Tumor-like presentation of herpetic cervicitis: A case report.

The case of a 20-year-old immunocompetent woman with necrotizing cervicitis of the cervix caused by a primary infection with herpes simplex virus type 2 is presented, along with its respective evolution in images. Cervical cancer was included in the differential diagnoses, but biopsies ruled out malignancy and laboratory tests demonstrated the viral etiology of the cervical inflammation. After initiating specific treatment, the cervical lesions completely healed within 3 weeks. This case highlights the need to consider herpes simplex infection in the differential diagnosis of cervical inflammation and tumor formation. Additionally, it provides images that can aid in diagnosis and allow for the observation of its clinical evolution.

The role of military forces in emergency management (civil-military interaction).

Those involved in emergency response and recovery, including the military, require an acute level of awareness of livelihoods that rely on livestock and their associated implications for human security. Emergencies cause injury and death and devastate livestock-based livelihoods, a key characteristic of the lives of many of the world's rural poor. The role for military forces in emergency management is expanding, and this can cause friction during an emergency due to competing agendas and objectives. Opportunities exist to make greater use of the military, such as providing support to livestock-based livelihoods, but there are challenges and barriers that must be overcome. A common framework for civil-military interaction may help to coordinate response efforts and enhance local and international responses to emergencies. The Livestock Emergency Guidelines and Standards and the proposed livelihood security model are constructs that can help to develop a shared understanding of the security environment during a livestock emergency response. Examples from the Philippines' response to Typhoons Sarika and Haima and Sri Lankan military agricultural engagements provide context for a proposed common operational framework.

Les intervenants dans la réponse et le redressement suite à une situation d'urgence, forces armées incluses, doivent avoir une conscience aiguë du fait que les moyens d'existence des populations affectées sont souvent tributaires du bétail, ce qui a des conséquences en termes de sécurité humaine. Les urgences humanitaires font des blessés et des morts mais elles ont aussi un effet dévastateur sur les moyens d'existence basés sur l'élevage, qui constituent une caractéristique essentielle d'une grande partie des populations rurales pauvres de la planète. Le rôle croissant des forces armées dans la gestion des situations d'urgence peut donner lieu à des frictions pendant les interventions en raison des priorités et des objectifs concurrentiels des différents intervenants. Des perspectives existent pour une utilisation accrue des forces militaires, par exemple pour soutenir les moyens d'existence basés sur l'élevage, mais pour cela il faut résoudre un certain nombre de difficultés et lever certains obstacles. Un cadre commun d'interactions civilo-militaires peut contribuer à coordonner les interventions et améliorer ainsi les réponses tant locales qu'internationales aux situations d'urgence. Les Normes et directives pour l'aide d'urgence à l'élevage (LEGS) et le modèle qu'il propose pour sécuriser les moyens d'existence sont des outils conceptuels qui visent à forger une vision commune du contexte sécuritaire pendant les interventions d'urgence auprès des éleveurs. La réponse des Philippines suite aux typhons Sarika et Haima et l'aide apportée aux agriculteurs par les forces armées sri-lankaises offrent des exemples qui pourraient inspirer un tel cadre opérationnel commun.

Todas las partes que intervienen en la respuesta a situaciones de emergencia y en la recuperación tras ellas, incluidos los cuerpos militares, deben conocer a fondo los medios de sustento que dependen de la ganadería y la forma en que estas actividades repercuten en la seguridad humana. Las emergencias no solo hieren y matan, sino que también devastan los medios de sustento basados en la actividad ganadera, que son una característica básica de la vida de muchos de los pobladores pobres de zonas rurales del mundo. Las fuerzas armadas intervienen cada vez más en la gestión de emergencias, hecho que durante estos episodios puede generar fricciones por la existencia de planes y objetivos discordantes. Existe margen para aprovechar en mayor medida la intervención de los cuerpos militares, por ejemplo para respaldar los medios de vida de quienes dependen de la ganadería, pero para ello hay dificultades y barreras que salvar. La existencia de un marco común que encuadre la interacción de civiles con militares puede ser útil para coordinar las actividades de respuesta a situaciones de emergencia y mejorar esta labor a escala local e internacional. Las directrices y normas para emergencias ganaderas [Livestock Emergency Guidelines and Standards, LEGS], así como la propuesta de un modelo para la seguridad de los medios de sustento, son creaciones teóricas que pueden ayudar a llegar a una concepción común de lo que deben ser las condiciones de seguridad durante la respuesta a una emergencia ganadera. Los ejemplos de la respuesta de Filipinas a los huracanes Sarika y Haima y de la participación de militares esrilanqueses en tareas agropecuarias sirven para contextualizar una propuesta de marco operativo común.

Evaluación reumatológica del paciente con enfermedad pulmonar intersticial / Rheumatological evaluation of the patient with interstitial lung disease

Las Enfermedades del Tejido Conectivo (ETC) comprenden un grupo heterogéneo de patologías multisistémicas de origen autoinmune. La Enfermedad pulmonar intersticial (EPI) asociada a ETC (EPI-ETC) es frecuente y empeora el pronóstico de la ETC. Las EPI-ETC representan aproximadamente 15-30% del total las EPI y se presentan con las mismas formas histopatológicas y radiológicas descritas para las EPI idiopáticas. Esto pone en evidencia la importancia de incorporar en forma rutinaria a reumatología en el comité multidisciplinario para el diagnóstico y manejo de las EPI.

Connective Tissue Diseases (CTD) comprise a heterogeneous group of multisystemic pathologies of autoimmune origin. Interstitial lung disease (ILD) associated with CTD (CTD-ILD) is common and and it worsens the prognosis of CTD. CTD-ILD represent approximately 15-30% of the universe of ILD and have the same histopathological and radiological forms described for idiopathic ILD. This highlights the importance of routinely incorporate a rheumatologist into the multidisciplinary committee for the diagnosis and management of ILD.

Cysteine auxotrophy drives reduced susceptibility to quinolones and paraquat by inducing the expression of efflux-pump systems and detoxifying enzymes in S. Typhimurium.

Currently, Salmonella enterica serovar Typhimurium (S. Typhimurium), is a major global public health problem, which has caused food-borne illnesses in many countries. Today, with the extensive use of antimicrobials, antimicrobial resistance is increasing at a serious rate in S. Typhimurium isolates. The present study sought the role of cysteine (Cys) auxotrophy on the resistance to quinolones and paraquat in S. Typhimurium. Cys auxotrophy was achieved by deleting either the cysDNC, cysJIH or cysQ loci. Deletion of these loci resulted in loss of susceptibility against nalidixic acid, levofloxacin, ciprofloxacin (CIP) and paraquat. Further studies with cysJIH mutant indicated increased expression of multi-antibiotic resistance genes marA and ramA, and consequently increased expression of efflux-pump systems. The cysJIH mutant presented a smaller increase of reactive oxygen species (ROS) in presence of paraquat or CIP. Expression of katG and sodA (expressing for a catalase and a superoxide dismutase, respectively) genes was increased in presence of paraquat in the cysJIH mutant; while expression of the superoxide dismutase gene sodB was decreased. These results indicate that deletion of cysDNC, cysJIH or cysQ genes of S. Typhimurium renders Cys auxotrophy along with decreased susceptibility in response to quinolone and paraquat. Overexpression of efflux-pump systems AcrB-TolC and SmvA-OmpD and antioxidant enzymes KatG and SodA could explain the mechanisms of antimicrobial resistance in the Cys auxotrophic mutants.

Incorporating non-equilibrium dynamics into demographic history inferences of a migratory marine species.

Understanding how dispersal and gene flow link geographically separated the populations over evolutionary history is challenging, particularly in migratory marine species. In southern right whales (SRWs, Eubalaena australis), patterns of genetic diversity are likely influenced by the glacial climate cycle and recent history of whaling. Here we use a dataset of mitochondrial DNA (mtDNA) sequences (n = 1327) and nuclear markers (17 microsatellite loci, n = 222) from major wintering grounds to investigate circumpolar population structure, historical demography and effective population size. Analyses of nuclear genetic variation identify two population clusters that correspond to the South Atlantic and Indo-Pacific ocean basins that have similar effective breeder estimates. In contrast, all wintering grounds show significant differentiation for mtDNA, but no sex-biased dispersal was detected using the microsatellite genotypes. An approximate Bayesian computation (ABC) approach with microsatellite markers compared the scenarios with gene flow through time, or isolation and secondary contact between ocean basins, while modelling declines in abundance linked to whaling. Secondary-contact scenarios yield the highest posterior probabilities, implying that populations in different ocean basins were largely isolated and came into secondary contact within the last 25,000 years, but the role of whaling in changes in genetic diversity and gene flow over recent generations could not be resolved. We hypothesise that these findings are driven by factors that promote isolation, such as female philopatry, and factors that could promote dispersal, such as oceanographic changes. These findings highlight the application of ABC approaches to infer the connectivity in mobile species with complex population histories and, currently, low levels of differentiation.

Efectividad de un programa de actividad física en personas con trastorno mental grave / Effectiveness of a program of physical activity in people with serious mental disorder

En el presente estudio se analiza el impacto que ha tenido un Programa de actividad física y deporte en un grupo de 28 personas con Trastorno Mental Grave (TMG). Se realizó una evaluación antes del comienzo del Programa y otra a los cuatro meses, tomando medidas antropométricas, de capacidad física funcional, equilibrio y coordinación, así como del funcionamiento social y las actividades de la vida cotidiana. Los resultados mostraron mejorías estadísticamente significativas en aquellas personas que asistieron a más del 50% de las sesiones en todas las variables antropométricas, y de condición física funcional y cualidades motrices, así como en la Escala de Funcionamiento Personal y Social (PSP).Por otro lado, la asistencia al programa fue alta, manteniéndose en el mismo el 80% de las personas que lo iniciaron. Se discute la relevancia de los resultados y la necesidad de implantar este tipo de intervenciones en el TMG (AU)

In this paper the effectiveness of a physical activity and sport program is analyzed in a group of 28 people with Severe Mental Illness (SMI). An assessment was made before the start of the program and again after four months, measuring anthropometric variables, physical functional ability, balance and coordination, and social functioning and activities of daily life. The results showed statistically significant improvements in those who attended more than 50% of the sessions in all anthropometric variables, and functional fitness and motor skills, as well as the Personal and Social Performance Scale (PSP). Moreover, assistance to the program was high, keeping the same 80% of people who started it. The relevance of the results and the need to implement such interventions in the SMI is discussed (AU)

Purification of a Human Prostate Specific Antigen.

Rabbit antiserum raised against the crude extract of normal human prostatic tissue contained antibodies to a prostatic tissue-specific antigen as shown by immunoprecipitation techniques. Using this antiserum a prostate antigen was detected in normal, benign hypertrophic, and malignant prostatic tissues, but not in other human tissues. The prostate antigen was purified to homogeneity from prostatic tissues and showed a single protein band on analytical polyacrylamide gel electrophoresis and isoelectric focusing. This report thus presents the first demonstration of the purification of a prostate-specific antigen that does not represent prostatic acid phosphatase.

Apoptotic activities of cardenolide glycosides from Asclepias subulata.

ETHNOPHARMACOLOGICAL RELEVANCE: Asclepias subulata Decne. (Apocynaceae) is a shrub occurring in Sonora-Arizona desert. The ethnic groups of Sonora, Mexico, Seris and Pimas, use this plant for the treatment of sore eyes, gastrointestinal disorders and cancer. AIM OF THE STUDY: To determine the cell death pathways that the cardenolide glycosides with antiproliferative activity found in the methanol extract of A. subulata are able to activate. MATERIALS AND METHODS: The effect of cardenolide glycosides isolated of A. subulata on induction of apoptosis in cancer cells was evaluated through the measuring of several key events of apoptosis. A549 cells were treated for 12h with doses of 3.0, 0.2, 3.0 and 1.0µM of 12, 16-dihydroxicalotropin, calotropin, corotoxigenin 3-O-glucopyranoside and desglucouzarin, respectively. Apoptotic and necrotic cell levels were measured by double staining with annexin V-FITC/PI. Mitochondrial membrane depolarization was examined through JC-1 staining. Apoptosis cell death and the apoptosis pathways activated by cardenolide glycosides isolated of A. subulata were further characterized by the measurement of caspase-3, caspase-8 and caspase-9 activity. RESULTS: Apoptotic assays showed that the four cardenolide glycosides isolated of A. subulata induced apoptosis in A549 cells, which was evidencing by phosphatidylserine externalization in 18.2%, 17.0%, 23.9% and 22.0% for 12, 16-dihydroxicalotropin, calotropin, corotoxigenin 3-O-glucopyranoside and desglucouzarin, respectively, compared with 4.6% of control cells. Cell death was also associated with a decrease in mitochondrial membrane potential, which was more than 75% in the treated cultures respect to control. The activation of caspase-3 was observed in all cardenolide glycosides-treated cancer cells indicating the caspase-dependent apoptosis of A549 cells. Extrinsic and intrinsic apoptosis pathways were activated by cardenolide glycosides treatment at the doses tested. CONCLUSION: In this study was found that cardenolide glycosides, 12, 16-dihydroxicalotropin, calotropin, corotoxigenin 3-O-glucopyranoside and desglucouzarin, isolated from A. subulata induced the cell death trough caspase-dependent apoptosis, which was activated, preferably, by extrinsic pathway.

Lose to win: marT pseudogenization in Salmonella enterica serovar Typhi contributed to the surV-dependent survival to H2O2, and inside human macrophage-like cells.

The difference in host range between Salmonella enterica serovar Typhimurium (S. Typhimurium) and Salmonella enterica serovar Typhi (S. Typhi) can be partially attributed to the gain of functions, to the loss of functions (i.e. pseudogenization), or to a combination of both processes. As previously reported, the loss of functions by pseudogenization may play a role in bacterial evolution, especially in host-restricted pathogens such as S. Typhi. The marT-fidL operon, located at the SPI-3, encodes the MarT transcriptional regulator and a hypothetical protein (i.e. FidL) with no significant similarities to known proteins, respectively. Even though predicted S. Typhimurium FidL exhibit 99.4% identity with S. Typhi FidL, marT has been annotated as a pseudogene in S. Typhi. In this work, we found that S. Typhi expressing S. Typhimurium marT-fidL exhibited an increased accumulation of reactive oxygen species (ROS), leading to a decreased survival in presence of H2O2. Moreover, we found that that the presence of a functional copy of S. Typhimurium marT-fidL in S. Typhi resulted in a repression of surV (STY4039), an ORF found in the S. Typhi SPI-3 but absent from S. Typhimurium SPI-3, that contribute to the resistance to H2O2 by decreasing the accumulation of ROS. Finally, we observed that the presence of S. Typhimurium marT-fidL in S. Typhi negatively affected the survival inside macrophage-like cells, but not in epithelial cells, after 24h post infection. Therefore, this work provides evidence arguing that marT pseudogenization in Salmonella Typhi contributed to the surV-dependent survival against H2O2, and inside human macrophage-like cells. This is a good example of how the loss of functions (marT pseudogenization) and the gain of functions (presence of surV) might contribute to phenotypic changes improving virulence.

Airborne pollen trends in the Iberian Peninsula.

Airborne pollen monitoring is an effective tool for studying the reproductive phenology of anemophilous plants, an important bioindicator of plant behavior. Recent decades have revealed a trend towards rising airborne pollen concentrations in Europe, attributing these trends to an increase in anthropogenic CO2 emissions and temperature. However, the lack of water availability in southern Europe may prompt a trend towards lower flowering intensity, especially in herbaceous plants. Here we show variations in flowering intensity by analyzing the Annual Pollen Index (API) of 12 anemophilous taxa across 12 locations in the Iberian Peninsula, over the last two decades, and detecting the influence of the North Atlantic Oscillation (NAO). Results revealed differences in the distribution and flowering intensity of anemophilous species. A negative correlation was observed between airborne pollen concentrations and winter averages of the NAO index. This study confirms that changes in rainfall in the Mediterranean region, attributed to climate change, have an important impact on the phenology of plants.

Near-infrared chemical imaging and its correlation with the mechanical properties of chitosan-gelatin edible films.

Plasticizers influence the physical properties of edible films by their interaction with the film-forming polymers. Using near-infrared chemical imaging, it is possible to characterize the interaction between compounds through the analysis of their relative presence throughout the film (abundance) and their variability. These parameters and standard mechanical properties were used to characterize the interaction between gelatin, chitosan and several plasticizers, pure or in binary combinations. Triacetin showed the least interaction with the polymers, while polyethylene glycol 400 and glycerol showed high interaction with them. In addition, we observed that the tensile strength of the film was well correlated with the variability of gelatin and chitosan.

Evaluación de presencia y severidad de periodontitis en pacientes chilenos con artritis reumatoide atendidos en el Hospital Padre Hurtado / Frequency and severity of periodontitis among patients with rheumatoid arthritis

Background: Periodontitis may have a triggering and aggravating role of various medical conditions, including rheumatoid arthritis. Aim: To evaluate the periodontal status in Chilean patients with rheumatoid arthritis (RA), treated in a public hospital. Patients and Methods: A trained professional conducted a periodontal examination in 40 patients with RA aged 23 to 73 years (85% women). When present, the severity of periodontitis and its relationship with gender, smoking, age, corticosteroids dose and AR activity were assessed. AR activity was evaluated using the Disease Activity Score Calculator for Rheumatoid Arthritis (DAS 28). Results: Thirty five of the 40 patients had periodontitis and in 13, it was severe. Men, smokers, and older patients had more severe stages. Patients using higher doses of corticosteroids had lower severity of periodontitis. No relationship between the severity of periodontitis and AR activity was found. Conclusions: Periodontitis is common and severe in patients with RA, and is influenced by gender, age, smoking and corticosteroid dose.

Genotypic and phenotypic diversity of Alicyclobacillus acidocaldarius isolates.

UNLABELLED: The fruit juice industry recognizes Alicyclobacillus as a major quality control target micro-organism. In this study, we analysed 19 bacterial isolates to identify Alicyclobacillus species by polymerase chain reaction (PCR) and sequencing analyses. Phenotypic and genomic diversity among isolates were investigated by API 50CHB system and ERIC-PCR (enterobacterial repetitive intergenic consensus-PCR) respectively. All bacterial isolates were identified as Alicyclobacillus acidocaldarius, and almost all showed identical DNA sequences according to their 16S rRNA (rDNA) gene partial sequences. Only few carbohydrates were fermented by A. acidocaldarius isolates, and there was little variability in the biochemical profile. Genotypic fingerprinting of the A. acidocaldarius isolates showed high diversity, and clusters by ERIC-PCR were distinct to those obtained from the 16S rRNA gene phylogenetic tree. There was no correlation between phenotypic and genotypic variability in the A. acidocaldarius isolates analysed in this study. SIGNIFICANCE AND IMPACT OF THE STUDY: Detection of Alicyclobacillus strains is imperative in fruit concentrates and juices due to the production of guaiacol. Identification of the genera originates rejection of the product by processing industry. However, not all the Alicyclobacillus species are deteriorative and hence the importance to differentiate among them. In this study, partial 16S ribosomal RNA sequence alignment allowed the differentiation of species. In addition, ERIC-PCR was introduced for the genotypic characterization of Alicyclobacillus, as an alternative for differentiation among isolates from the same species.

Antiproliferative activity of cardenolide glycosides from Asclepias subulata.

ETHNOPHARMACOLOGICAL RELEVANCE: Asclepias subulata Decne. is a shrub occurring in Sonora-Arizona desert (Mexico-USA). The ethnic groups, Seris and Pimas, use this plant for the treatment of sore eyes, gastrointestinal disorders and cancer. AIM OF THE STUDY: To isolate the compounds responsible for antiproliferative activity of the methanol extract of A. subulata. MATERIALS AND METHODS: A bioguided fractionation of methanol extract of A. subulata was performed using MTT assay to measure the antiproliferative activity of different compounds on three human cancer cell lines (A549, LS 180 and PC-3), one murine cancer cell line (RAW 264.7) and one human normal cell line (ARPE-19). The methanol extract was partitioned with hexane, ethyl acetate and ethanol. The active fractions, ethanol and residual, were fractioned by silica-column chromatography and active sub-fractions were separated using HPLC. The chemical structures of isolated compounds were elucidated with different chemical and spectroscopic methods. RESULTS: A new cardenolide glycoside, 12, 16-dihydroxycalotropin, and three known, calotropin, corotoxigenin 3-O-glucopyranoside and desglucouzarin, were isolated of active sub-fractions. All isolated compounds showed a strong antiproliferative activity in human cancer cells. Calotropin was the more active with IC50 values of 0.0013, 0.06 and 0.41 µM on A549, LS 180 and PC-3 cell lines, respectively; while 12, 16-dihydroxycalotropin reached values of 2.48, 5.62 and 11.70 µM, on the same cells; corotoxigenin 3-O-glucopyranoside had IC50 of 2.64, 3.15 and 6.62 µM and desglucouzarin showed values of 0.90, 6.57 and 6.62, µM. Doxorubicin, positive control, showed IC50 values of 1.78, 6.99 and 3.18 µM, respectively. The isolated compounds had a weak effect on murine cancer cells and human normal cells, exhibiting selectivity to human cancer cells. CONCLUSION: In this study, we found that 12, 16-dihydroxicalotropin, calotropin, corotoxigenin 3-O-glucopyranoside and desglucouzarin are responsible of antiproliferative properties of A. subulata, and that these compounds are highly selective to human cancer cells. Further studies are needed in order to establish the action mechanisms of the isolated compounds.

[Pneumomediastinum and cutaneous necrosis in dermatomyositis: Report of one case]. / Neumomediastino y necrosis cutánea en asociación a dermatomiositis: presentación de un caso clínico y revisión de la literatura.

We report a 37 years old male with a dermatomyositis treated with oral cyclophosphamide. He was admitted to the hospital due to a zone of skin necrosis with purulent exudate, located in the second left toe. A complete blood count showed a leukocyte count of 2,600 cells/mm³. A Chest CAT scan showed a pneumomediastinum with emphysema of adjacent soft tissue. Cyclophosphamide was discontinued and leukocyte count improved. The affected toe was amputated and a chest CAT scan showed a partial resolution of the pneumomediastinum. We discuss and review the pathogenesis, clinical presentation and management of pneumomediastinum and cutaneous necrosis in association with dermatomyositis.

Pseudogenization of sopA and sopE2 is functionally linked and contributes to virulence of Salmonella enterica serovar Typhi.

The difference in host range between Salmonella enterica serovar Typhimurium (S. Typhimurium) and S. enterica serovar Typhi (S. Typhi) can be partially attributed to pseudogenes. Pseudogenes are genomic segments homologous to functional genes that do not encode functional products due to the presence of genetic defects. S. Typhi lacks several protein effectors implicated in invasion or other important processes necessary for full virulence of S. Typhimurium. SopA and SopE2, effectors that have been lost by pseudogenization in S. Typhi, correspond to an ubiquitin ligase involved in cytokine production by infected cells, and to a guanine exchange factor necessary for invasion of epithelial cells, respectively. We hypothesized that sopA and/or sopE pseudogenization contributed to the virulence of S. Typhi. In this work, we found that S. Typhi expressing S. Typhimurium sopE2 exhibited a decreased invasion in different epithelial cell lines compared with S. Typhi WT. S. Typhimurium sopA completely abolished the hypo-invasive phenotype observed in S. Typhi expressing S. Typhimurium sopE2, suggesting that functional SopA and SopE2 participate concertedly in the invasion process. Finally, the expression of S. Typhimurium sopA and/or sopE2 in S. Typhi, determined changes in the secretion of IL-8 and IL-18 in infected epithelial cells.

A new method for determining the sources of airborne particles.

Air quality is a major issue for humans owing to the fact that the content of particles in the atmosphere has multiple implications for life quality, ecosystem dynamics and environment. Scientists are therefore particularly interested in discovering the origin of airborne particles. A new method has been developed to model the relationship between the emission surface and the total amount of airborne particles at a given distance, employing olive pollen and olive groves as examples. A third-degree polynomial relationship between the air particles at a particular point and the distance from the source was observed, signifying that the nearest area to a point is not that which is most correlated with its air features. This work allows the origin of airborne particles to be discovered and could be implemented in different disciplines related to atmospheric aerosol, thus providing a new approach with which to discover the dynamics of airborne particles.

Neumomediastino y necrosis cutánea en asociación a dermatomiositis: presentación de un caso clínico y revisión de la literatura / Pneumomediastinum and cutaneous necrosis in dermatomyositis: Report of one case

We report a 37 years old male with a dermatomyositis treated with oral cyclophosphamide. He was admitted to the hospital due to a zone of skin necrosis with purulent exudate, located in the second left toe. A complete blood count showed a leukocyte count of 2,600 cells/mm³. A Chest CAT scan showed a pneumomediastinum with emphysema of adjacent soft tissue. Cyclophosphamide was discontinued and leukocyte count improved. The affected toe was amputated and a chest CAT scan showed a partial resolution of the pneumomediastinum. We discuss and review the pathogenesis, clinical presentation and management of pneumomediastinum and cutaneous necrosis in association with dermatomyositis.

[Frequency and severity of periodontitis among patients with rheumatoid arthritis]. / Evaluación de presencia y severidad de periodontitis en pacientes chilenos con artritis reumatoide atendidos en el Hospital Padre Hurtado.

BACKGROUND: Periodontitis may have a triggering and aggravating role of various medical conditions, including rheumatoid arthritis. AIM: To evaluate the periodontal status in Chilean patients with rheumatoid arthritis (RA), treated in a public hospital. PATIENTS AND METHODS: A trained professional conducted a periodontal examination in 40 patients with RA aged 23 to 73 years (85% women). When present, the severity of periodontitis and its relationship with gender, smoking, age, corticosteroids dose and AR activity were assessed. AR activity was evaluated using the Disease Activity Score Calculator for Rheumatoid Arthritis (DAS 28). RESULTS: Thirty five of the 40 patients had periodontitis and in 13, it was severe. Men, smokers, and older patients had more severe stages. Patients using higher doses of corticosteroids had lower severity of periodontitis. No relationship between the severity of periodontitis and AR activity was found. CONCLUSIONS: Periodontitis is common and severe in patients with RA, and is influenced by gender, age, smoking and corticosteroid dose.