Integrated screening and testing for TB and COVID-19 in Peru.

We describe the experience of integrating COVID-19 screening and testing into a mobile TB screening unit in Lima, Peru. All attendees received chest radiographs, which were analysed using CAD4TB and CAD4COVID; Xpert MTB/RIF Ultra was used to test for TB, and antibody and polymerase chain reaction (PCR) for SARS-CoV-2. One Xpert-positive TB case was diagnosed per 168 people screened, one person with SARS-CoV-2 antibodies per 3 people screened, and one PCR-confirmed SARS-CoV-2 infection per 8 people screened. Integrated screening can help to avoid delays in the diagnosis of both TB and COVID-19.

Nous décrivons l'expérience de l'intégration du dépistage et du test COVID-19 dans une unité mobile de dépistage de la TB à Lima, au Pérou. Toutes les personnes présentes ont reçu des radiographies pulmonaires, qui ont été analysées à l'aide de CAD4TB et CAD4COVID ; Xpert® MTB/RIF Ultra a été utilisé pour le dépistage de la TB, et les anticorps et la réaction en chaîne par polymérase (PCR) pour le SARS-CoV-2. Un cas de TB Xpert-positif a été diagnostiqué pour 168 personnes dépistées, une personne présentant des anticorps du SARS-CoV-2 pour 3 personnes dépistées et une infection du SARS-CoV-2 confirmée par PCR pour 8 personnes dépistées. Le dépistage intégré peut contribuer à éviter les retards dans le diagnostic de la TB et du COVID-19.

Seroprevalencia de anticuerpos frente a virus linfotrópicos humanos (HTLV I y II) en donantes de órganos / Human T lymphotropic virus (HTLV I and II) antibodies seroprevalence among organ donors

No disponible

Epidemiological changes of acute/recent human immunodeficiency virus type 1 infection in Barcelona, Spain (1997-2015): a prospective cohort study.

OBJECTIVE: To describe the epidemiology of acute/recent human immunodeficiency virus (HIV) infection over two decades in Barcelona (Spain). METHODS: Prospective, single-centre cohort including all patients with an acute/recent HIV infection (<180 days) since 1997. Patients were stratified into four periods. Phylogenetic analysis was performed to determine clusters of transmission. RESULTS: A total of 346 consecutive acute/recently infected patients were included. The annual proportion of recent infections among total new HIV diagnoses increased over time from 1% (29 out of 1964) to 8% (112 out of 1474) (p <0.001). Proportion of men who have sex with men (MSM) in the cohort increased from 62% (18 out of 29) to 89% (100 out of 112) (p <0.001). The proportion of migrants showed a non-significant increasing trend (24% (7 of 29) to 40% (45 of 112)) likewise the non-B subtype (0% to 22% (22 of 112)). The mean time from infection to diagnosis was 53.6 days (interquartile range (IQR) 50-57), comparable among all periods. Mean time from infection to treatment decreased over the years from 575 (IQR 467-683) to 471 (IQR 394-549) days (p <0.001) without significant differences between migrants and non-migrants (133 (IQR 71-411) versus 208 (IQR 90-523) days p 0.089). Almost 50% (152 of 311) of recently infected individuals were included in a cluster of transmission, and 92% (137 of 149) of them were MSM. CONCLUSION: The MSM population has progressively grown within acutely/recently infected patients in Barcelona, and is frequently involved in transmission clusters. Although the time between diagnosis and treatment has been reduced, the time between infection and diagnosis still needs to be shortened.

Errores del desfibrilador semiautomático en el reconocimiento de la fibrilación ventricular / Semiautomated external defibrillator errors in recognizing ventricular fibrillation

Presentamos tres casos clínicos de errores del desfibrilador semiautomático (DESA) durante el análisis de la fibrilación ventricular (FV). El primer caso corresponde a un error operador dependiente, en el que las vibraciones de la ambulancia provocan una omisión en la orden de desfibrilar. Las otras dos situaciones, DESA dependientes, constatan que la actividad eléctrica del marcapasos influye en la decisión de no desfibrilar en el contexto de una FV (AU)

We report 3 cases of semi automated external defibrillator error during analysis of ventricular fibrillation. The first involved operator-dependent error, in which ambulance motion led to failure to order a shock. The other 2 cases involved defibrillator-dependent error, in which signals from a pacemaker apparently led to the automatic decision not to shock even when ventricular fibrillation was detected (AU)

Desgaste profesional en los técnicos de emergencias sanitarias del soporte vital básico del País Vasco / Professional burnout among basic life support caregivers in the Basque Country

Objetivos: Cuantificar los niveles de desgaste profesional entre los técnicos en emergencias sanitarias (TES) de los recursos de soporte vital básico (SVB) del País Vasco y estudiar su asociación a las variables sociolaborales más habituales. Métodos: Estudio exploratorio de corte transversal sobre una muestra representativa (intervalo de confianza del 95% y precisión del 9%) compuesta de 98 TES, obtenida mediante una técnica aleatoria estratificada por sector de trabajo, a los que se les administró una encuesta sobre las características sociolaborales y el Maslach Burnout Inventory (MBI) como test de evaluación psicométrica. Posteriormente se realizó la estadística descriptiva y el contraste de hipótesis para una significación del 95%. Resultados: Presentaron puntuaciones en la escala MBI compatibles con síndrome de desgaste profesional (SDP) 87 trabajadores (88,8%; IC95% 80,9-94,3%), los niveles globales de afectación fueron considerados como elevados o muy elevados en 61 sujetos(62,2%; IC95% 51,9-71,8%) y moderados en 26 (26,5%; IC95% 18,1-36,4). Presentaron mayores proporciones de afectación global en grado elevado los TES con mayor experiencia laboral (p < 0,05). Los TES con un nivel académico más bajo presentaron menores puntuaciones en la subescala cansancio emocional (p < 0,05) y una mayor antigüedad en el sector se correlacionó con un mayor sentimiento de falta de logro profesional (p < 0,05).Conclusiones: La prevalencia del SDP en los TES del SVB del País Vasco es muy elevada y es superior a la documentada en otros profesionales del ámbito sanitario. Una mayor antigüedad profesional se asocia a niveles elevados de SDP, sin embargo deben explorarse otras variables como posibles causas del síndrome en este colectivo (AU)

Objectives: To quantify the level of professional burnout among emergency medical responders who provide basic life support in the Basque Country of Spain and to explore the association between professional burnout and conventional social and occupational variables. Methods: Exploratory cross-sectional study of a representative sample (reporting 95% confidence intervals [CI];precision of 9%). The sample consisted of a stratified random selection of 98 emergency medical responders. The participants answered the Maslach Burnout Inventory (MBI), a psychometric questionnaire covering social and occupational characteristics. Descriptive statistics were compiled and comparisons between subgroups were considered significant at a level of P<.05.Results: Eighty-seven emergency responders (88.8%; 95% CI, 80.8%-94.3%) had MBI scores compatible with professional burnout syndrome. The global score indicated high or very high risk of burnout in 61 (62.2%; 95% CI,51.9%-71.8%) and moderate risk in 26 (26.5%; 95% CI, 18.1%-36.4%). Responders who had been working longer in the field were at higher risk of burnout (P=.031). A lower educational level correlated with lower scores on the subscale for feeling drained of emotional energy (P=.04). Longer experience in the profession correlated with a feeling of achieving less than one should (P=.031).Conclusions: The prevalence of risk of professional burnout syndrome is very high among emergency medical responders in the Basque Country and is higher than the prevalence identified among other groups of health care professionals. Spending a longer period in the profession is associated with high risk of burnout. However, additional variables should be explored to discover the possible reasons for burnout in these professionals (AU)

Broadly cross-neutralizing antibodies in HIV-1 patients with undetectable viremia.

Several recent studies have identified HIV-infected patients able to produce a broad neutralizing response, and the detailed analyses of their sera have provided valuable information to improve future vaccine design. All these studies have excluded patients on antiretroviral treatment and with undetectable viral loads, who have an improved B cell profile compared to untreated patients. To better understand the induction of neutralizing antibodies in patients on antiretroviral treatment with undetectable viremia, we have screened 508 serum samples from 364 patients (173 treated and 191 untreated) for a broadly neutralizing antibody (bNAb) response using a new strategy based on the use of recombinant viruses. Sera able to neutralize a minipanel of 6 recombinant viruses, including envelopes from 5 different subtypes, were found in both groups. After IgG purification, we were able to confirm the presence of IgG-associated broadly neutralizing activity in 3.7% (7 of 191) of untreated patients with detectable viremia and 1.7% (3 of 174) of aviremic patients receiving antiretroviral treatment. We thus confirm the possibility of induction of a broad IgG-associated neutralizing response in patients on antiretroviral treatment, despite having undetectable viremia. This observation is in stark contrast to the data obtained from long-term nonprogressors, whose little neutralizing activity has been attributed to the low levels of viral replication.

Ellagitannins from Tuberaria lignosa as entry inhibitors of HIV.

Screening of plants from the Iberian Peninsula for anti-human immunodeficiency virus (-HIV) activity revealed that aqueous extract of Tuberaria lignosa gave positive results. Following an activity-guided procedure, the crude extract was counterextracted, and the subsequent fractions obtained tested for their anti-HIV activity in vitro. The bioassay-guided fractionation of the extract afforded an ellagitannin enriched fraction (EEF) isolated for the first time from this species. This EEF exhibited antiviral activity against HIV in MT-2 infected cells, with an IC(50) value of 2.33mug/ml (selectivity index greater than 21). Inhibition of HIV infection by EEF appears to be mediated by CD4 down-regulation, the main receptor for HIV entry. CXCR4 and CCR5 receptors were not affected by EEF, explaining why EEF is able to inhibit R5 and X4 infections.

A new strategy based on recombinant viruses for assessing the replication capacity of HIV-1.

OBJECTIVE: In heavily pretreated patients, resistance mutations arise in both protease (PR) and reverse transcriptase (RT) sequences; however, the relative impact of PR and RT mutations on viral fitness cannot be evaluated with the majority of systems. To address this issue we have developed a model based on recombinant viruses (RVs) that allows the analysis of the replication capacity (RC) of viral populations in which PR and RT are cloned either in combination or separately. METHODS: RVs were generated for full-length polymerase (pol) gene, PR or RT sequences from nine naïve and 14 heavily pretreated HIV-infected patients in therapeutic failure. The relative RC was assessed by comparing luciferase activity between mutant RV and wild-type (wt) isolates. RESULTS: A strong decrease (>60%) in the RC of the pol RV population was observed in the 14 heavily pretreated patients as compared with the wt RVs. The analysis of PR and RT RVs from these patients showed that the decrease in RC was mainly attributable to PR sequences in three of these 14 patients and to RT sequences in seven of these patients. In the four remaining patients, PR and RT sequences independently reduced the RC of the RVs to similar extents. CONCLUSIONS: Different patterns of mutations in either PR or RT have a strong impact on RC in highly experienced HIV-infected patients.

A new strategy based on recombinant viruses as a tool for assessing drug susceptibility of human immunodeficiency virus type 1.

The emergence of drug-resistant variants during antiretroviral therapy is a serious obstacle to sustained suppression of the human immunodeficiency virus type 1 (HIV-1). For that reason, resistance assays are essential to guide clinicians in the selection of optimal treatment regimens. Genotypic assays are less expensive and results are available faster than phenotypic assays. However, in heavily experienced patients with multiple treatment failures interpretation of complex mutation patterns remains difficult, and in these cases phenotypic assays are recommended. This report describes a novel recombinant virus assay where protease (PR) and reverse transcriptase (RT) sequences derived from the plasma isolated from patients are introduced into the back-bone of an HIV molecular clone that expresses Renilla luciferase protein in the place of nef gene. All drug resistance profiles analyzed correlate with previously reported data and showed high reproducibility. This assay, in addition to a fast (completed in 10 days), precise, reproducible and automated method, presents several advantages as compared to other phenotypic assays. The system described below allows the generation of recombinant viruses with multiples cycles of replication carrying a reporter gene in their genomes. These features increase the sensitivity of the test, an important aspect to be considered in the evaluation of less fit viral isolates. In conclusion, the assay permits the quantitation of the level of resistance of clinical HIV-1 isolates to PR and RT inhibitors.

Evaluación del efecto residual del temephos en larvas de Aedes aegypti en Lima, Perú / Evaluation of the residual effect of temephos on Aedes aegypti larvae in Lima, Peru

El temephos ha sido usado como la única estrategia de control para Aedes aegypti en Lima durante los últimos años.Objetivo: Evaluar la eficacia residual de temephos para el control de Ae. aegypti en condiciones de campo y laboratorioen Lima, Perú. Materiales y métodos: Se eligieron ocho tanques bajos de concreto (TBC) depósitos predominantementeinfestados con Ae. aegypti en el distrito de San Juan de Lurigancho, situado al norte del área suburbana deLima. Se cuantificó el número de larvas con ayuda de una red de mano y luego fueron devueltas a los TBC. Los TBCfueron tratados con temephos a una dosis de 1 ppm en el día cero (0). Se evaluó la mortalidad de las larvas salvajesa 24, 48 y 72 horas y se hizo un seguimiento periódico cada siete días hasta las 14 semanas. Al mismo tiempo y enforma semanal se recogieron 500 mL de agua de cada TBC tratado y fueron enviados al laboratorio para los bioensayos(exposición de 25 larvas durante 24 a 48 horas y registro de mortalidad). Resultados: Todos los TBC estuvieroninfestados (mediana de 43,5 larvas). La mortalidad en los TBC a 24 horas fue 99,7 y no se evidenció recolonizaciónde los TBC hasta la 14.ª semana. Sin embargo, en el laboratorio se evidencia disminución semanal de 11 de la mortalidaddesde la 7.ª semana. La mortalidad en la semana número 14 estuvo asociada de forma inversa con la frecuenciade recambio de agua en los TBC (p<0,05). Conclusiones: No hubo evidencia en condiciones de campo de eficaciaresidual disminuida del temephos a la 14.a semana de aplicación. Este tipo de estudios deberían hacerse de manerarutinaria para vigilar la efectividad del larvicida temephos en Lima.

Temephos has been used as the only control strategy for Aedes aegypti in Lima for the past few years instead it is probably the only larvicidal agent currently being used in Peru. Objective: Assess the residual efficacy of temephos for the control of Ae. aegypti in field and laboratory conditions in Lima, Peru. Materials and methods: Eight low concrete tanks (LCT), containers, which are predominantly infested with Ae. aegypti in the San Juan de Lurigancho district, located North of the Lima sub-urban area. The number of larvae was determined with a hand net; all larvae were returned to the LCT after the tally. LCTs were treated with temephos, at a dose of 1 ppm on day zero (0). Mortality of wild larvae was evaluated at 24, 48 and 72 hours post treatment, and a periodic follow-up was conducted every 7 days for up to 14 weeks. At time 0 and on a weekly basis, 500 mL of water was collected from each treated tank and sent to a laboratory for bioassays (exposure of 25 larvae for 24 to 48 hours and subsequent record of mortality). Results: All the LCTs were infected (median of 43.5 larvae). Mortality at 24 hours in the LCTs was 99.7% and there appeared to be no further increase in mosquito larvae after the initial dose of Temephos in LCTs until week 14. However, evidence of 11% weekly decrease in mortality starting on week 7. Mortality at week 14 was inversely associated to the frequency of water changes in the LCTs (p<0,05). Conclusions: Temephos is efficient for the control of Ae. aegypti in field conditions in Lima for up to 14 weeks. This type of study should be conducted on a routine basis to monitor effectiveness of temephos.

Generation of Human Monoclonal Antibodies from HIV-Infected Individuals / Generación de anticuerpos monoclonales humanos a partir de individuos infectados por VIH

Recently, the protective role of anti-HIV-1 neutralising antibodies has been «re-discovered». Few broadly protective epitopes on the HIV envelope proteins are known, which were defined by few human monoclonal antibodies (mAbs) derived many years ago from non-progressor HIV-infected individuals. It is of interest to try to generate new neutralising human mAbs both to identify new protective epitopes for vaccine design and as potential passive immunotherapy agents. In addition, it is now known that rather than recognising HIV envelope proteins, some neutralising antibodies might be autoantibodies directed to the receptor (CD4) or co-receptors (CCR5 or CXCR4) on the HIV target cells. In that context, we attempted to generate neutralising human mAbs from few HIV-1-infected individuals who, after structured antiretroviral therapy interruptions, showed good virologic and immunologic responses, including serum HIV neutralising activity. We employed the classical heterohybridoma technology and found that the best screening strategy is a primary selection of IgG-producing hybridomas, followed by secondary screenings with different antigens and assays such as HIV neutralisation activity, direct binding to HIV components, binding to HIV target cells, and to cell lines transfected with human HIV receptors and co-receptors. From a single subject, 61 IgG-producing hybridomas out of 5,760 primary wells were obtained, and preliminary data indicate the presence of six (out of 23 tested) neutralising antibodies of the X4 strain, eight anti-p24 antibodies and two antibodies that bind to the MT-2 cell line, the target of X4 strains. None of the 61 mAbs obtained reacted with cells expressing CD4, CXCR4 or CCR5. Other screening tests such as neutralisation assay with the R5 strain, binding to HIV gp120-CD4 covalent complex, and to whole chemically (aldrithiol-2)-inactivated HIV are in progress. The screening strategy is also a means to “open” the repertoire of IgG antibodies of circulating B cells in HIV-infected individuals permitting to assess the frequency of HIV-related IgG antibodies and the IgV genes encoding them, an issue largely unknown (AU)

Recientemente se ha «re-descubierto» el carácter protectivo de los anticuerpos anti-VIH neutralizantes. Se conocen sólo unos pocos epitopos protectivos en las proteínas de la envoltura del VIH definidos gracias a unos pocos anticuerpos monoclonales humanos (mAbs) generados hace ya tiempo en pacientes infectados asintomáticos. Tiene interés intentar generar otros mAbs humanos neutralizantes que puedan definir nuevos epitopos protectivos para el diseño de vacunas, y ser útiles en inmunoterapia pasiva. Además, actualmente está claro que podrían existir anticuerpos neutralizantes que en vez de ir dirigidos contra la envoltura del VIH, reconocieran al receptor (CD4) o coreceptores (CCR5 o CXCR4) en la membrana de las células diana del VIH. En este contexto, hemos intentado obtener mAbs neutralizantes a partir de aquellos pacientes VIH+ que, tras un protocolo de interrupciones estructuradas de la terapia antiretroviral, mostraron buena respuesta virológica e inmunológica, con aumento de actividad sérica neutralizante. Utilizamos la metodología de heterohybridomas convencional y hallamos que la mejor estrategia de escrutinio es la selección primaria de hibridomas secretores de IgG, y luego el escrutinio con distintos ensayos para actividad neutralizante, unión a proteínas víricas, unión a la membrana de las células diana y a células transfectadas con receptores y co-receptores del VIH. A partir de un paciente, de 5.760 microcultivos primarios, se obtuvieron 61 hibridomas productores de IgG entre los que, según datos preliminares, hay seis mAbs (de 23 probados) neutralizantes contra cepas X4, ocho anti-p24 del VIH, y dos que se unen a la componentes de la membrana de la línea MT-2, diana de las cepas X4. Ningún mAb de los 61 obtenidos se unía a CCR5, CD4 o CXCR4. Hay otros escrutinios en curso como neutralización frente a cepa R5, la unión a complejo covalente gp120-CD4 y a VIH total inactivado químicamente con aldritiol-2. El escrutinio utilizado es también un modo de abrir el repertorio de anticuerpos IgG de los linfocitos B circulantes en individuos VIH+ y averiguar la frecuencia de los anticuerpos de especificidad relacionada con el VIH y los genes IgV que los codifican, un aspecto apenas estudiado (AU)

Trombosis de la vena ovárica en el puerperio / Ovarian vein thrombosis in the puerperium

La trombosis de la vena ovárica es una rara, pero potencialmente grave, complicación asociada a una serie de condiciones en la pelvis. Lo más frecuente es su aparición en el puerperio, secundaria a la siembra bacteriana a partir de una endometritis, con una trombosis secundaria (favorecida por la estasis y la hipercoagulabilidad sanguínea del embarazo). También puede aparecer tras la cirugía ginecológica, en la enfermedad pelviana inflamatoria y, más raramente, coincidiendo con tumores malignos, a veces en combinación con la quimioterapia. Aunque es una entidad poco frecuente en el puerperio (1:600 a 1:2.000 partos), debe tenerse presente en pacientes que comienzan con fiebre y dolor en la fosa ilíaca derecha, por las complicaciones que pueda conllevar. Entre ellas destacan la tromboembolia pulmonar (25 por ciento) y una tasa de mortalidad del 5 por ciento. El diagnóstico no es sencillo por la clínica, y se podría etiquetar erróneamente de otras enfermedades más comunes, como la pielonefritis, la urolitiasis, la apendicitis o los abscesos y los hematomas pelvianos. Sin embargo, las técnicas de imagen, y entre ellas tomografía axial computarizada con contraste, permiten diagnosticar esta afección con una sensibilidad del 100 por ciento. El tratamiento consiste en heparina y antibióticos de amplio espectro. Sólo en casos excepcionales sería necesario ligar las venas involucradas para evitar las complicaciones (AU)

Gestación gemelar / Twin pregnancy

Objetivo: Evaluar las características y las complicaciones de las gestaciones gemelares controladas en nuestro servicio durante el embarazo, el parto y el posparto. Material y método: Estudio retrospectivo de 149 gestaciones gemelares desde 1997 a 2001, controladas en la consulta de embarazo de alto riesgo. Resultados: La placentación más frecuente fue la bicorial-biamniótica (75, por ciento). El 30,2 por ciento de las gestantes ingresó por amenaza de parto prematuro. El 39,5 por ciento de los partos fueron pretérmino y hubo que realizar cesárea al 35,6 por ciento de las gestantes. El 66,8 por ciento de los recién nacidos pesó menos de 2.500 g; el 46,6 por ciento precisó ingreso en la unidad neonatal, y el 3,7 por ciento de los fetos y recién nacidos falleció antes del parto o en los primeros 28 días tras éste. Discusión: Las gestaciones gemelares conllevan un aumento de las complicaciones gestacionales, así como un mayor índice de cesáreas y un menor peso de los recién nacidos (AU)

Comportamiento estacional del Anopheles (Nyssorhynchus) darlingi Root 1926 en localidades de Loreto y Madre de Dios, Perú 1999-2000 / Seasonal behaviour of Anopheles (nyssorhynchus) darlingi root 1926 in Loreto and Madre de Dios, Peru, 1999-2000

Objetivos: Determinar el comportamiento estacional del anopheles darlingi en las localidades de Santa Clara (Loreto) y Villa Luz (Madre de Dios). Materiales y métodos: En las localidades de Santa Clara y Villa Luz, entre agosto de 1999 y junio del 2000 se realizó mensualmente la inspección de criaderos, colectas de larvas de Anopheles darlingi por el método del cucharon y colecta de mosquitos adultos por el método de cebo humano (intradomicilio y peridomicilio), trampa Shannon y refugio animal (extra domicilio). Se calcularon los indicadores: criadero positivo y densidad larvaria por cucharonada, índice de picadura hombre noche (IPHN), índice de picadura hombre hora (IPHH), índice esporozoitico y taza paridad. Resultados: El IPHN en ambas localidades se incrementó en la estación lluviosa con los valores más altos en mayo (Santa Clara) y febrero (Villa Luz). En Santa Clara el comportamiento de la picadura del Anopheles darlingi de agosto a diciembre de 1999, fue unimodal presentándose el pico de IPHH: entre las 19.00 y 22.00 horas y entre las 2.00 y 4.00 horas. En Villa Luz, el comportamiento de la picadura, de agosto a junio de 1999, se mantuvo unimodal, con el pico de IPHH entre las 21.00 y 24.00 horas. Las especies inmaduras de Anopheles darlingi representaron menos del 20 por ciento de las larvas encontradas en los criaderos permanentes. Conclusiones: el Anopheles darlingi presenta mayor densidad poblacional en meses de estación lluviosa, con comportamientos de picadura distintos según localidad de estación. Los criaderos evaluados no serían criaderos tan importantes de esta especie

Screening of selected plant extracts for in vitro inhibitory activity on human immunodeficiency virus.

As part of our screening of anti-AIDS agents from natural sources, extracts of 15 medicinal plants widely used in the folk medicines of North America and Europe were evaluated in vitro. Most of the extracts tested were relatively nontoxic to human lymphocytic MT-2 cells, but only the extracts of Hysopp officinalis and Dittrichia viscosa exhibited anti-HIV activity in an in vitro MTT assay. The 50% hydroalcohol extract of Hysopp officinalis and the aqueous extract of Dittrichia viscosa showed inhibitory effects against HIV-1 induced infections in MT-2 cells at concentrations ranging from 50 to 100 microg/mL and 25 to 400 microg/mL, respectively. Both extracts showed no appreciable cytotoxicity at these concentrations.

Atheromas that cause fatal thrombosis are usually large and frequently accompanied by vessel enlargement.

Several lines of clinical evidence show that AMI frequently occurs at sites with mild to moderate degree of coronary stenosis. The degree of luminal stenosis depends on plaque deposition and degree of vessel remodeling, features poorly assessed by coronary angiography. This postmortem study tested the hypothesis that the size of coronary atheroma and the type of remodeling distinguish culprit lesion responsible for fatal AMI from equi-stenotic nonculprit lesion in the same coronary tree. The main coronary branches from 36 consecutive patients with fatal AMI were studied. The culprit lesion (Group 1) and an equi-stenotic nonculprit segment (Group 2) obtained in measurements of another coronary branch from the same patient were compared. Morphometry and plaque composition was assessed in both groups. Compared to Group 2, Group 1 had larger areas of: plaque 9.6 vs. 4.7 mm(2), vessel 12.7 vs. 7.4 mm(2) and lumen 1.7 vs. 1.2 mm(2); (P< .01). Positive remodeling was more frequent in Group 1 than Group 2: 21/30 (70%) vs. 8/26 (31%). Plaque area correlated positively with lipid core and macrophages and negatively with fibrosis and smooth muscle cells. Atherosclerotic plaques that cause fatal thrombosis are more frequently positively remodeled and tend to be larger than nonculprit plaques with the same degree of cross-sectional stenosis. We tested whether arterial remodeling and plaque size vary between segments containing a fatal thrombosed plaque versus an equi-stenotic nonculprit plaque. Culprit vessel segments had higher cross-sectional areas of intimal plaque and of vessel wall than equi-stenotic nonculprit plaques. The cross-sectional area of the vessel correlated positively with both the lipid core area and CD68(+) macrophage content, and negatively with fibrosis area and smooth muscle cell content. These results add elements explaining limitations of angiography in identifying plaques and provide new insights into the role of remodeling in plaque instability.

Anti-HIV activity of medicinal plant extracts.

As part of our screening of anti-AIDS agents from natural sources, ethanolic and aqueous extracts of 15 medicinal plants widely used in the folk medicine of the Iberian Peninsula were evaluated in vitro. Most of the extracts tested were relatively nontoxic to human lymphocytic MT-2 cells, but only the extracts of Tuberaria lignosa and Sanguisorba minor magnolii exhibited anti-HIV activity in an in vitro MTT assay. The aqueous extracts of these plants showed inhibitory effects against HIV-1 induced infections in MT-2 cells at concentrations ranging from 12.5 to 50 microg/ml and 50 microg/ml, respectively. Both extracts showed no appreciable cytotoxicity at these concentrations.

Validación de sustratos atractivos a oviposición para la detección de Aedes Aegypti

Objetivo: Comparar tres tipos de atrayentes a oviposición para la detección de Aedes aegypti (agua local, infusión de pasto Stenotaphrum secundatum y solución acuosa de propionato de metilo al 0,5%) en tres ciudades endémicas de Dengue del Perú. Materiales y métodos: Entre Setiembre y Octubre del 2001 se realizó un muestreo dirigido en viviendas de localidades de las provincias de Tarapoto (departamento San Martín), Satipo (Junín) y Tumbes (Tumbes) en base al antecedente de haber presentado, un caso confirmado de dengue o la presencia de pupas y larvas de Ae. aegypti a la inspección. En cada vivienda se colocaron 4 ovitrampas (con las 3 soluciones y una solución control: agua mineral) y se observaron por 3 días consecutivos, inspeccionándolas cada 24 horas. Para el análisis se empleó el test de rango múltiple de Duncan y la prueba de Dunnett, siendo significativo un p<0,05. Resultados: De 248 ovitrampas instaladas (88 en Tarapoto, 88 en Satipo y 72 en Tumbes) en 62 lugares, resultaron positivas 13,7%. El promedio global de huevos por ovitrampa. fue 8,02 (rango: 0-131) y se encontró que el promedio de huevos en la infusión de pasto fue mayor al encontrado en las otras soluciones (p<0,05). Conclusión: La infusión de pasto resultó la más efectiva sustancia atrayente en las ovitrampas empleadas para detectar Ae. aegypti.

Objective: To compare three types of oviposition baits (local water, Stenotaphrum secundatum solution and 0.5%-methyl propionate solution) for the detection of Aedes aegypti in three Dengue endemic cities in Peru. Materials and methods: Based upon one confirmed Dengue case and in the occurrence of Aedes pupae and larvae, a selective sampling of houses in Tarapoto (San Martfn), Satipo (Junin) and Tumbes (Tumbes) was performed between September and October, 2001. Four traps (containing the three solutions, as well as a control solution: mineral water) were placed in each house and observed for a 3-day period, being supervised every 24 hours. The Duncan Multiple Test and the Dunnet Test (significance level, p < 0,05) were used to perform the analysis. Results: Of 248 traps placed (88 in Tarapoto, 88 in Satipo and 72 in Tumbes) in 62 houses, 13.7% were positive. The average egg content for each trap was 8,02 (range: 0-131) and the average egg content found in the vegetable infusion was higher than those met in the other solutions (p<0,05). Conclusion: The vegetable infusion is the most effective trap bait used for detection of Aedes aegypti.