Clinical and neurophysiological features of the hereditary neuropathy with liability to pressure palsy due to the 17p11. 2 deletion / Aspectos clínicos e neurofisiológicos de pacientes com a neuropatia hereditária com a susceptibilidade à pressão associada à deleção 17p11. 2

ABSTRACT The hereditary neuropathy with liability to pressure palsies (HNPP) is an autossomal dominant disorder manifesting recurrent mononeuropathies. Objective Evaluate its clinical and nerve conduction studies (NCS) characteristics, searching for diagnostic particularities. Method We reviewed the neurological manifestations of 39 and the NCS of 33 patients. Results Family history was absent in 16/39 (41%). The onset complaints were weakness in 24, pain in 6, sensory deficit in 5 and paresthesias in 4. Pain was seen in 3 other patients. The following neuropathy patterns were found: multiple mononeuropathy (26), mononeuropathy (7), chronic sensorimotor polyneuropathy (4), chronic sensory polyneuropathy (1) and unilateral brachial plexopathy (1). NCS showed a sensorimotor neuropathy with focal conduction slowing in 31, two had mononeuropathy and another brachial plexopathy. Conclusion HNPP presentation is variable and may include pain. The most frequent pattern is of an asymmetrical sensory and motor neuropathy with focal slowing at specific topographies on NCS.

RESUMO A neuropatia hereditária com susceptibilidade à pressão (HNPP) é uma doença autossômica dominante que manifesta mononeuropatias recorrentes. Objetivo Avaliar as características clínicas e os estudos da condução nervosa (ECN) procurando particularidades diagnósticas. Método Revisamos as características clínicas de 39 e os ECN de 33 pacientes. Resultados História familiar ausente em 16/39 (41%). As manifestações iniciais foram: fraqueza em 24, dor em 6, déficit sensitivo em 5 e parestesias em 4. Dor foi referida por outros 3 pacientes. Os seguintes padrões de neuropatia foram observados: mononeuropatia múltipla (26), mononeuropatia (6), polineuropatia sensitivo-motora (4), polineuropatia sensitiva (1) e plexopatia braquial unilateral (1). Os ECN mostraram uma neuropatia sensitivo-motora com redução focal da velocidade de condução em 31, dois tinham mononeuropatia e outro plexopatia braquial. Conclusão A apresentação da HNPP é variável e pode incluir dor. O padrão mais frequente é o de uma neuropatia sensitivo-motora assimétrica com alentecimentos focais da condução em topografias específicas nos ECN.

Estudo comparativo de técnicas de demonstraçao de amastigotas e isolamento de promastigotas no diagnóstico de leishmanione tegumentar americana

O PCR tem alta sensibilidade no diagnóstico da LTA, mas é caro e distante da prática. A cultura e o esfregaço são práticos, mas pouco sensíveis. O objetivo deste trabalho foi comparar os dois últimos métodos, buscando maior sensibilidade e menor custo.Foram comparados três meios de cultura no isolamento de leishmânia: Difco agar sangue + Schneider + soro bovino fetal (20 por cento); Difco agar sangue + Schneider + urina humana (2por cento); Schneider + urina humana (2por cento). Foram comparadas, também, duas técnicas de pesquisa de amastigotas: esfregaço realizado com biópsia, ou raspado através de palito (matchstick). Os índices de positividade e contaminação (29 a 33por cento e 8 a 11por cento, respectivamente, p>0.05) foram semelhantes na comparação dos cultivos. Os esfregaços com biópsia, ou palito também não tiveram diferenças significativas (14 e 19 por cento, respectivamente, p> 0,05). A Leishmania (Vianna) braziliensis predominou. No Brasil, a urina pode substituir o soro fetal bovino. Há vantagem na relação custo/benefício. A urina não tem custo enquanto 500ml de soro bovino fetal custa 185 dólares

Human papillomavirus infection at the United States-Mexico border: implications for cervical cancer prevention and control.

The United States-Mexico border is a region comprised of a country with one of the highest rates of invasive cervical cancer (Mexico) and a country with one of the lowest rates (United States). Recent evidence clearly indicates that human papillomavirus (HPV) infection is the cause of cervical cancer. The distribution of specific types of HPV is known to vary in different regions of the world, as do the cofactors that may inhibit or promote HPV carcinogenesis. Estimating the prevalence of oncogenic HPV is needed for guiding vaccine development. The purpose of this study was to determine the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV among women residing along the United States-Mexico border. A cross-sectional study of 2319 women, ages 15-79 years, self-referring for gynecological care was conducted between 1997 and 1998. HPV was detected by PCR using the PYGMY 09/11 L1 consensus primer, and HPV genotyping was conducted using the reverse line blot method. Overall, the HPV prevalence was 14.4% with no significant differences observed by country after adjustment for age. HPV 16 was the most commonly detected HPV type in both the United States and Mexico. Among women with high-grade squamous intraepithelial lesions, HPV types 58, 45, 51, 31, 35, 55, and 73 were most common in Mexico, and HPV types 18, 31, 35, 51, 52, and 58 were most common in the United States. In both countries, HPV prevalence declined linearly with age from 25% among women ages 15-19 years to 5.3% among women 56-65 years. Factors significantly independently associated with HPV infection were older age [adjusted odds ratio (AOR) = 0.15 for ages 56-65 years compared with those 15-19 years], a marital status other than married (AOR = 1.58-3.29), increased numbers of lifetime male partners (AOR = 3.8 for > or =10 partners compared with 1 partner), concurrent infection with Chlamydia trachomatis (AOR = 1.79), ever use of Norplant (AOR = 2.69), and current use of injectable contraceptives (AOR = 2.29). Risk factors for HPV infection did not differ by country. Results from this study suggest that in addition to HPV 16 and 18, HPV types 31, 45, 51, and 58 should be considered for inclusion in an HPV prevention vaccine for distribution in Mexico.

Design and results of the USA-Mexico border human papillomavirus (HPV), cervical dysplasia, and Chlamydia trachomatis study.

OBJECTIVE: Mexico has one of the highest mortality rates of invasive cervical cancer in the world. This is particularly true for the states in northern Mexico that border on the United States of America. In addition, Hispanics in the United States have higher rates than do non-Hispanics in the country. Therefore, a binational team was formed to focus on this problem and to determine the risk factors and prevalence of cervical dysplasia and human papillomavirus (HPV) infection, the sexually transmitted disease (STD) known to cause cervical cancer. Chlamydia trachomatis infection, a common STD and potential HPV cofactor, was also assessed. METHODS: Research was conducted in 1997 and 1998 in the border region of two states, Arizona in the United States and Sonora in Mexico, applying a cross-sectional study of women attending clinics for routine gynecologic care. Clinical measurements included Pap smears, HPV infection by both polymerase chain reaction (PCR) and Hybrid Capture (HC), and C. trachomatis status by HC and enzyme-linked immunoassay (EIA). A total of 2,436 women were enrolled (mean age 33.3 years +/- 10.3 years). RESULTS: The overall prevalence of abnormal cytology was 9.3%, with a significant difference in the prevalence in Mexico (11.4%) vs. the United States (6.6%). Of the participants, 14.5% of them tested positive for HPV by PCR, with no significant difference between the two countries, in spite of a lower behavioral risk profile for the Mexican women. Overall prevalence of C. trachomatis was found to be greater by HC than by EIA (8.2% vs. 3.0%), and in Mexico higher by both methods. CONCLUSIONS: An important accomplishment of the project was the implementation of a quality control program for Pap smear collection, which resulted in a significant reduction in inadequate smears in Mexico. Despite numerous potential logistical barriers, the binational team successfully conducted a large-scale study in the border area and developed an infrastructure for future research.

Design and results of the USA-Mexico border human papillomavirus (HPV), cervical dysplasia, and chlamydia trachomatis study / Diseño y resultados del estudio sobre los papilomavirus humanos (PVH), la displasia cervical y Chlamydia trachomatis en la frontera de Estados Unidos y México

México tiene una de las mayores tasas mundiales de mortalidad por cáncer cervical invasor, sobre todo en los estados del norte que tienen frontera con los Estados Unidos de América (EE.UU). Además, los hispanos residentes en los Estados Unidos tienen mayores tasas que los no hispanos de este país. Considerando esta situación, se formó un equipo de ambos países para analizar el problema y determinar la prevalencia y factores de riesgos de la displasia cervical y de la infección por papilomavirus humanos (PVH), una enfermedad de transmisión sexual que se sabe que causa cáncer. También se analizó la infección por Chlamydia trachomatis, una enfermedad de transmisión sexual frecuente que podría constituir un cofactor de los PVH. Métodos. La investigación, realizada EN 1997 Y 1998 en la zona fronteriza de los estados de Arizona (EE.UU) y Sonora (México), consistió en un estudio transversal de 2436 mujeres (media de 33,3 mas o menos 10,3 años) que acudían a consultas ginocológicas de rutina. Se efectuaron frotis cervicales de Papanicolaou y pruebas de detcción de la infección por PVH, mediante la reacción en cadena de la polimerasa (PCR) y la captación de híbridos (HC), y la infección por C. trachomatis, mediante HC e inmunoanálisis enzimático (EIA) Resultados. La prevalencia gobal de exámenes citológicox anormales fue del 9,3 por ciento la diferencia entre México (11,4 por ciento) y EE.UU.(6,6 por ciento) fue significativa. Un 14,5 por ciento de las participantes fueron positivas para los PVH en las PCR, sin que ubiera diferencias entre los dos países, y esto a pesar de que las mujeres mejicanas tenían menores riesgos relacionados con la conducta. La prevalencia global de C. trachomatis fue mayor con la HC que con el EIA (8,2 por ciento frente a 3,0 por ciento) y fue mayor en México que en EE.UU. con ambos métodos. Conclusiones. Un importante logro de este proyecto consistió en la puesta en marcha de un programa de control de la calidad de la recolección de los frotis de Papanicolaou que dio lugar a una notable reducción de los frotis inadecuados en México. A pesar de numerosas posibles barreras logísticas, el equipo de los dos países consiguió realizar con éxito un estudio a gran escala en el área fronteriza y desarrollar la infraestructura para futuras investigaciones

Objective. Mexico has one of the highest mortality rates of invasive cervical cancer in the world. This is particularly true for the states in northern Mexico that border on the United States of America. In addition, Hispanics in the United States have higher rates than do non-Hispanics in the country. Therefore, a binational team was formed to focus on this problem and to determine the risk factors and prevalence of cervical dysplasia and human papillomavirus (HPV) infection, the sexually transmitted disease (STD) known to cause cervical cancer. Chlamydia trachomatis infection, a common STD and potential HPV cofactor, was also assessed. Methods. Research was conducted in 1997 and 1998 in the border region of two states, Arizona in the United States and Sonora in Mexico, applying a cross-sectional study of women attending clinics for routine gynecologic care. Clinical measurements included Pap smears, HPV infection by both polymerase chain reaction (PCR) and Hybrid Capture (HC), and C. trachomatis status by HC and enzyme-linked immunoassay (EIA). A total of 2 436 women were enrolled (mean age 33.3 years ± 10.3 years). Results. The overall prevalence of abnormal cytology was 9.3%, with a significant difference in the prevalence in Mexico (11.4%) vs. the United States (6.6%). Of the participants, 14.5% of them tested positive for HPV by PCR, with no significant difference between the two countries, in spite of a lower behavioral risk profile for the Mexican women. Overall prevalence of C. trachomatis was found to be greater by HC than by EIA (8.2% vs. 3.0%), and in Mexico higher by both methods. Conclusions. An important accomplishment of the project was the implementation of a quality control program for Pap smear collection, which resulted in a significant reduction in inadequate smears in Mexico. Despite numerous potential logistical barriers, the binational team successfully conducted a large-scale study in the border area and developed an infrastructure for future research.

Design and results of the USA-Mexico border human papillomavirus (HPV), cervical dysplasia, and chlamydia trachomatis study

México tiene una de las mayores tasas mundiales de mortalidad por cáncer cervical invasor, sobre todo en los estados del norte que tienen frontera con los Estados Unidos de América (EE.UU). Además, los hispanos residentes en los Estados Unidos tienen mayores tasas que los no hispanos de este país. Considerando esta situación, se formó un equipo de ambos países para analizar el problema y determinar la prevalencia y factores de riesgos de la displasia cervical y de la infección por papilomavirus humanos (PVH), una enfermedad de transmisión sexual que se sabe que causa cáncer. También se analizó la infección por Chlamydia trachomatis, una enfermedad de transmisión sexual frecuente que podría constituir un cofactor de los PVH. Métodos. La investigación, realizada EN 1997 Y 1998 en la zona fronteriza de los estados de Arizona (EE.UU) y Sonora (México), consistió en un estudio transversal de 2436 mujeres (media de 33,3 mas o menos 10,3 años) que acudían a consultas ginocológicas de rutina. Se efectuaron frotis cervicales de Papanicolaou y pruebas de detcción de la infección por PVH, mediante la reacción en cadena de la polimerasa (PCR) y la captación de híbridos (HC), y la infección por C. trachomatis, mediante HC e inmunoanálisis enzimático (EIA) Resultados. La prevalencia gobal de exámenes citológicox anormales fue del 9,3 por ciento la diferencia entre México (11,4 por ciento) y EE.UU.(6,6 por ciento) fue significativa. Un 14,5 por ciento de las participantes fueron positivas para los PVH en las PCR, sin que ubiera diferencias entre los dos países, y esto a pesar de que las mujeres mejicanas tenían menores riesgos relacionados con la conducta. La prevalencia global de C. trachomatis fue mayor con la HC que con el EIA (8,2 por ciento frente a 3,0 por ciento) y fue mayor en México que en EE.UU. con ambos métodos. Conclusiones. Un importante logro de este proyecto consistió en la puesta en marcha de un programa de control de la calidad de la recolección de los frotis de Papanicolaou que dio lugar a una notable reducción de los frotis inadecuados en México. A pesar de numerosas posibles barreras logísticas, el equipo de los dos países consiguió realizar con éxito un estudio a gran escala en el área fronteriza y desarrollar la infraestructura para futuras investigaciones

Isolation of an intrinsic precursor to molecular chemisorption

Over the past 70 years, numerous gas-surface adsorption studies have indicated the existence of a weakly bound, mobile intermediate that is a precursor to chemical bond formation. The direct observation and characterization of such a species are presented. Precursor and chemisorbed benzene on a silicon surface were clearly distinguished with the use of a tunable-temperature scanning tunneling microscope. Precursor decay to chemisorption was observed, allowing the salient features of the potential energy surface to be determined.