Toothpaste use in Peruvian children during COVID-19 pandemic: results from a National Demographic and Health Survey.

PURPOSE: To determine the impact of COVID-19 pandemic on use of toothpaste in Peruvian children. METHODS: A national database of Peruvian children from 0 to 11 years old was used to develop a cross-sectional study, with a final sample of 51, 013 subjects. Data were obtained of results of the Demographic and Family Health Survey (ENDES); the questionnaire was self-reported. The use of toothpaste and fluoride concentration in toothpaste were dependent variables, and for the independent variable, the year was considered; in addition, other covariates were included. The statistical analyses applied were descriptive, bivariate, and multivariate tests. RESULTS: Use of toothpaste was 98.99% (n = 50,134), while fluoride toothpaste with < 1000 ppm was used by 77.29% (n = 27,366). For bivariate analysis, use of toothpaste was associated with place and area of residence, altitude, natural region, and age; for use of fluoride toothpaste with minimum 1000 ppm, there was an association with place and area of residence, natural region, wealth index, and age. In a multivariate manner, year only presented a positive association with use of fluoride toothpaste < 1000 ppm (RPa:1.04; 95%CI 1.01-1.07). CONCLUSIONS: Year 2020 of COVID-19 pandemic had a positive impact on the use of < 1000 ppm fluoride toothpaste in Peruvian children.

Ultrasound-guided percutaneous liver biopsy in children. Five-year experience at a tertiary care center.

INTRODUCTION AND AIMS: Percutaneous liver biopsy with histopathologic analysis is a valuable tool for the diagnosis, prognosis, and treatment evaluation of liver diseases. Its ultrasound-guided performance is useful, making the procedure safer and reducing the risk for complications and hospital stay. Our aim was to describe the indications, histopathologic study, and complications associated with the performance of ultrasound-guided percutaneous liver biopsy in pediatric patients. MATERIAL AND METHODS: The study included 102 ultrasound-guided percutaneous liver biopsies performed on patients <16 years of age, within the time frame of January 2014 and December 2019. The information was obtained from electronic files and histopathologic studies and the data were analyzed through descriptive statistics. RESULTS: A total of 102 procedures were carried out on 99 patients. Mean patient age was 72 months and 58.8% of the patients were female. Over 65% of the indications for liver biopsy included autoimmune hepatitis (23.5%), elevated liver enzymes (21.5%), and chronic liver disease (20.5%). Four patients presented with immediate complications (3.9%), three of which were major (2.9%), concurring with that reported in the international literature. CONCLUSIONS: Our study corroborates the importance of ultrasound-guided liver biopsy in the diagnosis and follow-up of pediatric patients. The procedure also had a low complication rate of only 3.9%.

Ultrasound-guided percutaneous liver biopsy in children. Five-year experience at a tertiary care center. / Biopsia hepática percutánea guiada por ultrasonido en pediatría. Experiencia de 5 años en un centro de tercer nivel.

INTRODUCTION AND AIMS: Percutaneous liver biopsy with histopathologic analysis is a valuable tool for the diagnosis, prognosis, and treatment evaluation of liver diseases. Its ultrasound-guided performance is useful, making the procedure safer and reducing the risk for complications and hospital stay. Our aim was to describe the indications, histopathologic study, and complications associated with the performance of ultrasound-guided percutaneous liver biopsy in pediatric patients. MATERIAL AND METHODS: The study included 102 ultrasound-guided percutaneous liver biopsies performed on patients <16 years of age, within the time frame of January 2014 and December 2019. The information was obtained from electronic files and histopathologic studies and the data were analyzed through descriptive statistics. RESULTS: A total of 102 procedures were carried out on 99 patients. Mean patient age was 72 months and 58.8% of the patients were female. Over 65% of the indications for liver biopsy included autoimmune hepatitis (23.5%), elevated liver enzymes (21.5%), and chronic liver disease (20.5%). Four patients presented with immediate complications (3.9%), three of which were major (2.9%), concurring with that reported in the international literature. CONCLUSIONS: Our study corroborates the importance of ultrasound-guided liver biopsy in the diagnosis and follow-up of pediatric patients. The procedure also had a low complication rate of only 3.9%.

Expression of BAFF and BAFF receptors in primary Sjögren's syndrome patients with ectopic germinal center-like structures.

B cell-activating factor (BAFF) is an essential cytokine in primary Sjögren's syndrome (pSS) physiopathology. It has been reported that pSS patients develop germinal center-like (GC-like) structures in their minor salivary glands (MSGs). BAFF, BAFF-R, TACI, and BCMA expression was analyzed in MSGs from 29 subjects (nonspecific chronic sialadenitis and focal lymphocytic sialadenitis with the presence [pSS-GC(+)] or absence [pSS-GC(-)] of GC-like structures). Twenty-four percent of patients showed ectopic GC-like structures and a high focus score [p < 0.001 vs pSS-GC(-)]. BAFF serum levels (sBAFF) were high in pSS patients (p = 0.025 vs healthy subjects). However, the pSS-GC(-) group showed higher sBAFF levels than pSS-GC(+) patients. BAFF and BAFF-R glandular expression levels were higher in pSS-GC(+) patients, without significant differences compared to pSS-GC(-) patients. Soluble levels of BAFF correlated with anti-La/SSB antibodies and disease duration. Our results showed that BAFF could contribute to focal lymphocytic infiltration. The role of BAFF-binding receptors in MSGs is proposed as a mechanism for the possible establishment of ectopic GC-like structures and disease progression in some patients. In conclusion, this study supports previous evidence that considers the active BAFF system role in the pathogenesis of pSS and the need for strong biomarkers in this disease.

Quantitative defects in invariant NKT cells and TLR responses in patients with hyper-IgE syndrome.

BACKGROUND: Autosomal dominant hyper-IgE syndrome (AD-HIES) is a primary immunodeficiency mainly caused by mutations in STAT3, a signalling molecule implicated in the development of appropriate immune responses. We aimed to characterise the innate immune response in AD-HIES. METHODS: The frequency of innate immune cells in peripheral blood (PB) from seven AD-HIES patients and healthy controls were determined. CD80/CD86 surface expression and cytokine levels in supernatants from PBMC after stimulation with TLR-2, -4 and -9 agonists were also measured by flow cytometry. In addition, several SNPs within these TLR genes in genomic DNA samples from patients and controls were examined. RESULTS: A significantly reduced number of PB iNKT cells was observed in the AD-HIES group. CpG-stimulated pDC and mDC from patients exhibited a lower increase in the expression of the costimulatory molecule CD80. We also observed an increase in the secretion of IL-12p70, TNF-alpha and IL-10 in PBMC from HIES patients after LTA or LPS stimuli. No association was found between the different SNPs detected and the HIES phenotype. CONCLUSIONS: These findings demonstrate that important mediators of the innate immunity responses are affected in AD-HIES. More studies are necessary to investigate how the STAT3 function interferes with development of iNKT cells and TLR-mediated responses.

Monte Carlo modeling and optimization of contrast-enhanced radiotherapy of brain tumors.

Contrast-enhanced radiotherapy involves the use of a kilovoltage x-ray beam to impart a tumoricidal dose to a target into which a radiological contrast agent has previously been loaded in order to increase the x-ray absorption efficiency. In this treatment modality the selection of the proper x-ray spectrum is important since at the energy range of interest the penetration ability of the x-ray beam is limited. For the treatment of brain tumors, the situation is further complicated by the presence of the skull, which also absorbs kilovoltage x-ray in a very efficient manner. In this work, using Monte Carlo simulation, a realistic patient model and the Cimmino algorithm, several irradiation techniques and x-ray spectra are evaluated for two possible clinical scenarios with respect to the location of the target, these being a tumor located at the center of the head and at a position close to the surface of the head. It will be shown that x-ray spectra, such as those produced by a conventional x-ray generator, are capable of producing absorbed dose distributions with excellent uniformity in the target as well as dose differential of at least 20% of the prescribed tumor dose between this and the surrounding brain tissue, when the tumor is located at the center of the head. However, for tumors with a lateral displacement from the center and close to the skull, while the absorbed dose distribution in the target is also quite uniform and the dose to the surrounding brain tissue is within an acceptable range, hot spots in the skull arise which are above what is considered a safe limit. A comparison with previously reported results using mono-energetic x-ray beams such as those produced by a radiation synchrotron is also presented and it is shown that the absorbed dose distributions rendered by this type of beam are very similar to those obtained with a conventional x-ray beam.

Confounding and interaction effect of Treponema denticola salivary carriage in chronic periodontitis.

AIM: To evaluate the salivary carriage of Treponema denticola and its association with demographic variables in the etiopathogenesis of chronic periodontitis. SUBJECTS AND METHODS: Ninety-seven chronic periodontitis (CP) patients and a control group of 51 healthy subjects (HC) were selected. Periodontal status was assessed by criteria based on probing depth, attachment loss, extent, and severity of periodontal breakdown. A polymerase chain reaction method was used to determine the occurrence of T. denticola in saliva samples. Risk indicators for CP were assessed individually and adjusted for confounding and/or interaction using a logistic regression model. RESULTS: Although univariate analysis revealed a positive association of age >or=30 years, smoking, and salivary carriage of T. denticola with CP, after logistic regression analysis, the association between age >or=30 years/smoking and CP persisted, whereas salivary carriage of T. denticola failed to achieve statistical significance. An interaction effect was significantly detected between these three variables. CONCLUSION: Although salivary carriage of T. denticola may be a risk indicator for CP, its pathogenicity should not be exclusively endorsed to its detection in saliva, but it might be associated with the synergistic biological interaction of the bacterium with some demographic characteristics of the susceptible host.

Sudden birth versus sudden death of entanglement in multipartite systems.

We study the entanglement dynamics of two cavities interacting with independent reservoirs. Expectedly, as the cavity entanglement is depleted, it is transferred to the reservoir degrees of freedom. We find also that when the cavity entanglement suddenly disappears, the reservoir entanglement suddenly and necessarily appears. Surprisingly, we show that this entanglement sudden birth can manifest before, simultaneously, or even after entanglement sudden death. Finally, we present an explanatory study of other entanglement partitions and of higher dimensional systems.

[Dimorphism and pathogenesis of Histoplasma capsulatum]. / Dimorfismo y patogenia de Histoplasma capsulatum.

Dimorphism and pathogenesis of Hisdistoplasma capsulatum is a dimorphic fungal pathogen with worldwide significance, which causes a broad spectrum of disease. In the saprophytic stage, it lives as a mycelial form consisting of hyphae bearing both macro and microconidia. Infection with H. capsulatum occurs by inhalation of microconidia (1-4 x 2-6 microm) or small mycelia fragments (5-8 microm) in the terminal bronchioles and alveoli of the lung. Inhaled conidia then convert into the yeast form that is responsible for the pathogenesis of histoplasmosis. As a soil fungus with no known requirements for interacting with a mammalian host as a necessary stage of its life cycle, the number of its strategies for successful pathogenesis is particularly remarkable. They include dimorphic mould-yeast transition, entry into host macrophages, subcellular localization, intracellular survival and proliferation during clinically unapparent infection with capacity for reactivation. H. capsulatum became the subject of increasing studies concurrently with the rising prevalence of human immunodeficiency. This paper presents an overall view of advances in the investigation of H. capsulatum dimorphic transition and pathogenesis.

Primary reconstruction of anterior neck burns with free flaps.

Comprehensive management of acute neck burns is directed towards a satisfactory aesthetic and functional result. Primary microsurgical burn reconstruction of the anterior neck may offer advantages over the traditional technique of skin grafting and delayed reconstruction. It can be indicated in selected patients, obtaining good aesthetic results, with earlier functional recovery and reducing the number of surgical procedures required.

Isolation of Resistance Gene Candidates (RGCs) and characterization of an RGC cluster in cassava.

Plant disease resistance genes (R genes) show significant similarity amongst themselves in terms of both their DNA sequences and structural motifs present in their protein products. Oligonucleotide primers designed from NBS (Nucleotide Binding Site) domains encoded by several R-genes have been used to amplify NBS sequences from the genomic DNA of various plant species, which have been called Resistance Gene Analogues (RGAs) or Resistance Gene Candidates (RGCs). Using specific primers from the NBS and TIR (Toll/Interleukin-1 Receptor) regions, we identified twelve classes of RGCs in cassava (Manihot esculenta Crantz). Two classes were obtained from the PCR-amplification of the TIR domain. The other 10 classes correspond to the NBS sequences and were grouped into two subfamilies. Classes RCa1 to RCa5 are part of the first subfamily and were linked to a TIR domain in the N terminus. Classes RCa6 to RCa10 corresponded to non-TIR NBS-LRR encoding sequences. BAC library screening with the 12 RGC classes as probes allowed the identification of 42 BAC clones that were assembled into 10 contigs and 19 singletons. Members of the two TIR and non-TIR NBS-LRR subfamilies occurred together within individual BAC clones. The BAC screening and Southern hybridization analyses showed that all RGCs were single copy sequences except RCa6 that represented a large and diverse gene family. One BAC contained five NBS sequences and sequence analysis allowed the identification of two complete RGCs encoding two highly similar proteins. This BAC was located on linkage group J with three other RGC-containing BACs. At least one of these genes, RGC2, is expressed constitutively in cassava tissues.

Bordetella bronchiseptica infection in human immunodeficiency virus-infected patients.

Bordetella bronchiseptica is a pleomorphic gram-negative coccobacillus that commonly causes respiratory tract infections in dogs. We identified nine human immunodeficiency virus (HIV)-infected persons with culture-confirmed B. bronchiseptica infections (eight respiratory tract and one disseminated infection). The respiratory illnesses ranged in severity from mild upper respiratory tract infection to pneumonia. All nine patients had had at least one AIDS-defining condition before the B. bronchiseptica infection. Two patients had household contact with dogs before their illnesses, and one had household contact with cats. Infection due to B. bronchiseptica is uncommon in HIV-infected persons. Additional data are needed to fully define the spectrum of disease due to B. bronchiseptica infections and to evaluate the possibility that this infection may be acquired from pets. Treatment of B. bronchiseptica infection should be tailored to the patient and should be based on the results of susceptibility testing.

[Phaeohyphomicosis by Wangiella dermatitidis in Republic Argentine.]. / Feohifomicosis producida por Wangiella dermatitidis en la República Argentina.

We are presenting the case of a 54 year-old woman, who had a kidney transplant. She came to our laboratory to consult for two cutaneous lesions: a cystic one at the back of her right leg and one localized on dorsum of left forearm. Biopsies of both lesions were performed for a histopathologic study as well as microbiological (both bacteriologic and mycologic) cultures. The histopathologic study showed a lesion compatible with a B type cutaneous lymphoma in the lesion in her leg, while in the mycologic study of the cystic lesion elements compatible with phaeohyphomycosis were observed. Development of Wangiella dermatitidis was obtained in the cultures. The cystic lesion localized on forearm was completely removed by surgery, while the lesion in the leg received oncological treatment. The aim of this paper is to describe the first published case of phaeohyphomycosis, by W. dermatitidis, in the Argentine Republic.

Determination of metal ions in algal solution samples by capillary electrophoresis.

Trace metals determination in aqueous samples can be readily accomplished by capillary electrophoresis (CE) via indirect absorbance detection. A method for the separation of metal ions is presented and applied to the determination of seven metals in algal solution samples. 2-Hydroxyisobutyric acid background electrolyte (BGE) containing UV CAT-1 (an ultraviolet-absorbing amine) is used to perform capillary ion analysis. Acetic acid is used to adjust the pH value of BGE to 4.4. All ions can be separated in less than 15 min. All peaks are well separated and baseline resolved (i.e., no peaks overlapped). This work presents the applicability of CE to the quantitative analysis of algal solution samples and shows the adsorption process of seven metals in solution (Mn, Cd, Cr, Ni, Zn, Pb, Cu) to Chlorella vulgaris. The innovation of the application of CE in the determination of metals bound by Chlorella vulgaris is shown to be an improvement of the pH over what has been published previously. The detection limit is in the range of 13 (Mn) to 102 (Pb) ppb with electrokinetic injection mode (15 kV, 7 s). Reproducibility was 1.4% for the migration time, better than 5% for peak area for four of the metal ions (Cr, Mn, Cd, and Cu), and lower than 5% for the other three (Ni, Zn, and Pb). Calibration curves are linear for most ions in the 10(-7)-10(-5)M range (correlation coefficient r2 = 0.9933-0.9986) using electrokinetic injection mode.

Revisión del género Fusarium: especies oportunistas más frecuentemente aisladas en materiales clínicos / Review of Fusarium genus: opportunistic species frequently isolated from clinical samples

La incidencia de infecciones humanas por especies de Fusarium se ha incrementado en la medicina contemporánea fundamentalmente con el advenimiento de la inmunodepresión. El reconocimiento de estas especies involucradas en tales procesos, como sabemos, es dificultosa, por eso en este trabajo resumimos los aspectos más característicos a tener en cuenta y los principales criterios que pueden ser usados para la identificación de las especies responsables. Las principales características que se describen son: macromorfología de la colonia, por el anverso y el reverso. Micromorfología de las colonias: conidióforos, conidias macroconidias, mesoconidias, microconidias, clamidoconidias. También se incluye una clave de identificación de las especies de Fusarium más frecuentemente aisladas de lesiones humanas (AU)

Revisión del género Fusarium: especies oportunistas más frecuentemente aisladas en materiales clínicos / Review of Fusarium genus: opportunistic species frequently isolated from clinical samples

La incidencia de infecciones humanas por especies de Fusarium se ha incrementado en la medicina contemporánea fundamentalmente con el advenimiento de la inmunodepresión. El reconocimiento de estas especies involucradas en tales procesos, como sabemos, es dificultosa, por eso en este trabajo resumimos los aspectos más característicos a tener en cuenta y los principales criterios que pueden ser usados para la identificación de las especies responsables. Las principales características que se describen son: macromorfología de la colonia, por el anverso y el reverso. Micromorfología de las colonias: conidióforos, conidias macroconidias, mesoconidias, microconidias, clamidoconidias. También se incluye una clave de identificación de las especies de Fusarium más frecuentemente aisladas de lesiones humanas

Hallazgos micológicos en materiales provenientes de pacientes HIV(+) / Mycologic finding of samples obtained from HIV infected patients

La característica inmunológica del síndrome de inmunodeficiencia adquirida es una marcada reducción en los mecanismos de defensa mediados por células por lo tanto, no nos debe sorprender que individuos afectados con HIV padezcan afecciones producidas por hongos concomitantemente, ya que estos requieren una funci ón linfo-macrófago intacta para su contención y erradicación. Esta infecciones, micóticas son muy frecuentes como enfermedades marcadoras. En nuestro país la candidiasis es la segunda en orden de frecuencia, entre todas las infecciones microbianas, siendo sólo superada por el Pneumocystis carinii. Son importantes también en orden de frecuencia: criptococosis, histoplasmosis, aspergilosis, zigomicosis, y otras micosis cuya incidencia es menor. El objetivo de este trabajo es evaluar los aislamientos en 1027 análisis micológicos realizados desde 1988 hasta 1996 inclusive, provenientes de pacientes HIV(+). Se analizaron distintas muestras: sangre, secreciones vaginales, LCR (líquido cefalorraquídeo), esputos, BAL (lavado broncoalveolar), médula ósea, biopsias, secreciones en general, materia fecal, orina, escamas de piel, entre otras. Las micosis que se detectaron con mayor frecuencia en estos enfermos inmunocomprometidos son candidiasis: 16,36 por ciento, histoplasmosis 5,06 por ciento, criptococosis 4,48 por ciento, dermatofitias 0,30 por ciento, aspergilosis: 0,10 por ciento, geotricosis 0,10 por ciento, trichosporonosis 0,10 por ciento, como se demuestra tanto en las tablas como en el gráfico. Esto concuerda con la frecuencia observada en otros laboratorios de detección de infecciones micóticas (AU)