The unequal impact of Covid-19 on the lives and rights of the children of modern slavery survivors, children in exploitation and children at risk of entering exploitation.

This article discusses the unequal impact of Covid-19 on the lives of the children of survivors of modern slavery, child victims of exploitation and children at risk of exploitation in the UK. It draws on research that has analysed the risks and impacts of Covid-19 on victims and survivors of modern slavery. It explores how pandemic responses may have hindered these children's rights to education, food, safety, development and participation and representation in legal processes. It suggests that the pandemic should be used as an impetus to address inequalities that existed pre-Covid-19 and those that have been exacerbated by it.

Integrative Review of Developmental Behavior-Analytic Concepts.

We reviewed five behavior-analytic concepts related to development: behavioral trap, cumulative-hierarchical learning (CHL), basic behavioral repertoire (BBR), pivotal behavior, and behavioral cusp. We searched for terminological variations of the concepts in the CAPES Journals Portal and selected for analysis 31 peer-reviewed articles written in English or Portuguese, published between 1967 and 2021, that contained the search terms in the title, abstract, or keywords and contextualized in the main text. We analysed the conventional usage of the concepts, their conceptual limitations, and the relationships among them, declared or implied, and proposed a conceptual integration of the concepts under a CHL framework, following a path indicated by other authors. We considered BBR, pivotal behavior, and behavioral cusp nonsynonymous concepts of the same logical category, referring to prerequisites for important developmental outcomes and targets of CHL-inspired interventions but defined by different effects on subsequent behavioral development. The three concepts can be conflated in a superset-subset fashion, based on the specificity of their effects: BBR consists of a broad class of behaviors that may affect subsequent learning; the subclass of BBRs characterized by far-reaching collateral effects are classified as pivotal behavior, and the subclass of pivotal behaviors whose potential effects include contact with unprecedented environmental contingencies are classified as behavioral cusps. We propose that behavioral traps be explicitly incorporated in the CHL framework, to emphasize the environmental component of the cumulative-hierarchical learning process. Our formulation seems to organize the conceptual field in a way that respects the conventional use of concepts, preserving their strengths. Regardless of the specific formulation, we believe that integrating the various development-related concepts within a cumulative-hierarchical learning framework can encourage a more proactive integration of findings, questions, and practices informed by each concept, which could lead to the mutual refinement of the corresponding conceptual and methodological frameworks, as well as new research questions and practical applications. In particular, we expect that explicitly incorporating behavioral traps within the CHL framework will provide a useful heuristic model to guide research on how natural environmental contingencies influence the systematic transformation of behavior across the lifespan.

Assessment of the hemagglutinating activity of the Porcine orthorubulavirus.

Blue eye disease (BED) in pigs is caused by Porcine orthorubulavirus (PRV) of the Paramyxoviridae family. It is an endemic disease in swine production in the central region of Mexico and causes nervous signs and high mortality in suckling pigs, pneumonia in growing pigs, orchitis in boars and mummification during gestation. PRV hemagglutinates most red blood cells (RBCs) of domestic species. For serological diagnosis, the hemagglutination inhibition test is used, and in this test, guinea pig, bovine and chicken RBCs have been commonly used. In this investigation, hemagglutination with PRV was evaluated using the RBCs of seven domestic species (chicken, bovine, horse, pig, dog, guinea pig and rabbit). In the hemagglutination test, the following parameters were evaluated: temperature (25 °C and 37 °C), bottoms of the wells (V and U), erythrocyte concentration (0.5%, 0.75%, and 1%), and reading time (15, 30, 45, 60 and 90 min). Significant differences (P < 0.001) were found in most of the evaluated treatments. The best hemagglutination results were obtained with chicken, bovine and horse RBCs. The hemagglutination titer is higher (2 dilutions) when using chicken RBCs than when using bovine or horse RBCs. If chicken RBCs are used in the inhibition of hemagglutination, the test will be more sensitive, while it is more specific when bovine or horse RBCs are used. The hemagglutination readings are imprecise when using RBCs from dogs, pigs, guinea pigs and rabbits. RBCs from these species should not be used for the diagnosis or investigation of PRV.

Effective use of the blank comparison procedure in simple discrimination by infant capuchin monkeys: A methodological note.

In studies of simple and conditional discrimination, procedures are needed to measure those aspects of stimuli that control behavior. The blank comparison procedure is one such procedure. It was designed explicitly for assessing S+ and S- functions when discriminative stimuli are presented simultaneously. In this procedure, a neutral stimulus serves sometimes as S+ and sometimes as S-. Its discriminative function is defined in relation to other stimuli in the display. The present study aimed to prepare 2 infant female capuchin monkeys for the effective use of the blank comparison procedure in a simple discrimination task. First, simple discrimination training was applied up to a stable accuracy criterion of ≥90%. This training was followed by the replacement of S+ and then of S- stimuli with new stimuli. Ultimately, trials with the blank comparison were introduced. Following this sequence, both monkeys immediately displayed highly accurate blank-comparison performances without the need for stimulus control shaping or other preparatory discrimination training. Thus, this procedure sequence may be an efficient, effective method for establishing blank-comparison baselines for experimental analyses of S+/S- discriminative functions and perhaps for other applications in teaching simple and conditional discrimination performances to this species and others.

Patrones de adherencia en células HEp-2 de cepas de Escherichia coli aisladas de ríos contaminados de La Habana / Adherence patterns in HEp-2 cells of Escherichia coli strains isolated from contaminated rivers in Havana

Introducción: El proceso de adherencia es fundamental en el desarrollo de la mayoría de las infecciones ocasionadas por Escherichia coli. Para los patotipos de esta especie se describen tres patrones de adherencia diferentes: adherencia localizada, adherencia difusa y adherencia agregativa, los cuales se relacionan con los procesos patogénicos específicos que ocasiona en la clínica. Sin embargo, son pocos los estudios en relación con los fenotipos de adherencia in vitro de E. coli aisladas del ambiente. Objetivo: Determinar los fenotipos de adherencia de cepas de E. coli aisladas de ecosistemas dulceacuícolas de La Habana. Métodos: Se analizaron 108 cepas de E. coli aisladas de los ríos Almendares, Quibú y Luyanó de La Habana. Se determinó el patrón de adherencia mediante ensayos de adherencia en cultivo celular de la línea HEp-2 así como el serotipo de cada cepa. Resultados: El 25 por ciento de las cepas de E. coli aisladas fueron adherentes y el 75 por ciento fueron no adherentes. Veintidós cepas mostraron el típico patrón de adherencia difusa y cinco cepas mostraron una adherencia agregativa. Se encontraron cepas de los dos patrones de adherencia en los tres ríos evaluados. Las cepas presentaron 24 serotipos diferentes. Conclusiones: Se demostró que las cepas de E. coli ambientales circulantes en estos ecosistemas presentan características adherentes, cuya patogenicidad implica un riesgo potencial para la salud humana, especialmente en edades pediátricas(AU)

Introduction: Adherence is crucial to the development of most Escherichia coli infections. Three different adherence patterns have been described for pathotypes of this species: localized, diffuse and aggregative adherence, based on the specific clinical pathogenic processes they bring about. However, few studies have been conducted about in vitro adherence phenotypes of E. coli isolated from the environment. Objective: Determine the adherence phenotypes of E. coli strains isolated from freshwater ecosystems in Havana. Methods: An analysis was conducted of 108 E. coli strains isolated from the rivers Almendares, Quibú and Luyanó in Havana. Determination was made of the adherence pattern by adherence assays in HEp-2 cell line cultures, as well as of the serotype for each strain. Results: Of the E. coli strains isolated, 25 percent were adherent and 75 percent were not. Twenty-two strains displayed the typical diffusely adherent pattern and five displayed aggregative adherence. Strains exhibiting the two adherence patterns were found in the three rivers evaluated. The strains contained 24 different serotypes. Conclusions: The environmental E. coli strains circulating in these ecosystems were found to have adherent characteristics whose pathogenicity implies a potential risk to human health, particularly in childhood(AU)

Comparison of hemagglutination inhibition tests, immunoperoxidase monolayer assays, and serum neutralizing tests in detecting antibodies against blue eye disease in pigs.

Blue eye disease (BED) of pigs was identified in the early 1980s in La Piedad, Michoacan, Mexico. The causal agent is Porcine orthorubulavirus (PRV), which affects pigs of all ages, producing nervous, respiratory, and reproductive disorders. BED is geographically endemic to the center of Mexico, where 75% of the country's swine industry is concentrated. Due to its adverse effects on the swine industry and the risk of dissemination to other countries, it is essential to have reliable diagnostic methods for BED. The objective of this study was to establish the optimal conditions for three serological tests, hemagglutination inhibition (HI), immunoperoxidase monolayer assay (IPMA), and serum neutralization (SN), and to compare their sensitivity, specificity, kappa coefficient, and predictive values. Twelve different HI protocols (9408 tests), one SN protocol and one IPMA protocol (784 tests, each) were evaluated. Forty-nine sera were analyzed, and thirty-seven sera showed true positive results, while twelve showed true negative results. The kappa coefficient was used to assess the variation in each test. The best HI protocol registered a sensitivity and specificity of 89 and 100%, respectively, the IPMA test showed values of 85 and 100%, and the SN test registered a sensitivity of 91% and a specificity of 96%. One of the disadvantages of the HI test is that when chicken red blood cells (RBCs) are used, elution occurs in a short incubation time, which would decrease the specificity. The use of bovine RBCs increases the specificity of the testy and makes it more stable, but it decreases the sensitivity. The results of HI and SN revealed the importance of eliminating the complement system of the serum and removing other inhibitors to avoid test nonspecificity. The IPMA test does not use an active virus; hence, it is considered safe and does not present any risk of disseminating PRV.

Effect and Analysis of Bacterial Lysates for the Treatment of Recurrent Urinary Tract Infections in Adults.

Urinary tract infection (UTI) is a relevant public health problem, economically and socially affecting the lives of patients. The increase of antimicrobial bacterial resistance significantly hinders the treatment of UTIs, raising the need to search for alternative therapies. Bacterial lysates (BL) obtained from Escherichia coli and other pathogens have been used to treat different infectious diseases with promising results. This work aims to evaluate the effect and composition of an autologous BL for the treatment and control of recurrent UTIs in adults. The results show remission in 70% of the patients within the first three months after the administration of BL, while the infection is maintained under control for 6-12 months. The analysis by liquid chromatography-mass spectrometry (LC-MS) of the BL fractions recognized by the sera of patients shows the presence of cytosolic proteins, fimbriae, OMPs, and LPS. Our study demonstrates that the autologous BL contributed to the treatment and control of recurrent UTIs in adults, and its composition shows that different surface components of E. coli are potential immunogens that could be used to create a polyvalent protective vaccine.

BCR/ABL1 Transcripts in Healthy Individuals: A Comparative Analysis Between First-Degree Relatives of Patients with Chronic Myelogenous Leukemia and Subjects without Antecedents of the Disease.

BCR/ABL1 transcripts, the molecular hallmarks of chronic myeloid leukemia (CML), have been detected in peripheral blood from healthy individuals. Although CML is a sporadic disease, familial occurrence has been reported. This raises the question of whether there is a hereditary factor related to the etiology of CML. Our aim is to compare the BCR/ABL1 e13a2 and e14a2 transcript frequency in healthy first-degree relatives of families with CML versus individuals from families without CML antecedents. Ninety-eight healthy individuals, sorted into two groups, were studied: a group consisting of 46 first-degree relatives from families having a CML affected, and another with 52 healthy individuals from families without CML antecedents. BCR/ABL1 e13a2 and e14a2 transcripts were detected in mRNA isolated from peripheral blood leukocytes. We observed 28 of 98 individuals positive for at least one BCR/ABL1 transcript: e14a2 was detected in 22, e13a2 in 4, and co-expression was observed in 2 subjects. The positivity rate in relatives of CML cases was 33%, whereas individuals without CML antecedents had a 25% positivity rate, showing no statistical difference. Our results corroborate the presence of e13a2 and e14a2 BCR/ABL1 transcripts in the peripheral blood of healthy individuals, but has not a found familial factor related to the etiology of this rearrangement.

Attitudes and preferences towards exercise training in individuals with alcohol use disorders in a residential treatment setting.

PURPOSE: Alcohol use disorders (AUD) are a major public health concern due to their association with several acute and chronic health conditions. Exercise training offers a myriad of physical and mental health benefits, and may be a promising adjunct intervention for those in AUD treatment. The purpose of this study was to explore the possible role of exercise training as a treatment strategy by examining the attitudes, beliefs, and preferences of individuals entering residential AUD treatment. METHODS: Surveys were administered to eligible individuals with AUD within 2days of intake to one of two residential treatment centers. The survey asked respondents about their attitudes, beliefs, and preferences towards exercise training as a part of their residential treatment. RESULTS: Respondents were in favor of receiving exercise counseling as part of their treatment (70.6%), in a face-to-face format (90.0%), and from an exercise counselor at the treatment center (55.5%). The top reported benefits included: improved health, feeling good about oneself, and feeling more confident. The most commonly reported barriers to exercise training included transportation issues, lack of motivation, knowledge, and proper equipment, and cost. CONCLUSION: Our study supports previous work in individuals with substance abuse disorders and suggests that exercise training would be widely accepted as a part of residential treatment for AUD. This study also identified several strategies that can be used to individualize exercise training programs to better meet the needs of AUD patients and maximize their participation in future interventions.

Characterization of a robust co(II) fluorescent complex deposited intact on HOPG.

The new diimine fluorescent ligand ACRI-1 based on a central acridine yellow core is reported along with its coordination complex [Co2 (ACRI-1)2 ] (1), a fluorescent weak ferromagnet. Due to the strong fluorescence of the acridine yellow fluorophore, it is not completely quenched when the ligand is coordinated to Co(II) . The magnetic properties of bulk complex 1 and its stability in solution have been studied. Complex 1 has been deposited on highly ordered pyrolitic graphite (HOGP) from solution. The thin films prepared have been characterized by AFM, time-of-flight secondary ion mass spectrometry (TOF-SIMS), grazing incidence X-ray diffraction (GIXRD), X-ray absorption spectroscopy (XAS), X-ray magnetic circular dichroism (XMCD) and theoretical calculations. The data show that the complex is robust and remains intact on the surface of graphite.

Lanthanide-organic coordination frameworks showing new 5-connected network topology and 3D ordered array of single-molecular magnet behavior in the Dy case.

Five isostructural lanthanide-organic coordination frameworks with a unique 3-D 5-connected (4(7).6(3))(4(3).6(5).8(2)) network, namely, [Ln(phen)(L)]n (Ln = Dy for 1, Gd for 2, Ho for 3, Er for 4, and Tb for 5), have been prepared based on bridging 5-hydroxyisophthalic acid (H3L) and chelating 1,10-phenanthroline (phen) coligand. Significantly, the Dy(III) complex 1 is an organized array of single-molecular magnets (SMMs), with frequency-dependent out-of-phase ac susceptibility signals and magnetization hysteresis at 4 K. Further analysis of the magnetic results can reveal that the SMM behavior of 1 should arise from the smaller ferromagnetic interaction between the Dy(III) ions. Complex 1 was also characterized by X-ray absorption spectra, which give the clear X-ray magnetic circular dichroism signal.

[Hypotonia in the neonatal period: 12 years' experience]. / Hipotonía en el período neonatal: 12 años de experiencia.

INTRODUCTION: Hypotonia is one of the most frequent signs of neurological pathology in newborn infants. AIMS: To determine, in a 12-year retrospective study, the relative frequency of neurological pathologies that can be accompanied by hypotonia during the neonatal period and to describe the neurological development after two years' follow-up. PATIENTS AND METHODS: We conducted a systematic review of the newborn infants with hypotonia due to an identifiable cause who were admitted to the neonatal unit of the Hospital Sant Joan de Deu between January 1996 and December 2008. Information collected referred to family history, data related with the pregnancy and childbirth, clinical features and complementary tests. RESULTS. A total of 73 hypotonic newborn infants were identified, 21 (28.7%) of whom met eligibility criteria. The majority, 81% (n = 17), were classified as central hypotonias and the remaining 19% (n = 4) were graded as peripheral hypotonias. In the first group, 47% (n = 8) presented chromosomal disorders, 29.4% (n = 5) had metabolic diseases and 23.5% (n = 4) displayed malformations of the central nervous system. CONCLUSIONS: The central causes of hypotonia continue to be the most prevalent in the neonatal period and, within these, chromosomal disorders are the most frequent. Peripheral causes are less common and have a more severe prognosis. Advances in molecular genetics have allowed many neuromuscular diseases to be diagnosed both genetically and at the molecular level. The diversity and complexity of the pathologies justifies a multidisciplinary approach being taken to treat these newborn infants.

Hipotonía en el período neonatal: 12 años de experiencia / Hypotonia in the neonatal period: 12 years' experience

Introducción. La hipotonía es uno de los signos más frecuentes de patología neurológica en el neonato. Objetivos. Determinar, en un estudio retrospectivo a 12 años, la frecuencia relativa de patologías neurológicas que pueden cursar con hipotonía durante el período neonatal y describir la evolución neurológica a los dos años de seguimiento. Pacientes y métodos. Revisión sistemática de los recién nacidos hipotónicos sin causa identificable que ingresaron en la unidad neonatal del Hospital Sant Joan de Déu de enero de 1996 a diciembre de 2008. Se han recogido antecedentes familiares, datos relacionados con el embarazo y parto, características clínicas y pruebas complementarias. Resultados. Se identificaron 73 recién nacidos hipotónicos, de los cuales 21 (28,7%) cumplieron los criterios de inclusión. El 81% (n = 17) se clasificó como hipotonías centrales y el 19% (n = 4) como hipotonías periféricas. En el primer grupo, el 47% (n = 8) presentó alteraciones cromosómicas; el 29,4% (n = 5), enfermedades metabólicas, y el 23,5% (n = 4), malformaciones del sistema nervioso central. Conclusiones. Las causas centrales de hipotonía siguen siendo las más prevalentes en el período neonatal y, dentro de éstas, las cromosomopatías. Las causas periféricas son menos frecuentes y de pronóstico más grave. Los avances en genética molecular han permitido el diagnóstico genético y molecular de numerosas enfermedades neuromusculares. La diversidad y complejidad de patologías justifica el abordaje multidisciplinar de estos recién nacidos (AU)

Introduction. Hypotonia is one of the most frequent signs of neurological pathology in newborn infants. Aims. To determine, in a 12-year retrospective study, the relative frequency of neurological pathologies that can be accompanied by hypotonia during the neonatal period and to describe the neurological development after two years’ follow-up. Patients and methods. We conducted a systematic review of the newborn infants with hypotonia due to an identifiable cause who were admitted to the neonatal unit of the Hospital Sant Joan de Déu between January 1996 and December 2008. Information collected referred to family history, data related with the pregnancy and childbirth, clinical features and complementary tests. Results. A total of 73 hypotonic newborn infants were identified, 21 (28.7%) of whom met eligibility criteria. The majority, 81% (n = 17), were classified as central hypotonias and the remaining 19% (n = 4) were graded as peripheral hypotonias. In the first group, 47% (n = 8) presented chromosomal disorders, 29.4% (n = 5) had metabolic diseases and 23.5% (n = 4) displayed malformations of the central nervous system. Conclusions. The central causes of hypotonia continue to be the most prevalent in the neonatal period and, within these, chromosomal disorders are the most frequent. Peripheral causes are less common and have a more severe prognosis. Advances in molecular genetics have allowed many neuromuscular diseases to be diagnosed both genetically and at the molecular level. The diversity and complexity of the pathologies justifies a multidisciplinary approach being taken to treat these newborn infants (AU)

Aminoácidos en líquido cefalorraquídeo y plasma: utilidad en el estudio de las enfermedades neuropediátricas / Amino acids in cerebrospinal fluid and plasma: its usefulness in the study of neuropaediatric diseases

Introducción. El estudio de aminoácidos en el líquido cefalorraquídeo (LCR) es imprescindible en el diagnóstico de algunas enfermedades neurológicas y apoya el diagnóstico en otras. No existen trabajos en la bibliografía que muestren la relación fisiológica entre los valores de aminoácidos en LCR y plasma en población pediátrica. Objetivo. Definir unas ratios de aminoácidos en plasma y LCR en población pediátrica que permitan su uso en la práctica clínica diaria. Pacientes y métodos. Se han recogido y analizado de forma retrospectiva los aminogramas en plasma y LCR de 105 pacientes de edades comprendidas entre 0 y 12 meses. Se han incluido aminogramas cuyos valores de aminoácidos son normales según los valores de referencia de nuestro laboratorio. El análisis cuantitativo de aminoácidos se realizó mediante cromatografía líquida de alta resolución, y el análisis estadístico, con el programa SPSS v. 19.0. Resultados. Se muestran los valores medios, rango y desviación estándar de las concentraciones de aminoácidos en plasma y LCR, así como de las ratios LCR/plasma. Se han encontrado correlaciones significativas a partir de 0,6 entre diferentes aminoácidos neutros, sobre todo los de peso molecular más pequeño (Thr, Ser, Gly y Ala). Conclusiones. La existencia de correlaciones significativas entre diferentes aminoácidos neutros apoya el hecho de que éstos compartan los mismos transportadores en la barrera hematoencefálica. La estandarización de ratios de aminoácidos permitirá aumentar la sensibilidad en la detección de valores patológicos en plasma y LCR, profundizar en la fisiopatología de enfermedades neurológicas y quizá describir nuevas aminoacidopatías (AU)

Introduction. Studying the amino acids in cerebrospinal fluid (CSF) is essential in the diagnosis of some neurological diseases and is an important aid in the diagnosis of others. No research has been published in the literature to prove the physiological relationship between the values of amino acids in CSF and plasma in the paediatric population. Aim. To define a set of ratios for amino acids in plasma and CSF in the paediatric population that can be used in daily clinical practice. Patients and methods. The aminograms in plasma and CSF of 105 patients with ages between 0 and 12 months were collected and analysed retrospectively. Aminograms with amino acid values that are considered to be normal according to the reference values of our laboratory were included in the sample. The quantitative analysis of amino acids was performed using high-resolution liquid chromatography and statistical analysis with the software application SPSS 19.0. Results. The mean values, range and standard deviation of the amino acid concentrations in plasma and CSF, together with the CSF/plasma ratios, are reported. Significant correlations were found from 0.6 onwards between different neutral amino acids, above all in those with smaller molecular weights (Thr, Ser, Gly and Ala). Conclusions. The existence of significant correlations between the different neutral amino acids supports the idea that they share the same transporters in the blood-brain barrier. Standardising the amino acid ratios will make it possible to increase sensitivity in the detection of pathological values in plasma and CSF, to further knowledge of the pathophysiology of neurological diseases and perhaps to describe new aminoacidopathies (AU)

Coping motives and trait negative affect: testing mediation and moderation models of alcohol problems among American Red Cross disaster workers who responded to the September 11,2001 terrorist attacks.

This study explored the mechanism by which trait negative affect and alcohol coping motives are associated with alcohol-related problems in a sample of American Red Cross workers who participated in the relief operation following the attacks in New York City, the Pentagon, and the Pennsylvania crash site on Sept. 11th 2001. The results supported the mediation but not moderation model of coping motives. The support for the mediation model was fairly strong, including small to moderate associations between negative affect and alcohol problems, moderate to strong associations between negative affect and coping motives, and evidence of coping motives mediating the negative affect to alcohol problems relationships. The association between negative affect and coping motives was stronger among younger participants.

Associations between alcohol use and PTSD symptoms among American Red Cross disaster relief workers responding to the 9/11/2001 attacks.

OBJECTIVE: This study examined associations between alcohol use and PTSD symptoms among Red Cross workers who responded to the 9/11/2001 attacks. METHOD: Participants were 779 Red Cross paid and volunteer staff that responded during the first three months to the September 11, 2001, attacks against the United States. Women made up 64% of the sample. The American Red Cross provided a mailing list of all paid and volunteer staff (N = 6055 with valid addresses) that participated in the disaster relief operations in response to the September 11, 2001, attacks. Participants were randomly assigned to receive one of four questionnaire packets. The present study is based on the fourth group, which received the alcohol questionnaires. RESULTS: Overall, traumatic stress symptoms and alcohol use were low. Hyperarousal and intrusion symptoms on the Impact of Events Scale-Revised (IES-R) were associated with alcohol consumption, hazardous alcohol consumption, and change in alcohol consumption when controlling for age, gender, and worksite. Positive associations between Intrusion and Avoidance scores and hazardous consumption were stronger for younger participants. Individuals who reported increasing or decreasing alcohol use had higher IES-R scores than did those who maintained their normal rate of alcohol consumption, though effects were stronger for increasing alcohol use. Associations between alcohol variables and avoidance symptoms were minimal. CONCLUSIONS: The results suggest that there is a functional relation between posttraumatic stress symptoms and alcohol consumption. The study indicates that efforts to cope with traumatic stress symptoms may manifest in either increases or decreases in alcohol consumption.

A complex translocation (9;22;16)(q34;q11.2;p13) in chronic myelocytic leukemia.

The t(9;22) is present in almost all cases with chronic myelocytic leukemia (CML). Around 5% of these patients show complex translocations involving a third chromosome in addition to chromosomes 9 and 22. All chromosomes have participated in these variants and the BCR-ABL1 hybrid gene is always present. We describe a CML case with a new complex t(9;22;16)(q34;q11.2;p13). Seven months after imatinib treatment a karyotype showed the appearance of a clone with a standard t(9;22) in addition to the clone with the complex translocation. The b3a2 transcript of BCR-ABL1 was detected both at diagnosis and 7 months after therapy. In CML, both complex translocations and standard translocations have the same prognosis. However, these complex variants could contribute to the tumoral evolution by conferring selective advantages that, in turn, cause the preferential manifestation at diagnosis of clones with complex translocations.