fish were randomly assigned to receive one of four treatments: control, 20 mL hydroalcoholic solution (alcohol 30° GL); 20 mL Homeopatila 100(®) per kg of meal; 40 mL Homeopatila 100(®) per kg of meal; or 60 mL of Homeopatila 100(®) per kg of meal, compared to control with out the addition of the complex. There were four replications per treatment type (16 experimental units total) at a density of 40 fish per m(3) over a period of 57 days. The Kruskal-Wallis H test (p < 0.05) was employed to analyse the physical and chemical parameters of water as well as for parasite prevalence; whereas analysis of variance was used for liver performance. If the values were significant (p < 0.05), they were compared by Tukey's test. Multiple comparisons of averages were performed using Student's t test (p < 0.05). RESULTS: There were no significant between the physical and chemical parameters of the water between the different groups at the end of the experiment. Significant differences (p < 0.05) in the mixed parasite conditions were found within the different Homeopatila 100(®) treatments. The hepatosomatic ratio of fish treated with Homeopatila 100(®) was significantly lower than that of fish from the control group. The best results in the liver and branchiae occurred in fish receiving Homeopatila 100(®) at 40 mL/kg in terms of the number of hepatocytes/mm(2), the intercellular glycogenic behaviour, the rates of histological changes (hyperplasia, lamella fusion and telangiectasia) and the percentage of neutral and acidic mucin-producing cells. CONCLUSION: The addition of Homeopatila 100(®) at a concentration 40 mL per kg/meal to the diet of juvenile Nile tilapias resulted in improved hepatocytes and intracellular glycogen levels as well as the lowest mean rate of branchial histological changes with an increase in acidic mucin-producing cells compared to neutral mucin-producing cells, compared to control.

Clinical and angiographic features of SCAD type 4.

INTRODUCTION: The angiographic type 4 in SCAD is described as a total occlusion of the coronary artery and its management may differ according to its clinical presentation. We previously have observed that these patients present a low incidence of adverse events. Our objective was to describe clinical and angiographic characteristics of this condition, according to its initial management in the DISCO registry. METHODS: We conducted an observational study of consecutive SCAD patients from 26 centres of Italy and Spain (DISCO registry). Angiotype 4 SCAD cases were selected and classified according to the initial treatment chosen: conservative management vs. percutaneous coronary intervention (PCI). Clinical and angiographic characteristics were compared. RESULTS: We recruited 81 (mean age 52.6 ± 11 years) patients with SCAD angiotype 4 out of 302 patients of the DISCO registry. Thirty-eight (46.9%) patients received conservative management and 43 (53.1%) received PCI. Nearly all patients undergoing PCI had ST-segment elevation (93% vs 47.4%, p < 0.0001), the left anterior descending artery (LAD) was more commonly involved (67.4% vs. 42.1%, p = 0.006), and they had more frequent proximal segment involvement (25.6% vs 2.7%, p = 0.004) and longer lesions (46.5 ± 23.2 mm vs 26.4 ± 18.8 mm, p = 0.017). On the other hand, non-ST-segment elevation myocardial infarction (52.6% vs 2.3%, p = 0.001) and isolated involvement of secondary branches (55.3 vs 4.7, p < 0.0001) were more common in the conservative management group. CONCLUSIONS: Patients with SCAD angiotype 4 who underwent PCI had a higher frequency of STEMI and involvement of proximal and longer coronary segments, particularly affecting the left anterior descending artery. NSTEMI and isolated involvement of secondary branches were more frequently found in those managed conservatively.

Morphological analysis of the digestive tract of Hypophthalmus marginatus (Valenciennes, 1840).

The mapará, Hypophthalmus marginatus, is a rheophilic and planktophagous catfish and it is one of the main fishing resources in the Amazon region. To understand its nutritional characteristics, this work described the morphology and histochemistry of the digestive tract of H. marginatus. The oropharyngeal cavity has abundant, long and thin gill rakers, responsible for retaining plankton, while the short and muscular oesophagus promotes the transport of these items to the stomach and prevents water ingestion. The stratified oesophageal epithelium has goblet cells with mucins predominantly neutral that could facilitate the food passage the food passage. The U-shaped siphonal stomach shows a columnar epithelium with neutral mucins to protect against autodigestion. The cardiac and fundic regions have gastric glands, while the pyloric region has a thick muscular layer with a sphincter. The coiled intestine with intestinal quotient of 2.14 ± 0.5 shows long longitudinal folds in the anterior region, decreasing in height in the aboral direction, and highlighting its function in digestion and nutrient absorption. Goblet cells are abundant in posterior intestine and rectum, and rectum shows epithelial cells with mucins in the apical cytoplasm, for protection and defecation. Intraepithelial lymphocytes also are abundant in posterior intestine and rectum, and it acts in immunological defence.

Association between hormone therapy and short-term cardiovascular events in women with spontaneous coronary artery dissection.

INTRODUCTION AND OBJECTIVES: Changes in sex hormone levels are a known triggering factor for spontaneous coronary artery dissection (SCAD) in women. However, it is unknown whether exposure to exogenous hormone therapy (HT) at the time of SCAD presentation modifies the clinical course of this condition. We investigated the association between HT in female patients presenting with SCAD and short-term clinical outcomes. METHODS: We enrolled consecutive patients presenting with SCAD from the DISCO-IT/SPA (dissezioni spontanee coronariche Italian-Spanish) registry. Women on HT (estrogens, progestagens, or gonadotropins) at the time of presentation were identified, and their clinical characteristics and short-term outcomes were compared with those not receiving active HT. The outcome measure was nonfatal myocardial infarction and/or unplanned percutaneous coronary intervention during the first 28 days after the index catheterization. RESULTS: Of 224 women presenting with SCAD (mean age 52.0±10.0 years), 39 (17.4%) were currently using HT while 185 (82.6%) were not. No significant differences were noted in the baseline demographics, clinical presentation, angiographic features, or initial treatment received between the 2 groups. All patients on systemic HT (n=36, 92%) discontinued it at the time of diagnosis. The composite outcome occurred in 7 (17.9%) patients with prior HT compared with 14 (7.6%) without (P=.039). After multivariable adjustment, HT remained associated with the composite outcome recorded in the first 28 days of follow-up (HR, 3.53; 95%CI, 1.30-9.61; P=.013). CONCLUSIONS: In women with SCAD, exposure to HT at the time of clinical presentation was associated with short-term recurrent cardiovascular events such as nonfatal myocardial infarction and/or unplanned percutaneous revascularization.

Stent strut thickness and acute vessel injury during percutaneous coronary interventions: an optical coherence tomography randomized clinical trial.

AIMS: Compare the degree of acute vascular injury caused by a polymer-free, thin-strut drug-eluting stent (DES) to that caused by a bioresorbable polymer, thick-strut DES using optical coherence tomography (OCT). METHODS AND RESULTS: Fifty patients requiring nonurgent PCI were randomized to receive either a thin or a thick-strut DES. OCT was performed before and after stent implantation. OCT-based injury score (IS) after implantation was numerically higher within thick-strut stents 0.32 vs. 0.23, but the difference was NS (P = 0.61). Edge dissections were present in 36% of the patients without differences between groups. Tissue prolapse (TP) area was larger with thin-strut stents (2.26 vs. 1.83 mm2, P = 0.04). Stent expansion and symmetry index were similar between the two platforms (85% vs. 94%, P = 0.08; and 0.82 vs. 0.80, P = 0.25). No differences were observed in total malapposition area (1.85 mm2 in thin-strut stents vs. 1.47 mm2, P = 0.48). Regarding the influence of plaque-type, IS tended to be higher (non-significant) with thick strut DES in fibrocalcific plaques. Stent malapposition area was smaller in fibrous plaques, especially with thin strut stents (P = 0.03). CONCLUSION: There was no difference in the extent of OCT-based vessel injury associated with thin and thick-strut DES platforms. TP was larger with the thin strut DES, potentially reflecting a deeper stent embedment in the vessel wall.

Clinical outcomes by angiographic type of spontaneous coronary artery dissection.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an increasingly diagnosed cause of myocardial infarction. Although different SCAD angiographic classifications exist, their clinical impact remains unknown. AIMS: The aim of this study was to evaluate the relationship between an angiographic classification and the development of adverse clinical events during the follow-up of a large, unselected cohort of patients with SCAD. METHODS: We conducted an observational study of consecutive SCAD patients from 26 centres across Italy and Spain. Cases were classified into five different angiotypes according to the latest classification endorsed by the European Society of Cardiology. The main composite endpoint included all-cause death, non-fatal myocardial infarction (MI), and any unplanned revascularisation. RESULTS: In total, 302 SCAD patients (mean age 51.8±19 years) were followed up for a median of 22 months (IQR 12-48). At 28 days, the composite outcome was higher for the angiotypes with a circumscribed contained intramural haematoma (2A and 3): 20.0% vs 5.4%, p<0.001 (non-fatal MI: 11.0% vs 3.5%, p=0.009; unplanned revascularisation: 11.0% vs 2.5%, p<0.001). This was sustained during follow-up (24.5% vs 9.9%, p=0.001). There were no differences in mortality (0.3% overall). The presence of an angiotype 2A or 3 was an independent predictor of a higher incidence of the composite outcome (adjusted HR 2.44, CI: 1.24-4.80, p=0.010). CONCLUSIONS: The SCAD angiographic classification correlates with outcome. Those presenting with an angiographically circumscribed contained intramural haematoma (angiotypes 2A and 3) showed an increased risk of short-term adverse clinical events that was maintained during follow-up.

Non-invasive assessment of endothelial function in patients with spontaneous coronary artery dissection: A case-control study.

BACKGROUND: The physiopathology underlying spontaneous coronary artery dissection remains largely unknown. Endothelial dysfunction is an early feature of many vascular disorders. We sought to determine the endothelial function assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT) in patients with SCAD and compare it to that of non-SCAD patients with similar cardiovascular risk profile. METHODS: This is a case-control study with the participation of 2 centers. Patients (cases) were diagnosed with SCAD between 2008 and 2018. Control subjects were individually matched 2:1 to SCAD cases from a cohort recruited for assessment with RH-PAT between 2006 and 2013. The primary measure variable was the mean difference in the log-transformed reactive hyperemia index (LnRH-PAT Index) between groups. RESULTS: LnRH-PAT data from 23 patients with SCAD and 46 matched controls were analyzed. No significant differences were noted in the matching variables (overall, 95.7% female with mean age 52.7 years). In the SCAD group, more patients reported migraine (61 vs. 21%) and more patients were on betablockers (70 vs 28%), ACE inhibitors (65 vs. 13%) and statins (70 vs. 28%), all differences statistically significant. The mean LnRH-PAT value was 0.55 ± 0.22 in patients with SCAD and 0.77 ± 0.23 in controls (mean difference: 0.22, p < 0.001). CONCLUSIONS: In this observational study, patients with SCAD had a poorer endothelial function than similar subjects without prior SCAD. This finding opens a new venue in the research of the physio pathologic mechanisms underlying SCAD.

Ultrastructure of the digestive tract in neotropical carnivorous catfish Hemisorubim platyrhynchos (Valenciennes, 1840) (Siluriformes, Pimelodidae).

The surface of the digestive tract of Hemisorubim platyrhynchos was analyzed by scanning electron microscopy. Morphometric studies by transmission electron microscopy were performed to analysis the intestinal microvilli. H. platyrhynchos is a Neotropical carnivorous freshwater catfish featuring a short digestive tract composed of a short esophagus, saccular stomach, and intestine with four regions: anterior, middle, posterior, and rectal. The esophageal surface is constituted by fingerprint-like microridges that anchor the mucosubstances secreted by goblet cells facilitating the passage of food. Goblet cells present the opening to the esophageal lumen, between the microridges. Club cells are in basal epithelium and they do not present the opening to the lumen. The gastric luminal surface shows polygon-shaped epithelial cells which secrete granules by exocytose to protect the gastric surface. The intestinal luminal surface reveals folds that are thicker in the anterior intestine than in the posterior intestine, increasing the absorptive surface area. The intestinal surface presents the microvilli of enterocytes and the opening of goblet cells. The morphometric analysis showed that the microvilli are longer in the anterior intestine, significantly decreasing towards the posterior intestine. The microvilli surface area significantly is greater in the anterior and middle intestine than in the posterior intestine. Numerous openings of goblet cells were observed in the posterior intestine acting in epithelial protection and lubrication. SCANNING 38:336-343, 2016. © 2015 Wiley Periodicals, Inc.

Acid and alkaline phosphatase localization in the digestive tract mucosa of the Hemisorubim platyrhynchos.

This cytochemical study investigated the acid and alkaline phosphatase of the digestive tract of Hemisorubim platyrhynchos. Acid phosphatase was detected in the lining epithelium throughout the digestive tract, whereas alkaline phosphatase was only observed in the intestine. In the esophagus, an acid phosphatase reaction occurred in the apical cytoplasm of the epithelial cells and was related to epithelial protection and freeing of superficial cells for sloughing. Similar results were also observed in epithelial cells of gastric epithelium. In the gastric glands, acid phosphatase occurred in lysosomes of the oxynticopeptic cells acting in the macromolecule degradation for use as an energy source, whereas in the vesiculotubular system, its presence could be related to secretion processes. Furthermore, acid phosphatase in the intestine occurred in microvilli and lysosomes of the enterocytes and was correlated to absorption and intracellular digestion. However, no difference was reported among the regions of the intestine. However, alkaline phosphatase reaction revealed a large number of reaction dots in the anterior intestine, with the number decreasing toward the posterior intestine. This enzyme has been related to several functions, highlighting its role in the nutrient absorption primarily in the anterior intestine but also being essential in pH regulation because this is a carnivorous species with many gastric glands with secretions that could damage the intestine.

Evaluation of adaptive/nonadaptive filtering and wavelet transform techniques for noise reduction in EMG mobile acquisition equipment.

The myoelectric signal can be used to control many rehabilitation systems, for instance, prostheses and artificial neuromuscular electrical stimulation toward restoring movement to spinal cord injured subjects. These mobile systems are usually used in different environments and thus are being exposed to different noise levels with characteristics not completely known. In this article, three main techniques for noise reduction were evaluated: wavelet transform (WT), adaptive digital filters, and nonadaptive digital filters. The WT was used to reconstruct the signal with the components without noise information. Adaptive filters were designed using least mean square (LMS) and recursive least square (RLS) algorithms. Finite-impulse response (FIR) and infinite-impulse response (IIR) nonadaptive filters were used for comparison to both the adaptive filters and the signal reconstruction through the WT.

Seroprevalencia del virus linfotrópico humano de células T tipo 1 (HTLV-1) en pacientes con tiroiditis autoinmune / Human T cell lymphotropic virus type 1 (HTLV-1) seroprevalence among out-patients with autoimmune thyroiditis

Objetivo: Describir la seroprevalencia de infección por HTLV-1 en pacientes con tiroiditis autoinmune. Material y Métodos: Estudio transversal realizado en pacientes con tiroiditis autoinmune que acudieron al consultorio de Endocrinología del Hospital Nacional Cayetano Heredia entre octubre del 2008 y enero del 2010. Se usó un cuestionario estructurado para obtener datos epidemiológicos y clínicos, paralelamente, se revisaron las historias clínicas para obtener datos de laboratorio. A los participantes se les tomó una muestra de sangre para el diagnóstico de HTLV-1 mediante prueba de ELISA y confirmación por Western Blot, previa firma de consentimiento informado. Resultados: Durante el período de estudio, se atendieron 285 pacientes con tiroiditis autoinmune. Se incluyeron 145 pacientes(50,9%); la edad media fue 48,1 ± 15 años y 135 (93,1%) fueron de sexo femenino. Tres pacientes tuvieron infección por HTLV-1, con una prevalencia estimada de 2,1% (IC 95%: 0-4,4%). Los seropositivos fueron de sexo femenino y tuvieron el diagnóstico de Enfermedad de Graves hipertiroidea. La frecuencia de infección por HTLV-1 en este grupo fue de 5% (3/60); IC 95%: 0-11%. No se encontró diferencia significativa entre los pacientes HTLV-1 positivos y negativos en cuanto a características demográficas, clínicas y de laboratorio. Conclusión: La prevalencia de infección por HTLV-1 en los pacientes con tiroiditis autoinmune fue similar a la prevalencia estimada para la población peruana en general.

Objective: To describe the seroprevalence of human T-cell lymphotropic virus type 1 (HTLV-1) infection among patients with autoimmune thyroiditis diagnosis. Material and Methods: Cross-sectional study including subjects with autoimmune thyroiditis at the outpatient Endocrinology unit of the Hospital Nacional Cayetano Heredia from October 2008 to January 2010. A structured questionnaire was used to get epidemiologic and clinic data; and hospital registries were reviewed to determine laboratory data. Participants were tested for HTLV-1 using Enzyme-Linked Immunosorbent Assay and Western blot confirmation. All participant provided informed consent. Results: During the study period, 285 subjects with autoimmune thyroiditis were attended at the Endocrinology Outpatient Service. We included 145 (50.9%); their mean age was 48,1±15 years and 135 (93.1%) were female. Three were HTLV-1 positive, with estimated prevalence of 2.1% (95% CI: 0-4.4%). All seropositive patients were women andhad Graveæs disease. The frequency of HTLV-1 infection in this group was 5% (3/60); 95% CI: 0-11%. Non significant differences for demographic, clinical and laboratory characteristics between the HTLV -1 seropositive and seronegative patients were founded. Conclusions: The seroprevalence of HTLV-1 infection among outpatients with autoimmune thyroiditis was similar to that estimated for the peruvian general population.

Compromiso hepático en fiebre tifoidea: Estudio bioquímico e histopatológico en pacientes anictéricos / Hepatic involvement typhoid fever: Biochemical and histopathological study in anicteric patients

El presente trabajo es un estudio prospectivo de 100 pacientes con diagnóstico de fiebre tifoidea mediante aislamiento de salmonella typhi. El procedimiento diagnóstico de mayor utilidad fue el mielocultivo, con un 90 por ciento de positividad. El compromiso hepático fue de presentación frecuente (85 por ciento), 67 pacientes fueron anictéricos y 18 pacientes cursaron con ictericia. Fueron sometidos a biopsia hepática 50 pacientes del grupo anictérico, de los cuales 50 por ciento mostraron hallazgos compatibles con hepatitis granulomatosa y el otro 50 por ciento, hepatitis reaccional. La respuesta al tratamiento antibiótico fue idéntica, en relación con los que no presentaron compromiso hepático.