Programa de intervención psicológica para potenciar el afrontamiento activo en pacientes con dolor crónico de la espalda / Psychological intervention program to promoted active coping in patients with chronic back pain

Objetivo: Evaluar la efectividad de un programa de intervención psicológica para potenciar al afrontamiento activo en pacientes con dolor crónico de la espalda.Material y método: Es una investigación de desarrollo tecnológico que parte de la metodología establecida para el diseño y evaluación de programas. Se llevó a cabo un diseño cuasi-experimental de comparación de grupos, pretest y postest con grupo de estudio y testigo. El estudio se realizó en el Hospital “Dr. Gustavo Aldereguía Lima” de la provincia de Cienfuegos, Cuba, de julio a noviembre de 2020. Se utilizó un muestreo intencional, no probabilístico casual o a conveniencia de participantes voluntarios, quedando conformada la muestra por 60 pacientes. Las variables estudiadas fueron las estrategias de afrontamiento, el autocuidado, las alteraciones emocionales y la discapacidad funcional. El análisis estadístico de la información se realizó en el paquete estadístico SPSS. Se utilizó la prueba de los rangos con signo de Wilcoxon para muestras relacionadas y la prueba de Mann-Whitney para realizar comparación de muestras independientes intergrupos (diferencias entre Grupo Estudio y Grupo Testigo después de la intervención). Se establece un error α de tipo 1 = 0,05. Para ello se trabajó con hipótesis nula.Resultados: Los resultados permiten afirmar que los indicadores más favorecidos por el programa de intervención fueron las estrategias de afrontamiento, el autocuidado y la discapacidad funcional, mientras que las alteraciones emocionales disminuyeron en menor frecuencia.Conclusiones: El programa de intervención psicológica implementado demostró ser efectivo para potenciar el afrontamiento activo en los pacientes con dolor crónico de la espalda, en tanto logró promover el uso de estrategias activas, estimular el autocuidado de la salud, disminuir las alteraciones emocionales y favorecer la capacidad funcional del paciente en las distintas esferas de la vida cotidiana.(AU)

Objective: To evaluate the effectiveness of a psychological intervention program to promote active coping in patients with chronic back pain.Material and method: It is a research of technological development that starts from the methodology established for the design and evaluation of programs. A quasi-experimental design of comparison of groups, pre-test and post-test with study and control group was carried out. The study was conducted at the Hospital “Dr. Gustavo Aldereguía Lima” from the province of Cienfuegos, Cuba, from July to November 2020. Intentional, non-probabilistic casual sampling or at the convenience of volunteer participants was used, the sample being made up of 60 patients. The variables studied were coping strategies, self-care, emotional disturbances and functional disability. The statistical analysis of the information was carried out in the statistical package SPSS. The Wilcoxon signed rank test was used for related samples and the Mann-Whitney test to compare independent samples between groups (differences between the Study Group and the Control Group after the intervention). An error α of type 1 = 0.05 is established. For this, the null hypothesis was used.Results: The results allow us to affirm that the indicators most favored by the intervention program were coping strategies, self-care and functional disability, while emotional disturbances decreased less frequently.Conclusions: The implemented psychological intervention program proved to be effective in promoting active coping in patients with chronic back pain, as it was able to promote the use of active strategies, stimulate self-care of health, reduce emotional disturbances and favor recovery functional capacity of the patient in the different spheres of daily life.(AU)

[Validation of the Oswestry disability scale for low back pain in patients with chronic back pain. Cienfuegos, 2017-2018]. / Validación de la escala de incapacidad por dolor lumbar de Oswestry, en paciente con dolor crónico de la espalda. Cienfuegos, 2017-2018.

INTRODUCTION: A large number of patients have chronic back pain, producing disability. Consequently, there is a need to validate instruments for pain measurement. The aim of this study was to determine the validity and reliability of the Oswestry Disability Scale for Low Back Pain in the population with chronic back pain in Cienfuegos. MATERIAL AND METHOD: The investigation consisted of the development of an instrument to validate the scale through content validity, construct validity and reliability analysis. The validation included linguistic and cultural adaptation of the instrument. The study was conducted at the Dr. Gustavo Aldereguía Lima University Hospital in Cienfuegos, Cuba, from September 2017 to October 2018. Systematic randomised sampling was used. The sample included 162 patients. The statistical analysis was performed with the SPSS statistical package. RESULTS: The experts considered that the instrument should remain unchanged. Factorial analysis identified the presence of three intercorrelated factors that represented 63% of the total. A global Cronbach α of 0.801 was obtained and the temporal stability of the instrument was demonstrated. CONCLUSIONS: The results confirm the validity and reliability of the Oswestry Disability Scale for Low Back Pain in the Cienfuegan population with chronic back pain.

[Morphological and dimensional changes of the magnetic resonance imaging in the carpal tunnel (pre- and postoperatively)]. / Cambios morfológicos y dimensionales en el túnel del carpo por resonancia magnética (preoperatorios y postoperatorios).

INTRODUCTION: Carpal tunnel syndrome is the most common compression neuropathy of the upper limb, and the release of the median nerve is the surgical treatment that is carried out. There are several surgical techniques used to treat this condition; However, this virtual cavity, which we call the carpal tunnel, undergoes several morphological and dimensional changes, prior to surgery and after surgery using the various techniques that the surgeon has a predilection for. MATERIAL AND METHODS: Observational, prospective and longitudinal study conducted in the period from March to November 2009. We studied patients of both sex, with a diagnosis of carpal tunnel syndrome, who underwent MRI pre and post-surgery studies, to which measurements and analysis of it were made. RESULTS: We evaluated 25 patients with an average of 40 years, 14 female patients and 11 male, finding a palmar displacement of the nerve after surgery with a diameter of 6.2 mm, maintaining changes from the oval to a circular shape. DISCUSSION: There are morphological and dimensional changes, evaluated by magnetic resonance after the release, for which the favorable clinical response after surgery is related; however, we found a larger diameter of the nerve due to the fact that they underwent neurolysis.

INTRODUCCIÓN: El síndrome del túnel de carpo es la neuropatía por compresión más frecuente de la extremidad superior y la liberación del nervio mediano es el tratamiento quirúrgico que se aplica. Existen diversas técnicas quirúrgicas que se utilizan para tratar este padecimiento; sin embargo, esa cavidad virtual a la que llamamos túnel del carpo sufre diversos cambios morfológicos y dimensionales previo y posterior a la cirugía con el uso de diversas técnicas que el cirujano elige. MATERIAL Y MÉTODOS: Estudio observacional, prospectivo y longitudinal realizado en el período comprendido de Marzo a Noviembre de 2009. Se estudiaron pacientes de ambos sexos con diagnóstico de síndrome del túnel del carpo, a los cuales se les realizaron estudios de resonancia magnética antes y después de la cirugía para obtener mediciones y análisis. RESULTADOS: Se evaluaron 25 pacientes con una media de 40 años, 14 pacientes femeninos y 11 masculinos, encontrándose un desplazamiento palmar del nervio posterior a la cirugía con un diámetro de 6.2 mm manteniendo cambios de la forma oval a una circular. DISCUSIÓN: Existen cambios morfológicos y dimensionales evaluados por resonancia magnética después de la liberación, por lo cual se relaciona la respuesta clínica favorable posterior a la cirugía; sin embargo, encontramos un diámetro mayor del nervio, esto debido a que se les realizó neurólisis.

In vitro and in vivo genotoxicity assessment of gold nanoparticles of different sizes by comet and SMART assays.

Due to the increasing use of gold nanoparticles (AuNPs) in different areas such as medicine, biotechnology or food sector, human exposure to them has grown significantly and its toxicity evaluation has become essential. Therefore, the purpose of this study was to compare the potential genotoxic effects of 30, 50 and 90 nm AuNPs, using in vitro comet assay with the in vivo mutagenic and recombinogenic activity (SMART Test) in Drosophila. The results indicated that in both cell lines, 30, 50 and 90 nm (1-10 µg ml-1) AuNPs increased DNA strand breaks following 24 h treatment. This damage was not dose and size-dependent. Moreover, a modified comet assay using endonuclease III and formamidopyrimidine-DNA glycosylase restriction enzymes showed that in both cell lines, pyrimidines and purines were oxidatively damaged by all AuNPs, being 90 nm AuNPs slightly more genotoxic. However, the data obtained with SMART showed that 30 nm AuNPs did not modify the spontaneous frequencies of spots indicating lack of mutagenic and recombinogenic activity. Therefore, further experiments must be carried out to gain a better understanding of the mechanism of action of AuNPs to ensure their safe use.

Coinfection of Avibacterium paragallinarum and Ornithobacterium rhinotracheale in Chickens from Peru.

The coinfection of Avibacterium paragallinarum and Ornithobacterium rhinotracheale in two outbreaks of infectious coryza from Peru is reported. The diagnosis was confirmed by bacteriologic isolation, PCR testing, and sequencing of the 16S rRNA gene. The susceptibility of the isolates to 12 antimicrobial agents was tested by a disk diffusion method. The isolates were susceptible to amoxicillin/clavulanic acid and florfenicol and were resistant to oxacillin and sulfamethoxazole/trimethoprim. The coinfection of Av. paragallinarum and O. rhinotracheale and the severity of clinical signs were evaluated by experimental infection of specific-pathogen-free chickens. The group inoculated with O. rhinotracheale alone presented minimal clinical signs in 3 of 10 chickens. However, the groups inoculated with both Av. paragallinarum and O. rhinotracheale induced the most-severe clinical signs compared with the group inoculated with Av. paragallinarum alone. In conclusion, coinfections with Av. paragallinarum and O. rhinotracheale may occur, and these outbreaks could be more severe than single infections. Hence, the prevention, control, and diagnosis of Av. paragallinarum with O. rhinotracheale are important in outbreaks of infectious coryza.

REPRODUCTIVE ACTIVITY AFTER INDUCED ANESTRUS USING ALTRENOGEST IN Tursiops truncatus FEMALES IN CAPTIVITY IN MARINE ENVIRONMENT / ACTIVIDAD REPRODUCTIVA DESPUÉS DEL ANESTRO INDUCIDO CON ALTRENOGEST EN HEMBRAS DE Tursiops truncatus EN CAUTIVERIO EN AMBIENTE MARINO

Interest to reproduce Bottlenose dolphin (Tursiops truncatus) in captivity has increased due to the international restrictions for its commercialization and the risks and logistical difficulties for transporting specimens. Therefore, it has become important to study its reproductive biology in captivity. The objective of the present study was to determine altrenogest (Regumate ®) post-treatment indicators of vaginal cytology, estradiol levels and restarting of reproductive activity of T truncatus females in captivity in marine environment. Twelve females received altrenogest at a daily dose of 0.07mg kg-1 for a year. A total 420 slides of vaginal cytology of each female were performed to determine the percentage of cornified cells. Also, 60 blood samples of each animal were analyzed to determine estradiol levels. Regarding the vaginal cytology; percentage of cornified cells increased between 60 and 70% from day 4 to day 9 after removing the altrenogest treatment and between 70 and 80% from day 12 to day 19. Estradiol levels were in the range of 16 to 1l4pg ml-1 during the entire monitoring period. A positive correlation (r = 0.7062; P<0.05) was found between these indicators. Therefore, we conclude that treatment with altrenogest and monitoring the estrous cycle with simple techniques such as vaginal cytology might be used for designing protocols for assisted reproduction for groups of T truncatus in captivity.

La necesidad de reproducir delfín nariz de botella (Tursiops truncatus) en cautiverio se ha incrementado debido a las restricciones internacionales para su comercialización y por el riesgo y dificultad logística para el traslado de ejemplares. Por lo anterior, se hace importante conocer su biología reproductiva en cautiverio. El objetivo de este trabajo, fue conocer los indicadores post tratamiento con altrenogest (Regumate®), de citología vaginal, niveles de estradiol y reinicio de la actividad reproductiva en cautiverio de hembras de T truncatus en ambiente marino. Por un año, 12 hembras recibieron diariamente una dosis de 0,07mg kg-1 de altrenogest. Se realizaron un total 420 citologías vaginales, una diaria de cada hembra, para determinar el porcentaje de células cornificadas. También se obtuvieron de la red vascular, 60 muestras sanguíneas, en las que se determinó los niveles de estradiol. En cuanto a la citología vaginal, al cuarto día de retirar la administración de altrenogest, el porcentaje total de células cornificadas incrementó del 60% a 70% hasta el día nueve y continuó ascendiendo al 80% entre los días 12 al 19. Los niveles de estradiol, presentaron un rango de 16 a 114pg ml-1. Se encontró una correlación (r = 0,7062 P<0.05) positiva entre estos indicadores. Se concluye que es posible la manipulación con altrenogest y el monitoreo del ciclo estral de las hembras mediante técnicas simples como la citología vaginal para el diseño de protocolos de reproducción asistida específicos para grupos en cautiverio de T truncatus.

Manufactured silver nanoparticles of different sizes induced DNA strand breaks and oxidative DNA damage in hepatoma and leukaemia cells and in dermal and pulmonary fibroblasts.

Many classes of silver nanoparticles (AgNPs) have been synthesized and widely applied, but no conclusive information on their potential cytotoxicity and genotoxicity mechanisms is available. Therefore, the purpose of this study was to compare the potential genotoxic effects (DNA strand breaks and oxidative DNA damage) of 4.7 nm coated and 42 nm uncoated AgNPs, using the comet assay, in four relevant human cell lines (hepatoma, leukaemia, and dermal and pulmonary fibroblasts) in order to understand the impact of such nanomaterials on cellular DNA. The results indicated that in all cell lines tested, 4.7 nm coated (0.1-1.6 µg ml⁻¹) and 42 nm uncoated (0.1-6.7 µg ml⁻¹) AgNPs increased DNA strand breaks in a dose- and size-dependent manner following 24 h treatment, the smaller AgNPs being more genotoxic. Human pulmonary fibroblasts showed the highest sensitivity to the AgNPs. A modified comet assay using endonuclease III and formamidopyrimidine- DNA glycosylase restriction enzymes showed that in tumoral and normal human dermal fibroblasts, pyrimidines and purines were oxidatively damaged by both AgNPs, but the damage was not size-dependent. However, in human pulmonary fibroblasts, no oxidative damage was observed after treatment with 42 nm AgNPs. In conclusion, both AgNP sizes induced DNA damage in human cells, and this damage could be related to oxidative stress.

Parámetros hemaoológicos en polluelos de psitácidos en cautiverio de origen silvestre / Hematologial parrameters of wild parrot chicks kept in captivity

El objetivo de este estudio fue describir los parámetros hematológicos en 69 polluelos en cautiverio de origen silvestre, clínicamente sanos, menores de tres meses de edad, en cuatro especies de psitácidos: Pionus senilis (n = 18), Amazona albifrons (n = 15), Amazona autumnalis (n = 25) y Amazona oratrix (n = 11), procedentes de la región central de México. Para determinar dichos parámetros, de cada ejemplar se obtuvieron 500 µl de sangre por punción de la vena braquial. En las cuatro especies citadas, el porcentaje del hematocrito fue de 56,4 ± 3,36; 51 ± 6,52; 47,6 ± 6,47 y 53,8 ± 9,26; el VCM en fl fue de 184,6 ± 13,4; 142,0 ± 25,4; 106,3 ± 11,7 y 162,3 ± 71,9; la cuenta eritrocítica fue de 4,7 ± 2,1 x10(6)/µl; 6,1 ± 8,2 x10(6)/µl; 6,9 ± 1,2 x10(6)/µl y 5,4 ± 1,1 x10(6)/µl; y la cuenta leucocitaria de 3,06 ± 0,15 x10³/µl; 3,62 ± 0,24 x10³/µl; 4,48 ± 0,36 x10³/µl y 3,56 ± 0,71 x10³/µl respectivamente para P. senilis, A. albifrons, A. autumnalis y A. oratrix. Se constató tendencia a la heterofilia en A. albifrons y A. oratrix, lo cual puede ser de gran utilidad para un diagnóstico cada vez más preciso en la clínica de aves en cautiverio.

The aim of this study, conducted in central Mexico, was to describe the hematological parameters in 69 wild chicks of psittacine kept in captivity, younger than three months of age of four different species: Pionus senilis (n = 18), Amazona albifrons (n = 15), Amazona autumnalis (n = 25) and Amazona oratrix (n = 11). All parrots were sampled to obtaind 500 µl of blood for quantifying hematological parameters. Hematocrit percentage was 56.4 ± 3.36, 51 ± 6.52, 47.6 ± 6.47 and 53.8 ± 9.26; the MCV (fl) was 184.6 ± 13.4, 142.0 ± 25.4, 106.3 ± 11.7 and 162.3 ± 71.9; the erythrocyte count was, 4.7 ± 2.1x10(6)/μl, 6.1 ± 8.2 x10(6)/μl, 6.9 ± 1.2 x10(6)/μl and 5.4 ± 1.1 x10(6)/μl, and leukocyte count was of 3.06 ± 0.15 x10³/µl, 3.62 ± 0.24 x10³/µl, 4.48 ± 0.36 x10³/µl y 3.56 ± 0.71 x10³/µl respectively for P. senilis, A. albifrons, A. autumnalis y A. oratrix. There was a trend to heterophilia in A. oratrix and A. albifrons, which represents a contribution that may be useful for more precise diagnosis in avian clinical practice.

Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia.

BACKGROUND: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). METHODS: A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. RESULTS: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91). CONCLUSION: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.

Incidence of pneumococcal infections among children under 15 years in southern Catalonia throughout the heptavalent conjugate vaccine era, 2002-2009.

PURPOSE: Updating epidemiological studies to document current incidences of pneumococcal diseases are greatly needed in the current era of new pneumococcal conjugate vaccines (PCVs). The aim of this study is to analyze the incidence and distribution of different serotypes causing pneumococcal infections among the pediatric population in southern Catalonia, Spain, throughout the 2002-2009 PCV7 eras. METHODS: A population-based surveillance study was conducted among children aged ≤ 14 years in the region of Tarragona (Catalonia, Spain) during the period 2002-2009. All cases of pneumococcal infections (invasive and non-invasive cases) were included in the study. Incidence rates (per 100,000 population-year) and prevalence of infections caused by serotypes included in different PCV formulations were calculated for the 2002-2005 and 2006-2009 periods. RESULTS: Globally, across the total 2002-2009 period, the incidence of pneumococcal infections was 48.2 per 100,000 children-year (22.4 and 25.8 for invasive and non-invasive infections, respectively). Between 2002-2005 and 2006-2009, the incidence rates largely decreased among children aged <2 years (from 171 to 111 per 100,000 children-year; p = 0.059), but they did not substantially vary among children aged 2-14 years. The percentages of cases caused by serotypes included in PCV7 (60.0 vs. 16.7 %; p < 0.001), PCV10 (75.0 vs. 47.4 %; p = 0.028), and PCV13 (85.0 vs. 70.5 %; p = 0.190) decreased in both periods. CONCLUSION: In this study, which was conducted in a setting with intermediate PCV7 uptakes, a considerable protective direct effect of vaccination occurred among young infants, but an indirect protective effect did not emerge in the rest of the pediatric population. Despite new PCVs with higher serotype coverage, an important proportion of pneumococcal infections is still not covered by these vaccines.

Vascular endothelial growth factor isoforms 120, 164 and 205 are reduced with atresia in ovarian follicles of sheep.

Vascular endothelial growth factor (VEGF) is a potent stimulator of endothelial cell proliferation and neo-vasculogenesis. In the ovary, VEGF mRNA is localised in the follicle, and it is associated with follicular growth and dominance. Alternative splicing of VEGF mRNA produces eight mature forms of mRNA for equal number of VEGF isoforms. In the present study, the VEGF isoforms in granulosa and theca cells of large (4-6mm) and preovulatory (>6mm) sheep follicles were studied during the process of atresia. Follicles were classified as healthy, early atretic and atretic, and the granulosa and theca cells were isolated. The mRNA for three of these isoforms was found in both theca and granulosa cells, and was quantified by image analysis after RT-PCR using primers that amplified VEGF120, VEGF164, VEGF188 and VEGF205 isoforms. The mRNA for these three isoforms was found in both theca and granulosa cells of healthy and atretic follicles. Atresia was accompanied with a reduction in mRNA for VEGF164 and VEGF120 in granulosa and theca cells (P<0.05). Amounts of both isoforms were reduced with the extent of atresia in the granulosa cells, whilst in the theca cells this reduction was only evident in advanced atretic follicles. Furthermore, after the onset of atresia, VEGF205 was not detectable in the granulosa cells. Follicle size did not affect the amount of VEGF mRNA. Hence, the onset of atresia in follicles of sheep is coupled with a reduction in VEGF mRNA. The decrease in VEGF observed with atresia in follicles of sheep was greater in granulosa than in theca cells.

Breastfeeding and early infection in the aetiology of childhood leukaemia in Down syndrome.

BACKGROUND: For a child to develop acute leukaemia (AL), environmental exposure may not be sufficient: interaction with a susceptibility factor to the disease, such as Down syndrome (DS), may also be necessary. We assessed whether breastfeeding and early infection were associated with the risk of developing AL in children with DS. METHODS: Children with DS in Mexico City, and either with or without AL, were the cases (N=57) and controls (N=218), respectively. Population was divided in children with AL and with acute lymphoblastic leukaemia (ALL) and also in children < or = 6 and >6 years old. RESULTS: Breastfeeding and early infections showed moderate (but not significant) association for AL, whereas hospitalisation by infection during the first year of life increased the risk: odds ratios (confidence interval 95%) were 0.84 (0.43-1.61), 1.70 (0.82-3.52); and 3.57 (1.59-8.05), respectively. A similar result was obtained when only ALL was analysed. CONCLUSION: We found that breastfeeding was a protective factor for developing AL and ALL, and during the first year of life, infections requiring hospitalisation were related to a risk for developing the disease in those children with DS >6 years of age. These data do not support the Greaves's hypothesis of early infection being protective for developing ALL.

Micobacteriosis sistémica por mycobacterium avium en paciente con SIDA / Systemic mycobacteriosis for Mycobacterium avium in a AIDS patient

Se analizaron repetidas muestras procedentes de un paciente cubano con SIDA, para descartar la presencia de bacilos ácido alcohol resistente (BAAR), pasadas 2-3 semana en las muestras de esputo, líquido cefalorraquídeo y de hemocultivo que habían sido procesadas y cultivadas se detecta la presencia de algunas colonias, como resultado se obtuvo el aislamiento de una cepa micobacteriana no pigmentada, de crecimiento lento perteneciente al Grupo III de Runyon, esta cepas fueron clasificadas como Mycobacterium avium por los métodos convencionales establecidos para la identificación de cepas micobacterianas, como técnica confirmativa diagnóstica se utilizó el análisis de las fracciones de ácido micólicos por la técnica de cromatografía en capa delgada bidimensional. El objetivo fundamental de este estudio ha sido reportar el primer caso de micobacteriosis sistémica en un paciente cubano con SIDA

Several sputum and blood culture simples from a Cuban HIV/AIDS patient were analyzed to discard the presence of alcohol acid resistant bacillus. After 2-3 weeks the culture revealed in both kinds of samples some colonies from non-pigmented mycobacterium strain with slow growth and belonging to III Runyon Group. This strain was classified as Mycobacterium avium by conventional methods established for mycobacterium identification. To diagnostic confirmative method was used the analysis of fraction mycolic acid by bi-dimensional thin layer chromatography. The main objective of this study was to report the first case of systemic mycobacteriosis in a Cuban HIV/AIDS patient

Safety and efficacy of nevirapine- and efavirenz-based antiretroviral treatment in adults treated for TB-HIV co-infection in Botswana.

BACKGROUND: The safety and efficacy of nevirapine (NVP) and efavirenz (EFV) based highly active antiretroviral treatment (ART) with concurrent anti-tuberculosis treatment in sub-Saharan Africa has not been well established. METHODS: We performed a retrospective study comparing human immunodeficiency virus (HIV) infected adults exposed and not exposed to tuberculosis (TB) treatment with similar baseline HIV-1 RNA levels who were started on ART as part of Botswana's ART Programme. ART regimens, HIV-1 RNA, CD4+ cell count, and liver function tests were reviewed for 12 months following ART initiation. RESULTS: Among 155 patients on ART only and 155 exposed to TB treatment, there was no difference in virologic or immunologic response throughout the first year of ART. Furthermore, there remained no differences in virologic or immunologic outcomes when NVP and EFV groups were stratified by TB treatment exposure status. While more hepatotoxic events occurred in the group exposed to TB treatment than in those not exposed (9% vs. 3%, P = 0.05), there was no difference between patients treated with NVP and those treated with EFV. CONCLUSIONS: Patients co-infected with HIV and TB in Botswana can be treated effectively with either NVP- or EFV-based ART and TB treatment. As hepatotoxic events were more common in the group exposed to TB treatment, liver function tests should be monitored closely.

Association of serum pepsinogen with atrophic body gastritis in Costa Rica.

Individuals with atrophic gastritis (AG), especially atrophic body gastritis (ABG), are at increased risk of developing gastric cancer. Serum concentrations of pepsinogens (PG) have been proposed as markers for ABG. The aim of this study was to determine the risk factors for AG and ABG and the potential of using serum PG concentrations to detect ABG in a dyspeptic population in Costa Rica, which is one of the countries with the highest incidence and mortality rates of gastric cancer in the world. Seven biopsy specimens, a fasting blood sample and a questionnaire concerning sociodemographic factors were obtained from 501 consecutive dyspeptic patients. The serum PGI level and the PGI/PGII ratios were significantly lower in patients with ABG than in other groups (P<0.000). A cut-off point of 3.4 led to a sensitivity of 91.2% in identifying ABG, a negative predictive value of 98.1%, but a positive predictive value of only 11.2%. Helicobacter pylori were present in 93% of the patients and all those with peptic ulcers were positive. AG was associated with increased age, lower body mass index, high alcohol intake and low fruit consumption. ABG was associated with age, alcohol consumption and PGI/PGII<3.4. In dyspeptic patients with a high prevalence of H. pylori infection, serum PG levels provide an assessment of ABG but it is necessary to introduce other serological and genetic markers in order to achieve a better specificity. Those markers could be serum antibodies to H. pylori-CagA, cytokine gene polymorphisms or others.

A closer look at specific therapeutic strategies in leukemia.

Leukemia-associated fusion genes are detected in a significant proportion of newly diagnosed cases, where genes encoding transcription factors are usually found at one of the breakpoints. Activated fusion proteins, such as PML-RARalpha and AML1-ETO, have been shown to inhibit cellular differentiation by recruitment of nuclear corepressor complexes, which maintain local histone deacetylase (HDAC) in a variety of hematologic lineage-specific gene promoters. This HDAC-dependent transcriptional repression appears as a common pathway in the development of leukemia and could represent an important target for new therapeutic agents. On the other hand, the Bcr-Abl oncoprotein shows high tyrosine kinase activity and deregulates signal transduction pathways involved normally in both apoptosis and proliferation. This aberrant activity is affected by signal transduction inhibitors (STIs), which block or prevent the oncogenic pathway. In this review, we present a closer look at our understanding of both the reversible transcriptional repression controlled by HDAC and the deregulated Bcr-Abl signal transduction. In addition, the application of low molecular weight drugs for human leukemia treatment based in this knowledge results in durable clinical remission and acceptable risk of toxic effects that should increase the cure rate. We hope that this review will provide timely information to the readers.

Role of the chemokines RANTES, monocyte chemotactic proteins-3 and -4, and eotaxins-1 and -2 in childhood asthma.

Eosinophil recruitment into the airways is a feature of asthma in children. However, the mechanisms by which these cells migrate into the airways are not fully understood. The present study investigated the presence of the eosinophil-activating chemokines regulated on activation, normal T-cell expressed and secreted (RANTES), monocyte chemotactic proteins (MCP)-3 and -4, and eotaxins-1 and -2 in the bronchoalveolar lavage (BAL) fluid obtained from both asthmatic (n=10, age 6-10 yrs) and normal children (n=10, age 5-10 yrs). Measurements of chemokines in BAL fluid showed that levels of RANTES, MCPs-3 and -4, and eotaxins-1 and -2 were significantly increased in fluid obtained from asthmatic children when compared with normal children. Among the different chemokines, RANTES was the cytokine released in greatest quantities in BAL fluid from asthmatic children. There was a significant correlation between the concentrations of MCP-4 and eosinophil numbers in BAL fluid and a trend between both chemokines MCP-3 and eotaxin-2 and eosinophils. Interestingly, the levels of most chemokines correlated with one another. These findings suggest that RANTES monocyte chemotactic proteins-3 and -4, and eotaxins-1 and -2 may regulate eosinophil trafficking into the airways of asthmatic children in a coordinated manner.