Immune response in breast cancer surgery. A comparative and prospective study of different anesthetic techniques.

INTRODUCTION: The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. METHODS: A prospective, comparative and non- randomised study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48 h after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. RESULTS: 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks. We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48 h after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). CONCLUSIONS: Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.

Respuesta inmunológica en cirugía del cáncer de mama. Estudio comparativo y prospectivo de diferentes técnicas anestésicas / Immune response in breast cancer surgery. A comparative and prospective study of different anesthetic techniques

Introducción: El principal motivo de la alta mortalidad en el cáncer de mama es la recurrencia local y las metástasis, siendo la cirugía la primera opción terapéutica. La técnica anestésica utilizada en quirófano puede modificar la respuesta inmunológica del paciente. Métodos: Estudio prospectivo, comparativo y no aleatorizado en pacientes intervenidos de cáncer de mama en el Hospital Universitario de Getafe (Madrid) tras la aprobación del Comité Ético del Hospital.Dividimos a los pacientes en dos grupos: grupo A, que recibió anestesia general con propofol y fármacos opiáceos; grupo B, en el que además de la anestesia general, se realizaron tres bloqueos interfasciales (Pec I, Pec II y BRILMA) en todos los pacientes. Se obtuvieron tres muestras sanguíneas: 1) antes de la inducción anestésica; 2) 2h después de finalizar la cirugía y 3) 24-48h posquirúrgicas. En cada muestra, se analizaron el número de leucocitos, células CD3, CD4 y CD8, así como las células natural killer (NK). Resultados: Se incluyeron en el estudio un total de 103 pacientes; 59 (grupo A) recibieron anestesia general y 54 (grupo B) anestesia general y bloqueos interfasciales. Según las características basales, la edad fue significativamente superior en las pacientes que recibieron anestesia general. La mastectomía se realizó con más frecuencia en el grupo que recibió bloqueos interfasciales. Observamos que después de la cirugía hay un aumento en el número de leucocitos pero regresa a los niveles basales a las 48h, comportamiento que se repite a nivel inmunológico: disminuye después de la cirugía pero vuelve a niveles previos a las 48h de la cirugía. Los grupos A y B presentan resultados similares en el resto de parámetros estudiados, al igual que los subgrupos según los receptores hormonales (HER+, PR y/o ER+).(AU)

Introduction: The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. Methods: A prospective, comparative and non-randomized study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48hours after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. Results: 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks.We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48hours after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). Conclusions: Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.(AU)

Bloqueo del cuadrado lumbar: nueva vía de abordaje para el dolor crónico de cadera. Serie de casos / Quadratus lumborum block. New approach for a chronic hip pain. Cases report

La artrosis de cadera es una enfermedad frecuente y de difícil manejo. El dolor que genera supone un gran impacto en la calidad de vida del paciente. El objetivo del tratamiento debe ser reducir el dolor y mejorar la función. Atendiendo a la compleja inervación de la cadera las técnicas mínimamente invasivas han ido en aumento. En este contexto presentamos los resultados obtenidos en 4 pacientes con dolor crónico por coxartrosis a los que realizamos un bloqueo del cuadrado lumbar tipo 2 (QL2) con levobupivacaína más dexametasona como opción terapéutica. Los resultados han mostrado un descenso significativo de la intensidad del dolor evaluado en la escala verbal numérica (EVN) durante un periodo superior a 6 meses

Hip arthrosis is a frequent and difficult to manage disease. The generated pain supposes a great impact in the quality life of the patient. The goal of the treatment should be to reduce pain and to improve function. Based on the complex innervation of the hip, the minimally invasive thecniques have been increasing. In this context, we present the results obtained in four patients with a hip chronic pain due to arthrosis, to whom we performed a quadratus lumborum block type 2 (QL2) with levobupivacaine plus dexametasone as therapeutic option. The results have shown a significant decrease of the intensity of pain (NRS) for more than 6 months

Quadratus lumborum block. New approach for a chronic hip pain. Cases report. / Bloqueo del cuadrado lumbar: nueva vía de abordaje para el dolor crónico de cadera. Serie de casos.

Hip arthrosis is a frequent and difficult to manage disease. The generated pain supposes a great impact in the quality life of the patient. The goal of the treatment should be to reduce pain and to improve function. Based on the complex innervation of the hip, the minimally invasive thecniques have been increasing. In this context, we present the results obtained in four patients with a hip chronic pain due to arthrosis, to whom we performed a quadratus lumborum block type 2 (QL2) with levobupivacaine plus dexametasone as therapeutic option. The results have shown a significant decrease of the intensity of pain (NRS) for more than 6 months.

Analysis of liquid metal foams through X-ray radioscopy and microgravity experiments.

Complex liquid structures such as metallic foams were produced in a furnace that allowed in situ X-ray monitoring of the evolution of the structure and distribution of the liquid in the foam. The experiments were carried out during parabolic flights which provided varying levels of gravity. The evolution of the characteristic liquid fraction profiles due to gravity induced drainage was measured and analysed in terms of the foam drainage equation, obtaining viscosity and surface tension by fitting solutions of the equation to the experimental data. The surface tension of the melt in the foam was decreased up to 40%. Effective viscosities of up to 139 times the viscosity of a pure bulk melt were observed. These effects could be attributed to the smaller influence of solid particles dispersed in the melt and the larger influence of the complex foam structure.

Effect of the natural pesticide spinosad (GF-120 formulation) on the foraging behavior of Plebeia moureana (Hymenoptera: Apidae).

In this study we evaluated the effects of the biorational pesticide, Spinosad (GF-120 formulation), on foraging behavior in the stingless bee Plebeia moureana (Ayala). Several foragers were individually trained to collect an unscented 1.0 M sucrose solution (31% sucrose wt:wt) from a blue plate in one arm of a Y-tube maze. The other arm offered plain water on a yellow plate. After 20-30 visits to the setup, the sucrose solution was exchanged for a sucrose solution mixed with one of five concentrations of GF-120 and 30 consecutive choices of each bee were recorded. Interestingly, the foragers collected the sucrose solution with GF-120 at all concentrations. Our results show that: 1) the GF-120 formulation, when applied at the recommended concentration and mixed with food, does not discourage engaged foragers and, 2) foraging behavior over time is not significantly impaired by the continuous collection of GF-120.

[Anesthetic treatment of patients with osteogenesis imperfecta]. / Experiencia en el tratamiento anestésico de los pacientes afectos de osteogénesis imperfecta.

BACKGROUND AND OBJECTIVE: Although the prevalence of osteogenesis imperfecta is low, the effect of this hereditary disease on patients' quality of life is considerable. We report our experience in the perioperative management of patients with this condition in our hospital. PATIENTS AND METHODS: Retrospective study describing the interventions on patients with this disease in our hospital from 1991 to 2009. We analyzed demographic data, disease variants, concomitant disorders, surgical procedures, type of anesthesia, and intraoperative and postoperative complications. RESULTS: From 1991 to 2009, 105 procedures were performed on 29 patients (ages 1 to 25 years) with osteogenesis imperfecta (37.9% women and 62.1% men). The most common type of osteogenesis imperfecta was type III (65.5%). Most patients (93%) had no associated diseases. Two patients were allergic to latex. No complications occurred in 62% of interventions. Reported complications during surgery were 1 case of non-malignant hyperthermia and 1 contralateral femur fracture. CONCLUSIONS: The prevalence of osteogenesis imperfecta is low. Treatment requires a multidisciplinary approach, in which appropriate perioperative management must be based on a proper understanding of the skeletal and extraskeletal abnormalities associated with this disease.

Experiencia en el tratamiento anestésico de los pacientes afectos de osteogénesis imperfecta / Anesthetic treatment of patients with osteogenesis imperfecta

Objetivos: La osteogénesis imperfecta es una enfermedad hereditaria con una baja prevalencia, pero gran impacto en la calidad de vida de los pacientes. Se presenta la experiencia en el manejo perioperatorio de estos pacientes en nuestro hospital. Pacientes y métodos: Estudio descriptivo retrospectivo de las intervenciones realizadas en nuestro centro durante los años 1991 a 2009, en los pacientes con esta enfermedad. Se analizan los datos demográficos, variante de la enfermedad, alteraciones asociadas, procedimientos quirúrgicos, tipo de anestesia y complicaciones intraoperatorias y postoperatorias. Resultados: Desde el año 1991 hasta el 2009 se han realizado un total de 105 intervenciones en 29 pacientes con osteogénesis imperfecta (37,9% mujeres, 62,1% varones), con una edad que oscila entre 1 a 25 años. El tipo más frecuente de osteogénesis imperfecta fue el tipo III (65,5%). El 93% de los pacientes no presentaron enfermedades asociadas. Dos pacientes eran alérgicos al látex. El 62% de las intervenciones transcurrieron sin complicaciones. Se registró un caso de hipertermia no maligna y una fractura de fémur contralateral en el quirófano. Conclusiones: La osteogénesis imperfecta es una enfermedad de baja prevalencia que precisa un tratamiento multidisciplinar. Es necesario un adecuado conocimiento de las alteraciones tanto esqueléticas como extraesqueléticas de esta enfermedad para un correcto tratamiento perioperatorio(AU)

Background and objective: Although the prevalence of osteogenesis imperfecta is low, the effect of this hereditary disease on patients’ quality of life is considerable. We report our experience in the perioperative management of patients with this condition in our hospital. Patients and methods: Retrospective study describing the interventions on patients with this disease in our hospital from 1991 to 2009. We analyzed demographic data, disease variants, concomitant disorders, surgical procedures, type of anesthesia, and intraoperative and postoperative complications. Results: From 1991 to 2009, 105 procedures were performed on 29 patients (ages 1 to 25 years) with osteogenesis imperfecta (37.9% women and 62.1% men). The most common type of osteogenesis imperfecta was type III (65.5%). Most patients (93%) had no associated diseases. Two patients were allergic to latex. No complications occurred in 62% of interventions. Reported complications during surgery were 1 case of non-malignant hyperthermia and 1 contralateral femur fracture. Conclusions: The prevalence of osteogenesis imperfecta is low. Treatment requires a multidisciplinary approach, in which appropriate perioperative management must be based on a proper understanding of the skeletal and extraskeletal abnormalities associated with this disease(AU)

Estudio de las características individualizantes de las rugas palatinas. Caso: Bomberos de la Universidad de Los Andes Mérida – Venezuela / Study of characteristics of palatal rugae individualizing. Case: Fire department of Los Andes University Mérida - Venezuela

La rugoscopia es un método seguro y de bajo costo, que puede utilizarse como técnica alternativa en la individualización de personas y en el reconocimiento de cadáveres no identificados por diversas causas. El objetivo de esta investigación fue aplicar una ficha rugoscópica en una muestra de veinte (20) Bomberos Universitarios del estado Mérida-Venezuela y crear una base de datos de una población de alto riesgo a partir de las características individualizantes de las rugas palatinas. Se utilizó una ficha rugoscópica diseñada y validada en esta investigación, modelos de estudio del maxilar superior y fotografías intraorales. Mediante el análisis de 266 rugas palatinas, se determinaron formas y números diferentes en cada individuo, lo que permite reconocerlo en cualquier lugar del mundo. Se concluye que la rugoscopia es un método sencillo y aplicable fácilmente en el consultorio odontológico, que permite la identificación de cualquier persona, a partir de las características individualizantes de las rugas palatinas (AU)

Rugoscopy is a safe and low cost method that can be used as an alternative technique in the identification of persons and the recognition of bodies which cannot be identified due to various reasons. The objective of this research was to apply a rugoscopy card in a sample of twenty (20) firefighters of the Fire Department of Los Andes University in the State of Merida, and to create a database of high risk cases taken from the individualizing characteristics of palatal rugaes. We used a rugoscopy card designed and validated in this investigation, as well as, study models of maxillary and intraoral photographs. Through the analysis of 266 palatal rugae, shapes and different numbers in each individual were determined, allowing their identification anywhere in the world. We conclude that rugoscopy is a simple method and easily applicable in the dental office, which allows the identification of any person from the individualizing characteristics of the palatal rugae (AU)

Note: X-ray radiography for measuring chemical diffusion in metallic melts.

A x-ray radioscopy technique for measuring in situ chemical diffusion coefficients in metallic melts is presented. The long-capillary diffusion measurement method is combined with imaging techniques using microfocus tubes and flat panel detectors in order to visualize and quantitatively analyze diffusive mixing of two melts of different chemical composition. The interdiffusion coefficient as function of temperature and time is obtained by applying Fick's diffusion laws. Tracking the time dependence of the mean square penetration depth of the mixing process allows to detect changes in the mass transport caused by convective flow. The possibility to sort out convective mass transport contributions from analysis enhances significantly the accuracy compared to the conventional long-capillary diffusion measurement method with postmortem analysis. The performance of this novel diffusion measurement method with x-ray radiography technique is demonstrated by a diffusion experiment in an Al-Ni melt.

Irrigación de las cápsulas adrenales en humanos / Irrigation of the human adrenal capsules

Las cápsulas adrenales también conocidas como glándulas adrenales o suprarrenales, son 2 pequeñas estructuras, una derecha y otra izquierda, ubicadas en la región suprahiliar del borde interno de cada riñón. A pesar de su pequeño tamaño, su función dentro del sistema endocrino es indispensable para el equilibrio metabólico de los seres humanos, de allí que su aporte vascular viene a jugar un papel fundamental en su funcionamiento. Los diferentes textos de anatomía han descrito por años un patrón vascular clásico, sin embargo, éste presenta importantes variaciones en el origen y distribución de sus ramas. Trabajamos con fetos frescos, cuidadosamente disecados, perfundidos con vinil rojo en el sistema arterial, extrayendo un bloque visceral y resecando 66 glándulas adrenales. En nuestros resultados el patrón vascular clásico descrito por los libros de anatomía sólo se observó en el 15,38 por ciento de los casos. El origen de la arteria suprarrenal superior fue detectado en la arteria Aorta (46,15 por ciento), la arteria media también en la Aorta (53,85 por ciento) y la rama inferior igualmente en la Aorta abdominal en tres cuartas partes de los casos (61,54 por ciento sola y en un 12,31 por ciento junto a la arteria renal). La distribución vascular de la glándula derecha difiere de la izquierda en 36 (56,25 por ciento) de los casos

The adrenal glands also known as suprarenal glands, are two small structures located on the suprahiliar border of the kidney. They belong to the endocrine system. The Anatomical books describe for them a classic vascular pattern, nevertheless they really have important variations in origin and branching pattern. In this work we employed human fetuses, carefully dissected, vinyl perfused. The sample was constituted by 66 adrenal glands. After a very careful observation of the serie we found that the classic pattern was seen in 15.30 percent of the sample. Superior suprarenal artery was localized at the abdominal Aorta in 46.15 percent, the medial artery was arising from Aorta in 53.85. percent, and the inferior suprarenal artery was also found taking origin at abdominal Aorta,on its own in 61.54 percent , and in 12.31 percent together with the renal artery. We also notice that the vascular approach to right adrenal gland is different from that for the left gland in 56.25 percent

Antimicrobial activity of selected plant species from "the Argentine Puna" against sensitive and multi-resistant bacteria.

AIM: The plant species reported here are traditionally used in the "Puna" or "Altiplano" of Argentina for ailments related to bacterial infections. The aim of this study was to evaluate their antimicrobial properties against a panel of sensitive and multi-resistant gram-positive and gram-negative bacteria. MATERIALS AND METHODS: The antimicrobial activity of tinctures and aqueous extracts (Baccharis boliviensis, Chiliotrichiopsis keidelii, Chuquiraga atacamensis, Fabiana bryoides, Fabiana densa, Fabiana punensis, Frankenia triandra, Parastrephia lucida, Parastrephia lepidophylla, Parastrephia phyliciformis, Tetraglochin cristatum) was determined using the agar macrodilution and broth microdilution methods recommended by the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS). The antibiotic resistant clinical strains were isolated from nosocomial infection in human lesions of skin and soft parts. RESULTS: The ethanolic extracts of 11 plant species inhibited the growth of one or more of the following strains: Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterobacter cloacae, Morganella morganii, Pseudomonas aeruginosa. Ethanol extracts (tinctures) of aerial parts of Baccharis, Fabiana and Parastrephia showed the highest levels of antibacterial activity on methicillin, oxacillin and gentamicin resistant Staphylococcus with MIC values from 20 to 150 microg/ml. Baccharis boliviensis and Fabiana bryoides were more active than the other plant species on Enterococcus faecalis with different phenotype. The most interesting activity on multi-resistant gram-negative strains was obtained from Chuquiraga atacamensis. Parastrephia species showed activity against Enterobacter cloacae, Pseudomonas aeruginosa and Proteus mirabilis. The ethanolic extracts exhibited stronger activity and broader spectrum of action than aqueous extracts. The extracts were bactericidal in most cases. CONCLUSIONS: The presence of antibacterial activity in Puna plant extracts against multi-resistant bacteria give support to their traditional use for treating conditions associated with microorganisms in humans and animals and consequently seems promising for the treatment of multi-resistant bacteria.

Evaluación de la transmisión vertical de Bartonella bacilliformis en Lutzomyia Verrucarum (Diptera: Psychodidae) / Bartonella bacilliformes vertical transmision assessment in Lutzomyia Verrucarum (Dipteria: Psychodidae)

Objetivos: Identificar la existencia de transmisión vertical de Bartonella bacilliformis en Lutzomyia verrucarum. Materiales y métodos: En este estudio experimental, se realizó la crianza individual y masiva (Tº 22º C mas menos 2º C humedad relativa: 80 por ciento mas menos 5 por ciento) de Lutzomyia verrucarum en el laboratorio de Entomología del Centro de Investigaciones del Hospital de Caraz (Ancash-Perú). Con la finalidad de lograr la infección de las hembras se procedió a alimentarlas con sangre infectada obtenida por estas directamente al picar la piel de pacientes con bartonelosis aguda frotis positivo. Las hembras, luego de poner sus huevos, fueron evaluadas a través de la prueba de PCR para Bartonella baciliformis. Resultados: 13 de 18 (72.2 por ciento) hembras alimentadas con sangre infectada con bacteremia al 3 por ciento lograron poner huevos y de éstas ninguna resultó ser positiva al PCR. 12 de 54 (22.2 por ciento) hembras alimentadas con sangre infectada con bacteremia al 80 por ciento ovipusieron y de éstas sólo una (8.3 por ciento) resultó ser positiva al PCR. Ninguno de los descendientes adultos de esta hembra resultó positivo al PCR. Conclusiones: El bajo porcentaje de infección por Bartonella baciliformis encontrado en hembras oviponedoras no permitió determinar la existencia de transmisión vertical de Bartonella baciliformis en Lutzomyia Verrucarum.

Objectives: To determine vertical transmisión of Bartonella baciliformis in Lutzomyia Verrucarum. Materials and methods: In this study, we performed individual and massive breeding (Tº 22 mas menos 2º C, relative humidity: 80 mas menos 5 percentage) of Lutzomyia Verrucarum at the entomology laboratory in Caraz Hospital (Ancash-Perú). In order to infect female mosquitoes, we fed them with blood from patients with positive-smear acute bartonellosis. Female mosquitoes were assessed after they laid their eggs, using a PCR test for Bartonella baciliformis. Results: Thirteen of 18 (72.2 percentage) females fed with infected blood with 3 percentage bacteremia laid their eggs, and none of them was PCR positive. Twelve of 54 (22.2 percentage) females fed with infected blood, with 80 percentage bacteremia laid their eggs, and only one (8.3 percentage) was PCR positive. No adult offspring of this female was PCR positive. Conclusions: The low rate of Bartonella baciliformis infection in female mosquitoes laying their eggs did not show the existence of vertical transmission of Bartonella baciliformis in Lutzomyia Verrucarum.

Proceso evolutivo de la osificación del hueso occipital en fetos humanos y su relación con la presencia de huesos suturados en el adulto / Evolutive in the bone ossification in human fetus and it's relations with presence of suturate bone in adult

Se presentan los resultados de 70 cráneos de embriones y fetos de diferentes edades, los cuales están comprendidos entre la semana 8 y la 38 de la vida intrauterina. Con el objeto de teñir las sales de calcio de los núcleos de osificación se utilizó Alizarina roja. Se revisó el proceso de osificación del Occipital y se encontró que el mismo se inicia en la 8va. semana de la vida intrauterina, se hacen consideraciones sobre las variaciones que presentan el Occipital en su osificación

[General aspects of sexual behavior among in-coming university students in Guatemala City]. / Aspectos generales de la conducta sexual del estudiante pre-universitario en la Ciudad de Guatemala.

PIP: 880 randomly selected new students and 270 graduating students at the University of San Carlos in Guatemala City were surveyed between July 1990 and June 1991 during routine physical examinations on various aspects of their sexual behavior. Questionnaires were completed anonymously and confidentially. 61% of the new students and 70% of the graduating students were male. 82% of new students were aged 18-23 years and 68% of graduating students were 23-28 years old. Among new students, 37.5% of men and 2.8% of women reported having their first sexual contact by age 15, while 19.4% of the men and 78.9% of the women had never had sexual relations. 33.4% of the men reported their first sexual contact was with a prostitute. 2.8% of new students reported having been victims of sexual abuse in the past. Among new students, 6% of men and 2% of women reported at least one homosexual experience, while 24% of graduating men and 10% of graduating women did so. Among new and graduating students, respectively 18% and 9% of men and 1% and 0% of women reported having more than one regular sexual partner at the time of the survey. Among new students, 13.3% of men and 3.4% of women reported always using condoms, while 15.3% of men and 1.1% of women reported using them nearly always. 60% of graduating men and 37% of graduating women reported using condoms always or nearly always. 19% of new male students and 2.4% of new female students reported a history of sexually transmitted diseases, compared to 33% of graduating men and 7% of graduating women. 22.8% of new male students and 56% of graduating male students reported having had contact with prostitutes.^ieng

[Sexually transmitted diseases in Guatemala City street children]. / Enfermedades de transmision sexual en ninos de la calle de la Ciudad de Guatemala.

PIP: Drug consumption, sexual promiscuity, extreme poverty, and low educational level place street children at high risk of sexually transmitted diseases. A prospective study was conducted of 143 street children attending a sexually transmitted disease clinic in Guatemala City over a three month period in 1991. 11 of the children were aged 7-10 years, 47 were aged 11-14 years, and 85 were aged 15-18 years. 104 were male and 39 female. 26 were illiterate and the rest had incomplete primary educations. All had been sexually abused. Over half had had their first sexual experience with a relative. None had ever used condoms. 101 of the children reported they had 1 or 2 sexual partners each day, 6 had 3 or 4, and 36 had more than 4. 133 reported histories of sexually transmitted diseases, of which 94 cases were ulcerative. 112 of the children had genital herpes, 71 had gonorrhea, 39 had human papillomavirus, 19 had vaginal trichomoniasis, 24 had chancroid, and 6 each had vaginal candidiasis, early latent syphilis, and pubic pediculosis. All the children reported using alcohol, tobacco, or marijuana. All used solvents and most used a variety of other drugs.^ieng

Chagas' disease: lymphoma growth in rabbits treated with Benznidazole.

Administration of the trypanocidal drug, Benznidazole (N-benzyl-2-nitro-imidazoleacetamide) to Trypanosoma cruzi-infected rabbits did not arrest the destructive Chagas' heart myocarditis. A typical feature of lymphocytic infiltrates associated with non-parasitized heart cell lysis was present in both treated and untreated groups of rabbits. Benznidazole-treated rabbits had their survival time shortened, probably as a consequence of Chagas' heart disease and of the development of lymphomas. The survival time of untreated T. cruzi-infected rabbits was 765 +/- 639 days and those treated with Benznidazole in the chronic phase of infection survived for 392 +/- 571 days. Malignant, non-Hodgkin's lymphomas were present in 38% of the rabbits that received the nitroarene therapy. Testicular atrophy was observed in 2 out of 10 nitroarene-treated rabbits. Benznidazole administration caused severe cell-mediated immunosuppression in T. cruzi-infected and BCG-immunized rabbits. Specific antibodies against the parasite and an unrelated antigen were detected in high levels, regardless of the nitroarene administration.