Penfigoide ampolloso / Bullous pemphigoid

El penfigoide ampolloso (PA) es una enfermedad cutánea ampollar subepidérmica autoinmunitaria que habitualmente se presenta en ancianos. Clásicamente el PA se caracteriza por presentar ampollas tensas, grandes en piel normal o eritematosa, con o sin prurito. Es difícil identificar al penfigoide ampollar prodrómico (PAP) o en estadio temprano. El PAP no se presenta con lesiones vesiculares o ampollar es como el penfigoide clásico. Se han publicado reportes en los que la enfermedad se manifiesta como prurito generalizado sin lesiones visibles, placas urticarianas, placas eritematosas, parches de eccema y dishidrosis, lesiones tipo prúrigo nodular, eritrodermia y lesiones vegetantes. Se reporta el caso de un paciente en la octava década de su vida que acude a nuestro servicio por presentar cuadro clínico e histopatológico de PA; mediante la anamnesis encontramos que debutó con la forma no ampollar del penfigoide, siendo tratado por diferentes diagnósticos sin mejoría hasta que presentó la fase ampollar clásica siendo el diagnóstico evidente. Presentamos este caso para tener en cuenta dentro del diagnóstico diferencialde aquellas lesiones inespecífica de curso tórpido, el estadio temprano del PA, pues un reconocimiento y tratamiento y temprano puede prevenir la progresión a PA clásico cuyo curso es crónico, con fases de exacerbaciones y remisiones espontáneas, que puede resultar en morbilidad significativa.

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering skin disease that typically occurs in the elderly. Classically (BP) is characterized by tense blisters, large normal or erythematous skin, with or without pruritus. Itis difficult to identify the prodromal bullous pemphigoid(PBP) or early stage. The PBP is not presented with vesicular lesions or bullous pemphigoid such as classic. Reports have been published in which the disease manifests as generalized pruritus without visible lesions, urticarial plaques, erythematous plaques, patches of eczema and dyshidrosis, nodular prurigo-like lesions, erythroderma and vegetative lesions. We report the case of a patient inthe eighth decade of his life referred to our department to present clinical and histopathological picture bullouspemphigoid; through history we find that debuted with the bullous pemphigoid is not being treated for different diagnoses did not improve until presented by the classic blister stage diagnosis being evident. We present this case to account for the differential diagnosis of those injuries nonspecific chronic course, the early stage of the BP, asan early recognition and treatment can prevent progression to classical PA whose course is chronic, with periods of exacerbations and spontaneous remissions, which can result in significant morbidity.

Aestivation of the African malaria mosquito, Anopheles gambiae in the Sahel.

The African malaria mosquito, Anopheles gambiae, inhabits diverse environments including dry savannas, where surface waters required for larval development are absent for 4-8 months per year. Under such conditions, An. gambiae virtually disappears. Whether populations survive the long dry season by aestivation (a dormant state promoting extended longevity during the summer) or are reestablished by migrants from distant locations where larval sites persist has remained an enigma for over 60 years. Resolving this question is important, because fragile dry season populations may be more susceptible to control. Here, we show unequivocally that An. gambiae aestivates based on a demographic study and a mark release-recapture experiment spanning the period from the end of one wet season to the beginning of the next. During the dry season, An. gambiae was barely detectable in Sahelian villages of Mali. Five days after the first rain, before a new generation of adults could be produced, mosquito abundance surged 10-fold, implying that most mosquitoes were concealed locally until the rain. Four days after the first rain, a marked female An. gambiae s.s. was recaptured. Initially captured, marked, and released at the end of the previous wet season, she has survived the 7-month-long dry season. These results provide evidence that An. gambiae persists throughout the dry season by aestivation and open new questions for mosquito and parasite research. Improved malaria control by targeting aestivating mosquitoes using existing or novel strategies may be possible.

A wide diversity of zoonotic intestinal parasites infects urban and rural dogs in Neuquén, Patagonia, Argentina.

The presence of parasites was investigated by the examination of 1944 dog faecal samples collected from urban (n=646) and rural (n=1298) areas of the province of Neuquén, Patagonia, Argentina. Parasitic agents (PA) were found in 37.86% of samples. A total of 15 different PA were detected, including Toxocara canis (16.35%), Taenia spp./Echinococcus spp. (12.65%), Trichurisvulpis (6.06%), Giardia spp. (1.29%), Toxascaris leonina (0.56%), Ancylostomacaninum (0.41%), Dipylidium caninum (0.31%), Diphyllobothrium spp. (0.10%), among others. Several of these PA are recognized as zoonotic agents. Therefore, the results of this investigation revealed that local population is exposed to a broad spectrum of zoonotic parasites by means of environmental contamination with dog faeces. Prevalence of PA was slightly higher in rural (40.06%) than in urban (33.44%) locations. Distribution of groups of PA (cestodes, nematodes, and protozoa) showed statistical differences between both habitats. Prevalence of cestodes (18.18%) and protozoa (11.86%) was significantly higher in the rural environment than in urban areas and nematodes (29.10%) were more frequent in urban locations. Infection of dogs with Linguatula serrata and Cryptosporidium sp. was demonstrated for the first time in Neuquén. Rural dogs of the study area are under hydatic disease control program, which includes treatment with praziquantel every 6 weeks; thus, the finding of high level of cestode infection in these areas is of great relevance. The epidemiology of zoonotic parasitic infections in urban and rural dogs showed different patterns and, in consequence, different control measurements should be applied in each location.

Symbiosis-related plant genes modulate molecular responses in an arbuscular mycorrhizal fungus during early root interactions.

To gain further insight into the role of the plant genome in arbuscular mycorrhiza (AM) establishment, we investigated whether symbiosis-related plant genes affect fungal gene expression in germinating spores and at the appressoria stage of root interactions. Glomus intraradices genes were identified in expressed sequence tag libraries of mycorrhizal Medicago truncatula roots by in silico expression analyses. Transcripts of a subset of genes, with predicted functions in transcription, protein synthesis, primary or secondary metabolism, or of unknown function, were monitored in spores and germinating spores and during interactions with roots of wild-type or mycorrhiza-defective (Myc-) mutants of M. truncatula. Not all the fungal genes were active in quiescent spores but all were expressed when G. intraradices spores germinated in wild-type M. truncatula root exudates or when appressoria or arbuscules were formed in association with wild-type M. truncatula roots. Most of the fungal genes were upregulated or induced at the stage of appressorium development. Inactivation of the M. truncatula genes DMI1, DMI2/MtSYM2, or DMI3/MtSYM13 was associated with altered fungal gene expression (nonactivation or inhibition), modified appressorium structure, and plant cell wall responses, providing first evidence that cell processes modified by symbiosis-related plant genes impact on root interactions by directly modulating AM fungal activity.

Prevalencia de infección cervical por Chlamydia trachomatis en mujeres de la Región Metropolitana / Prevalence of cervical infection by Chlamydia trachomatis among Chilean women living in the Metropolitan Región

Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) worídwide. In women, chlamydia infections are 75 percent asymptomatic and can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. Infants exposed to the microorganism at birth also have a high risk to develop conjunctivitis and pneumonía. Aim: To determine the prevalence of C trachomatis in women in the Metropolitan área of Santiago (Chile). Patients and methods: Cervical specimens were collected from 403 women attending three gynecological outpatient settings from Apríl 2003 to June 2005. These included one public hospital (n =100), a prívate medical center (n =268), and a clinic for adolescents (n =35). Mean ages ofeach group of patients were 35.6±8,2, 33.4±8.1 and 16.9±4.2 years, respectively. The diagnosis of C trachomatis was performed by the amplification byPCRofa 517-base pair segment of the cryptic plasmid on specimens extracted by a commercial procedure. Positive specimens were conñrmed by nested PCRs targeting the ompl gene. The presence of vaginal infections and its association with C trachomatis was investigated in a subset of 223 women ofthe prívate center. Residís: C trachomatis was detected in the cervix of 19 out of 403 women, resulting in a prevalence of 4.7 percent. The distribution of positive cases among different age groups was not significantly different. Women presenting with bacterial vaginosis had a significantly higher prevalence of C trachomatis infection (p <0.01). Conclusions: This study found a high prevalence of C trachomatis among gynecologic patients that should prompt preventive strategies.

Spatial monitoring of gene activity in extraradical and intraradical developmental stages of arbuscular mycorrhizal fungi by direct fluorescent in situ RT-PCR.

Gene expression profiling based on tissue extracts gives only limited information about genes associated with complex developmental processes such as those implicated in fungal interactions with plant roots during arbuscular mycorrhiza development and function. To overcome this drawback, a direct fluorescent in situ RT-PCR methodology was developed for spatial mapping of gene expression in different presymbiotic and symbiotic structures of an arbuscular mycorrhizal fungus. Transcript detection was optimized by targeting the LSU rRNA gene of Glomus intraradices and monitoring expression of a stearoyl-CoA-desaturase gene that is consistently expressed at high levels in spores, hyphae, arbuscules and vesicles. This method was further validated by localizing expression of fungal peptidylprolyl isomerase and superoxide dismutase genes, which are expressed to different extents in fungal structures. Direct fluorescent in situ RT-PCR offers new perspectives for the sensitive analysis of fungal developmental processes that occur during functional differentiation in symbiotic arbuscular mycorrhiza interactions.

[Prevalence of cervical infection by Chlamydia trachomatis among Chilean women living in the Metropolitan Region]. / Prevalencia de infección cervical por Chlamydia trachomatis en mujeres de la Región Metropolitana.

BACKGROUND: Chlamydia trachomatis is the most common bacterial sexually transmitted infection (STI) worldwide. In women, chlamydia infections are 75% asymptomatic and can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy. Infants exposed to the microorganism at birth also have a high risk to develop conjunctivitis and pneumonia. AIM: To determine the prevalence of C trachomatis in women in the Metropolitan area of Santiago (Chile). PATIENTS AND METHODS: Cervical specimens were collected from 403 women attending three gynecological outpatient settings from April 2003 to June 2005. These included one public hospital (n=100), a private medical center (n=268), and a clinic for adolescents (n=35). Mean ages of each group of patients were 35.6+/-8,2, 33.4+/-8.1 and 16.9+/-4.2 years, respectively. The diagnosis of C trachomatis was performed by the amplification by PCR of a 517-base pair segment of the cryptic plasmid on specimens extracted by a commercial procedure. Positive specimens were confirmed by nested PCRs targeting the ompl gene. The presence of vaginal infections and its association with C trachomatis was investigated in a subset of 223 women of the private center. RESULTS: C trachomatis was detected in the cervix of 19 out of 403 women, resulting in a prevalence of 4.7%. The distribution of positive cases among different age groups was not significantly different. Women presenting with bacterial vaginosis had a significantly higher prevalence of C trachomatis infection (p<0.01). CONCLUSIONS: This study found a high prevalence of C trachomatis among gynecologic patients that should prompt preventive strategies.

Alopecia cicatricial, como manifestación del síndrome de poems / Cicatricial alopecia as manifestation of Poem`s syndrome

Se define el síndrome de POEMS como la presencia de polineuropatía, organomegalia, endocrinopatía, proteína M monoclonal y cambios de la piel comúnmente hiperpigmentación, angiomas, livedo reticularis, hipertricosis, vasculitis leucocitoclástica y endurecimiento de la misma. Comunicamos el caso de un paciente varón, de 55 años, con alopecia cicatricial, como manifestación cutánea poco usual del síndrome de POEMS, sin plasmocitoma contiguo; concomitantemente, se evidenció compromiso del sistema nervioso periférico, de tipo desmielinizante, diabetes mellitus, hepatomegalia, linfadenopatía y presencia de plasmocitoma en columna vertebral.

POEMS´s syndrome is defined as the presence of polineuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes such as hiperpigmentation, angiomas, livedo reticularis, hypertrichosis, leukocytoclastic vasculitis and thickening. We report the case of a 55 year-old male patient with cicatricial alopecia, an unusual cutaneous manifestation of the POEMS´syndrome, without contiguous plasmocitoma; in addition, the patient presented demyelinating-type peripheral nervous system compromise, diabetes mellitus, hepatomegaly, lymphadenopathy and spine plasmacytoma.

Enfermedades metabólicas asociadas a la presencia de acrocordornes / Metabolic diseases associated with acrochordons

Objetivo: Determinar la asociación de acrocordón con enfermedades metabólicas. Material y métodos: Estudio observacional prospectivo realizado en el Hospital Central FAP. La muestra estuvo conformada por 150 pacientes con diagnóstico de acrocordón atendidos en el consultorio externo del Servicio de Dermatología, entre enero y diciembre de 2005, seleccionados mediante muestreo aleatorio simple. Los pacientes fueron sometidos a examen clínico y se les realizó determinación de los niveles séricos de glicemia, insulina, tolerancia a la glucosa y perfil lipídico. La evaluación incluyó la toma de presión arterial y la determinación del IMC. Se valoró la presencia de enfermedades metabólicas asociadas como resistencia a la insulina, obesidad, diabetes mellitus, dislipidemia, hipertensión arterial e intolerancia a la glucosa. Resultados: Se presentaron 150 casos de acrocordón, de ellos 87 pacientes (58.0 por ciento) fueron del sexo femenino. La edad promedio de los pacientes fue de 47.7±11.6 años. Se encontró que la presencia de acrocordones estuvo asociada a enfermedades metabólicas en 109 pacientes (72.6 por ciento), siendo las más frecuentes la resistencia a la insulina (71.3 por ciento), obesidad (51.3 por ciento) y diabetes mellitus tipo 2 (49.3 por ciento). La presencia de enfermedades metabólicas constituyó un factor de riesgo para la presencia de más de diez lesiones en los pacientes (p menor que 0.001). El análisis multivariable mostró que la presencia de obesidad, diabetes mellitus e hipertensión arterial constituyeron predictores independientes para desarrollar más de diez acrocordones. Conclusiones: Existe alta frecuencia de asociación de acrocordón y enfermedades metabólicas en pacientes del Hospital Central FAP. La presencia de más de diez acrocordones se asocia a obesidad y constituiría un predictor de diabetes mellitus y/o hipertensión arterial.

The polytene chromosomes of Cnsia dissimilis (Edwards) and three species of Gigantodax Enderlein (Diptera: Simuliidae) from Lanin National Park (Argentina)

Cytological studies were made on larvae of Giagantodax marginalis. G. chilensis, G. fulvescens and Cnesia dissimilis from four creeks in Lanin National Park, Neuquen Province, Argentina. Chromosome maps and idiograms of these species are presented. The following inversions were observed: G. marginalis: IL-1 (X-linked inversion), IL-2 (Y-linked inversion), IIS-1.2, IIL-1, IIIL-4,5; G. chilinsis: IL-4 (X-linked inversions), IIS-1.2, IIIL-4,5; G. fulvescens: IL-1 (X-linked inversion), IL-3 (Y-linked inversion), IIS-1.2, IIL-1, IIIL-4,5; C. dissimilis: IL-1, IL-5, IIIL-1. Karyological information was used to construct a cladogram and Cnesia sp. Was found to show close resemblance to the three Gigantodax spp.