Actualización en clasificación y manejo de anomalías vasculares laríngeas en adultos

Introducción: Las anomalías vasculares (AV) de cabeza y cuello son una patología prevalente en niños, pero son poco frecuentes en adultos. La última clasificación descrita por la International Society for the Study of Vascular Anomalies (ISSVA) en 2018, propone dividirlas en tumores vasculares (TV) y malformaciones vasculares (MV) con una aproximación basada en la etiopatogenia, comportamiento biológico e inmunohistoquímico (IHQ). Objetivo: Describir la experiencia en el manejo de AV laríngeas (AVL) en adultos operados en los últimos 5 años en el Servicio de Otorrinolaringología (ORL) del Hospital Barros Luco Trudeau (HBLT) y realizar una revisión actualizada en cuanto a diagnóstico y manejo. Material y Método: Revisión retrospectiva y descriptiva de los casos de AVL en adultos operados del servicio de ORL del HBLT informadas por biopsia en el servicio de anatomía patológica del mismo hospital entre los años 2015 a 2020. Resultados: Se encontraron cinco casos de AVL. Los síntomas descritos fueron disfonía, odinofagia y disfagia. La sospecha diagnóstica se fundó en historia clínica, nasofibroscopia y estudio imagenológico, y se confirmó con biopsia posoperatoria. Todos los pacientes fueron resueltos de manera quirúrgica con leve preferencia por el láser CO2. No se registraron complicaciones ni signos de recidiva durante el seguimiento. Conclusión: Recomendamos el manejo quirúrgico de las AVL en adultos, realizando una resección completa de la lesión y su clasificación, según las recomendaciones de la ISSVA, con biopsia posoperatoria e inmunohistoquímica debido a la heterogeneidad de las clasificaciones previas.

Introduction: Head and neck vascular abnormalities (AV) are common alterations found in children, but rare in adults. The latest classification described by the International Society for the Study of Vascular Anomalies (ISSVA) in 2018, proposes dividing them into vascular tumors (TV) and vascular malformations (MV), based on their etiopathogenesis, biological and immunohistochemical behavior (IHC). Aim: To describe the experience in the management of laryngeal AV (AVL) of adults treated surgically on in the last 5 years in the Otolaryngology Service (ORL) of the Hospital Barros Luco Trudeau (HBLT). Material and Method: Retrospective and descriptive review of cases with histologically confirmed AVL in adults treated surgically in the ORL service of the same hospital between the years 2015 and 2020. Results: Five cases of AVL were found. The symptoms described were dysphonia, pharyngodine, and dysphagia. The diagnostic suspicion was based on clinical history, nasofibroscopy and imaging study, confirmed with post-operative biopsy. All patients were resolved surgically with a slight preference for the CO2 laser. No complications or signs of recurrence were recorded during the follow-up. Conclusion: We recommend surgical management of AVL in adults with a complete resection and their classification according to the recommendations of the ISSVA with postoperative and immunohistochemical biopsy, due to heterogeneity of previous classifications systems.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics / Diversidade bacteriana em solos de prados andinos elevados perturbados por culturas de Lepidium meyenii avaliadas por metagenômica

Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e póscolheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics / Diversidade bacteriana em solos de prados andinos elevados perturbados por culturas de Lepidium meyenii avaliadas por metagenômica

Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e pós colheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics

Abstract Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

Resumo A qualidade do solo é normalmente determinada pelas suas características físico-químicas sem ter em conta as comunidades bacterianas que desempenham um papel fundamental na decomposição química dos nutrientes das plantas. Neste contexto, o objetivo do estudo foi avaliar a diversidade bacteriana em solos de prados andinos elevados perturbados pelo cultivo de Lepidium meyenii sob diferentes gradientes de utilização (primeira, segunda e terceira utilizações) e desenvolvimento das culturas (pré-semeadura, desenvolvimento do hipocótilo e pós-colheita). A amostragem foi realizada no planalto de Bombón, nos Andes centrais do Peru, durante as estações das chuvas e das águas baixas, pelo método sistemático baseado num padrão específico atribuído em forma geométrica retangular a uma profundidade de 0 - 20 cm. A caracterização das comunidades bacterianas foi realizada através da sequenciação metagenômica do rRNA 16S. Foram relatadas 376 famílias de bactérias, das quais se verificou uma alteração significativa na composição e distribuição bacteriana em relação à pressão de utilização. Não se registaram grandes alterações devido ao desenvolvimento do Lepidium meyenii. As famílias mais sensíveis à utilização de indicadores de pressão e pobreza do solo foram as Verrucomicrobiaceae, Acidobacteraceae e Aakkermansiaceae.

Bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii crops evaluated by metagenomics.

Soil quality is usually determined by its physical-chemical characteristics without taking into account the bacterial communities that play a fundamental role in the chemical decomposition of plant nutrients. In this context, the objective of the study was to evaluate bacterial diversity in high Andean grassland soils disturbed with Lepidium meyenii cultivation under different gradients of use (first, second and third use) and crop development (pre-sowing, hypocotyl development and post-harvest). The sampling was carried out in the Bombón plateau in the central Andes of Peru, during the rainy and low water seasons, by the systematic method based on a specific pattern assigned in a geometric rectangular shape at a depth of 0 - 20 cm. The characterization of the bacterial communities was carried out through the metagenomic sequencing of the 16S rRNA. 376 families of bacteria were reported, of which it was determined that there was a significant change in bacterial composition and distribution in relation to use pressure. There were no major changes due to the development of Lepidium meyenii. The families most sensitive to use pressure and soil poverty indicators were Verrucomicrobiaceae, Acidobacteraceae and Aakkermansiaceae.

Endoftalmitis endógena como primera manifestación de meningitis por Haemophilus influenza: reporte de un caso / Endogenous endophthalmitis as the initial presentation of Haemophilus influenzae meningitis

La endoftalmitis endógena es responsable del 2-15 % de las endoftalmitis, se relaciona con una infección sistémica hasta en un 52-90% de los casos, en el contexto de infecciones sistémicas como abscesos hepáticos, neumonia, infecciones de vias urinarias, meningitis, usurios de drogas endovenosas y fungémias. Haemophilus influenzae es un agente etiológico inusual de esta patología, hay pocos casos reportados a nivel mundial y no se han reportado casos en nuestro país; las endoftalmitis por Haemophilus se caractererizan por tener un pronóstico visual sombrio, ya que pueden presentar complicaciones severas y comprometer permanentemente la visión. A continuación, se describe un caso de endoftalmitis endogéna como primera manifestación de meningitis asociada a H. Influenzae en una paciente inmunocompetente y sin factores de riesgo.

Endogenous endophthalmitis is responsible for 2-15% of endophthalmitis, it is associated with a systemic infection in up to 52-90% of cases, in the context of systemic infections such as liver abscesses, pneumonia, urinary tract infections, meningitis, intravenousdrug users and fungaemia. Haemophilus influenzae is an unusual etiologic agent of this pathology, there are few cases reported worldwide and no cases have been reported in our country. The endophthalmitis due to Haemophilus are characterized by having a somber visual prognosis, since they can present severe complications and can permanently affect vision. Mentioned hereinafter, a case of endogenous endophthalmitis is described as the first manifestation of meningitis associated with H.Influenzae in an immunocompetent patient with no risk factors.

Adenoma pleomorfo originado en pared lateral nasal: reporte de un caso clínico / Pleomorphic adenoma of lateral nasal wall: a case report

RESUMEN El adenoma pleomorfo constituye la neoplasia benigna más frecuente de las glándulas salivales mayores, y puede también presentarse en otros sitios con mucha menor frecuencia como orofaringe, hipofaringe y nasofaringe. El adenoma pleomorfo intranasal es muy infrecuente y los casos descritos en la literatura local se refieren a tumores septales. Se presenta un caso clínico de una paciente que consulta por obstrucción nasal unilateral a derecha asociado a, epistaxis y epífora ipsilateral con estudio imagenológico y biopsia que sugiere adenoma pleomorfo de la pared lateral nasal. Se realiza revisión bibliográfica al respecto.

ABSTRACT The pleomorphic adenoma is the most frequent benign neoplasm of the major salivary glands. It can also present itself in other places with much less frequency such as oropharynx, hypopharynx and nasopharynx. The intranasal pleomorphic adenoma is very unusual and the cases described in the local literature address septal tumors. A clinical case is presented of a patient who consulted for unilateral right nasal obstruction associated with epistaxis and ipsilateral epiphora with imaging study and biopsy suggesting pleomorphic adenoma of the lateral nasal wall. A bibliographic review is made in this regard.

Validation and adaptation of rapid neurodevelopmental assessment instrument for infants in Guatemala.

BACKGROUND: Timely detection of neurodevelopmental impairments in children can prompt referral for critical services that may prevent permanent disability. However, screening of impairments is a significant challenge in low-resource countries. We adapted and validated the rapid neurodevelopmental assessment (RNDA) instrument developed in Bangladesh to assess impairment in nine domains: primitive reflexes, gross and fine motor development, vision, hearing, speech, cognition, behaviour and seizures. METHODS: We conducted a cross-sectional study of 77 infants (0-12 months) in rural Guatemala in July 2012 and July 2013. We assessed inter-rater reliability and predictive validity between the 27-item RNDA and the 325-item Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and concurrent validity based on chronic malnutrition, a condition associated with neurodevelopmental impairments. For both RNDA and BSID-III, standardized scores below 80 were defined as borderline impairment. RESULTS: Children came from rural households (92%), were born to indigenous women of Mayan descent (73%) and had moderate or severe growth stunting (43%). Inter-rater reliability for eight RNDA domains was of moderate to high reliability (weighted κ coefficients, 0.49-0.99). Children screened positive for impairment in fine motor (17%) and gross motor (14%) domains using the RNDA. The RNDA had good concurrent ability; infants who were growth stunted had higher mean levels of impairment in gross motor, speech and cognition domains (all p < 0.001). The RNDA took 20-30 min to complete compared with 45-60 min for BSID-III. CONCLUSIONS: Wide-scale implementation of a simple, valid and reliable screening tool like the RNDA by community health workers would facilitate early screening and referral of infants at-risk for neurodevelopmental impairment.

Relation of anthropometric profile and performance in competition for Mexican high school football players on the offensive squad / Relación entre perfil antropométrico y desempeño en la competición para jugadores juveniles mexicanos de futbol americano de posición ofensiva

The present study of Mexican high school football players on the offensive squad had the aim of determining the relation between their anthropometric profile, position on the team, and performance in competition. The study included 41 players from 15 to 18 years of age, studying and playing football at one of two high schools. Anthropometric measurements were taken (weight, height, diameter and perimeter of muscle areas) to determine the body mass index, body composition and somatotype. The results show that the anthropometric profile is related to performance (good/very good or poor/deficient), and that this relation depends on the position of the player. For linemen, good performance was associated with being tall, heavy and with a relatively high body fat percentage, and poor/deficient performance with a significantly lower height, lower weight and lower body fat percentage. For receivers and running backs, height did not appear to influence performance. For running backs, good performance was associated with heavy weight and a high body fat percentage. However for receivers, good performance was associated with a lower body fat percentage. The average somatotype for linemen was mesomorph-endomorph, for running backs meso-ectomorph, and for receivers mesomorph-ectomorph.

El objetivo de este trabajo fue determinar la relación entre los perfiles antropométricos de jugadores juveniles mexicanos de futbol americano y su desempeño en la competición, tomando en cuenta su posición ofensiva en el juego. Se estudiaron 41 jugadores de 15 a 18 años de edad, de nivel bachillerato de dos instituciones educativas. Se registraron medidas antropométricas (peso, estatura, pliegues, diámetros y perímetros) para determinar el índice de masa corporal, la composición corporal y el somatotipo. Nuestros resultados muestran que el perfil antropométrico de los jugadores estuvo relacionado con su desempeño (bueno/muy bueno o malo/deficiente) en su posición ofensiva en el juego. La estatura fue un factor importante en el caso de los linieros, ya que los clasificados como malos/deficientes para esa posición, tuvieron una talla significativamente más baja que los buenos/muy buenos; sin embargo, ésta no parece influir como criterio para clasificar a receptores y corredores. Se encontró que los linieros ofensivos fueron los jugadores más altos y pesados y con mayor porcentaje de grasa, seguidos de los receptores y por último de los corredores. En esta posición, los malos/deficientes fueron los de menor peso, y los buenos/muy buenos fueron los de mayor porcentaje graso, al igual que en la posición de corredores. Sin embargo en los receptores la relación se invierte, ya que los buenos/muy buenos fueron los de menor porcentaje graso. El somatotipo medio por posición fue mesomorfo-endomorfo para los linieros, mesomorfo-ectomorfo para los receptores y meso-ectomorfo para los corredores.

Analysis of 23 364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons learned from Sweden.

CONTEXT: In Sweden, patient malpractice claims are handled administratively and compensated if an independent physician review confirms patient injury resulting from medical error. Full access to all malpractice claims and hospital discharge data for the country provided a unique opportunity to assess the validity of patient claims as indicators of medical error and patient injury. OBJECTIVE: To determine: (1) the percentage of patient malpractice claims validated by independent physician review, (2) actual malpractice claims rates (claims frequency / clinical volume) and (3) differences between Swedish and other national malpractice claims rates. DESIGN, SETTING AND MATERIAL: Swedish national malpractice claims and hospital discharge data were combined, and malpractice claims rates were determined by county, hospital, hospital department, surgical procedure, patient age and sex and compared with published studies on medical error and malpractice. RESULTS: From 1997 to 2004, there were 23 364 inpatient malpractice claims filed by Swedish patients treated at hospitals reporting 11 514 798 discharges. The overall claims rate, 0.20%, was stable over the period of study and was similar to that found in other tort and administrative compensation systems. Over this 8-year period, 49.5% (range 47.0-52.6%) of filed claims were judged valid and eligible for compensation. Claims rates varied significantly across hospitals; surgical specialties accounted for 46% of discharges, but 88% of claims. There were also large differences in claims rates for procedures. CONCLUSIONS: Patient-generated malpractice claims, as collected in the Swedish malpractice insurance system and adjusted for clinical volumes, have a high validity, as assessed by standardised physician review, and provide unique new information on malpractice risks, preventable medical errors and patient injuries. Systematic collection and analysis of patient-generated quality of care complaints should be encouraged, regardless of the malpractice compensation system in use.

Analysis of 23 364 patient-generated, physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons learned from Sweden.

CONTEXT: In Sweden, patient malpractice claims are handled administratively and compensated if an independent physician review confirms patient injury resulting from medical error. Full access to all malpractice claims and hospital discharge data for the country provided a unique opportunity to assess the validity of patient claims as indicators of medical error and patient injury. OBJECTIVE: To determine: (1) the percentage of patient malpractice claims validated by independent physician review, (2) actual malpractice claims rates (claims frequency / clinical volume) and (3) differences between Swedish and other national malpractice claims rates. Design, setting and material: Swedish national malpractice claims and hospital discharge data were combined, and malpractice claims rates were determined by county, hospital, hospital department, surgical procedure, patient age and sex and compared with published studies on medical error and malpractice. RESULTS: From 1997 to 2004, there were 23 364 inpatient malpractice claims filed by Swedish patients treated at hospitals reporting 11 514 798 discharges. The overall claims rate, 0.20%, was stable over the period of study and was similar to that found in other tort and administrative compensation systems. Over this 8-year period, 49.5% (range 47.0-52.6%) of filed claims were judged valid and eligible for compensation. Claims rates varied significantly across hospitals; surgical specialties accounted for 46% of discharges, but 88% of claims. There were also large differences in claims rates for procedures. CONCLUSIONS: Patient-generated malpractice claims, as collected in the Swedish malpractice insurance system and adjusted for clinical volumes, have a high validity, as assessed by standardised physician review, and provide unique new information on malpractice risks, preventable medical errors and patient injuries. Systematic collection and analysis of patient-generated quality of care complaints should be encouraged, regardless of the malpractice compensation system in use.

In vitro leukemic cell differentiation and WT1 gene expression.

Cell differentiation and four WT1 isoforms were assessed in CD34(+) cells from patients with acute myelogenous leukemia in presence or absence of recombinant human GM-CSF and G-CSF, on days 0, 10 and 20 of culture. We found that WT1 isoforms expression was consistently higher in AML-derived CD34+ cell-enriched cell fractions, as compared to their normal counterparts, and interestingly, in both cases, cells had differentiation towards the myeloid lineage with WT1 expression different patterns. This data suggest that WT1 expression seems to be modulated by the presence of cytokines, especially on day 20 of culture.

Leucemia neutrofílica crónica asociada a leucemia cutánea: reporte de un caso clinico / Vhronic neutrophilic leukemia asociated with leukemia cutis: case report

Se describe un caso de leucemia neutrofílica crónica asociada a leucemia de piel, en una paciente de 49 años de edad, sexo femenino, diagnosticada en julio de 2001; con presencia de 43.605/mm3 neutrófilos en sangre periférica y médula ósea hipercelular con serie granulocítica hiperplástica. el estudio histopatológico de la piel reveló infiltrado del 70 porciento de blastos tipo mieloide. Fue tratada con hidroxiurea, siendo favorable la resuesta clínica y laboratorial. el hemograma de diciembre de 2001 presentó 5.656/mm3 neutrófilos.

Validación del método mispho para el diagnóstico de leucemias agudas / Mispho's diagnostic method validation for acute leukemia: premio a la mejor teis, Facultad de Bioquimica 2000

Pregunta de investigación. Cuáles son los valores de sensibilidad, especificidad y valores predictivos de las pruebas morfológicas, citoquímicas e inmunofenotipo desarrolladas en el método MISPHO para el diagnóstico de Leucemias Agudas en sujetos de ambos sexos en todo grupo etário?.Objetivos. Determinar los valores de sensibilidad especificidad y valores predictivos de las pruebas morfológicas, citoquímicas e inmunofenotipo desarrolladas en el método MISPHO para el diagnóstico de Leucemias Agudas en sujetos de ambos sexos en todo grupo etáreo. Conocer a través de estadisticas descriptivas el comportamiento de otras variables en estudio. Diseño. Test diagnóstico. Lugar. Unidad de Biología Molecular, Instituto de Genética, Fac. Medicina, UMSA. Poblacón 44 casos y 20 controles por cálculo muestral en ambos sexos y de grupos etáreos diverso y que realizaron sus exámenes hematológicos en la Unidad mencionada. Métodos. Se recolectó médula ósea para realizar las pruebas morfológica, citoquímica, inmunofenotipo y determinación de daños moleculares, se llenó una hoja de registro con datos personales, antecedentes generales y parámetros hematológicos. Se utilizó estadítica descriptiva, test de significancia, t-test, chi2, tablas de contingencia de 2x2. Resultados. Se observó que no existe asociación sexo-enfermedad con P de 0,279. No existe diferencia entre los promedios de edad de los pacientes con la enfermedad con P de 0, 652. La sensibilidad del método para el diagnóstico de leucemia linfoblástica es de 100 por ciento, especialidad 100 por ciento, valores predictivos positivos y negativos 100 por ciento. La sensibilidad del método para el diagnóstico de leucemia mieloide es de 83 por ciento, especialidad 100 por ciento, valor predictivo positivo 100 por ciento y valor predictivo negativo 90 por ciento La sensibilidad, especialidad y valores predictivos tanto negativo como positivo del método MISPHO global son del 100 por ciento. Conclusiones.Los métodos utilizados son altamente sensibles y especificos, así mismo los valores predictivos compueban que el método MISPHO es válido y aplicable para el diagnóstico de Leucemias Agudas con la aplicación de recursos minimos.

(AC)n dinucleotide repeat polymorphism in 5' beta-globin gene in native and Mestizo Mexican populations.

Repeated sequences are dispersed along the human genome. These sequences are useful as markers in diagnosis of inherited diseases, in forensic medicine, and in tracking the origin and evolution of human populations. The (AC)n repeated element is the most frequent in the human genome. In this paper, the (AC)n repeated element located in the 5' flanking region of the beta-globin gene was studied by single-strand conformation polymorphism (SSCP). Four ethnic Mexican groups (Mixteca, Nahua, Otomí, Purépecha) and a Mestizo population were analyzed. We observed three alleles, A [(AC)16, B [(AC)14], and C [(AC)18], with a frequency of between 68.2% and 86.9%, 13.1% and 18.2%, and 6.7% and 13.7%, respectively. Allele C was present only in Purépecha and Mestizo groups. The absence of this allele in the other ethnic groups studied suggests that there is low genetic admixture of Purépecha and that this is a relatively isolated population. However, it could be that the C allele occurs in low frequencies in the other groups as a result of small sample sizes. The (AC)n repeat polymorphism in the beta-globin gene has not been previously studied in Amerindian populations.

Característica bio-celulares de las leucemias agudas en Bolivia y su diversidad en relación con otros paises: reporte de 100 caos de leucemias agudas / Biocell characteristic of the acute leukemia in Bolivia and its diversity in the relationship with another countries: report of the 100 cases of acute leukemia

Pregunta de investigación. ¿Cuáles son las características bio-celularesde las leucemias agudas en Bolivia, y presentará diferencias comparando con otros países?. Objetivos: 1. Determinar las caracteristicas bio-celulares de las leucemias agudas en Bolivia. 2. Comparar la frecuencia y distribución de las características bio-celualres de las leucemias agudas en otros países. Diseño: Descriptivo, corte transversal.Lugar: Unidad de Biología Molecular Paolo Belli, Instituto de Genética, Facultad de Medicina. UMSA. La Paz, Bolivia. Poblacióo: 100 Pacientes con leucemias agudas, 48 niños y 52 adultos provenientes de diferentes Centros Hospitalarios del país. Métodos: Las muestras de sangre periférica y médula ósea fueron estudiados con lossiguientes métodos de análissi: a)Estudio morfológico con tinción May Grunwald-Giemsa, B9 Estudio citoquímico con Mieloperoxidasa y Alfa Nalfta Naftil Butirato Esterasa c) Estudio Inmunocitoquímico utilizando anticuerpos monoclonales. Los resultados fueron analizados según el paquete estadísitco EPIDAR versión 2.0. Resultados: De los 100 casos de leucemias agudas, 48 fueron pediatricos (LLA 83.3 porciento y LMA 16.7 porciento); 95 porciento fueron LLA-B y 5 porciento LLA-T; por ora parte las LMA se distribuyeron como sigue: 12.5 porciento MO, 37.5 M1, 37.5 porciento M2 y 12.5 porciento M4. De los 52 adultos (LLA 61.5 porciento y LMA 38.5 porciento); 87.5 porciento fueron LLA-B y 12.5 porciento LLA-T. La LMA se distribuyeron de la siguiente manera: 10 porciento MO, 35 porciento M1, 15 porciento M2, 35 porciento M3 y 5 porciento M5. Conclusiones: Los valores porcentuales obtenidos en el presente estudio reflejan un patrón característico para nuestra población y confirman su diversidad epidemiológica de las leucemias agudas en comparación con otras regiones.

The Fort Bragg continuum of care for children and adolescents: mental health outcomes over 5 years.

Controversial early results of the Fort Bragg mental-health-effectiveness study indicated that the continuum of care did not produce better outcomes (i.e., children's rate of improvement was the same in both the demonstration and comparison sites). The present study considered outcomes at 5-year follow-up to examine long-term effects from the continuum of care. A random regression longitudinal model analyzed 10 key outcome variables measured 7 times. Long-term outcomes in continuum-treated children were no better than those of comparison children; results are consistent with those of earlier studies.

Leucemia Eosinofilica: reporte de un caso clínico / Eosinophilic leukemia: on pourpose of a case

Se describe un caso de leucemia eosinofilica en niñade 11 años sin alteraciones croosómicas, en fase de crisis blástica. Con cuadro clínico de compromiso gastrointestinal cutáneo, asociado a 21216 eosinófilos/mL en sangre periférica en un infiltrado del 60porciento en médula ósea.

Alteraciones en el patron de apoptosis de celulas precursoras de eritrocitos en mujeres postmenopausicas con eitrocitosis patológica de la altura / Alteration in the Apoptosis pattern of erithocytes precursors Cells of postmenopausic women with high altitude erithrocytosis

Pregunta de investigación. ¿Existe alteraciones en el patrón de apoptisis de células precursoras de eritrocitos en mujeres postmenaopausicas con ertitrocitosis patológicas de la altura?. Objetivo. Determinar la existencia de alteraciones en el patrón de apoptosis de células precursoras de eritrocitos en mujeres postmenopausicas con eritrocitosis patológica de la altura. Diseño Corte transversal. Lugar. unidad de Biologia Molecular Paolo Belli, Instituto de Genética, Facultad de Medicina, UMSA. Poblacion. dos pacinetes mujeres postmenopausicas diagnosticadas con EPA según criterio clínico- laboratoriales, sin sobrepeso ni enfermedades cardiacorrespiratorias, no fumadoras y que no recibian tratamiento hormonal. El grupo control estuvo conformado por 4 mujeres de iguales características sin EPA. Metodos. Las células nononucleadas de la médula ósea fueron separadas en medio LSD y se cultivaron en medios líquidos en presencia y ausencia de Eritropoyetina. De estos cultivos se recuperaron las células a 1, 2, 7 y 14 días de ultivo, a partir de estas células se realizaron 2 frotis para la evaluación de la apoptosis por morfologia y el remanente celular fue empleado en el anális de la formación del DNA degradado. Finalmente los resultados fueron sujeto de test de significancia. Resultados. La morfología y el DNA degraado detectaron un retardo de patrón de apoptosis, de los progenitores eritroides, en las dos pacientes con EPA estudiadas; donde el porcentaje de células apoptosis tiende a mantenerse constante en función del tiempo, en lugar de incrementarse, como ocurre en los controles (p,00). el patrón de apoptosis en los controles es EPO dependiente, observandose una diferencia significativa ente los cultivos con y sin EPO (p0,00); mientras que en los pacientes es no EPO dependiente (p0,23). Conclusiones. El patron de aptosis modificado en los pacientes es indicativo de la presencia de alteraciones en la sobrevivencia celular y el incremento de la tasa de producción de progenitores eritroides durante la deferenciación EPO dependiente, posblemente sean factores etiopatogénicos de la eritrocitosis.