A non-replicative antibiotic resistance-free DNA vaccine delivered by the intranasal route protects against canine leishmaniasis.

Leishmania infantum is the etiological agent of zoonotic visceral leishmaniasis (ZVL). The disease is endemic in Central and South America, Central and South East Asia, and the Mediterranean basin. Dogs are the main reservoir, with an estimated prevalence of approximately 2.5 million dogs in Southern Europe. Current treatments cause side effects, disease recurrence, and drug resistance. Therefore, the development of vaccines against canine leishmaniasis is necessary. We have generated a DNA vaccine based on the non-replicative antibiotic resistance marker-free plasmid vector pPAL that contains the encoding gene for the L. infantum activated protein kinase C receptor analog (LACK). Homologous pPAL-LACK prime-boost intranasal administration confers efficacious protection in Beagle dogs with a reduction of clinical signs and a statistically significant reduction of the parasite burden in the bone marrow of more than 90% of dogs after experimental infection with highly infective promastigotes. This DNA vaccine elicits a robust cellular immune response skewed towards the Th1 profile.

mtDNA variability determines spontaneous joint aging damage in a conplastic mouse model.

Mitochondria and mtDNA variations contribute to specific aspects of the aging process. Here, we aimed to investigate the influence of mtDNA variation on joint damage in a model of aging using conplastic mice. A conplastic (BL/6NZB) mouse strain was developed with the C57BL/6JOlaHsd nuclear genome and NZB/OlaHsd mtDNA, for comparison with the original C57BL/6JOlaHsd strain (BL/6C57). Conplastic (BL/6NZB) and BL/6C57 mice were sacrificed at 25, 75, and 90 weeks of age. Hind knee joints were processed for histological analysis and joint pathology graded using the Mankin scoring system. By immunohistochemistry, cartilage expression of markers of autophagy (LC3, Beclin-1, and P62) and markers of senescence (MMP13, beta-Galactosidase, and p16) and proliferation (Ki67) were analyzed. We also measured the expression of 8-oxo-dG and cleaved caspase-3. Conplastic (BL/6NZB) mice presented lower Mankin scores at 25, 75, and 90 weeks of age, higher expression of LC3 and Beclin-1 and lower of P62 in cartilage than the original strain. Moreover, the downregulation of MMP13, beta-Galactosidase, and p16 was detected in cartilage from conplastic (BL/6NZB) mice, whereas higher Ki67 levels were detected in these mice. Finally, control BL/6C57 mice showed higher cartilage expression of 8-oxo-dG and cleaved caspase-3 than conplastic (BL/6NZB) mice. This study demonstrates that mtDNA genetic manipulation ameliorates joint aging damage in a conplastic mouse model, suggesting that mtDNA variability is a prognostic factor for aging-related osteoarthritis (OA) and that modulation of mitochondrial oxidative phosphorylation (OXPHOS) could be a novel therapeutic target for treating OA associated with aging.

Mitochondrial DNA impact on joint damaged process in a conplastic mouse model after being surgically induced with osteoarthritis.

It has been suggested that mitochondrial dysfunction and mtDNA variations may contribute to osteoarthritis (OA) pathogenesis. However, the causative link to support this claim is lacking. Here, we surgically-induced OA in conplastic mice in order to evaluate the functional consequences of mtDNA haplotypes in their joint degeneration. BL/6NZB strain was developed with C57BL/6JOlaHsd nuclear genome and NZB/OlaHsdmtDNA while BL/6C57, which is the original, was developed with C57BL/6JOlaHsd nuclear genome and C57/OlaHsdmtDNA for comparison. The surgical DMM OA model was induced in both strains. Their knees were processed and examined for histopathological changes. Cartilage expression of markers of autophagy, apoptosis, oxidative stress and senescence were also analyzed by immunohistochemistry. The joints of BL/6NZB mice that were operated presented more cellularity together with a reduced OARSI histopathology score, subchondral bone, menisci score and synovitis compared to those of BL/6C57 mice. This was accompanied with higher autophagy and a lower apoptosis in the cartilage of BL/6NZB mice that were operated. Therefore, the study demonstrates the functional impact of non-pathological variants of mtDNA on OA process using a surgically-induced OA model. Conplastic (BL/6NZB ) mice develop less severe OA compared to the BL/6C57original strain. These findings demonstrate that mitochondria and mtDNA are critical targets for potential novel therapeutic approaches to treat osteoarthritis.

Electromyographic biofeedback improves upper extremity function: a randomized, single-blinded, controlled trial.

OBJECTIVE: To examine the effects of a 6-week surface electromyographic biofeedback intervention on the re-learning of upper extremity motor function in subjects with paretic upper extremity after stroke. DESIGN: A randomized controlled trial. SETTING: State Centre of Attention to Brain Injury, Madrid, Spain. PARTICIPANTS: Thirty-eight participants in the sub-acute post-stroke stage were recruited and randomly allocated into either the surface electromyographic biofeedback (sEMG-BFB) or sham biofeedback (BFB) groups. INTERVENTIONS: The sEMG-BFB group (n=19) received the intervention focused on re-learning scapulothoracic control during arm-reaching tasks involving shoulder abduction. The sham BFB group (n=19) received a sham intervention. OUTCOME MEASURES: Upper extremity motor function assessed using the Fugl-Meyer Assessment-Upper Extremity Scale (66 points), the glenohumeral active range of motion, and the electromyographic amplitude signal of the middle deltoid and upper trapezius muscles were collected at baseline, after the intervention, and at the one-month follow-up. RESULTS: Compared with the sham BFB group, the sEMG-BFB group experienced significant increases in upper extremity motor function after the intervention. The mean differences between groups were as follows: 4.79 points (95% CI 2.92 to 6.66) after the intervention; 6.55 points (95% CI 3.75 to 9.34) at the one-month follow-up; improved active range of motion 15.75 points (95% CI 6 to 30) after the intervention and electromyographic activity in the upper trapezius muscle changed in favour of the sEMG-BFB. CONCLUSIONS: In the short term, a 6-week sEMG-BFB intervention effectively improved paretic upper limb motor function. Future research is needed to determine if the sEMG-BFB intervention has any long-term effects. Clinical trial number registration: NCT02974465 (ClinicalTrials.gov).

Evaluación del consumo de grasas, frutas, vegetales y fibra en personas adultas del Municipio de San Pablo del Monte, Tlaxcala (México) / Evaluation of the consumption of fats, fruits, vegetables and fiber, in adult persons of the Municipality of San Pablo del Monte, Tlaxcala (México)

FUNDAMENTOS: En personas adultas una dieta poco saludable con consumo elevado de grasas y consumo bajo en frutas y vegetales desencadena problemas de obesidad y enfermedades crónicas. El objetivo del presente estudio fue analizar la frecuencia de consumo de grasas, frutas, vegetales y fibra en personas adultas de San Pablo del Monte, Tlaxcala, México. MÉTODOS: Estudio descriptivo, transversal, se encuestaron a 2.848 adultos entre 18 y 59 años de edad. Se utilizó el instrumento validado Nutrition Quest, que consta de dos partes: 1) Evaluación dietética de grasas y 2) Evaluación dietética de frutas, vegetales y fibra. RESULTADOS: El 58% de la población de estudio tienen una dieta baja en grasas, 17% adecuada y un 25% alta y muy alta en grasas. El 94% de la población tiene un consumo deficiente y muy deficiente de frutas, vegetales y fibra y un 6% un consumo recomendable. CONCLUSIONES: Una cuarta parte de la población tiene un consumo alto en grasas, poniéndolos en riesgo de enfermedades cardiovasculares. La mayoría de la población tiene un consumo deficiente del consumo de frutas, vegetales y fibra, presentando riesgo de deficiencia de micronutrientes

BACKGROUND: In adults an unhealthy diet with high fat consumption and low consumption in fruits and vegetables triggers problems of obesity and chronic diseases. The objective of this study was to analyze the frequency of consumption of fats, fruits, vegetables and fiber in adults of San Pablo del Monte, Tlaxcala, México. METHODS: Descriptive, cross-sectional study, where 2,848 adults between 18 and 59 years of age were surveyed. The instrument validated by Block et al Nutrition Quest was used, which consists of two parts: 1) Dietary evaluation of fats and 2) Dietary evaluation of fruits, vegetables and fiber. RESULTS: 58% of the study population have a diet low in fat, 17% adequate and 25% high and very high in fat. 94% of the population has a deficient and very deficient consumption of fruits, vegetables and fiber and 6% a recommended consumption. CONCLUSIONS: A quarter of the population has a high fat intake, putting them at risk of cardiovascular disease. The majority of the population has deficient consumption of fruits, vegetables and fiber, presenting a risk of micronutrient deficiency

IL12 p35 and p40 subunit genes administered as pPAL plasmid constructs do not improve protection of pPAL-LACK vaccine against canine leishmaniasis.

Leishmania infantum causes zoonotic visceral leishmaniasis (ZVL) in the Mediterranean basin and South America. The parasite has been shown to co-infect HIV patients and an outbreak in central Spain was reported in the last decade. Therfore, ZVL is a public health problem, dogs being the parasite's reservoir. We have developed a DNA vaccine based on the L. infantum activated protein kinase A receptor (LACK) using different plasmid vectors and vaccinia virus strains as vehicles. Recently, we have generated an antibiotic resistance marker-free plasmid vector called pPAL. Homologous pPAL-LACK prime-boost vaccination protects Beagle dogs as well as a heterologous plasmid-virus regime. For both reasons, pPAL improves safety. IL12 was described to trigger Th1 response through IFN-γ production in infected dogs, being a good candidate for cytokine therapy in conventional treatment-unresponsive dogs. Herein, we report a complete protection study in dogs through inoculation of genes encoding for the p35 and p40 subunits which compose canine IL12 in combination with the LACK gene. A homologous plasmid-plasmid regime using independent pPAL constructs for each gene was inoculated in a 15-day interval. The infectious challenge using L. infantum promastigotes was successful. The outcome was pPAL-LACK vaccine protection suppression by IL12 administration. The important implications of this finding are discussed in the manuscript.

Intraneural IFG-1 in Cryopreserved Nerve Isografts Increase Neural Regeneration and Functional Recovery in the Rat Sciatic Nerve.

BACKGROUND: Insulin-like growth factor 1 (IGF-1) was found to stimulate Schwann cell mitosis. Exogenous IGF-1 may improve nerve regeneration after cryopreservation. OBJECTIVE: To evaulate the effect of intraneural administration of IGF-1 in cryopreserved nerve isografts. METHODS: Eighteen millimeter grafts were used for bridging an 18-mm defect in the rat sciatic nerve. A total of 57 rats were randomly divided into three groups: (1) autograft (Group 1); (2) cryopreserved isograft (Group 2); (3) cryopreserved isograft with intraneural IGF-1 administration (Group 3). 12 weeks after surgery, functional recovery (Sciatic functional index [SFI], Swing speed [SS], nerve conduction velocity [NCV], amplitude of compound motor action potentials [CMAP], and gastrocnemius muscle index [GMI]) and nerve regeneration (myelin sheath area, total fiber counts, fiber density, and fiber width) were all evaluated. RESULTS: The intraneural injection of IGF-1 significantly improved SFI and SS at weeks 10 and 12. There were no statistical differences between Groups 1 and 3 in any of the SFI or SS evaluations. CMAP and NCV in Group 1 were significantly higher than in Groups 2 and 3, and Group 3 had significantly higher CMAP and NCV compared to Group 2. No significant differences were found in fiber width. The number of nerve fibers, percentage of myelinated fibers, fiber density, and GMI was significantly higher in Group 1 compared to Group 2, but no significant differences were found between Groups 1 and 3. CONCLUSION: The results show that intraneural injection of IGF-1 in an 18 mm cryopreserved isograft improve axonal regeneration and functional recovery.

p73 regulates ependymal planar cell polarity by modulating actin and microtubule cytoskeleton.

Planar cell polarity (PCP) and intercellular junctional complexes establish tissue structure and coordinated behaviors across epithelial sheets. In multiciliated ependymal cells, rotational and translational PCP coordinate cilia beating and direct cerebrospinal fluid circulation. Thus, PCP disruption results in ciliopathies and hydrocephalus. PCP establishment depends on the polarization of cytoskeleton and requires the asymmetric localization of core and global regulatory modules, including membrane proteins like Vangl1/2 or Frizzled. We analyzed the subcellular localization of select proteins that make up these modules in ependymal cells and the effect of Trp73 loss on their localization. We identify a novel function of the Trp73 tumor suppressor gene, the TAp73 isoform in particular, as an essential regulator of PCP through the modulation of actin and microtubule cytoskeleton dynamics, demonstrating that Trp73 is a key player in the organization of ependymal ciliated epithelia. Mechanistically, we show that p73 regulates translational PCP and actin dynamics through TAp73-dependent modulation of non-musclemyosin-II activity. In addition, TAp73 is required for the asymmetric localization of PCP-core and global signaling modules and regulates polarized microtubule dynamics, which in turn set up the rotational PCP. Therefore, TAp73 modulates, directly and/or indirectly, transcriptional programs regulating actin and microtubules dynamics and Golgi organization signaling pathways. These results shed light into the mechanism of ependymal cell planar polarization and reveal p73 as an epithelial architect during development regulating the cellular cytoskeleton.

The Use of Antidotes for Calcium Gluconate Extravasation: An Experimental Study in Mice.

BACKGROUND: Calcium gluconate extravasation is a process that can cause serious lesions, such as necrosis and calcification of the soft tissues. The aim of the present study was to analyze the beneficial effects of four possible local antidotes for calcium gluconate extravasation: hyaluronidase, sodium thiosulfate, triamcinolone acetonide, and physiologic saline solution. METHODS: Seventy-four BALB/c mice were used in the study. The substances selected for use in this study were calcium gluconate (4.6 mEq/ml), hyaluronidase (1500 IU/ml), sodium thiosulfate (25%), triamcinolone acetonide (40 mg/ml 0.5 mg/kg), and saline solution 0.9%. Five minutes were allowed to lapse after the calcium gluconate infiltration, and then an antidote was infiltrated. After 3 weeks, a skin biopsy was performed and a radiographic and histologic study was carried out. RESULTS: Only in the group infiltrated with sodium thiosulfate did all skin lesions disappear after the 3-week period after infiltration. In the radiographic study, calcium deposits larger than 0.5 mm were observed in 40 percent of cases without an antidote, in 33 percent with triamcinolone acetonide, in 13 percent with a saline solution, and in none with thiosulfate and hyaluronidase. In the histologic study, calcium deposits were found in 53 percent of cases without antidote, 100 percent of cases with triamcinolone acetonide, 33 percent of cases with saline solution, and 13 percent of cases with sodium thiosulfate or hyaluronidase. CONCLUSION: Sodium thiosulfate and hyaluronidase prevent the development of calcium deposits after calcium gluconate extravasation.

Tratamiento farmacológico y terapia electroconvulsiva en la depresión unipolar; a propósito de un caso / Pharmacological treatment and electroconvulsive therapy in unipolar depression; report of a case

Los episodios depresivos con síntomas psicóticos son una entidad clínica de gravedad con riesgo para el paciente, por lo que la respuesta terapéutica debe ser acorde a la gravedad de la misma. Las principales guías de tratamiento del trastorno depresivo unipolar recomiendan como primera línea de tratamiento el uso de medicación antipsicótica adyuvante al tratamiento antidepresivo. Además está bien establecida la eficacia del uso de terapia electroconvulsiva tanto en el episodio agudo en formas severas o en formas menos severas refractarias a tratamiento farmacológico. Se presenta el caso clínico de una paciente que sufre un episodio depresivo unipolar en el que desarrolla síntomas psicóticos de tinte nihilista (delirio de Cotard), así como su manejo terapéutico con el uso de terapia electroconvulsiva combinada con tratamiento farmacológico basado en fármacos antidepresivos y antipsicóticos que conllevó una rápida y marcada mejoría clínica con restitutio ad integrum de la paciente, a pesar de la refractariedad a la clínica presentada en tratamientos previos del episodio actual (AU)

Depressive episodes with psychotic symptoms are a clinical entity with serious risk to the patient, thus the therapeutic response should be based on the severity of the illness. The main treatment guidelines for unipolar depressive disorder recommend using antidepressive agents with adjuvant antipsychotic agents as first-line of treatment. The efficacy of electroconvulsive therapy in acute episode with severe forms, or less severe treatment resistant forms, has also been well-established. The case is presented of a patient suffering from a unipolar depressive episode, and who developed nihilistic psychotic symptoms (Cotard's delusion). Her therapeutic management, with the use of electroconvulsive therapy combined with drug treatment based on antidepressive and antipsychotics agents, led to a quick and marked clinical improvement with restitutio ad integrum of the patient, despite the resistance to clinical treatment presented in previous treatments of the current episode (AU)

Desarrollo de un modelo murino de inflamación y remodelación de vías respiratorias en asma experimental / Development of a Murine Model of Airway Inflammation and Remodeling in Experimental Asthma

IntroducciónLa investigación de los mecanismos de enfermedad del asma y la identificación de nuevas dianas terapéuticas requieren modelos animales experimentales. En este trabajo presentamos los datos del desarrollo de un modelo murino de asma experimental que permite valorar de forma conjunta parámetros de inflamación y remodelación de las vías respiratorias mediante morfología cuantitativa.Material y métodosSe sensibilizó a ovoalbúmina a ratones Balb/c y se les realizó broncoprovocación con ovoalbúmina o excipiente 3 veces por semana durante 12 semanas.ResultadosEn el lavado broncoalveolar, los ratones del grupo de ovoalbúmina presentaron un incremento significativo de leucocitos totales, con una mediana (cuartiles 25–75) de 670,0células/ml·103 (376,2–952,5), frente a 40,0células/ml·103 (60,0–85,0) en controles (p=0,001), y de las fracciones eosinófila y linfocitaria en recuento diferencial. En secciones sagitales de los pulmones inflados a presión estandarizada, estos ratones mostraron hiperplasia de células caliciformes en el epitelio respiratorio —reacción de ácido peryódico de Schiff: 53,89 (36,26–62,84) frente a 0,66 (0,00–1,06)células/mm2 (p<0,001)—, densa infiltración inflamatoria mononuclear y eosinófila —hematoxilina-eosina: 32,87 (27,34–37,13) frente a 0,06 (0,00–0,20)eosinófilos/mm2 (p=0,002)—, infiltración subepitelial por mastocitos —azul de toluidina: 2,88 (2,00–3,28) frente a 0,28 (0,15–0,35)mastocitos/mm2 (p<0,001)—, incremento de la masa de tejido contráctil —inmunofluorescencia para alfaactina de músculo liso: 2,60 (2,28–2,98) frente a 1,08 (0,93–1,16), adimensional (p<0,001)— e incremento del depósito de matriz extracelular (tricrómico de Masson: 2,18 (1,85–2,80) frente a 0,50 (0,37–0,65), adimensional (p<0,001)—.ConclusionesLos datos aportados configuran un modelo de asma experimental inducida por exposición alergénica prolongada, con desarrollo y evaluación integrada de inflamación y remodelación de vías respiratorias(AU)

Background and ObjectiveExperimental animal models are necessary for studying asthma disease mechanisms and for identifying new therapeutic targets. We present a murine model of experimental asthma that allows integrated, quantitative assessment of airway inflammation and remodeling.Material and MethodsBALB/c mice were sensitized to ovalbumin (OVA) and challenged with OVA or vehicle 3 times per week for 12 weeks.ResultsOn bronchoalveolar lavage, the OVA-sensitized mice had significantly higher total leukocyte counts, with a median (Q25–Q75) of 670.0cells/mL×103 (376.2, 952.5) in comparison with 40.0cells/mL×103 (60.0–85.0) in controls (P=.001), and higher eosinophil and differential lymphocyte counts. In sagittal sections of lungs inflated to a standard pressure, the OVA-sensitized animals showed goblet cell hyperplasia in the respiratory epithelium (periodic acid-Schiff staining, 53.89 [36.26–62.84]cells/mm2 vs 0.66 [0.00–1.06]cells/mm2, P<.001), dense mononuclear and eosinophilic inflammatory infiltrates (hematoxylin-eosin, 32.87 [27.34–37.13]eosinophils/mm2 vs 0.06 [0.00–0.20]eosinophils/mm2, P=.002), subepithelial infiltration by mast cells (toluidine blue, 2.88 [2.00–3.28] mast cells/mm2 vs 0.28 [0.15–0.35] mast cells/mm2, P<.001), increased contractile tissue mass (immunofluorescence analysis for α-smooth-muscle actin, 2.60 [2.28–2.98] vs 1.08 [0.93–1.16], dimensionless, P<.001) and enhanced extracellular matrix deposition (Masson's trichrome, 2.18 [1.85–2.80] vs 0.50 [0.37–0.65], dimensionless, P<.001).ConclusionsOur dataset describes an experimental model of asthma which is driven by prolonged allergen exposure and in which airway inflammation and remodeling develop and are assessed together(AU)

[Development of a murine model of airway inflammation and remodeling in experimental asthma]. / Desarrollo de un modelo murino de inflamación y remodelación de vías respiratorias en asma experimental.

BACKGROUND AND OBJECTIVE: Experimental animal models are necessary for studying asthma disease mechanisms and for identifying new therapeutic targets. We present a murine model of experimental asthma that allows integrated, quantitative assessment of airway inflammation and remodeling. MATERIAL AND METHODS: BALB/c mice were sensitized to ovalbumin (OVA) and challenged with OVA or vehicle 3 times per week for 12 weeks. RESULTS: On bronchoalveolar lavage, the OVA-sensitized mice had significantly higher total leukocyte counts, with a median (Q25-Q75) of 670.0 cells/mL x 10(3) (376.2, 952.5) in comparison with 40.0 cells/mL x 10(3) (60.0-85.0) in controls (P=.001), and higher eosinophil and differential lymphocyte counts. In sagittal sections of lungs inflated to a standard pressure, the OVA-sensitized animals showed goblet cell hyperplasia in the respiratory epithelium (periodic acid-Schiff staining, 53.89 [36.26-62.84]cells/mm(2) vs 0.66 [0.00-1.06]cells/mm(2), P<.001), dense mononuclear and eosinophilic inflammatory infiltrates (hematoxylin-eosin, 32.87 [27.34-37.13]eosinophils/mm(2) vs 0.06 [0.00-0.20]eosinophils/mm(2), P=.002), subepithelial infiltration by mast cells (toluidine blue, 2.88 [2.00-3.28] mast cells/mm(2) vs 0.28 [0.15-0.35] mast cells/mm(2), P<.001), increased contractile tissue mass (immunofluorescence analysis for alpha-smooth-muscle actin, 2.60 [2.28-2.98] vs 1.08 [0.93-1.16], dimensionless, P<.001) and enhanced extracellular matrix deposition (Masson's trichrome, 2.18 [1.85-2.80] vs 0.50 [0.37-0.65], dimensionless, P<.001). CONCLUSIONS: Our dataset describes an experimental model of asthma which is driven by prolonged allergen exposure and in which airway inflammation and remodeling develop and are assessed together.

Rare earth arenedisulfonate metal-organic frameworks: an approach toward polyhedral diversity and variety of functional compounds.

Eight 2D and 3D metal-organic framework (MOF) rare earth naphthalenedisulfonates have been obtained. The different geometry of the naphthalenedisulfonic acids used as connectors [(1,5-NDS) and (2,6-NDS)] gives rise to the three new structure types. In Ln(OH)(1,5-NDS)H2O, LnPF-1 (lanthanide polymeric framework; Ln=La, Nd, Pr, Sm and Eu), the lanthanide ion is octacoordinated. Its 3D structure is formed by (Ln2O14)-S-(Ln2O14) infinite chains, connected through complete NDS connectors. LnPF-2 (Ln=Nd), with the same empirical formula as the former, and the lanthanide in octa- and nonacoordination, owns an arrangement of sulfonate bridges and neodymium polyhedra that gives rise to a 2D structure. [Ln5(2,6-NDS)3(OH)9(H2O)4](H2O)2, LnPF-3 (Ln=Nd, Eu), demonstrates that it is possible to obtain a 3D structure with (2,6-NDS), when a greater Ln/connector ratio is employed. It is worth pointing out the existence, in this latter family of compounds, of a mu5-OH group, whose hydrogen atom is very close to one-sixth Ln atom (distance Ln...H=2.09 A). The materials, with high thermal stability, act as active and selective bifunctional heterogeneous catalysts in oxidation of linalool yielding cyclic hydroxy ethers. The absence of any 3D Nd-Nd magnetic interaction is explained due to the inner nature of 4f orbitals of Nd3+, which do not favor the magnetic exchange. The influence of the polymeric frame matrix results in a better photoluminescence efficiency for NdPF-1.

Infecciones fúngicas invasivas y cáncer / Invasive mycotic infections and cancer

La epidemiología de la infección fúngica invasiva ha cambiado durante los últimos 20 años, la incidencia ha aumentado y la etiología de estas infecciones se ha diversificado. Aunque siguen siendo las levaduras el agente causal más frecuente, en años recientes los hongos han llegado a ser más habituales en ciertos grupos de pacientes. De la misma manera, la población de pacientes en riesgo se ha ampliado hasta incluir un amplio grupo de condiciones médicas, tales como: cáncer, transplante de médula ósea y órganos sólidos, terapia inmunosupresora, SIDA, nacimiento prematuro, edad avanzada y cirugía extensa. Se presenta una serie de imágenes de aislamientos micóticos provenientes de sangre, líquidos corporales y lavado brocoalveolar, tomados a partir de hemocultivos.

Cross-reactivity between swine leukocyte antigen and human anti-HLA-specific antibodies in sensitized patients awaiting renal transplantation.

Xenotransplantation is increasingly viewed as a promising way to alleviate the problem of patients who have alloreactive lymphocytotoxic antibodies and therefore tend to accumulate on the waiting list for renal transplantation. One barrier to xenotransplantation in these patients could be the hyperacute or acute vascular rejection as a result of preexisting anti-HLA antibodies that recognize swine leukocyte antigens. The cross-reactivity of sera from 98 patients with pig lymphocytes was studied by flow cytometry. After absorption of xenoreactive natural antibodies (XNA), isotype, class, and antibody specificity causing a positive cross-match (XM) were determined. For nonsensitized patients, all of the antibody binding to pig lymphocytes was due to XNA, which were removed by pig red blood cells absorption. In contrast, in sensitized patients, after removal of XNA, pig lymphocyte XM remained positive. There was no correlation between antibody binding to pig lymphocytes and Ig isotype (IgG or IgM) or HLA class-specific antibodies. For testing evidence that class II-specific antibodies were responsible for antibody binding to pig lymphocytes, HLA class I-specific antibodies were absorbed with pooled human platelets. It was confirmed that HLA class II-specific antibodies were responsible for the positive pig XM, but the strength of the positive XM was weaker than the strength caused by HLA class I-specific antibodies. Sera with multiple specificities (plurispecific sera) displayed a greater frequency of cross-reactivity with swine leukocyte antigens (P < 0.05). Seven of 11 highly immunized patients without cross-reactivity IgG with porcine lymphocytes showed positive XM before an IgM was used. The results demonstrate the cross-reactive nature of HLA antibodies and therefore point out the need to perform a prospective XM after absorption of XNA in presensitized individuals.

Manejo selectivo vs. laparotomia rutinaria en herida toracica penetrante al abdomen / Selective management vs. routine laparotomy in thoracic stab wounds to the abdomen

De 15 pacientes operados por presentar heridas toracicas penetrantes a abdomen, durante los meses de julio a noviembre de 1981, se encontraron 9 (60%) con compromiso diafragmatico. Los requisitos para ingresar al estudio fueron: a) Presencia de herida en el area toraco-abdominal delimitada asi: cuarto a septimo espacios intercostales en la linea medio clavicular; septimo a noveno espacios intercostales en la linea axilar media; y noveno a undecimo espacios intercostales en la linea escapular. b) Abdomen clinicamente negativo. Antes de la cirugia, a todos los pacientes se les practico placa de torax, neumoperitoneo diagnostico y lavado peritoneal. El analisis de los resultados permite concluir que ninguno de esos estudios es adecuado por su sensibilidad o por suespecificidad, para la valoracion completa de los casos. Aunque la practica rutinaria de la laparotomia exploradora puede producir una proporcion elevada de intervenciones en blanco, hasta cuando se pongan en practica metodos diagnosticos mas sensibles y especificos, esta cirugia continuara siendo la unica alternativa. Finalmente, se formulan algunas recomendaciones para el estudio futuro de este problema