Toward Precision Medicine in Atopic Dermatitis Using Molecular-Based Approaches / Hacia una medicina de precisión en la Dermatitis Atópica mediante el uso de enfoques moleculares

Atopic dermatitis is the most common chronic inflammatory skin disorder, affecting up to 20% of children and 10% of adults in developed countries. The pathophysiology of atopic dermatitis is complex and involves a strong genetic predisposition and T-cell driven inflammation. Although our understanding of the pathology and drivers of this disease has improved in recent years, there are still knowledge gaps in the immune pathways involved. Therefore, advances in new omics technologies in atopic dermatitis will play a key role in understanding the pathogenesis of this burden disease and could develop preventive strategies and personalized treatment strategies. In this review, we discuss the latest developments in genetics, transcriptomics, epigenomics, proteomics, and metagenomics and understand how integrating multiple omics datasets will identify potential biomarkers and uncover nets of associations between several molecular levels (AU)

La dermatitis atópica es el trastorno inflamatorio de la piel crónico más común. Afecta hasta a 20% de los niños y a 10% de los adultos en países desarrollados. La fisiopatología de la dermatitis atópica es compleja e implica una fuerte predisposición genética e inflamación impulsada por células T. Aunque nuestra comprensión de la patología y las causas de esta enfermedad ha mejorado en los últimos años, aún existen lagunas de conocimiento en las vías inmunológicas involucradas. En consecuencia, los avances en nuevas tecnologías ómicas en la dermatitis atópica desempeñarán un papel clave en la comprensión de la patogénesis de esta enfermedad y podrían desarrollar estrategias preventivas y tratamientos personalizados. En esta revisión se discuten los últimos avances en genética, transcriptómica, epigenómica, proteómica y metagenómica, y entendemos cómo la integración de múltiples conjuntos de datos ómicos identificará posibles biomarcadores y descubrirá redes de asociaciones entre varios niveles moleculares (AU)

[Artículo traducido] Hacia una medicina de precisión en la dermatitis atópica mediante el uso de enfoques moleculares / Toward Precision Medicine in Atopic Dermatitis Using Molecular-Based Approaches

La dermatitis atópica es el trastorno inflamatorio de la piel crónico más común. Afecta hasta a 20% de los niños y a 10% de los adultos en países desarrollados. La fisiopatología de la dermatitis atópica es compleja e implica una fuerte predisposición genética e inflamación impulsada por células T. Aunque nuestra comprensión de la patología y las causas de esta enfermedad ha mejorado en los últimos años, aún existen lagunas de conocimiento en las vías inmunológicas involucradas. En consecuencia, los avances en nuevas tecnologías ómicas en la dermatitis atópica desempeñarán un papel clave en la comprensión de la patogénesis de esta enfermedad y podrían desarrollar estrategias preventivas y tratamientos personalizados. En esta revisión se discuten los últimos avances en genética, transcriptómica, epigenómica, proteómica y metagenómica, y entendemos cómo la integración de múltiples conjuntos de datos ómicos identificará posibles biomarcadores y descubrirá redes de asociaciones entre varios niveles moleculares (AU)

Atopic dermatitis is the most common chronic inflammatory skin disorder, affecting up to 20% of children and 10% of adults in developed countries. The pathophysiology of atopic dermatitis is complex and involves a strong genetic predisposition and T-cell driven inflammation. Although our understanding of the pathology and drivers of this disease has improved in recent years, there are still knowledge gaps in the immune pathways involved. Therefore, advances in new omics technologies in atopic dermatitis will play a key role in understanding the pathogenesis of this burden disease and could develop preventive strategies and personalized treatment strategies. In this review, we discuss the latest developments in genetics, transcriptomics, epigenomics, proteomics, and metagenomics and understand how integrating multiple omics datasets will identify potential biomarkers and uncover nets of associations between several molecular levels (AU)

Toward Precision Medicine in Atopic Dermatitis Using Molecular-Based Approaches. / [Artículo traducido] Hacia una medicina de precisión en la dermatitis atópica mediante el uso de enfoques moleculares.

Atopic dermatitis is the most common chronic inflammatory skin disorder, affecting up to 20% of children and 10% of adults in developed countries. The pathophysiology of atopic dermatitis is complex and involves a strong genetic predisposition and T-cell driven inflammation. Although our understanding of the pathology and drivers of this disease has improved in recent years, there are still knowledge gaps in the immune pathways involved. Therefore, advances in new omics technologies in atopic dermatitis will play a key role in understanding the pathogenesis of this burden disease and could develop preventive strategies and personalized treatment strategies. In this review, we discuss the latest developments in genetics, transcriptomics, epigenomics, proteomics, and metagenomics and understand how integrating multiple omics datasets will identify potential biomarkers and uncover nets of associations between several molecular levels.

Toward Precision Medicine in Atopic Dermatitis Using Molecular-Based Approaches.

Atopic dermatitis is the most common chronic inflammatory skin disorder, affecting up to 20% of children and 10% of adults in developed countries. The pathophysiology of atopic dermatitis is complex and involves a strong genetic predisposition and T-cell driven inflammation. Although our understanding of the pathology and drivers of this disease has improved in recent years, there are still knowledge gaps in the immune pathways involved. Therefore, advances in new omics technologies in atopic dermatitis will play a key role in understanding the pathogenesis of this burden disease and could develop preventive strategies and personalized treatment strategies. In this review, we discuss the latest developments in genetics, transcriptomics, epigenomics, proteomics, and metagenomics and understand how integrating multiple omics datasets will identify potential biomarkers and uncover nets of associations between several molecular levels.

Increased levels of soluble fms-like tyrosine kinase-1 are associated with adverse outcome in pregnant women with COVID-19.

OBJECTIVE: In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy. METHODS: This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis. RESULTS: Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia. CONCLUSION: sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Growth performance, oxidative stress and immune status of newly weaned pigs fed peroxidized lipids with or without supplemental vitamin E or polyphenols.

BACKGROUND: This study evaluated the use of dietary vitamin E and polyphenols on growth, immune and oxidative status of weaned pigs fed peroxidized lipids. A total of 192 piglets (21 days of age and body weight of 6.62 ± 1.04 kg) were assigned within sex and weight blocks to a 2 × 3 factorial arrangement using 48 pens with 4 pigs per pen. Dietary treatments consisted of lipid peroxidation (6% edible soybean oil or 6% peroxidized soybean oil), and antioxidant supplementation (control diet containing 33 IU/kg DL-α-tocopheryl-acetate; control with 200 IU/kg additional dl-α-tocopheryl-acetate; or control with 400 mg/kg polyphenols). Pigs were fed in 2 phases for 14 and 21 days, respectively. RESULTS: Peroxidation of oil for 12 days at 80 °C with exposure to 50 L/min of air substantially increased peroxide values, anisidine value, hexanal, and 2,4-decadienal concentrations. Feeding peroxidized lipids decreased (P < 0.001) body weight (23.16 vs. 18.74 kg), daily gain (473 vs. 346 g/d), daily feed intake (658 vs. 535 g/d) and gain:feed ratio (719 vs. 647 g/kg). Lipid peroxidation decreased serum vitamin E (P < 0.001) and this decrease was larger on day 35 (1.82 vs. 0.81 mg/kg) than day 14 (1.95 vs. 1.38 mg/kg). Supplemental vitamin E, but not polyphenols, increased (P ≤ 0.002) serum vitamin E by 84% and 22% for control and peroxidized diets, respectively (interaction, P = 0.001). Serum malondialdehyde decreased (P < 0.001) with peroxidation on day 14, but not day 35 and protein carbonyl increased (P < 0.001) with peroxidation on day 35, but not day 14. Serum 8-hydroxydeoxyguanosine was not affected (P > 0.05). Total antioxidant capacity decreased with peroxidation (P < 0.001) and increased with vitamin E (P = 0.065) and polyphenols (P = 0.046) for the control oil diet only. Serum cytokine concentrations increased with feeding peroxidized lipids on day 35, but were not affected by antioxidant supplementation (P > 0.05). CONCLUSION: Feeding peroxidized lipids negatively impacted growth performance and antioxidant capacity of nursery pigs. Supplementation of vitamin E and polyphenols improved total antioxidant capacity, especially in pigs fed control diets, but did not restore growth performance.

Biological parameters of the triatomine, Meccus phyllosomus pallidipennis, fed on two bloodmeal sources under laboratory conditions.

Chagas disease is one of the most important vector-borne diseases in Latin America, including Mexico. Meccus phyllosomus pallidipennis (Stål), 1872 (Hemiptera: Reduviidae) is a Mexican triatomine vector that is commonly associated with hens and rabbits. The biological parameters of two cohorts fed on hens (H) and on rabbits (R) were evaluated. The median lifecycles of the two cohorts were 198 days (H) and 180 days (R). Moreover, mortality was around 30% in both cohorts. Time lapse for beginning of feeding was 0.5-1.9 (H) and 1.1-2.4 min (R). Feeding times of each instar in both cohorts were over 10 min. Most specimens fed on hens defecated immediately after feeding, whereas those that fed on rabbits defecated within 1-5 min post-feeding. Similar numbers of males and females (50%) were obtained in both cohorts. An average of 2.1-2.3 eggs per female per day was noted in both cohorts, with eclosion rates of 95.4 (H) and 88.8% (R). Thus, it can be concluded that M. phyllosomus pallidipennis may take advantage of feeding in hens, as in rabbits, which could imply a higher risk of Trypanosoma cruzi transmission to humans and animals in its distribution area.

Feasibility of dose enhancement assessment: Preliminary results by means of Gd-infused polymer gel dosimeter and Monte Carlo study.

This work reports the experimental development of an integral Gd-infused dosimeter suitable for Gd dose enhancement assessment along with Monte Carlo simulations applied to determine the dose enhancement by radioactive and X-ray sources of interest in conventional and electronic brachytherapy. In this context, capability to elaborate a stable and reliable Gd-infused dosimeter was the first goal aimed at direct and accurate measurements of dose enhancement due to Gd presence. Dose-response was characterized for standard and Gd-infused PAGAT polymer gel dosimeters by means of optical transmission/absorbance. The developed Gd-infused PAGAT dosimeters demonstrated to be stable presenting similar dose-response as standard PAGAT within a linear trend up to 13 Gy along with good post-irradiation readout stability verified at 24 and 48 h. Additionally, dose enhancement was evaluated for Gd-infused PAGAT dosimeters by means of Monte Carlo (PENELOPE) simulations considering scenarios for isotopic and X-ray generator sources. The obtained results demonstrated the feasibility of obtaining a maximum enhancement around of (14 ±â€¯1)% for 192Ir source and an average enhancement of (70 ±â€¯13)% for 241Am. However, dose enhancement up to (267 ±â€¯18)% may be achieved if suitable filtering is added to the 241Am source. On the other hand, optimized X-ray spectra may attain dose enhancements up to (253 ±â€¯22) %, which constitutes a promising future alternative for replacing radioactive sources by implementing electronic brachytherapy achieving high dose levels.

Theory, simulation and experiments for precise deflection control of radiotherapy electron beams.

Conventional radiotherapy is mainly applied by linear accelerators. Although linear accelerators provide dual (electron/photon) radiation beam modalities, both of them are intrinsically produced by a megavoltage electron current. Modern radiotherapy treatment techniques are based on suitable devices inserted or attached to conventional linear accelerators. Thus, precise control of delivered beam becomes a main key issue. This work presents an integral description of electron beam deflection control as required for novel radiotherapy technique based on convergent photon beam production. Theoretical and Monte Carlo approaches were initially used for designing and optimizing device´s components. Then, dedicated instrumentation was developed for experimental verification of electron beam deflection due to the designed magnets. Both Monte Carlo simulations and experimental results support the reliability of electrodynamics models used to predict megavoltage electron beam control.

Interactive effect of dietary protein and dried citrus pulp levels on growth performance, small intestinal morphology, and hindgut fermentation of weanling pigs.

Weanling pigs ( = 108, 21 d of age, 5.82 ± 0.16 kg initial BW) were assigned to a 2 × 2 factorial arrangement of treatments to evaluate the effects of dietary levels of CP (high- and low-CP diets) and dried citrus pulp (DCP; 0% and 7.5%) on growth performance, small intestinal morphology, and hindgut fermentation. Pigs were blocked by initial BW and allotted to 1 of 9 pens, each containing 3 pigs. The high-CP diets consisted of feeding 20% and 21% CP levels throughout phase 1 (0 to 14 d) and phase 2 (14 to 28 d), respectively. For the low-CP diets, CP levels were reduced by 4% units as compared with the high-CP diets in both phases. Crystalline AA were supplied to maintain an ideal AA pattern. Pig BW and pen feed disappearance were recorded weekly. On d 7 and 28 postweaning, 1 pig from each pen was euthanized for collection of small intestinal tissues and digesta from cecum and colon. There were no CP × DCP interactions for growth performance and gut morphology. Although the low-CP diet decreased ADG ( = 0.03) and G:F ( = 0.02) from d 21 to 28 postweaning, overall performance was unaffected by the treatments. On d 7 postweaning, pigs fed the low-CP diet tended to have increased ( = 0.09) crypt depth in the duodenum. Low-CP diets tended to increase ( = 0.06) crypt depth and reduce ( = 0.08) villus:crypt ratio in the jejunum on d 7. Dietary treatments did not affect ileal morphology. On d 7 postweaning, low-CP diets tended to reduce ( = 0.09) cecal total VFA, whereas dietary DCP inclusion tended to decrease ( = 0.07) colonic propionate. Including 7.5% DCP to the diet decreased ( < 0.05) colonic isovalerate and ammonia N concentrations on d 7 only for pigs fed the low-CP diet. On d 28 postweaning, DCP inclusion in low-CP diets decreased ( < 0.05) butyrate, isovalerate, and valerate concentrations in the cecum, as well as isovalerate, valerate, and ammonia N concentrations in the colon. Including 7.5% DCP to the diet increased ( < 0.05) acetate:propionate ratio in the hindgut on both d 7 and 28 postweaning only for pigs fed the high-CP diet. Lactate concentration was unaffected by the treatments. These results indicate that feeding low-CP AA-supplemented diets did not compromise overall growth performance, but slightly increased damage in the gut morphology of weanling pigs. Moreover, adding 7.5% DCP to low-CP AA-supplemented diets shifted the fermentation pattern in the hindgut of weanling pigs by decreasing protein fermentation metabolites.

Operational stability to changes in composition of herbicide mixtures fed to a laboratory-scale biobarrier.

The main objective of this work was to evaluate the operational stability of a laboratory-scale aerobic biobarrier designed for the treatment of water contaminated by mixtures of three herbicides frequently found in agricultural runoffs, atrazine, simazine and 2,4-dichlorophenoxyacetic acid (2,4-D). The microbial consortium used to degrade the herbicides was composed by six cultivable bacterial strains, identified as members of the genera Variovorax, Sphingopyxis, Hydrocarboniphaga, Methylobacterium, Pseudomonas and Acinetobacter. The effect caused by a seventh member of the microbial consortium, a ciliated protozoa of the genus Colpoda, on the herbicides biodegradation kinetics, was also evaluated. The biodegradation of five combinations of the herbicides 2,4-D, atrazine and simazine was studied in the biobarrier, operated in steady state continuous culture at different volumetric loading rates. In all cases, removal efficiencies determined by chemical oxygen demand (COD) and HPLC were nearly 100 %. These results, joined to the null accumulation of aromatic byproducts of atrazine and simazine catabolism, show that after 495 days of operation, in the presence of the protozoa, the adaptability of the microbial consortium to changing environmental conditions allowed the complete removal of the mixture of herbicides.

Biological and genetic aspects of crosses between phylogenetically close species of Mexican triatomines (Hemiptera: Reduviidae).

Reproductive isolation between Triatoma mexicana (Herrich-Scaeffer) and the six species of the Phyllosoma complex, belonging to the genus Meccus, was examined by analyzing the fertility of experimental hybrids. The percentage of couples with offspring was highest in the set of crosses between Meccus phyllosomus (Burmeister) and T. mexicana, and lowest in those between Meccus pallidipennis (Stål) and Meccus bassolsae (Alejandre-Aguilar, Nogueda-Torres, Cortés-Jiménez, Jurberg, Galvão, and Carcavallo) with respect to T. mexicana. Crosses between Meccus mazzottii (Usinger), Meccus picturatus (Usinger), and Meccus longipennis (Usinger) and T. mexicana had scarce offspring, whereas offspring from crosses between M. phyllosomus and T. mexicana were abundant. However, all F1 nymphs died in different instars before reaching sexual maturity. The biological evidence in this study suggests that different degrees of reproductive isolation exist between T mexicana and the different species of Meccus. Our data also support the current status of T. mexicana as a separate species.

Concordancia de antígenos de dengue en el ELISA de captura de IgM (MAC ELISA) en el IICS-UNA / Concordance of dengue antigens M antibody-capture ELISA (MAC ELISA) in the IICS-UNA

El dengue es una enfermedad aguda grave considerada actualmente como infección reemergente, cuyo vector principal es el Aedes aegypti. En Paraguay en el 2007 fueron reportados 28.181 casos, 55 se clasificaron como fiebre hemorrágica del dengue de los cuales 7 fallecieron. El 90% de los casos fueron de Asunción y del Departamento Central,10% del resto del país. En los últimos años se han desarrollado diferentes sistemas inmunoenzimáticos para el diagnóstico del dengue, entre ellos el ELISA de captura de IgM (MAC ELISA). El objetivo de este estudio observacional analítico de corte transverso fu ecomparar la prueba del MAC ELISA desarrollada en el Instituto de Investigaciones en Ciencias de la Salud (IICS) utilizando antígenos suministrados por el Instituto Pedro Kouri(IPK) de Cuba y el Evandro Chagas de Brasil, con el kit comercial ELISA IgM por capturapara virus del dengue (Focus Diagnostics Inc. Cypress, CA, USA). Fueron seleccionados alazar 92 sueros de pacientes codificados que concurrieron al IICS con sospecha de dengue, respetándose la confidencialidad de los mismos. La concordancia obtenida fue del94.6% (Índice Kappa: 0.891) utilizando el antígeno del IPK y 96.7% (Índice Kappa:0.9350) con el antígeno del Evandro Chagas, mostrándose alta significancia estadística(p<0.00001) en ambos casos. La excelente concordancia obtenida con los dos antígenos indica que los mismos pueden ser utilizados indistintamente en la prueba del MAC ELISA desarrollada en el IICS, a fin de apoyar el diagnóstico del dengue a menor costo y quesería de producción local.

Dengue is an acute disease currently considered a re-emerging infection, whose main vector is Aedes aegypti. In 2007, 28,181 cases were reported in Paraguay, 55 were classified as dengue hemorrhagic fever and seven of them died. Ninety percent of the cases were from Asunción and the Central Department and the remaining 10% from the rest of the country. In recent years various immunoenzymatic systems have been developed immunoassay for the diagnosis of dengue, including the M antibody captureELISA (MAC ELISA). The aim of this cross-sectional observational study was to compare the MAC ELISA test developed at the Instituto de Investigaciones en Cienciad de la Salud(IICS) using antigens supplied by the Instituto Pedro Kouri (IPK) of Cuba and Evandro Chagas of Brazil with a commercial kit of M antibody capture ELISA for dengue virus (Focus Diagnostics Inc. Cypress, CA, USA). Ninety two coded serum samples wererandomly selected from patients who attended the IICS with suspected dengue, respecting their confidentiality. The concordance obtained was 94.6% (Kappa Index: 0.891) using the IPK antigen and 96.7% (Kappa index: 0.9350) with the antigen from Evandro Chagas showing high statistical significance (p<0.00001) in both cases. The excellent concordance obtained with the two antigens indicates that they can be used indistinctly in the MAC ELISA test developed in the IICS to support the diagnosis of dengue at a lower cost and would be locally produced.

Concordancia entre las pruebas de ELISA avidez IgG desarrollados en el Instituto de Investigaciones en Ciencias de la Salud y un ELISA avidez comercial / Concordance between the IgG avidity ELISA tests developed at the Instituto de Investigaciones en Ciencias de la Salud and a commercial avidity ELISA

La infección aguda de toxoplasmosis en la mujer durante el embarazo en su mayor parte es asintomática y detectable solo por anticuerpos lo que podría afectar severamenteal feto si no es diagnosticada y tratada precozmente. En este estudio observacionalanalítico de corte transverso se comparó la prueba de ELISA Avidez IgG paratoxoplasmosis desarrollado en el Instituto de Investigaciones en Ciencias de la Salud(IICS) con un test comercial de avidez InmunoLISA Organics USA. Para la concordanciase utilizó 41 sueros mantenidos a -20 ºC procedentes de la seroteca del Departamento de Producción-Bioquímica seleccionados al azar. La concordancia obtenida fue de 92.7% y un índice de Kappa de 0.820 con IC95% (0.6-1) y p<0.0001. El índice bajo de avidez sugiere una infección aguda pero para el diagnóstico debería estar acompañado de otras pruebas serológicas y la clínica del paciente. En cambio un índice alto es diagnóstico de una infección crónica.

The acute infection caused by Toxoplasma gondii in pregnant women is mostly asymptomatic and detectable only by antibodies that could severely affect the fetus if the infection is not diagnosed and treated precociously. In this cross-sectional observational,the analytical the IgG avidity ELISA test for toxoplasmosis, developed at the Instituto de Investigaciones en Ciencias de la Salud (IICS), was compared to a commercial avidity kit InmunoLISA (Organics, USA). For the concordance, 41 serum samples kept at -20ºC atthe Department of Production-Biochemistry of IICS were tested. The concordance obtained was 92.7% and a Kappa index of 0.820 with IC95% (0.6-1) and p <0.0001. The low avidity index suggests an acute infection but for diagnosis this result should beaccompanied by other serologic tests and clinical symptoms. Instead, a high avidity index suggests a chronic infection.

Estudio de Fiebre Amarilla en primates en áreas de brote de los departamentos de San Pedro y Central del Paraguay / Study of Yellow Fever in primates in outbreaks areas of the departments of San Pedro and Central in Paraguay

La Fiebre Amarilla (FA) es una de las más importantes zoonosis que afecta a poblaciones humanas. La FA silvestre es imposible de ser erradicada, manteniéndose activa en zonas tropicales en África y Sudamérica. Todas las especies de primates son susceptibles y se consideran reservorios en el medio silvestre. La mortalidad es baja, se desconoce su valor con precisión, sin embargo existen epizootias con alta mortalidad, en humanos varía entre 20-50%. El objetivo de este trabajo fue buscar evidencias de FA en primates capturados en áreas de brote de FA de los departamentos de San Pedro y Central del Paraguay mediante la técnica de Neutralización por reducción de placas para FA cepa vacunal 17 D. Los resultados en los 35 primates estudiados fueron negativos, quizás por lo tardío del momento en la toma de muestras y bajo número de primates capturados.

Yellow Fever (YF) is one of the most important zoonotic diseases affecting human population. It is impossible to eradicate wild YF remaining active in tropical zones of Africa and South America. All species of primates are susceptible and are considered reservoirs in wild regions. Mortality is low and its precise value is unknown though there are epizootics with high mortality rates and in humans varies between 20-50%. The objective of this study was to search for evidence of YF in primates caught in YF outbreaks areas of the departments of San Pedro and Central in Paraguay through the neutralization technique by plates reduction for YF vaccine strain 17 D. The results in the 35 primates studied were negative, perhaps because of the lateness of the time sampling and the low number of captured primates.

Importance of species of Triatominae (Heteroptera: Reduviidae) in risk of transmission of Trypanosoma cruzi in western Mexico.

The epidemiological risk of infection by Trypanosoma cruzi Chagas in human populations of western Mexico is still under study. Although most vectors in this region and their vector capability are already known, new studies estimating the risk and the importance of individual Triatominae species (Hemiptera: Reduviidae) for T. cruzi transmission are necessary. For 1 yr, every month, > 400 human dwellings and their surroundings in eight communities of two western Mexico states were searched for triatomines. More than 1,000 specimens representing four species were collected and checked for T. cruzi infection. Based on the usual entomological indices, only the inhabitants of Gavilán El Progreso-La Villita are at serious risk of vectorial infection by T. cruzi. A population of Meccus longipennis (Usinger) was found living in peridomestic rock pile boundary walls after an insecticide spraying. It was confirmed the major role of peridomestic habitats as shelter areas for triatomines, particularly in rock pile boundary walls and chicken roosts. Triatominae presence also was verified in certain sylvatic habitats, including primarily heaps of stones. The important role of M. longipennis in the potential transmission of T. cruzi in the region and the secondary role of M. picturatus (Usinger) and Triatoma barberi Usinger also were confirmed. Null colonization of houses by T. barberi, which was collected primarily in peridomestic habitats, differs from its common intradomiciliary collection in other studies. Meccus pallidipennis (Stål) most probably does not exist in Nayarit. Meccus mazzottii (Usinger) and Meccus phyllosomus (Burmeister) are no longer found in Nayarit and Jalisco. Additional studies are necessary to determine the current epidemiological situation in other areas of western Mexico.

Disminución de hospitalización por L-Carnitina en pacientes hemodializados / Decreased hospitalization rate due to L-carnitine in hemodialysed patients

No disponible

Shock eléctrico asociado a fractura de falange media del dedo medio de mano izquierda / Electric Shock associated to fracture of half phalange of the half finger of hand left

Lesiones por shock eléctrico son descritas en la literatura determinando lesiones locales y sistémicas. Lesiones esqueléticas como luxaciones y fracturas son infrecuentes en nuestras emergencias; aparentemente asociadas a contracciones tetánicas de la musculatura circundante. Describimos un paciente femenino, 43 años, ingresado a la emergencia posterior a sufrir choque eléctrico con electrodoméstico (nevera), refiere sitio de entrada en cara volar de los últimos cuatro dedos de mano izquierda, con exposición aproximada de 30 segundos, se interrumpe desconectando electrodoméstico, niega perdida de conciencia y traumatismo directo e indirecto en miembros. Niega antecedentes importantes. Signos vitales normales, sin signos de traumatismo corporal, posterior al ingreso refiere molestia para la flexo-extensión de mano izquierda, presentando dolor a la palpación profunda sobre la Falange Media del dedo medio. La Radiografía Postero-Anterior evidencia fractura espiroidea no desplazado desde apífisis distal hasta diáfisis de Falange medial del dedo medio de la mano izquierda. Es inmovilizada con férula digital, observada durante 24 horas y egresada previo descarte de lesiones sistémicas importantes. Estas fracturas son de fácil diagnóstico cuando comprometen articulaciones y huesos grandes pero nunca olvidar las fracturas de huesos y articulaciones pequeñas ante una clínica leve.

[Scrotal digestion caused by pancreatic ascites]. / Digestión escrotal por ascitis pancreática.

One case of scrotal necrosis during acute necro-haemorrhagic pancreatitis. A histological study of the resected tissue demonstrated presence of fatty digestion caused by the pancreatic fluid. Discussion of the etiological possibilities, including a review of the relevant literature.