Association between smoking and peri-implant diseases: A retrospective study.

OBJECTIVES: To determine the association between tobacco and peri-implant diseases in a sample of patients who had received implant-supported restorations in a university dental clinic. Furthermore, the study aimed to investigate patient- and implant-related variables associated with peri-implant diseases. MATERIALS AND METHODS: The present retrospective study analyzed data from 117 patients treated with implant-supported restorations from 2001 to 2013. A total of 450 implants were evaluated. Patients were selected from an electronic database, and patient- and implant-related variables were evaluated. Detailed information regarding the smoking history (i.e., smoking status, lifetime cumulative dose, duration of exposure, intensity of the habit, and smoking cessation) was recorded. The primary study outcome was peri-implant status [i.e., health (H), peri-implant mucositis (PM) and peri-implantitis (PI)]. Univariate and multinomial regression models comparing PM and PI versus peri-implant health were conducted. RESULTS: A total of 117 subjects [55 (47%) females and 62 (53%) males] with a mean age at examination of 64.2 years (SD 11.6) and rehabilitated with 450 implants were included. The average number of implants per patient was 4.6 (SD 3.3) with a mean time in function of 8.0 years (SD 1.9). Fifty-six patients (47.9%) were non-smokers, 42 (35.9%) were former-smokers, and 19 (16.2%) were current-smokers. Thirty-nine subjects (33.4%) were H, whereas 41 (35%) and 37 (31.6%) exhibited PM and PI, respectively. At implant level, the corresponding values were 142 (31.6%), 230 (51.1%) and 78 (17.3%). In the multinomial regression model, significant associations for peri-implant diseases were observed for the mean number of implants per patient (p = .016), function time (p = .048), implants placed simultaneously with guided bone regeneration (p = .016), implant surface (p = .020), keratinized mucosa at the buccal aspect (p = .032), and access to interproximal hygiene (p < .001). In addition, ever smokers >23 pack-years exhibited a significantly higher risk for peri-implantitis (p = .002). Finally, the multinomial regression analysis revealed that subjects who had stopped smoking more than 21 years before the last examination presented a significantly lower risk of peri-implant diseases than a smoking cessation of ≤21 years (p = .028). CONCLUSIONS: Smoke intensity was associated with an increased risk of the development of peri-implantitis. Moreover, the risk of peri-implant diseases might be similar in those subjects who had stopped smoking for more than 21 years with respect to never-smokers.

Effectiveness of thromboprophylaxis with low molecular weight heparin in critically ill patients with COVID-19. An observational prospective, multicenter study.

INTRODUCTION: COVID-19 induces coagulopathy associated with an increase of thromboembolic events. Due to the lack of agreement on recommendations for thromboprophylactic management, the aim of this study was to study the dosages of LMWH used in critically ill COVID-19 patients assessing the effect on their outcome. METHODS: We evaluated data of the Reg-COVID19. According to LMWH dose two groups were analyzed: prophylaxis and treatment. Primary outcome was the relationship of LMWH dosage with mortality. Secondary outcomes included the incidence of thrombotic and bleeding events, length of ICU stay, invasive mechanical ventilation, and thrombotic and inflammatory parameters. RESULTS: Data of 720 patients were analyzed, 258 in the prophylaxis group and 462 in the treatment group. C Reactive Protein, invasive mechanical ventilation, tocilizumab and corticosteroid treatments were related with the choice of LMWH dose. Hemorrhagic events (66/720, 9.2%) and thrombotic complications (69/720, 9.6%) were similar in both groups (p = .819 and p = .265), as was the time course of the thrombotic events, earlier than hemorrhagic ones (9 [3-18] and 12 [6-19] days respectively). Mortality was lower in prophylaxis group (25.2% versus 35.1%), but once an inverse probability weighting model was applied, we found no effect of LMWH dose. CONCLUSION: We found no benefit or harm with the administration of therapeutic or prophylactic LMWH dose in COVID19 critically ill patients. With a similar rate of hemorrhagic or thrombotic events, the LMWH dose had no influence on mortality. More studies are needed to determine the optimal thromboprophylaxis protocol for critically ill patients.

[Effectiveness of thromboprophylaxis with low molecular weight heparin in critically ill patients with COVID-19. An observational prospective, multicenter study]. / Eficacia de la tromboprofilaxis con heparina de bajo peso molecular en pacientes críticos con COVID-19: estudio observacional, prospectivo y multicéntrico.

Introduction: COVID-19 induces coagulopathy associated with an increase of thromboembolic events. Due to the lack of agreement on recommendations for thromboprophylactic management, the aim of this study was to study the dosages of LMWH used in critically ill COVID-19 patients assessing the effect on their outcome. Metohds: We evaluated data of the Reg-COVID19. According to LMWH dose two groups were analyzed: prophylaxis and treatment. Primary outcome was the relationship of LMWH dosage with mortality. Secondary outcomes included the incidence of thrombotic and bleeding events, length of ICU stay, invasive mechanical ventilation, and thrombotic and inflammatory parameters. Results: Data of 720 patients were analyzed, 258 in the prophylaxis group and 462 in the treatment group. C Reactive Protein, invasive mechanical ventilation, tocilizumab and corticosteroid treatments were related with the choice of LMWH dose. Hemorrhagic events (66/720, 9.2%) and thrombotic complications (69/720, 9.6%) were similar in both groups (P=.819 and P=.265), as was the time course of the thrombotic events, earlier than hemorrhagic ones (9 [3-18] and 12 [6-19] days respectively). Mortality was lower in prophylaxis group (25.2% versus 35.1%), but once an inverse probability weighting model was applied, we found no effect of LMWH dose. Conclusion: We found no benefit or harm with the administration of therapeutic or prophylactic LMWH dose in COVID19 critically ill patients. With a similar rate of hemorrhagic or thrombotic events, the LMWH dose had no influence on mortality. More studies are needed to determine the optimal thromboprophylaxis protocol for critically ill patients.

Proteinuria in canine patients with lymphoma.

OBJECTIVES: To determine if proteinuria is more common in dogs with lymphoma when compared with healthy dogs and to assess the severity and frequency of proteinuria in dogs with lymphoma. METHODS: Determination of urine protein:creatinine ratio in 32 dogs with lymphoma compared with 30 healthy dogs. RESULTS: Canine patients with lymphoma are more likely to be proteinuric compared with healthy dogs. Proteinuria is common in dogs with lymphoma, although in most cases it is not severe. The presence of proteinuria is not linked with the stage or substage of lymphoma. CLINICAL SIGNIFICANCE: Mild proteinuria is a common finding in dogs with lymphoma. The clinical impact of the proteinuria is probably low.

Niveles bajos de procalcitonina ¿descartan bacteriemia en shock séptico adquirido en la unidad de cuidados intensivos? aprendizaje desde una serie de casos / Low levels of procalcitonin in the diagnosis of bacteremia in septic shock acquired in the intensive care unit

La procalcitonina representa un sustancial avance en el diagnóstico de infección bacteriana. Sin embargo, debe correlacionarse con el cuadro clínico y los otros marcadores de laboratorio ya que la sensibilidad reportada en bacteriemia es menor a 90 por ciento. Presentamos 6 pacientes críticos en shock séptico durante su estadía en la unidad de cuidados intensivos (UCI). Como parte de su estudio y porque en su mayoría se trataba de pacientes con causas de respuesta inflamatoria sistémica no infecciosas como cuadro de base, se solicitó la procalcitonina con la idea de discriminar. Estos pacientes habían sido tratados (o estaban en tratamiento) por alguna infección previa. Posteriormente, se demostró que 5 de los 6 pacientes tenían ambos hemocultivos positivos de los 2 tomados dentro del mismo día de la toma de procalcitonina con los valores promedio y desviación estándar: 0,66 +/- 0,44 ng/ml y un retraso de toma respecto al hemocultivo de 11,5 +/- 4,9 horas(siempre posterior a este último).Discusión: Se destaca que en esta serie de pacientes críticos en shock séptico y bacteriémicos, donde por nivel de gravedad gravedad y tiempo de toma de la procalcitonina sería esperable encontrar valores mayores a 2 ng/ml (asociado con sepsis para la mayoría de los laboratorios), situación claramente diferente. Dado lo complejo de los pacientes críticos y la cinética de la procalcitonina, su valor puntual aún bajo, no reemplaza al juicio clínico, que en estos casos fue correcto habiéndose iniciado tratamiento empírico y no suspendido sólo por un valor aislado.

Procalcitonin represents a substantial advance in the diagnosis of bacterial infection. However, it should correlate with the clinical and other laboratory markers, because the sensitivity reported in bacteraemia is less than 90 percent. We present six critical patients in septic shock during their stay in the intensive care unit (ICU). Because most of these were patients with noninfectious systemic inflammatory response, procalcitonin was requested with the idea of discriminating as part of the study. These patients had been treated (or were in treatment) for some previous infection. Subsequently, it was demonstrated that 5 of the 6 patients had positive blood cultures 2 of 2 the same day of collection of procalcitonin, with average values and standard deviation: 0.66 +/- 0.44 ng /ml. The sampling delay in respect of the blood culture was 11.5 +/- 4.9 hours (always after the latter). Discussion: It should be noted that these ICU patients in septic shock and bacteraemia, where by levels of severity and time of making the procalcitonin, it would be expected to find values greater than 2 ng / ml (associated with sepsis for most laboratories), a situation clearly different. Given the complexity of critically ill patients and the kinetics of procalcitonin, its precise value (still low), does not replace clinical assessment. In these cases the clinic was correct, beginning empirical treatment and not suspended it only by an isolated value.

Acute generalized exanthematous pustulosis due to tetrazepam.

Tetrazepam is a benzodiazepine that is widely used in Spain as a muscle relaxant, with occasional cutaneous side effects. We report a patient who developed a generalized pruriginous cutaneous reaction compatible with acute generalized exanthematous pustulosis (AGEP) due to tetrazepam. Patch tests with bromazepam, diazepam, and tetrazepam were negative at 48 and 72 hours; however, the tetrazepam patch showed a positive reaction at 10 days. Immunohistochemical studies revealed a mononuclear infiltrate composed of CD4+ and CD8+ T lymphocytes. Analysis of interleukin (IL) 8 expression by quantitative polymerase chain reaction revealed increased IL-8 mRNA levels in patch test-positive skin. Lymphoblast transformation test (LTT) was positive with tetrazepam but not with diazepam. Positive patch test and LTT suggested that tetrazepam-specific lymphocytes might be responsible for a T cell-mediated reaction. These results support previous data suggesting an important role for IL-8 and drug-specific T cells in the pathogenesis ofAGEP and imply that the reaction was specific to tetrazepam with no cross-reactivity to other benzodiazepines.

Seguridad eléctrica en quirófano / No disponible

En nuestra actividad profesional diaria es básica la anticipación y conocimiento del entorno donde se ejerce. Los hipotéticos problemas anestésicos que puedan surgir en quirófano deben ser conocidos, detectados y corregidos cuanto antes para una satisfactoria resolución. Dentro del hospital, es el quirófano uno de los lugares donde es mayor la implicación de los sistemas eléctricos; tanto por su suministro, como por la gran cantidad de aparataje que depende de él con las consiguientes implicaciones de su mal funcionamiento. Dichas implicaciones son extrapolables a unidades de recuperación postoperatorias, salas de cuidados críticos,... Dichas complicaciones son muy temidas por los anestesiólogos, tanto por su desconocimiento como por su potencial lesivo. Se pretende realizar una revisión de conceptos básicos de electricidad, qué conocimientos y precauciones debemos manejar en nuestro entorno de trabajo para optimizar el uso de los aparatos eléctricos en quirófano: comprender su funcionamiento y prevenir los posibles daños derivados de un mal uso o un mal funcionamiento

In our daily practice is important to be ready for the unforeseen situations and to have an excellent knowledge of our environment. The problems that could arise in the operating theatre have to be known, detected and corrected as soon as possible in order to have a satisfactory resolution. In the hospital is the operating theatre where are the main electrical systems involved, being this importance based in the correct supply and in the fact that there is important equipment which work is based in such correct supply. All the items involved can be applied to all the postanesthesia and critical care units. All these inconveniences and complications are feared by the anesthesia due to the ignorance and to the injures that can be caused. The main objective is to review all the elementary electrical concepts, the knowledge and the preventive measures and steps we should take in order to optimize the electrical device used; to ensure the understanding and the correct way of working and to take the necessary steps in order to avoid the problems derived of an incorrect use

Up-regulation of CCL17, CCL22 and CCR4 in drug-induced maculopapular exanthema.

BACKGROUND: Maculopapular exanthema has been reported to be the most frequently drug-induced cutaneous reaction. Although T lymphocytes are involved in the pathomechanism of this disease, little is know about the recruitment of these cells to the skin. OBJECTIVE: The aim of this work is to study the role of the chemokines TARC/CCL17 and MDC/CCL22 in the lymphocyte trafficking to affected skin in drug-induced exanthemas. METHODS: Real-time PCR was performed to quantify gene expression levels of CCL17, CCL22 and their receptor CCR4 in lesional skin biopsies and in peripheral blood mononuclear cells from patients. CCL27 and CCL22 proteins were detected in the skin by immunochemistry. Protein expression of CCR4 was determined by flow cytometry in peripheral blood lymphocytes. Functional migration assays to CCL17 and CCL22 were assessed to compare the migratory responses of peripheral blood lymphocytes from patients and healthy subjects. RESULTS: CCL17 and CCL22 were up-regulated in maculopapular exanthema-affected skin. CCR4 mRNA levels and protein expression were increased in peripheral blood mononuclear cells during the acute phase of the disease. The increased expression of the receptor was consistent with a higher response of peripheral blood lymphocytes to CCL17 and CCL22 compared with the migratory response in healthy donors. CONCLUSION: TARC/CCL17 and MDC/CCL22 might cooperate in attracting T lymphocytes to skin in drug-induced maculopapular exanthemas.

Entropía. Monitorización, fundamentos y comparación respecto al resto de monitores de profundidad anestésica / Entropy. Bases and monitoring. comparison with other anesthesia depth monitors

El uso de monitores de profundidad anestésica, basados en el electroencefalograma, ha demostrado su utilidad tanto en la disminución de los despertares intraoperatorios como en la titulación de los distintos fármacos anestésicos. Varios aparatos han sido diseñados con la intención de extraer y procesar el registro electroencefalográfico, dando como resultado un valor numérico representativo de un nivel de hipnosis. Distintos estudios analizan la diferencia entre estos monitores y el comportamiento de los mismos con los fármacos anestésicos utilizados en la práctica diaria; recientemente ha aparecido un nuevo módulo para la medición de la hipnosis, entropía, basado en un concepto termodinámico, analiza los datos según su variabilidad; aportando como novedad dos indicadores, entropía de respuesta y entropía de estado, que recogen un rango de frecuencias electroencefalográficas distintas, con la intención de poder distinguir entre electromiograma y electroencefalograma

Anaesthesia depth monitors that are based mainly on the electroencephalogram (EEG) have demonstrated but also titrating the different anaesthetic agents. Several devices have been designed to analyse and process the EEG trace and obtain a single number that represents the hypnpsis level. Different studies analyse this monitors and their response with the anaesthetics agents used on the daily practice. Recently the entropy monitor have appeared, it is based on the thermodynamic concept, analyzes the data variability and innovates to offer two different indexes: response and state entropy; that allow distinguish between electromyogram and electroencephalogram

Musca domestica como vector mecánico de bacterias enteropatógenas en mercados y basurales de Lima y Callao / Musca domestica as a mechanic vector of enteropathogenic bacteria in markets and junkyards in Lima and Callao

Objetivos: Demostrar que la mosca doméstica (Musca domestica) es un vector mecánico de bacterias enteropatógenas en distritos de Lima y Callao. Materiales y Métodos: Estudio de tipo descriptivo transversal. Unidad de estudio: Musca domestica. Entre mayo de 2004 y julio de 2005 se realizó un muestreo en diferentes distritos de las provincias de Lima y el Callao teniendo en cuenta el índice de infestación de cada zona elegida. Se recolectaron moscas de mercados, periferia y basurales aledaños. En el laboratorio fueron procesadas en medios de cultivo para aislamientode enterobacterias y su identificación. Resultados: De un total de 780 moscas domésticas se aisló Escherichia coli enteropatógena, Salmonella typhi, Shigella flexneri y Yersinia enterocolitica. Se estableció una relación directa entre el hallazgo de bacterias enteropatógenas y las zonas de mayor grado de infestación (>20 moscas/hora de observación). Conclusión: El aislamiento de bacterias enteropatógenas en Musca domestica permitió demostrar su papel vector

Objectives: To prove that domestic fly (Musca domestica) is a mechanic vector for enteropathogenic bacteria in Lima and Callao districts. Materials and methods: Cross sectional descriptive study. Between May 2004 and July 2005 a sampling was performed in different districts in Lima and Callao, considering the infestation index in each selected area. Flies from markets, peripheral areas and surrounding junkyards were collected. The insects were later processed in the laboratory for isolation and identification of enterobacteria. Results: Out of 780 flies, enteropathogenic Escherichia coli, Salmonella typhi, Shigella flexneri, and Yersinia enterocolitica were isolated. A direct relationship between finding enteropathogenic bacteria and the areas with greatest infestation indexes (>20 flies/hour in observation). Conclusion: The isolation of enteropathogenic bacteria in Musca domestica allowed us to prove its role as a vector.

Analgesia postoperatoria con lornoxicam frente a metamizol en cirugía mayor ambulatoria. Estudio prospectivo aleatorio / Postoperative analgesia with lornoxicam versus metamizol for outpatient major surgery. A randomized prospective study

Objetivos:Comparar la eficacia analgésica postoperatoria en cirugíamayor ambulatoria de dos fármacos analgésicos noopioides: metamizol, habitualmente utilizado en nuestromedio, frente a lornoxicam, introducido recientemente parauso clínico. Métodos:Estudio prospectivo y aleatorio. Incluimos 73 pacientesprogramados para un procedimiento de cirugía mayor ambulatoria.Al final de la cirugía administramos una dosisúnica de metamizol i.v. a todos los pacientes. Cuando lospacientes comenzaron la tolerancia administramos medicaciónanalgésica oral aleatorizando los pacientes en dos grupos:en el grupo lornoxicam (n = 35) un comprimido delornoxicam 8 mg cada 12 horas y en el grupo metamizol (n= 38) un comprimido de metamizol 575 mg cada 8 horas.Evaluamos el dolor postoperatorio en cuatro momentosdistintos del proceso postoperatorio: en la Unidad de Reanimaciónal final de la cirugía, al inicio del tratamientoanalgésico con la tolerancia oral, al alta hospitalaria, y alas 48 horas tras la cirugía. Utilizamos la escala analógicavisual (EVA), una escala numérica sencilla para valorar eldolor por encuesta telefónica a las 48 horas, la satisfaccióndel paciente al final del procedimiento, la opinión del pacientesobre la medicación recibida, y la necesidad de medicaciónde rescate.Resultados:No encontramos diferencias estadísticamente significativasen el EVA en la Unidad de Reanimación, en el iniciodel tratamiento analgésico oral, ni en la valoración del dolora las 48 h de la cirugía. El EVA del alta domiciliaria fuemenor en el grupo metamizol que en el grupo lornoxicam(p < 0,05). La satisfacción del paciente también fue mejoren el grupo metamizol al igual que en la opinión del pacientesobre la medicación recibida (p < 0,05). En la necesidadde rescate no hubo diferencias significativas.Discusión:Ambos fármacos proporcionan una buena analgesiapostoperatoria, si bien con la pauta de administración deldiseño del estudio metamizol se muestra superior a lornoxicamtanto en la analgesia al alta hospitalaria como en lavaloración subjetiva de los pacientes sobre la medicaciónanalgésica administrada

Objectives:To compare the analgesic effectiveness for outpatientmajor surgery of two non-opiate analgesic drugs: metamizol,frequently used in our setting, versus lornoxicam, recentlyintroduced in the clinical practice.Methods:Prospective and randomized study in 73 patients scheduledfor outpatient major surgery. At the end of the procedure,all patients received a single dose of metamizol i.v.Oral analgesics were administered when patients started todevelop tolerance and were randomized to one of the followinggroups: Lornoxicam Group (n = 35), with onetablet of lornoxicam 8 mg each 12 hours; or MetamizolGroup, with one tablet of metamizol 575 mg each 8 hours.Post-operative pain was assessed at four different timepoints during the postoperative process: at the reanimationunit after surgery, at the beginning of the analgesic treatmentwith oral tolerance, upon hospital discharge and 48hours after surgery. We used the Visual Analogue Scale(VAS), a simple numerical scale to assess pain through aphone call performed at 48 hours, patient satisfaction atthe end of the procedure, patient opinion regarding themedication received and need for rescue medication.Results:We did not find any statically significant differences inVAS scores at the reanimation unit, the beginning of theoral analgesic treatment or the assessment of pain 48hours after surgery. VAS scores upon hospital dischargewere lower in the metamizol group compared to thelornoxicam group (p < 0.05). Patient satisfaction and patientopinion regarding the medication received were alsobetter in the metamizol group (p < 0.05). No significantdifferences were observed regarding the need for rescuemedication.Discussion:Both drugs provide appropriate postoperative analgesia,but perhaps the dosage regime used in the metamizolgroup provided better analgesia upon hospital dischargeand improved subjective assessment of patients regardingthe analgesic drug received

Acute generalized exanthematous pustulosis associated with pseudoephedrine.

Acute generalized exanthematous pustulosis (AGEP) is an uncommon skin disorder most often caused by drugs. Few adverse reactions to sympathomimetic drugs have been reported, despite their extensive use. Although the aetiology of AGEP remains uncertain, recent data have reported involvement of drug-specific T cells and interleukin (IL)-8 production. We characterized an adverse reaction to pseudoephedrine both clinically and immunologically. Histological analysis of skin biopsies confirmed the clinical entity as AGEP, while epicutaneous tests confirmed the specificity of the reaction to the drug. Moreover, immunohistochemical studies showed a mononuclear infiltrate consisting of activated memory T cells in addition to polymorphonuclear cells. Reverse transcription-polymerase chain reaction revealed an increased expression of IL-8 in AGEP-affected skin.

[Electrocardiography and echocardiography aspects of hypertrophic myocardiopathy in pediatrics]. / Aspectos electrocardiográficos y ecocardiográficos de la miocardiopatía hipertrófica en edad pediátrica.

Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease, characterized by asymmetric hypertrophy of the left and/or right ventricle with disarray of myocardial fibers. In order to know its clinical and electrocardiographic manifestation in the pediatric age group, we made a retrospective study of 24 cases from 1986 to 1995. There were: 15 girls and 9 boys, with a mean age of 6 years (age range: 1 month to 17 years). Clinical manifestations were dyspnea (71%), syncope (42%) and palpitations (42%). Physical examination disclosed an aortic systolic murmur in all patients, a mitral regurgitation in 42% and physical signs of congestive heart failure in 54% of patients. Chest X rays showed cardiac enlargement in 71% and pulmonary capillary hypertension in 42%. The most frequent ECG abnormalities were: a prolonged time in the intrinsecoid deflection onset on leads corresponding to the affected region, more or less deep and clean Q waves on leads aVF, aVL, V5 and V6, as well as supraventricular and ventricular rhythm disturbances in 11 patients (46%) with and without congestive heart failure. Bidimensional echocardiography confirmed antero-septal hypertrophy in all patients. The mortality rate was 17%. HCM is rare disease in the pediatric age group. Mortality increases when congestive heart failure and arrhythmias are present. Treatment must be individualized in all cases.

A case of pleomorphic lipoma of the hypopharynx.

We report the first case of pleomorphic lipoma in the hypopharynx. A 69-year-old man was admitted because of a 12 year history of dysphagia and cough. Direct laryngo-pharyngoscopy revealed a polypoid, yellow, smooth, submucosal tumor with well defined borders. At CT scan the tumor showed a hypodense pattern and measured 3 cm. Microscopically the neoplasm was composed mainly by typical lipomatous tissue, bundles of collagen and pleomorphic multinucleated cells, some with floret-like appearance. Lipoblasts and mitoses were not found. Six months after resection there was no evidence of recurrence.

[Polycystic endodermal heterotopy of the atrioventricular node]. / Heterotopía endodérmica poliquística del nódulo auriculoventricular.

We present the two first Spanish cases about the endodermic heterotopia of the atrioventricular node. This is an infrequent and probably congenital lesion, with a not well known histogenesis and associated with heart blocks and sudden death, which affects women in most cases. The first observation attaches a 55 years-old woman with an acute leukemia who died during the first chemotherapy treatment. The second observation affects a 25 years-old woman, with previous heart blocks, who died suddenly. A complete post-mortem study was done in both cases (including cardiac conduction system) with conventional histopathological study and extensive immunohistochemical panel. Ultrastructural study of first case was done. In both cases a multicystic and tubular lesion was found in the atrioventricular node region. It was lined by two or more cubic and polyhedral cell layers. In the cystic lumina an eosinophilic material, which corresponded to acid and neutral mucosubstances was found. The maximal lesion's diameter were: 0.9 and 1.3 cm, respectively. Immunohistochemically it was detected in both cases strong positivity for cytoqueratines, EMA, CEA and focally for chromogranin A and calcitonin. The immunohistochemical results in both cases express and endodermic differentiation (with neuroendocrine fenotipe).

Distribution of hydatidosis and cysticercosis in different Peruvian populations as demonstrated by an enzyme-linked immunoelectrotransfer blot (EITB) assay. The Cysticercosis Working Group in Peru (CWG).

A serosurvey for human hydatidosis and cysticercosis was performed in different regions of Peru. Those regions included a known endemic area for cystic hydatid disease, a cooperative in the central Peruvian Andes near the city of Tarma, Department of Junin; three areas endemic for cysticercosis in the Departments of Ancash, Cuzco, and San Martin, where the status of hydatid disease is not well defined; and an urban shantytown near Lima, where neither zoonosis is known to be present. A seroprevalence for hydatidosis 1.9% (6 of 309) was found with both the enzyme-linked immunoelectrotransfer blot (EITB) and double diffusion assays in the area endemic for hydatidosis. Seroprevalence in the other zones tested was zero using only the EITB assay. Cysticercosis seroprevalence was high in pig-raising zones but low in the high-altitude, sheep-raising areas and in the seaport of Callao. No cross-reactions between Echinococcus granulosus and cysticercosis were noted in any of the regions studied. Hydatid infection remains a major health problem in the central Peruvian Andes where sheep raising is widely practiced; however, in those regions where mainly swine are raised, human hydatid infection is not a problem.