[Introduction of an anticholinesterase drug in the context of myasthenia, in a severe asthmatic patient]. / Introduction d'un anticholinestérasique dans le contexte d'une myasthénie, chez une patiente asthmatique sévère.

Association of asthma with myasthenia gravis presents a twofold peculiarity. First, as dyspnea characterizes both conditions, diagnostic orientation is difficult. Second, from a therapeutic standpoint, the initiation of anticholinesterase treatment requires a multidisciplinary approach due to possible contraindication for asthma. We report on the case of a patient monitored for severe asthma and treated with biotherapy, and also monitored for myasthenia gravis, and treated with anticholinesterase.

Incidence of Fusarium oxysporum f. sp. lycopersici Races in Tomato in Sinaloa, Mexico.

Sinaloa State is the main producer of tomatoes (Solanum lycopersicum L) in Mexico where production attained 15,784 ha in 2008 (3). Fusarium wilt of tomato caused by Fusarium oxysporum f. sp. lycopersici (Sacc) Snyder & Hansen causes significant yield losses in Sinaloa each year (2). Three pathotypes or races of F. oxysporum f. sp. lycopersici have been described: races 1, 2, and 3 (1). The purpose of this study was to determine the races of F. oxysporum f. sp. lycopersici present in Sinaloa and distribution of these races in the region. F. oxysporum f. sp. lycopersici isolates were obtained from plants showing symptoms of yellowing and necrosis of vascular bundles. Plants were sampled from 50 fields throughout the production area in Sinaloa from November 2008 to March 2009. Four differential cultivars were used to identify the races of 26 F. oxysporum f. sp. lycopersici isolates collected across Sinaloa: Bonny Best (susceptible to all races), UC-82-L (susceptible to races 2 and 3), F1 MH-1 (susceptible to race 3), and IR-3 (resistant to all races). A microconidial suspension was prepared for each isolate (1 × 106 CFU/ml) from cultures grown in potato dextrose broth with constant agitation (110 rpm) at 28°C for 7 days. Five 25-day-old seedlings (three fully expanded true leaves) from each differential cultivar were immersed in the appropriate microconidial suspension for 10 min, then individually transplanted into a pot containing 1 kg of sterilized commercial potting mix, and grown in a growth chamber at 25 to 28°C and 60 to 75% relative humidity for 5weeks with 14-h light/10-h darkness. Control plants (root dipped for 10 min in sterile water) were grown similarly and remained asymptomatic. Susceptible cv. Bonny Best showed typical symptoms of Fusarium wilt including epinasty, yellowing, defoliation, vascular necrosis, and wilt. None of these plants survived 25 days postinoculation for any of the isolates. All UC-82-L plants inoculated with each of the 26 isolates died before 35 days, indicating that none of the isolates was of race 1. F1 MH-1 plants only survived inoculation with 3 of the 26 isolates (11.5%), indicating that the 23 isolates that killed these plants (88.5% of the 26 isolates) were of race 3, and only 3 isolates were of race 2. All IR-3 plants inoculated with the 26 isolates survived. The isolates showed variation in response to the differential cultivar UC-82L in duration from inoculation to when the plants died (variation in isolate aggressiveness). The three F. oxysporum f. sp. lycopersici race 2 isolates were restricted to the Culiacan Valley, whereas the 23 F. oxysporum f. sp. lycopersici race 3 isolates were widely distributed across Sinaloa. Koch's postulates were confirmed by reisolating the fungus from the roots and stem base of each dead, inoculated plant (4). This study provides baseline data for future surveys to monitor changes in distribution of F. oxysporum f. sp. lycopersici races in Sinaloa, Mexico. References: (1) G. Cai et al. Phytopathology 93:1014, 2003. (2) P. Sánchez-Peña. Programa de Fomento y Apoyo a Proyectos de Investigación (PROFAPI), Universidad Autónoma de Sinaloa, México, 2007. (3) Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación, Servicio de Información Agroalimentaria y Pesquera, México. www.siap.gob.mx , 2009. (4) B. A. Summerell et al. Plant Dis. 87:117, 2003.

Diseases associated with HIV infection: study of biopsies and surgical resection specimens at a large general hospital in Mexico City.

The objective of this study was to analyze the type of diseases associated with HIV infection from a survey of the surgical pathology material accessioned at a large general hospital in Mexico City. From the archives of the pathology unit of the General Hospital of Mexico (Ministry of Health), we compiled data on biopsies and surgical specimen from different organs and tissues of HIV-infected patients (HIV/AIDS) received in the period from January 2005 to July 2008. We found a total of 52 cases, 41 men and 11 women. The main affected anatomical organ was the lymphatic nodes in 33 cases (63.4%), 7 corresponded to the digestive tract (13.46), 3 corresponded to bone marrow (5.76%), 3 corresponded to the perianal region (5.76%), 2 cases corresponded to the hard palate (3.84%), and 1 case each corresponded to the following regions: peritoneum, breast, and lung. The most frequent diagnoses were non-Hodgkin's large B-cell lymphoma in 11 cases (21.12%) and its morphological variants, 8 reactive lymphadenopathy cases (15.38%), 5 atypical mycobacterioses (9.61%), 2 nonspecific granulomatous lesions (3.84%), 2 Burkitt's lymphoma (3.84%), 3 Kaposi sarcoma (5.76%), 1 mixed cellularity Hodgkin's lymphoma (1.92%), 1 Kaposiform hemangioendothelioma (1.92%), and 1 with infection by cytomegalovirus + cryptosporidiosis in the duodenum (1.92%). In this series, the most affected organ in patients with HIV/AIDS was the lymphatic nodes. The most common neoplasm was the non-Hodgkin's lymphoma followed by Kaposi sarcoma. Mycobacterioses were the main infectious diseases, followed by mycotic and viral infections.

[Anticoagulant treatment in atrial fibrillation]. / Traitement anticoagulant dans la fibrillation auriculaire.

Atrial fibrillation is the most frequent arrhythmia in the general population, and it increases with age. The prevention of thromboembolic events, the most important complication of the disease, is a major problem. Antivitamin K is to date the most efficient therapeutic class for the prevention of these events. Although they allow a decrease in stroke by at least 50%, they are associated with an increased haemorrhagic risk (annual incidence ranging from 7% to 22%). This risk makes oral anticoagulant treatment underused in high risk patients, particularly in the elderly populations. Optimisation of the management of patients with atrial fibrillation should be based on an individual evaluation of the thromboembolic and haemorrhagic risks. Several stratifications have been performed to identify the risk predictors of thromboembolic and haemorrhagic events in patients with atrial fibrillation, allowing an evaluation of the benefit/risk ratio of antithrombotic treatments and using indices such as NNT (number of patients needed to treat to avoid an event) and NNH (number of patients needed to harm with haemorrhagic event). The available data do not allow, however, to evaluate precisely the individual level of haemorrhagic risk.