Population structure of Pseudomonas aeruginosa through a MLST approach and antibiotic resistance profiling of a Mexican clinical collection.

Pseudomonas aeruginosa is one of the most important pathogens worldwide. Population genetics studies have shown that the P. aeruginosa population has an epidemic structure with highly conserved clonal complexes. Nonetheless, epidemiological studies of P. aeruginosa have been historically absent or infrequent in developing countries, in which different medical treatments, conditions and infrastructure may have an impact in population dynamics and evolutionary outcomes, including antibiotic resistance profiles. In this study we contribute to fill this gap by analyzing 158 P. aeruginosa isolates from the most extensive nosocomial collection in Mexico City. We investigated the population genetic structure through a MLST approach together with a classical microbiology antibiotic resistance profiling, one of the associated concerns in the evolution of this pathogen. On the one hand, our results are in accordance with previous studies on the epidemic structure of P. aeruginosa, as well as the existence of three main phylogroups, that are not related to environmental parameters. On the other hand, antibiotic resistance profiles indicate higher prevalence in our sample of multi drug resistant (75.15%), extremely drug resistant (17.72%) and pan-drug resistant (9.49%) than resistance reported in developed countries. It is important to reflect on the causes that make less developed countries hotspots of antibiotic resistance, considering the multifactorial aspects of the socio-political context of such countries that include, but are not restricted to, public policy implementation and enforcement regarding access to antibiotics, as well as health care personnel education and other obstacles related to poverty and unequal access to health services and information.

Embarazo adolescente: Diversidad de síntomas de un mismo diagnóstico / Teenage pregnancy: Diversity of symptoms of the same diagnosis

Introducción: En la Argentina, hay 754.600 nacimientos por año, de los cuales el 15% proviene de madres adolescentes de entre 15 a 19 años. Este porcentaje varía en las diferentes provincias, siendo mayor en el Noreste y Noroeste argentino. El 65.5% de ellas no usaba ningún método anticonceptivo al momento de la concepción, muchas de ellas por desconocimiento sobre salud reproductiva. La alta frecuencia de embarazos en la población adolescente, muchos de ellos no planeados, aumenta el riesgo de exposición a un aborto inseguro, abandono escolar y de limitaciones en el acceso al mercado laboral, condicionando así las perspectivas de desarrollo personal. Es evidente que la diversidad de manifestaciones clínicas de esta entidad hace que ante la consulta del adolescente no siempre se lo tenga presente como posible diagnóstico diferencial en primera instancia. Considerar el embarazo a tiempo optimizaría la atención al brindar información a la paciente y al realizar la derivación a un centro especializado para su seguimiento. Asimismo también se evitaría la utilización de métodos diagnósticos o terapéuticos que resulten nocivos para el producto de la gestación. Objetivos: Describir los motivos de consulta realizados por pacientes adolescentes menores de 19 años, en el Hospital Garrahan durante el período comprendido entre 2012 y 2016, que concluyeron con el diagnóstico de embarazo. Describir el número de consultas, y exámenes complementarios solicitados hasta que se arribó al diagnóstico. Metodología: estudio retrospectivo, descriptivo observacional, a través del análisis de las historias clínicas (HC) y base de datos del laboratorio de todas las pacientes femeninas menores de 19 años, que hayan consultado en el periodo comprendido entre 2012 a 2016. Resultado: Se obtuvo un total de 46 pacientes adolescentes con diagnóstico de embarazo. Si bien el síntoma más frecuente fue la alteración del ciclo menstrual, sólo en el 50% fue lo que motivó la consulta. En el 74% de los casos el diagnóstico se realizó en la primera atención. En el 33% de las pacientes no se registró en la HC el uso de MAC (Métodos Anti Conceptivos). En los casos que se interrogó acerca del uso de MAC, sólo el 55% lo hacía en forma correcta. Conclusión: El diagnóstico de embarazo debe considerarse frente a la consulta de pacientes adolescentes. Es necesario pesquisar la existencia de alteraciones en el ciclo menstrual y el uso de MAC en esta población (AU)

In Argentina, there are 754,600 births yearly, of which 15% are to adolescent mothers between 15 and 19 years of age. This percentage varies according to the different provinces, and is higher in the north-east and north-west of the country. Of the mothers, 65.5% did not use any contraceptive method at the moment of conception, in many of them due to lack of knowledge of reproductive health. The high rate of teenage pregnancies, many of them unplanned, increases the risk of exposure to unsafe abortions, school drop-out, limitation to access to the labor market thereby reducing perspectives of personal development. Clearly, the variability of clinical manifestations associated with this entity, in an adolescent pregnancy is not always considered as an early differential diagnosis. Early awareness of pregnancy would improve care by providing information to the patient and referral to a specialized center for follow-up. Additionally, the use of diagnostic or therapeutic methods that are harmful for the fetus are avoided. Objectives: To describe the reasons for consultation of teenage patients under 19 years of age at Garrahan Hospital between 2012 and 2016, in whom finally the diagnosis was pregnancy and to describe the number of consultation and complementary exams previous to the diagnosis. Methodology: A retrospective, descriptive, observational study was conducted through the analysis of clinical charts (CC) and laboratory data base of all female patients younger than 19 years of age that consulted between 2012 and 2016. Results: 46 teenage patients with the diagnosis of pregnancy were identified. Although the most frequent symptom was alteration of the menstrual cycle, this was the reason for consultation in only 50%. In 74% of the cases the diagnosis was made in the first visit. In 33% of the patients the use of methods of contraception (MOC) was not recorded in the CC. When the patient was asked about the use of MOC, only 55% used them correctly. Conclusion: The diagnosis of pregnancy should be considered in teenage patients. Screening for alterations in the menstruation and the use of MOC is necessary in this population (AU)

Comparative analysis of low complexity regions in Plasmodia.

Low complexity regions (LCRs) are a common feature shared by many genomes, but their evolutionary and functional significance remains mostly unknown. At the core of the uncertainty is a poor understanding of the mechanisms that regulate their retention in genomes, whether driven by natural selection or neutral evolution. Applying a comparative approach of LCRs to multiple strains and species is a powerful approach to identify patterns of conservation in these regions. Using this method, we investigate the evolutionary history of LCRs in the genus Plasmodium based on orthologous protein coding genes shared by 11 species and strains from primate and rodent-infecting pathogens. We find multiple lines of evidence in support of natural selection as a major evolutionary force shaping the composition and conservation of LCRs through time and signatures that their evolutionary paths are species specific. Our findings add a comparative analysis perspective to the debate on the evolution of LCRs and harness the power of sequence comparisons to identify potential functionally important LCR candidates.

Microsurgical reconstruction in limb salvage due to a giant cell tumor of the distal radius. Case report.

The giant cell tumor of bone is one of the most controversial neoplasms due to growth patterns that may present. The case reported shows a very aggressive tumor in a classic location, but key to hand function. Rather than treat with radical surgery, was planned and performed a wide resection with an ulnar-carpus arthrodesis and microsurgical reconstruction of the defect throught an anterolateral thigh flap. The multidisciplinary approach of bone neoplasms produce a positive impact on patients.

El tumor óseo de células gigantes es una de las neoplasias más controversiales debido a los patrones de crecimiento que pueden presentar. El caso reportado muestra un tumor muy agresivo en una localización clásica, pero clave para la función de la mano. En lugar de tratarla mediante cirugía radical, se planeó y realizó una resección amplia con artrodesis cúbito-carpiana y la reconstrucción microquirúrgica del defecto mediante un colgajo anterolateral de muslo. El abordaje multidisciplinario de las neoplasias óseas repercute positivamente en los pacientes.

GIS-based pollution hazard mapping and assessment framework of shallow lakes: southeastern Pampean lakes (Argentina) as a case study.

The assessment of water vulnerability and pollution hazard traditionally places particular emphasis on the study on groundwaters more than on surface waters. Consequently, a GIS-based Lake Pollution Hazard Index (LPHI) was proposed for assessing and mapping the potential pollution hazard for shallow lakes due to the interaction between the Potential Pollutant Load and the Lake Vulnerability. It includes easily measurable and commonly used parameters: land cover, terrain slope and direction, and soil media. Three shallow lake ecosystems of the southeastern Pampa Plain (Argentina) were chosen to test the usefulness and applicability of this suggested index. Moreover, anthropogenic and natural medium influence on biophysical parameters in these three ecosystems was examined. The evaluation of the LPHI map shows for La Brava and Los Padres lakes the highest pollution hazard (≈30 % with high to very high category) while Nahuel Rucá Lake seems to be the less hazardous water body (just 9.33 % with high LPHI). The increase in LPHI value is attributed to a different loading of pollutants governed by land cover category and/or the exposure to high slopes and influence of slope direction. Dissolved oxygen and biochemical oxygen demand values indicate a moderately polluted and eutrophized condition of shallow lake waters, mainly related to moderate agricultural activities and/or cattle production. Obtained information by means of LPHI calculation result useful to perform a local diagnosis of the potential pollution hazard to a freshwater ecosystem in order to implement basic guidelines to improve lake sustainability.

[Irritable bowel syndrome: frequency and phylogenetic relationship of Blastocystis sp. from Mexican patients]. / Síndrome de intestino irritable: frecuencia y relación filogenética de Blastocystis sp. de pacientes mexicanos.

INTRODUCTION: Recent studies reported increased presence of Blastocystis in patients with Irritable Bowel Syndrome (IBS) and an etiologic role has been proposed. The pathogenic role of Blastocystis is controversial, because it is frequently found not only in individuals with enteric symptoms but also in healthy and asymptomatic subjects. Furthermore, there are few studies of blastocistosis in Mexico. OBJECTIVE: To assess the frequency of Blastocystis sp. in IBS patients using molecular techniques and to describe its phylogenetic relationship with sequences of other countries. METHODS: IBS patients according to Rome III criteria were enrolled. In all patients evaluations included: colonoscopies, coproparasitoscopic studies, coproculture, fecal virus screening. PCR and sequencing for Blastocystis sp. were also performed. RESULTS: We recruited 11 men and 51 women with a mean age of 45.6 (SD ± 15.7) years. Eighty-six percent of the IBS patients presented a normal colonoscopy, 8% showed polyps and 6% diverticular disease. Blastocystis sp. was identified in 25% patients (all of them with normal colonoscopy), while two patients had Endolimax nana and Entamoeba histolytica/E. dispar, respectively. Phylogenetic analysis showed that major sequences of Mexican carriers clustered together with sequences of parasites from Japan and Denmark; furthermore, two sequences from IBS patients were grouped in a single cluster. CONCLUSIONS: Blastocystis sp. was identified in 25% of the IBS patients. Our data support the hypothesis of clonal lineages in distinct geographical areas in the world.

Isolation and characterization of new facultative alkaliphilic Bacillus flexus strains from maize processing waste water (nejayote).

AIMS: This work describes the isolation and characterization of two new alkaliphilic micro-organisms present in nejayote. METHODS AND RESULTS: Samples of fresh industrial nejayote were plated on nejayote medium and incubated for 4 days at 37 °C. Isolates were identified based on morphological and physiological characteristics, as well as 16S rDNA sequence analysis. Two gram-positive strains, NJY2 and NJY4, able to hydrolyse starch, xylan, and gelatin were isolated from nejayote. Comparative sequence analysis of 16S rDNA and phylogenetic studies indicate that the micro-organisms studied were closely related to members of the Bacillus flexus species. The strains were identified as facultative alkaliphilic salt tolerant bacteria. Isolate NJY2 produced cell associated phenolic acid esterases, able to release ferulic acid from nixtamalised corn bran and ethyl and methyl esters. CONCLUSIONS: The isolated strains of B. flexus NJY2 and NJY4 showed important physiological properties to produce high-value molecules from agroindustrial by-products. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report about the isolation of alkaliphilic micro-organisms from nejayote and the first report of phenolic acid esterases synthesised by alkaliphiles. The new alkaliphilic micro-organisms have potential application in the treatment and transformation of tortilla industry residues.

Glycoproteins histochemistry of the gills of Odontesthes bonariensis (Teleostei, Atherinopsidae).

The histochemistry of glycoproteins (GP) in the mucous cells of the gills of the silverside Odontesthes bonariensis was identified with: (1) oxidizable vicinal diols; (2) sialic acid and some of their chain variants, carbon 7 ((7) C), carbon 8 ((8) C) or carbon 9 ((9) C); (3) sialic acid residues without O-acyl substitution and with O-acyl substitution at (7) C, (8) C or (9) C; (4) carboxyl groups and (5) sulphate groups. A battery of seven biotinylated lectins allowed GPs sugar residues to be distinguished. Mucous cells showed the presence of neutral, sulphated and sialylated GPs. Dolichos biflorus agglutinin (DBA) and Glycine max agglutinin (SBA) showed strong positive staining; Arachis hypogaea agglutinin (PNA), Ricinus communis agglutinin-I (RCA-I) and Triticum vulgaris agglutinin (WGA) showed moderate staining, while Ulex europaeus agglutinin-I (UEA-I) was completely negative.

Molecular profiles of Venezuelan isolates of Trypanosoma sp. by random amplified polymorphic DNA method.

Nine Trypanosoma sp. Venezuelan isolates, initially presumed to be T. evansi, were collected from three different hosts, capybara (Apure state), horse (Apure state) and donkey (Guarico state) and compared by the random amplification polymorphic DNA technique (RAPD). Thirty-one to 46 reproducible fragments were obtained with 12 of the 40 primers that were used. Most of the primers detected molecular profiles with few polymorphisms between the seven horse, capybara and donkey isolates. Quantitative analyses of the RAPD profiles of these isolates revealed a high degree of genetic conservation with similarity coefficients between 85.7% and 98.5%. Ten of the primers generated polymorphic RAPD profiles with two of the three Trypanosoma sp. horse isolates, namely TeAp-N/D1 and TeGu-N/D1. The similarity coefficient between these two isolates and the rest, ranged from 57.9% to 68.4% and the corresponding dendrogram clustered TeAp-N/D1 and Te Gu-N/D1 in a genetically distinct group.

Effects of ramipril and rosiglitazone on cardiovascular and renal outcomes in people with impaired glucose tolerance or impaired fasting glucose: results of the Diabetes REduction Assessment with ramipril and rosiglitazone Medication (DREAM) trial.

OBJECTIVE: Impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG) are risk factors for diabetes, cardiovascular disease (CVD), and kidney disease. We determined the effects of ramipril and rosiglitazone on combined and individual CVD and renal outcomes in people with IGT and/or IFG in the Diabetes REduction Assessment With ramipril and rosiglitazone Medication (DREAM) trial. RESEARCH DESIGN AND METHODS: A total of 5,269 people aged >or=30 years, with IGT and/or IFG without known CVD or renal insufficiency, were randomized to 15 mg/day ramipril versus placebo and 8 mg/day rosiglitazone versus placebo. A composite cardiorenal outcome and its CVD and renal components were assessed during the 3-year follow-up. RESULTS: Compared with placebo, neither ramipril (15.7% [412 of 2,623] vs. 16.0% [424 of 2,646]; hazard ratio [HR] 0.98 [95% CI 0.84-1.13]; P = 0.75) nor rosiglitazone (15.0% [394 of 2,635] vs. 16.8% [442 of 2,634]; 0.87 [0.75-1.01]; P = 0.07) reduced the risk of the cardiorenal composite outcome. Ramipril had no impact on the CVD and renal components. Rosiglitazone increased heart failure (0.53 vs. 0.08%; HR 7.04 [95% CI 1.60-31.0]; P = 0.01) but reduced the risk of the renal component (0.80 [0.68-0.93]; P = 0.005); prevention of diabetes was independently associated with prevention of the renal component (P < 0.001). CONCLUSIONS: Ramipril did not alter the cardiorenal outcome or its components. Rosiglitazone, which reduced diabetes, also reduced the development of renal disease but not the cardiorenal outcome and increased the risk of heart failure.

Genetic diversity in the Block 2 region of the merozoite surface protein 1 (MSP-1) of Plasmodium falciparum: additional complexity and selection and convergence in fragment size polymorphism.

Fragment size in the Block 2 repetitive region of merozoite surface protein 1 (MSP1) has commonly been used as a molecular marker in studies of malaria transmission dynamics and host immunity in Plasmodium falciparum malaria. In this study, we further explore the genetic variation in MSP-1 Block 2 underlying potential problems faced while studying the immune responses elicited by this vaccine target and while using it as a molecular marker in epidemiologic investigations. We describe the distribution of a new Block 2 recombinant allele family in samples collected from western Kenya and other malarious regions of the world and provide evidence that this allele family is found worldwide and that all MR alleles most likely originated from a single recombination event. We test whether the number of tandem repeats (i.e. fragment size) can be considered neutral in an area of high transmission in western Kenya. In addition, we investigate the validity of the assumption that Block 2 alleles of the same size and allele family are identical by examining MSP1 Block 2 amino acid sequences obtained from full-length MSP-1 clones generated from infected Kenyan children and find that this assumption does not hold. We conclude that the worldwide presence of a new allele family, the effect of positive natural selection, and the lack of conserved amino acid motifs within alleles of the same size suggest a higher level of complexity that may hamper our ability to elucidate allele family specific immune responses elicited by this vaccine target and its overall use as genetic marker in other types of epidemiologic investigations.

Histology and histochemistry of the pharyngeal cavity and oesophagus of the silverside Odontesthes bonariensis (Cuvier and Valenciennes).

The histology of the pharyngeal cavity and oesophagus of the freshwater 'silverside'Odontesthes bonariensis (Cuvier and Valenciennes) and the characteristics of their mucous cells were investigated. The histological characterization of its digestive wall revealed that the mucosa is thrown with longitudinal folds. The epithelium covering the folds was stratified with abundant mucous cells and gustative corpuscles, which are lacking in the oesophagus. The muscularis mucosa was absent. The submucosa presented the compactum stratum. The muscularis was organized in longitudinal and circular layers of muscular striated fibres. The serosa with a flat epithelium was located only in the oesophagus. Using histochemical procedures including methods for localization and characterization of glycoproteins (GPs), no differences were detected between the mucous cells contents of the pharyngeal cavity and those of the oesophagus. The mucous cells showed a weak periodic acid-Schiff (PAS) positive reaction in their content. The reactions for the differential analysis of sialic acids from GPs are feeble for periodic acid-Schiff at low temperature and low pH (PA*S) and KOH/PA*S and strong for periodic acid/borohydride/KOH/PAS (PA/Bh/KOH/PAS) and KOH/PA*/Bh/PAS revealing the scarce presence of C7 or C9 substituted and non-substituted sialic acids and the abundance of C7, C8 substituted sialic acids, O-acyl sugars and neutral sugars respectively. The results suggest that the pharyngeal cavity with the gustative corpuscles would induce the gastric secretion whereas the oesophagus is mainly involved in the transport of the food bolus to the stomach with the aid of abundant secretion of mucus. GPs secreted on the surface of the mucous cells, likely related to environmental conditions, would be involved in the lubrication, protection against abrasion and inhibition of microorganism proliferation.

Molecular evolution and intragenic recombination of the merozoite surface protein MSP-3alpha from the malaria parasite Plasmodium vivax in Thailand.

The merozoite surface antigens of malaria parasites are prime anti-morbidity/mortality vaccine candidates. However, their highly polymorphic nature requires extensive surveys of parasite populations to validate vaccine designs. Previous studies have found 3 molecular types (A, B and C) of the Plasmodium vivax merozoite surface protein 3a (PvMSP-3alpha) among parasite field populations. Here we analysed complete PvMSP-3alpha sequences from 17 clinical P. vivax isolates from Thailand and found that the nucleotide diversity was as high as that from samples widely separated by time and space. The polymorphic sites were not randomly distributed but concentrated in the N-terminal Ala-rich domain (block 2A), which is partially deleted in type B and C sequences. The size variations among type A sequences were due to small indels occurring in block 2A, whereas type B and C sequences were uniform in length with each type having a different large deletion. Analysis of synonymous and non-synonymous substitutions suggested that different selection forces were operating on different regions of the molecule. The numerous recombination sites detected within the Ala-rich domain suggested that intragenic recombination was at least partially responsible for the observed genetic diversity of the PvMSP-3alpha gene. Phylogenetic analysis failed to link any alleles to a specific geographical origin, even when different domains of PvMSP-3alpha were used for analysis. The highly polymorphic nature and lack of geographical clustering of isolates suggest that more systematic investigations of the PvMSP-3alpha gene are needed to explore its evolution and vaccine potential.

Lower limb arterial incompressibility and obstruction in rheumatoid arthritis.

BACKGROUND: Despite increased cardiovascular morbidity and mortality in rheumatoid arthritis, the peripheral arteries remain understudied. OBJECTIVE: To examine the lower limb arteries in age and sex matched, non-smoking subjects with and without rheumatoid arthritis. METHODS: The ankle-brachial index (ABI) was measured at the posterior tibial and dorsal pedal arteries. Arteries were classified as obstructed with ABI < or =0.9, normal with ABI >0.9 but < or =1.3, and incompressible with ABI >1.3. Multinomial logistic regression was used to estimate differences in ABI between patients and controls, adjusting for cardiovascular risk factors, rheumatoid arthritis manifestations, inflammation markers, and glucocorticoid dose. RESULTS: 234 patients with rheumatoid arthritis and 102 controls were studied. Among the rheumatoid patients, 66 of 931 arteries (7%) were incompressible and 30 (3%) were obstructed. Among the controls, three of 408 arteries (0.7%) were incompressible (p = 0.002) and four (1%) were obstructed (p = 0.06). At the person level, one or more abnormal arteries occurred among 45 rheumatoid patients (19%), v five controls (5%, p = 0.001). The greater frequency of arterial incompressibility and obstruction in rheumatoid arthritis was independent of age, sex, and cardiovascular risk factors. Adjustment for inflammation markers, joint damage, rheumatoid factor, and glucocorticoid use reduced rheumatoid arthritis v control differences. Most arterial impairments occurred in rheumatoid patients with 20 or more deformed joints. This subgroup had more incompressible (15%, p< or =0.001) and obstructed arteries (6%, p = 0.005) than the controls, independent of covariates. CONCLUSIONS: Peripheral arterial incompressibility and obstruction are increased in rheumatoid arthritis. Their propensity for patients with advanced joint damage suggests shared pathogenic mechanisms.

Pacientes neurológicos del noreste del Perú con serología positiva por Western Blot a la larva de Taenia solium / Neurological patients in northwestern Peru with positive Western Blot serology to Taenia solium larvae

Obejtivo: Determinar la frecuencia de pacientes con sintomatología neurológica de la zona noroeste del Perú que presentan serología positiva por Western Blot a la larva de Taenia solium. Material y Métodos: El estudio se realizó en 3515 pacientes de cero a noventa años de edad y de ambos sexos con sintomatología neurológica, procedentes de los departamentos de Piura, Lambayeque, Cajamarca, Ancash, La Libertad y algunas poblaciones de la zona selvática (5 a 10º LS; 77a 82º LO). Dichos pacientes fueron atendidos en consultorios privados y en los servicios de neurología de los Hospitales Belén y Regional de Trujillo desde enero de 1997 hasta diciembre de 2001. De cada uno de los pacientes se obtuvo una muestra sanguínea, cuyo suero fue procesado por la técnica de Western Blot, la cual tiene una sensibilidad de 91 por ciento y una especificidad de 100 por ciento. Resultados: Se detectó serología positiva en 562 pacientes, la cual representa una prevalencia de 16 por ciento, siendo el sexo masculino el que presentó mayor porcentaje (58,4 por ciento). Los grupos etáreos con mayor frecuencia de serología positiva fueron los de 41 a 50 años (18,7 por ciento) y 31 a 40 años (17,4 por ciento). Los mayores porcentajes de serología positiva se obtuvo en pacientes procedentes de Piura y Lambayeque. Conclusiones: Los pacientes estudiados presentan una alta frecuencia de serología positiva a la larva de T. solium.

Objective: To determine the frequency of patients presenting with neurological symptoms in Northwestern Peru who have positive Western Blot serology to Taenia solium larvae. Material and Methods: The study was performed in 3515 patients, from zero to ninety years old and from both sexes, who presented with neurological symptoms. Patients came from Piura, Lambayeque, Cajamarca, Ancash, and La Libertad departments, as well as from certain areas in the jungle (5 to 10º southern latitude; 77 to 82º western longitude). Those patients were taken care of in private offices and in Neurology services in Belen and Regional hospitals in Trujillo, from January 1997 to December 2000. A blood sample was obtained from all patients, and the sera were processed using the Western Blot technique, which has 91 percent sensitivity and 100 percent specificity. Results: Positive serological Western Blot tests were detected in 562 patients, representing 16 per cent prevalence, and the infection was more frequent in males (58.4 percent). Age groups more frequently found to have positive serological tests were those form 41 to 50 years old (18.7 percent), and those from 31 to 40 years old (17.4 percent). The maximum percentages for positive serological tests were obtained in patients from Piura and Lambayeque. Conclusions: Patients studied show a high frequency of positive serology for Taenia solium larvae.

Validating a computerized neuropsychological test battery for mixed ethnic lupus patients.

Patients with systemic lupus erythematosus (SLE) often show cognitive impairment on traditional neuropsychological tests; however, many of these tests are unsuitable for use with mixed ethnic populations. Computer-administered cognitive tests are promising, but have not been validated against traditional tests or with predominantly Hispanic samples. We gave 67 lupus patients a computer-administered test battery (Automated Neuropsychological Assessment Metrics--ANAM) and a battery of traditional neuropsychological tests. The two batteries were compared using correlation and multiple regression analyses. All patients were fluent in English, 54% were Hispanic and 13% were bilingual. Non-Hispanic patients were predominantly European American (37%). About 80% of patients were rated as impaired on traditional tests. Hispanics were younger, had less education and more current SLE disease activity than non-Hispanics; but did not differ in lifetime SLE-related organ damage or current steroid use. Hispanics and younger patients were more impaired on many of the traditional tests, while ANAM was not affected by Hispanic ethnicity or education. ANAM tests were moderately correlated with analogous traditional tests. Age and selected ANAM scores accounted for about 60% of the variance in the traditional battery. These results replicate the high prevalence of cognitive deficits in SLE found by others and suggest that computer-administered tests like ANAM may be useful for assessment of cognitive impairment in mixed-ethnic samples. Confounding variables such as age, education, English language fluency and prior experience with tests were identified and need to be controlled statistically or with comparison groups in future studies.

Long-distance colonization, isolation by distance, and historical demography in a relictual Mexican pinyon pine (Pinus nelsonii Shaw) as revealed by paternally inherited genetic markers (cpSSRs).

Pinus nelsonii is a relictual pinyon pine distributed across a wide altitudinal range in semiarid zones in Mexico near the border between the States of Nuevo León and Tamaulipas. It also occurs in small patches in the State of San Luis Potosí. Pinus nelsonii is classified in the monotypic subsection Nelsoniae, separated from other pinyon pines (subsection Cembroides), because it possesses several distinctive characters including persistent fascicle sheaths, connate needles, and a distinctive wood anatomy. In the present study, chloroplast simple sequence repeats (cpSSRs) were used to estimate genetic variation in most known populations (nine) of P. nelsonii. The genetic variation (HT = 0.73; 27 haplotypes in 256 individuals) is moderate when compared to other pine species. Population differentiation ranged between low and moderate (FST = 0.13 and RST = 0.05), as did the Nei and Goldstein genetic distances between populations. However, this pattern varied depending on whether the infinite alleles or stepwise mutation model was used. In the former case a significant isolation by distance was found, but not in the latter. A significant association between geographical and genetic structure in one clade, through a nested clade analysis, was found, which suggested long-distance colonization between 125000 and 309000 years ago. We found weak evidence for a population expansion. A mismatch distribution suggests that P. nelsonii populations underwent an expansion 4.25 times their size between 59000 and 146000 years ago. On the other hand, the populations' star-like phylogeny and a slight parabolic relationship between coalescence times and lineage number also suggest weak population expansion. Overall, this species appears to have been in demographic stasis for a large proportion of the time detected by the markers used.

Neuropsychiatric syndromes in lupus: prevalence using standardized definitions.

OBJECTIVE: The San Antonio Lupus Study of Neuropsychiatric Disease is a longitudinal study designed to characterize the spectrum of and important risk factors for specific neuropsychiatric systemic lupus erythematosus (NPSLE) syndromes. METHODS: Subjects must meet criteria for SLE and must be at least 18 years of age. A standardized medical history, neurologic, rheumatologic, and psychiatric examinations, computerized neuropsychological evaluation, and serologic testing are performed. RESULTS: This report is based on the first 128 subjects (120 women and 8 men) who completed the initial study visit. Data from this initial study visit were evaluated for the prevalence of NPSLE using the American College of Rheumatology case definitions for 19 NPSLE syndromes. One or more NPSLE syndromes were present in 80% of subjects: cerebrovascular disease (2, 2%; ischemic stroke); headaches (73, 57%); mononeuropathy (9, 8%; median 8, ulnar 1); movement disorder (1, 1%; chorea); neuropathy, cranial (2, 2%; trigeminal); polyneuropathy (29, 22%; sensorimotor); seizures (21, 16%; partial); anxiety disorder (27, 24%); major depressive-like episode (37, 28%); mood disorder with depressive features (21, 19%); mood disorder with manic features (3, 3%); mood disorder with mixed features (1, 1%); psychosis (6, 5%). In a subset of 67 patients who received standardized neuropsychological testing, 21% had normal results. In the remainder, the following levels of impairment were seen: 43% mild, 30% moderate, and 6% severe. CONCLUSIONS: The prevalence of NPSLE was high in this cohort of unselected patients with SLE. Headaches, cognitive dysfunction, and psychiatric disorders were the most common NPSLE syndromes seen. These results will be easily comparable to other studies also using standardized diagnostic criteria. However, the lack of ethnicity and language-matched normative neuropsychological data may make comparisons of cognitive dysfunction in SLE populations difficult.

Walking velocity in aged persons: its association with lower extremity joint range of motion.

OBJECTIVE: To measure the association between walking velocity and hip and knee flexion range, ethnic background, anthropometrics, comorbid pathologies, and coimpairments, in a sample of community-dwelling aged persons. METHODS: To reach our objective, we used data from the San Antonio Longitudinal Study of Aging (SALSA), a population-based cohort of Mexican American and European American persons aged 64 to 79. By fitting hierarchical regression models, we measured the variance in the walking velocity over 50 feet explained by hip and knee flexion range, adjusting for the combined influence of demographic and anthropometric variables, coexistent pathologic conditions, impairments, and the examiners who conducted the assessments. RESULTS: The average walking velocity among the 702 subjects for whom data were available was 73.6 meters per minute (range 20 to 121). Bivariate analyses revealed significant associations between walking velocity and age, sex, ethnic background, height, weight, presence of arthritis, diabetes mellitus, stroke, upper leg pain, peripheral vascular disease, left ventricular hypertrophy, and forced expiratory volume at 1 second. The correlation (r) between walking velocity and flexion range of the hip and knee were 0.40 and 0.35, respectively (P < or = 0.001 for each). Multivariate hierarchical models adjusting for demographic and anthropometric characteristics of the subjects, and examiner variation, revealed that hip and knee flexion range explained 6% of the variance in walking velocity. Adjusting for the presence of comorbid conditions and coimpairments reduced the variance attributable to hip and knee flexion range only slightly, to 5%. CONCLUSION: Hip and knee flexion range contribute significantly to walking velocity in the SALSA cohort of community-dwelling aged persons.