Fatal attraction: intestinal amebiasis and COVID-19 as risk factors for colonic perforation.

The parasite Entamoeba histolytica, the causal agent of amebiasis, is considered a worldwide emergent disease and still represents an important cause of death in Mexico. Here, we describe a clinical case, involving an inflammatory response to both Coronavirus Infectious Disease 2019 (COVID-19) and intestinal amebiasis 54-year-old, COVID-positive Mexican gentleman was admitted to surgery following 6 days of hematochezia. An exploratory laparotomy and colonoscopy revealed multiple fibrous and amebic ulcerations (5-10 cm in diameter), with necrotic tissue predominantly localized in the sigmoid, descending and ascending colon. We discuss the pathophysiological interplay of both COVID-19 and intestinal amebiasis with the aim of highlighting a potentially novel aggravating mechanism in surgical patients suffering from colonic perforation in the setting of abdominal sepsis.

Expression of a novel surfactant protein gene is associated with sites of extrapulmonary respiration in a lungless salamander.

Numerous physiological and morphological adaptations were achieved during the transition to lungless respiration that accompanied evolutionary lung loss in plethodontid salamanders, including those that enable efficient gas exchange across extrapulmonary tissue. However, the molecular basis of these adaptations is unknown. Here, we show that lungless salamanders express in the larval integument and the adult buccopharynx-principal sites of respiratory gas exchange in these species-a novel paralogue of the gene surfactant-associated protein C (SFTPC), which is a critical component of pulmonary surfactant expressed exclusively in the lung in other vertebrates. The paralogous gene appears to be found only in salamanders, but, similar to SFTPC, in lunged salamanders it is expressed only in the lung. This heterotopic gene expression, combined with predictions from structural modelling and respiratory tissue ultrastructure, suggests that lungless salamanders may produce pulmonary surfactant-like secretions outside the lungs and that the novel paralogue of SFTPC might facilitate extrapulmonary respiration in the absence of lungs. Heterotopic expression of the SFTPC paralogue may have contributed to the remarkable evolutionary radiation of lungless salamanders, which account for more than two thirds of urodele species alive today.

Growth Factor Independence-1 (Gfi1) Is Required for Pancreatic Acinar Unit Formation and Centroacinar Cell Differentiation.

BACKGROUND & AIMS: The genetic specification of the compartmentalized pancreatic acinar/centroacinar unit is poorly understood. Growth factor independence-1 (Gfi1) is a zinc finger transcriptional repressor that regulates hematopoietic stem cell maintenance, pre-T-cell differentiation, formation of granulocytes, inner ear hair cells, and the development of secretory cell types in the intestine. As GFI1/Gfi1 is expressed in human and rodent pancreas, we characterized the potential function of Gfi1 in mouse pancreatic development. METHODS: Gfi1 knockout mice were analyzed at histological and molecular levels, including qRT-PCR, in situ hybridization, immunohistochemistry, and electron microscopy. RESULTS: Loss of Gfi1 impacted formation and structure of the pancreatic acinar/centroacinar unit. Histologic and ultrastructural analysis of Gfi1-null pancreas revealed specific defects at the level of pancreatic acinar cells as well as the centroacinar cells (CACs) in Gfi1-/- mice when compared with wild-type littermates. Pancreatic endocrine differentiation, islet architecture, and function were unaffected. Organ domain patterning and the formation of ductal cells occurred normally during the murine secondary transition (E13.5-E14.5) in the Gfi1-/- pancreas. However, at later gestational time points (E18.5), expression of cellular markers for CACs was substantially reduced in Gfi1-/- mice, corroborated by electron microscopy imaging of the acinar/centroacinar unit. The reduction in CACs was correlated with an exocrine organ defect. Postnatally, Gfi1 deficiency resulted in severe pancreatic acinar dysplasia, including loss of granulation, autolytic vacuolation, and a proliferative and apoptotic response. CONCLUSIONS: Gfi1 plays an important role in regulating the development of pancreatic CACs and the function of pancreatic acinar cells.

[Tubal obstruction with an implant inserted by hysteroscopy: a report of 50 cases]. / Obstrucción tubaria con un implante insertado mediante histeroscopia: reporte de 50 casos.

BACKGROUND: The Essure contraceptive device consists of a titanium and nickel coiled spring containing Dacron fibers. It is placed under hysteroscopic visualizaron in the proximal section of the Fallopian tube. The microinsert acts by inducing a tissue reaction that permanently blocks the tube within three months. OBJECTIVE: Show our experience in the use and insertion of the Essure device, in a private office. METHODS: We reviewed insertion procedure, complications, degree of tolerance and acceptance by user. Between June 2008 and May 2013 fifty cases with Essure placement were made in our office. RESULTS: The average age was 36 years, as for the average number of pregnancies was two. The procedure time average was 6 minutes 25 seconds, no intraoperative complication was reported. All patients expressed very good tolerance and high degree of satisfaction with the procedure. A simple abdominal radiography was performed three months after the hysteroscopy to dem6nstrate the correct placement and position of the device, in all patients. CONCLUSION: [corrected] The number of patients is enough to show the advantages of the method and the possibility of performing it in an ambulatory environment, as it can be a private office with the correct equipment to do it.

[Usefulness of office hysteroscopy]. / Utilidad de la histeroscopia de consultorio.

OBJECTIVE: To demonstrate the efficacy and feasibility of the office hysteroscopy in the treatment of the endouterine pathologies. DESIGN: retrospective, descriptive and observational. PATIENTS AND METHOD: We included all the office hysteroscopies performed since February-2000 to August-2004 (n=84) in a private medical office. We performed 32 diagnostic procedures without anesthesia and 52 operative procedures with anesthesia (I.V. sedation). We used a Karl Storz diagnostic telescope and a Bettocchi operative telescope. RESULTS: Postoperative care was in the office since 90 minutes and all patients went home without complications, Mean age of the patients was 38+/-10 years. The indications to perform the procedure were infertility and abnormal transvaginal bleeding. There were not complications. All of the diagnostic procedures were done without anesthesia and we verified patient satisfaction with a pain store since 1 to 10 points. Twenty patients could get pregnant after the procedure and in two patients we detected endometrial carcinoma. CONCLUSION: With these results, we can assume that office hysteroscopy is a procedure with minimal complications when is performed by expert hands and with excellent patients' satisfaction and benefit.