Comparative response to PDT with methyl-aminolevulinate and temoporfin in cutaneous and oral squamous cell carcinoma cells.

Cutaneous and Head and Neck squamous cell carcinoma (CSCC, HNSCC) are among the most prevalent cancers. Both types of cancer can be treated with photodynamic therapy (PDT) by using the photosensitizer Temoporfin in HNSCC and the prodrug methyl-aminolevulinate (MAL) in CSCC. However, PDT is not always effective. Therefore, it is mandatory to correctly approach the therapy according to the characteristics of the tumour cells. For this reason, we have used cell lines of CSCC (A431 and SCC13) and HNSCC (HN5 and SCC9). The results obtained indicated that the better response to MAL-PDT was related to its localization in the plasma membrane (A431 and HN5 cells). However, with Temoporfin all cell lines showed lysosome localization, even the most sensitive ones (HN5). The expression of mesenchymal markers and migratory capacity was greater in HNSCC lines compared to CSCC, but no correlation with PDT response was observed. The translocation to the nucleus of ß-catenin and GSK3ß and the activation of NF-κß is related to the poor response to PDT in the HNSCC lines. Therefore, we propose that intracellular localization of GSK3ß could be a good marker of response to PDT in HNSCC. Although the molecular mechanism of response to PDT needs further elucidation, this work shows that the most MAL-resistant line of CSCC is more sensitive to Temoporfin.

[Translated article] Peripheral trauma treated in the paediatric emergency department: Descriptive study.

INTRODUCTION: Peripheral trauma is a very frequent cause of consultation in paediatric emergency departments but few studies have been published describing the characteristics of these patients. MATERIAL AND METHODS: We performed a retrospective descriptive study by reviewing computerised emergency department forms during January and February 2020. OBJECTIVE: To describe the characteristics of traumatic injuries in our area and to detect possible areas for improvement. RESULTS: A total of 714 peripheral trauma cases were attended, which represents 9.5% of the total consultations. A total of 52.7% were schoolchildren (6-11 years). The most frequent locations were the ankle (27.5%) and fingers (17.2%). Fracture was detected in 6.7% of cases. Radiographs were requested in 78.6% of the patients, with pathological findings in 9.6% of them. Half of the X-rays were requested due to ankle or finger trauma. Referral to traumatology was made in 16.4% of patients, mainly for elbow and knee trauma, and the most commonly used treatment was general measures (49%) and bandaging (29.4%). CONCLUSIONS: Peripheral trauma is very common and, in general, banal. A large number of X-rays are requested with a very low yield, so it seems necessary to establish new protocols to reduce the number of requests. Improving training in elbow and knee trauma could improve paediatricians' autonomy in dealing with these more complex injuries.

Peripheral trauma treated in the pediatric emergency department: Descriptive study. / Traumatismos periféricos atendidos en el Servicio de Urgencias Pediátricas. Estudio descriptivo.

INTRODUCTION: Peripheral trauma is a very frequent cause of consultation in paediatric emergency departments but few studies have been published describing the characteristics of these patients. MATERIAL AND METHODS: We performed a retrospective descriptive study by reviewing computerised emergency department forms during January and February 2020. OBJECTIVE: To describe the characteristics of traumatic injuries in our area and to detect possible areas for improvement. RESULTS: A total of 714 peripheral trauma cases were attended, which represents 9.5% of the total consultations. A total of 52.7% were schoolchildren (6-11 years). The most frequent locations were the ankle (27.5%) and fingers (17.2%). Fracture was detected in 6.7% of cases. Radiographs were requested in 78.6% of the patients, with pathological findings in 9.6% of them. Half of the X-rays were requested due to ankle or finger trauma. Referral to traumatology was made in 16.4% of patients, mainly for elbow and knee trauma, and the most commonly used treatment was general measures (49%) and bandaging (29.4%). CONCLUSIONS: Peripheral trauma is very common and, in general, banal. A large number of X-rays are requested with a very low yield, so it seems necessary to establish new protocols to reduce the number of requests. Improving training in elbow and knee trauma could improve paediatricians' autonomy in dealing with these more complex injuries.

Sticholysin II shows similar immunostimulatory properties to LLO stimulating dendritic cells and MHC-I restricted T cell responses of heterologous antigen.

Induction of CD8+ T cell responses against tumor cells and intracellular pathogens is an important goal of modern vaccinology. One approach of translational interest is the use of liposomes encapsulating pore-forming proteins (PFPs), such as Listeriolysin O (LLO), which has shown efficacy at priming strong and sustained CD8+ T cell responses. Recently, we have demonstrated that Sticholysin II (StII), a PFP from the sea anemone Stichodactyla helianthus, co-encapsulated into liposomes with ovalbumin (OVA) was able to stimulate, antigen presenting cells, antigen-specific CD8+ T cells and anti-tumor activity in mice. In the present study, we aimed to compare StII and LLO in terms of their abilities to stimulate dendritic cells and to induce major histocompatibility complex (MHC) class I restricted T cell responses against OVA. Interestingly, StII exhibited similar abilities to LLO in vitro of inducing dendritic cells maturation, as measured by increased expression of CD40, CD80, CD86 and MHC-class II molecules, and of stimulating OVA cross-presentation to a CD8+ T cell line. Remarkably, using an ex vivo Enzyme-Linked ImmunoSpot Assay (ELISPOT) to monitor gamma interferon (INF-γ) producing effector memory CD8+ T cells, liposomal formulations containing either StII or LLO induced comparable frequencies of OVA-specific INF-γ producing CD8+ T cells in mice that were sustained in time. However, StII-containing liposomes stimulated antigen-specific memory CD8+ T cells with a higher potential to secrete IFN-γ than liposomes encapsulating LLO. This StII immunostimulatory property further supports its use for the rational design of T cell vaccines against cancers and intracellular pathogens. In summary, this study indicates that StII has immunostimulatory properties similar to LLO, despite being evolutionarily distant PFPs.

Kinetics of antibodies in sera, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infections.

OBJECTIVES: The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue infection were studied. DESIGN: Serum, saliva, and urine samples were collected from 22 patients with clinical and confirmed dengue 3 virus infection during the outbreak in Havana City in 2001. They were tested by capture IgM (MAC-ELISA), IgA (AAC-ELISA), and IgE (EAC-ELISA) and IgG ELISA inhibition method (EIM) to detect specific dengue antibodies. RESULTS: Similar kinetics were observed in IgM, IgA, and IgG antibodies in saliva and IgA and IgG in urine samples from secondary cases compared with kinetics in serum samples, although the values were lower. No IgG antibody was detected in saliva and urine samples in primary cases and IgM antibody was not detected in urine samples from either primary or secondary infection. All secondary cases were positive for IgG in saliva and urine samples at day 7. The kinetics of specific IgE antibodies in primary and secondary cases were different. CONCLUSIONS: The kinetics of three serological markers (IgM, IgA, and IgG) in serum, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infection were studied for the first time, showing its behavior and usefulness in dengue virus diagnosis. The specific IgE could play a role as a serological marker in secondary infections.

Breast cancer screening: another point of view.

The breast cancer screening programmes (BCSP) are very controversial at the present time. They are evaluated by different socio-economic sectors, each with its own particular point of view. Large numbers of breast cancer cases are concentrated in the Oncology Services, which are, therefore, sensitive to the changes that these programmes could bring about. All patients attending the medical oncology and radiotherapy services of the Reina Sofia University Hospital, Cordoba from January 1994 until January 2003 were reviewed. Of 1785 patients, 829 went to these services after the start of the BCSP introduced in March 1999 and 956 before it. The variables analysed were age, presentation form, stage and treatment received. In conclusion, the BCSP has produced favourable changes with respect to stage (increasing the percentage of early breast cancer) and therapeutic management (increasing conservative surgery and decreasing the number of adjuvant treatments (radiotherapy and chemotherapy)). These changes are more outstanding in the population group covered by the BCSP.

Evaluation of a novel multiplex RT-qPCR assay for the quantification of leukemia-associated BCR-ABL1 translocation.

Although monitoring of BCR-ABL1 translocation has become an established practice in the management of chronic myeloid leukemia (CML), the detection limit of the BCR-ABL1 transcripts needs more standardization. The aim of the present study was to evaluate the clinical performances of a novel assay for the quantification of BCR-ABL1 fusion transcripts (e13a2 and e14a2) and ABL1 in a single reaction. This assay is based on the real-time reverse transcription polymerase chain reaction (RT-qPCR) in multiplex format. In a retrospective comparative clinical study performed in a reference laboratory, RNA was extracted from 48 CML patient blood samples with various BCR-ABL1/ABL1 ratios and RT-qPCR was performed using either MAScIR assay or the RT-qPCR simplex reference assay used in routine clinical testing. The comparative clinical results showed high qualitative and quantitative concordance (correlation coefficient >0.95) between MAScIR and the reference assays. The present study illustrates the utility of MAScIR assay as a sensitive, rapid, and cost-effective quantitative device to monitor the BCR-ABL1 ratios by RT-qPCR on whole blood of diagnosed Philadelphia chromosome-positive (Ph+) leukemia patients. This test could be used as an aid in the assessment of molecular response to available treatments.

Lung metastases in oligometastatic patients: outcome with stereotactic body radiation therapy (SBRT).

PURPOSE: To assess the clinical results in terms of local control, toxicity, failure pattern and toxicity of SBRT in oligometastatic patients with inoperable lung metastases. METHODS: Forty-four patients were treated (53 metastases). Dose regimen: 5 × 12 Gy (66 %), 8 × 7.5 Gy (20.8 %) and 10 × 5 Gy (13.2 %). Response was assessed using PET/CT at 6 months after SBRT. RESULTS: Local control at 1 and 2 years was 86.7 %. Seventy-five percent of local failures had received a BED <105 Gy. After a median follow-up of 13.3 months, 25 % experienced distant progression. Overall survival at 1 and 2 years was 86.7 and 60.4 %, and cancer-specific survival was 95.3 and 75.2 %, respectively. Grade 2 toxicity was 6.8 %. There was no grade 3-4 toxicity. CONCLUSION: SBRT is effective and safe. The main failure pattern is distant progression. The selection of patients with a high probability of remaining oligometastatic is crucial for the efficiency of SBRT, both clinically and in terms of resources.

Lung metastases in oligometastatic patients: outcome with stereotactic body radiation therapy (SBRT)

Purpose. To assess the clinical results in terms of local control, toxicity, failure pattern and toxicity of SBRT in oligometastatic patients with inoperable lung metastases. Methods. Forty-four patients were treated (53 metastases). Dose regimen: 5 × 12 Gy (66 %), 8 × 7.5 Gy (20.8 %) and 10 × 5 Gy (13.2 %). Response was assessed using PET/CT at 6 months after SBRT. Results. Local control at 1 and 2 years was 86.7 %. Seventy-five percent of local failures had received a BED <105 Gy. After a median follow-up of 13.3 months, 25 % experienced distant progression. Overall survival at 1 and 2 years was 86.7 and 60.4 %, and cancer-specific survival was 95.3 and 75.2 %, respectively. Grade 2 toxicity was 6.8 %. There was no grade 3–4 toxicity. Conclusion. SBRT is effective and safe. The main failure pattern is distant progression. The selection of patients with a high probability of remaining oligometastatic is crucial for the efficiency of SBRT, both clinically and in terms of resources (AU)

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Functional maturation of adult mouse resting microglia into an APC is promoted by granulocyte-macrophage colony-stimulating factor and interaction with Th1 cells.

A precise knowledge of the early events inducing maturation of resting microglia into a competent APC may help to understand the involvement of this cell type in the development of CNS immunopathology. To elucidate whether signals from preactivated T cells are sufficient to induce APC features in resting microglia, microglia from the adult BALB/c mouse CNS were cocultured with Th1 and Th2 lines from DO11.10 TCR transgenic mice to examine modulation of APC-related molecules and Ag-presenting capacity. Upon Ag-specific interaction with Th1, but not Th2, cells, microglia strongly up-regulated the surface expression of MHC class II, CD40, and CD54 molecules. Induction of CD86 on mouse microglia did not require T cell-derived signals. Acutely isolated adult microglia stimulated Th1 cells to secrete IFN-gamma and, to a lesser extent, IL-2, but were inefficient stimulators of IL-4 secretion by Th2 cells. Microglia exposed in vitro to IFN-gamma showed enhanced expression of MHC class II, CD40, and CD54 molecules and became able to restimulate Th2 cells. In addition to IFN-gamma, GM-CSF increased the ability of microglia to activate Th1, but not Th2, cells without up-regulating MHC class II, CD40, or CD54 molecules. These results suggest that interaction with Th1 cells and/or Th1-secreted soluble factors induces the functional maturation of adult mouse microglia into an APC able to sustain CD4+ T cell activation. Moreover, GM-CSF, a cytokine secreted by T cells as well as reactive astrocytes, could prime microglia for Th1-stimulating capacity, possibly by enhancing their responsiveness to Th1-derived signals.

Intracerebral regulation of immune responses.

Major progress has been made over the last years in our understanding of the mechanisms underlying immune privilege and immune surveillance of the central nervous system (CNS). Once considered a passive process relying only on physical barriers, immune privilege is now viewed as a more complex phenomenon, which involves active regulation of immune reactivity by the CNS microenvironment. Evidence has also emerged that the immune system continuously and effectively patrols the CNS and that dysregulated immune responses against CNS-associated (exogenous or self) antigens are involved in the pathogenesis of various neurological diseases. In this article we shall briefly review current knowledge of how the immune response is regulated locally in the CNS and which cell types and molecular mechanisms are involved in shaping intracerebral immune responses.

Relative efficiency of microglia, astrocytes, dendritic cells and B cells in naive CD4+ T cell priming and Th1/Th2 cell restimulation.

We have compared the efficiency of central nervous system and peripheral antigen-presenting cells (APC) in T cell priming and restimulation. OVA peptide 323 - 339-dependent activation of DO11.10 TCR-transgenic naive CD4+ and polarized Th1 or Th2 cells was assessed in the presence of microglia and astrocytes from the neonatal mouse brain as well as dendritic cells (DC) and B cells purified from adult mouse lymph nodes. DC were the most efficient in inducing naive T cell proliferation, IL-2 secretion and differentiation into Th1 cells, followed by IFN-gamma-preactivated microglia, large and small B cells. Astrocytes failed to activate naive T cells. IFN-gamma-pretreated microglia were as efficient as DC in the restimulation of Th1 cells, whereas IFN-gamma-pretreated astrocytes, large and small B cells were much less efficient. Conversely, Th2 cells were efficiently restimulated by all the APC types examined. During T cell priming, DC secreted more IL-12 than microglia but similar amounts of IL-12 were secreted by the two cell types upon interaction with Th1 cells. The hierarchy of APC established in this study indicates that DC and microglia are the most efficient in the stimulation of naive CD4(+) T cells and in the restimulation of Th1 cells, suggesting that activated microglia may effectively contribute to Th1 responses leading to central nervous system inflammation and tissue damage. These potentially pathogenic responses could be counteracted by the high efficiency of astrocytes as well as microglia in restimulating Th2 cells.

Intracerebral recruitment and maturation of dendritic cells in the onset and progression of experimental autoimmune encephalomyelitis.

Dendritic cells (DCs) are thought to be key elements in the initiation and maintenance of autoimmune diseases. In this study, we sought evidence that DCs recruited to the central nervous system (CNS), a site that is primarily devoid of resident DCs, play a role in the effector phase and propagation of the immune response in experimental autoimmune encephalomyelitis (EAE). After immunization of SJL mice with proteolipid protein 139-151 peptide, process-bearing cells expressing the DC markers DEC-205 and CD11c appeared early in the spinal cord. During acute, chronic, and relapsing EAE, DEC-205(+) DCs expressing a lymphostimulatory phenotype (including the mature DC marker MIDC-8, major histocompatibility complex class II, CD40, and CD86 molecules) accumulated within the CNS inflammatory cell infiltrates. More prominent infiltration of the spinal cord parenchyma by mature DCs was observed in mice with relapsing disease. Macrophage inflammatory protein 3alpha, a chemokine active on DCs and lymphocytes, and its receptor CCR6 were up-regulated in the CNS during EAE. These findings suggest that intracerebral recruitment and maturation of DCs may be crucial in the local stimulation and maintenance of autoreactive immune responses, and that therapeutic strategies aimed at manipulating DC migration could be useful in the treatment of CNS autoimmune disorders.

Opposite effects of interferon-gamma and prostaglandin E2 on tumor necrosis factor and interleukin-10 production in microglia: a regulatory loop controlling microglia pro- and anti-inflammatory activities.

Following brain injury, microglial cells produce pro- and anti-inflammatory cytokines, such as tumor necrosis factor (TNF) and interleukin-10 (IL-10). IL-10 provides an efficient autocrine mechanism for controlling microglia activation. To elucidate the mechanisms that regulate the cytokine profile of microglia, we examined the effects of several immunomodulators on IL-10 and TNF production by cultured mouse microglia. Lipopolysaccharide (LPS) was the only inducer of IL-10 and TNF gene expression and secretion. The T helper 1-type cytokine interferon-gamma (IFN-gamma) induced TNF transcripts, but not TNF secretion, and suppressed LPS-induced IL-10 mRNA and secretion by microglia. Opposite to IFN-gamma, the lipid mediator prostaglandin E2 (PGE2) enhanced the LPS-induced production of IL-10 and inhibited that of TNF. The effects of PGE2 on cytokine gene expression and secretion were antagonized by IFN-gamma. Agents that increase cAMP levels mimicked the action of PGE2 on cytokine secretion, indicating the involvement of cAMP-coupled prostaglandin receptors. In conclusion, IFN-gamma and PGE2, two mediators released at inflammatory sites, differentially regulate the production of a proinflammatory and an anti-inflammatory cytokine in microglia. We suggest that the activity and role of microglia in the damaged CNS could be finely tuned by the local concentration ratio of these mediators.

Radiotherapy in rectal cancer: development, adequacy and radiotherapy utilisation rate. A comparative analysis with the most frequent tumour sites

INTRODUCTION: Radiotherapy is a basic weapon in the local treatment of multiple solid tumors. The radiotherapy activity has been evaluated in our centre during the past eleven years. The study focused on rectal cancer. MATERIALS AND METHODS: This is a descriptive study of all radiotherapy procedures performed between January 1998 and December 2008. It quantifies the workload of each pathology treated, the rate of irradiation and its adequacy with optimal rates of irradiation according to the best available scientific evidence. RESULTS: We quantified 9,622 external radiotherapy procedures of which 6,009 were associated with the five pathologies that involved the highest workloads. Of these, 905 were performed in rectal cancer. The workloads due to cancers of the breast, prostate, lung, gynaecological pathologies and rectal cancers were 23.2%, 11.8%, 11.6%, 6.3% and 9.3% respectively. The real "radiotherapy utilisation rates" of these pathologies were 62%, 20.2%, 34.3%, 21% and 64% respectively, while the "rates of adequacy" were 74.7%, 33.6%, 45.1%, 60% and 104.8%. CONCLUSIONS: The "radiotherapy utilisation rate" for rectal cancer was equivalent to the estimated optimum rate as defined on the basis of reference groups. The therapy utilised developed chronologically in parallel with the available scientific evidence. The radiotherapy utilisation rates for breast and prostate cancer gradually increased, with a tendency to reach optimal rates. Radiotherapy as a treatment for lung cancer was underutilised. In global terms, the rate of utilisation of radiation therapy was low, although it displayed a tendency to increase (AU)

Niveles de resistencia a drogas antituberculosas en pacientes con coinfección VIH / tuberculosis, Lima 1998-2001 / Resistance rates to antituberculous drugs in patients co-infected with the human immunodeficiency virus and tuberculosis, Lima 1998-2001

Objetivos: Determinar los niveles de resistencia a drogas antituberculosas de primera línea en muestras clínicas depacientes con coinfección por el virus de la inmunodeficiencia humana y tuberculosis (VIH-TB) en cinco hospitales deLima en el periodo 1998-2000. Materiales y métodos: Estudio descriptivo que incluyó las muestras de cultivos deMycobacterium tuberculosis de pacientes con coinfección VIH-TB, a los que se realizó las pruebas de sensibilidad porel método de las proporciones para isoniacida (H), estreptomicina (S), etambutol (E) y rifampicina (R), y el método deWayne para pirazinamida (H). Resultados: De 523 muestras de pacientes incluidos, 78,2 por ciento correspondieron a varones,72,7 por ciento fueron de pacientes sin antecedentes de tratamiento previo. Los valores de resistencia global primaria ymultidrogorresistencia (MDR) primaria fueron 55,8 por ciento y 32,1 por ciento, respectivamente; en tanto que los valores de resistenciaglobal adquirida y MDR adquirida fueron 93,0 por ciento y 74,8 por ciento. La resistencia primaria por drogas fue H (42,1 por ciento), R (35,0 por ciento),S (35,3 por ciento), E (19,0 por ciento) y Z (24,5 por ciento) respectivamente; y la resistencia adquirida por drogas fueron H (85,3 por ciento), R (78,3 por ciento),S (64,4 por ciento), E (42,0 por ciento) y Z (46,2 por ciento). Conclusión: Los niveles resistencia a drogas antituberculosas y la MDR en pacientescon coinfección VIH-TB provenientes de hospitales de Lima son elevados

Objective: To determine resistance rates to first-line antituberculous drugs in clinical samples from patients co-infected with the human immunodeficiency virus (HIV) and M. tuberculosis (TB) in five hospitals in Lima between 1998–2000. Materials and methods: A descriptive study including samples sent for culturing Mycobacterium tuberculosis in patients co-infected with HIV-TB. Susceptibility tests for isoniazid (H), streptomycin (S), ethambutol (E), and rifampin (R) were performed using the proportion method and Wayne’s method for pyrazinamide (Z). Results: Out of 523 samples, 78,2% were from male patients, and 72,7% were from naive patients. Overall primary resistance and multidrug-resistance (MDR) rates were 55,8% and 32,1%, respectively; and overall acquired resistance and MDR rates were 93,0% and 74,8%, respectively. Primary resistance rates were: H, 42,1%; R, 35,0%; S, 35,3%; E, 19.0%, and Z, 24,5%, respectively; and acquired resistance rates were: h, 85,3%; R, 78,3%; S, 64,4%; E, 42,0%; and Z, 46,2%. Conclusion: There are high resistance rates to antituberculous drugs and MDR TB in patients co-infected with HIV and TB in Lima hospitals.

Hiperendemicidad de hepatitis viral B y delta en pueblos indígenas de la Amazonía Peruana / Hyperendemicity of viral hepatitis B and delta in indigenous populations in te Peruvian Amazon jungle

Objetivos: Determinar la prevalencia de marcadores serológicos de hepatitis viral B y delta en pueblos indígenas de laAmazonía, así como su distribución en las diferentes cuencas y cuales son los factores de riesgo asociados. Materialesy métodos: Se realizó un estudio transversal en 870 pobladores de 37 comunidades nativas distribuidas en 12 cuencasde la Amazonía peruana. Se obtuvieron datos epidemiológicos en relación a hepatitis viral B y delta y una muestrade sangre venosa para determinar la presencia de HBsAg, HBeAg, anticuerpos totales anti-HBcAg, IgM Anti-HBcAg,Anti-HBeAg y anti delta usando la técnica de ELISA. Resultados: La edad promedio fue de 22,7 años (1-94 a), 50,7 por ciento(441/870) fueron varones. Se determinó infección previa por HVB en 519 (59,7 por ciento) e infección reciente en 16 (1,8 por ciento). Seencontraron 82 portadores de HBsAg (9,4 por ciento) de estos 18 (21,9 por ciento) tenían HBeAg positivo, y 15 (83,3 por ciento) eran varones.44,2 por ciento de los menores de diez años tenían antecedente de infección. 39 por ciento(32/82) de los portadores de HBsAg teníainfección por HVD. Fue mayor la prevalencia de HVB en nativos (64,3 por ciento) que en mestizos (50,6 por ciento); así como en lascuencas de la selva norte (73 por ciento) que en las de centro y sur (42 por ciento). La infección por HVB se encontró asociada con elconsumo de masato (OR: 4,9; IC95 por ciento: 3,4-7,4) y al antecedente de mordedura por murciélago (OR: 1,7; IC95 por ciento: 1,2-2,4).No se encontró diferencias significativas con relación al sexo. Conclusiones: La población indígena y mestiza de lasdiferentes cuencas de la Amazonía peruana es hiperendémica para la infección por hepatitis viral B y delta

Objective: To determine the prevalence of serological markers for viral hepatitis B and delta in indigenous communities in the Peruvian Amazon jungle, as well as their distribution in the different river basins and what are the associated risk factors. Materials and methods: A cross-sectional study was performed in 837 inhabitants from 37 native communities distributed alongside 12 river basins in the Peruvian Amazon jungle. Epidemiological data were obtained with respect to the presence of viral hepatitis B and delta, and a venous blood sample was taken in order to determine HBsAg, HBeAg, total anti-HBcAg anti-HBcAg IgM, and anti-delta antibodies using an ELISA technique. Results: Average age in the studied population was 22,7 years (range 1–94 years), and 50,/% were male. Previous infection caused by hepatitis B virus was determined in 519 (59,7%) subjects, and a recent infection was detected in 16 (1,8%) subjects. 82 HBsAg carriers were found (9,4%); of them, 18 (21,9%) were positive for HBeAg, and 15 (3,3%) were male. 44,2% of subjects less than ten years old had past history of infection. 39% (32/82) of HBsAg carriers had also hepatitis delta virus infection. The prevalence of HBV was higher in natives (64,3) compared to that in mestizos (50,6%); as well in northern jungle river basins (73%) compared to findings in central and southern areas (42%). HBV infection was associated with masato (liquor made of yucca) use (OR: 4,9; 95% CI: 3,4 – 7,4) and with history of being bitten by bats (OR: 1,7; 95% IC: 1,2 – 2,4). There were no significant differences with respect to sex distribution. Conclusions: Viral hepatitis B and delta is hyperendemic in indigenous and mestizo populations in different river basins in Peruvian Amazon jungle.

Aislamiento y mantenimiento in vitro de Plasmodium falciparum

Se aislaron 08 cepas de Plasmodium falciparum a partir de 10 pacientes. Luego fueron adaptadas y mantenidas en cultivo in vitro durante 60 días en eritrocitos humanos grupo O, en medio RPMI 1640 enriquecido con plasma humano grupo O, bajo una atmósfera de 5% de CO2, 5% de O2 y 90% de Nitrógeno y luego preservados a -70ºC.

Eight strains of Plasmodieum Flaciparum, were isolated from 10 patients. They were adapted and mantained in culture during 60 days using human red celis, group O, RPMI 16 40 medium and human plasma, group O, under 5% oxigen and 90% Nitrigen mixed gases. Finally, they were preserved at -70º C.

Determinación de Anticuerpos IgM contra Virus dengue partir de sangre absorbida en papel filtro: Un método alternativo y sencillo

Objetivo: Se propone como alternativa la obtención de muestras de sangre total en papel filtro, para la determinación de anticuerpos IgM contra dengue, por ser un método de recolección sencillo y no requerir de muchos cuidados en el envío al laboratorio. Materiales y métodos: De 100 pacientes con diagnóstico clínico de dengue clásico, se obtuvieron en forma simultánea, muestras de suero en tubos al vacío y de sangre total en papel filtro. Ambas muestras fueron evaluadas con el método serológico ELISA Captura de IgM a los 30 días de obtenida la muestra. Resultados: De las 100 muestras 25 fueron positivas y 75 negativas en suero, y 24 positivas y 74 negativas en papel filtro. Se obtuvo una concordancia por índice Kappa de 0,97, sensibilidad y especificidad de 96,0% y 98,0% respectivamente; el valor predictivo positivo fue 96,0%, y valor predictivo negativo fue 98,0%. Conclusión: Se evidencia muy buena sensibilidad, especificidad y concordancia en la determinación de IgM contra dengue, al utilizar papel filtro en la obtención de muestra de sangre.

Objective: This study proposes the use of filter paper, in whole blood samples to test for Dengue, as an alternate method, due to the fact that it is very simple and does not require of much detail for shipping samples to the laboratory. Materials and Methods: Using vacutainers and filter papers, whole blood sample obtained simultaneously from 100 patients diagnosed as classic dengue. All samples were tested using IgM capture ELISA. Findings: Out of 100 samples, 25 were positive and 75 were negative in sera, in filter paper 24 positive and 74 negative, with a Kappa concordance index of 0,97 and a sensitivity and specificity of 96,0% and 98,0% respectively: the positive predictive value was 96.0% and the negative predictive value was 98,0%. Conclusions: A very good sensitivity, specificity and concordance in the determination of IgM antibodies against Dengue is evidenced using filter paper when obtaining blood samples.

Equipamiento y perspectivas de futuro de la Radioterapia Oncológica. Situación española / Equipment and Outlook for Radiotherapy Oncology. The situation in Spain

Durante la última década la radioterapia ha presentado un desarrollo tecnológico y radiobiológico exponencial. La aplicación clínica del avance en conocimientos biológicos es todavía escasa pero se augura un gran potencial de mejora en resultados terapéuticos. La evolución tecnológica está consiguiendo optimizar la distribución de la dosis en los volúmenes irradiados y conseguir tratamientos menos tóxicos. Hasta la fecha se desconoce la exacta repercusión del mejor control local tumoral sobre la supervivencia de la enfermedad. El nivel de desarrollo tecnológico español era escaso en 1999. La dotación actual es sin duda superior en parte fruto de la evidente infradotación explicita en el inventario practicado por la Asociación Española de Radioterapia y Oncología en los años 1999-2000 y cuyos datos se resumen (AU)

The authors of this paper describe the advances Radiotherapy has brought to this country over the last decade. They discuss the technological developments which are allowing radiation volume dosing to be optimized, leading to less toxic treatment (AU)