Discovery of candidate biomarkers from plasma-derived extracellular vesicles of patients with cirrhosis and hepatocellular carcinoma: an exploratory proteomic study.

Extracellular vesicles (EVs) represent an attractive source of biomarkers due to their biomolecular cargo. The aim of this study was to identify candidate protein biomarkers from plasma-derived EVs of patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Plasma-derived EVs from healthy participants (HP), LC, and HCC patients (eight samples each) were subjected to label-free quantitative proteomic analysis using LC-MS/MS. A total of 248 proteins were identified, and differentially expressed proteins (DEPs) were obtained after pairwise comparison. We found that DEPs mainly involve complement cascade activation, coagulation pathways, cholesterol metabolism, and extracellular matrix components. By choosing a panel of up- and down-regulated proteins involved in cirrhotic and carcinogenesis processes, TGFBI, LGALS3BP, C7, SERPIND1, and APOC3 were found to be relevant for LC patients, while LRG1, TUBA1C, TUBB2B, ACTG1, C9, HP, FGA, FGG, FN1, PLG, APOB and ITIH2 were associated with HCC patients, which could discriminate both diseases. In addition, we identified the top shared proteins in both diseases, which included LCAT, SERPINF2, A2M, CRP, and VWF. Thus, our exploratory proteomic study revealed that these proteins might play an important role in the disease progression and represent a panel of candidate biomarkers for the prognosis and diagnosis of LC and HCC.

Identification of ABCC3 and its isoforms as potential biomarker in hepatocellular carcinoma.

Liver diseases preceding the occurrence of hepatocellular carcinoma (HCC) play a crucial role in the progression and establishment of HCC, a malignancy ranked as the third deadliest cancer worldwide. Late diagnosis, alongside ineffective treatment, leads patients to a poor survival rate. This scenario argues for seeking novel alternatives for detecting liver alterations preceding the early occurrence of HCC. Experimental studies have reported that ABCC3 protein increases within HCC tumors but not in adjacent tissue. Therefore, we analyzed ABCC3 expression in public databases and investigated the presence of ABCC3 and its isoforms in plasma, urine and its release in extracellular vesicles (EVs) cargo from patients bearing cirrhosis and HCC. The UALCAN and GEPIA databases were used to analyze the expression of ABCC3 in HCC. The results were validated in a case-control study including 41 individuals bearing cirrhosis and HCC, and the levels of ABCC3 in plasma and urine samples, as well as EVs, were analyzed by ELISA and western blot. Our data showed that ABCC3 expression was higher in HCC tissues than in normal tissues and correlated with HCC grade and stage. ABCC3 protein levels were highly increased in both plasma and urine and correlated with liver disease progression and severity. The isoforms MRP3A and MRP3B of ABCC3 were significantly increased in both EVs and plasma/urine of patients bearing HCC. ABCC3 expression gradually increases in HCC tissues, and its protein levels are increased in both plasma and urine of patients with cirrhosis and HCC. MRP3A and MRP3B isoforms have the potential to be prognostic biomarkers of HCC.

Study of Candidemia and its Antifungal Susceptibility Profile at the University Hospital of Montevideo, Uruguay.

Systemic candidiasis are high mortality infections caused by yeasts of the genus Candida, affecting patients with numerous risk factors. Nowadays, candidemia produced by "non-albicans" species has increased considerably. Timely diagnosis and subsequent treatment substantially improve patients' survival. Our objectives are to study the frequency, distribution, and antifungal susceptibility profiles of candidemia isolates in our hospital. We conducted a descriptive, cross-sectional study. Positive blood cultures were recorded from January 2018 to December 2021. Positive Candida genus blood cultures were selected, classified, and analyzed on their susceptibility profile for amphotericin B, fluconazole and caspofungin using AST-YS08® card for VITEK 2 Compact® to determine minimum inhibitory concentration (MIC) and CLSI M60 2020 2nd Edition to determine breakpoints. 3862 positive blood cultures were obtained, 113 (2.93%) presented growth of Candida spp., corresponding to 58 patients. 55.2% came from the Hospitalization Ward and Emergency Services and 44.8% from the Intensive Care Unit. The species were distributed as follows: Nakaseomyces glabratus (Candida glabrata) (32.74%), Candida albicans (27.43%), Candida parapsilosis (23.01%), Candida tropicalis (7.08%) and others (9.73%). Most species were found to be susceptible to most antifungals, except for C. parapsilosis, presenting 4 isolates with resistance to fluconazole and N. glabratus (C. glabrata), whose clinical susceptibility data remains insufficient to provide accurate breakpoints. The percentage of recorded positive blood cultures of Candida spp. was 2.93%, these results were consistent with those reported at a regional level. A predominance of "non-albicans" species was observed. It is essential to know the prevalence, epidemiology, and susceptibility profiles of candidemia in our country, as well as being updated on its subsequent changes, maintaining epidemiological surveillance. This allows professionals to map out early and effective therapeutic strategies, staying alert of possible multi-resistant strains.

3'5-Dimaleamylbenzoic Acid Attenuates Bleomycin-Induced Pulmonary Fibrosis in Mice.

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterized by parenchymal scarring, leading progressively to alveolar architecture distortion, respiratory failure, and eventually death. Currently, there is no effective treatment for IPF. Previously, 3'5-dimaleamylbenzoic acid (3'5-DMBA), a maleimide, demonstrated pro-apoptotic, anti-inflammatory, and anti-cancer properties; however, its potential therapeutic effects on IPF have not been addressed. Bleomycin (BLM) 100 U/kg was administered to CD1 mice through an osmotic minipump. After fourteen days of BLM administration, 3'5-DMBA (6 mg/kg or 10 mg/kg) and its vehicle carboxymethylcellulose (CMC) were administered intragastrically every two days until day 26. On day 28, all mice were euthanized. The 3'5-DMBA effect was assessed by histological and immunohistochemical staining, as well as by RT-qPCR. The redox status on lung tissue was evaluated by determining the glutathione content and the GSH/GSSG ratio. 3'5-DMBA treatment re-established typical lung histological features and decreased the expression of BLM-induced fibrotic markers: collagen, α-SMA, and TGF-ß1. Furthermore, 3'5-DMBA significantly reduced the expression of genes involved in fibrogenesis. In addition, it decreased reduced glutathione and increased oxidized glutathione content without promoting oxidative damage to lipids, as evidenced by the decrease in the lipid peroxidation marker 4-HNE. Therefore, 3'5-DMBA may be a promising candidate for IPF treatment.

SARS-CoV-2 Spike Protein in Intestinal Cells of a Patient with Coronavirus Disease 2019 Multisystem Inflammatory Syndrome.

A previously healthy 12-year-old boy had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related multisystem inflammatory syndrome (MIS-C) that was rapidly fatal. Autopsy revealed the presence of a large intracardiac thrombus. SARS-CoV-2 spike protein was detected in intestinal cells, supporting the hypothesis that viral presence in the gut may be related to the immunologic response of MIS-C.

Uses, Knowledge and Extinction Risk Faced by Agave Species in Mexico.

We compiled an updated database of all Agave species found in Mexico and analyzed it with specific criteria according to their biological parameters to evaluate the conservation and knowledge status of each species. Analyzing the present status of all Agave species not only provides crucial information for each species, but also helps determine which ones require special protection, especially those which are heavily used or cultivated for the production of distilled beverages. We conducted an extensive literature review search and compiled the conservation status of each species using mainstream criteria by IUCN. The information gaps in the database indicate a lack of knowledge and research regarding specific Agave species and it validates the need to conduct more studies on this genus. In total, 168 Agave species were included in our study, from which 89 are in the subgenus Agave and 79 in the subgenus Littaea. Agave lurida and A. nizandensis, in the subgenus Agave and Littaea, respectively, are severely endangered, due to their endemism, lack of knowledge about pollinators and floral visitors, and their endangered status according to the IUCN Red List. Some species are at risk due to the loss of genetic diversity resulting from production practices (i.e., Agave tequilana), and others because of excessive and unchecked overharvesting of wild plants, such as A. guadalajarana, A. victoriae-reginae, A. kristenii, and others. Given the huge economic and ecological importance of plants in the genus Agave, our review will be a milestone to ensure their future and continued provision of ecosystem services for humans, as well as encouraging further research in Agave species in an effort to enhance awareness of their conservation needs and sustainable use, and the implementation of eco-friendly practices in the species management.

Effect of Experimental Gestational Diabetes Mellitus on Mechanical Sensitivity, Capsaicin-Induced Pain Behaviors and Hind Paw Glabrous Skin Innervation of Male and Female Mouse Offspring.

PURPOSE: Gestational diabetes mellitus (GDM) induces cardiovascular and metabolic disturbances in offspring. However, the effects of GDM in pain processing in offspring and whether male and female offspring are equally affected is not well known. Thus, we determined: i) whether GDM in mice affects offspring hindpaw mechanical sensitivity, capsaicin-induced spontaneous pain-like behaviors, and epidermal nerve fiber density (ENFD); and ii) whether there is sexual dimorphism in these parameters in offspring from GDM dams. METHODS: GDM was induced in pregnant ICR mice via i.p. streptozotocin (STZ). Then, glucose levels from dams and offspring were determined. Male and female offspring 2-3 months of age were evaluated for: a) baseline mechanical sensitivity of the hind paw by using von Frey filaments; b) number of flinches and time spent guarding induced by intraplantar capsaicin (0.1%); and c) density of PGP-9.5 and CGRP axons in the epidermis from the hind paw glabrous skin. RESULTS: Prepartum levels of glucose in STZ-treated dams were significantly increased compared to vehicle-treated dams; however, GDM or vehicle offspring displayed normal and similar blood glucose levels. Male and female GDM offspring showed significantly greater mechanical sensitivity and capsaicin-induced pain behaviors compared to vehicle offspring. Male GDM offspring displayed a slightly more intense nociceptive phenotype in the capsaicin test. PGP-9.5 and CGRP ENFD in hind paw glabrous skin were greater in male and female GDM offspring versus their controls. Sexual dimorphism was generally not observed in GDM offspring in most of the studied parameters. CONCLUSION: These results suggest GDM induced greater pain-like behaviors in adult offspring regardless of sex along with an increased ENFD of PGP-9.5 and CGRP in the hind paw glabrous skin. We show that GDM peripheral neuropathy differs from diabetic peripheral neuropathy acquired in adulthood and set the foundation to further study this in human babies exposed to GDM.

Greater caries-free survival of first permanent molars: Findings from a 7-year follow-up evaluation of a community-based oral health preventive program.

BACKGROUND: The occlusal surface of the first permanent molar is the most frequently affected site by dental caries. AIM: To assess the caries-free survival of first permanent molars in children participating in a community-based oral health preventive program. DESIGN: This was a retrospective study conducted on 426 children under 12 years of age, beneficiaries of a preventive program from 2009 to 2015, in El Cedro, Colombia. The program offered oral health care education, supervised brushing and mouth washing, and application of topical fluoride. By using parametric survival models for interval-censored data, primary and secondary caries-free survival of any first permanent molar was estimated and analyzed. RESULTS: Before program implementation, dental caries lesions presented at an average age, adjusted by age of eruption, of 8.3 years for primary caries lesion and 9.3 years for secondary caries lesion. After 7 years of the program, the estimated average age for presenting primary dental caries lesion was delayed by 4.6 years and by 5.3 years for secondary caries. CONCLUSION: The implementation of the oral health program led to improved caries-free survival of first permanent molars.

Pénfigo vulgar / Pemphigus vulgaris

Resumen: El pénfigo es una enfermedad autoinmunitaria y crónica de incidencia y prevalencia bajas; sin embargo, puede alcanzar mortalidad de incluso 75% sin tratamiento. Existen dos variedades principales: el pénfigo vulgar y el foliáceo, que en términos clínicos se distinguen por la aparición de ampollas en la piel, con afección de las mucosas en los pacientes con pénfigo vulgar. En esta revisión se detalla la epidemiología, causas, fisiopatología y tratamiento de esta enfermedad, con insistencia en la importancia de los esteroides como piedra angular del tratamiento de estos pacientes.

Abstract: Pemphigus is an autoimmune and chronic disease with low incidence and preva- lence. Nevertheless it could reach a 75% mortality rate without treatment. There are two principal types: vulgar pemphigus and foliaceus pemphigus, which are clinically characterized by skin blister appearance, with mucosal affection in patients with pemphigus vulgaris. This review details the epidemiology, etiology, physiopathology and treatment of this disease, remarking the steroid importance as the cornerstone in the management of these patients.

Características epidemiológicas y clínicas de los brotes de Enfermedades Transmitidas por Alimentos. Paraguay 2015 - 2016 / Epidemiological and clinical characteristics of disease broadcastes transmitted by food. Paraguay 2015 - 2016

Introducción: Las enfermedades transmitidas por alimentos (ETA) son consideradas como un problema de salud pública por el daño físico y económico que genera. Objetivo: Describir las características epidemiológicas y clínicas de los brotes de ETA en el Paraguay entre el 2015 y 2016. Metodología: Estudio descriptivo de corte transversal, con datos secundarios de la Dirección General de Vigilancia de la Salud. MSPyBS. Se calcularon frecuencias, medidas de tendencia central y proporción. Resultados: 14 brotes involucraron a 231personas, 56% mujeres (2015: 47%; 2016: 64%), 52% entre 5-14 años (2015: 57%; 2016: 47,5%). Las regiones sanitarias afectadas en 2015: Asunción (73%) y Central (19,8%), en tanto que en 2016: Caaguazú (42,5%) y Asunción (34,2%). En ambos años, se registran brotes en domicilios (2015: 14,4%; 2016: 5,8%) e instituciones educativas (2015: 4,5%; 2016: 35%). En un 62,8% (2015-2016) no se identifica el alimento sospechoso ingerido. El vómito fue síntoma más referido en 2015 (54,1%); en 2016 fue dolor abdominal (67,9%). El 44% de los casos se registraron en la semana epidemiológica (SE) 49 (2015) y el 42% en la SE 32 (2016). Conclusión: Para ambos periodos fueron similares las características de edad y sexo. Asunción se encuentra entre los primeros sitios de mayor notificación, identificándose como lugar de ingesta el domicilio o institución educativa en ambos periodos. Se observa deficiencias en cuanto al registro del alimento sospechoso y variaciones en cuanto a las manifestaciones clínicas y el periodo de tiempo en el que registraron el mayor número de casos (2015: verano; 2016: invierno) Palabras-clave: brote; enfermedades transmitidas por alimentos; vigilancia; Paraguay.

Introduction: Food borne diseases (ETA) is considered a public health problem due to the physical and economic damage it causes. Objective: To describe the epidemiological and clinical characteristics of ETA outbreaks in Paraguay between 2015 and 2016. Methodology: Cross-section descriptive study, with secondary data from the General Directorate of Health Surveillance. MSPyBS. Frequencies, measures of central tendency and proportion were calculated. Results: 14 outbreaks involved 231 people, 56% women (2015: 47%, 2016: 64%), 52% between 5-14 years (2015: 57%, 2016: 47.5%). The health regions affected in 2015: Asunción (73%) and Central (19.8%), while in 2016: Caaguazú (42.5%) and Asunción (34.2%). In both years, outbreaks were recorded in homes (2015: 14.4%, 2016: 5.8%) and educational institutions (2015: 4.5%, 2016: 35%). In 62.8% (2015-2016) the suspected ingested food is not identified. Vomiting was the most referred symptom in 2015 (54.1%); in 2016 it was abdominal pain (67.9%). 44% of the cases were registered in the epidemiological week (SE) 49 (2015) and 42% in EW 32 (2016). Conclusion: For both periods, the characteristics of age and sex were similar. Asunción is among the first sites of greater notification, identifying as place of intake the address or educational institution in both periods. Deficiencies are observed in the registration of suspect food and variations in clinical manifestations and the period of time in which they recorded the highest number of cases (2015: summer, 2016: winter) Key words: outbreak; foodborne diseases; surveillance; Paraguay

Perfil clínico-epidemiológico de los derechohabientes con tuberculosis del IHSS, Teguciglpa; período 2011-2016 / Clinical and epidemiological profile of rightholders with tuberculosis of IHSS, Tegucigalpa; period 2011-2016

Antecedentes: Las condiciones laborales de ciertas personas pueden favorecer la aparición de tuberculosis. Objetivo. Determinar la existencia de patrones ocupacionales entre derechohabientes con tuberculosis (TB), del Instituto Hondureño de Seguri-dad Social (IHSS) en Tegucigalpa y resultado del abordaje diagnóstico y tratamiento. Metodología. Estudio descriptivo, retrospectivo, en los derechohabientes del IHSS Tegucigalpa, con universo de 460,150; la muestra fueron todos los expedientes de personas con Tuberculosis del periodo 2011-2016 mayores de 18 años. Se obtuvo información de la base de datos, fichas de notificación, expediente clínico y libro de seguimiento, determinando ocupación, variables sociodemográficas y programáticas. Se analizaron frecuencias e intervalos de confianza utilizando Epi Info Versión 7.2. Se solicitó permiso al IHSS y se respetó la confidencialidad de datos. Resultados. Se encontró expedientes de 214 pacientes con tuberculosis siendo mujeres (113) 52.6% y hombres (101) 47.4%; (137) 64% presentaron tuberculosis pulmonar y (77) 36% con tuberculosis extrapulmonar. La situación laboral predominante fue la de los asalariados de ocupación no especificada (73/214) 34%, seguido de Jubilados (16/214) 7%, empleados de salud (12/214) 6%, vigilantes (5/214) 2% y empleados de maquila (5/214) 2%. El método diagnóstico más frecuente fue baciloscopia (127) 59%, tuvieron éxito de tratamiento (171) 80%, fallecieron (13) 6%, perdida de seguimiento (13) 6%. ConclusiónEs necesario diseñar estrategias de prevención y capacitación para diagnóstico y tratamiento oportuno en lugares de trabajo como compañías de vigilancia, maquila, escuelas y universidades, hospitales e investigar razones de excedo de fallecimientos y perdida de seguimiento de pacientes...(AU)

Mielitis Transversa Análisis Clínico y Revisión de Caso / Transverse Myelitis, Clinical Analysis and Case Review

Resumen: La mielitis transversa es una enfermedad inflamatoria y desmielinizante aguda o subaguda que se desarrolla en ausencia de afectación neurológica previa y compromete las vías sensitiva y motora además del control autónomo de la medula espinal. El cuadro se presenta como un dolor lumbar localizado, parestesias de inicio súbito en miembros inferiores con pérdida de la sensibilidad y paraparesia que puede evolucionar a paraplejia a lo que se suma comúnmente la disfunción vesical e intestinal; la coordinación y la sensibilidad de los miembros superiores también puede verse comprometida La incidencia de esta patología es baja, en los Estados Unidos oscila entre 14.000 casos nuevos en el año, de los cuales 33.000 persisten con secuelas. Afecta a hombres, mujeres y niños de todas las razas por igual, presentándose con más frecuencia entre los 10-19 años y los 30-39 años de edad. El diagnóstico diferencial incluye: síndrome de Guillain-Barré, compresión medular por tumores, mielopatías de origen vascular, esclerosis múltiple, neuromielitis óptica entre otros. El diagnóstico se basa en la presunción clínica, ante la cual debe solicitarse una resonancia magnética de manera urgente. El siguiente paso es realizar una punción lumbar para estudio en líquido cefalorraaquídeo (LCR) de células blancas, IgG y albúmina. El tratamiento de la mielitis transversa va encaminado hacia la resolución del proceso inflamatorio a nivel medular y la detención del avance del mismo.

Abstract Transverse myelitis is an acute or subacute inflammatory demyelinating disease that develops in the absence of previous neurological involvement and compromises the sensory and motor pathways in addition to the autonomous control of the spinal cord, the table is presented as a localized back pain, sudden paresthesia in lower limbs with loss of sensation and paraparesis which may progress to paraplegia commonly associated with bladder and bowel dysfunction; coordination and sensitivity of the upper limbs may also be compromised The incidence of this disease is low, in the United States ranges from 14,000 new cases per year of which 33,000 remain with sequelae. It affects men, women and children of all races equally predominantly between 10-19 years and 30-39 years of age. Differential diagnoses include Guillain- Barré syndrome, compression by spinal cord tumors, vascular myelopathy, multiple sclerosis, neuromyelitis óptica spectrum diseases amongst others. Diagnosis is based on clinical suspicion upon which an MRI should be requested urgently, the next step is to perform a lumbar puncture to study CSF white cell count, IgG and albumin. The treatment of transverse myelitis is aimed towards resolution of the inflammatory process in the spinal cord and avoiding neural deficit progression.

La era digital en la ortodoncia del siglo XXI / The digital age in the orthodontics of the 21st century

Desde el inicio mismo de los estudios diagnósticos y los análisis terapéuticos en el campo de la ortodoncia, y de manera progresiva y continua, se han desarrollado numerosas propuestas superadoras para conocer, profundizar y perfeccionarlos. El principal objetivo de esta permanente evolución es el de identificar y caracterizar con precisión las condiciones clínicas y radiográficas que cada paciente presenta en su particularidad y ofrecer tratamientos cada día más adecuados a las condiciones propias de cada sistema biológico en el que trabajamos como una unidad única, es decir, con individualidad. Los principales avances desde este último siglo están ligados a diversas filosofías conceptuales y a diferentes técnicas de trabajo. Es así que actualmente, los conceptos de eficacia y de eficiencia clínica, tanto para el paciente como para el profesional, nos llevan al desarrollo de diseños oclusales virtuales mediante tecnología asistida por computadoras y a la confección e instalación de aparatologías ortodóncicas personalizadas. Hoy podemos decir que la revolución digital es una realidad en la ortodoncia actual, lo que permite nuevas propuestas diagnósticas y la producción de nueva aparatología, para mejorar, facilitar y hacer más eficientes los tratamientos.

Since the very beginning of the diagnostic studies and the therapeutic analysis within orthodontics field, and in a progressive and continuous way, it has been developed plenty of overcoming proposals to know, learn more and improve them. The main goal of this every-day evolution is to precisely identify and characterize clinical and radiographic conditions that every patient shows in his particularity and to offer more and more proper treatments according to each own biological system conditions in which we work as a single unit, that is to say, with individuality. From the last century on, the principle advances are connected to various conceptual philosophies and to different working techniques. Thus, nowadays, clinical efficacy and efficiency concepts, both for the patient and the professional, lead us to the development of virtual occlusal designs through computer-assisted technology and to the making and installation of customized orthodontic appliances. Now we can say that digital revolution is a real fact in current orthodontics, that allows new diagnostic proposals and the production of new appliances to improve, facilitate and make treatments more efficient.

Contrasting trends of tuberculosis in the cities of San Pedro Sula and Tegucigalpa, Honduras, 2005-2014.

Objective To 1) describe and compare the trends of tuberculosis (TB) case notification rates (CNRs) and treatment outcomes in the two largest cities in Honduras (San Pedro Sula and Tegucigalpa) for the period 2005-2014 and 2) identify possible related socioeconomic and health sector factors. Methods This retrospective ecological operational research study used aggregated data from the National TB Program (socioeconomic and health sector information and individual data from the 2014 TB case notification report). Results TB CNRs declined steadily over the study period in Tegucigalpa (from 46 to 28 per 100 000 inhabitants) but remained high in San Pedro Sula (decreasing from 89 to 78 per 100 000 inhabitants). Similar trends were observed for smear-positive TB. While presumptive TB cases examined were similar for both cities, in San Pedro Sula the proportions of presumptive cases with a positive smear; (7.7% versus 3.6%) relapses (8.9% versus 4.2%); and patients lost to follow-up (10.9% versus 2.7%) were significantly higher, and the treatment success lower (75.7% versus 87.0%). San Pedro Sula had lower annual income per capita, fewer public sector health workers and facilities, and a higher and increasing homicide index. The 2014 TB case data from San Pedro Sula showed a significantly lower median age and a higher proportion of assembly plant workers, prisoners, drug abusers, and diabetes. Conclusions The TB rate was higher and treatment success lower, and health care resources and socio-demographic indicators less favorable, in San Pedro Sula versus Tegucigalpa. City authorities, the NTP, and the health sector overall should strengthen early case detection, treatment, and infection control, involving both public and private health sectors.

Estudio de Trombofilia en mujeres que sufrieron un evento trombótico durante una gesta. Tucumán / Thrombophilia study in women who suffered a thrombotic event during gestation. Tucumán

INTRODUCCIÓN El embarazo representa un estado de hipercoagulabilidad transitoria, como consecuencia de modificaciones en el flujo venoso, factores genéticos y anatómicos. La trombosis venosa es un evento cinco veces más frecuente en la mujer embarazada que en la no gestante de igual edad. Las alteraciones trombofílicas pueden estar presentes en el 50% de los pacientes con tromboembolismo venoso. OBJETIVO Investigar los factores trombofílicos hereditarios y/o adquiridos de las pacientes que sufrieron un evento tromboembólico venoso durante el embarazo y/o puerperio y fueron derivadas al Departamento Bioquímico-Laboratorio de Salud Pública de Tucumán entre enero de 2014 y agosto de 2016. MÉTODOS Se efectuó un estudio observacional descriptivo. Se realizó las pruebas globales de coagulación y dosaje de Antitrombina, Proteína C, Proteína S, Homocisteína, Fibrinógno, Laboratorio de Anticoagulante Lúpico a 39 mujeres que durante una gestación sufrieron un evento trombótico. RESULTADOS El 2,6% de las pacientes presentaron Antitrombina descendida, el 5% de Proteína C y un 12,8% de Proteína S. El estudio de la trombofilia mixta reveló hiperhomocisteinemia en un 30,8% y fibrinógeno superior a 400 mg% en un 7,7%. El laboratorio de SAF fue positivo en 2,6% con elevación aislada de beta dos glicoproteína I. DISCUSIÓN Un 46% de las pacientes estudiadas presentó alguna alteración en los componentes del sistema hemostático. Las mujeres que sufrieron un evento tromboembólico durante la gestación, son jóvenes, en edad fértil, susceptibles a nuevas gestas, procedimientos de fertilidad, u hormonales, ingesta de anticonceptivos, es por ello que resulta de interés evaluar el sistema hemostático, para que ante situaciones que favorezcan el desarrollo de un trombo, el servicio de salud pueda definir el tratamiento más adecuado

Anemia in Children Aged Four to Eight from a Semirural Community in Central East Area of Argentina.

We present the results of the first stage of the Program for the Control of Intestinal Parasitosis and Nutrition, analyzing the frequency of anemia and its relation with intestinal parasitic infections and socio-cultural and environmental factors present in school children from a semirural community of Argentina. A total of 123 children aged 4-8 years were interviewed; 93 (75.6%) of them showed up for blood extraction and a fecal sample was taken properly. The frequency of anemia was 33.3%; 45.0% in children aged 4-5 years and 24.5% in those aged 6-8 years (p=0.038). Intestinal parasites were found in 83.9% of the children; 75.0% in children aged 4-5 years and 90.6% in those aged 6-8 years (p=0.043). No statistical differences were found when relating parasitic infections, social/cultural variables and housing characteristic with anemia, probably of nutritional origin. This study reveals the coexistence of anemia and parasitic infections in apparently healthy children who were unnoticed by the conventional public health system.

Contrasting trends of tuberculosis in the cities of San Pedro Sula and Tegucigalpa, Honduras, 2005–2014 / Contrasting trends of tuberculosis in the cities of San Pedro Sula and Tegucigalpa, Honduras, 2005–2014 Ejecución Tendencias discordantes de tuberculosis en San Pedro Sula y Tegucigalpa, Honduras, del 2005 al 2014

Objective. To 1) describe and compare the trends of tuberculosis (TB) case notification rates (CNRs) and treatment outcomes in the two largest cities in Honduras (San Pedro Sula and Tegucigalpa) for the period 2005–2014 and 2) identify possible related socioeconomic and health sector factors. Methods. This retrospective ecological operational research study used aggregated data from the National TB Program (socioeconomic and health sector information and individual data from the 2014 TB case notification report). Results. TB CNRs declined steadily over the study period in Tegucigalpa (from 46 to 28 per 100 000 inhabitants) but remained high in San Pedro Sula (decreasing from 89 to 78 per 100 000 inhabitants). Similar trends were observed for smear-positive TB. While presumptive TB cases examined were similar for both cities, in San Pedro Sula the proportions of presumptive cases with a positive smear; (7.7% versus 3.6%) relapses (8.9% versus 4.2%); and patients lost to follow-up (10.9% versus 2.7%) were significantly higher, and the treatment success lower (75.7% versus 87.0%). San Pedro Sula had lower annual income per capita, fewer public sector health workers and facilities, and a higher and increasing homicide index. The 2014 TB case data from San Pedro Sula showed a significantly lower median age and a higher proportion of assembly plant workers, prisoners, drug abusers, and diabetes. Conclusions. The TB rate was higher and treatment success lower, and health care resources and socio-demographic indicators less favorable, in San Pedro Sula versus Tegucigalpa. City authorities, the NTP, and the health sector overall should strengthen early case detection, treatment, and infection control, involving both public and private health sectors.

Objetivo. Describir y comparar las tendencias de las tasas de notificación de casos de tuberculosis y los desenlaces terapéuticos en las dos principales ciudades de Honduras (San Pedro Sula y Tegucigalpa) durante el período del 2005 al 2014; y reconocer los posibles factores socioeconómicos y del sector de la salud que se relacionan con estos resultados. Métodos. Estudio ecológico retrospectivo de investigación operativa con datos agregados del Programa Nacional contra la Tuberculosis. La información socioeconómica y del sector de la salud y los datos individuales se obtuvieron del informe de notificación de casos de tuberculosis del 2014. Resultados. Las tasas de notificación de casos de tuberculosis disminuyeron en forma sostenida durante el período del estudio en Tegucigalpa (de 46 a 28 por 100 000 habitantes) pero permanecieron altas en San Pedro Sula (disminuyeron de 89 a 78 casos por 100 000 habitantes). Se observaron tendencias análogas en los casos de tuberculosis con baciloscopia positiva. Si bien el número de casos con presunción clínica de tuberculosis examinados en ambas ciudades fue equivalente, en San Pedro Sula los casos con baciloscopia positiva, las recaídas (8,9% frente a 4,2%) y los pacientes perdidos durante el seguimiento (10,9% frente a 2,7%) fueron significativamente más frecuentes y la tasa de éxito terapéutico fue más baja (75,7% frente a 87,0%). En San Pedro Sula se observó un ingreso anual por habitante más bajo, menos personal y establecimientos de salud en el sector público, y un índice más alto y creciente de homicidios. Los datos sobre los casos de tuberculosis del 2014 en San Pedro Sula revelaron una mediana de edad de los pacientes significativamente menor y una mayor proporción de trabajadores de instalaciones de montaje, prisioneros, consumidores de drogas y pacientes con diabetes. Conclusiones. En San Pedro Sula la tasa de tuberculosis fue más alta, la tasa de éxito terapéutico fue inferior y los indicadores sobre los recursos de atención de salud y los aspectos sociodemográficos fueron menos favorables en comparación con Tegucigalpa. Las autoridades municipales, el Programa Nacional contra la Tuberculosis y el sector sanitario en general deben fortalecer la detección temprana de casos, el tratamiento y el control de la infección mediante la participación del sector público y el sector privado de la salud. Palabras clave Tuberculosis, zonas

Contrasting trends of tuberculosis in the cities of San Pedro Sula and Tegucigalpa, Honduras, 2005 and 2014 / Tendencias discordantes de tuberculosis en San Pedro Sula y Tegucigalpa, Honduras, del 2005 al 2014

ABSTRACT Objective To 1) describe and compare the trends of tuberculosis (TB) case notification rates (CNRs) and treatment outcomes in the two largest cities in Honduras (San Pedro Sula and Tegucigalpa) for the period 2005–2014 and 2) identify possible related socioeconomic and health sector factors. Methods This retrospective ecological operational research study used aggregated data from the National TB Program (socioeconomic and health sector information and individual data from the 2014 TB case notification report). Results TB CNRs declined steadily over the study period in Tegucigalpa (from 46 to 28 per 100 000 inhabitants) but remained high in San Pedro Sula (decreasing from 89 to 78 per 100 000 inhabitants). Similar trends were observed for smear-positive TB. While presumptive TB cases examined were similar for both cities, in San Pedro Sula the proportions of presumptive cases with a positive smear; (7.7% versus 3.6%) relapses (8.9% versus 4.2%); and patients lost to follow-up (10.9% versus 2.7%) were significantly higher, and the treatment success lower (75.7% versus 87.0%). San Pedro Sula had lower annual income per capita, fewer public sector health workers and facilities, and a higher and increasing homicide index. The 2014 TB case data from San Pedro Sula showed a significantly lower median age and a higher proportion of assembly plant workers, prisoners, drug abusers, and diabetes. Conclusions The TB rate was higher and treatment success lower, and health care resources and socio-demographic indicators less favorable, in San Pedro Sula versus Tegucigalpa. City authorities, the NTP, and the health sector overall should strengthen early case detection, treatment, and infection control, involving both public and private health sectors.

RESUMEN Objetivo Describir y comparar las tendencias de las tasas de notificación de casos de tuberculosis y los desenlaces terapéuticos en las dos principales ciudades de Honduras (San Pedro Sula y Tegucigalpa) durante el período del 2005 al 2014; y reconocer los posibles factores socioeconómicos y del sector de la salud que se relacionan con estos resultados. Métodos Estudio ecológico retrospectivo de investigación operativa con datos agregados del Programa Nacional contra la Tuberculosis. La información socioeconómica y del sector de la salud y los datos individuales se obtuvieron del informe de notificación de casos de tuberculosis del 2014. Resultados Las tasas de notificación de casos de tuberculosis disminuyeron en forma sostenida durante el período del estudio en Tegucigalpa (de 46 a 28 por 100 000 habitantes) pero permanecieron altas en San Pedro Sula (disminuyeron de 89 a 78 casos por 100 000 habitantes). Se observaron tendencias análogas en los casos de tuberculosis con baciloscopia positiva. Si bien el número de casos con presunción clínica de tuberculosis examinados en ambas ciudades fue equivalente, en San Pedro Sula los casos con baciloscopia positiva, las recaídas (8,9% frente a 4,2%) y los pacientes perdidos durante el seguimiento (10,9% frente a 2,7%) fueron significativamente más frecuentes y la tasa de éxito terapéutico fue más baja (75,7% frente a 87,0%). En San Pedro Sula se observó un ingreso anual por habitante más bajo, menos personal y establecimientos de salud en el sector público, y un índice más alto y creciente de homicidios. Los datos sobre los casos de tuberculosis del 2014 en San Pedro Sula revelaron una mediana de edad de los pacientes significativamente menor y una mayor proporción de trabajadores de instalaciones de montaje, prisioneros, consumidores de drogas y pacientes con diabetes. Conclusiones En San Pedro Sula la tasa de tuberculosis fue más alta, la tasa de éxito terapéutico fue inferior y los indicadores sobre los recursos de atención de salud y los aspectos sociodemográficos fueron menos favorables en comparación con Tegucigalpa. Las autoridades municipales, el Programa Nacional contra la Tuberculosis y el sector sanitario en general deben fortalecer la detección temprana de casos, el tratamiento y el control de la infección mediante la participación del sector público y el sector privado de la salud.

Frequency of mandibular asymmetries evaluated by cone beam computed tomography at a radiology diagnostic center in Medellin, Colombia: 2011-2013 / Frecuencia de asimetrias mandibulares evaluadas por tomografia computarizada cone beam de un centro de diagnóstico radiológico de Medellín,Colombia: 2011-2013

Longitudinal differences on the left and right sides of the jaw with respect to the midline in three spatial planes are called mandibular asymmetries. Objective: To determine the frequency of mandibular asymmetries in three spatial planes by means of Cone Beam computed tomography (CBCT) and classify them according to the degree of difference between both sides. Methods: A total of 40 Cone Beam volumetric tomography (New Tom 3G Cone Beam Volumetric tomographic scanner) records were analyzed using simple random sampling of patients between the ages of 18 and 70 from 2011 until 2013. Axial slices were obtained from the lingula in cranio-caudal direction every 5 mm until the gonial angle. Results: From the records, 2.5 percent showed moderate degree of difference in the length of the mandibular body with predominance on the right side. For breadth of the ramus, predominance was found on the left side. In the length of the mandibular ramus, 10 percent presented moderate degree of predominance on the right side. Conclusions: 1) asymmetries are more frequent at the level of the mandibular ramus thickness; (2) moderate and severe degrees of differences are most frequently found in the mandibular ramus thickness. 3) It is not possible to proportionally determine mandibular ramus thickness only with a 2D image...

Se denominan asimetrías mandibulares a las diferencias longitudinales de los lados derecho e izquierdo de la mandíbula con respecto a la línea media en los tres planos espaciales. Objetivo: Determinar la frecuencia de asimetrías mandibulares en los tres planos del espacio por medio de tomografía computarizada Cone Beam (TCCB) y clasificarlas según el grado de diferencia entre ambos lados. Métodos: Se analizaron 40 registros de tomografía volumétrica Cone Beam, (New Tom 3G Cone Beam Volumetric Tomographic Scanner) mediante muestreo aleatorio simple de pacientes entre los 18 y 70 años de edad, entre los años 2011 y 2013. Se obtuvieron cortes axiales a partir de la língula en sentido cráneo-caudal cada 5 mm hasta llegar al ángulo goníaco. Resultados: El 2,5 por ciento de los registros presentaron diferencias moderadas en la longitud del cuerpo mandibular con predominio del lado derecho. En la amplitud de la rama se encontró predominio del lado izquierdo. En la longitud de la rama mandibular el 10 por ciento presentó predominio moderado del lado derecho. Conclusiones: 1) las asimetrías más frecuentes se encuentran a nivel del grosor de las ramas mandibulares. 2) Los grados de diferencias moderados y altos se presentan con mayor frecuencia en el grosor de las ramas mandibulares. 3) No es posible determinar proporcionalmente el grosor de las ramas mandibulares obteniendo solo una imagen 2D...

Evaluation of total white blood cell count as a marker for proviral load of bovine leukemia virus in dairy cattle from herds with a high seroprevalence of antibodies against bovine leukemia virus.

OBJECTIVE: To determine the reference interval for WBC counts in Holstein dairy cows from herds with high seroprevalence for anti-bovine leukemia virus (BLV) antibodies, analyze the correlation of total WBC counts and blood proviral load (bPVL) in BLV-infected animals, and determine whether total WBC count can be used a hematologic marker for in vivo infection. ANIMALS: 307 lactating cows from 16 dairy herds with high BLV seroprevalence. PROCEDURES: Blood samples were collected for assessment of plasma anti-BLV p24 antibody concentration (all cows), manual determination of WBC count (161 BLV-seronegative cows from 15 herds), and evaluation of bPVL (146 cows from another herd). RESULTS: The WBC count reference interval (ie, mean ± 2 SD) for BLV-seronegative dairy cows was 2,153 to 11,493 cells/µL. Of the 146 cows used to analyze the correlation between WBC count and bPVL, 107 (73%) had WBC counts within the reference interval; of those cows, only 21 (19.6%) had high bPVL. Most cows with high WBC counts (35/39) had high bPVL. Mean WBC count for cows with high bPVL was significantly higher than values for cows with low or undetectable bPVL. White blood cell counts and bPVL were significantly (ρ = 0.71) correlated. CONCLUSIONS AND CLINICAL RELEVANCE: These data have provided an updated reference interval for WBC counts in Holstein cows from herds with high BLV seroprevalence. In dairy cattle under natural conditions, WBC count was correlated with bPVL; thus, WBC count determination could be a potential tool for monitoring BLV infection levels in attempts to control transmission.