Challenging diagnosis of Plasmodium ovale malaria in a Colombian traveler: the importance of including P. ovale wallikeri in molecular screening.

This study reports a challenging diagnosis of Plasmodium ovale malaria in a Colombian citizen returning from Cameroon. Initial microscopy screenings conducted at two private hospitals yielded conflicting results, with the first showing negative smears and the second diagnosing P. vivax. Subsequent microscopy examinations at two government laboratories identified P. ovale, although the routine species-specific PCR strategy was negative. PCR confirmation was finally obtained when P. ovale wallikeri primers were used. Although P. ovale is not frequently found in Colombia, there is a clear need to include both P. ovale curtisi and P. ovale wallikeri in the molecular diagnostic strategy. Such need stems primarily from their extended latency period, which affects travelers, the increasing number of African migrants, and the importance of accurately mapping the distribution of Plasmodium species in Colombia.

Differential gut microbiome in spondyloarthritis patients associated to Blastocystis colonization.

The role of Blastocystis in intestinal health is an open controversy, and little is known about the potential effect of this microorganism in autoinflammatory diseases such as spondyloarthritis (SpA). Here, we analyzed the gut microbiome of 36 SpA patients and 13 control individuals and demonstrated that the richness, diversity, and taxonomic composition between these two groups are different. We also showed that colonization by Blastocystis in control individuals increases the richness and diversity of the intestinal microbiome, whereas in SpA patients, it does not seem to have any impact. This may reflect a potential role of Blastocystis in sculpting the gut microbiome architecture in control individuals, whereas in subjects with SpA, the modulation of the microbiome may be governed by disease-dependent factors that cannot be overcome by Blastocystis. Regarding taxonomic characterization, SpA patients colonized by Blastocystis showed significant increases in the phylum Pseudomonadota, class Gammaproteobacteria, family Succinivibrionaceae, and genus Succinivibrio. Simultaneously, there were significant increases in the class Bacilli, order Lactobacillales, families Lactobacillaceae and Clostridiaceae, and genera Lactobacillus and Clostridium in non-colonized SpA patients. On the other hand, PICRUSt analysis in Blastocystis-positive SpA patients showed elevations in pathways that may enhance antioxidant capacities and alleviate intestinal inflammation, while Blastocystis-negative SpA patients showed significant changes in pathways that promote cell division/proliferation and can lead to larger changes in the gut microbiome. Our analyses lead us to believe that these changes in the gut microbiome of SpA patients may trigger protective mechanisms as an initial response to inflammation in an attempt to restore balance in the intestinal environment.

Prevalence of Chikungunya, Dengue and Zika viruses in blood donors: a systematic literature review and meta-analysis.

BACKGROUND: Blood transfusion centres should understand the epidemiology of emerging diseases that are transmissible through the transfusion of blood components. The risk of transmission of arboviruses through this route has become apparent in recent years. The aim of our study is to summarise the reported prevalence (viraemic rate, seroprevalence and/or antigen detection) of Chikungunya (CHIKV), Dengue (DENV) and Zika (ZIKV) viruses in blood donors according to screening test used and world region. MATERIALS AND METHODS: We conducted a systematic literature review and meta-analysis having searched for information in the main bibliographic databases (MEDLINE, Embase, and Scopus). The prevalence for each of the viruses was calculated according to the screening test used and geographic location. RESULTS: We included 18 records on CHIKV, 71 on DENV, and 27 on ZIKV. The highest prevalences of RNA for CHIKV were 1.9% in Puerto Rico (2014), 1.0% in Thailand (2009), and 1.0% in French Polynesia (2014-15). The highest prevalences of RNA for DENV were 5.5% in Saudi Arabia (2015-16), 2.3% in Madeira, Portugal (2012-13), and 0.6% in Brazil (2012). The highest prevalences of RNA for ZIKV were 2.8% in French Polynesia (2013-14), 2.7% in Brazil (2015-16), and 1.8% in Martinique (2016). Overall seroprevalence, as assessed by IgG antibodies, was 21.6% for CHIKV, 24.0% for DENV, and 5.1% for ZIKV. DISCUSSION: Our study shows a high proportion of donors who are viraemic and asymptomatic, especially during outbreaks, with prevalences surpassing 5% for DENV, 1% for CHIKV, and 2% for ZIKV. These data confirm a clear threat to blood transfusion safety. The elevated seroprevalence for these three arboviruses is also indicative of their wide circulation in populations, correlating with an increased risk of infected but asymptomatic donors. Health centres and institutions must address this threat, especially in tropical regions where the biggest outbreaks occur.

Transfusion-transmitted arboviruses: Update and systematic review.

BACKGROUND: The detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics. MATERIAL AND METHODS: Systematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355. RESULTS: A total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety. DISCUSSION: In the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety.

Case Report: Three Case Reports of Rapidly Progressive Dementias and Narrative Review.

Rapidly progressive dementia (RPD) is a heterogeneous group of diseases characterized by cognitive impairment and other neurological disorders developed in a short span of fewer than 2 years. Currently viewed as new and infrequent entities, most medical personnel have little understanding of it. Nevertheless, they significantly compromise many patients' quality of life. Here, we drive 3 clinical cases that evolve as RPD with different etiologies. Case 1: 70-year-old woman presented to the emergency with neuropsychiatric syndrome for 18 days. The researchers identified inflammatory cerebrospinal fluid (CSF), protein 14-3-3-positive T-tau protein, MRI: T2 and FLAIR hyperintensities in bilateral caudate nuclei with diffusion restriction, EEG shows a generalized periodic pattern with triphasic wave morphology. Case 2: 29-year-old man with cognitive impairment and faciobrachial dystonia seizure. The diagnosis was confirmed by achieving elevated antibodies against voltage-gated potassium channels. Case 3: A 49-year-old woman with encephalopathy and myoclonic seizures; EEG and MRI showed subtle changes. The patient also had a normal CSF but a positive CBA serologic NMDA-R antibody test. We described fundamental aspects of RPD to allow made differential diagnoses in patients with cognitive impairment and encephalopathy. Establishing an early and accurate diagnosis can benefit patients with RPD etiologies that are treatable and even reversible, decreasing in morbidity and mortality.

Neuropsychiatric Alterations in a Patient Diagnosed with Advanced Korsakoff's Syndrome: Clinical Case of Low Incidence and Prevalence in Colombia.

Korsakoff's syndrome (KS) is an insidious and progressive neuropsychiatric disorder that affects specific neurocognitive functioning, especially in tasks that require sustained attention, memory, executive functions, and visuospatial functioning. Usually, this disease generates neuropsychiatric complications that worsen the quality of life (QOL) of patients in the medium term. We present a case of a 63-year-old male who presented with a diagnosis of advanced Korsakoff's syndrome and has a clinical history of recurrent memory loss and a history of alcohol abuse. The patient showed difficulty manipulating immediate information, associated with a possible frontal lobe dysfunction, and inability to remember material given through the auditory pathway. The patient showed a psychiatric clinical picture which is constantly worsening his and his immediate caregiver's QOL. The data obtained demonstrate that the patient presents a progressive cognitive impairment, which in the short term is correlated with Korsakoff-type dementia. It is suggested to carry out functional neurorehabilitation plans aimed at improving the QOL of the patient, his immediate caregiver, and future people with this type of diagnosis.

SUMOylation of HMGA2: selective destabilization of promyelocytic leukemia protein via proteasome.

The HMGA2 architectural protein functions in a variety of cellular processes, such as cell growth, transcription regulation, neoplastic transformation, and progression. Up-regulation of HMGA2 protein is observed in many tumors and is associated with advanced cancers with poor prognoses. Although the expression and biochemical properties of HMGA2 protein are regulated by microRNA and phosphorylation, it is unknown whether HMGA2 activity can also be regulated by SUMOylation, and that is what is investigated in this report. We identified HMGA2 as a SUMOylation target and showed that the expression of wild-type HMGA2, but not SUMOylation-defective HMGA2(2K/R), selectively lowered the steady-state level of PML protein. Consequently, the HMGA2-elicited PML down-regulation rendered a reduction in the average number of PML nuclear bodies per cell and the volume of PML assembled per PML nuclear body. Using small interfering RNA to suppress endogenous ubiquitin expression and proteasome inhibitor to repress ubiquitin-mediated protein degradation, we showed that HMGA2 confers PML down-regulation through ubiquitin-proteasome-dependent protein degradation. Importantly, arsenic trioxide treatment stimulated HMGA2 SUMOylation, leading to the formation of HMGA2 nuclear foci surrounding PML nuclear bodies and the stimulation of PML degradation. Collectively, our results unveil a previously unrecognized effect by HMGA2 on the modulation of PML protein level, providing a novel mechanism underlying HMGA2 function and underscoring the molecular basis for oncogenic progression by HMGA2.

Challenging diagnosis of Plasmodium ovale malaria in a Colombian traveler: the importance of including P. ovale wallikeri in molecular screening

ABSTRACT This study reports a challenging diagnosis of Plasmodium ovale malaria in a Colombian citizen returning from Cameroon. Initial microscopy screenings conducted at two private hospitals yielded conflicting results, with the first showing negative smears and the second diagnosing P. vivax. Subsequent microscopy examinations at two government laboratories identified P. ovale, although the routine species-specific PCR strategy was negative. PCR confirmation was finally obtained when P. ovale wallikeri primers were used. Although P. ovale is not frequently found in Colombia, there is a clear need to include both P. ovale curtisi and P. ovale wallikeri in the molecular diagnostic strategy. Such need stems primarily from their extended latency period, which affects travelers, the increasing number of African migrants, and the importance of accurately mapping the distribution of Plasmodium species in Colombia.

Effects of KGF on alveolar epithelial cell transdifferentiation are mediated by JNK signaling.

Rat alveolar epithelial cells (AEC) in primary culture transdifferentiate from a type II (AT2) toward a type I (AT1) cell-like phenotype, a process that can be both prevented and reversed by keratinocyte growth factor (KGF). Microarray analysis revealed that these effects of KGF are associated with up-regulation of key molecules in the mitogen-activated protein kinase (MAPK) pathway. To further explore the role of three key MAPK (i.e., extracellular signal-related kinase [ERK] 1/2, c-Jun N-terminal kinase [JNK] and p38) in mediating effects of KGF on AEC phenotype, primary rat AEC cultivated in minimal defined serum-free medium (MDSF) were treated with KGF (10 ng/ml) from Day 4 for intervals up to 48 hours. Exposure to KGF activated all three MAPK, JNK, ERK1/2, and p38. Inhibition of JNK, but not of ERK1/2 or p38, abrogated the ability of KGF to maintain the AT2 cell phenotype, as evidenced by loss of expression of lamellar membrane protein (p180) and increased reactivity with the AT1 cell-specific monoclonal antibody VIIIB2 by Day 6 in culture. Overexpression of JNKK2, upstream kinase of JNK, increased activation of endogenous c-Jun in association with increased expression of p180 and abrogation of AQP5, suggesting that activation of c-Jun promotes retention of the AT2 cell phenotype. These results indicate that retention of the AT2 cell phenotype by KGF involves c-Jun and suggest that activation of c-Jun kinase may be an important determinant of maintenance of AT2 cell phenotype.

Resultados obstétricos y perinatales en pacientes con o sin analgesia obstétrica durante el trabajo de parto / Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor / Resultados obstétrico e perinatal em pacientes com ou sem analgesia obstétrica durante o trabalho de parto

Objetivo: describir y comparar los resultados obstétricos y perinatales en las pacientes que recibieron analgesia obstétrica durante el trabajo de parto con los de quienes no la recibieron y determinar si dicha analgesia se asocia a resultados maternos o perinatales adversos. Metodología: estudio descriptivo, comparativo, retrospectivo de 502 pacientes sanas y con embarazo normal de las cuales 250 recibieron analgesia, atendidas entre enero y noviembre del 2014. Los grupos se compararon en cuanto a resultados maternos y perinatales. Resultados: predominaron las madres jóvenes, solteras y nulíparas; el parto fue vaginal en 86 % de los casos y por cesárea en 14 %. La analgesia obstétrica se asoció a mayor duración del segundo período del parto, parto instrumentado y cesárea por detención de la dilatación y por bradicardia fetal; sin embargo, no se relacionó con mayor incidencia de hemorragia posparto ni con resultados perinatales adversos como líquido amniótico teñido de meconio, Apgar menor de 5 al minuto o de 7 a los 5 minutos, necesidad de reanimación neonatal o de admisión a la UCI neonatal. Conclusión: la analgesia obstétrica aumenta la duración del expulsivo y puede elevar la tasa de cesáreas y de parto instrumentado; sin embargo, no se asocia a resultados maternos o perinatales adversos, por lo que su uso está justificado en el trabajo de parto.

Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal orperinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes.Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

Objetivo: descrever e comparar os resultados obstétricos e perinatais nas pacientes que receberam analgesia obstétrica durante o trabalho de parto com as de quem não a receberam e determinar se dita analgesia se associa aos resultados maternos ou perinatais adversos. Metodologia: estudo descritivo, comparativo, retrospectivo de 502 pacientes sanas e com gravidez normal das quais 250 receberam analgesia, atendidas entre janeiro e novembro de 2014. Os grupos se compararam em quanto a resultados maternos e perinatais. Resultados: predominaram as mães jovens, solteiras e nulíparas; o parto foi vaginal em 86 % dos casos e por cesárea em 14 %. A analgesia obstétrica se associou a maior duração do segundo período do parto, parto instrumentado e cesárea por detenção da dilatação e por bradicardia fetal; embora, não se relacionou com maior incidência de hemorragia pós-parto nem com resultados perinatais adversos como líquido amniótico tingimento de mecônio, Apgar menor de 5 ao minuto ou de 7 aos 5 minutos, necessidade de reanimação neonatal ou de admissão à UTI neonatal. Conclusão: a analgesia obstétrica aumenta a duração do expulsivo e pode elevar a taxa de cesáreas e de parto instrumentado; embora, não se associa a resultados maternos ou perinatais adversos, porque seu uso está justificado no trabalho de parto.

Características clínicas y presencia deprolactinoma en mujeres con hiperprolactinemia / Clinical characteristics and presence of prolactinoma in women with hyperprolactinemia / Características clínicas e presencia de prolactinoma em mulheres com hiperprolactinemia

Objetivos: caracterizar clínicamente a las pacientes que consultaron en InSer Pereira con diagnóstico de hiperprolactinemia, y determinar la prevalencia de prolactinomas. Metodología: descripción retrospectiva de 45 pacientes con diagnóstico de hiperprolactinemia y estudio por resonancia magnética (RM) contrastada de la silla turca entre enero del 2008 y julio del 2013. Se evaluaron las manifestaciones clínicas, la etiología, el nivel sérico de prolactina y los hallazgos imaginológicos. Resultados: las manifestaciones clínicas más frecuentes fueron: infertilidad, galactorrea y oligomenorrea. Hubo 26 casos de prolactinoma (57,8 %) y 12 de hiperprolactinemia idiopática (26,6 %). De los prolactinomas, 23 fueron microadenomas (tamaño promedio: 5,1 mm; DE ± 3,2 mm). El nivel sérico promedio de prolactina fue de 74,05 ng/mL (DE ± 13,33 ng/ mL). El 78 % de las pacientes con prolactinoma tenían la prolactina sérica por debajo de 70,0 ng/mL. No hubo asociación significativa entre el nivel sérico de prolactina y la presencia de prolactinoma. Conclusión: los prolactinomas son la principal causa de hiperprolactinemia y se encuentran en su mayor parte con elevaciones ligeras de la prolactina sérica. Se recomienda hacer RM contrastada de la silla turca en pacientes con hiperprolactinemia, independientemente del nivel de prolactina.

Objectives: To clinically characterize women with hyperprolactinemia at InSer Pereira (Colombia) and to determine the prevalence of prolactinoma. Methods: Retrospective description of 45 patients with hyperprolactinemia, and contrasted pituitary magnetic resonance (MR), between January 2008 and July 2013. Clinical manifestations, etiology, serum prolactin level, and MR findings were included. Results: The most frequent clinical manifestations were: infertility, galactorrhea, oligomenorrhea. There were 26 cases of prolactinoma (57.8 %), and 12 of idiopathic hyperprolactinemia (26.6 %). Out of the 26 prolactinomas, 23 were microadenomas (average size 5.1 mm; SD ± 3.2 mm). Average serum prolactin level was 74.05 ng/mL (SD ± 13.33 ng/mL). 78 % of patients with prolactinoma had serum prolactin level under 70.0 ng/mL. No significant association was found between serum prolactin level and the presence of prolactinoma. Conclusion: Prolactinomas are the main cause of hyperprolactinemia and they are found mostly with slight rise of serum prolactin. Pituitary MRI is recommended in patients with hyperprolactinemia, regardless of their prolactin level.

Objetivos: caracterizar clinicamente às pacientes que consultaram em InSer Pereira com diagnóstico de hiperprolactinemia, e determinar a prevalência de prolactinomas. Metodologia: descrição retrospectiva de 45 pacientes com diagnóstico de hiperprolactinemia e estudo por ressonância magnética (RM) contrastada da sela túrcica entre janeiro de 2008 e julho de 2013. Se avaliaram as manifestações clínicas, a etiologia, o nível sérico de prolactina e as descobertas imagiológicos. Resultados: as manifestações clínicas mais frequentes foram: infertilidade, galactorreia e oligomenorreia. Houve 26 casos de prolactinoma (57,8 %) e 12 de hiperprolactinemia idiopática (26,6 %). Dos prolactinomas, 23 foram microadenomas (tamanho médio: 5,1 mm; DE ± 3,2 mm). O nível sérico médio de prolactina foi de 74,05 ng/mL (DE ± 13,33 ng/mL). 78 % das pacientes com prolactinoma tinham a prolactina sérica por debaixo de 70,0 ng/mL. Não houve associação significativa entre o nível sérico de prolactina e a presencia de prolactinoma. Conclusão: os prolactinomas são a principal causa de hiperprolactinemia e se encontram na sua maior parte com elevações ligeiras da prolactina sérica. Se recomenda fazer RM contrastada da sela túrcica em pacientes com hiperprolactinemia, independentemente do nível de prolactina.

Model-based optimal immunization for antibody production in birds.

A dynamic model of the immune response in poultry was developed in order to enhance antibody production. Efficient production of antibodies is very valuable for researchers and physicians since they are used for other molecules detection. Large amounts of poultry-based antibodies are found in birds' eggs. However, inoculation timetables are based on empirical data. A seven differential equation system represents cellular and molecular populations of the humoral immune response in poultry. Model parameters are presented and simulation results reflect the typical immune responses. Finally, a genetic algorithm was designed in order to optimize antibody production.

Protein kinase Cdelta-dependent and -independent signaling in genotoxic response to treatment of desferroxamine, a hypoxia-mimetic agent.

Protein kinase C (PKC) plays a critical role in diseases such as cancer, stroke, and cardiac ischemia and participates in a variety of signal transduction pathways including apoptosis, cell proliferation, and tumor suppression. Here, we demonstrate that PKCdelta is proteolytically cleaved and translocated to the nucleus in a time-dependent manner on treatment of desferroxamine (DFO), a hypoxia-mimetic agent. Specific knockdown of the endogenous PKCdelta by RNAi (sh-PKCdelta) or expression of the kinase-dead (Lys376Arg) mutant of PKCdelta (PKCdeltaKD) conferred modulation on the cellular adaptive responses to DFO treatment. Notably, the time-dependent accumulation of DFO-induced phosphorylation of Ser-139-H2AX (gamma-H2AX), a hallmark for DNA damage, was altered by sh-PKCdelta, and sh-PKCdelta completely abrogated the activation of caspase-3 in DFO-treated cells. Expression of Lys376Arg-mutated PKCdelta-enhanced green fluorescent protein (EGFP) appears to abrogate DFO/hypoxia-induced activation of endogenous PKCdelta and caspase-3, suggesting that PKCdeltaKD-EGFP serves a dominant-negative function. Additionally, DFO treatment also led to the activation of Chk1, p53, and Akt, where DFO-induced activation of p53, Chk1, and Akt occurred in both PKCdelta-dependent and -independent manners. In summary, these findings suggest that the activation of a PKCdelta-mediated signaling network is one of the critical contributing factors involved in fine-tuning of the DNA damage response to DFO treatment.

Prevalencia de anomalías müllerianasen un centro de medicina reproductiva / Mullerian anomalies prevalence in a reproductive medicine center

Objetivos: determinar la prevalencia y las características clínicas de las pacientes conanomalías müllerianas que consultan a un centro de reproducción asistida en la región del eje cafetero (Pereira) en Colombia.Métodos: se realizó un estudio descriptivo - transversal en pacientes con diagnóstico de anomalíamülleriana, en el centro de reproducción asistida del eje cafetero, In Ser Pereira, entre el 1 de enerode 2005 y el 30 de abril del 2008.Resultados: de un total de 731 pacientes que asistieron a consulta especializada, 62 pacientescumplieron los criterios de inclusión, hallándose una prevalencia de 8,4 %. Las anomalías másfrecuentes fueron en su orden: útero septado, útero arcuato y útero didelfo. El método de diagnósticoinicial fue la ultrasonografía transvaginal y la confirmación y tratamiento se realizaron mediantehisteroscopia-laparoscopia simultáneas.Conclusiones: las anomalías müllerianas son entidadesfrecuentes con repercusiones importantes reproductivas yobstétricas, las cuales deben ser buscadas sistemáticamenteen todos los casos de infertilidad, pérdida gestacionalrecurrente, partos pretérminos y presentaciones fetalesanormales. La ultrasonografía transvaginal presentauna alta especificidad para el diagnóstico inicial.

Objectives: To determine the prevalenceand clinical characteristics of patients with Mülleriananomalies consulting a fertility clinic inthe coffee-region (Pereira) in Colombia.Methods: We performed a cross-sectional studyin patients with a diagnosis of Müllerian anomalyin the center of assisted reproductionIn Ser Pereira in the coffe-region, between January1, 2005 and April 30, 2008. We used chi-squaretest.Results: Of a total of 731 patients attendingspecialized outpatient medical centerIn Ser-Pereira, in the coffee-region, 62 patientsmet inclusion criteria, we found a prevalence of8.4 %. The most frequent anomalies were in order:septate uterus, arcuate uterus and uterusdidelphys. The method of initial diagnosis wastransvaginal ultrasonography and confirmationand treatment was perfomed with simultaneoushysteroscopy-laparoscopy.Conclusions: Müllerian anomalies are a commoncondition with important implicationsfor reproductive and obstetricians should besought systematically in all cases of infertility, recurrentpregnancy loss, preterm birth and abnormalfetal presentations. Transvaginal ultrasonographyhas a high specificity for the initialdiagnosis.

Etk/Bmx mediates expression of stress-induced adaptive genes VEGF, PAI-1, and iNOS via multiple signaling cascades in different cell systems.

We recently showed that Etk/Bmx, a member of the Tec family of nonreceptor protein tyrosine kinases, promotes tight junction formation during chronic hypoxic exposure and augments normoxic VEGF expression via a feedforward mechanism. Here we further characterized Etk's role in potentiating hypoxia-induced gene expression in salivary epithelial Pa-4 cells. Using transient transfection in conditionally activated Etk (DeltaEtk:ER) cells, we demonstrated that Etk enhances hypoxia-response element-dependent reporter activation in normoxia and hypoxia. This Etk-driven reporter activation is ameliorated by treatment with wortmannin or LFM-A13. Using lentivirus-mediated gene delivery and small interfering RNA, we provided direct evidence that hypoxia leads to transient Etk and Akt activation and hypoxia-mediated Akt activation is Etk dependent. Northern blot analyses confirmed that Etk activation led to induction of steady-state mRNA levels of endogenous VEGF and plasminogen activator inhibitor (PAI)-1, a hallmark of hypoxia-mediated gene regulation. We also demonstrated that Etk utilizes a phosphatidylinositol 3-kinase/Akt pathway to promote reporter activation driven by NF-kappaB, another oxygen-sensitive transcription factor, and to augment cytokine-induced inducible nitric oxide synthase expression in endothelial cells. To establish the clinical relevance of Etk-induced, hypoxia-mediated gene regulation, we examined Etk expression in keloid, which has elevated VEGF and PAI-1. We found that Etk is overexpressed in keloid (but not normal skin) tissues. The differential steady-state Etk protein levels were further confirmed in primary fibroblast cultures derived from these tissues, suggesting an Etk role in tissue fibrosis. Our results provide further understanding of Etk function within multiple signaling cascades to govern adaptive cytoprotection against extracellular stress in different cell systems, salivary epithelial cells, brain endothelial cells, and dermal fibroblasts.

Identification of novel membrane structures in Plasmodium falciparum infected erythrocytes

Little is known about the molecular mechanisms underlying the release of merozoites from malaria infected erythrocytes. In this study membranous structures present in the culture medium at the time of merozoite release have been characterized. Biochemical and ultrastructural evidence indicate that membranous structures consist of the infected erythrocytes membrane, the parasitophorous vacuolar membrane and the residual body containing electron dense material. These are subcellular compartments expected in a structure that arises as a consequence of merozoite release from the infected cell. Ultrastrutural studies show that a novel structure extends from the former parasite compartment to the membrane. Since these membrane modifications are detected only after merozoites have been released from the infected erythrocyte, it is proposed that they might play a role in the release of merozoites from the host cell.