The fourth national anti-tuberculosis drug resistance survey in Peru.

BACKGROUND: Peru has one of the highest burdens of multidrug-resistant tuberculosis (MDR-TB), but universal drug susceptibility testing (DST) has not yet been achieved.OBJECTIVE: To estimate the proportion of drug resistance among smear-positive TB patients in Peru.DESIGN: From September 2014 to March 2015, we performed a national drug resistance survey of patients aged ≥15 years; TB was diagnosed based on sputum smear positivity. We performed DST at the National Reference Laboratory of the Peruvian National Institute of Health, Lima, Peru, using the proportion method in Middlebrook 7H10 agar for four first-line drugs and six second-line drugs, and the Wayne method for pyrazinamide.RESULTS: Of the 1908 new and 272 previously treated patients included in the analysis, 638 (29.3%) patients had resistance to at least one first-line drug. MDR-TB was diagnosed in 7.3% of new and 16.2% of previously treated patients (P < 0.001). There were five (0.2%) patients with extensively drug-resistant TB.CONCLUSION: MDR-TB has increased to 7.3% in new patients from 5.3% in the previous survey, indicating that resistance to anti-tuberculosis drugs is increasing in Peru. Ongoing community transmission of resistant strains highlights an urgent need for early diagnosis, optimised treatment and effective contact tracing of MDR-TB patients.

Exploratory analysis for the identification of false banknotes using portable X-ray Fluorescence spectrometer.

The aim of this study was to verify if a portable X-ray fluorescence (pXRF) spectrometer can recognize the security features in banknotes that are reproducible by counterfeiters. Peruvian Nuevo Sol banknotes were studied: 4 genuine and 3 fake ones, in 11 points of analysis for each one, at all 77 data set. The correlation analysis of spectra among original notes was 1.0, and there was no correlation with fake banknotes. pXRF prove that two security features were reproducible for counterfeiters.

Valuing and understanding fish populations in the Anthropocene: key questions to address.

Research on the values of fish populations and fisheries has primarily focused on bio-economic aspects; a more nuanced and multidimensional perspective is mostly neglected. Although a range of social aspects is increasingly being considered in fisheries research, there is still no clear understanding as to how to include these additional values within management policies nor is there a cogent appreciation of the major knowledge gaps that should be tackled by future research. This paper results from a workshop held during the 50th anniversary symposium of the Fisheries Society of the British Isles at the University of Exeter, UK, in July 2017. Here, we aim to highlight the current knowledge gaps on the values of fish populations and fisheries thus directing future research. To this end, we present eight questions that are deeply relevant to understanding the values of fish populations and fisheries. These can be applied to all habitats and fisheries, including freshwater, estuarine and marine.

Granuloma anular lineal / Linear granuloma annulare

Presentamos el caso de un varón de 60 años que consultó por lesiones violáceas, de morfología lineal, ligeramente infiltradas al tacto, localizadas en ambos flancos y región proximal de las extremidades, de 10 años de evolución y asintomáticas. El examen histopatológico resultó compatible con granuloma anular. El granuloma anular lineal es una entidad muy poco frecuente, siendo aún menos usual su presentación tan extensa (AU)

A 60 year-old man with a 10 year’s history of progressive a symthomatic eruption characterized by violaceous bands on the lateral aspect of trunk and internal part of the extremities is reported. The histopathological examination showed a granuloma annulare. Linear granuloma annulare is a very uncommon variant, and such an extensive eruption is exceptional to our knowledge (AU)

[Lymphomatoid papulosis in children: report of 9 cases and review of the literature]. / Papulosis linfomatoide en la infancia: presentación de 9 casos y revisión de la literatura.

BACKGROUND: Lymphomatoid papulosis is a rare lymphoproliferative T cell CD30+ disease with excellent prognosis which affects almost exclusively adult patients, being rarely in the childhood; thus the clinic and pathologic spectrum and the risk of evolution to another type of lymphoma are not well defined in the pediatric group. OBJECTIVE: The aim of this article is to analyze the characteristics of infantile lymphomatoid papulosis and review the literature. MATERIAL AND METHOD: A retrospective study analyzing the characteristics of 9 patients aged up to 18 diagnosed of lymphomatoid papulosis attended in our department from 1995 to 2009 was performed. RESULTS: The study included 7 boys and 2 girls aged between 2 and 17. Pityriasis lichenoides acuta's lesions appeared associated before and after lymphomatoid papulosis' development in 2 and 1 cases respectively. The lesions resolved spontaneously, leaving a postinflammatory hyperpigmentation (77%) or hypopigmentation (23%). The development of varioliform scars occurred in over 77% of cases. Histologically, all cases showed features compatible with type A of lymphomatoid papulosis. Molecular studies showed monoclonality in the 3 cases in which this technique was done. CONCLUSIONS: Infantile lymphomatoid papulosis is a rare entity clinically manifested as the adult form. This lymphoproliferative disease, which is occasionally associated with pityriasis lichenoides acuta, shows features compatible with the type A or histiocytoid pattern in the histological analysis. The development of other lymphoproliferative disorders is less frequent in the infantile form than in the adulthood. The prevalent association among pityriasis lichenoides and lymphomatoid papulosis observed in our analysis, as well as the difficulties which supposed to differentiate between these two pathologies in various cases, suggest that those entities could be part of a common clinical and pathological spectrum.

Papulosis linfomatoide en la infancia: presentación de 9 casos y revisión de la literatura / Lymphomatoid Papulosis in Children: Report of 9 Cases and Review of the Literature

Introducción: La papulosis linfomatoide es un proceso linfoproliferativo de células T CD30+ poco frecuente y de pronóstico excelente que generalmente afecta a adultos y, en menor medida a niños, por lo que tanto el espectro clínicopatológico como el riesgo de progresión a otro tipo de linfoma en el grupo pediátrico no está bien establecido. Objetivo: Analizar las características de la papulosis linfomatoide infantil a partir de la descripción de nuevos casos y de la revisión de la literatura. Material y método: Se realizó un estudio retrospectivo de 9 pacientes menores de 18 años diagnosticados de papulosislinfomatoide atendidos en nuestro servicio entre 1995 y 2009. Resultados: Se incluyeron 7 niños y 2 niñas de edades entre 2 y 17 años. Las lesiones de papulosis linfomatoide se vieron precedidas en 2 casos y seguidas en 1 de otras compatibles con pitiriasis liquenoide aguda. La resolución de las lesiones fue espontánea, dejando hiperpigmentación (77%) o hipopigmentación postinflamatoria (23%) y cicatrices en el 77% de los casos. Histológicamente todos los casos presentaron el patrón tipo A de papulosis linfomatoide. El estudio molecular mostró monoclonalidad en los 3 casos en los que fue realizado. Conclusiones: La papulosis linfomatoide infantil es una entidad rara que se manifiesta clínicamente como la forma adulta. Esta enfermedad linfoproliferativa, que ocasionalmente se asocia a pitiriasis liquenoide aguda, muestra hallazgos histológicos compatibles con el patrón histiocitoide o tipo A. El desarrollo de otros procesos linfoproliferativos malignos en el seguimiento posterior es menos frecuente en la papulosis linfomatoide infantil comparado con la variante adulta. La frecuente asociación de pitiriasis liquenoide y de papulosis linfomatoide encontrada en nuestro análisis, así como la dificultad que supone en algunos casos el diferenciar entre ambos procesos, permite sugerir que ambas patologías podrían formar parte de un espectro clínico-patológico común (AU)

Background: Lymphomatoid papulosis is a rare lymphoproliferative T cell CD30+ disease with excellent prognosis which affects almost exclusively adult patients, being rarely in the childhood; thus the clinic and pathologic spectrum and the risk of evolution to another type of lymphoma are not well defined in the pediatric group. Objective: The aim of this article is to analyze the characteristics of infantile lymphomatoid papulosis and review the literature. Material and method: A retrospective study analyzing the characteristics of 9 patients aged up to 18 diagnosed of lymphomatoid papulosis attended in our department from 1995 to 2009 was performed. Results: The study included 7 boys and 2 girls aged between 2 and 17. Pityriasis lichenoides acuta's lesions appeared associated before and after lymphomatoid papulosisŒ development in 2 and 1 cases respectively.The lesions resolved spontaneously, leaving a postinflammatory hyperpigmentation (77%) or hypopigmentation (23%). The development of varioliform scars occurred in over 77% of cases. Histologically, all cases showed features compatible with type A of lymphomatoid papulosis. Molecular studies showed monoclonality in the 3 cases in which this technique was done. Conclusions: Infantile lymphomatoid papulosis is a rare entity clinically manifested as the adult form. This lymphoproliferative disease, which is occasionally associated with pityriasis lichenoides acuta, shows features compatible with the type A or histiocytoid pattern in the histological analysis. The development of other lymphoproliferative disorders is less frequent in the infantile form than in the adulthood. The prevalent association among pityriasis lichenoides and lymphomatoid papulosis observed in our analysis, as well as the difficulties which supposed to differentiate between these two pathologies in various cases, suggest that those entities could be part of a common clinical and pathological spectrum (AU)

[Immunological status of the pediatric patient who has undergone heart surgery]. / Estado immunitario del paciente pediátrico operado del corazón.

UNLABELLED: Communication of results a study the effect of open and closed-heart surgery in the immune system of infants and children. Data collected 24 hrs before anesthesia and surgery and five days after surgery. Operating room and pediatric intensive care of Hospital Central de Petróleos Mexicanos (PEMEX) in the South, Mexico City. Children undergoing surgery for correction of congenital heart disease (age 16 months to 14 years). A total of 16 patients. MEASUREMENTS AND RESULTS: increased neutrophil counts with luymphopenia in both groups (p < 0.05), serum levels of the complement components C3 and C4 were higher after surgery, serum immunoglobulin IgG, IgA and IgM were higher after surgery, serum immunoglobulin IgG, IgA and IgM were decreased form preoperative levels (p < 0.01). Two patients had infection in the surgical wound. The effect of open and closed-heart surgery produced transitory immunodeficiency with recuperation of his immune systems and 5th day after surgery.

The effect of clobazam on steady state plasma concentrations of carbamazepine and its metabolites.

Steady state metabolite/parent drug plasma ratios were measured in 15 epileptic patients on carbamazepine (CBZ) monotherapy and in seven patients treated with CBZ and clobazam (CLB). CBZ plasma concentrations did not differ between the two groups but patients also treated with CLB exhibited higher concentrations of CBZ-10,11-epoxide (CBZ-E) and trans-10,11-dihydro-10,11-dihydroxy-CBZ (CBZ-T). Ratios between all of the metabolites of CBZ and the parent compound were higher in patients on polytherapy but the ratio between metabolites was not different. CLB comedication causes a moderate increase (about 1.5-fold) in CBZ metabolism, probably by inducing its epoxidation.