Concordancia citocolposcópica con la prueba histopatológica en la identificación de neoplasias intraepiteliales cervicales / Cytocolposcopic concordance with histopathologic testing in the identification of cervical intraepithelial neoplasia

Resumen OBJETIVO: Evaluar la concordancia diagnóstica entre la citología y la colposcopia respecto del diagnóstico histopatológico de cáncer cervicouterino en mujeres del estado de San Luis Potosí que acudieron a un hospital de segundo nivel de atención. MATERIALES Y MÉTODOS: Estudio correlacional efectuado en un hospital de segundo nivel de atención del Municipio de San Luis Potosí, entre 2015 y 2017. Criterios de inclusión: reunir tres reportes de las pruebas de Papanicolaou, colposcopia e histopatología basados en la clasificación de Richart, ser usuarias de la clínica de colposcopia del hospital y haber firmado el consentimiento informado. Para evaluar la concordancia diagnóstica, tomando como referencia el resultado histopatológico, se realizó la prueba de Kappa. RESULTADOS: Se estudiaron 379 pacientes con media de edad de 34.61 años. La sensibilidad, especificidad, valor predictivo positivo y negativo de la prueba de Papanicolaou fueron: 95.60, 6.60, 96.13 y 5.82%, respectivamente. La sensibilidad, especificidad, valor predictivo positivo y negativo de la colposcopia fueron: 95.98, 33.33, 98.90 y 11.76%, respectivamente. Al hacer la prueba de Kappa el desenlace para el Papanicolaou fue: 0.021 (p = 0.677) y para la colposcopia 0.154 (p = 0.001). CONCLUSIONES: La sensibilidad de la prueba diagnóstica de Papanicolaou y la colposcopia fue alta al igual que el valor predictivo positivo. Es importante analizar las variables que pudieran estar ocasionando la discordancia diagnóstica entre Papanicolaou-colposcopia-histopatología.

Abstract OBJECTIVE: To evaluate the diagnostic concordance between cytology and colposcopy with respect to the histopathological diagnosis of cervical cancer in women from the state of San Luis Potosí who attended a second-level care hospital. MATERIALS AND METHODS: Correlational study performed in a second-level care hospital in the municipality of San Luis Potosí, between 2015 and 2017. Inclusion criteria: to gather three reports of Papanicolaou, colposcopy and histopathology tests based on Richart's classification, to be users of the hospital's colposcopy clinic and to have signed the informed consent. To evaluate the diagnostic concordance, taking the histopathological result as a reference, the Kappa test was performed. RESULTS: We studied 379 patients with a mean age of 34.61 years. The sensitivity, specificity, positive and negative predictive value of the Papanicolaou test were: 95.60, 6.60, 96.13 and 5.82%, respectively. The sensitivity, specificity, positive and negative predictive value of colposcopy were: 95.98, 33.33, 98.90 and 11.76%, respectively. When doing the Kappa test the outcome for Papanicolaou was: 0.021 (p = 0.677) and for colposcopy 0.154 (p = 0.001). CONCLUSIONS: The sensitivity of the Papanicolaou diagnostic test and colposcopy was high as was the positive predictive value. It is important to analyze the variables that could be causing the diagnostic discordance between Papanicolaou-colposcopy-histopathology.

Evaluación del ángulo de fase por bioimpedancia vectorial eléctrica en mujeres con cáncer cervicouterino / Phase angle assessment by electrical vector bioimpedance in women with cervical cancer

Introducción: el cáncer cervicouterino es el segundo cáncer más común en las mujeres en el mundo. Se asocia a un índice de masa corporal elevado. Sin embargo, no se ha determinado el ángulo de fase en las mujeres con cáncer cervicouterino. La bioimpedancia vectorial eléctrica está validada para evaluar la composición corporal, el estado nutricional y la integridad de la membrana celular en pacientes con cáncer mediante el ángulo de fase. Objetivo: evaluar el ángulo de fase, la composición corporal por bioimpedancia vectorial eléctrica y el consumo dietético en mujeres con diagnóstico de cáncer cervicouterino usuarias de un hospital de segundo nivel de atención en San Luis Potosí, México. Métodos: estudio observacional, transversal y analítico. Se estudiaron 70 mujeres con diagnóstico de cáncer cervicouterino en el servicio de oncología. Se realizó la medición del ángulo de fase y se aplicó la frecuencia de alimentos del Sistema de Evaluación de Hábitos Nutricionales, así como un cuestionario para medir el nivel socioeconómico. Resultados: el ángulo de fase presentó una media de 4,66° ± 0,87° con un rango de 2,9° a 6,2°. El modelo de regresión lineal múltiple formado para el ángulo de fase como variable dependiente y la evolución del cáncer cervicouterino, el índice de masa corporal, la masa de músculo esquelético, el agua extracelular, la fructosa, los ácidos grasos saturados y los ácidos grasos trans como variables independientes, tuvo un valor de R2 de 0,748 con un valor de p de 0,001. Conclusión: las mujeres con cáncer cervicouterino mostraron daños en la integridad de la membrana celular, con un ángulo de fase menor que el de la población de referencia. (AU)

Introduction: cervical cancer is the second most common cancer in women in the world. It is associated with a high body mass index. However, the phase angle has not been determined in women with cervical cancer. Electrical vector bioimpedance has been validated to assess body composition, nutritional status, and cell membrane integrity in cancer patients using phase angle. Objetive: to evaluate phase angle, body composition by electrical vector bioimpedance, and dietary intake in women with cervical diagnosis who are users of a second-level care hospital in San Luis Potosí, Mexico. Methods: an observational, cross-sectional, and analytical study. Seventy women with a diagnosis of cervical cancer were studied in the oncology service. Phase angle was measured, and the frequency of food from the Nutritional Habits Assessment System and a questionnaire to measure socioeconomic level were applied. Results: the data of the phase angle in a mean of 4.66° ± 0.87° with a range of 2.9° to 6.2°. In a multiple linear regression model formed for phase angle as a dependent variable, and evolution of the cervical cancer, body mass index, skeletal muscle mass, extracellular water, fructose, saturated fatty acids, and trans fatty acids as independent variables, had an R2 value of 0.748 with a p-value of 0.001. Conclusion: women with cervical cancer have integrity damage of the cell membrane with a lower phase angle than the reference population. (AU)

[Phase angle assessment by electrical vector bioimpedance in women with cervical cancer]. / Evaluación del ángulo de fase por bioimpedancia vectorial eléctrica en mujeres con cáncer cervicouterino.

INTRODUCTION: Introduction: cervical cancer is the second most common cancer in women in the world. It is associated with a high body mass index. However, the phase angle has not been determined in women with cervical cancer. Electrical vector bioimpedance has been validated to assess body composition, nutritional status, and cell membrane integrity in cancer patients using phase angle. Objetive: to evaluate phase angle, body composition by electrical vector bioimpedance, and dietary intake in women with cervical diagnosis who are users of a second-level care hospital in San Luis Potosí, Mexico. Methods: an observational, cross-sectional, and analytical study. Seventy women with a diagnosis of cervical cancer were studied in the oncology service. Phase angle was measured, and the frequency of food from the Nutritional Habits Assessment System and a questionnaire to measure socioeconomic level were applied. Results: the data of the phase angle in a mean of 4.66 ° ± 0.87 ° with a range of 2.9 ° to 6.2 ° In a multiple linear regression model formed for phase angle as a dependent variable, and evolution of the cervical cancer, body mass index, skeletal muscle mass, extracellular water, fructose, saturated fatty acids, and trans fatty acids as independent variables, had an R2 value of 0.748 with a p-value of 0.001. Conclusion: women with cervical cancer have integrity damage of the cell membrane with a lower phase angle than the reference population.

INTRODUCCIÓN: Introducción: el cáncer cervicouterino es el segundo cáncer más común en las mujeres en el mundo. Se asocia a un índice de masa corporal elevado. Sin embargo, no se ha determinado el ángulo de fase en las mujeres con cáncer cervicouterino. La bioimpedancia vectorial eléctrica está validada para evaluar la composición corporal, el estado nutricional y la integridad de la membrana celular en pacientes con cáncer mediante el ángulo de fase. Objetivo: evaluar el ángulo de fase, la composición corporal por bioimpedancia vectorial eléctrica y el consumo dietético en mujeres con diagnóstico de cáncer cervicouterino usuarias de un hospital de segundo nivel de atención en San Luis Potosí, México. Métodos: estudio observacional, transversal y analítico. Se estudiaron 70 mujeres con diagnóstico de cáncer cervicouterino en el servicio de oncología. Se realizó la medición del ángulo de fase y se aplicó la frecuencia de alimentos del Sistema de Evaluación de Hábitos Nutricionales, así como un cuestionario para medir el nivel socioeconómico. Resultados: el ángulo de fase presentó una media de 4,66 ° ± 0,87 ° con un rango de 2,9 ° a 6,2 °. El modelo de regresión lineal múltiple formado para el ángulo de fase como variable dependiente y la evolución del cáncer cervicouterino, el índice de masa corporal, la masa de músculo esquelético, el agua extracelular, la fructosa, los ácidos grasos saturados y los ácidos grasos trans como variables independientes, tuvo un valor de R2 de 0,748 con un valor de p de 0,001. Conclusión: las mujeres con cáncer cervicouterino mostraron daños en la integridad de la membrana celular, con un ángulo de fase menor que el de la población de referencia.

Geospatial modelling to estimate the territory at risk of establishment of influenza type A in Mexico - An ecological study.

The aim of this study was to estimate the territory at risk of establishment of influenza type A (EOITA) in Mexico, using geospatial models. A spatial database of 1973 outbreaks of influenza worldwide was used to develop risk models accounting for natural (natural threat), anthropic (man-made) and environmental (combination of the above) transmission. Then, a virus establishment risk model; an introduction model of influenza A developed in another study; and the three models mentioned were utilized using multi-criteria spatial evaluation supported by geographically weighted regression (GWR), receiver operating characteristic analysis and Moran's I. The results show that environmental risk was concentrated along the Gulf and Pacific coasts, the Yucatan Peninsula and southern Baja California. The identified risk for EOITA in Mexico were: 15.6% and 4.8%, by natural and anthropic risk, respectively, while 18.5% presented simultaneous environmental, natural and anthropic risk. Overall, 28.1% of localities in Mexico presented a High/High risk for the establishment of influenza type A (area under the curve=0.923, P<0.001; GWR, r2=0.840, P<0.001; Moran's I =0.79, P<0.001). Hence, these geospatial models were able to robustly estimate those areas susceptible to EOITA, where the results obtained show the relation between the geographical area and the different effects on health. The information obtained should help devising and directing strategies leading to efficient prevention and sound administration of both human and financial resources.

Efecto del aceite esencial de Chrysactinia mexicana A. Gray sobre aislados clínicos de Candida glabrata / Effect of the essential oil of Chrysactinia mexicana A. Gray on clinical isolates of Candida glabrata

El objetivo del trabajo fue evaluar el efecto del aceite esencial Chrysactinia mexicana A. Gray en aislados clínicos de C. glabrata. Se obtuvo aceite esencial por arrastre de vapor de las flores, hojas y ramas secundarias de C. mexicana. Se realizó cromatografía de gases y espectrometría de masas para conocer la composición del aceite. Se hicieron ensayos de microdilución en fase logarítmica y fase estacionaria con Saccharomyces cerevisiae y aislados clínicos de C. glabrata para determinar la Concentración Mínima Inhibitoria (CMI) en presencia del aceite esencial. Los principales compuestos del aceite esencial fueron la piperitona (29.57 %), eucaliptol (26.86 %), a-terpineol (14.65 %), delta-3-careno (12.37 %) y linalool (3.56 %). Se determinaron las CMI del aceite esencial, para las cinco cepas utilizadas en las dos fases de crecimiento, siendo menor la CMI para S. cerevisiae que para los diferentes aislados clínicos de C. glabrata. El aceite esencial de C. mexicana tiene efecto fungicida en S. cerevisiae y los aislados clínicos de C. glabrata.

Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third Histologic Level.

AIM: Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce. OBJECTIVE: To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC. MATERIALS AND METHODS: A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution. RESULTS: During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant. CONCLUSION: By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.

Insights into Ergosterol Peroxide's Trypanocidal Activity.

Trypanosoma cruzi, which causes Chagas disease, is a significant health threat in many countries and affects millions of people. Given the magnitude of this disease, a broader understanding of trypanocidal mechanisms is needed to prevent and treat infection. Natural endoperoxides, such as ergosterol peroxide, have been shown to be toxic to parasites without causing harm to human cells or tissues. Although prior studies have demonstrated the trypanocidal activity of ergosterol peroxide, the cellular and molecular mechanisms remain unknown. The results of this study indicate that a free-radical reaction occurs in T. cruzi following ergosterol peroxide exposure, leading to cell death. Using a combination of biochemical, microscopic and in silico experimental approaches, we have identified, for the first time, the cellular and molecular cytotoxic mechanism of an ergosterol peroxide obtained from Pleurotus ostreatus (Jacq) P. Kumm. f. sp. Florida.

Situación futura de la cardiopatía isquémica en el estado de San Luis Potosí: un modelo dinámico predictivo / Future status of ischaemic heart disease in the state of San Luis Potosí: A predictive dynamic model

Resumen Objetivo: Desarrollar un modelo dinámico predictivo para generar y analizar la situación futura de la tasa de incidencia de la enfermedad isquémica del corazón en población de 25 años y mayores en México, en función de la variación en el tiempo de algunos factores de riesgo. Método: Estudio ecológico retrospectivo durante el periodo 2013-2015, en la ciudad de San Luis Potosí (México). Se utilizaron bases de datos secundarias con indicadores oficiales de los 58 municipios que conforman el estado de San Luis Potosí, los cuales corresponden a los años 2000, 2005 y 2010. Se analizaron 8 indicadores a nivel municipio, por medio de los métodos de análisis de componentes principales, modelos de ecuaciones estructurales, modelaje dinámico y software de simulación. Resultados: Fueron extraídos 3 componentes que en conjunto explican el 80.43% de la varianza total de los indicadores oficiales utilizados; el segundo componente tiene un peso de 16.36 unidades que favorecen el incremento de la enfermedad analizada; este componente está integrado solo por el indicador EDAD 60-64 y el escenario esperado del mismo va en aumento. El modelo estructural confirma que los indicadores explican el 42% de la variación de esta enfermedad; los posibles escenarios para los años 2015, 2020 y 2025 son de 195.7, 240.7 y 298, respectivamente, por cada 100,000 habitantes de 25 años y mayores. Conclusiones: Se espera un incremento exponencial en la tasa de incidencia de la enfermedad isquémica del corazón; la edad de 60-64 años se identificó como el factor de riesgo de más peso. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Abstract Objective: To develop a predictive dynamic model to generate and analyse the future status of the incidence rate of ischaemic heart disease in a population of 25 years and over in Mexico, according to the variation in time of some risk factors. Method: Retrospective ecological study performed during the period 2013-2015, in San Luis Potosí City, Mexico. Secondary databases that corresponded to the years 2000, 2005, and 2010, were used along with official indicators of the 58 municipalities of the state of San Luis Potosí. Eight indicators were analysed at municipality level, using principal components analysis, structural equation modelling, dynamic modelling, and simulation software methods. Results: Three components were extracted, which together explained 80.43% of the total variance of the official indicators used. The second component had a weight of 16.36 units that favoured an increase of the disease analysed. This component was integrated only by the indicator AGE 60-64 and the expected stage of it increasing. The structural model confirmed that the indicators explain 42% of the variation of this disease. The possible stages for the years 2015, 2020, and 2025 are 195.7, 240.7, and 298.0, respectively for every 100,000 inhabitants aged 25 and over. Conclusions: An exponential increase in the incidence rate of ischaemic heart disease is expected, with the age of 60-64 years being identified as the highest risk factor. © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

[Future status of ischaemic heart disease in the state of San Luis Potosí: A predictive dynamic model]. / Situación futura de la cardiopatía isquémica en el estado de San Luis Potosí: un modelo dinámico predictivo.

OBJECTIVE: To develop a predictive dynamic model to generate and analyse the future status of the incidence rate of ischaemic heart disease in a population of 25 years and over in Mexico, according to the variation in time of some risk factors. METHOD: Retrospective ecological study performed during the period 2013-2015, in San Luis Potosí City, Mexico. Secondary databases that corresponded to the years 2000, 2005, and 2010, were used along with official indicators of the 58 municipalities of the state of San Luis Potosí. Eight indicators were analysed at municipality level, using principal components analysis, structural equation modelling, dynamic modelling, and simulation software methods. RESULTS: Three components were extracted, which together explained 80.43% of the total variance of the official indicators used. The second component had a weight of 16.36 units that favoured an increase of the disease analysed. This component was integrated only by the indicator AGE 60-64 and the expected stage of it increasing. The structural model confirmed that the indicators explain 42% of the variation of this disease. The possible stages for the years 2015, 2020, and 2025 are 195.7, 240.7, and 298.0, respectively for every 100,000 inhabitants aged 25 and over. CONCLUSIONS: An exponential increase in the incidence rate of ischaemic heart disease is expected, with the age of 60-64 years being identified as the highest risk factor.

A novel downstream regulatory element cooperates with the silencing machinery to repress EPA1 expression in Candida glabrata.

Candida glabrata, an opportunistic fungal pathogen, adheres to mammalian epithelial cells; adherence is mediated primarily by the Epa1 adhesin. EPA1 is a member of a large gene family of ≈ 23 paralogues, which encode putative adhesins. In this study, we address how EPA1 transcription is regulated. Our data show that EPA1 expression is subject to two distinct negative regulatory mechanisms. EPA1 transcription is repressed by subtelomeric silencing: the Sir complex (Sir2-Sir4), Rap1, Rif1, yKu70, and yKu80 are required for full repression. Activation of EPA1 occurs immediately after dilution of stationary phase (SP) cells into fresh media; however, transcription is rapidly repressed again, limiting expression to lag phase, just as the cells exit stationary phase. This repression following lag phase requires a cis-acting regulatory negative element (NE) located in the EPA1 3'-intergenic region and is independent of telomere proximity. Bioinformatic analysis shows that there are 10 copies of the NE-like sequence in the C. glabrata genome associated with other EPA genes as well as non-EPA genes.