Características clínicas, virológicas, inmunológicas y psicosociales de los adolescentes con infección por HIV: 15 años después de la implementación del programa de transición / Clinical, virological, immunological, and psychosocial characteristics of adolescents with HIV infection: 15 years after the implementation of the transition program

Desde 2007, el Servicio de Epidemiología e Infectología, ha implementado un programa de transición que busca optimizar la atención de los adolescentes con infección por el HIV durante el paso de la atención pediátrica a la de adultos. Objetivo: Describir las características clínicas, epidemiológicas, virológicas y psicosociales de los adolescentes con infección HIV atendidos en el Programa y analizar el proceso de transición. Materiales y Métodos: Estudio de cohorte retrospectivo. Se incluyeron a los adolescentes, atendidos en el Programa de Transición entre enero de 2019 y diciembre de 2023, en el Hospital Garrahan, con al menos un resultado de CV y CD4+ en ese período. Se obtuvo la información de la historia clínica electrónica y se analizaron variables clínicas, epidemiológicas, virológicas, terapéuticas y psicosociales. Resultados: Se incluyeron 124 pacientes. La vía de transmisión fue vertical en el 92,74% y el estadio clínico e inmunológico era avanzado. En el momento de la transición 77,4% se encontraban con supresión virológica y con recuperación inmunológica. El 55,6% ya realizó la transición a un centro de adultos, 31,4% continúan en el programa, 11,3% se perdieron en el seguimiento y 1,7% fallecieron. Se recopilaron los datos de 31 pacientes transferidos. La mediana de seguimiento fue de 2 años; 25 pacientes (80,6%) continúan en seguimiento. Conclusiones: A pesar de la pandemia de COVID-19, el programa logró la retención de los adolescentes con infección por HIV y una transferencia sostenida en el tiempo. Además de un programa de transición estructurado para garantizar una atención continua y de calidad, es necesario continuar evaluando la evolución postransición (AU)

Since 2007, the Epidemiology and Infectious Diseases Department has implemented a transition program to optimize the care of adolescents with HIV infection during their transition from pediatric to adult care. Objective: To describe the clinical, epidemiological, virological, and psychosocial characteristics of adolescents with HIV infection treated in the program and to analyze the transition process. Materials and Methods: A retrospective cohort study was conducted. Adolescents followed in the Transition Program at Garrahan Hospital between January 2019 and December 2023, with at least one viral load and CD4+ result during that period, were included. Information was obtained from electronic medical records, and clinical, epidemiological, virological, therapeutic, and psychosocial variables were analyzed. Results: A total of 124 patients were included. The route of transmission was vertical in 92.74%, and the clinical and immunologic stage was advanced. At the time of transition, 77.4% were virologically suppressed and had achieved immunologic recovery. Of the patients, 55.6% had already transitioned to an adult center, 31.4% were still in the program, 11.3% were lost to follow-up, and 1.7% died. Data were collected from 31 transferred patients, with a median follow-up of 2 years; 25 patients (80.6%) remain in follow-up. Conclusions: Despite the COVID-19 pandemic, the program successfully retained HIVinfected adolescents and ensured sustained transition over time. In addition to a structured transition program to ensure continuous and quality care, it is necessary to continue evaluating post-transition outcomes (AU)

Dosage of anti-PD-1 monoclonal antibodies: a cardinal open question.

Discovery and clinical development of monoclonal antibodies with the ability to interfere in the regulation of the immune response have significantly changed the landscape of oncology in recent years. Among the active agents licensed by the regulatory agencies, nivolumab and pembrolizumab are paradigmatic as the most relevant ones according to the magnitude of available data derived from the extensive preclinical and clinical experience. Although in both cases the respective data sheets indicate well-defined dosage regimens, a review of the literature permits to verify the existence of many issues still unresolved about dosing the two agents, so it must be considered an open question of potentially important consequences, in which to work to improve the effectiveness and efficiency of use.

R230C but not - 565C/T variant of the ABCA1 gene is associated with type 2 diabetes in Mexicans through an effect on lowering HDL-cholesterol levels.

PURPOSE: Type 2 diabetes (T2D) and low serum concentration of high-density lipoprotein cholesterol (HDL-c) are common coexisting metabolic disorders. ABCA1 variants have been shown to be associated to these conditions. We sought to test the combined effect of two ABCA1 gene common variants, rs2422493 (- 565C > T) and rs9282541 (R230C) on HDL-c levels and T2D risk. METHODS: Path analysis was conducted in 3,303 Mexican-mestizos to assess the specific contributions of rs2422493 and rs9282541 ABCA1 variants, insulin resistance, waist-to-height ratio (WHtR), and age on HDL-c levels and T2D risk. Participants were classified into four groups according to their ABCA1 variants carrier status: (i) the reference group carried wild type alleles for both ABCA1 variants (-/-), (ii) +/- were carriers of rs2422493 but non-carriers of rs9282541, (iii) -/+ for carriers of rs9282541 but not carriers of rs2422493 and (iv) carriers of minor alleles for both SNPs (+/+). Principal components from two previous genome-wide association studies were used to control for ethnicity. RESULTS: We identified significant indirect effects on T2D risk mediated by HDL-c in groups -/+ and +/+ (ß = 0.04; p = 0.03 and ß = 0.06; p < 0.01, respectively) in comparison to the -/- reference group. Low concentrations of HDL-c were directly and significantly associated with increased T2D risk (ß = -0.70; p < 0.01). WHtR, male gender, age, and insulin resistance were also associated with T2D risk (p < 0.05). There was no significant direct effect for any of the ABCA1 groups on T2D risk: p = 0.99, p = 0.58, and p = 0.91 for groups +/-, -/+, and +/+ respectively. CONCLUSIONS: The ABCA1 rs9282541 (R230C) allele is associated with T2D in Mexicans through its effect on lowering HDL-c levels. This is the first report demonstrating that HDL-c levels act as an intermediate factor between an ABCA1 variant and T2D.

Manejo del edema pulmonar agudo cardiogénico en el servicio de urgencia / Review of Acute Cardiogenic Pulmonary Edema Management in the Emergency Department

El Edema Pulmonar Agudo Cardiogénico es un cuadro clínico frecuente en los servicios de urgencia y conlleva una alta mortalidad, y junto a otras complicaciones de la insuficiencia cardíaca podría continuar incrementándose con los años. Los avances en la evaluación y el manejo de esta patología en el Servicio de Urgencia se centran en la utilidad de la ultrasonografía al lado del paciente, en la utilización apropiada de la farmacoterapia existente y la aplicación de herramientas de soporte ventilatorio que anticipen y eviten la necesidad de intubación oro-traqueal y ventilación mecánica.

Acute cardiogenic pulmonary edema is a medical condition often seen in the emergency department. It has high mortality and, as with other complications of heart failure, its incidence may continue to rise in the future. Advances in the evaluation and management of this pathology in the emergency department focus on the benefit of bedside ultrasound, the appropriate use of existing pharmacotherapy and the use of ventilation support equipment that anticipate and avert the need for orotracheal intubation and mechanical ventilation.

Manejo del edema pulmonar agudo cardiogénico en el servicio de urgencia / Management of acute cardiogenic pulmonary edema in an emergency service

El Edema Pulmonar Agudo Cardiogénico es un cuadro clínico frecuente en los servicios de urgencia y conlleva una alta mortalidad, y junto a otras complicaciones de la insuficiencia cardíaca podría continuar incrementándose con los años. Los avances en la evaluación y el manejo de esta patología en el Servicio de Urgencia se centran en la utilidad de la ultrasonografía al lado del paciente, en la utilización apropiada de la farmacoterapia existente y la aplicación de herramientas de soporte ventilatorio que anticipen y eviten la necesidad de intubación oro-traqueal y ventilación mecánica.

Acute cardiogenic pulmonary edema is frequently seen in the emergency services and has a high mortality and, as with other complications of heart failure, it may increase over the years. Advances in its evaluation and management in the emergency services are centered on bedside ultrasonography, appropriate use of available drugs and early ventilation support that anticipates and avoids the need for endotracheal intubation and mechanical ventilation.

Impact of radical and partial nephrectomy on renal function in patients with renal cancer.

OBJECTIVE: To evaluate renal function in renal cancer patients undergoing radical nephrectomy (RN) or partial nephrectomy (PN) (open or laparoscopic - ORN, OPN, LRN or LPN) and to identify risk factors contributing to renal function loss. METHODS: We analysed 228 consecutive renal cancer patients admitted for OPN, LPN, ORN or LRN. The variables analysed were age, gender, weight, type of surgery (radical versus partial), type of surgical access (open versus laparoscopic), preoperative renal function and history of hypertension, diabetes or malignancy. Absolute renal function was calculated as the difference in glomerular filtration rate (ΔGFR) between the renal function before (GFR0) and 12 months after surgery (GFR12). The relative renal function of patients undergoing PN and RN was evaluated by the change in chronic kidney disease stage. RESULTS: LRN caused the greatest loss in absolute renal function, followed by ORN, LPN and OPN. A GFR of ≥60 ml/min was noted for 90 (68.7%) patients before and 65 (49.6%) patients after RN and for 80 (82.5%) patients before and 74 (76.3%) patients after PN. The chronic kidney disease stage dropped to 4 or 5 in the case of 6 (4.6%) patients who underwent RN and 2 (2.1%) patients who underwent PN. Multivariate analysis revealed that only preoperative weight and type of surgery (radical versus partial) had a significant impact on renal function. CONCLUSION: Renal function significantly decreased in patients undergoing RN, irrespective of the access route. Patients with preoperative poor renal function are at risk of postoperative end-stage renal disease.

Evaluation of Water Sanitation Health Education Programme: Working with the Knowledge of the Basic Sanitation Services in a Developing Community in Rural Haiti after the 2010 Earthquake.

OBJECTIVE: The aim of this study is to measure the knowledge regarding the new sanitation water system being implemented in Dessources, a rural community in the municipality of Croix-des-Bouquets in Haiti after a two-year intervention programme. DESIGN AND METHODS: A cross-sectional epidemiologic design was used to measure the knowledge of the people in the community using a semi-structured questionnaire. Data collection followed a face-to-face interview process in all houses of the community. The instrument content validity was performed by a panel of experts followed by Cronbach's alpha test to establish the reliability of knowledge scale. In addition, association measures were done using Stata 11.0 statistical package. RESULTS: Content validity test were performed with minimum changes and an alpha of 0.74 was obtained for the scale. Response rate was 65.57% (41/60 houses); non-participants were only those who did not meet the inclusion criteria. Most of the participants (77.5%) were 21-49 years old and 85% had been living in the community for more than 20 years. Bivariate analysis showed that the people of Dessources had adequate knowledge. Significant differences, however, were found among the zones that are not in use of the new sanitary systems and among families with more than seven members per house. CONCLUSIONS: Differences found can be explained based on the Rogers theoretical diffusion of innovation model. The evaluation shows that people of Dessources in Haiti have a high knowledge regarding the new water sanitation system and provided evidence of an adequate health education programme intervention.

Disparities and barriers encountered by immigrant Dominican mothers accessing prenatal care services in Puerto Rico.

Inadequate access to prenatal services has been associated with higher rates of mother and child mortality and premature births in the general population. Thus, this paper aims to compare the utilization and adequacy of prenatal care services of Dominican immigrant mothers with that of Puerto Rican mothers. Data was extracted from birth certificates using a cohort from 1998 to 2002 (n = 252, 919). The Kotelchuck index for adequate prenatal care was used for comparison with socio-demographic characteristics of the population. Less than half of Dominican mothers (48.5 %) received adequate prenatal care compared to more than two-thirds (69.1 %) of Puerto Rican mothers (p < .001). After controlling for demographic characteristics, health insurance, pregnancy risks, complications and previous birth (parity) the odds of receiving adequate care of Dominican mothers was 0.7 that of Puerto Rican mothers (p < .001). These results suggest significant disparities in obtaining adequate prenatal care services among migrant women and native Puerto Ricans.

Síndrome del ligamento arcuato medio: review article / Median arcuate ligament syndrome (mals): review article

The aim of this article is to describe the clinical, pathophysiology and diagnostic imaging aspects of median arcuate ligament syndrome (MALS) by presenting clinical cases and literature review. Development: The median arcuate ligament syndrome corresponds to a clinical syndrome secondary to the extrinsic compression of the celiac trunk by fibrous bands of the median arcuate ligament. In recent decades, some authors have questioned its true meaning and existence given the reported cases of asymptomatic patients who presented extrinsic compression of the celiac trunk by MAL. However, the presence of intestinal angina symptoms and certain specific imaging findings leads to consider its differential diagnosis and directs toward the corresponding study. The diagnosis is made by using Doppler ultrasound, Multislice Computed Tomography (CT) Angiography and Magnetic Resonance Angiography (MRA), the Angiography-fluoroscopy being left out of the first-line study. In recent years use of MRA has increased due to the absence of ionizing radiation and the high efficiency in the diagnosis. Within its complications include acute mesenteric angina and pancreaticoduodenal artery aneurysms secondary to the extensive formation of adjacent collateral circulation. Surgical treatment has been the most effective, having a very low recurrence.

El objetivo de este artículo es describir la presentación clínica, fisiopatología y diagnóstico imagenológico del síndrome del ligamento arcuato medio (LAM), mediante la presentación de casos clínicos y revisión de la literatura. Desarrollo: El síndrome del ligamento arcuato medio corresponde a un síndrome clínico secundario a compresión extrínseca del tronco celíaco determinado por bandas fibróticas del ligamento arcuato medio. En las últimas décadas, algunos autores han puesto en tela de juicio su verdadero significado y existencia dado los casos reportados de pacientes asintomáticos que presentan compresión extrínseca del tronco celíaco por LAM. Sin embargo, la presencia de un cuadro de angina intestinal y ciertos hallazgos imagenológicos específicos, hacen considerar su diagnóstico diferencial y orientar el estudio correspondiente. El diagnóstico se realiza mediante el uso de Ecografía Doppler, Angiografía por Tomografía Computada Multicorte y Angioresonancia Magnética, quedando la Angiografía Fluoroscópica fuera del estudio de primera línea. En los últimos años se ha potenciado el uso de la Angioresonancia por la ausencia de radiación ionizante y la gran eficacia en el diagnóstico. Dentro de sus complicaciones se encuentran la angina mesentérica aguda y aneurismas de la arteria pancreático-duodenal secundarios a la extensa formación de circulación colateral adyacente. El tratamiento más efectivo ha sido el quirúrgico, existiendo una muy baja recidiva.

Aspectos sociales de la muerte materna: análisis de 5 años en el hospital general de occidente: Jalisco, México / social aspects of maternal death: analysis of five years in the general hospital of the west: Jalisco, Mexico

Objetivo: Analizar los aspectos sociales de las muertes maternas ocurridas en el Hospital General de Occidente, Jalisco, México (2006-2010). Método: Se recurrió al archivo del hospital para identificar los expedientes de las muertes maternas ocurridas durante el periodo de estudio. Las fuentes de información fueron certificados de defunción, autopsia verbal, cuestionario confidencial y dictamen de las muertes. Se utilizó estadística descriptiva y medidas de tendencia central para el análisis de la información. Resultados: Se identificaron 22 muertes maternas, evidenciando un aumento de las muertes maternas durante el periodo de estudio. La edad media fue de 28,27 años, el 68,27 por ciento se dedicaba actividades del hogar, 45 por ciento vivían en unión libre, 55 por ciento no tenían registro de tener seguridad social, el 50 por ciento poseían estudios de primaria o menos, y solo 77,2 por ciento presentaba control prenatal. Conclusiones: La presencia de factores sociales, que además de los clínicos, y que inciden en la muerte materna, deben ser conocidos por el personal del servicio de obstetricia, y deben ser considerados para el diseño e implementación de acciones para disminuir la muerte materna en todos los niveles de atención.

Objective: Analyze the social aspects of the maternal mortality occurred in the Hospital General de Occident, Jalisco, Mexico (2006-2010). Method: It is resorted the archive of the hospital to identify files of maternal mortality during the study period. The sources of information were death certificates, verbal autopsy, confidential questionnaire and opinion of the deaths. We used descriptive statistics and measures of central tendency for the analysis of the information. Results: We identified 22 maternal deaths, demonstrating an ascending trend of maternal mortality during the study period. The mean age was 28.27 years old, 68.27 percent was dedicated to the home, 45 percent lived in free union, 55 percent had no record of social security, 50 percent had a primary education or less, and only 77.2 percent had prenatal control. Conclusions: The presence of social factors, in addition to clinicians, and that influence maternal death should be known for the obstetrics service personnel, and should be considered for the design and implementation of actions to reduce maternal death at all levels of care.

Síndrome cardiopulmonar por hantavirus: a propósito de un caso: [revisión] / Hantavirus pulmonary syndrome: a case report: [review]

El Hantavirus es un patógeno de aparición relativamente nueva. El año 1996 fue publicado el primer en Chile y un año antes se habla establecido el primer diagnostico de síndrome cardiopulmonar (SCPH) en nuestro país. En Chile el tipo de Hantavirus es el Andes cuyo reservorio es el ratón de cola larga (Oligoryzomys longicaudatus). Se puede presentar como infección inaparente, como una enfermedad leve por Hantavirus o como su expresión más grave que es el SCPH. En general se manifiesta como un cuadro rápidamente progresivo, que tiene 3 etapas, la prodrómica, la cardiopulmonar y la de convalecencia. Comienza como si fuera un cuadro gripal, con fiebre y mialgias o como un cuadro gastrointestinal, seguido por aparición súbita de insuficiencia respiratoria con o sin aparición de inestabilidad hemodinámica que puede progresar en algunos casos hasta edema agudo de pulmón, shock y muerte. En Chile se han confirmado casos de SCPH desde la ciudad de Valparaíso hasta Aysén, siendo esta última la de mayor incidencia en el país. A la fecha, durante el 2010 se han confirmado 30 casos. La letalidad alcanza a un 33 por ciento El objetivo de este trabajo es comunicar un caso de SCPH de rápida regresión y revisar la literatura respecto al tema.

Bocio amiloídeo: reporte de tres casos / Amyloid goitier: report of three cases

La amiloidosis es una patología de causa no precisada, la cual tiene distintas formas de presentación clínica según la proteína que se deposita. Este material amorfo puede depositarse en cualquier órgano, en forma aislada o como parte de una enfermedad generalizada. El compromiso del tiroides ocurre en el 50 a 80 por ciento de los casos de amiloidosis sistémica y corresponde, en general, a una infiltración difusa leve que no determina aumento de tamaño glandular ni alteraciones funcionales. El bocio amiloideo se define como el crecimiento del tiroides determinado por el depósito abundante de amiloide, el que puede dar síntomas compresivos de las estructuras del cuello. Se presentan tres casos de bocio amiloideo tratados en nuestro servicio, cuyo síntoma cardinal es la compresión tiroidea, uno de ellos con compromiso sistémico severo. Fueron tratados con hemitiroidectomía en un caso y tiroidectomía total en los otros dos, sin complicaciones. Se concluye que el bocio amiloideo es una patología poco frecuente, cuyo diagnóstico principalmente es un hallazgo durante el estudio anatomopatológico; sin embargo, se puede sospechar en un paciente con bocio que presenta enfermedades sistémicas.

Thyroid involvement occurs in 50 to 80 percent of cases with systemic amyloidosis. Usually the infiltration is mild, not altering morphology or function. Amyloid goiter occurs when large amounts of amyloid are accumulated, enlarging the gland and compressing neighboring structures. We report three patients aged 42, 49 and 59 years (two women) with amyloid goiter. All had dysphagia and two had dysphonia. One was subjected to a hemithyroidectomy and two to a total thyroidectomy. Pathology reported the presence of amyloid deposits in the surgical pieces.

A novel icetexane diterpene, 5-epi-icetexone from Salvia gilliessi is active against Trypanosoma cruzi.

In this work the effect of a novel compound, 5-epi-icetexone (ICTX) obtained from Salvia gilliessi Benth. (Labiatae), is studied on cultured epimastigotes of Trypanosoma cruzi (Tulahuen). It was found that the compound exerts an antiproliferative effect on the parasites at concentrations between 2.8 and 4.2 microM, and similar sensitivity in other strains (Dm28c, CL-Brener and Y-strain). The compound was deleterious at concentrations higher than 4.2 microM, with an estimated IC50 of 6.5+/-0.75 microM, but with low cytotoxicity to mammalian cells. These effects were irreversible, even at short times of exposure to the drug. In solution, ICTX showed to be stable for at least 96 h at 29 degrees C. With cytostatic dose a little percentage of parasites was resistant to the action of ICTX, and they continued growing although with different kinetic. By electron transmission microscopy, at dose of 4.2 microM an external vesiculization was observed on the first day of exposure to the compound, but the parasite cytoplasm became plenty of vacuoles and exhibited nuclear disorganization from the second day of exposure. It was concluded that ICTX is active against T. cruzi and may act by multiple mechanisms. In future, this novel icetexane diterpene may be a good candidate for therapeutic use against Chagas' disease.

Oligozoospermia and heat-shock protein expression in ejaculated spermatozoa.

BACKGROUND: Heat-shock protein A2 (HspA2) is correlated with sperm maturity, function and fertility, and a dysfunctional expression of such a gene results in abnormal spermatogenesis. The purpose of this study was to compare HspA2 gene expression in spermatozoa from oligozoospermic men and normozoospermic controls. METHODS: Semen was obtained and analysed according to World Health Organization (World Health Organization, 1999) guidelines, morphology by Kruger's strict criteria. Seventeen patients with oligozoospermia and 21 fertile controls were studied. Total RNA was extracted from ejaculated and Percoll density-gradient-separated spermatozoa followed by semiquantitative RT-PCR analysis. The relative expression level of HspA2 was analysed according to the expression level of the housekeeping beta-actin gene. Serum hormonal profiles (FSH, LH and testosterone) and a peripheral karyotype were also performed. RESULTS: All patients possessed normal karyotype, and no significant hormonal differences were found between the two groups. The study group had significantly lower sperm concentration and normal morphology than the controls. Semiquantitative RT-PCR analysis of HspA2 showed significantly lower expression levels in the oligoteratozoospermic men when compared to controls (P=0.0021). CONCLUSIONS: The HspA2 gene was down-regulated in sperm from infertile men with idiopathic oligoteratozoospermia, suggesting that such anomalies of gene expression might be associated with pathogenesis in some subtypes of male infertility.

Free jejunal intrathoracic graft after esophageal replacement failure

We present the case of a 24 year old man who suffered from severe chronic esophagitis and an esophageal stricture. He was managed by gastric pull-up but complicated by leakage of the anastomosis. Subsequent sophageasurgical treatment with free jejunal graft was performed and the rationale for the technique selected is discussed.

Lupus eritematoso sistémico (LES): perfil de severidad al ingreso hospitalario de 44 pacientes sin seguimiento postdiagnóstico / Systemic Lupus Erythematosus (SLE): Severity profile at hospital admisión of 44 patients without post-diagnosis monitoring

El grado que un paciente cumpla con el seguimiento medico y se adhiera a las indicaciones terapéuticas, se ha convertido en un punto esencial en la repercusión que tendrá sobre la evolución de su enfermedad. Es un tema de gran trascendencia sobre todo en enfermedades crónicas. El incumplimiento es grave porque hace ineficaz el tratamiento prescripto, provocando un aumento de la morbilidad. El paciente presentará complicaciones y secuelas que pueden acarrear lesiones de tipo irreversibles. En el Lupus Eritematoso Sistémico, la adherencia al tratamiento es de suma trascendencia en el control de su enfermedad. El presente estudio tiene como objetivo valorar el impacto que provoca la falta de cumplimiento al tratamiento y el abandono al seguimiento médico. Concomitantemente se evaluó la prevalencia del daño en los distintos órganos y su actividad. Los datos obtenidos en el relevamiento de ingreso a nuestro hospital muestran que 44 pacientes con diagnóstico previo de LES abandonaron el seguimiento en su hospital de origen. Se revisaron las historias clínicas de los ingresados entre mayo de 1984 y de junio de 1999. Desde julio de 1999 a mayo de 2005 se obtuvieron datos en forma prospectiva según grilla prediseñada. Se definieron términos según criterios de clasificación, SLEDAI e Indice de Daño (ACR). Se evaluaron las distintas prevalencias, observándose que la gran mayoría de los pacientes presentó actividad multisistémica con mayor prevalencia en riñón. Más del 50% de los casos presentó daño irreversible con alta prevalencia en riñón y sistema nervioso. Los pacientes dañados evidenciaron mayor tiempo de evolución, pero sin diferencias estadísticamente significativas. No encontramos relación entre daño y mantenimiento del tratamiento corticoideo.

Morphometric analysis of Mexican and South American populations of the Anastrepha fraterculus complex (Diptera: Tephritidae) and recognition of a distinct Mexican morphotype.

Discriminant function and cluster analyses were performed on 19 morphometric variables of the aculeus, wing and mesonotum to determine whether populations of Anastrepha fraterculus (Wiedemann) from different parts of Mexico could be distinguished from populations from South America. Samples were collected from seven localities across Mexico, two from Brazil, and one each from Colombia and Argentina. Results showed there were statistically significant differences between Mexican and South American populations with respect to the aculeus (tip length, length of serrated section, mean number of teeth) and wing (width of S-band and connection between S- and V-bands). The degree of morphological variation observed among Mexican populations was extremely low, and as a consequence, the Mexican populations were identified as a single morphotype by discriminant analysis. The 'Andean morphotype'consisting of the Colombian population, and the 'Brazilian morphotype'consisting of the two Brazilian populations plus the single Argentinian population were also distinguished. It was concluded that the macro-geographical morphotypes from Mexico, Colombia, and Brazil plus Argentina correspond to three distinct taxonomic entities. Comparisons of results with those obtained from behavioural, karyotypic, isozyme and DNA studies suggest that sufficient evidence now exists to name a new Mexican species from within the A. fraterculus complex. This will be done in a separate publication. A provisional key to the morphotypes of A. fraterculus studied is provided.

Apoptosis and necrosis increase antigenicity of proteins recognized by antinuclear antibodies.

OBJECTIVE: Present study addresses the issue whether apoptosis and necrosis increases the antigenicity of proteins recognized by antinuclear antibodies. MATERIAL AND METHODS: HEp-2 cells were cultured in standard conditions; apoptosis was induced by camptothecin and necrosis by mercuric chloride. Protein antigenicity of cell extracts was tested onto nitrocellulose membranes and probed with positive or negative sera for antinuclear antibodies by a luminescent-dot-ELISA system. RESULTS: Apoptotic changes in HEp-2 cells appeared by 24 hours of camptothecin exposure, meanwhile the necrotic features become visible earlier. Luminescence was significantly superior in ANA positive sera than in ANA negative controls. Antinuclear antibody sera recognized better the antigens from the apoptotic and necrotic cells than controls without chemical treatments. CONCLUSIONS: Apoptosis and necrosis increase the ANA binding by better availability of intracellular antigens, or by disclosing cryptic epitopes.