[Lupus enteritis. Report of one case]. / Dificultades en el diagnóstico de enteritis lúpica: presentación de un caso.

In lupus enteritis, circulating pathological immune complexes and thrombosis of intestinal vessels may occur, resulting in acute abdominal pain. We report a 24-year-old woman without a history of systemic lupus erythematosus (SLE), admitted for abdominal pain. An exploratory laparotomy found an appendicitis along with ascites. An appendectomy was performed, and the patient was discharged from the hospital two days later. Three days after discharge, the patient was admitted to another hospital due to the persistence of abdominal pain. An abdominal computed tomography scan showed diffuse mesenteric congestion, concentric bowel loops (double halo or target sign) and the presence of free fluid in the peritoneal cavity. Suspecting a rheumatic disorder, the diagnosis of SLE was confirmed by immunological studies. The patient was treated with pulses of methylprednisolone with good results.

Dificultades en el diagnóstico de enteritis lúpica: presentación de un caso / Lupus enteritis: report of one case

In lupus enteritis, circulating pathological immune complexes and thrombosis of intestinal vessels may occur, resulting in acute abdominal pain. We report a 24-year-old woman without a history of systemic lupus erythematosus (SLE), admitted for abdominal pain. An exploratory laparotomy found an appendicitis along with ascites. An appendectomy was performed, and the patient was discharged from the hospital two days later. Three days after discharge, the patient was admitted to another hospital due to the persistence of abdominal pain. An abdominal computed tomography scan showed diffuse mesenteric congestion, concentric bowel loops (double halo or target sign) and the presence of free fluid in the peritoneal cavity. Suspecting a rheumatic disorder, the diagnosis of SLE was confirmed by immunological studies. The patient was treated with pulses of methylprednisolone with good results.

Prevalence of eosinophilic esophagitis: A multicenter study on a pediatric population evaluated at thirty-six Latin American gastroenterology centers. / Prevalencia de esofagitis eosinofílica: estudio multicéntrico en población pediátrica evaluada en 36 centros de gastroenterología de América Latina.

INTRODUCTION AND OBJECTIVE: Eosinophilic esophagitis is a chronic, immune-mediated disease described in case series and publications worldwide. Over the past twenty years, the authors of different studies have attempted to evaluate its incidence and prevalence. The objetive of the present study was to estimate the prevalence of eosinophilic esophagitis in a group of children seen at 36 pediatric gastroenterology centers in ten Latin American countries. MATERIALS AND METHODS: A multicenter, observational, and cross-sectional study was conducted that estimated the period prevalence of eosinophilic esophagitis in children seen at outpatient consultation and that underwent diagnostic upper gastrointestinal endoscopy for any indication at 36 centers in 10 Latin American countries, within a 3-month time frame. RESULTS: Between April and June 2016, 108 cases of eosinophilic esophagitis were evaluated. Likewise, an average of 29,253 outpatient consultations and 4,152 diagnostic upper gastrointestinal endoscopies were carried out at the 36 participating centers. The period prevalence of eosinophilic esophagitis in the population studied (n=29,253) was 3.69 cases×1,000 (95% CI: 3.04 to 4.44), and among the children that underwent routine upper gastrointestinal endoscopy (n=4,152), it was 26x1,000 (95% CI: 22.6 to 29.4). CONCLUSIONS: The general period prevalence of eosinophilic esophagitis in a group of children evaluated at 36 Latin American pediatric gastroenterology centers was 3.69×1,000, and in the children that underwent endoscopy, it was 26×1,000. There was important prevalence variability between the participating countries and centers. The present analysis is the first study conducted on the prevalence of pediatric eosinophilic esophagitis in Latin America.

Procedimiento de frenotomía en infantes con láser / Frenectomy procedure in infants with laser

La anquiloglosia es una anormalidad congénita relativamente común del frenillo lingual, que impide los movimientos adecuados de la lengua y causa disturbios motores en este órgano. Esta alteración ocurre en 0.02% al 4.8% de los recién nacidos y está asociado en un 25% a 60% de dificultades durante el amamantamiento.El propósito del presente reporte de caso es mostrar las aplicaciones del Sistema Láser de Diodo Infrarrojo (940nm) para simplificar el abordaje quirúrgico de la anquiloglosia lingual en infantes y sus ventajas frente a la técnica convencional. (AU)

Ankyloglossia is a relatively common congenital abnormality of the lingual frenum that prevents tonge movements and causes motor disturbances in this organ. This alteration occurs in 0.02% to 4.8% of newborns and associated with 25% to 60% incidence of difficulties with breastfeeding.The purpose of this case report is to show applications of infrared Diode Laser System (940nm) to simplify the surgical approach lingual ankyloglossia in infants and its advantages over the conventional technique. (AU)

Within herd transmission and evaluation of the performance of clinical and serological diagnosis of foot-and-mouth disease in partially immune cattle herds.

The control of foot-and-mouth disease (FMD) in vaccinated populations relies upon surveillance activities such as clinical inspections (CI) and serological monitoring. New evidence to refine current surveillance guidelines has been provided by evaluating (1) the diagnostic performance of CI and serological tests for detection of FMD virus (FMDV) non-structural proteins (NSP), and (2) the within-herd transmission of the virus in partially immune cattle. Data came from 23 affected herds during an epidemic of FMDV type O in Bolivia, in 2007. All cattle (n=957) in these herds were clinically inspected and serum samples were collected one month after the last animal with clinical signs was detected. Samples were tested for the presence of antibodies against NSP using the PANAFTOSA 3ABC-ELISA test and a subset of samples were tested using the enzyme-linked immunoelectrotransfer blot assay (EITB). Data from clinical and serological diagnoses were analysed using a Bayesian model. The sensitivity Se and specificity Sp of the tests, as well as the prevalence and the within-herd reproduction ratio R of FMDV were estimated. In addition, risk factors for infection were identified. The Se of CI, the 3ABC-ELISA and the EITB tests were estimated to be 0.30, 0.88 and 0.96 respectively. The estimated Sp, in the same order, were 0.88, 0.93 and 0.97. The within-herd prevalence of infected animals ranged from 0.04 to 0.91 and R ranged from 1.02 to 2.68. It was observed that cattle coming from areas with high vaccination coverage had a lower risk of becoming infected than home-bred cattle from the affected herds, where vaccination coverage was thought to be low. Although these estimates come from herds kept under specific conditions, they provide a reference for future surveillance design and can inform simulation models for surveillance and control of FMD in similar cattle populations.

Pronóstico y recaída alcohólica en el hospital psiquiátrico n°14 de la Caja Nacional de Salud / Prognosis and alcoholic relapse at the Hospital Psiquiátrico N° 14, Caja Nacional de Salud

Objetivo: Estimar el tiempo de recaída alcohólica de pacientes internados en el hospital psiquiátrico N° 14 y construir un modelo predictivo de aquellos factores; pronóstico que cotidianamente se evalúan y registran en la historia clínica. Material y Métodos: Cohorte histórica descriptiva. La cohorte se construyó a través de la información contenida en 70 fichas clínicas de pacientes internados por intoxicación y dependencia alcohólica. El inicio del estudio fue el momento de la internación y se consideró un tiempo de seguimiento de 6 meses. Se usó el estimador de Kaplan Meier y regresión de Cox para los factores pronósticos. Resultados: El promedio de edad fue de 44.5 años, de 23.1 meses el tiempo de bebedor y de 16.2 días la ingesta de alcohol previa recaída. El 61 por ciento presenta una pareja legal y a los 6 meses, el 51 por ciento de los pacientes presentaron a lo menos una recaída. Controlando por factores de confusión, los factores predictores de recaída son la edad (HR 0.7 IC95 por ciento0.5, 0.99), tiempo de bebedor (HR 1.5 IC95 por ciento 1.1, 2.2), tiempo de ingesta previa recaída (HR 1.2 IC95 por ciento 0.97, 1.5), tenencia de pareja (HR<0.002 IC95 por ciento <0.004, 0.05), buena relación con la pareja (HR 0.002 IC95 por ciento <0.006, 0.4) y uso de drogas (HR 58.6IC95 por ciento 1.2, 2977). Conclusión: El tiempo estimado para la primera recaída de los pacientes del hospital psiquiátricos es de 5.8 meses. Controlando por factores de confusión, los factores de mal pronóstico son el uso asociado de drogas, mayor tiempo de bebedor e ingesta alcohol previa a la recaída.

Objective: To estimate the time to alcoholic relapse at the psychiatric hospital No. 14 and to estimate a predictive model of prognostic factors in clinical records. Methods: This is a historical cohort descriptive study. The cohort was constructed with the information contained in 70 clinical records. The onset of the study was considered when the patient was admitted for the first time and considered a follow-up period of 6 months. The time to alcoholic relapse and predictive model was estimated with the Kaplan-Meier estimator and Cox regression model. Results: The mean age was 44.5 years, 23.1 months for the time of alcohol intake and 16.2 drinking days and alcohol intake before the relapse. The 61 percent of the patients were married. At 6 months, 51 percent of patients experienced at least one alcoholic relapse. Controlling for confounders, predictors of relapse were age (HR 0.7CI95 percent 0.5, 0.99), time of alcohol intake (HR 1.5 CI95 percent 1.1, 2.2), while previous intake relapse (HR 1.2 95 percent 0.97, 1.5) having a partner (HR <0.002 95 percent <0.004, 0.05), good relationship with partner (HR 0.002 95 percent <0.006, 0.4) and drug use (HR 58.6IC95 percent 1.2, 2977). Conclusion: The estimated time to first alcoholic relapse of psychiatric hospital patients is 5.8 months. Controlling for confounders, the predictors of first relapse are drug use, longer drinking and alcohol intake prior to a relapse.

KCNH1 potassium channels are expressed in cervical cytologies from pregnant patients and are regulated by progesterone.

Potassium voltage-gated channel, subfamily H (eag-related), member 1 (KCNH1) potassium channels are potential tumour markers and cancer therapeutic targets and are up-regulated by oestrogens and human papilloma virus (HPV) oncogenes. However, the role of KCNH1 in normal tissues is poorly understood, and its expression in pregnancy is unknown. We wondered whether KCNH1 channels are expressed in cervical cells from pregnant patients and whether progesterone (P4) regulates KCNH1. The association with HPV was also investigated. KCNH1 protein expression was studied by immunocytochemistry in liquid-based cervical cytologies; 93 samples were obtained from pregnant patients at different trimesters, and 15 samples were obtained from non-pregnant women (controls). The presence of HPV was studied by PCR with direct sequencing and nested multiplex PCR. HeLa cervical cancer cells were transfected with human progesterone receptor-B (PR-B) and treated with P4. KCNH1 mRNA expression in these cultures was studied by real-time PCR. KCNH1 protein was detected in 100% of the pregnancy samples and in 26% of the controls. We found 18 pregnant patients infected with HPV and detected 14 types of HPV. There was no association between the percentage of cells expressing KCNH1 and either the presence or type of HPV. P4 induced KCNH1 mRNA and protein expression in cells transfected with human PR-B. No regulation of KCNH1 by P4 was observed in non-transfected cells. We show for the first time the expression of an ion channel during human pregnancy at different trimesters and KCNH1 regulation by P4 in human cells. These data raise a new research field for KCNH1 channels in human tissues.

Biochemical characterization of ecuadorian wild Solanum lycopersicum Mill. plants produced from non-cryopreserved and cryopreserved seeds.

This paper presents some of the effects of cryopreservation of wild Solanum lycopersicum Mill. seeds on the early stages of germination post liquid nitrogen exposure. Percentage of germination, conversion into plantlets and plant fresh mass were evaluated after cryostorage. Levels of chlorophyll pigments (a, b, total), malondialdehyde, other aldehydes, phenolics (cell wall-linked, free, and total) and proteins were determined. Peroxidase and superoxide dismutase activities were recorded. Liquid nitrogen exposure increased the percentage of seed germination at 5 days but at 7 days, the conversion into plantlets and the plant fresh mass were not statistically different between non-cryopreserved and cryopreserved samples. Several significant effects of cryopreservation were recorded at the biochemical level at 7 days of germination under controlled conditions. Highly significant effects due to liquid nitrogen exposure were observed in leaves: increased levels of peroxidase enzymatic and specific activities and cell wall-linked phenolics. Very remarkable effects were also recorded in roots: decreased contents of chlorophylls and cell wall-linked phenolics.

Bovine trypanosomosis in the Bolivian Pantanal.

Trypanosomosis caused by Trypanosoma vivax has been a constraint for cattle production in the Bolivian lowlands, since it was introduced in 1996. Flooded areas like the Bolivian Pantanal have a suitable environment for the presence and transmission of Salivarian trypanosomes and farmers from that region often report trypanosomosis-like problems on their farms. The objective of the present study, therefore, was to characterize the epidemiology of bovine trypanosomosis in the Bolivian Pantanal. In order to achieve this objective, 202 cattle from the province of Angel Sandoval and 209 cattle from the province of German Busch were randomly sampled (the Pantanal is located in both provinces). Twenty-nine farms in both provinces were visited, the farmers interviewed, and biologic samples collected from their cattle. Samples were submitted for parasitological and PCR evaluation and the prevalence of bovine trypanosomosis was estimated for each province. Laboratory results were correlated with the sampled animals packed cell volume (PCV) and body condition (BC) scores and the observed T. vivax parasites measured for morphometry analysis. Results from this study show differences in morphometric measures between T. vivax parasites from each province. Differences between provinces were also observed in the T. vivax-related disease situation. While in Angel Sandoval the PCV and BC of T. vivax-affected animals were significantly lower than those of the T. vivax-negative animals, in German Busch no differences were observed in the PCV and BC of T. vivax-positive or negative animals. Animal prevalence of T. vivax in Angel Sandoval was 27.79% (95% CI: 14.52-44.28) and in German Busch was 19.03% (95% CI: 9.19-30.75). The T. evansi animal prevalence in each province was 0.99% (95% CI: 0.27-2.99) and 5.71% (95% CI: 2.43-12.19), respectively. Based on questionnaire and laboratory results, it was concluded that trypanosomosis is a primary constraint for cattle production in the Bolivian Pantanal.

Sensitivity of different Trypanosoma vivax specific primers for the diagnosis of livestock trypanosomosis using different DNA extraction methods.

There are several T. vivax specific primers developed for PCR diagnosis. Most of these primers were validated under different DNA extraction methods and study designs leading to heterogeneity of results. The objective of the present study was to validate PCR as a diagnostic test for T. vivax trypanosomosis by means of determining the test sensitivity of different published specific primers with different sample preparations. Four different DNA extraction methods were used to test the sensitivity of PCR with four different primer sets. DNA was extracted directly from whole blood samples, blood dried on filter papers or blood dried on FTA cards. The results showed that the sensitivity of PCR with each primer set was highly dependant of the sample preparation and DNA extraction method. The highest sensitivities for all the primers tested were determined using DNA extracted from whole blood samples, while the lowest sensitivities were obtained when DNA was extracted from filter paper preparations. To conclude, the obtained results are discussed and a protocol for diagnosis and surveillance for T. vivax trypanosomosis is recommended.

Reconstrucción mamaria: injerto autólogo del complejo areola pezón / Breast reconstruction: nipple areola complex utologous graft

Presentar la experiencia en la utilización del injerto autólogo del complejo areola-pezón en la cirugía reconstructiva de la mama. Se analizan retrospectivamente las pacientes con cáncer de mama ingresadas para tratamiento quirúrgico en el Servicio de Cirugía II, del Hospital Central de Maracay, entre abril 1986 y abril 2001. Sólo 20 pacientes de un total de 178 (11,2 por ciento) fueron sometidas a variados procedimientos de reconstrucción y donde el complejo areola pezón fue retirado y luego utilizado como injerto. Pasos de la técnica son presentados señalando aspectos relacionados con la selección. La edad promedio fue de 41 años (24-58 años). Utilizando distintas técnicas de reconstrucción mamaria, doce de ellos con cirugía radical preservadora de piel, cuatro con técnica periareolar y ocho con trazado de mastopexia. A todo este grupo se le colocó prótesis subpectoral; tres casos reconstruidas con TRAM Flap, las cinco restantes con latissimus dorsi con adición de prótesis en cuatro de ellos. Ocho casos (40 por ciento), venían de recibir quimioterapia de inducción. El injerto autólogo de areola y pezón fue utilizado en todos los casos. Hubo epidermolisis e infección con pérdida de injerto en un caso, en otro, pérdida parcial, requiriendo ser reconstruidos en forma diferida con injerto de piel de zona pigmentada. La enorme ventaja y el impacto psicológico de una reconstrucción inmediata es evidente. El complejo areola-pezón utilizado como injerto, ofrece una alternativa válida y segura, sin riesgo de recidiva dando un aspecto más natural

Purification and characterization of beta-N-acetylhexosaminidase from bovine tick Boophilus microplus (Ixodide) larvae.

beta-N-Acetylhexosaminidase (HEX, E.C. 3.2.1.52) from larvae of the ixodid tick Boophilus microplus was purified to capillary zone electrophoresis homogeneity, and characterized. Enzyme purification was carried out by sequential liquid chromatography on Sephadex G-200, p-aminobenzyl-N-acetyl-beta-D-thioglucosamine affinity, and Mono-Q FPLC columns. Purification was about 1600-fold, with a yield of 10%, as determined with p-nitrophenyl-N-acetylglucosaminide as substrate. The enzyme presented optimum pH 4.7, and optimum temperature 65 degrees C. The molecular weight of non-denatured enzyme was estimated as 127,000 by gel filtration chromatography, and 60,000 in SDS-PAGE. The tick hexosaminidase presented glycosyl residues, as evidenced by binding to Concanavalin-A. Among several p-nitrophenyl glycosides tested as substrate, HEX was active only on p-nitrophenyl-N-acetylglucosaminide and p-nitrophenyl-N-acetylgalactosaminide. The purified enzyme presented immunogenicity in rabbit, and the correspondent antibodies inhibited about 90% of its original, in vitro activity.

Effect of antibodies against beta-N-acetylhexosaminidase on reproductive efficiency of the bovine tick Boophilus microplus.

A polyclonal antibody (anti-HEX) was developed against a soluble N-acetylhexosaminidase (HEX) isolated from larval extracts of Boophilus microplus. Purified hexosaminidase was strongly inhibited by the IgG fraction of this antibody. The antibody inhibited the hexosaminidase activity of other sources, such as haemolymph and larval membranes. The antibody reacted with different antigens in the tick haemolymph, but did not recognize any antigen in saliva, as seen by immunoblot analysis. The anti-HEX was inoculated into fully engorged B. microplus females, resulting in a decrease in oviposition of approximately 26%, relative to the effect of pre-immune IgG. These data show the potential of the use of this tick enzyme as an antigen in vaccine development.

Dietary risk factors associated with the transmission of Helicobacter pylori in Lima, Peru.

The factors influencing the risk of acquisition of Helicobacter pylori infection are not well established. One hundred four children (0-17 years of age) requiring an endoscopy for the evaluation of gastrointestinal symptoms had demographic and dietary data collected and biopsy specimens of the gastric antrum stained for the identification of H. pylori. The 52 (50%) infected subjects were significantly older than the uninfected ones with no difference in gender, crowding, source of drinking water, or exposure to domestic animals. Increased prevalence of infection was associated with increased consumption of food from street vendors, and decreased consumption of fruits in the subgroup that denied consuming food from street vendors. No association was found with consumption of fish, chicken, beef, beans, vegetables, rice, cheese, milk, and unboiled water. These findings support the role of food prepared under unhygienic conditions as a probable mechanism of transmission of H. pylori in developing countries.

Isolation of an aspartic proteinase precursor from the egg of a hard tick, Boophilus microplus.

An aspartic proteinase precursor, herein named BYC (Boophilus Yolk pro-Cathepsin) was isolated from eggs of the hard tick, Boophilus microplus. As judged by electrophoresis on sodium dodecyl sulfate polyacrylamide slab gel (SDS-PAGE), purified BYC presented 2 bands of 54 and 49 kDa, bearing the same NH2-terminal amino acid sequence. By Western blot analysis, BYC was also found in the haemolymph, indicating an extraovarian site of synthesis. Several organs were incubated in culture medium with [35S]methionine, and only the gut and fat body showed synthesis of BYC polypeptides. Protein sequencing of both the NH2-terminal and an internal sequence obtained after cyanogen bromide (CNBr) cleavage of BYC revealed homology with several aspartic proteinase precursors. Incubation at pH 3.5 resulted in autoproteolysis of BYC, which produced the mature form of the enzyme, that displayed pepstatin-sensitive hydrolytic activity against haemoglobin. Western blot analysis using anti-BYC monoclonal antibodies showed proteolytic processing of BYC during embryogenesis and suggested activation of the enzyme during development. A role of BYC in degradation of vitellin, the major yolk protein of tick eggs, is discussed.

Immunization of bovines with an aspartic proteinase precursor isolated from Boophilus microplus eggs.

The capacity of the Boophilus Yolk pro-Cathepsin (BYC) to induce a protective immune response in cattle against Boophilus microplus infestation was tested by vaccination experiments and by inoculation of monoclonal antibody (MAb) against BYC into fully engorged tick females. In immunization experiments the measurement of various biological parameters demonstrated a partial protection against B. microplus. A continuous decrease in the levels of specific antibodies was observed over 11 months when six bovines were maintained in field conditions. The inoculation of the MAb into tick females produced a dose-dependent decrease in oviposition and survival of the ectoparasite compared to the control.

Helicobacter pylori infection in children with abdominal ailments in a developing country.

Helicobacter pylori commonly infects children in developing countries. To determine the frequency of this infection and its potential role in specific gastrointestinal entities, all patients requiring upper gastrointestinal endoscopy for the evaluation of abdominal ailments in a gastroenterology practice in Lima, Peru, were evaluated during a 1-year period. Gastric biopsies were obtained for each child and were stained with hematoxylin-eosin and Warthin-Starry stains. Of the 107 evaluable patients (mean age 7.4 years, 58% boys), 52 (49%) were infected. The infection rate increased with older patients (P = 0.004). Children with recurrent abdominal pain (P = 0.04), an endoscopic finding of nodular gastritis (P = 0.007), and a histologic finding of chronic active gastritis (P < 0.0001) were infected more commonly.

Monoclonal antibodies against Boophilus microplus and their effects on tick reproductive efficiency.

Four monoclonal antibodies (mAbs) against extracts of embryo and gut tissue obtained from fully engorged Boophilus microplus were produced. The mAb BrBml reacted with different instars and tissues, the BrBm2 recognized only antigens present in gut extract and the mAbs BrBm3 and BrBm4 recognized vitellin. The effect of inoculation of these mAbs into fully engorged Boophilus microplus females was also evaluated. The mAbs BrBm1 and BrBm2 caused a decrease in oviposition of approximately 50% and 70%, respectively, and the mAbs BrBm3 and BrBm4 did not affect reproductive efficiency. This assay may be useful as a low-cost test to provide preliminary information on the possible effects of anti-tick antibodies in damaging ticks before attempting cattle vaccination experiments.

Functional bovine immunoglobulins in Boophilus microplus hemolymph.

The aim of the present work was to quantify the passage of bovine immunoglobulins into the hemolymph of the tick Boophilus microplus during the feeding process and to determine their antibody activity. The knowledge is of paramount importance when vector control or blocking of disease transmission is attempted by vaccination of cattle. Approximately 2% of bovine immunoglobulin present in the serum as determined by competitive ELISA was demonstrated in hemolymph of B. microplus and antibody activity against an antigen of B. microplus in the hemolymph of ticks fed on bovine immunized with the antigen purified from tick eggs was detected by Western blot assay. The antibody reactivity detected against the B. microplus antigen showed that functional antibodies are present in the hemolymph of fully engorged ticks for at least 48 h after completing the parasitic life cycle.