Preoperative central macular thickness as a risk factor for pseudophakic macular edema.

PURPOSE: This study aims to determine whether elevated central macular thickness (CMT) before uncomplicated cataract surgery may be a risk factor for developing cystic macular edema (CMEs) as measured by Cirrus-OCT and defined as the presence of macular intraretinal cysts. METHODS: A prospective study in Hospital Universitario Poniente, Almeria, Spain, where 379 patients were included for optical coherence tomography (OCT) before cataract surgery, the following day, at 1 month and at 3 months and the presence of macular intraretinal cysts assessed by OCT. Patients with known risk factors for developing CME and patients who developed major surgical complications were excluded. RESULTS: One hundred seventy-nine patients completed the study. The pre-surgical CMT was 257.75 (20.60) µm measured by Cirrus-OCT. After 1 month, there was an average increase in CMT of 277.86 (45.29) µm, and this increase in thickness decreased after 3 months to an average value of 267.86 (20.17) µm. There were 10.34% of patients with cysts in some of the controls after surgery. This study proposes a binary logistic model to predict the presence of CME depending on the pre-surgery CMT. The cut-off point was 260.5 µm. CONCLUSION: Patients with pre-surgical macular thickness > 260.5 µm measured by Cirrus- OCT before cataract surgery, no known risk factors for developing CME and no major surgical complications presented 9.08 times more probability to develop macular intraretinal cysts after uncomplicated cataract surgery.

Food safety impacts of finfish and crustacean aquaculture on food security in Asia.

Asia is the world's largest aquaculture producer. The aquaculture industry faces a multitude of threats ranging from microbiological and chemical to parasitic. These threats could potentially affect aquatic animal health and food safety and alter the consumer's perception of aquacultural produce. The development of antimicrobial resistance is also of increasing concern. These actual or perceived food safety threats could result in reductions in the food supply that adversely affect the food security of a country or region. Harmonised regional regulatory requirements, increased consumer awareness and the adoption of good aquaculture practices are ways in which the aquaculture industry can mitigate these risks. Together with the increased use of smart technology in production and encouragement to adopt certification and accreditation schemes, these tools can help the aquaculture industry in Asia to become more resilient in the face of such challenges. In this paper, the authors present an insight into the hazards faced by the aquaculture industry, which could potentially adversely affect food supply and hence food security, in an Asian context. The authors make several recommendations to mitigate these risks and thus safeguard against disruptions to regional food security.

L'Asie est le premier producteur aquacole du monde. Le secteur de l'aquaculture fait face à une multiplicité de menaces, depuis les dangers microbiologiques et chimiques jusqu'à ceux d'ordre parasitaire. Ces menaces pesant sur la santé des animaux aquatiques et la sécurité sanitaire des aliments peuvent aussi modifier la perception des produits de l'aquaculture par les consommateurs. L'intensification du phénomène de résistance aux agents antimicrobiens est également un sujet de préoccupation croissante. Les risques (réels ou perçus comme tels) pour la sécurité sanitaire des aliments pourraient se traduire par une réduction de l'approvisionnement en denrées alimentaires, avec un impact négatif sur la sécurité alimentaire d'un pays ou d'une région entière. Les perspectives d'atténuation de ces risques pour l'aquaculture passent par la mise en place de dispositions réglementaires harmonisées au plan régional, par une meilleure sensibilisation des consommateurs et par l'adoption de bonnes pratiques aquacoles. Parallèlement à une utilisation accrue des technologies intelligentes en production et aux mesures encourageant l'adoption de dispositifs de certification et d'accréditation, ces outils pourront aider le secteur aquacole asiatique à renforcer sa résilience face à de tels défis. Les auteurs font le point sur les menaces pesant sur le secteur de l'aquaculture dans le contexte asiatique et décrivent leur impact potentiellement négatif sur l'offre de denrées alimentaires ainsi que sur la sécurité alimentaire. Les auteurs formulent plusieurs recommandations visant à atténuer ces risques et à préserver la continuité de la production afin d'assurer la sécurité alimentaire dans la région.

El sector de la acuicultura, que tiene en Asia al mayor productor del mundo, hace frente a multitud de amenazas de carácter microbiológico, químico o parasitario que pueden afectar la salud de los animales acuáticos y la inocuidad de los alimentos derivados de ellos y alterar de este modo la visión que tiene el consumidor de los productos acuícolas. La adquisición de resistencias a los antimicrobianos es otro tema que genera creciente preocupación. Estas amenazas que penden sobre la inocuidad de los alimentos, ya sean reales o subjetivas, pueden traducirse en caídas del suministro de alimentos que afecten negativamente a la seguridad alimentaria de un país o una región. La armonización de los requisitos reglamentarios a escala regional, una mayor sensibilización del consumidor y la aplicación de buenas prácticas de acuicultura son otros tantos medios por los que el sector de la acuicultura puede mitigar estos riesgos y que, combinados con un mayor uso de tecnología inteligente en la producción y con el fomento de la adopción de sistemas de certificación y acreditación, pueden ayudar a la industria acuícola asiática a dotarse de mayor resiliencia ante esas dificultades. Los autores, centrándose en el contexto asiático, exponen los peligros que amenazan al sector de la acuicultura y que en potencia, al incidir negativamente en el suministro de alimentos, pueden hacer zozobrar la seguridad alimentaria. Después formulan varias recomendaciones para conjurar estos riesgos y con ello proteger de eventuales desequilibrios la seguridad alimentaria de la región.

XRCC1 Arg399Gln polymorphism and risk for cervical cancer development in Argentine women.

BACKGROUND: XRCC1 (X-ray repair cross-complementing group 1) plays a central role in the DNA base excision repair mechanism. Single nucleotide polymorphisms (SNPs) in the XRCC1 gene are thought to modulate DNA repair capacity and have been linked to cancer risk in several studies. MATERIALS AND METHODS: We conducted a case-control study comprising 217 cervical samples, including 103 cervical carcinomas and 114 normal tissue samples. Cervical samples were genotyped for two XRCC1 SNPs (Arg194Trp and Arg399Gln) by PCR-RFLPs. RESULTS: Subjects carrying heterozygous Arg399Gln or the combined Gln399Gln + Arg399Gln variant genotypes had a significantly reduced risk for cervical cancer development. In addition, the 194Arg-399Gln haplotype was also found to be associated with a decreased risk for cervical carcinoma. CONCLUSION: Our findings suggest that XRCC1 genotypes and haplotypes contribute in reducing the risk for cervical cancer development. Furthermore, genetic susceptibility conferred by Arg399Gln polymorphism operates independently of human papillomavirus infection of cervical tissue.

Cutaneous schwannomas in 22 horses.

Schwannomas are uncommonly recognized in horses. This study describes cutaneous schwannomas in 22 horses aged 8 to 25 years: 12 male, 7 female, and 3 of unknown sex. The horses had solitary cutaneous masses: 9 on the head, 3 on the neck, and the others on the shoulder, hip, thorax, abdomen, rump, extremities, or tail. The location of 1 tumor was unknown. The dermal tumors were well demarcated and expansile. Twelve had a multinodular pattern, whereas 10 formed a single nodule. Antoni A areas were observed in all tumors, and 10 tumors contained Antoni B areas. In Antoni A areas, the densely packed spindle-shaped neoplastic cells were arranged in short fascicles with nuclear palisading. In the hypocellular Antoni B areas, neoplastic cells were separated by abundant myxomatous stroma. Tumors commonly had hyalinization of stroma and vessel walls and ancient change. Cellular vacuolation was observed in 18 tumors. In all 22 cases, neoplastic cells were immunopositive for S100 protein. Expression of laminin and glial fibrillary acidic protein was observed in all 6 tumors evaluated by immunohistochemistry for these markers. One tumor was examined ultrastructurally: Neoplastic cells had branched cytoplasmic processes and were surrounded by an external lamina. Follow-up information was available 8 months to 10 years postexcision for 9 horses, for which surgical excision of the tumor was curative. The equine cutaneous schwannomas in this study had microscopic features like those of human schwannoma and had benign clinical behavior. Correct classification of equine cutaneous schwannoma will facilitate accurate prognosis and appropriate treatment.

Efficacy and tolerance of different types of prophylaxis for prevention of early aspergillosis after heart transplantation.

BACKGROUND: The incidence of aspergillosis (ASP) after heart transplantation (HTx) is low (<4%-5%), but the mortality is high (>78%). AIM: To determine the incidence of ASP in the first 3 months post-HTx according to the type of prophylaxis and assess the tolerance to these regimens. METHODS: This retrospective study of 571 adult HTx patients engrafted from 1991 to December 2009 included 83% males with an overall group age of 54.9±11 years. Three types of prophylaxis were compared: group A was no prophylaxis (n=99; 1991-1994); group B, itraconazole for 3 months (n=352; 1995-November 2004); and group C, inhaled amphotericin for 3 months (n=120; December 2004-2009). The dependent variables were the presence and severity or tracheobronchitis and invasive/disseminated disease as well as, prognosis of Aspergillus infection and tolerance to the regimen. RESULTS: The incidences of aspergillosis were 5% in group A (n=5); 1.4% in group B (n=5); and 0% in group C. Significant differences were observed between groups A versus B (P=.030) and between groups A versus C (P=.013), but there were no differences between groups B versus C. In terms of severity, there were no significant differences among the five cases of tracheobronchitis (20% group A/80% group B), five of invasive/disseminated disease (80% group A/20% group B). There were two deaths (20%) from invasive/disseminated ASP at 0.67 months after diagnosis. The mean time from HTx to ASP was 0.98±0.40 months. There were no adverse effects associated with itraconazole, but they occurred in 3/120 patients (2.5%) treated with inhaled amphotericin, all of whom were on mechanical ventilation, developing respiratory failure requiring amphotericin withdrawal. CONCLUSIONS: Prophylaxis with itraconazole or inhaled amphotericin was effective for the prevention and severity of pulmonary ASP in the first 3 months post-HTx. Although the incidence of early ASP was low in our series, the 20% mortality rate justified the use of preventive measures. Tolerance to both prophylactic treatments was good.

In vitro synthesis of sulfated glycosaminoglycans coupled to inter-compartmental Golgi transport.

We have used isolated rat liver Golgi membranes to reconstitute the synthesis of sulfated glycosaminoglycans (GAGs) onto the membrane-permeable, external acceptor xyloside. Biosynthetic labeling of GAGs with [35S]sulfate in vitro is shown to have an absolute requirement for ATP and cytosolic proteins and is inhibited by dismantling the Golgi apparatus with okadaic acid or under mitotic conditions suggesting that inter-compartmental transport between Golgi cisternae is a prerequisite for the successful completion of the initiation, polymerization, and sulfation of GAGs. Accordingly, we show that in vitro synthesis of 35S-GAGs utilizes the same machinery employed in Golgi transport events in terms of vesicle budding (ADP-ribosylation factor and coatomer), docking (Rabs), targeting (SNAREs), and fusion (N-ethylmaleimide-sensitive factor). This provides compelling evidence that GAGs synthesis is linked to Golgi membrane traffic and suggests that it can be used as a complementation-independent method to study membrane transport in Golgi preparations from any source. We have applied this system to show that intra-Golgi traffic requires the function of the Golgi target-SNARE, syntaxin 5.

Distinct molecular events during secretory granule biogenesis revealed by sensitivities to brefeldin A.

The biogenesis of peptide hormone secretory granules involves a series of sorting, modification, and trafficking steps that initiate in the trans-Golgi and trans-Golgi network (TGN). To investigate their temporal order and interrelationships, we have developed a pulse-chase protocol that follows the synthesis and packaging of a sulfated hormone, pro-opiomelanocortin (POMC). In AtT-20 cells, sulfate is incorporated into POMC predominantly on N-linked endoglycosidase H-resistant oligosaccharides. Subcellular fractionation and pharmacological studies confirm that this sulfation occurs at the trans-Golgi/TGN. Subsequent to sulfation, POMC undergoes a number of molecular events before final storage in dense-core granules. The first step involves the transfer of POMC from the sulfation compartment to a processing compartment (immature secretory granules, ISGs): Inhibiting export of pulse-labeled POMC by brefeldin A (BFA) or a 20 degrees C block prevents its proteolytic conversion to mature adrenocorticotropic hormone. Proteolytic cleavage products were found in vesicular fractions corresponding to ISGs, suggesting that the processing machinery is not appreciably activated until POMC exits the sulfation compartment. A large portion of the labeled hormone is secreted from ISGs as incompletely processed intermediates. This unregulated secretory process occurs only during a limited time window: Granules that have matured for 2 to 3 h exhibit very little unregulated release, as evidenced by the efficient storage of the 15-kDa N-terminal fragment that is generated by a relatively late cleavage event within the maturing granule. The second step of granule biogenesis thus involves two maturation events: proteolytic activation of POMC in ISGs and a transition of the organelle from a state of high unregulated release to one that favors intracellular storage. By using BFA, we show that the two processes occurring in ISGs may be uncoupled: although the unregulated secretion from ISGs is impaired by BFA, proteolytic processing of POMC within this organelle proceeds unaffected. The finding that BFA impairs constitutive secretion from both the TGN and ISGs also suggests that these secretory processes may be related in mechanism. Finally, our data indicate that the unusually high levels of unregulated secretion often associated with endocrine tumors may result, at least in part, from inefficient storage of secretory products at the level of ISGs.

Topological studies on rat liver microsomal cholesterol ester hydrolase.

Lateral and transversal distribution of cholesterol ester hydrolase activity in rat liver microsomal membranes has been studied. Total cholesterol ester hydrolase activity was found predominantly (75%) in rough microsomes though specific esterase activities were similar in rough and smooth microsomal fractions. The transversal asymmetry of the enzyme was examined using the criteria of protease sensitivity and latency of mannose-6-phosphate phosphatase. Cholesterol ester hydrolase resulted drastically inhibited by proteolysis with trypsin when microsomal integrity had been previously disrupted with sodium deoxycholate or sodium taurocholate. Under these conditions, most lumenal mannose-6-phosphate phosphatase activity was destroyed. However, cholesterol esterase was unaffected by preincubating microsomes with the detergent alone, which led to the complete expression of latent mannose-6-phosphate phosphatase or by preincubating them with trypsin, where less than a 15% of the lumenal mannose-6-phosphate phosphatase was lost. These findings suggest that cholesterol ester hydrolase activity is located on the lumenal surface of the hepatic microsomal vesicles.

Kinetic properties and solubilization of microsomal cholesterol ester hydrolase from rat liver.

Some kinetic properties of the microsomal cholesterol ester hydrolase (CEH) have been examined in rat liver. The reaction was linear with time up to 60 min and with enzyme concentration up to 0.3 mg/mL, and a pH optimum of 6.7 for enzyme activity was observed. Cholesterol esterase exhibited the following apparent kinetic constants: Km, 68.88 microM and Vmax, 33 Units/mg protein. Cholesteryl palmitate was hydrolyzed to a much greater extent than cholesteryl oleate by the enzyme. Product inhibition with cholesterol and palmitic acid was not apparent; however, oleic acid added to the system reduced markedly microsomal CEH activity. The present paper also reports the solubilization of cholesteryl palmitate hydrolase from the microsomal fraction by pretreating it with Triton X-100, sodium deoxycholate, and sodium dodecylsulfate. All ionic and non-ionic detergents tested are capable of making the enzyme soluble, and maximal effects were found at higher concentrations of detergents although the esterase activity was strongly inhibited. Triton X-100 was found to be more effective than sodium deoxycholate and sodium dodecylsulfate in enzyme and protein solubilization. When the direct effects of detergents on CEH activity were studied, progressive concentration-dependent inhibitions were observed.

[Epidemiological survey of vaccination]. / Encuesta epidemiológica vacunal.

This paper presents the results obtained in an epidemiological survey conducted at Unidad de Pediatría del Hospital General de México, S.S.A., in 1,009 patients, randomly selected. The routine immunization schedule, followed in Mexico during the last few years was investigated. The results are presented for every one of the vaccines, according with the age periods. Considering the group as a whole, the results are significantly low, as far as the recommended standards pretend. It is concluded that it is necessary to strengthen the vaccination program in this country, in order to avoid the possibilities of new breaks of epidemics related with this marked lack of immunization in the community.

[Community in medical education programs of integral general medicine]. / La comunidad en la educación médica en el programa de medicina general integral.

This paper includes the chief considerations about the community work in the Integral General Medicine Program Called Plan A36. General considerations are made abour the four years of trainign program in which the medical student in exposed to be in close contac with the most common medical and health problems in his country, and during this period of time, he becomes capable to develop all the techniques to act as a primary contac physicain.