[Cognitive performance of preschoolers with Congenital Hypothyroidism enrolled in a follow-up program]. / Desempeño cognitivo en preescolares con Hipotiroidismo Congénito incorporados en un programa de seguimiento.

The age at treatment initiation is decisive for limiting the neurological sequelae of Congenital Hypothyroidism (CH). Incorporating children into follow-up programs could be very helpful. OBJECTIVE: To evaluate the cognitive performance of preschool children with CH incorporated into a follow- up program. PATIENTS AND METHOD: Prospective study of 93 patients with a confirmed diagnosis of CH. Intelligence quotient (IQ) was assessed using the Wechsler Preschool and Primary Intelligence Scale (WPPSI) at 4 and 5 years, and the WISC-R at 6 years of age. Full-Scale IQ (FSIQ), Verbal IQ (VIQ), and Performance IQ (PIQ) scores were analyzed. RESULTS: The study sample was 80 children. The average age at starting hormonal treatment was 42 ± 18 days; treatment started early in 25 patients (24 ± 6 days) and late in 55 patients (50 ± 16 days). The mean initial dose of Levothyroxine was 13.5 ± 1.5µg/kg/day. Children with athyrosis and late initiation of treatment had lower scores on the VIQ (85 ± 14), the PIQ (89 ± 12), and the FSIQ (86 ± 13) scales at 4 years of age, in comparison with patients with early initiation of treatment. These patients scored within the cut-off point for the normal IQ classification (90-109 points). IQ comparison at 6 years of age revealed differences up to 14 points in the PIQ and 11 points in the FSIQ between children with athyrosis and early initiation of treatment, with and without regular attendance to the follow-up program. DISCUSSION: These results support the importance of early initiation of treatment and the incorporation of children in follow-up programs and early stimulation. The etiology of hypothyroidism and the age at initiation of treatment were the most significant factors that affected cognitive performance.

The percentage of CD39+ monocytes is higher in pregnant COVID-19+ patients than in nonpregnant COVID-19+ patients.

Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.

Multiscale Assessment of Agricultural Consumptive Water Use in California's Central Valley.

Spatial estimates of crop evapotranspiration with high accuracy from the field to watershed scale have become increasingly important for water management, particularly over irrigated agriculture in semiarid regions. Here, we provide a comprehensive assessment on patterns of annual agricultural water use over California's Central Valley, using 30-m daily evapotranspiration estimates based on Landsat satellite data. A semiempirical Priestley-Taylor approach was locally optimized and cross-validated with available field measurements for major crops including alfalfa, almond, citrus, corn, pasture, and rice. The evapotranspiration estimates explained >70% variance in daily measurements from independent sites with an RMSE of 0.88 mm day-1. When aggregated over the Valley, we estimated an average evapotranspiration of 820 ± 290 mm yr-1 in 2014. Agricultural water use varied significantly across and within crop types, with a coefficient of variation ranging from 8% for Rice (1,110 ± 85 mm yr-1) to 59% for Pistachio (592 ± 352 mm yr-1). Total water uses in 2016 increased by 9.6%, as compared to 2014, mostly because of land-use conversion from fallow/idle land to cropland. Analysis across 134 Groundwater Sustainability Agencies (GSAs) further showed a large variation of agricultural evapotranspiration among and within GSAs, especially for tree crops, e.g., almond evapotranspiration ranging from 339 ± 80 mm yr-1 in Tracy to 1,240 ± 136 mm yr-1 in Tri-County Water Authority. Continuous monitoring and assessment of the dynamics and spatial heterogeneity of agricultural evapotranspiration provide data-driven guidance for more effective land use and water planning across scales.

Leiomiomas cutáneos: revisión clinicopatológica y epidemiológica / Cutaneous leiomyomas: a clinicpathological and epidemiological review

Fundamento: Los leiomiomas cutáneos, superficiales o suprafasciales, se dividen en tres variantes: piloleiomiomas(PL), angioleiomiomas (AL) y leiomiomas genitales (LG) queincluyen las formas vulvares, escrotales y areolares. El objetivo fue establecer las características clinicohistológicas yla incidencia de cada variante, y las posibles asociacionescon neoplasias internas. Material y métodos: Se revisaron 255 casos de leiomiomascutáneos diagnosticados entre 1982 y 2018 en los serviciosde Anatomía Patológica de tres centros hospitalarios (Navarra y Alicante). Se describieron y compararon variables de-mográficas, clínicas, histológicas e inmunohistoquímicas. Resultados: La incidencia en Navarra de PL fue 4,3 casospor año y millón de habitantes, de AL 20 y de LG 1,4. Lasformas cutáneas suponen aproximadamente el 3,5 % deltotal de leiomiomas. La población con PL sufrió más frecuentemente cáncer de mama (OR = 4,8; IC95%: 1,3-17,4;p = 0,006). Los leiomiomas areolares son de pequeño tamaño, acompañados de dolor local, predominantementefasciculares o sólidos, con muy rara afectación del tejidocelular subcutáneo y escasa atipia. Esto contrasta con elresto de LG, de tamaño medio y rara vez dolorosos, predominantemente nodulares, con frecuente afectación deltejido celular subcutáneo y atipia. Conclusiones: Se aporta información sobre las características clinicohistológicas de las distintas variantes de leio-miomas, según las cuales debería replantearse la clasificación de los leiomiomas areolares fuera del grupo de LG. Sedetectó una asociación entre PL y carcinoma de mama quedeberá confirmarse en futuros estudios para determinar sieste leiomioma constituye un marcador de riesgo de cáncerde mama en mujeres.(AU)

Background: Cutaneous, superficial and or suprafascial leio-myoma are divided into three variants: piloleiomyomas (PL),angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study setout to establish the clinical and histological characteristicsand incidence of each variant, and any likely associationswith internal neoplasms. Methods: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at thePathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohis-tochemical variables were described and compared. Results: The incidence of PL in Navarra was 4.3 cases permillion inhabitants a year, with another 20 cases of AL and1.4 cases of GL. Cutaneous forms make up approximately3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR = 4.8; CI 95%:1.3-17.4; p = 0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicularor solid, with very infrequent effect on the subcutaneouscellular tissue and scarce atypia. This makes for a contrastwith the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on thesubcutaneous tissue and atypia. Conclusions: The information provided here about the clinical and histological characteristics of the different varietiesof leiomyomas indicate that there is a need to reconsiderthe classification of nipple leiomyomas outside the group ofGLs. An association between PL and breast carcinoma wasdetected, which needs to be confirmed in future studies soas to determine if this leiomyoma is a risk marker for breastcancer.(AU)

[Cutaneous leiomyomas: a clinicpathological and epidemiological review].

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.

Analysis of phenanthrene degradation by Ascomycota fungi isolated from contaminated soil from Reynosa, Mexico.

Polycyclic aromatic hydrocarbons (PAHs) are organic compounds generated mainly by anthropogenic sources. They are considered toxic to mammals, since they have carcinogenic, mutagenic and genotoxic properties, among others. Although mycoremediation is an efficient, economical and eco-friendly technique for degrading PAHs, the fungal degradation potential of the phylum Ascomycota has not been widely studied. In this work, we evaluated different fungal strains from the polluted soil of 'La Escondida' lagoon in Reynosa, Mexico to know their potential to degrade phenanthrene (PHE). Forty-three soil isolates with the capacity to grow in the presence of PHE (0·1% w/v) were obtained. The fungi Aspergillus oryzae MF13 and Aspergillus flavipes QCS12 had the best potential to degrade PHE. Both fungi germinated and grew at PHE concentrations of up to 5000 mg l-1 and degraded 235 mg l-1 of PHE in 28 days, with and without an additional carbon source. These characteristics indicate that A. oryzae MF13 and A. flavipes QCS12 could be promising organisms for the remediation of sites contaminated with PAHs and detoxification of recalcitrant xenobiotics.

Prevalence and virulence of Vibrio species isolated from raw shrimp from retail markets in Reynosa, Mexico.

In this study, the prevalence of Vibrio cholerae, Vibrio parahaemolyticus, Vibrio mimicus, Vibrio vulnificus and Vibrio spp. in shrimp from retail markets in Reynosa, Mexico was determined. A total of 765 isolates, identified as Vibrio spp. (59·1%), V. cholerae (17·8%), V. mimicus (6·7%) and V. parahaemolyticus (4·6%), were obtained; V. vulnificus was not detected. Most of the strains were isolated from supermarkets (48·1%), followed by street vendors (37·3%) and retail stores (14·6%). Moreover, several virulence genes were identified in V. cholerae: toxR (100%), OmpU (76·5%), hlyA (76·5%), VPI (19·9%) and tcpA (5·1%); in V. mimicus: vmh (100%), wzb (74·5%), pilF (54·9%), VPI (43·1%), OmpU (29·4%) and tdh (9·8%); and in V. parahaemolyticus: toxR (100%), tlh (100%), VP1680 (51·4%) and VPI (11·4%). These results show the low safety of this food and the potential risk to consumers' health, since this product in Mexican cuisine is sometimes served raw or semi-cooked. SIGNIFICANCE AND IMPACT OF THE STUDY: This study shows the prevalence of pathogenic Vibrio cholerae, Vibrio mimicus and Vibrio parahaemolyticus isolated from shrimp that is commercialized in Reynosa city. This could represent a risk to consumers' health, since outbreaks related to shrimp contaminated with Vibrio have been previously reported. Additionally, shrimp fishing has a major role in Mexico's economy.

Antisepsys and profilatic antimicrobial therapy in prevention of surgical site infection of horses / [Antissepsia e terapia antimicrobiana profilática no controle infeccioso do foco cirúrgico em equinos

The efficacy of an antisepsis protocol comprising chlorhexidine gluconate and ethyl alcohol in combination with prophylactic antimicrobial therapy in controlling surgical site infection in horses was studied. To that purpose, seven mixed breed horses received potassium penicillin and gentamicin at least 30 minutes prior to surgery. The surgical site was scrubbed with chlorhexidine gluconate and rinsed with ethyl alcohol. Samples were collected at four time points: (A) - before and (B) - immediately following shaving of the hair coat, (C) - at the end of antisepsis procedures, and (D) - at the end of the surgical procedure. Duration of surgery was recorded. Samples were cultured in three different culture mediums: Mitis Salivarus (Streptococcus sp.), Staphylococcus 110 (Staphylococcus sp.), and Mac Conkey (Enterobacteria). A high level of bacterial growth was observed in all culture mediums at (A) and (B), with no bacterial growth in (C). Staphylococcus sp. growth was observed in (D) in a single patient whose surgical procedure lasted for 120 minutes. Shaving of the hair coat reduced microbial flora on the surface of the skin. Antisepsis in combination with prophylactic antimicrobial therapy was effective in controlling surgical site infection in elective procedures with an average duration of 90 minutes.(AU)

Objetivou-se averiguar a eficácia do protocolo de antissepsia com clorexidina degermante e álcool etílico hidratado 70%, em associação com terapia antimicrobiana profilática, no controle microbiano do foco cirúrgico de equinos submetidos a procedimentos cirúrgicos. Foram utilizados 07 cavalos adultos de raças variadas, onde ambos receberam o mesmo tratamento (terapia antimicrobiana profilática e antissepsia com clorexidina degermante 2% e álcool etílico hidratado 70%), coletando-se amostras em quatro tempos distintos [(A - antes da tricotomia), (B - imediatamente após tricotomia), (C - ao término da antissepsia), (D - ao término do procedimento cirúrgico)]. O tempo de cada procedimento cirúrgico foi contabilizado. Foram utilizados três meios de cultura diferentes, cada um com especificidade para um tipo de crescimento bacteriano. Constatou-se alta incidência de crescimento bacteriano nos três meios utilizados nos tempos de coleta A e B. Para o tempo C, não foi observado crescimento bacteriano. No tempo D averiguou-se crescimento bacteriano do tipo Staphylococcus sp. em um único paciente, cujo tempo cirúrgico foi de 120 minutos de duração. Desta forma, a tricotomia reduziu a carga microbiana na superfície da pele. A antissepsia associada à terapia antimicrobiana profilática mostrou-se eficaz no controle microbiano do foco cirúrgico em procedimentos eletivos, com duração média de 90 minutos.(AU)

Isolation and identification of Vibrio species in the Rio Bravo/Grande and water bodies from Reynosa, Tamaulipas.

The Rio Bravo (Rio Grande) adjoins various states in the Mexican region and has a great importance in water distribution in the northeast Tamaulipas (Mexico). In this work 161 strains were isolated, identified and characterized from the water samples taken from the flow of the Rio Bravo and the two inner canals that cover Reynosa city. The strains were identified as Vibrio cholerae (74·5%), Vibrio spp. (1·2%) and Vibrio mimicus (0·6%). Furthermore, the detected virulence genes in the V. cholerae strains, were the hlyA, ompU, tcpA, toxR genes in 78·3, 62·5, 15·8 and 90·8% respectively. Only the ompU and vmh genes were detected in the V. mimicus strain. These results indicate the presence of multi-toxigenic V. cholerae strains in the Rio Bravo/Grande and in the water bodies from Reynosa city, which could represent a risk for the exposed population. SIGNIFICANCE AND IMPACT OF THE STUDY: Water quality is associated with public health, as it plays an important role in the transmission and epidemiology of pathogens such as Vibrio, since this species have been responsible for human diseases around the world. This study demonstrated the presence of toxigenic Vibrio species in water bodies in Reynosa surroundings, indicating that water bodies may be a source of public health risk.

Linfoma mediastinal em equino - relato de caso / Equine mediastinal lymphoma - case report

Uma égua SRD, com 20 anos de idade, foi encaminhada ao hospital veterinário com histórico de emagrecimento, perda de apetite e aumento de volume na região peitoral e no pescoço. Aos exames físico e laboratorial, constatou-se que o animal apresentava taquicardia, taquipneia, hiperproteinemia, hiperfibrinogenemia e hipoalbuminemia. À auscultação cardíaca, os sons das válvulas pulmonar e aórtica não foram audíveis. Realizaram-se as avaliações eletrocardiográfica e ecodopplercardiográfica transtorácica bilateral, nas quais se observaram presença de efusão pleural e deslocamento caudal do coração. Na varredura ultrassonográfica ao redor do coração, constatou-se a presença de uma massa na base do coração. Para tentar amenizar o quadro respiratório, foi realizada drenagem torácica. A efusão pleural apresentava característica serossanguinolenta, com padrão citológico inflamatório. Algumas horas após retornar a baia, o animal veio a óbito. Realizou-se a necropsia, na qual pôde ser observada a presença da massa posicionada ao redor do tronco braquiocefálico. Na análise histopatológica, diagnosticou-se o linfoma difuso de células pequenas e médias.(AU)

A 20-year-old mixed breed mare was referred to the veterinary hospital with history of weight loss, loss of appetite, and swelling of the chest and neck. On physical exam the patient was in tachycardia and tachypnea and laboratory results indicated hyperproteinemia, hyperfibrinogenemia and hypoalbuminemia. On cardiac auscultation, the pulmonary and aortic valves sounds were not audible. Presence of pleural effusion and heart caudal displacement were identified on electrocardiographic and Doppler echocardiography evaluation and a mass at the base of the heart was oberved through ultrasound scanning around the heart. To alleviate the respiratory condition, thoracic drainage was performed. The pleural effusion presented characteristic serosanguineous with cytologic inflammatory. After returning to stall, the animal died. In necropsy, the presence of a mass positioned around the brachiocephalic trunk was identified and histopathology results were compatible with diffuse small and medium cell lymphoma.(AU)

Equine mesenchymal stem cells derived from endometrial or adipose tissue share significant biological properties, but have distinctive pattern of surface markers and migration.

Adult stromal mesenchymal stem cells (MSCs) have been postulated as responsible for cell renewal in highly and continuously regenerative tissues such as the endometrium. MSCs have been identified in the endometrium of many species including humans, rodents, pets and some farm animals, but not in horses. The objective of this work was to isolate such cells from the endometrium of mares and to compare their main biological attributes with horse adipose-derived MSCs. Here we successfully isolated and characterized endometrial MSCs (eMSCs) from mares. Said cells showed fibroblast-like morphology, grew on plastic, had doubling population times of 46.4 ± 3.38 h, underwent tri-lineage (osteo, chondro and adipogenic) differentiation after appropriate inductions, migrated toward the attraction of fetal calf serum and displayed a pattern of surface markers commonly accepted for horse MSCs. All these are properties of MSCs. Some of these attributes were shared with equine adipose-derived MSCs, but the migration pattern of eMSC at 12 and 24 h after stimulation was reduced in comparison with adipose MSCs. Also, expression of CD44, CD90 and MHCI surface markers were dramatically down-regulated in eMSCs. In conclusion, equine-derived endometrial MSC share biological attributes with adipose MSC of this species, but displayed a different surface marker phenotype and an impaired migration ability. Conceivably, this phenotype is distinctive for MSC of this origin.

A importância dos exames neurológico e radiográfico no diagnóstico de lesões cervicais em equino: relato de caso / Fundamentals of neurological and radiographic examination on diagnosis of cervical lesions of a horse: case report

As lesões vertebrais cervicais são relativamente comuns nos equinos. No entanto, são poucas as descrições a respeito desse tema na literatura. Acredita-se que esse fato se deva, em parte, às limitações relacionadas ao diagnóstico. Em virtude de um traumatismo cervical, o animal pode apresentar sinais clínicos de paresia e paraplegia até tetraparesia ou tetraplegia, que podem culminar em estado comatoso e, eventualmente, em morte. Esses sinais clínicos podem ser detectados no exame físico, porém, quando associado à imaginologia (avaliação radiográfica), permite a obtenção de diagnóstico mais preciso da lesão. Consequentemente, um prognóstico mais adequado pode ser estabelecido para o paciente. Em face do exposto, apresenta-se o caso de uma égua Mangalarga, de quatro anos de idade, com sinais de tetraplegia pós-trauma, aumento de tônus muscular e paralisia espástica, com hiperreflexia, nos quatros membros. Por meio dos exames neurológicos realizados na paciente, em associação com as imagens radiográficas convencionais e contrastadas, foi possível estabelecer o diagnóstico do quadro. O animal apresentava lesões envolvendo as duas primeiras vértebras cervicais, atlas (C1) e áxis (C2), e a quinta e a sexta vértebra (C5-C6), destacando fratura de C1, deslocamento do dente de C2 e subluxação entre C5 e C6, com compressão ventrodorsal da medula espinhal. Confirmadas as suspeitas neurológicas e mediante prognóstico desfavorável, o animal foi submetido à eutanásia, com consentimento do proprietário. As lesões observadas nas imagens radiográficas foram confrontadas e confirmadas na necropsia.(AU)

Cervical vertebral lesions are relatively common in equine patients, but its diagnosis seems challenging for the clinician. Clinical signs most commonly associated with this clinical feature are paresis, paraplegia, tetraparesis, tetraplegia, which may lead the patient to a comatose state, and even death. Fortunately, these clinical signs can be perceived during physical examination. All of which, alongside imaging techniques, may allow a precise diagnose of the location of lesions and prediction of a prognosis for the patient. We present a case report of a Mangalarga mare, with four years of age, presenting signs of post-traumatic tetraplegia with spastic paralysis with increased muscular tonus and hyperreflexia in all four limbs. A thorough neurological examination of the patient associated with conventional and contrast medium radiographic imaging of the cervical region identified lesions at the atlas (C1) and axis (C2, and fifth (C5) and sixth (C6) cervical vertebrae. Fracture of the atlas vertebrae, dislocation of the axis' dens as well as subluxation of C5-C6 causing ventrodorsal medullary compression of the spinal cord were diagnosed radiographically. Due to the extent of the lesions the animal was euthanatized with the owner's consent. All lesions identified radiographically were posteriorly confirmed during post-mortem examination.(AU)

Associação de plasma sanguíneo ao tratamento de envenenamento botrópico em equino: relato de caso / Plasma blood associated with the treatment of bothropic poisoning in equine: case report

O presente trabalho tem por objetivo relatar um caso de envenenamento botrópico em um equino, fêmea, seis anos de idade, da raça Quarto de Milha, pesando 460kg, que foi atendido no hospital veterinário da FCAV/Unesp, Campus de Jaboticabal, SP. No exame clínico, observou-se aumento bilateral de narina, com extrema sensibilidade ao toque, presença das marcas da presa da serpente na região rostral de focinho, mucosas róseas com petéquias. No exame de sangue, pôde-se detectar alteração no tempo de coagulação sanguínea (>30 minutos). O animal permaneceu internado, sendo instituída a seguinte terapia: soro antiofídico polivalente, transfusão de plasma sanguíneo equino, fluidoterapia intensa, flunixin meglumine e sulfa associado ao trimetoprim. A associação da transfusão de plasma sanguíneo equino ao tratamento convencional foi de extrema importância para correção da coagulopatia causada pelo acidente ofídico. A égua apresentou melhora clínica e resolução do quadro de envenenamento após cinco dias da internação.(AU)

This study aims to report a case of blood plasma association with the treatment of bothrops poisoning in an equine, female, six years of age, Quarter Horses, weighing 460 kg, which was served in the veterinary hospital of the FCAV/UNESP, Jaboticabal/SP. Clinical examination showed bilateral increase in nostrils, with great sensitivity to touch, presence of snake prey marks the rostral region of the snout, mucous rosy and with petechiae. Blood samples showed changes in blood clotting time (> 30 minutes). The animal remained in hospitalization with the following treatment: polyvalent antivenom, blood plasma transfusion, intensive fluid therapy, flunexim meglumine and sulfa associated with trimethoprim. The association of transfusion equine blood plasma to conventional treatment was extremely important for correction of coagulopathy caused by snakebite. The mare showed clinical improvement and resolution of poisoning symptoms after five days of hospitalization.(AU)

The ATHENA HPV study underrepresents "other" high-risk HPV genotypes when compared with a diverse New York City population.

OBJECTIVE: Persistent infection with oncogenic high risk HPV (hrHPV) types causes virtually all cases of cervical cancer. HPV 16 and 18 have been targeted for individual genotyping and vaccination because of their presence in 71% of invasive cervical cancers worldwide. Montefiore Medical Center, Bronx, New York serves a population known for ethnic and racial diversity. Given this diversity it is possible that HPV genotypes not individually detected by current testing are causing significant disease. METHODS: We conducted a retrospective analysis of liquid based cervicovaginal cytology and Cobas HPV results reported between October 5, 2015 and March 30, 2016. This included 20 483 samples from patients aged 16-95 (average age 42), with racial distribution including: African-American 32.4%, Other (includes denied, unknown, mixed, Hispanic) 52.1%, Caucasian 14.5%, Asian 0.7%, American Indian/Alaskan Native 0.3%. In all, 14 938 samples (72.9%) were submitted for clinically requested COBAS 4800 HPV testing, which separately reports HPV 16, 18 and a pool of 12 other hrHPV. RESULTS: A total of 3180 (21.5%) tested hrHPV positive. The percentage of patients with cytologic diagnosis of HSIL (high-grade squamous intraepithelial lesion) that were positive only for HPV 16 was 19.4% vs 1.8% for all cytologic diagnoses. However, only one of the HSIL cases was HPV 18 positive along with other hrHPV (OHR). Surprisingly, a majority (64.5%) was positive for only OHR. CONCLUSIONS: Further evaluation is needed to determine if this pool of other hrHPV includes individual genotypes that in our population carry a higher risk of persistence and progression to cancer.

SurePath Specimens Versus ThinPrep Specimen Types on the COBAS 4800 Platform: High-Risk HPV Status and Cytology Correlation in an Ethnically Diverse Bronx Population.

OBJECTIVE: To compare the cytologic preparations of 130 cervical specimens (from women of various ethnicities at high risk for human papillomavirus [HPV] infection) using the SurePath (SP) collection system with specimens gathered using the ThinPrep (TP) system, as processed on the Cobas 4800 analyzer, to determine which collection method more accurately identifies HPV infection. METHODS: In our prospective study, specimens were collected from 130 women of various ethnicities residing in or near Bronx County, NY. The SP-collected specimen was first processed for cytologic findings; if clinical HPV testing was requested on that specimen, it was tested using Hybrid Capture II (HC2) methodology. We tested the remnant SP-collected cell concentrate using the Cobas analyzer. Then, the TP-collected and SP-collected specimens were tested in the same run on that analyzer, and the results were compared. We also compared the results with the concurrent cytologic findings. RESULTS: The results were concordant for overall HR-HPV status in 93.8% of cases. Also, a statistically significant lower cycle threshold value was observed with Cobas testing of specimen concentrates tested via the BD SurePath Pap Test (P = .001), suggesting higher sensitivity compared with specimens tested via the ThinPrep Pap Test. CONCLUSION: Cobas 4800 HPV testing of SP-collected specimen concentrates yields comparable results to TP-collected specimen concentrates. Based on the limited data that we derived, SP collection may be a more favorable methodology than TP collection for HPV testing of individuals at high risk in our ethnically diverse, urban patient population.

Late-Time Mixing Sensitivity to Initial Broadband Surface Roughness in High-Energy-Density Shear Layers.

Using a large volume high-energy-density fluid shear experiment (8.5 cm^{3}) at the National Ignition Facility, we have demonstrated for the first time the ability to significantly alter the evolution of a supersonic sheared mixing layer by controlling the initial conditions of that layer. By altering the initial surface roughness of the tracer foil, we demonstrate the ability to transition the shear mixing layer from a highly ordered system of coherent structures to a randomly ordered system with a faster growing mix layer, indicative of strong mixing in the layer at a temperature of several tens of electron volts and at near solid density. Simulations using a turbulent-mix model show good agreement with the experimental results and poor agreement without turbulent mix.

[Infrequent etiology inguinal tumor: Nuck channel cyst]. / Tumoración inguinal de etiología excepcional: quiste del canal de Nuck.

BACKGROUND: Cyst of Nuck is an infrequent disease originated in the inadequate obliteration of the processus vaginalis during the embrionary life of the woman. Clinically usually appears as a slowly growth inguinal tumor, painless, smooth, soft, fluctuant and irreducible. Differential diagnosis must include inguinal hernia and other etiologies of inguinal tumor, for which echography is the main diagnostic test. Treatment consists on surgical extirpation and local reparation. It is exposed a case of a patient with cyst of Nuck clinically typical. CLINICAL CASE: It is made a review of clinical, diagnostic and therapeutic approach of this disease.

Implementation of a new integrated d-lactic acid biosensor in a semiautomatic FIA system for the simultaneous determination of lactic acid enantiomers. Application to the analysis of beer samples.

An integrated amperometric d-lactic acid biosensor involving a gold film deposited by sputtering on a stainless steel disk electrode where the enzymes D-lactic acid dehydrogenase (DLDH) and diaphorase (DP) as well as the redox mediator tetrathiafulvalene (TTF) are coimmobilized by using a dialysis membrane, is reported in this work. Amperometry in stirred solutions at a detection potential of +0.15 V (vs Ag/AgCl reference electrode) provided a linear calibration plot for D-lactic acid over the 1.0×10(-4) to 3.8×10(-3) g L(-1) concentration range, with a limit of detection of 3.1×10(-5) g L(-1). The usefulness of the biosensor was demonstrated by determining D-lactic acid in beer samples with good results. Additionally, the biosensor was implemented together with a commercial L-lactic amperometric biosensor in a semiautomatic flow-injection analysis (FIA) system able to perform a rapid and simple stereo-specific determination of D- and D-lactic without a previous separation step. The operational characteristics of the biosensors under flow conditions were evaluated and its applicability was demonstrated through the simultaneous determination of both enantiomers in beer samples.