Alzheimer's disease DNA methylome of pyramidal layers in frontal cortex: laser-assisted microdissection study.

OBJECTIVE: To study DNA methylation patterns of cortical pyramidal layers susceptible to late-onset Alzheimer's disease (LOAD) neurodegeneration. METHODS: Laser-assisted microdissection to select pyramidal layers' cells in frontal cortex of 32 human brains (18 LOAD) and Infinium DNA Methylation 450K analysis were performed to find differential methylated positions and regions, in addition to the corresponding gene set functional enrichment analyses. RESULTS: Differential hypermethylation in several genomic regions and genes mainly in HOXA3, GSTP1, CXXC1-3 and BIN1. The functional enrichment analysis revealed genes significantly related to oxidative-stress and synapsis. CONCLUSION: The present results indicate the differentially methylated genes related to neural projections, synapsis, oxidative stress and epigenetic regulator genes and represent the first epigenome of cortical pyramidal layers in LOAD.

Prevalence of Trypanosoma cruzi in dogs (Canis familiaris) and triatomines during 2008 in a sanitary region of the State of Mexico, Mexico.

American trypanosomiasis is a public health problem in Latin America and southern parts of the United States. Infection in triatomines (vector) and domestic dogs (reservoir host) is a good indicator of Trypanosoma cruzi circulation and human risk of infection. The State of Mexico, Mexico, has been considered free of T. cruzi, and no detailed epidemiologic study has been conducted to assess the intricacies of the transmission cycle of the parasite in the region. Such studies would enhance our understanding of the epidemiology of T. cruzi infection in this geographic region and provide regional sanitary authorities with stronger fundamental knowledge for making decisions and allocating funds for Chagas disease control programs in the State of Mexico. The objective of this study was to determine the prevalence of T. cruzi infection in dogs (seroprevalence) and triatomines (fecal parasites) in a previously identified, discrete endemic region of parasite circulation and to widen our studies in the Tejupilco Sanitary Region located in the southern part of the State of Mexico. Dog blood samples (n=102) were analyzed for the presence of anti-T. cruzi antibodies by two assays, namely indirect hemagglutination assay and enzyme-linked immunosorbent assay. Triatomines (n=88) were collected and fecal aliquots were analyzed for the presence of parasites by light microscopy. Average seroprevalence in dogs in the Tejupilco Sanitary region was 24.5%, and the overall triatomine infection rate was 34.01%. Triatoma pallidipennis was the only triatomine species found in this region. Our data demonstrate that T. cruzi is actively circulating in the Tejupilco Sanitary Region and emphasize the requirement for epidemiologic surveillance programs throughout the putative endemic areas of the State of Mexico.

Initial surgical experience in laparoscopic total mesorectal excision for middle and lower third rectal cancer: short-term results.

INTRODUCTION: Total mesorectal excision (TME) of the rectum has been advocated as the gold standard surgical treatment of middle and lower third rectal cancer. Laparoscopy has gained acceptance among surgeons in the treatment of colon malignancies, while scepticism exists about laparoscopic TME in terms of safety and its oncological adequacy. OBJECTIVE: To evaluate the impact of laparoscopic TME on surgical and oncological outcome in a group of consecutive unselected patients. METHODS: One hundred and thirty-two patients with middle or inferior rectal cancer were admitted to our unit and underwent TME from December 1998 to February 2008. Eighty-nine patients were approached with laparoscopy. Patients staged cT3/4 cTxN+ or uTxN+ were submitted to neoadjuvant treatment. Postoperative complications and oncological outcomes were registered. RESULTS: In the laparoscopic group 80 anterior resections (including 4 intersphincteric resections and manual colo- anal anastomosis) and 9 abdominal-perineal resections were performed. 33.3% of patients were enrolled in "long-course" neoadjuvant chemo-radiotherapy (partial and complete response rates 88.2% and 11.8%, respectively). Protective lateral ileostomy was performed in 72% of patients. Mean operative time was 254.3+/-38.3 min and mean blood loss was 215+/-180 ml. Conversion rate was 12.7%. Morbidity rate was 39.3% without mortality. The rate of anastomotic leaks was 13.48%, reoperation rate 13.48%, recovery rate 3.1+/-1.4 days and hospital stay 10.4+/-4.6 days. Concerning adequacy of oncologic resection, mean distance of the tumour from the anal verge was 4.3+/-2.2 cm. Nodal sampling of 12.4+/-4.8 were obtained. Six patients (6/89, 6.74%) had a R1 margin: 3 distal and 3 circumferential. Median follow-up was 29 months and local recurrence rate was 5.79%. Four-year cumulative overall survival was 78% and disease-free survival was 63% (Kaplan-Meier method). CONCLUSIONS: Laparoscopic approach for rectal tumour is a technically demanding procedure, but it is oncologically safe.

Anestesia general balanceada: tramadol-halotano / Balanced general anesthesia: tramadol-halothano

El presente es un estudio prospectivo, para evaluar la técnica de anestesia general balanceada con Tramadol Clorhidrato al 0.1 por ciento vía endovenosa por infusión más Halotano al 1 por ciento vía inhalatoria; realizado en el Departamento de Anestesiología y Reanimación del Hospital General Nacional Dos de Mayo entre los meses de Agosto a Diciembre de 1993. El trabajo incluyó 50 pacientes entre los 16 y 70 años, previamente seleccionados, donde 27 (54 por ciento) fueron de sexo masculino y 23 (46 por ciento) de sexo femenino; los cuales fueron sometidos a diferentes tipos de cirugía, entre ellos: Cirugía Abdominal: 29 (58 por ciento), Traumatológica: 7 (14 por ciento), Ginecológica: 5 (10 por ciento), Otorrinolaringológica: 1 (2 por ciento). La mayoría fueron de cirugía electiva y algunos de cirugía de emergencia. Estos pacientes estaban incluidos dentro de ASA I y II. Se observó que las variaciones de funciones vitales (PAS, PAD,PAM Y FC) no fueron significativos tanto entre los basales, inducción y durante el transoperatorio. El tiempo operatorio varió entre menos de 1 hora hasta las 5 horas. Un gran porcentaje despertó entre los 30 y los 60 minutos post-operatorio, con un despertar de buena calidad con sedación óptima y analgesia residual importante, concluyendo que el 100 por ciento de casos presentaron analgesia residual de moderada a intensa por lo menos hasta cerca de las 6 horas post-operatorios. Aunque no se encontró una relación causa-efecto específica entre los efectos secundarios y la técnica tanto quirúrgica como anestésica, se presentaron náuseas en 13 pacientes, 5 llegaron al vómito, diaforesis: 7, retención uribnaria: 3, bradicardia: 1, depresión respiratoria: 1. Efectos secundarios de escasa incidencia clínica y reversibles en todos los casos. Debemos resaltar que estos efectos secundarios se presentaron de manera independiente de la dosis de Tramadol aplicados. Podemos concluir que ésta técnica anestésica, produce un adecuado balance analgésico-quirúrgico que hace llevadera la cirugía, además de continuar con un adecuado despertar y analgesia residual importante.