Molecular detection of Rickettsia species in ticks collected in the Mexico-USA transboundary region.

Zoonotic tick-borne diseases, including those caused by Rickettsia species, continue to have serious consequences for public health worldwide. One such disease that has emerged as a major problem in several countries of the American continent is the Rocky Mountain Spotted Fever (RMSF) caused by the bacterium Rickettsia rickettsii. Several tick species are capable of transmitting R. rickettsia, including Amblyomma cajennense, A. aureolatum, A. imitator, Rhipicephalus sanguineus, Dermacentor andersoni, D. variabilis and possibly A. americanum. Despite previous reports in Mexico linking new outbreaks of RMSF to the presence of these tick species, no robust measures have tackled transmission. In the present study, we amplified R. rickettsii from 109 test DNA samples extracted from ticks collected from several animals and humans of Tamaulipas, Mexico, between November 2015 and December 2017. Our analysis revealed the presence of R. rickettsii in six samples and these findings contribute to a spatial distribution map that is intended to minimize the risk of transmission to humans.

Analysis of sexual function in kidney transplanted men.

INTRODUCTION: Sexual dysfunction among renal failure and kidney transplant patients remains controversial. The aim of this study was to evaluate sexual functions of men on hemodialysis compared with patients undergoing kidney transplantation. MATERIALS AND METHODS: Our study was based on 36 end-stage renal disease (ESRD) patients undergoing hemodialysis versus 32 kidney transplanted patients. A control group was composed of 23 healthy patients. The patients underwent an anamnesis, a physical examination, and the International Index of Erectile Function about sexual performance. Statistical analysis was performed by Student's t-test or the chi-square test with the level of significance set at P < .05. Data are reported as mean values +/- standard error of the means. RESULTS: The mean scores of the control, ESRD, and transplanted group were, respectively: for erectile function, 27.4 +/- 0.5, 22.4 +/- 1.3, 23.4 +/- 1.3; for orgasmic function, 9.5 +/- 0.1, 7.6 +/- 0.5, 8.9 +/- 0.5; for sexual desire function 9.4 +/- 0.1, 7.1 +/- 0.3, 9.0 +/- 0.5; for intercourse satisfaction 12.8 +/- 0.3, 9.4 +/- 0.7, 11.0 +/- 0.7; and for satisfaction related to sexual life 9.2 +/- 0.2, 7.7 +/- 0.3, 8.6 +/- 0.6, proving that there were significant differences regarding orgasmic function, sexual desire, and intercourse satisfaction. CONCLUSION: It was possible to conclude from our study that kidney transplants do improve sexual function of patients with ESRD on hemodialysis.

Timing of ondansetron administration to prevent postoperative nausea and vomiting

BACKGROUND: The original guidelines for using ondansetron recommending its administration prior to induction of anesthesia have been questioned. METHOD: In an effort to determine the most effective timing of ondansetron administration to prevent postoperative nausea and vomiting (PONV), a prospective, randomized, double-blind study was performed. Patients undergoing ambulatory plastic surgery procedures estimated to last two hours or more and who had at least two risk factors for PONV (female gender, non-smoker, previous history of PONV and postoperative opioids) participated in the study. General anesthesia for all patients followed the same standard institutional protocol and all patients received dexamethasone 4 mg intravenously at the start of surgery. The control group (n = 188) received 4 mg of ondansetron intravenously prior to the induction of anesthesia. The study group (n = 184) received 4 mg of ondansetron intravenously 30 minutes prior to completion of the surgery. The incidence of PONV during the early (0-2 hours) and delayed (2-24 hours) postoperative periods was recorded. RESULTS: No significant difference was found between the groups regarding early postoperative nausea or vomiting (p > 0.05). However, a significant difference (p < 0.05) was noted in both late postoperative nausea (control: 30% vs. study group: 20%) and late postoperative vomiting (control: 17% vs. study group: 8%). CONCLUSION: This clinical study indicates that when performing prolonged surgical procedures, late administration of ondansetron (within 30 minutes prior to completing the surgery) is significantly more effective in the prevention of late PONV than when administered prior to the induction of anesthesia.

Pigmented basal cell carcinoma: an unusual case.

The case of a 66-year-old man who presented with an extensive pigmented basal cell carcinoma of the left cheek is reported. Treatment consisted of irradiation and staged surgical resections. The cosmetic result was excellent, and the patient has been free of the cheek tumor for 2 1/2 years. The numerous problems inherent in the treatment of patients with disfiguring facial skin malignancies were surmounted by a multidisciplinary team in which radiotherapy, plastic surgery, and dental services participated.

Inhibition of human keloid fibroblast growth by isotretinoin and triamcinolone acetonide in vitro.

In this study, we evaluated the effects of isotretinoin and triamcinolone acetonide on the growth of keloid and embryonal human skin fibroblasts in vitro. Culture bottles were plated with 2 x 10(5) cells and after 3 days of growth in Eagle's minimum essential medium, the medium was changed to one containing the drug being evaluated. Five groups were established: (1) regular medium as the control; (2) the medium containing 0.1% ethyl alcohol (the vehicle in which isotretinoin is dissolved); (3) the medium containing isotretinoin; (4) the medium containing triamcinolone acetonide; (5) the medium containing both drugs. Our study demonstrated that isotretinoin and triamcinolone acetonide each significantly inhibited the growth of the cells, and the effect of the combination was greater than that of either drug used alone.

[The use of silicone breast prosthesis in Puerto Rico]. / El uso de prótesis mamarias de silicona en Puerto Rico.

To obtain data on the use of gel-filled silicone breast implants in Puerto Rico, a study was undertaken by the Division of Plastic Surgery of the University of Puerto Rico. Questionnaires, designed to obtain information about their breast implant patients, were mailed to the 22 plastic surgeons in Puerto Rico. Sixty-eight percent of the plastic surgeons responded. The collected data showed that 1,682 patients received gel-filled silicone breast implants, of whom breast augmentation accounted for 82%, and post-mastectomy reconstruction for 18%. Capsular contracture occurred in 16% and early complications in 2.5% of the patients. Autoimmune disease was rare (.0006%), as was breast cancer (.0002%). Very few patients in Puerto Rico received polyurethane foam covered breast implants (.005%). The risk of problems associated with breast implants in our Island appears to be very low.

Current status of silicone breast implants.

The current status of the silicone breast implants which have recently come under scrutiny by the FDA and received much unfavorable media coverage is reviewed. The gel-filled breast implants which in 1976 were "grandfathered" by the FDA have now been required to provide scientific evidence of safety and effectiveness by July 9, 1991. The possible risks of silicone breast implants include capsular contracture, interference with early tumor detection by routine mammography, development of sarcomas in laboratory animals (no human cases are reported), silicone gel leakage and connective tissue disease. In the less frequently used polyurethane covered implants, the degradation of the polyurethane to diaminotoluene (TDA) has caused liver cancer in laboratory animals, yet at present, this type of implant has been voluntarily removed from the market by the manufacturer. After reviewing the available evidence, the American Society of Plastic Surgery still considers silicone breast implants reliable and safe.

Cholecystectomy and right colon cancer in Puerto Rico.

A case-control study was undertaken to evaluate the possible relationship between cholecystectomy and right colon cancer. Two hundred patients with adenocarcinoma of the cecum or ascending colon (diagnosed between 1984 and 1989) were compared with 200 matched neighborhood controls. Cholecystectomy history was obtained through interviews using structured questionnaires and subsequently validated from hospital records. A statistically significant association (odds ratio = 2.14) was found between right colon cancer and a history of prior cholecystectomy. The altered bile metabolism which occurs after removal of the gallbladder may have a carcinogenic effect on the right colon. Dietary habits of the colon cancer patients in our study were consistent with prior reports in the literature, showing that this group has a lower intake of vegetables and cereal fiber than the control population.

Current findings in the pathological evaluation of breast reduction specimens.

A study of the histopathologic findings in the specimens of 100 consecutive cases of reduction mammoplasty was performed. The current classification of premalignant breast changes using the presence or absence of atypia in specimens with epithelial hyperplasia was employed. Of the group studied only 1% showed atypical ductal hyperplasia and no cases of lobular carcinoma in situ or ductal carcinoma in situ were found. Fifty percent of the specimens showed simply fibrosis of the stroma dominating the gross and microscopic picture. The other pathological findings in descending order of frequency were cysts (30%) epithelial hyperplasia without atypia (6%), adenosis (5%) and apocrine metaplasia (5%).

Accelerated healing of full-thickness burns by the use of high-voltage pulsed galvanic stimulation in the pig.

An experimental study was designed using domestic pigs to evaluate the effect of high-voltage pulsed galvanic stimulation (HVPGS) on the rate of healing of full-thickness thermal burns. Twenty animals were used in the study; each one received two standardized burns over the paravertebral region. In half of the animals, HVPGS was performed daily for the study period. One of the burn wounds in each pig was used to evaluate wound contraction by measuring the wound surface weekly for four weeks. The second burn wound had weekly tissue biopsies to evaluate fibroblast population. The data showed a significantly faster rate of wound contraction (p less than 0.001) and a higher fibroblast response (p less than 0.001) in the HVPGS group when compared with controls.

The effect of systemic isotretinoin on wound contraction in guinea pigs.

An experimental study was designed using Hartley guinea pigs to evaluate wound contraction on animals receiving systemic isotretinoin at a dose of 10 mg/kg. Half the animals received isotretinoin for 4 weeks before the surgery and for 2 weeks after the surgical procedure. A square of skin and panniculus carnosus measuring 200 mm2 was excised from the back of each animal, and the amount of wound contraction was determined by a computer program from the drawings on celluloid overlays done weekly. The animals on systemic isotretinoin had a significant delay in wound contraction when compared to control animals (p less than 0.001). When the medication was discontinued, all the animals had complete wound healing within a week.

Muscle flaps in the management of vascular grafts in contaminated wounds: an experimental study in dogs.

This study evaluates in an animal model the efficacy of muscle flaps in protecting the fabric vascular prosthesis when placed in contaminated wounds. A total of 20 adult mongrel dogs received a 2-cm interpositional polytetrafluoroethylene (PTFE) graft to each femoral artery at the groin level. During the surgical procedure, the wounds were inoculated with a Staphylococcus aureus suspension containing either 1 x 10(4) or 1 x 10(5) organisms per milliliter. In half the animals, the grafts were wrapped with a distally based sartorius muscle flap before a standard two-layer closure was completed. One month after the surgery, all the animals were sacrificed and quantitative cultures were performed of the grafts and wounds. The muscle flaps were capable of protecting the vascular prosthesis with inoculums up to 1 x 10(4) organisms (p less than 0.05), but at greater bacterial contamination their efficacy was no longer significant.

The effect of a high fat diet on the incidence of colonic cancer after cholecystectomy in mice.

An experimental study was designed to evaluate the effects of both a high fat diet and a cholecystectomy on the incidence of carcinogen-induced colon cancer in mice. Sixty pink-eyed jax (P/J) mice were divided equally into two groups. One group was fed a standard rodent diet and the other group received a diet supplemented with 20% corn oil. From each diet group, 50% of the mice had a cholecystectomy and the other 50% had a sham operation. Two weeks after surgery, each mouse received weekly subcutaneous injections of a carcinogen (dimethylhydrazine, 20 mg/kg) for 12 weeks. After the treatment period, the mice were killed and their large bowels were examined. Evaluation of the results demonstrated that the mice that had a cholecystectomy and a high fat diet had the highest incidence (P less than 0.05) of colonic adenocarcinomas.

Comparative evaluation of aloe vera in the management of burn wounds in guinea pigs.

An experimental study was designed using Hartley guinea pigs, who received full-thickness burns covering 3 percent of their body surface area by direct contact with a hot plate. A total of 40 animals were equally divided among four modalities of closed burn wound management as follows: group I: silver sulfadiazine (Silvadine); group II: aloe vera gel extract (Carrington Dermal Wound Gel); group III: salicylic acid cream (aspirin); and group IV: plain gauze occlusive dressing only. The dressings were changed daily, and the size and appearance of each burn wound were recorded until complete healing. On the sixth postburn day, quantitative burn wound cultures were made. The average time to complete healing in the control group was 50 days, and the only significant difference was found in the aloe vera-treated animals, which healed on an average of 30 days (p less than 0.02). Wound bacterial counts were effectively decreased by silver sulfadiazine (p = 0.015) and by aloe vera extract (p = 0.015). From our data it appears that aloe gel extracts permit a faster healing of burn wounds.

Reversing the detrimental effect of adriamycin on skin grafts in rats.

We evaluated in a rat model the effects of a homologous fibrin glue in reversing the effects of Adriamycin on adherence and take of skin grafts. A total of 40 male Fisher rats were used in the study. During the first phase of the experiment, the animals were assigned to either group I (N = 10) receiving normal saline or group II (N = 10) receiving 6 mg/kg Adriamycin by tail vein injection 24 hours before surgery. Skin grafts with and without fibrin glue were placed over wounds in the backs of the animals and adherence was measured at 24 and 48 hours. In the second phase (N = 20), the experiment was repeated, this time evaluating the total area of skin graft take at 7 days. Fibrin glue was found to increase adherence and take of skin grafts in all Adriamycin-treated animals.

Evaluation of fibrin glue in rat sciatic nerve repairs.

Using the rat sciatic nerve model, we evaluated the merits of homologous fibrin glue in the repair of peripheral nerve transections as compared to standard epineural suture repairs. A total of four study groups were used, with 10 animals assigned to each group. In group I, the transected sciatic nerve was repaired with six interrupted 10-0 nylon sutures; in group II, only two interrupted sutures were used; in group III, a two-suture repair was reinforced with fibrin glue; and in group IV, only fibrin glue was used. All animals were sacrificed at 8 weeks, and histologic sections evaluated. When fibrin alone was used, dehiscence occurred in 80 percent of the animals, and as reinforcement of a two-suture repair, it only increased the inflammatory reaction.

Inhibition of vasoactive substances in experimental endotoxin shock.

Using the endotoxin shock model in mongrel dogs, the effects of a cyclooxygenase antagonist (diclofenac sodium) and an antihistamine (chlorpheniramine) were evaluated. Both drugs significantly raised the mean arterial pressure and systemic vascular resistance. The vasomotor activity of histamine appeared to be independent from the one mediated by prostaglandins (cyclooxygenase pathway) since the effect was additive during the first 60 minutes. Yet at 120 minutes only diclofenac sodium continued to be effective, suggesting a sustained role of prostaglandins in the pathophysiology of endotoxin shock.