The integration of HR-HPV increases the expression of cyclins A and E in cytologies with and without low-grade lesions.

BACKGROUND: Cyclin-A and cyclin-E are regulators of G1-S phase of normal cell cycle. Integration of human papilloma virus high-risk (HR-HPV) could alter this mechanism, and its overexpression has been associated with poor prognosis in cervical cancer. AIM: To determine the expression of cyclin-A and cyclin-E, types of HR-HPV and physical state of DNA in cytologies with the diagnosis of low-grade squamous intraepithelial lesion (LSIL). MATERIALS AND METHODS: 115 cytological specimens in liquid base (liquid-PREP(™)) were analyzed. 25 specimens were with no signs of SIL (NSIL) and without HPV; 30 with NSIL with low-risk HPV (LR-HPV); 30 with NSIL with HR-HPV; and 30 with both LSIL and HR-HPV. The expression of cyclins was evaluated by immunocytochemistry; and the detection of viral DNA was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLPs) for genotyping or sequencing of HPV. The physical state of HPV was evaluated by in situ hybridization with amplification with tyramide. RESULTS: In the cytologies NSIL with LR-HPV, the expression of cyclin-A and cyclin-E was found respectively in 23.3% and 33.3% of the specimens. Among the specimens of NSIL with HR-HPV, 33.3% expressed cyclin-A and 40% cyclin-E, while 100% of the LSILs expressed the 2 cyclins. On the other hand, 100% of the samples NSIL with LR-HPV presented an episomal pattern. Of the specimens of NSIL with HR-HPV, 56.6% exhibited an episomal pattern, 23.3% integrated and 20%, mixed. Among the LSILs, 90% were mixed and 10% integrated. CONCLUSIONS: The cyclins A and E are present in the LSILs that occur predominantly in mixed state in the presence of HR-HPV.

Enoyl-coenzyme A hydratase and antigen 85B of Mycobacterium habana are specifically recognized by antibodies in sera from leprosy patients.

Leprosy is an infectious disease caused by Mycobacterium leprae, which is a noncultivable bacterium. One of the principal goals of leprosy research is to develop serological tests that will allow identification and early treatment of leprosy patients. M. habana is a cultivable nonpathogenic mycobacterium and candidate vaccine for leprosy, and several antigens that cross-react between M. leprae and M. habana have been discovered. The aim of the present study was to extend the identification of cross-reactive antigens by identifying M. habana proteins that reacted by immunoblotting with antibodies in serum samples from leprosy patients but not with antibodies in sera from tuberculosis (TB) patients or healthy donors (HDs). A 28-kDa antigen that specifically reacted with sera from leprosy patients was identified. To further characterize this antigen, protein spots were aligned in two-dimensional polyacrylamide gels and Western blots. Spots cut out from the gels were then analyzed by mass spectrometry. Two proteins were identified: enoyl-coenzyme A hydratase (lipid metabolism; ML2498) and antigen 85B (Ag85B; mycolyltransferase; ML2028). These proteins represent promising candidates for the design of a reliable tool for the serodiagnosis of lepromatous leprosy, which is the most frequent form in Mexico.

Tratamiento endovascular de pseudoaneurisma subclavio iatrogénico. A propósito de un caso / Endovascular treatment of iatrogenic subclavian pseudoaneurysms. A case report

Introducción. La cateterización de vías venosas centrales puede presentar como rara complicación la formación de un pseudoaneurisma en una arteria adyacente por punción inadvertida de ésta. Caso clínico. Mujer de 45 años que, tras ser intervenida de cirugía bariátrica, presentó complicaciones que requirieron reingreso en el hospital y estancia en la Unidad de Cuidados Intensivos, necesitándose una vía central subclavia izquierda para su tratamiento. Tras el alta, la paciente refirió la aparición de masa pulsátil súbita en la región laterocervical izquierda que resultó un pseudoaneurisma subclavio, tratado con éxito mediante implante endovascular de stent recubierto vía femoral derecha. Conclusiones. En la arteria subclavia, el tratamiento quirúrgico sigue siendo complejo, particularmente si es necesario abordar el tórax o en pacientes de alto riesgo. En los últimos años, el uso de técnicas endovasculares en las lesiones de la arteria subclavia, tanto traumáticas como iatrogénicas, han minimizado las complicaciones del tratamiento quirúrgico

Introduction. A rarely observed complication deriving from catheterisation of central venous lines is the formation of a pseudoaneurysm in an adjacent artery owing to accidental puncture. Case report. Here we report the case of a 45-year-old female who, following bariatric surgery, developed as series of complications that required readmission to hospital and a stay in the Intensive Care Unit; treatment was established with a left-side subclavian central line. After being discharged from hospital, the patient reported the sudden appearance of a pulsatile mass on the left side of the neck, which turned out to be a subclavian pseudoaneurysm and was successfully treated by implanting a covered stent via the right femoral. Conclusions. Surgical treatment is still complex in the subclavian artery, and more so if it is necessary to approach the thorax or in high-risk patients. In recent years, the use of endovascular techniques to treat both traumatic and iatrogenic lesions in the subclavian artery have minimised the complications deriving from surgical treatment

Tratamiento endovascular de aneurisma en aloinjerto femoropoplíteo. A propósito de un caso / Endovascular treatment of an aneurysm in a femoral-popliteal allograft. A case report

Introducción. La aparición de aneurismas en los injertos vasculares de vena umbilical humana se describió por primera vez en 1982. El tratamiento más habitual ha sido la cirugía. La llegada de las técnicas endovasculares ha incrementado las posibilidades terapéuticas que podemos ofrecer al paciente así como ha minimizado las complicaciones de la cirugía. Caso clínico. Paciente de 76 años con isquemia crónica de extremidades inferiores, intervenido en varias ocasiones (simpatectomía lumbar izquierda, bypass femoropoplíteo izquierdo a primera porción con politetrafluoroetileno en 1989 y bypass femoropoplíteo izquierdo a tercera porción con bioprótesis homóloga en 1994). Durante el seguimiento apareció dilatación aneurismática en aloinjerto diagnosticado mediante eco-Doppler. Se completó el estudio con tomografía axial computarizada (TAC) y angiografía por resonancia magnética. Como tratamiento, se implantó stent recubierto Viabahn de 8 × 100 mm, quedando el aneurisma completamente excluido. A los seis meses de seguimiento no se aprecian endofugas ni migración, y permanece permeable según eco-Doppler y TAC. Conclusión. El avance en las técnicas endovasculares permite un tratamiento rápido y sencillo de los aneurismas de injertos infrainguinales, especialmente útil en pacientes técnicamente complicados o de alto riesgo quirúrgico

INTRODUCTION. The appearance of aneurysms in human umbilical vein vascular grafts was first reported in 1982. Surgical intervention has been the most common treatment until now. The advent of endovascular techniques has expanded the possible therapeutic options that we can offer the patient, while at the same minimising the complications that can result from the intervention. CASE REPORT. We report the case of a 76-year-old patient with chronic ischaemia in both lower extremities who had been submitted to surgery on several occasions (left-side lumbar sympathectomy, a femoral-popliteal polytetrafluoroethylene bypass in the first portion of the left-hand side in 1989 and a femoral-popliteal bypass in the third portion with a homologous bioprosthesis in 1994). During the follow-up an aneurysmal dilatation appeared in the allograft, as diagnosed by Doppler ultrasound recording. The study was completed with computerised axial tomography (CAT) and magnetic resonance angiography. Treatment consisted in the placement of an 8 × 100 mm Viabahn covered stent, after which the aneurysm was completely excluded. At three months’ follow-up no endoleaks or migration were detected and, according to Doppler ultrasound and a CAT scan, patency is preserved. CONCLUSION. The progress being made in endovascular techniques allows fast, simple treatment of aneurysms in infrainguinal grafts, which is especially useful in technically complicated patients or those with a high surgical risk

Isquemia aguda por embolia paradójica / Acute ischemia due to paradoxical embolism

Introducción. La embolia paradójica es un raro evento dentro de los fenómenos isquémicos centrales o periféricos que necesariamente requieren un proceso trombótico venoso o cardíaco más una comunicación derecha-izquierda, habitualmente cardíaca. El correcto diagnóstico y tratamiento es fundamental en el manejo de esta inusual patología para prevenir recurrencias posteriores. Caso clínico. Mujer de 35 años con antecedentes de obesidad mórbida y encamamiento continuado de cuatro días, que acudió por presentar un cuadro isquémico agudo de la extremidad superior izquierda con pérdida de todos los pulsos a ese nivel acompañado de disnea, hipoxemia e hipocapnia. Se realizó una arteriografía urgente que evidenció el cuadro isquémico agudo sobre la arteria subclavia, de probable origen embólico, y ante la sospecha de embolismo pulmonar concomitante se realizó igualmente una angiografía pulmonar que confirmó un tromboembolismo pulmonar masivo, y se intuyó al mismo tiempo una comunicación derecha izquierda por el llenado simultáneo de arteria pulmonar y aorta; se sospechó, por tanto, de la existencia de un embolismo paradójico. La embolectomía se realizó sin incidencias, y el embolismo pulmonar se trató mediante fragmentación local más perfusión de uroquinasa durante 24 horas con estancia perioperatoria en unidad de cuidados intensivos más implante de filtro de cava temporal. Controlada la situación clínica de la paciente, se continuó el estudio con el diagnóstico posterior de foramen oval permeable mediante ecografía transesofágica que se cerró mediante abordaje percutáneo femoral e implante de oclusor tipo Amplatzer (PFO). Se dio de alta a la paciente tras completar el paso a anticoagulación oral ya que en todo momento estuvo bajo tratamiento con heparina sódica en perfusión. Conclusiones. La embolia paradójica supone un mínimo porcentaje de todos los casos de isquemias agudas. No obstante, se debe sospechar de su existencia ante casos atípicos de episodios isquémicos, asociados o no a clínica de trombosis venosa profunda, y valorarse siempre de manera individualizada dada la falta de estrategia definida ante esta inusual patología (AU)

Multivariate characterization of wine vinegars from the south of Spain according to their metallic content.

Forty wine vinegar samples from the south of Spain were analyzed for mineral content. Nine metals (As, Ca, Cu, Fe, K, Mg, Mn, Na and Zn) were chosen as chemical features that may account for the rate of the vinegar fermentation process. Pattern recognition techniques were applied for distinguishing quick and slow processed vinegars. The results obtained indicated an excellent performance in both recalling and prediction ability.

[Quality of sputum microscopy in the network of tuberculosis bacteriology laboratories in Colombia]. / Calidad de la baciloscopia de esputo en la red de laboratorios de bacteriología de tuberculosis en Colombia.

The objective of this study was to evaluate the technical quality of sputum microscopy carried out for diagnostic purposes in the Network of Tuberculosis Bacteriology Laboratories in Colombia. The National Central Reference Laboratory received 6,529 slides for reexamination from the network of 513 sectional, regional, and local laboratories, which contributed 33.2%, 27.6%, and 39.2%, respectively, of the slides. These included all the positive (3,283) and negative (3,246) smears processed during a 4-month period. The reexamination was carried out by six laboratory workers who did not know the origin of the slides or the original diagnosis. When qualitative problems were detected, a second reexamination was done, which significantly increased the percentage of agreement for both the positive results (93.9%) and the negative (98.7%). Overall, the level of agreement was 96.3%. A significant correlation was found (P < 0.05) between good slide preparation and staining and agreement in the readings, as well as between thin smears, presence of fuchsin precipitates, and deficient coloration and conflicting readings (P < 0.05). The highest percentages of agreement were associated with laboratories that performed the largest number of sputum examinations each month (96.5%), and with readings done by experienced, university-trained bacteriologists (96.6%). It is concluded that indirect technical supervision and ongoing training of laboratory personnel are important determinants of the impact of the tuberculosis control program.

Calidad de la baciloscopia de esputo en la red de laboratorios de bacteriología de tuberculosis en Colombia / Quality of sputum microscopy in the network of tuberculosis bacteriology laboratories in Colombia

El objetivo fue evaluar la calidad técnica de la baciloscopia de esputo realizada con fines diagnósticos en la Red de Laboratorios de Bacteriología de la tuberculosis en Colombia. En el Laboratorio Central Nacional de Referencia se recibieron para relectura 6 529 láminas provenientes de la red de 513 laboratorios seccionales, regionales y locales, los cuales contribuyeron 33,2, 27,6 y 39,2 por ciento de las láminas, respectivamente. Estas representaron todas las baciloscopias positivas (3 283) y la siguiente negativa (3 246) procesadas durante un período de cuatro meses. La relectura estuvo a cargo de seis lectores que desconocían la procedencia de las láminas y el diagnóstico original. Cuando se detectaron discordancias cualitativas, se hizo una segunda relectura que aumentó significativamente las concordancias, tanto de los resultados positivos ((3,9 por ciento) como de los negativos (98,7 por ciento), con una concordancia total de 96,3 por ciento. Se hallo una correlación significativa (P0,05) entre buen extendido y buena coloración y las lecturas concordantes, así como entre extendidos delgados, presencia de precipitados de fucsina y decoloración deficiente y las lecturas discordantes (P0,05). Los porfcentajes de concordancia más altos se relacionaron con los laboratorios que realizan mensualmente el mayor número de baciloscopias (96,5 por ciento), y con las lecturas por bacteriólogos universitarios experimentados (96,6 por ciento). Se concluyed que la supervisión técnica indirecta y la continua capacitación del personal de laboratorio son factores determinantes del impacto del Programa de Control de la Tuberculosis

[A comparison and synergy in the treatment of essential arterial hypertension]. / Comparación y sinergia en el tratamiento de la hipertensión arterial esencial.

Forty patients with mild or moderate essential hypertension were studied. They received daily doses of either 240 mg verapamil or 10 mg enalapril, as well as a placebo. Total duration of trial was 24 weeks: a "washout" period of 2 weeks, a treatment period of 6 weeks with one of the two drugs, another "washout" period of 2 weeks, and another treatment period of 6 weeks with the alternate drug. Those patients with persistence of diastolic blood pressure (DBP) above 90 mmHg received simultaneously both drugs for an additional period of 8 weeks. Patients were assigned alternately to one of the groups. When each drug was given during the first treatment period, DBP was reduced below 90 mmHg in 15 of 19 patients receiving verapamil, and in 12 of 20 that received enalapril. When the drugs were given during the second treatment period, DBP became normal in 16 of 19 patients receiving enalapril, and in all the 18 patients treated with verapamil. Three patients achieved normal DBP when received simultaneously both drugs. Two patients withdrew from the trial for personal reasons and one for experimenting cough as reaction to enalapril. There were no other undesirable side effects. Laboratory tests did not show changes. Both products were similarly effective. Synergy was shown by the improvement of patients unresponsive to either drug when given singly, but responding when both were given simultaneously.

Calidad de la baciloscopia de esputo en la red de laboratorios de bacteriología de tuberculosis en Colombia / Quality of sputum microscopy in the network of tuberculosis bacteriology laboratories in Colombia

El objetivo fue evaluar la calidad técnica de la baciloscopia de esputo realizada con fines diagnósticos en la Red de Laboratorios de Bacteriología de la tuberculosis en Colombia. En el Laboratorio Central Nacional de Referencia se recibieron para relectura 6 529 láminas provenientes de la red de 513 laboratorios seccionales, regionales y locales, los cuales contribuyeron 33,2, 27,6 y 39,2 por ciento de las láminas, respectivamente. Estas representaron todas las baciloscopias positivas (3 283) y la siguiente negativa (3 246) procesadas durante un período de cuatro meses. La relectura estuvo a cargo de seis lectores que desconocían la procedencia de las láminas y el diagnóstico original. Cuando se detectaron discordancias cualitativas, se hizo una segunda relectura que aumentó significativamente las concordancias, tanto de los resultados positivos ((3,9 por ciento) como de los negativos (98,7 por ciento), con una concordancia total de 96,3 por ciento. Se hallo una correlación significativa (P0,05) entre buen extendido y buena coloración y las lecturas concordantes, así como entre extendidos delgados, presencia de precipitados de fucsina y decoloración deficiente y las lecturas discordantes (P0,05). Los porfcentajes de concordancia más altos se relacionaron con los laboratorios que realizan mensualmente el mayor número de baciloscopias (96,5 por ciento), y con las lecturas por bacteriólogos universitarios experimentados (96,6 por ciento). Se concluyed que la supervisión técnica indirecta y la continua capacitación del personal de laboratorio son factores determinantes del impacto del Programa de Control de la Tuberculosis

[Study of renal function by creatinine clearance]. / El estudio de la función renal a través de la depuración de la creatinina.

This paper was designed to investigate the correlation between the renal clearance and the plasma concentration of creatinine. Of the curve obtained, three segments were studied: 1 - When the glomerular filtration rate (GFR) was greater than 60 ml per min. the plasma concentration fluctuated between 0.44 and 1.59 mg/dl. 2 - When GFR was between 30 and 60 ml per min. the plasma concentration reached 2.4 mg/dl, and 3 - When GFR was less than 30 ml per min. the plasma level increased to values as high as 28 ml/min. The urinary concentration of creatinine can be divided into two broad groups depending on the GFR. The boundary of this division is around 60 ml per min. This suggests that when GFR is depressed there would exist a limitation of the tubular secretion of creatinine or urinary dilution problems. It is demonstrated that there is a poor correlation between creatinine clearance and its plasma concentration, and hence the repeated measurement of creatinine clearance becomes imperative in the follow-up of patients.