Beyond Wax Printing: Fabrication of Paper-Based Microfluidic Devices Using a Thermal Transfer Printer.

Paper-based microfluidic devices, also known as microPADs, are an emerging analytical platform with the potential to improve point-of-care diagnostics. MicroPADs are fabricated by patterning hydrophobic inks onto sheets of paper to create hydrophilic channels and test zones. One of the main advantages of microPADs is that they are inexpensive and simple to fabricate, making them accessible even to researchers with limited budgets or no prior fabrication expertise. Wax printing, where a solid ink printer is used to pattern wax on paper, has been the most convenient and popular method for fabricating paper-based microfluidic devices. Unfortunately, solid ink printers were discontinued in 2016 and are no longer available commercially. Here we introduce a method for fabricating microPADs using a portable thermal transfer printer that retains the convenience of wax printing. Devices fabricated by thermal transfer printing were comparable to devices fabricated via wax printing and laser printing. The low cost, convenience, and portability of the thermal transfer printer make this approach an exciting prospect for replacing wax printing and facilitating the continued development of paper-based microfluidics.

Ovarian strumal carcinoid producing peptide YY associated with severe constipation: a case report and review of the literature.

Primary carcinoid tumors are rare neoplasms of the ovary. Of the 4 histologic subtypes, ovarian carcinoid tumors with insular patterns produce carcinoid syndrome in approximately one third of cases, versus strumal and trabecular carcinoids which very rarely cause typical carcinoid syndrome. A unique presentation of ovarian carcinoid tumors with concurrent severe constipation has been reported, which is thought to represent a new carcinoid syndrome. The proposed mechanism is the production of peptide YY by the tumor, a gastrointestinal hormone responsible for decreasing gut motility. We report a case of a 34-yr-old white woman who presented with constipation and weight loss for 1 yr, and was found to have a unilateral ovarian strumal carcinoid, which produced peptide YY as demonstrated by immunohistochemistry. The 13 previous case reports of ovarian carcinoids with constipation are reviewed and the clinicopathologic features are discussed. This report and literature review further solidifies this entity as a new type of carcinoid syndrome.

Development of Solid-State Storage for Cell-Free Expression Systems.

The fragility of biological systems during storage, transport, and utilization necessitates reliable cold-chain infrastructure and limits the potential of biotechnological applications. In order to unlock the broad applications of existing and emerging biological technologies, we report the development of a novel solid-state storage platform for complex biologics. The resulting solid-state biologics (SSB) platform meets four key requirements: facile rehydration of solid materials, activation of biochemical activity, ability to support complex downstream applications and functionalities, and compatibility for deployment in a variety of reaction formats and environments. As a model system of biochemical complexity, we utilized crudeEscherichia colicell extracts that retain active cellular metabolism and support robust levels of in vitro transcription and translation. We demonstrate broad versatility and utility of SSB through proof-of-concepts for on-demand in vitro biomanufacturing of proteins at a milliliter scale, the activation of downstream CRISPR activity, as well as deployment on paper-based devices. SSBs unlock a breadth of applications in biomanufacturing, discovery, diagnostics, and education in resource-limited environments on Earth and in space.

Using 1H low-field NMR relaxometry to detect the amounts of Robusta and Arabica varieties in coffee blends.

Low-field nuclear magnetic resonance (LF-NMR) is a method of widespread use in food research due to its non-destructive character and the relatively low cost of the instruments, allowing the determination of oil / fat contents and the achievement of images of different types of food materials, among other uses. In this work, 1H LF-NMR relaxometry was used to distinguish the contributions due to Arabica and Robusta coffee varieties present in coffee blends. As the method detects preferentially the NMR signals due to phases with high molecular mobility, which exhibit longer values of the 1H transverse relaxation time (T2), the difference in the oil contents associated with Arabica and Robusta coffee was the key factor responsible for the detection of the contributions due to each variety. The analysis presented in this work showed that the relative hydrogen index is a useful parameter to be used in quantitative analyses of the contents of each coffee variety present in the blends. The results illustrate the high potential of applicability of LF-NMR relaxometry as a screening tool for quality control and adulteration detection of coffee-related products.

Selecting the lowest instrumented vertebra in a multilevel posterior cervical fusion across the cervicothoracic junction: a biomechanical investigation.

OBJECTIVE: Posterior cervical fusion is a common surgical treatment for patients with myeloradiculopathy or regional deformity. Several studies have found increased stresses at the cervicothoracic junction (CTJ) and significantly higher revision surgery rates in multilevel cervical constructs that terminate at C7. The purpose of this study was to investigate the biomechanical effects of selecting C7 versus T1 versus T2 as the lowest instrumented vertebra (LIV) in multisegmental posterior cervicothoracic fusion procedures. METHODS: Seven fresh-frozen cadaveric cervicothoracic spines (C2-L1) with ribs intact were tested. After analysis of the intact specimens, posterior rods and lateral mass screws were sequentially added to create the following constructs: C3-7 fixation, C3-T1 fixation, and C3-T2 fixation. In vitro flexibility tests were performed to determine the range of motion (ROM) of each group in flexion-extension (FE), lateral bending (LB), and axial rotation (AR), and to measure intradiscal pressure of the distal adjacent level (DAL). RESULTS: In FE, selecting C7 as the LIV instead of crossing the CTJ resulted in the greatest increase in ROM (2.54°) and pressure (29.57 pound-force per square inch [psi]) at the DAL in the construct relative to the intact specimen. In LB, selecting T1 as the LIV resulted in the greatest increase in motion (0.78°) and the lowest increase in pressure (3.51 psi) at the DAL relative to intact spines. In AR, selecting T2 as the LIV resulted in the greatest increase in motion (0.20°) at the DAL, while selecting T1 as the LIV resulted in the greatest increase in pressure (8.28 psi) in constructs relative to intact specimens. Although these trends did not reach statistical significance, the observed differences were most apparent in FE, where crossing the CTJ resulted in less motion and lower intradiscal pressures at the DAL. CONCLUSIONS: The present biomechanical cadaveric study demonstrated that a cervical posterior fixation construct with its LIV crossing the CTJ produces less stress in its distal adjacent discs compared with constructs with C7 as the LIV. Future clinical testing is necessary to determine the impact of this finding on patient outcomes.

Implementation of telecytology for immediate assessment of endoscopic ultrasound-guided fine-needle aspirations compared to conventional on-site evaluation: analysis of 240 consecutive cases.

OBJECTIVE: To evaluate the implementation of telecytology in an academic cytology service for immediate assessment of endoscopic ultrasound (EUS) and endobronchoscopic ultrasound (EBUS) fine-needle aspiration (FNA). STUDY DESIGN: Telecytology was evaluated over a 10-month period. Using an Olympus BX41(®) microscope and an Olympus DP72(®) camera with Olympus cellSens(®) software, real-time dynamic images of air-dried Diff-Quik(®)-stained smears were transmitted by a cytopathology fellow or cytotechnologist using a secure internet connection. The cytopathologists remotely accessed the real-time images on a computer in their office and rendered immediate assessments. Mean procedure times, and preliminary and final diagnoses were compared between telecytology and conventional on-site evaluation. RESULTS: Two hundred and forty consecutive EUS-FNA and EBUS-FNA procedures with immediate assessments were performed during the evaluation period, of which 158 (66%) utilized telecytology and 82 (34%) did not utilize telecytology. The mean procedure time required for cytotechnologists and cytology fellows was 1.1 h for both conventional on-site and telecytology evaluations. The mean procedure time for cytopathologists was 0.74 h for conventional on-site evaluations and 0.2 h for telecytology. CONCLUSIONS: Incorporation of telecytology for immediate assessment of EUS-FNA increased cytopathologist efficiency.

[Chronic health problems in schools]. / Problemas crónicos de salud en el ambito escolar percepción de los profesores.

The presence of children with chronic diseases to school can be a concern for teachers, pupils and parents. Was conducted this study using auto reply survey in the Autonomous Community of Madrid (CAM). The questionnaire was sent to 1161 teachers. Seventy three recognize have a student with chronic diseases in their classrooms and 56% believe their presence will generate some degree of doubt or insecurity about the possibility of occurrence of acute complications. The main reason for it was the absence of explicit instructions on handling certain situations. They find some conditions can induce school absenteeism, difficulties for physical activity and excursions attendance. They agree that school is a good place for health education and expressed readiness to learn to improve their knowledge and skills in this regard.

ChatGPT: oportunidades y riesgos en la asistencia, docencia e investigación médica / ChatGPT: opportunities and risks in the fields of medical care, teaching, and research

Resumen ChatGPT es un asistente virtual con inteligencia artificial que utiliza lenguaje natural para comunicarse, es decir, mantiene conversaciones como las que se tendrían con otro humano. Puede aplicarse en educación a todos los niveles, que incluye la educación médica, tanto para la formación, la investigación, la escritura de artículos científicos, la atención clínica y la medicina personalizada. Puede modificar la interacción entre médicos y pacientes para mejorar los estándares de calidad de la atención médica y la seguridad, por ejemplo, al sugerir medidas preventivas en un paciente que en ocasiones no son consideradas por el médico por múltiples causas. Los usos potenciales del ChatGPT en la educación médica, como una herramienta de ayuda en la redacción de artículos científicos, un asistente en la atención para pacientes y médicos para una práctica más personalizada, son algunas de las aplicaciones que se analizan en este artículo. Los aspectos éticos, originalidad, contenido inapropiado o incorrecto, citas incorrectas, ciberseguridad, alucinaciones y plagio son ejemplos de las situaciones a tomar en cuenta al usar las herramientas basadas en inteligencia artificial en medicina.

Abstract ChatGPT is a virtual assistant with artificial intelligence (AI) that uses natural language to communicate, i.e., it holds conversations as those that would take place with another human being. It can be applied at all educational levels, including medical education, where it can impact medical training, research, the writing of scientific articles, clinical care, and personalized medicine. It can modify interactions between physicians and patients and thus improve the standards of healthcare quality and safety, for example, by suggesting preventive measures in a patient that sometimes are not considered by the physician for multiple reasons. ChatGPT potential uses in medical education, as a tool to support the writing of scientific articles, as a medical care assistant for patients and doctors for a more personalized medical approach, are some of the applications discussed in this article. Ethical aspects, originality, inappropriate or incorrect content, incorrect citations, cybersecurity, hallucinations, and plagiarism are some examples of situations to be considered when using AI-based tools in medicine.

Universal screening for Lynch syndrome in endometrial cancers: frequency of germline mutations and identification of patients with Lynch-like syndrome.

Lynch syndrome (LS) is an inherited clinical syndrome characterized by a high risk of colorectal, endometrial (lifetime risk of up to 60%), ovarian, and urinary tract cancers. The diagnosis is confirmed by identification of germline mutations in the DNA mismatch repair genes MLH1, PMS2, MSH2, MSH6, or EPCAM. In 2015, our institution implemented universal screening of endometrial cancer (EC) hysterectomy specimens by mismatch repair immunohistochemistry (IHC) with reflex MLH1 promoter hypermethylation analysis for tumors with loss of MLH1/PMS2 expression. Patients with tumors negative for MLH1 methylation and those with a loss of the heterodimer pair MSH2 and MSH6, or isolated loss of either PMS2 or MSH6 were referred to the Familial Cancer Program for genetic counseling and consideration of germline testing. Between May 2015 to Dec 2016, 233 EC patients were screened by IHC for LS with a median age of 63 years. Sixty tumors (27%) had abnormal IHC staining results. Fifty-one (22%) harbored heterodimeric loss of MLH1 and PMS2, 49 of which showed MLH1 promoter methylation (1 failure, 1 negative). One showed loss of MLH1/PMS2 and MSH6, 2 showed loss of MSH2/MSH6, and 6 had isolated loss of MSH6 only. Ten patients underwent genetic counseling, and germline testing was performed in 8; LS was confirmed in 5 patients (2.1%). In addition, 3 patients with negative germline testing and presumed Lynch-like syndrome were identified and offered additional somatic testing. Universal screening for LS in EC patients has yielded positive results for identification of patients at risk for this inherited syndrome.

Ovarian cancer progression is controlled by phenotypic changes in dendritic cells.

We characterized the initiation and evolution of the immune response against a new inducible p53-dependent model of aggressive ovarian carcinoma that recapitulates the leukocyte infiltrates and cytokine milieu of advanced human tumors. Unlike other models that initiate tumors before the development of a mature immune system, we detect measurable anti-tumor immunity from very early stages, which is driven by infiltrating dendritic cells (DCs) and prevents steady tumor growth for prolonged periods. Coinciding with a phenotypic switch in expanding DC infiltrates, tumors aggressively progress to terminal disease in a comparatively short time. Notably, tumor cells remain immunogenic at advanced stages, but anti-tumor T cells become less responsive, whereas their enduring activity is abrogated by different microenvironmental immunosuppressive DCs. Correspondingly, depleting DCs early in the disease course accelerates tumor expansion, but DC depletion at advanced stages significantly delays aggressive malignant progression. Our results indicate that phenotypically divergent DCs drive both immunosurveillance and accelerated malignant growth. We provide experimental support for the cancer immunoediting hypothesis, but we also show that aggressive cancer progression after a comparatively long latency period is primarily driven by the mobilization of immunosuppressive microenvironmental leukocytes, rather than loss of tumor immunogenicity.

Immunohistochemical patterns of ProEx C in vulvar squamous lesions: detection of overexpression of MCM2 and TOP2A.

Two major subtypes of vulvar squamous cell carcinomas (SCC) have been described. Basaloid and warty SCC are human papillomavirus-related and associated with classic vulvar intraepithelial neoplasia (VIN). Keratinizing SCC is associated with lichen sclerosus and differentiated VIN, but not with human papillomavirus. This study was undertaken to examine the expression patterns of ProEx C in vulvar SCC and its precursors. We analyzed 22 cases with normal vulvar epidermis, 13 cases of lichen sclerosus, 14 cases of condylomas, 23 cases of high-grade classic VIN, 6 cases of differentiated VIN, 3 cases of verrucous carcinomas, 10 cases of keratinizing SCC, and 8 cases of basaloid and warty SCC. ProEx C targets minichromosome maintenance protein and topoisomerase II alpha protein which are overexpressed in the cell nucleus during aberrant S-phase induction. Marked confluent ProEx C expression is present in high-grade classic VIN with nuclear staining extending into the middle and upper layers of the epidermis. Condylomas show parabasal nuclear immunoreactivity associated with scattered ProEx C-positive nuclei in the more differentiated suprabasilar layers. Invasive SCC shows variable staining patterns. In contrast, ProEx C staining is essentially limited to the basal and parabasal layers in normal epidermis, lichen sclerosus, differentiated VIN, and verrucous carcinoma. Overall, ProEx C is a useful proliferation marker for high-grade VIN analogous to the staining patterns reported in high-grade cervical intraepithelial neoplasia.

Pseudolipomatosis in hysteroscopically resected tissues from the gynecologic tract: pathologic description and frequency.

Pseudolipomatosis is an artifactual microscopic change in tissues that resembles fatty infiltration, most often described in the gastrointestinal tract. The fatlike spaces represent air or gas bubbles that enter the mucosa through microscopic ruptures secondary to gaseous insufflation. We report a series of cases of pseudolipomatosis encountered in gynecologic tissues removed during hysteroscopic procedures, a finding not previously described. We identified 300 consecutive hysteroscopic procedures performed at our institution from 2006 to 2008. Patients' medical records were reviewed to collect pertinent clinical data. Slides from all cases were systematically reviewed. The diagnosis of pseudolipomatosis was established by consensus. Twenty-eight cases of pseudolipomatosis, representing 9.3% of patients who under went hysteroscopy, were identified. Pseudolipomatosis was found in 9 endometrial curettings or biopsy tissues, 8 endometrial or endocervical polyps, 8 uterine fibroids, 2 fallopian tubes, and 1 endocervical biopsy. The type of distention medium used and length of hysteroscopic procedure did not differ significantly between cases with and without pseudolipomatosis. Pseudolipomatosis vacuoles varied in distribution from crowded clusters to sparsely scattered and solitary. Occasionally, vacuoles were found in vascular channels. Vacuoles were round or ovoid, unilocular, and variable in size. Immunohistochemical staining for adipocyte and endothelial markers were negative. We hypothesize that pseudolipomatosis derives from air that is almost invariably introduced into the uterus during media insufflation for hysteroscopy, creating a bubble under pressure. The air enters tissues either through lining microruptures or during the biopsy procedure. Pseudolipomatosis is a relatively common, easily overlooked finding in hysteroscopically derived specimens that may be misdiagnosed when prominent.

Quality improvement by standardization of procurement and processing of thyroid fine-needle aspirates in the absence of on-site cytological evaluation.

BACKGROUND: Thyroid nodules are relatively common and are routinely evaluated by fine-needle aspiration cytology, usually performed by clinicians. We noticed qualitative and/or quantitative variability in samples submitted to the cytopathology laboratory from clinicians, for example, the number of glass slides submitted (2-25) and air-dried smears versus alcohol-fixed slides, with variability in specimen adequacy and interpretability. The objective of this study was to standardize the preanalytic variables to determine if there is an improvement in the specimen quality. METHODS: We standardized the method of collection (ultrasound-guided, 25-gauge needle, four passes) and preparation of samples (four total smears: two air-dried, two fixed, with liquid-based preparation and/or cell block) and personnel involved. RESULTS: Standardization of thyroid nodule fine-needle aspiration and sample preparation by clinical staff resulted in an overall improvement in the quality of sample (odds ratio = 3.82, 95% confidence interval 2.02-7.24, p < 0.0001) with an increased proportion of satisfactory samples from 67% prestandardization to 89% poststandardization. CONCLUSIONS: Standardization resulted in a significant improvement in specimen interpretability.

Evaluación de la hemostasia en niños con Síndrome de Ehlers-Danlos tipo III / Hemostasis evaluation in children with type III Ehlers-Danlos syndrome

Introducción: Aunque no se ha demostrado la existencia de alteraciones de la hemostasia que formen parte del cuadro clínico del síndrome de Ehlers-Danlos, se han reportado diversas alteraciones de la coagulación en casos aislados, como son eficiencia y alteraciones de la movilidad electroforética de la fibronectina, disfunción de la agregación plaquetaria con prolongación del tiempo de sangramiento, deficiencia de factores VIII, IX, XII y XIII y aumento de la sensibilidad a la aspirina, entre otras. Objetivo: Evaluar la existencia de alteraciones de la hemostasiaen niños con síndrome de Ehlers-Danlos tipo III. Métodos: Se realizó una investigación aplicada, observacional, descriptiva y transversal en 305 niños con síndrome de Ehlers-Danlos tipo III para evaluar, en aquellos con historia de manifestaciones hemorrágicas, la existencia de alteraciones de la hemostasia.Previa suspensión de drogas con acción antiagregante plaquetaria, a todos los pacientes se les realizaron estudios decoagulación y función y agregación plaquetaria. Resultados: En 181 pacientes se encontró historia de sangramiento espontáneo o traumático, predominantemente cutáneo-mucoso. Elcoagulograma fue normal en todos los casos y el extendido de sangre periférica mostró la presencia de macroplaquetas y escasa formación de grumos como alteración frecuente. Las pruebas de agregación y función plaquetaria evidenciaron la existencia de trastornos cualitativos con predominio de la disminución de la agregación con ADP, sola o combinada con epinefrina y colágeno, y con menor frecuencia trastornos de la disponibilidad de los fosfolípidos plaquetarios. La mayoría de estos pacientes habían utilizado antihistamínicos (ketotifeno) por diversas causas. Conclusiones: Se reporta la presencia de defectos cualitativos plaquetarios en niños con síndrome de Ehlers-Danlos tipo III destacándose el papel de la utilización de drogas antihistamínicas en la aparición de manifestaciones hemorrágicas en estos pacientes

Introduction: Although the existence of hemostasis disorders as part of type-III Ehlers-Danlos syndrome has not been confirmed, several coagulation alterations have been reported in isolated cases such as: deficiencies and modification in electrophoresis mobility of fibronectin, dysfunction of platelet aggregation with lengthening of bleeding time, deficiency of VIII, IX, XII and XIII factors and increase of aspirin sensitivity, among others. Objective: Evaluate the existence of hemostasis disorders in children with type III Ehlers-Danlos syndrome. Method: an applied, observational, descriptive and cross-sectional research was carried out in 305 children suffering from type-III Ehlers_Danlos syndrome to evaluate in those having history of hemorrhagic manifestations, the existence of alterations of the hemostasis. Previous suspension of drugs with platelet anti-aggregation action, coagulation and platelet aggregation function studies were carried out. Results: The study revealed that 181 patients presented history of spontaneous or traumatic bleeding mainly mucous-cutaneous. Coagulogram was normal in all cases and peripheral-blood smears showed the presence of macro-platelets and deficient formation of clots as the most frequent alteration. Aggregation and platelet function tests evidenced the presence of qualitative disorders, where a decrease of aggregation prevailed with the use of adenosine diphosphate (ADP), alone or combined with epinephrine and collagen, and with less frequency, disorders of of platelet phospholipids availability. The majority of these patients presented history of long-lasting use of antihistamines (ketotifen) due to diverse causes. Conclusions: The occurrence of these qualitative platelet defects in children with EDS-type III is reported, standing out the role of the use of antihistamine drugs on the onset of the hemorrhagic symptoms in these patients

Prevalencia de hemofilia en seis provincias cubanas / Prevalence of hemophilia in six cuban provinces

Introducción:la hemofilia es una enfermedad hemorrágica con una incidencia casi constante para diferentes poblaciones. Desde la década del 80 del pasado siglo, en el Instituto de Hematología e Inmunología se creó un grupo multidisciplinario de especialistas para la atención del paciente con hemofilia. En la actualidad existe un programa nacional de atención integral al hemofílico que permite el monitoreo continuo y el tratamiento adecuado. Objetivo: conocerla prevalencia de la hemofilia en Cuba. Métodos:se incluyeron los datos de 229 pacientes procedentes de 5 provincias cubanas y el municipio especial Isla de la Juventud (según la división política-administrativa previa), que representan el 58,1 por ciento de los pacientes registrados. Los datos incluyeron aspectos demográficos, gravedad de la enfermedad, presencia de inhibidores y de infecciones transmitidas por las transfusiones. Resultados: los pacientes con hemofilia A fueron 188 (82,10 por ciento) y 41 (17,90 por ciento) con hemofilia B. El 56,33 por ciento de los pacientes presentaron la enfermedad en forma severa, 24 por ciento moderada y 19,7 por ciento leve. Los inhibidores se encontraron en el 17,03 por ciento de los casos. La infección por el virus de inmunodeficiencia humana estuvo presente solamente e el 0,87 por ciento de los pacientes, y la hepatitis C en el 39,03 por ciento. La edad media al diagnóstico fue de 2.15 años. Conclusiones: la prevalencia general ajustada a la edad fue de 9,63 casos de hemofilia por 100 000 varones y la mayor prevalencia de pacientes se encontró en las edades entre 20 y 59 años

Introduction: hemophilia is an inherited bleeding disorder; its incidence is almost constant in different populations. Since the 80th decade a multidisciplinary group for the care of patients with hemophilia was created at the Instituto de Hematología e Inmunología. Nowadays a national comprehensive care program allows patients to receive a continuous monitoring and an effective treatment. Objective: to know prevalence of patients with hemophilia in Cuba. Results: data of 229 patients from 5 provinces and the special municipality Isla de la Juventud were included, which covered 58,71 percent of the total patients registered in Cuba. The information included demographic data, severity of hemophilia, presence of inhibitors and infection status for viral diseases. Hemophilia A patients were 188 (82.10 percent) and 41 (17.90 percent) with hemophilia B. The disease was severe in 56.33 percent of patients, moderate in 24 percent, and mild in 19.7percent . Inhibitors were present in 17.03 percent of the patient percents. Human immunodeficiency virus infection was present only in 0.87 percent of patients and hepatitis C virus infection in 39.03 percent. The mean age at diagnosis was 2.15 years. Conclusions: the general age-adjusted prevalence was 9.63 cases of hemophilia per 100 000 male and the main prevalence of patients was found in ages between 20 and 59 years

Polyomavirus infection of the urinary tract presenting as hemorrhagic cystitis in an immunocompetent five-year-old boy.

Human polyomavirus infection, which can be detected morphologically on Pap-stained routine urine cytology specimens, is most commonly encountered in immunocompromised patients and is a well-described complication of renal transplantation. We present a case of an immunocompetent 5-year-old boy with a sudden onset of dysuria and hematuria due to a self-limited polyomavirus urinary tract infection detected on routine urine cytology and confirmed with real-time PCR. Although rare cases of nonhemorrhagic cystitis have been reported, to the best of our knowledge this is the first case of hemorrhagic cystitis occurring in this setting.

Phenotype characterization of Pelibuey native lambs resistant to Haemonchus contortus.

Specific phenotypic traits of the blood-feeder nematode Haemonchus contortus were characterized on Pelibuey native, cross-breed sheep in a tropical region of Mexico with background of anthelmintic problems. Data were collected on 4-month-old lambs (n= 63) and analyzed weekly in three stages: stage 1 (S1, not infected (0-3 weeks)); S2, first infection with 350 H. contortus infective larvae (L(3)) per kg of body weight by oral route (3-10 weeks); and S3, second infection with 175 H. contortus L(3) per kg of body weight by oral route (10-18 weeks). Once infection took place, sheep grazed in a free-nematode experimental paddock, and hemoncosis-related traits, such as the number of eggs per gram of feces (epg), packed cell volume (%pvc), and eosinophils (%eo), were measured each week. Results were analyzed on specific traits and stages using SAS statistics. Statistical differences of the main phenotypic traits (P < 0.05) were observed throughout S2 on Pelibuey high (hr) and low (lr) responders, respectively: epg mean, 475 +/- 340.5 and 1439 +/- 243.6; %pvc mean, 31 +/- 0.3 and 27 +/- 0.2; and %eo mean, 2.5 +/- 0.3 and 1.99 +/- 0.2. In addition, lr and hr sheep grazed for 3 months on an area infected with Haemonchus, Cooperia, and Strongyloides, and the hr sheep showed a low number of epg after being exposed to multiple infections, so that no further treatment was required. These results showed that the selection of animals resistant to nematodes can be an alternative method of control against anthelmintic resistance problems in order to improve animal health and avoid a negative environmental impact.

Asociación de la púrpura trombocitopénica inmunológica y el síndrome de Guillain-Barré: a propósito de un caso / Association of immunologic thrombocytopenia and the Guillain-Barré syndrome: with regard to a case

La púrpura trombocitopénica inmunológica es una enfermedad autoinmune, benigna, de aparición frecuente, caracterizada por la presencia de anticuerpos dirigidos contra las glicoproteínas de la membrana plaquetaria que producen una disminución del recuento plaquetario y manifestaciones hemorrágicas cutáneo-mucosas. El diagnóstico de esta entidad se realiza por exclusión de otras causas de trombocitopenia. El síndrome de Guillain-Barré es también una enfermedad de naturaleza autoinmune donde la pérdida de la tolerancia inmunológica trae como consecuencia la aparición de anticuerpos dirigidos contra los gangliósidos de los nervios periféricos. Se presenta una paciente femenina de 40 años con diagnóstico de una púrpura trombocitopénica inmunológica crónica que comenzó con una parálisis motora ascendente, sin toma respiratoria, parálisis facial y dolor intenso en las regiones dorsal y lumbar. Fue diagnosticada como un síndrome de Guillain-Barré e inmediatamente se comenzó tratamiento con vitaminoterapia y esteroides a altas dosis. Después de varios meses de seguimiento y rehabilitación presentó una evolución satisfactoria con remisión de todos los síntomas neurológicos

The immunologic thrombocytopenic purpura is an autoimmune, benign, of frequent appearance disease characterized by the presence of antibodies directed to glycoproteins of platelet membrane producing a decrease of platelet count and cutaneous-mucosal hemorrhagic manifestations. The Guillain-BarrÚ syndrome is also a disease autoimmune by origin where the loss of immunological tolerance causes the appearance of antibodies directed to gangliosides of peripheral nerves. This is the case of female patient aged 40 diagnosed with a chronic immunologic thrombocytopenic purpura beginning with an ascendant motor paralysis, without respiratory compromise, facial paralysis and intense pain in dorsal and lumbar regions and also a diagnosis of Guillain-BarrÚ syndrome with immediate treatment based on vitamin-therapy and high dose of steroids. After some months of follow-up and rehabilitation there was a satisfactory evolution with remission of all neurological symptoms

Chemokine receptor expression in the human ectocervix: implications for infection by the human immunodeficiency virus-type I.

Human immunodeficiency virus-type 1 (HIV-1) is a sexually transmitted pathogen that can infect cells in the female reproductive tract (FRT). The mechanism of viral transmission within the FRT and the mode of viral spread to the periphery are not well understood. To characterize the frequency of potential targets of HIV infection within the FRT, we performed a systematic study of the expression of HIV receptors (CD4, galactosyl ceramide (GalCer)) and coreceptors (CXCR4 and CCR5) on epithelial cells and leucocytes from the ectocervix. The ectocervix is a likely first site of contact with HIV-1 following heterosexual transmission, and expression of these receptors is likely to correlate with susceptibility to viral infection. We obtained ectocervical tissue specimens from women undergoing hysterectomy, and compared expression of these receptors among patients who were classified as being in the proliferative or secretory phases of their menstrual cycle at the time of hysterectomy, as well as from postmenopausal tissues. Epithelial cells from tissues at early and mid-proliferative stages of the menstrual cycle express CD4, although by late proliferative and secretory phases, CD4 expression was absent or weak. In contrast, GalCer expression was uniform in all stages of the menstrual cycle. CXCR4 expression was not detected on ectocervical epithelial cells and positive staining was only evident on individual leucocytes. In contrast, CCR5 expression was detected on ectocervical epithelial cells from tissues at all stages of the menstrual cycle. Overall, our results suggest that HIV infection of cells in the ectocervix could most likely occur through GalCer and CCR5. These findings are important to define potential targets of HIV-1 infection within the FRT, and for the future design of approaches to reduce the susceptibility of women to infection by HIV-1.