Cumulative steroid dose in hospitalized patients and COVID-19-associated pulmonary aspergillosis.

BACKGROUND: Severe COVID-19 elicits a hyperimmune response frequently amenable to steroids, which in turn increase the risk for opportunistic infections. COVID-19 associated pulmonary aspergillosis (CAPA) is a complication known to be associated with immunomodulatory treatment. The role of cumulative steroid dose in the development of CAPA is unclear. This study evaluates the relationship between cumulative steroid dose in hospitalized individuals with COVID-19 pneumonia and the risk for CAPA. METHODS: This retrospective cohort study includes 135 hospitalized patients with PCR-confirmed COVID-19 pneumonia at a tertiary centre in north Mexico. Patients who developed CAPA were matched by age and gender to two controls with COVID-19 pneumonia who did not develop CAPA defined and classified as possible, probable, or proven according to 2020 ECMM/ISHAM criteria. Cumulative steroid dose in dexamethasone equivalents was obtained from admission until death, discharge, or diagnosis of CAPA (whichever occurred first). The risk of CAPA by the continuous cumulative steroid dose was assessed using a logistic regression model. RESULTS: Forty-five patients were diagnosed with CAPA and matched to 90 controls. Mean age was 61 ± 14 years, and 72% were male. Mean cumulative steroid dose was 66 ± 75 mg in patients without CAPA vs 195 ± 226 mg in patients with CAPA (P<0.001). The risk for CAPA increased with higher cumulative dose of steroids (OR 1.0075, 95% CI: 1.0033-1.0116). CONCLUSIONS: Patients who developed CAPA had a history of higher cumulative steroid dose during hospitalization. The risk for CAPA increases ∼8% for every 10 mg of dexamethasone used.

Disseminated fusariosis in immunocompromised children: a case series and review of literature.

In the era of antifungal prophylaxis for cancer patients, Fusarium genus has become the second leading cause of invasive fungal infections and mortality in this group of patients. The intrinsic resistance to antifungal agents and the patient's risk factors are the most important variables for prognosis and survival. Currently, the use of monotherapy in comparison to combined antifungal treatment information is scarce. In this report, we present a series of three cases of children with acute lymphoblastic leukemia and disseminated fusariosis categorized according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG). Furthermore, we present a current literature review focused on treatment using monotherapy or combined antifungal treatment.

Sizing single nanoscale objects from polarization forces.

Sizing natural or engineered single nanoscale objects is fundamental in many areas of science and technology. To achieve it several advanced microscopic techniques have been developed, mostly based on electron and scanning probe microscopies. Still for soft and poorly adhered samples the existing techniques face important challenges. Here, we propose an alternative method to size single nanoscale objects based on the measurement of its electric polarization. The method is based on Electrostatic Force Microscopy measurements combined with a specifically designed multiparameter quantification algorithm, which gives the physical dimensions (height and width) of the nanoscale object. The proposed method is validated with ~50 nm diameter silver nanowires, and successfully applied to ~10 nm diameter bacterial polar flagella, an example of soft and poorly adhered nanoscale object. We show that an accuracy comparable to AFM topographic imaging can be achieved. The main advantage of the proposed method is that, being based on the measurement of long-range polarization forces, it can be applied without contacting the sample, what is key when considering poorly adhered and soft nanoscale objects. Potential applications of the proposed method to a wide range of nanoscale objects relevant in Material, Life Sciences and Nanomedicine is envisaged.

Identificación de Helicobacter pylori a partir de lesión aterosclerótica coronaria humana / Identification of Helicobacter pylori from human coronary aterosclerótica injury

Introducción:El principal mecanismo patogénico que subyace la génesis y desarrollo de enfermedades del sistema circulatorio es la aterosclerosis. Es un proceso patológico complejo y progresivo de la pared arterial que afecta especialmente a las arterias coronarias, cerebrales y periféricas.Actualmente se habla sobre "La hipótesis infecciosa de la aterosclerosis". La infección por Helicobacter pyloriha sido una de las más investigadas a nivel global. Objetivo:Identificar H. pyloria partir de lesiones ateroscleróticas de pacientes que acuden a los servicios de cirugía cardiovascular y angiología de la ciudad de Barranquilla.Métodos:Se realizó un estudio descriptivo de corte transversal.En una muestra de 102 participantes.Los ateromas fueron tomados por personal experto en endarterectomía y disección de vasos sanguíneos. Los especímenes fueron embebidos en solución formaldehído al 4%.Se realizó extracción de ADN a partir de ateromas. El diagnóstico molecular de H. Pylorise realizó por PCR ANIDADA, evidenciando un fragmento de 120 pb posterior a la electroforesis en gel de agarosa al 3,5% en TBE 0,5X. Resultados:Se obtuvieron 102 muestras de ateromas. Una muestra resultó positiva para H. pylori(Muestra #14; 1/102).El tejido aterosclerótico fue obtenido a partir de arteria coronaria derecha. Conclusión: La hipótesis infecciosa de la aterosclerosis ha sido uno de los principales temas de investigación a nivel mundial en las últimas décadas. La infección por H. pylori es un factorde riesgo, sin embargo, varios estudios son necesarios para poder concluir de manera más precisa.

Introduction:The main pathogenic mechanism underlying the genesis and development of diseases of the circulatory system is atherosclerosis. It is a complex and progressive pathological process of the arterial wall that affects especially the coronary, cerebral and peripheral arteries. Currently, there is talk about "The infectious hypothesis of atherosclerosis". Helicobacter pyloriinfection has been one of the most researched worldwide. Objective:To identify H. pylori from atherosclerotic lesions of patients who attend the cardiovascular and angiology services of the city of Barranquilla. Methods:A descriptive cross-sectional study was carried out. In a sample of 102 participants. The atheromas were taken by expert personnel in endarterectomy and dissection of blood vessels. The specimens were embedded in 4% formaldehyde solution. DNA extraction was performed from atheromas. The molecular diagnosis of H. pyloriwas performed by ANIDADA PCR, evidencing a 120 bp fragment after electrophoresis in a 3.5% agarose gel in 0.5X TBE. Results:102 samples of atheromas were obtained. One sample was positive for H. pylori (Sample # 14, 1/102). The atherosclerotic tissue was obtained from the right coronary artery. Conclusion:The infectious hypothesis of atherosclerosis has been one of the main research topics worldwide in recent decades. H. pyloriinfection is a risk factor, however, several studies are necessary to be able to conclude more accurately

Diagnóstico molecular de infección por virus herpes simplex tipo 1 en tejido aterosclerótico humano / Molecular diagnosis of infection by herpes simplex type 1 virus in human aterosclerótico tissue

Introducción:Las enfermedades del sistema circulatorio representan uno de los mayores problemas de salud pública a nivel mundial, nacional y regional. Elmecanismo patogénico que subyace esta patología es la aterosclerosis. Existenvarios factores que favorecen la etiopatogeniade la lesión aterosclerótica.Las infecciones, juegan un papel importante.La infección por el Virus del Herpes Simplexse ha considerado como un factor de riesgo emergente. Objetivo:Realizar diagnósticomolecular de infección porVirus Herpes Simplex tipo 1 y tipo 2en tejido aterosclerótico humano.Método:Se realizó extracción de ADN viral a partir de ateromas usando el kit comercial PureGenomeTM Tissue DNA Extraction.La amplificación delmaterial genético viralse realizó porPCR en tiempo real (qPCR) con el kit comercial "Human Herpes Virus 2 (Herpes simplex type 2)UL36 region genesig Standard Kit y Human Herpes Virus 1 (Herpes simplex type 1) Capsid assembly and DNA maturation gene. Genesig Standard Kit".Resultados:En total se obtuvieron 102 muestras de ateromas, extraídas de diferentes fuentes anatómicas. Tresmuestras resultaronpositivas para VHS tipo 1(3/102).Ninguna muestra evidenció material genético para VHS tipo 2 (0/102). Conclusión:La etiopatogenia de la aterosclerosis es un proceso altamente complejo.Los virus juegan un papel importante, en especial la infección por Virus del herpes simplex tipo 1. La infección por estevirus genera cambios a nivel de las células vasculares y no vasculares, favoreciendo el acumulo de lipoproteínas de baja densidad químicamente oxidadas, importantespara la aterogénesis

Introduction:Diseases of the circulatory system represent one of the greatest public health problems worldwide, nationally and regionally. The pathogenic mechanism that underlies this pathology is atherosclerosis. There are several factors that favor the etiopathogeny of the atherosclerotic lesion. Infections play an important role. Infection with Herpes Simplex Virus has been considered as an emerging risk factor. Objective: To perform molecular diagnosis of infection by Herpes Simplex virus type 1 and type 2 in human atherosclerotic tissue. Method:Viral DNA extraction was performed from atheromas using the commercial PureGenomeTM Tissue DNA Extraction kit. The amplification of the viral genetic material was performed by real-time PCR (qPCR) with the commercial kit "Human Herpes Virus 2 (Herpes simplex type 2) UL36 region genesig Standard Kit and Human Herpes Virus 1 (Herpes simplex type 1) Capsid assembly and DNA maturation gene Genesig Standard Kit ". Results:A total of 102 samples of atheromas were obtained, extracted from different anatomicalsources. Three samples were positive for HSV type 1 (3/102). No sample showed genetic material for HSV type 2 (0/102). Conclusion:The etiopathogenesis of atherosclerosis is a highly complex process. Viruses play an important role, especially the infection by Herpes simplex virus type 1. The infection by this virus generates changes at the level of vascular and non-vascular cells, favoring the accumulation of chemically oxidized low density lipoproteins, important for the atherogenesis

Factores que afectan la calidad seminal en toros: [revisión] / Factors affecting seminal quality in bulls: [review]

La calidad seminal de los toros se puede ver afectada por múltiples causas tanto de origen infeccioso o no infeccioso. El entendimiento adecuado de estas causas es de gran importancia ya que de este modo se pueden tomar los correctivos necesarios ya sea para tratar al toro, o en otros casos para descartar lo del sistema productivo del cual haga parte. No se debe olvidar como la presencia física del toro se puede dar a partir de un banco de germoplasma (semen congelado), el cual puede tener problemas de calidad no inherentes al proceso de criopreservación sino a factores infecciosos o no infecciosos previos a la congelación. Los problemas de calidad seminal se verán reflejados en los diferentes parámetros reproductivos del sistema productivo, lo que a su véz será de gran relevancia al hacer un balance de pérdidas y ganancias de una ganadería tanto de ganado de carne como de leche.

Semen quality of bulls can be affected by multiple causes, both infectious and non infectious. Proper understanding of these causes is imperative, either to take the necessary correctives to treat the bull or to discard it from the productive system. It is important not to forget that the physical presence of the bull can be from a germoplasm bank (frozen semen) which can have quality problems not related to the cryopreservation procedure but to infectious or not infectious factors before freezing. Seminal quality problems will be reflected on different reproductive parameters of the productive system and these will be highly relevant when estimating earnings and losses of the productive system, both for beef or milk production.

[Immune-testicular regulation and cytokines]. / Regulación inmuno-testicular y citocinas.

The pathogenesis of male infertility can be reflected in alterations of spermatogenesis caused by testicular cancer, aplasia of the germinal cells, varicocele, environmental factors or defect in the transport of the sperms, among others. In general, 48% of men suffer unexplained infertility. During a long time, the masculine reproductive tract and the immune system have been studied as different and independent systems. However, in the last two decades a particular interest has arisen in the interaction of both systems on masculine infertility, in particular in the evaluation of antisperm antibodies as a common cause of infertility. Also, the inflammation due to genital or systemic infections can cause alterations in the testicular function. The recognition of intratesticular antigens provokes the production of antibodies by B lymphocytes. Then, the immune system induces a cellular response, by cytokines secretion, activation of complement and T lymphocytes activation. In this review the components and the immune system response mechanism, the organization of the testicle as a reproductive organ and the mediators of the immunologic response will be examined: interleukin-1 (IL-1), IL-6, leukaemia Inhibitory factor, tumor necrosis factor-alpha, the molecule FasL (CD95L) and Fas (CD95), macrophage migration-inhibitory factor, mononuclear phagocyte colony stimulating factor, Granulocyte/macrophage colony stimulating factor, as well as stem cell factor, interferon, transforming growth factor B and activins.

Regulación inmuno-testicular y citocinas / Immune-testicular regulation and cytokines

La patogénesis de la infertilidad masculina se puede reflejar en una alteración de la espermatogénesis, causada por cáncer testicular, aplasia de las células germinales, varicocele, factores ambientales o defecto en el transporte de los espermatozoides, entre otros. En general, un 48 por ciento de hombres cursa con esterilidad sin causa aparente. Durante mucho tiempo, el tracto reproductor masculino y el sistema inmunológico han sido estudiados como sistemas diferentes e independientes. Sin embargo, en las dos últimas décadas se ha despertado un particular interés por la interacción de ambos sistemas en la infertilidad masculina, con énfasis en la evaluación de anticuerpos antiespermáticos como causa común de infertilidad. Además, la inflamación debida a infecciones genitales o sistémicas puede causar alteraciones en la función testicular. El reconocimiento de los antígenos intratesticulares, provoca la producción de anticuerpos por parte de los linfocitos B. Luego, el sistema inmunológico induce una respuesta celular, mediante la secreción de citoquinas, activación del complemento y activación de los linfocitos T. En la presente revisión se examinar n los componentes y el mecanismo de respuesta del sistema inmunológico, la organización del testículo como órgano reproductor, los mediadores de la respuesta inmunológica: interleucina-1 (IL-1), IL-6 Factor Inhibidor de la Leucemia, Factor de necrosis tumoral a, Molécula FasL (CD95L) y Fas (CD95), Factor inhibitorio de la migración de macrófagos, Factor Estimulador de las Colonias de Fagocitos Mononucleares y Factor Estimulador de las Colonias de Granulocitos/macrófagos, así como Factor de Células Madres, Interferón, Factor de Transformación y Crecimiento ß y activinas.

Improving access to liver transplantation: the University of Puerto Rico experience

Liver transplantation is the only treatment for end-stage liver disease. It is costly, difficult, and not performed in Puerto Rico. For these reasons, it has been a limited option for Puerto Ricans with advanced cirrhosis, especially for those with no medical insurance to cover for the procedure. In an effort to improve access to the procedure and offer this chance of life to more Puerto Ricans facing death from complications of advanced liver disease, the Gastroenterology and Liver Diseases Division of the University of Puerto Rico, in collaboration with LifeLink Transplant Institute in Tampa, Florida and the Office of Catastrophic Funds of the Commonwealth of Puerto Rico, opened a clinic for liver transplant evaluation at the Medical Sciences Campus. The purpose of this clinic is to coordinate the pre-transplant evaluation of candidates for this therapy, provide the evaluation by the transplant surgeon in Puerto Rico, expedite the process in seriously ill patients, and offer post-transplant follow-up upon the patient's return to Puerto Rico. The purpose of this article is to describe the experience in this clinic from 1999 to 2003. One hundred ninety-three patients were seen from September 1999 to January 2003. The most common causes for liver disease were hepatitis C and alcohol, alone or in combination. One hundred thirty four were accepted as candidates for evaluation. Of these, 63 had completed the process, 33 were listed for transplantation and 21 had been transplanted by January 2003. Neither education level, marital status, health insurance nor Child score were associated with successful outcome. This clinic offers Puerto Ricans, especially those with limited resources, with a viable access to liver transplantation.

Ovarian steroids in endometrial angiogenesis.

Angiogenesis, the sprouting of new blood vessels from pre-existing ones, is fundamental for human endometrial development and differentiation, which are necessary for implantation. This vascular process is supposed to be mainly mediated by the vascular endothelial growth factor (VEGF), also named vascular permeability factor (VPF). We report here the expression and modulation of VEGF and its receptors, Flk-1/KDR and Flt-1, in the functionalis throughout the menstrual cycle. Using immunocytochemistry, VEGF is localized in glandular epithelial cells and in the surrounding stroma, as well as in capillaries and spiral arterioles. The localization of VEGF on the endothelium correlates with the presence of Flt-1 and Flk-1/KDR receptors on vascular structures, including capillary strands that have not yet formed a lumen and that have been previously described in tumors as angiogenic capillaries. The strongest immunoreactivity for both VEGF and Flk-1/KDR receptor on endothelial cells is detected in the proliferative and midsecretory phases. Enhanced expression of VEGF and its Flk-1 receptors on narrow capillary strands during the proliferative phase may account for the rapid capillary growth associated with endometrial regeneration from the residual basal layer following menstrual shedding of the functionalis. The vascular expression of Flt-1 is more important in the secretory than in the proliferative phase, associated with a high microvascular density and an increase in vascular permeability in the implantation period. Consistently with these in vivo observations, the treatment of isolated endometrial stromal cells with estradiol (E(2)), or E(2) + progesterone, significantly increased VEGF mRNA over the control value in a dose-dependent manner. These results demonstrate that the expression of VEGF and its receptors is cyclically modulated by ovarian steroids, and that this endothelial growth factor acts on the endothelium in a paracrine fashion to control endometrial angiogenesis and permeability.

VP4 and VP7 genotyping by reverse transcription-PCR of human rotavirus in mexican children with acute diarrhea.

Dual typing (VP4 and VP7) of rotavirus obtained from 257 Mexican children during three epidemiological seasons was performed by reverse transcription-PCR. The P1G1 genotype was the most prevalent (40%), followed by P1G3 (19%) and P2G2 (16%). Thirty-one specimens (12%) presented mixed infections, while some genotypes were not found. This is the first dual typing of isolates from diarrhea cases in Mexico.

[Cytotoxic effect of Vibrio cholerae non-O1 on Vero cells]. / Efecto citotóxico de Vibrio cholerae no-O1 en células Vero.

At the present time there is still in Mexico a diarrhoeal outbreak due to Vibrio cholerae O1. In INDRE we have isolated from the same outbreak last year (jan-apr), 70 strains of Vibrio cholerae Non-O1. These were isolated from patients with a diarrhoeal illness different from cholera. Patients were of different ages and sex, and from various geographic areas. The isolated strains were confirmed by serological agglutination test with polyclonal antisera, and they neither belong to O1 serogroup or O139. We assayed all the 70 strains in Vero cells, searching for cytotoxic effect, probably attributed to cholera toxin, or any other toxin. The strains were screened by PCR for cholera toxin gene detection, and negative results were obtained. We have found only one CT-producer strain, but it was a rough one so, we are not able to affirm that is not a V. cholerae O1 serotype. Vibrio cholerae Non-O1 strains, tested in Vero cells assay, produced cytotoxic effect within 24 h. It was found that 48/70 strains (66.6%), had cytotoxic activity, showing rounding and then lysis of cells. From our results we concluded that this cytotoxic effect, is not cholera toxin related, instead we propose it could be due to an unknown virulence factor, probably a different toxin in mexican Vibrio cholerae Non-O1 strains.

Clinical evaluation of Per Q Cath for both pediatric and adult home infusion therapy.

The use of a single-lumen silastic percutaneous catheter, Per Q Cath, in home pediatric and adult cases was evaluated among 54 patients. Sixty-one catheters were successfully placed in 54 home infusion patients. No patient demonstrated systemic signs of infection or sepsis. Five catheters were removed because of local phlebitis and four because of clotting. Per Q Cath provided long-term I.V. access without the trauma and expense of inserting a central venous catheter.