Endometriosis rectosigmoidea infiltrante profunda. Claves para su diagnóstico / Deep infiltrating rectosigmoid endometriosis. Diagnostic keys

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¿A qué velocidad «muere» el ácido desoxirribonucleico del espermatozoide tras descongelar muestras seminales procedentes de donantes? / At what speed does sperm deoxyribonucleic acid “die” after donor semen samples are thawed?

Objetivo. Analizar los niveles de daño que se registran en el ADN de espermatozoides de donantes y estimar la velocidad a la que este se degrada tras la descongelación. Material y métodos. Dosis seminales procedentes de donantes (n = 50) y un grupo control formado por pacientes normozoospérmicos (n = 40). Se estudiaron los valores de fragmentación del ADN espermático (SDF) en su nivel basal, así como los valores de SDF tras incubación de las muestras a 37 °C durante 2, 6 y 24 h. Se calcularon las velocidades de degradación del ADN por tramos de incubación. Resultados. El semen criopreservado de donante presenta unos niveles basales de SDF 2 veces inferiores a los observados en los controles, y su ADN es 2,5 veces más longevo que el del grupo control. Niveles basales de SDF sobre un 8% generan una sensibilidad de un 82% y una especificidad de un 65% para discriminar entre los donantes y los controles. Los valores de incremento del daño de 1,8% por hora, analizados durante las 2 primeras horas de incubación, identifican a los donantes con un 77% de sensibilidad y un 65% de especificidad. Ambos valores no muestran ninguna correlación dentro del grupo de los controles, ni entre los donantes. Conclusiones. El establecimiento de este tipo de valores umbral se podría utilizar para identificar donantes considerados como «superdonantes» en relación con sus bajos niveles de SDF y su alta estabilidad de la cromatina. Los donantes que se seleccionaron en las diferentes clínicas presentan características equiparables para estos parámetros(AU)

Objective. The study was made to analyze the baseline levels of damage recorded in sperm DNA fragmentation (SDF) and to estimate sperm DNA longevity as observed in donors after thawing. Material and methods. Fifty donors and forty individuals attending a clinic and classified as a normo-zoospermic population were compared. The baseline SDF levels and the increasing rate of SDF (r-SDF) obtained after thawing when the sperm was incubated for a period of 24 h with different sub-sampling performed after 2, 6 and 24 h of incubation were considered as the independent variables and compared. Results. Cryopreserved donor sperm exhibited baseline SDF values approximately 2 times lower than those observed in the control group. DNA stability was 2.5 times higher than that observed in the control cohort. Baseline values of SDF of approximately 8% generates 65% sensitivity and 82% specificity to discriminate between the donors and controls. Values of increase of damage of 1.8% per hour, analyzed during the first hours of incubation, identify the donor characteristics with 77% sensibility and 65% specificity. Neither value show any correlation within the control and donor cohorts group. Conclusion. The establishment of these types of threshold values can be used to identify donors considered as “super-donors” in relation to their low levels of SDF and high chromatin stability. The donors selected from the different clinics participating in this study showed similar characteristics for these parameters(AU)

Rotura espontánea del bazo en paciente con neumonía por virus H1N1 / Spontaneous splecnic rupture in a patient with H1N1 virus pneumonia

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HIV-hepatitis C virus co-infection is associated with decreased plasmatic IL-7 levels.

We analysed the potential influence of hepatitis C virus (HCV) co-infection over IL-7 levels and thymic function in naive HIV-infected patients and after effective HAART. HIV-HCV-co-infected patients had lower plasmatic IL-7 levels compared with HIV-monoinfected patients. This effect may not be associated either with HCV monoinfection or with the rate of liver injury. These lower levels may explain, at least partly, the lower CD4 cell repopulation of HIV-HCV-co-infected patients after HAART.

Absence of de novo Y-chromosome microdeletions in male children conceived through intracytoplasmic sperm injection.

Molecular screening for Y-chromosome microdeletions in 96 Spanish male children conceived through intracytoplasmic sperm injection (ICSI) was conducted. No microdeletions were detected; these results support the notion that de novo Y-chromosome alterations are rare and unrelated to the ICSI technique itself.

Scanning of Y-chromosome azoospermia factors loci using real-time polymerase chain reaction and melting curve analysis.

OBJECTIVE: To develop a novel method to scan AZF loci looking for microdeletions. DESIGN: Molecular method development. SETTING: Men undergoing reproductive techniques in a private fertility unit. Molecular methods were performed in a private center for biomedical research. PATIENT(S): : Fifty-eight men divided in two groups depending on seminal analyses. A group of 19 women were also included as positive controls (absence of amplification). INTERVENTION(S): Peripheral blood extraction and DNA purification. MAIN OUTCOME MEASURE(S): Our method is based on real-time polymerase chain reaction (PCR) and melting curve analysis. We performed the screening of 16 selected sequence tagged sites (STS) within AZF loci, and we also calculated the mean, range, and standard deviation for melting temperature patterns and the crossing points values for each STS tested. RESULT(S): We detected one azoospermic patient with several STS deleted within the AZFc region. No deletions were detected in a group of 13 healthy men, and no amplification for any of the STS tested were observed in the positive control group (19 healthy women). CONCLUSION(S): We have developed a novel method based on real-time PCR and melting curve analysis to scan AZF loci looking for microdeletions This method is fast and reliable and permits the scanning of DNA from one patient per hour, minimizing the risk of cross contamination, and false-positive and false-negative results.

Comparison of thymic function-related markers to predict early CD4 T-cell repopulation in adult HIV-infected patients on HAART.

The aim of this work was to compare thymic function-related markers for predicting early CD4 T-cell repopulation in adult HIV-infected patients under HAART. Forty-three consecutive antiretroviral-naive patients were prospectively analysed for clinical, biochemical, immunological and virological parameters at starting HAART, and followed for 4 weeks and every 12 weeks thereafter. At baseline, all patients underwent a thoracic computer tomography scan, in order to measure thymic volume, as well, T-cell phenotype (naive CD4 and CD8 T cells) and the number of TREC-bearing cells were obtained. CD4 cell repopulation was considered as an increase > or = 200 cells/mm3 above baseline count. Twenty-seven patients (62.8%) increased > or = 200 cells/mm3 above baseline levels during the follow-up. The median time to event was 182 days (84-537 days). On the univariate analysis, to be younger than 36 years, showing a CD4 cell count > or = 272 cells/mm3, a total naive T-cell count > or = 128 cells/mm3, a TREC-bearing cell count > or = 0.74 cells/mm3, and a thymic volume > or =3.07 cc at baseline were statistically associated to the event studied. However, when the multivariate analysis was performed, only thymic volume at baseline was independently associated (P=0.002) to CD4 cell recovery. This co-variable was identified as a positive predictor [hazard ratio, 1.22 (95% confidence interval: 1.16-1.28)]. In summary, data presented herewith show that thymic volume is the best thymic function-related marker for predicting early CD4 T-cell recovery in adult HIV-infected patients under HAART.

Endogenous IL-7 is associated with increased thymic volume in adult HIV-infected patients under highly active antiretroviral therapy.

OBJECTIVE: Immune reconstitution after highly active antiretroviral therapy (HAART) in HIV-infected patients has led to an increase in the number of new CD4 T lymphocytes. Neolymphopoiesis in the thymus has been proposed as a mechanism in T-cell regeneration. Nevertheless, factors involved in the regeneration of T cells by thymic-dependent pathways in HIV-infected patients under HAART are still unknown and might be of relevance in HIV infection. The aim of this work was to study the role of IL-7 in the thymic rebound of HIV-infected adults under HAART. DESIGN: To study the association between IL-7 and thymic function-related markers, these variables were measured in 49 antiretroviral-naive HIV-infected patients at baseline and at weeks 12, 24, 36 and 48 of treatment. METHODS: Thymic function-related markers: thymic volume, naive phenotype, and T-cell receptor excision circles (TREC) bearing-cells, were evaluated by computed tomography, flow cytometry, and quantitative polymerase chain reaction, respectively. IL-7 levels were evaluated using a high sensitivity colorimetric enzyme-linked immunosorbent assay. RESULTS: At baseline, we found an inverse correlation between IL-7 levels and thymic function-associated parameters: thymic volume, naive T cells and TREC-bearing cells. After 48 weeks of therapy increased levels of thymic function-related markers along with a significant decrease in IL-7 levels were found. IL-7 levels at baseline were the only independently associated variable with respect to changes in thymic volume at weeks 12, 24 and 48 of follow-up. CONCLUSION: These data suggest that IL-7 plays an important role in thymic rebound in adult HIV-infected patients under HAART.

Baseline thymic volume is a predictor for CD4 T cell repopulation in adult HIV-infected patients under highly active antiretroviral therapy.

The objective of the present study was to assess the impact of baseline thymic volume on the CD4 cell repopulation induced by highly active antiretroviral therapy (HAART) in HIV-infected adults. Therefore, 37 previously untreated HIV-1-infected adults were prospectively followed from August 1998 to September 2001. All patients underwent a thorax CT scan at starting HAART to measure thymic volume. The median follow-up time was 189 [87.5-498.5] days. CD4 cell repopulation was considered as an increase > or = 200 cells/mm3 above baseline count. Twenty-one (57%) patients achieved this CD4 repopulation. Baseline thymic volume was the main independent factor associated with CD4 repopulation (P = 0.016); this factor was a positive predictor (adjusted hazard ratio: 1.25 [95% confidence interval 1.1-1.4]). Although, CD4 cell count and non-AIDS diagnosis at baseline were associated with CD4 cell repopulation on the univariate analysis (P = 0.03 and P = 0.02, respectively), no statistical signification was found on the multivariate test. In summary, baseline thymic volume is a predictor of early CD4 cell repopulation in adult HIV-1-infected patients taking HAART.

Evidence of thymic function in heavily antiretroviral-treated human immunodeficiency virus type 1-infected adults with long-term virologic treatment failure.

Thymic function was evaluated in 32 heavily antiretroviral-treated human immunodeficiency virus type 1 (HIV-1)-infected adults with long-term virologic treatment failure by measuring thymic volume, by determining the absolute number of naive T cell phenotypes, and by determining the number of cells carrying T cell receptor excision circles (TRECs). There was a significant inverse correlation between age and thymic volume (r=-0.415; P=.018), and there was a significant direct correlation between thymic volume and total naive T cell counts (r=0.529; P=.002), naive CD4(+) cell counts (r=0.437; P=.012), naive CD8(+) cell counts (r=0.467; P=.007), and TREC levels (r=0.391; P=.027). In conclusion, this study found clear evidence that the thymus of heavily antiretroviral-treated HIV-1-infected adults with long-term virologic treatment failure is actively engaged in thymopoiesis, which generates new naive T cells for the peripheral lymphocyte pool.

T-cell repopulation and thymic volume in HIV-1-infected adult patients after highly active antiretroviral therapy.

The origin of T cells after highly active antiretroviral therapy (HAART) in patients infected with human immunodeficiency virus 1 (HIV-1) is now under discussion. The possibility of renewed lymphopoiesis in aged thymuses is still controversial. In this work we combine the analysis of naïve T cells, T-cell receptor excision circles (TRECs), and computed tomography scanning of thymic tissue to further assess whether the thymus is involved in immune reconstitution. Fifteen antiretroviral-naïve HIV-1-infected patients were evaluated during 48 weeks of HAART. At baseline, significant correlation was present among age and both thymic volume and TRECs, and between naïve T cells and TRECs. After starting HAART, there was a significant increase at week 12 in naïve CD4(+) and CD8(+) T cells, TRECs, and thymic volume. The initial net increases in naïve T cells and TREC counts were significantly correlated. Changes in thymic volume and TRECs were also indirectly related; splitting the population into 2 groups of high and low baseline TREC levels, only the group with low TREC levels had significant increases in both TRECs and thymic volume. Thus, the increase in thymic volume might be functional, in response to depleted TREC levels. Taken together, our data strongly suggest a thymic role in immune reconstitution, at least in patients with depleted baseline TREC levels. (Blood. 2002;99:3702-3706)

Manifestaciones radiológicas típicas y atípicas del oncocitoma renal / Typical and atypical radiological manifestations of renal oncocytoma

Objetivos: Valorar los hallazgos radiológicos [Rx convencional, urografía intravenosa (UIV), ecografía y tomografía computarizada (TC)] de los oncocitomas renales, y determinar si presentan rasgos propios que nos permitan diferenciarlos del carcinoma de células renales (CCR).Material y método: Estudiamos de manera retrospectiva ocho enfermos diagnosticados de oncocitoma renal, analizando las características que presentaron en la radiografía simple y UIV, ecografía y TC sin y con contraste i.v. Resultados: Las masas eran bien delimitadas en siete casos y mal delimitadas en uno, siendo homogéneas en cuatro ocasiones y heterogéneas en dos. Las dos restantes fueron homogéneas, salvo por la presencia de una cicatriz central. Dos lesiones mostraron un comportamiento biológico agresivo, coincidiendo con signos sugestivos de malignidad desde el punto de vista radiológico. Conclusiones: La cicatriz fibrosa en un hallazgo típico pero infrecuente de oncocitoma renal, que detectamos únicamente mediante TC. No es posible diferenciarlos de lesiones agresivas exclusivamente mediante técnicas de imagen, aunque existen hallazgos orientativos (AU)

Respuesta al tratamiento de la infección urinaria baja con curas vesicales con solución de nitrofurazona

Se selecciona un grupo de pacientes con infección urinaria, se estudian precisamente los síntomas y gérmenes responsables de la infección. Se realizaron curas vesicales diariamente durante 10 días con solución de nitrofurazona. Se obtiene buen resultado en el 94,1 por ciento de los casos. Se muestra la sustitucion de medicamentos con esta terapéutica como medida alternativa (AU)

Respuesta al tratamiento de la infección urinaria baja con curas vesicales con solución de nitrofurazona / Response to the treatment of the infection low urinal with vesicle cures with solution of nitrofurazona

Se selecciona un grupo de pacientes con infección urinaria, se estudian precisamente los síntomas y gérmenes responsables de la infección. Se realizaron curas vesicales diariamente durante 10 días con solución de nitrofurazona. Se obtiene buen resultado en el 94,1 por ciento de los casos. Se muestra la sustitucion de medicamentos con esta terapéutica como medida alternativa