Neochetracin: An Unusual Chetracin-Type Epithiodiketopiperazine Derivative Produced by the Fungus Amesia atrobrunnea.

Epithiodiketopiperazines are a widely distributed class of secondary metabolites originating from an NRPS biosynthetic pathway and featuring diverse biological activities. In this study, the soil-borne fungus Amesia atrobrunnea FMR 19325 was found to produce a novel chetracin-like epithiodiketopiperazine, neochetracin (1), featuring a unique C-11a'-S-N cross-linkage, along with the known congener, chetracin B (2). Chemical structures were elucidated based on HR-ESI-MS and comprehensive 1D/2D NMR spectroscopic analyses. The relative configuration of 1 was distinguished based on a ROESY experiment while its absolute configuration remains undetermined. Chetracin B was found to be a more potent cytotoxic agent compared with its new congener. Compounds 1 and 2 also exerted strong antibacterial effects against the tested bacteria; however, our results suggested that the presence of the C-11a'-S-N cross-linkage in 1 resulted in the total or partial loss of activity against Gram-negative bacteria.

Insights into Some Onygenalean Fungi from Freshwater Sediments in Spain and Description of Novel Taxa.

During the course of a project investigating culturable Ascomycota diversity from freshwater sediments in Spain, we isolated 63 strains of cycloheximide-resistant fungi belonging to the order Onygenales. These well-known ascomycetes, able to infect both humans and animals, are commonly found in terrestrial habitats, colonizing keratin-rich soils or dung. Little is known about their diversity in aquatic environments. Combining morphological features and sequence analyses of the ITS and LSU regions of the nrDNA, we identified 14 species distributed in the genera Aphanoascus, Arachniotus, Arthroderma, Arthropsis, Emmonsiellopsis, Gymnoascoideus, Leucothecium, Malbranchea, and Myriodontium. Furthermore, three novel species for the genus Malbranchea are proposed as M. echinulata sp. nov., M. irregularis sp. nov., and M. sinuata sp. nov. The new genera Albidomyces and Neoarthropsis are introduced based on Arachniotus albicans and Arthropsis hispanica, respectively. Neoarthropsis sexualis sp. nov. is characterized and differentiated morphologically from its counterpart by the production of a sexual morph. The novel family Neoarthropsidaceae is proposed for the genera Albidomyes, Apinisia, Arachnotheca, Myriodontium, and Neoarthropsis, based on their phylogenetic relationships and phenotypic and ecological traits. Pseudoamaurascopsis gen. nov. is introduced to accommodate P. spiralis sp. nov., a fungus with unclear taxonomy related to Amaurascopsis and Polytolypa. We traced the ecology and global distribution of the novel fungi through ITS environmental sequences deposited in the GlobalFungi database. Studying the fungal diversity from freshwater sediments not only contributes to filling gaps in the relationships and taxonomy of the Ascomycota but also gives us insights into the fungal community that might represent a putative risk to the health of animals and humans inhabiting or transient in aquatic environments.

Anxiety in Mexican adults throughout the COVID-19 pandemic: A cross sectional study.

INTRODUCTION: Perceived fear during a pandemic along with measures used to contain it can develop or intensify anxiety symptoms. In Mexico, information on the psychological impact of the COVID-19 pandemic in the general population is scarce. OBJECTIVE: We examined the prevalence and factors associated with anxiety during the COVID-19 outbreak in a Mexican sample. METHOD: We conducted a cross sectional study from June 15, 2020, to January 31, 2021, in a state in north-eastern Mexico, using an online survey. Beck Anxiety Inventory was used to determine the prevalence and severity of anxiety. RESULTS: The overall prevalence of anxiety was 43.5 %. Categories with the highest anxiety prevalence within their groups were women (46.2 %), age group of 18-30 years (47.3 %), higher level of education (43 %), students (48.8 %) and people who weren't currently with a couple (47.3 %). Additionally, we found that people who reported clinically significant anxiety were more likely to be women, ages 18-30 years, not currently partnered and currently living with a psychiatric disorder. Moreover, patients with clinically significant anxiety were more likely to be diagnosed with a mood, anxiety, trauma and stress, or an eating disorder. We also observed that being a woman and having at least one psychiatric disorder were independent factors related to a positive anxiety screening. DISCUSSION AND CONCLUSION: COVID-19 outbreak results in considerable increase in anxiety symptoms among the Mexican population. It is important to acknowledge the psychological impact of contingency situations to provide information that can allow establishing preventive and therapeutic strategies.

Two Novel Genera, Neostemphylium and Scleromyces (Pleosporaceae) from Freshwater Sediments and Their Global Biogeography.

Although the Pleosporaceae is one of the species-richest families in the Pleosporales, research into less-explored substrates can contribute to widening the knowledge of its diversity. In our ongoing survey on culturable Ascomycota from freshwater sediments in Spain, several pleosporacean specimens of taxonomic interest were isolated. Phylogenetic analyses based on five gene markers (ITS, LSU, gapdh, rbp2, and tef1) revealed that these fungi represent so far undescribed lineages, which are proposed as two novel genera in the family, i.e., Neostemphylium typified by Neostemphylium polymorphum sp. nov., and Scleromyces to accommodate Scleromyces submersus sp. nov. Neostemphylium is characterized by the production of phaeodictyospores from apically swollen and darkened conidiogenous cells, the presence of a synanamorph that consists of cylindrical and brown phragmoconidia growing terminally or laterally on hyphae, and by the ability to produce secondary conidia by a microconidiation cycle. Scleromyces is placed phylogenetically distant to any genera in the family and only produces sclerotium-like structures in vitro. The geographic distribution and ecology of N. polymorphum and Sc. submersus were inferred from metabarcoding data using the GlobalFungi database. The results suggest that N. polymorphum is a globally distributed fungus represented by environmental sequences originating primarily from soil samples collected in Australia, Europe, and the USA, whereas Sc. submersus is a less common species that has only been found associated with one environmental sequence from an Australian soil sample. The phylogenetic analyses of the environmental ITS1 and ITS2 sequences revealed at least four dark taxa that might be related to Neostemphylium and Scleromyces. The phylogeny presented here allows us to resolve the taxonomy of the genus Asteromyces as a member of the Pleosporaceae.

New and interesting species of Penicillium (Eurotiomycetes, Aspergillaceae) in freshwater sediments from Spain.

Penicillium species are common fungi found worldwide from diverse substrates, including soil, plant debris, food products and air. Their diversity in aquatic environments is still underexplored. With the aim to explore the fungal diversity in Spanish freshwater sediments, numerous Penicillium strains were isolated using various culture-dependent techniques. A preliminary sequence analysis of the ß-tubulin (tub2) gene marker allowed us to identify several interesting species of Penicillium, which were later characterized phylogenetically with the barcodes recommended for species delimitation in the genus. Based on the multi-locus phylogeny of the internal transcribed spacer region (ITS) of the ribosomal DNA, and partial fragments of tub2, calmodulin (cmdA), and the RNA polymerase II largest subunit (rpb2) genes, in combination with phenotypic analyses, five novel species are described. These are P.ausonanum in sectionLanata-Divaricata, P.guarroi in sect.Gracilenta, P.irregulare in sect.Canescentia, P.sicoris in sect.Paradoxa and P.submersum in sect.Robsamsonia. The study of several isolates from samples collected in different locations resulted in the reinstatement of P.vaccaeorum into sectionCitrina. Finally, P.heteromorphum (sect.Exilicaulis) and P.tardochrysogenum (sect.Chrysogena) are reported, previously only known from Antarctica and China, respectively.

Brief Report: Self-Reported Knowledge of HIV Status Among Cisgender Male Sex Partners of Transgender Women in Lima, Peru.

BACKGROUND: Knowledge of HIV status is a critical first step in the HIV care cascade. Cisgender male sex partners of transgender women (MSTW) are at a disproportionately high risk of HIV, but little is known about their access to HIV testing or knowledge of HIV status. METHODS: We used cross-sectional data from a respondent-driven sampling study to analyze self-reported HIV status and predictors of knowledge of HIV status among MSTW in Lima, Peru. Mixed-effects models were used to generate crude and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for the association between knowledge of HIV status and predictors of interest, including sociodemographics and recent sexual behavior. RESULTS: From February to July 2018, 196 eligible MSTW enrolled, of which 90 (46%) reported not knowing their HIV status. Recent casual or 1-time partners were reported by 84% of MSTW and 54% reported purchasing sex. In adjusted analyses, MSTW participants were less likely to know their HIV status if they reported buying sex (aPR 0.43, 95% CI: 0.32 to 0.59) or reported ≥16 recent sex partners compared with ≤5 partners [aPR 0.32, (0.20 to 0.50)]. Those who reported male sex partners were 80% more likely to know their status [aPR 1.80, (1.33 to 2.44)]. CONCLUSIONS: Reported knowledge of HIV status was low among MSTW in Lima, and unknown HIV status was associated with behaviors linked to HIV acquisition. MSTW who reported male partners were more likely to know their status, potentially indicating that HIV testing is more accessible to men who have sex with men.

Exploring HIV risk behavior and sexual/gender identities among transgender women and their sexual partners in Peru using respondent-driven sampling.

HIV prevalence is high among transgender women, but little is known about cisgender men who have sex with transgender women (MSTW). The objective of this study was to investigate characteristics and behavior of MSTW compared to transgender women and men who have sex with men (MSM) using a modified respondent-driven sampling design. Seed participants completed a survey and invited up to three sex partners. Forward recruitment continued in waves through the referral of sex partners. Cross-sectional data were assessed using mixed effects models. From February to July 2018, 479 participants in Lima, Peru enrolled (n = 199 transgender women, n = 196 MSTW, and n = 45 MSM). MSTW behavior and identity differed significantly from that of transgender women and MSM. MSTW primarily identified as bisexual (69%) or heterosexual (15%) and only 6% reported male partners. Insertive condomless anal intercourse was reported by 61% of MSTW; 46% did not know their HIV serostatus. Compared to MSTW without male partners, those with recent male partners were more likely to sell sex (OR 15.7, 95% CI 4.1-60.5), and report condomless receptive anal intercourse (OR 89.0, 95% CI 19.1-414.8). This evidence suggests that MSTW are a distinct population from MSM, and highlights the critical need to include MSTW in HIV research and interventions.

La clínica en el diagnóstico de la neurotoxoplasmosis / Clinic in the diagnosis of neurotoxoplasmosis

RESUMEN La toxoplasmosis cerebral o neurotoxoplasmosis es una de las infecciones oportunistas más frecuentes en los pacientes positivos al VIH. Se produce aproximadamente en el 10 % de los pacientes con sida no tratados. La localización de la infección, causada por el parásito Toxoplasma gondii, indica inmunodeficiencia severa, con linfocitos T CD4+ menor a 100 cel/mm3. El objetivo de este trabajo fue describir la evolución clínica e imagenológica de un paciente con diagnóstico de neurotoxoplasmosis, atendido en el Hospital Militar Dr. Carlos J. Finlay: hombre de 33 años, con síntomas neurológicos focales, sin factor de riesgo vascular, con estudios de imagen sugestiva de proceso expansivo intracraneal. Durante su ingreso se recibe el resultado de positivo al VIH y se interpreta como una neurotoxoplasmosis. Se empleó tratamiento antiparasitario con mejoría del trastorno neurológico y de las neuroimágenes. Ante un paciente con VIH y síntomas neurológicos focales se debe pensar en una neurotoxoplasmosis. La respuesta al tratamiento en el caso estudiado confirmó el diagnóstico (AU).

ABSTRACT Cerebral toxoplasmosis or neurotoxoplasmosis is one of the most common opportunistic infections in HIV-positive patients. It occurs in approximately 10 % of untreated AIDS patients. The location of the infection, caused by the parasite Toxoplasma gondii, indicates severe immunodeficiency, with CD4+ T lymphocytes less than 100 cell/mm3. The objective of this work was to describe the clinical and imaging evolution of a patient with diagnosis of neurotoxoplasmosis, attended at the Military Hospital Dr. Carlos J. Finlay: 33-year-old man, with focal neurological symptoms, without vascular risk factor, with studies of suggestive imaging of intracranial expansive process. During admission, the HIV positive result is received and interpreted as a neurotoxoplasmosis. Antiparasitic treatment was used with improvement of neurological disorder and neuroimagens. In the case of a patient with HIV and focal neurological symptoms doctors should think about neurotoxoplasmosis. The response to treatment in the case studied confirmed the diagnosis (AU).

Self-Identity, Beliefs, and Behavior Among Men Who Have Sex with Transgender Women: Implications for HIV Research and Interventions.

While transgender women have been identified as a global priority population for HIV prevention and treatment, little is known about the cisgender male partners of transgender women, including their sexual behavior and HIV prevalence. Previous research has suggested that these male partners have varied identities and sexual behavior, which make identifying and engaging them in research difficult. This paper describes interviews conducted with fifteen cisgender men who reported recent sexual activity with transgender women in Lima, Peru. The purpose of this research was to explore how these men reported their identities and sexual behavior, to better understand how they would interact with HIV outreach, research, and care. The major themes were sexual orientation and identity; view of transgender partners; social ties to transgender women and other men with transgender women partners; disclosure of relationships; HIV knowledge and risk perception; and attitudes toward interventions. We found that language used to assess sexual orientation was problematic in this population, due to lack of consistency between orientation and reported behavior, and unfamiliarity with terms used to describe sexual orientation. In addition, stigma, lack of knowledge of HIV prevention methods, and fear of disclosure of sexual behavior were identified as barriers that could impact engagement in HIV research, prevention, and care. However, participants reported social relationships with both transgender women and other men who have transgender partners, presenting possible avenues for recruitment into HIV research and healthcare services.

Hábito de fumar y comorbilidad en pacientes con enfermedad pulmonar obstructiva crónica / Smoking habit and comorbidity in patients with chronic obstructive pulmonary disease

RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica constituye un problema de salud en Cuba y el mundo; su pronóstico está en relación con varios factores. Objetivo: Caracterizar a una serie de pacientes hospitalizados con enfermedad pulmonar obstructiva crónica, según edad, sexo, fenotipo, hábito de fumar y enfermedades comórbidas. Métodos: Se realizó un estudio descriptivo transversal que incluyó a los 296 pacientes que ingresaron en el Servicio de Medicina Interna del Hospital Militar Central "Dr. Carlos J. Finlay" con el diagnóstico de enfermedad pulmonar obstructiva crónica, en el período de dos años. Se determinaron las enfermedades comórbidas, el fenotipo dado por la forma clínica de presentación de los pacientes (A, B, C y D); la edad, sexo, hábito de fumar, tiempo y cantidad que fuma. Se utilizó el índice de comorbilidad de Charlson, para valorar la comorbilidad asociada en la enfermedad. Resultados: El 54 % de los pacientes fueron masculinos, el 96,9 % mayor de 50 años, el 36,1 % del fenotipo C y el 76,6 % fumadores. La hipertensión arterial fue más frecuente en los fenotipos B, C y D, en más del 70 %, la diabetes mellitus en el 73,7 % del fenotipo B y la cardiopatía isquémica en el 61,7 % del fenotipo D. Conclusiones: La mayoría de los pacientes estudiados fueron masculinos, mayores de 50 años, fumadores por más de 10 años y del fenotipo C. Las enfermedades comórbidas más frecuentes fueron la hipertensión arterial, la diabetes mellitus y la cardiopatía isquémica.

ABSTRACT Introduction: Chronic obstructive pulmonary disease constitutes a health problem in Cuba and the world, its prognosis is related to several factors. Objective: To characterize a series of hospitalized patients with chronic obstructive pulmonary disease, according to age, sex, phenotype, smoking habit and comorbid diseases. Method: A descriptive cross-sectional study was carried out that included the 296 patients who were admitted to the Internal Medicine Service of the Central Military Hospital Dr. Carlos J. Finlay with the diagnosis of chronic obstructive pulmonary disease in the period of two years. Comorbid diseases were determined, the phenotype given by the clinical presentation of the patients (A, B, C and D); age, sex, smoking habit, time and amount of smoking. The Charlson comorbidity index was used to assess the associated comorbidity in COPD. Results: 54% of the patients were male, 96,9% older than 50 years, 36,1% phenotype C, and 76,6% smokers. Hypertension was more frequent in phenotypes B, C and D, in more than 70%, diabetes mellitus in 73,7% of phenotype B, and ischemic heart disease in 61,7% of phenotype D. Conclusions: Most of the patients studied were male, older than 50 years, smokers for more than 10 years and phenotype C. The most frequent comorbid diseases were arterial hypertension, diabetes mellitus and ischemic heart disease.

Novel species of Cladosporium from environmental sources in Spain.

Cladosporium is a monophyletic genus in Cladosporiaceae (Cladosporiales, Dothideomycetes) whose species are mainly found as saprobes and endophytes, but it also includes fungi pathogenic for plants, animals and human. Species identification is currently based on three genetic markers, viz., the internal transcribed spacer regions (ITS) of the rDNA, and partial fragments of actin (act) and the translation elongation factor 1-α (tef1) genes. Using this phylogenetic approach and from morphological differences, we have recognized six new species originating from soil, herbivore dung and plant material collected at different Spanish locations. They are proposed as Cladosporium caprifimosum, C. coprophilum, C. fuscoviride and C. lentulum belonging in the C. cladosporioides species complex, and C. pseudotenellum and C. submersum belonging in the C. herbarum species complex. This study revealed that herbivore dung represented a reservoir of novel lineages in the genus Cladosporium.

Gran tumor cardiaco de cavidades derechas con infiltración pulmonar en una mujer joven / Large right-cavity cardiac tumor with pulmonary infiltration in a young woman

Introducción: El diagnóstico diferencial de una masa intracavitaria incluye las variantes normales, los trombos, las vegetaciones y las neoplasias. Los tumores cardíacos primarios son poco frecuentes, con una incidencia que varía del 0,0017 por ciento al 0,28 por ciento y las metástasis aparecen entre el 1,5 por ciento al 20,6 por ciento de las necropsias de los enfermos neoplásicos. Objetivo: Presentar una paciente con masa en ventrículo derecho y vértice pulmonar derecho, con diagnóstico de rabdomiosarcoma cardíaco con metástasis pulmonar. Caso clínico: Paciente femenina de 46 años sin enfermedad previa ni hábitos tóxicos, que ingresa en el servicio de Medicina Interna del Hospital Militar Dr. Carlos J. Finlay, por falta de aire y síntomas dispépticos. Evoluciona de forma tórpida en 48 días, con progresión de la disnea, asociada a hipotensión y taquicardia. Hubo una sospecha inicial de tromboeembolismo pulmonar y luego de enfermedad neoplásica, intracavitaria o pulmonar. Conclusiones: El rabdomiosarcoma cardíaco es poco frecuente y se caracteriza por su crecimiento rápido que conduce a la muerte en semanas o meses, a partir del momento de su presentación clínica(AU)

Introduction: The differential diagnosis of an intracavitary mass includes normal variants, thrombi, vegetations and neoplasms. Primary cardiac tumors are rare, with an incidence ranging from 0.0017 percent to 0.28 percent and metastases appear in 1.5 percent to 20.6 percent of necropsies in neoplastic patients. Objective: To present a patient with a right ventricular and right lung apex mass diagnosed with cardiac rhabdomyosarcoma with pulmonary metastases. Clinical case: A 46-year-old female patient with no previous illness or toxic habits was admitted to the Internal Medicine Service of Military Hospital Dr. Carlos J. Finlay due to lack of air and dyspeptic symptoms. Torpid evolution in 48 days with progression of dyspnea associated with hypotension and tachycardia. Initial suspicion of pulmonary thromboeembolism and then neoplastic, intracavitary or pulmonary disease. Conclusions: Cardiac rhabdomyosarcoma is rare and characterized by rapid growth leading to death within weeks or months from the time of clinical presentation(AU)

Caracterización clínica de pacientes con infecciones del sistema nervioso central en un centro de atención terciaria / Clinical description of patients with central nervous system infections at a tertiary care center

Introducción: Las infecciones del sistema nervioso central constituyen un problema de salud a nivel mundial por la elevada morbimortalidad que produce. Objetivo: Caracterizar clínicamente a pacientes con infección del sistema nervioso central. Métodos: Estudio observacional, descriptivo y retrospectivo (2009-2018) en pacientes con infección del sistema nervioso central atendidos en el Hospital Hermanos Ameijeiras. Las variables estudiadas fueron: edad, sexo, tipo de infección, estado de inmunocompetencia, manifestaciones clínicas, complicaciones, agentes etiológicos, celularidad en el líquido cefalorraquídeo, estado al egreso, estadía hospitalaria. Resultados: Fueron incluidos 133 pacientes, 52,6 por ciento eran del sexo masculino y 45,9 por ciento tenían entre 40-59 años. Prevalecieron los pacientes con infecciones bacteriana en 58,6 por ciento, el staphylococcus sp fue el agente etiológico que más se identificó, la meningoencefalitis representó 36,8 por ciento, estaban inmunodeprimidos 56,4 por ciento, la cefalea y la fiebre estuvieron presente en 82,7 por ciento y la rigidez nucal en 15 por ciento. Las complicaciones respiratorias y la hidrocefalia representaron 21 por ciento y 12,8 por ciento respectivamente. El estado al egreso se asoció al estado de inmunocompetencia (p=0,002), la estadía hospitalaria (p=0,001) y el tipo de infección (p=0,002). Conclusiones: El principal tipo de infección según predominio de la celularidad fue la bacteriana, fue bajo el número de agentes etiológicos identificados. La meningoencefalitis fue la infección más frecuente. La cefalea, la fiebre y la rigidez nucal los síntomas y signos que predominaron, así como las complicaciones respiratorias y la hidrocefalia. Hubo asociación del estado al egreso con el tipo de infección, estado de inmunocompetencia y la estadía hospitalaria(AU)

Introduction: Central nervous system infections constitute a health problem worldwide due to the high morbidity and mortality that it produces. Objective: To clinically describe patients with central nervous system infection. Methods: An observational, descriptive and retrospective study was carried out from 2009 to 2018, in patients with central nervous system infection treated at Hermanos Ameijeiras Hospital. The variables studied were age, sex, type of infection, immunocompetence status, clinical manifestations, complications, etiological agents, cellularity in the cerebrospinal fluid, state at discharge, hospital stay. Results: One hundred thirty three patients were included, 52.6 percent were male and 45.9 percent aged between 40-59 years. Patients with bacterial infections prevailed in 58.6 percent, staphylococcus sp was the most identified etiological agent, meningoencephalitis accounted 36.8 percent, 56.4 percent were immunosuppressed, headache and fever were present in 82.7 percent and nuchal rigidity in 15 percent. Respiratory complications and hydrocephalus covered 21 percent and 12.8 percent respectively. Status at discharge was associated with immunocompetence status (p = 0.002), hospital stay (p = 0.001) and type of infection (p = 0.002). Conclusions: Bacterial infection was the main type of infection according to the cellularity predominance; the number of etiological agents identified was low. Meningoencephalitis was the most frequent infection. Headache, fever and nuchal stiffness were the predominant symptoms and signs, as well as respiratory complications and hydrocephalus. There was an association of the state at discharge with the type of infection, immunocompetence status and hospital stay(AU)

Three new Curvularia species from clinical and environmental sources.

Curvularia is a Pleosporalean monophyletic genus with a great diversity of species, including relevant phytopathogenic, animal and human pathogenic fungi. However, their microscopic identification is difficult due to overlapping morphological features amongst species. In recent years, multi-locus sequence analysis using the ITS region of the rDNA and fragments of the genes gapdh and tef1 revealed numerous cryptic species, especially in isolates that commonly produced 3-septate conidia. Therefore, based on sequence analysis of the above-mentioned DNA barcodes recommended for species delineation in Curvularia, we propose three novel species, C. paraverruculosa, C. suttoniae and C. vietnamensis, isolated from soil, human clinical specimens and plant material, respectively, collected in different countries. These new species are morphologically characterised and illustrated in the present study. Curvularia paraverruculosa differs from its counterparts, C. americana and C. verruculosa, mainly by its narrower conidia. Curvularia suttoniae and C. vietnamensis are closely related to C. petersonii, but the former two have larger conidia.

Heliocephala variabilis and Pseudopenidiella vietnamensis: Two New Hyphomycetous Species in the Microthyriaceae (Dothideomycetes) from Vietnam.

In a survey of microfungi from plant debris collected in Vietnam, two new hyphomycetous species were found, which belong to the genera Heliocephala and Pseudopenidiella and the family Microthyriaceae (Microthyriales, Dothideomycetes). Maximum Likelihood and Bayesian Inference sequence analyses of the internal transcribed spacers (ITS) and large subunit (LSU) of the ribosomal DNA barcodes allowed assessing the phylogenetic relationships of the new species with other species of the respective genera. Heliocephala variabilis sp. nov. was closely related to Heliocephala elegans, Heliocephala gracilis, and Heliocephala zimbabweensis, from which it was morphologically distinguished by its smaller conidiophores and non-rostrate conidia of up to four septa on the natural substratum. Pseudopenidiella vietnamensis sp. nov. was related to Pseudopenidiella piceae and Pseudopenidiella podocarpi and differed from the former principally by its lack of microcondiophores and from P. podocarpi by having larger macroconidiophores and smooth conidia. Key morphological features to distinguish the accepted species in Heliocephala and Pseudopenidiella are also provided. In addition, Pseudopenidiella pini was excluded from the genus on the basis of its morphological features.

Polyphasic identification of three new species in Alternaria section Infectoriae causing human cutaneous infection.

BACKGROUND: Cutaneous phaeohyphomycosis is an emerging disease in immunocompromised patients, being Alternaria one of the most common genera reported as a causative agent. Species identification is not carried out mainly due to the complexity of the genus. Analysis of the ITS barcode has become standard for fungal identification, but in Alternaria it is only able to discriminate among species-groups or sections. METHODS: We present three cases of cutaneous infection caused by Alternaria isolates morphologically identified as belonging to section Infectoriae. They have been morphologically characterised and phylogenetically delineated with five molecular markers (ITS, ATPase, gapdh, rpb2 and tef1). RESULTS: Mycotic infections have been diagnosed by repeated cultures and histopathological examination in two of the cases. The polyphasic approach has allowed to delineate three new species of Alternaria section Infectoriae, that is A anthropophila, A atrobrunnea and A guarroi. ATPase has been the only locus able to discriminate most of the species (29 out of 31) currently sequenced in this section, including A infectoria the commonest reported species causing alternariosis. Susceptibility test showed different antifungal patterns for the three species, although terbinafine was the most active in vitro drug against these fungi. CONCLUSIONS: The ATPase gene is recommended as an alternative barcode locus to identify Alternaria clinical isolates in section Infectoriae. Our results reinforce the relevance of identification of Alternaria isolates at the species level and the necessity to carry out antifungal susceptibility testing to determine the most adequate drug for treatment.

Neodendryphiella, a novel genus of the Dictyosporiaceae (Pleosporales).

In a survey of soil and herbivore dung microfungi in Mexico and Spain, several dendryphiella-like species were found. Phylogenetic analyses based on ITS and LSU sequences showed that these fungi belonged to the family Dictyosporiaceae (Pleosporales) and represent an undescribed monophyletic lineage distant from Dendryphiella. Therefore, the genus Neodendryphiella is proposed to accommodate three new species, N.mali, N.michoacanensis and N.tarraconensis. The novel genus shares morphological features with Dendryphiella such as differentiated conidiophores and polytretic integrated conidiogenous cells, that produce acropetal branched chains of conidia. Neodendryphiella differs in the absence of nodulose conidiophores bearing conidiogenous cells with pores surrounded by a thickened and darkened wall, typical features in the conidiogenous apparatus of Dendryphiella. In addition, the phylogenetic and morphological analysis of several reference strains of different Dendryphiella species, available for comparison, support the proposal of D.variabilissp. nov., which mainly differs from the other species of the genus by having conidia up to 7 septa and highlight that D.vinosa and D.infuscans are obscure species that require further taxonomic review.

Estadios clínicos en pacientes con esclerosis sistémica en Holguín / Clinical stadiums in patients with systemic sclerosis in Holguin

La esclerosis sistémica es una enfermedad multisistémica y multiorgánica, de perfil autoinmune, con una etiopatogenia poco dilucidada. Se observan algunos avances desde hace cinco años a la fecha, fundamentalmente de los principales eventos que se presentan: anormal respuesta del sistema inmunológico, vasculopatía y fibrosis. La atención médica precoz a pacientes con ES, es muy difícil, requiere de la identificación temprana de los pacientes de alto riesgo, diagnóstico precoz de la enfermedad, evaluación de la afectación de órganos internos, y el diseño de una conducta terapéutica adecuada. El diseño fue de serie de casos con inicio en enero del 2013-2014. Universo 44 pacientes mayores de 18 años, con diagnóstico de esclerosis sistémica en la provincia de Holguín, según criterios de ACR. De ellos se tomó una muestra de 31 pacientes vivos para establecer estadios clínicos de la enfermedad, en correspondencia con la severidad de la toma orgánica para cada paciente, según método estadístico aplicado. Se obtuvo cuatro estadios clínicos útiles para la clasificación de los pacientes y evaluación posterior en otros momentos investigativos(AU)

The systemic sclerosis is a multi-systemic and multi-organic disease, of autoimmune profile, with an ethiopatogenia little elucidated. They observe some advances for five years to date, fundamentally of the principal events that present itself : Abnormal answer of the immune system, vasculopatía and fibrosis. The precocious medical attention to patients with. It is very difficult, you call for the premature recognition of the patients of loud risk, precocious diagnosis of the disease, evaluation of the affectation of internal organs, and a therapeutic adequate conduct's design. The design went from series of cases with start in January of the 2013-2014. Universe 44 patient elders of 18 years, with diagnosis of systemic sclerosis at Holguín's province, according to criteria of ACR. You took 31 alive patients' sign to establish clinical stadiums of the disease in mail, with the severity of organic the overtaking for each patient, according to applied statistical method of them. Four clinical useful stadiums for the patients' classification and later evaluation in another investigating moments were obtained(AU)

Cryptic Aspergillus from clinical samples in the USA and description of a new species in section Flavipedes.

BACKGROUND: In the last few decades there has been an emergence of cryptic Aspergillus as agents of human infections due to the increase in immunocompromised population and to the improvement of identification tools. METHODS: Continuing our study on Aspergillus isolates from clinical origin deposited in a mycological reference centre in the United States, we selected 37 isolates belonging to less common sections of the genus, to study their species diversity and detect cryptic species by using a polyphasic approach. RESULTS: From this set of isolates, a total of 16 species were identified; the most frequent being A. calidoustus (48.6%, section Usti), A. terreus (13.5%, section Terrei), and A. nidulans (5.7%, section Nidulantes). The remaining isolates corresponded to 13 species of rare or cryptic Aspergillus, i.e. A. europaeus (section Cremei); A. iizukae, A. micronesiensis, A. spelaeus (section Flavipedes); A. pachycristatus, A. quadrilineatus, A. spinulosporus, A. unguis (section Nidulantes); A. alabamensis, A. carneus, A. hortai (section Terrei), A. granulosus (section Usti); and the new species A. suttoniae (section Flavipedes), which is described here. CONCLUSIONS: Correct identification of cryptic species is crucial to reveal new potential pathogens, to gather accurate epidemiological data and to choose an appropriate treatment.

Deterioro neurológico progresivo como forma de presentación inusual del neurobehçet / Progressive neurological deterioration as unusual form of neuro-behçet presentation

La enfermedad de Behçet puede afectar a varios órganos y tiene dentro de sus características la presencia de úlceras recurrentes genitales, orales y la uveítis. El neurobehçet es una de las manifestaciones clínicas más serias e infrecuente de la enfermedad de Behçet y debe ser considerado en el diagnóstico diferencial con enfermedades inflamatorias, infecciosas o desmielinizante del sistema nervioso central. Este reporte de caso describe a una paciente con manifestaciones neurológicas aguda severas, lo cual es inusual en esta enfermedad(AU)

Behçet's disease can affect several organs and the presence of recurrent genital, oral and uveitis ulcers characterize it. Neuro-Behçet's is one of the most serious and uncommon clinical manifestations of Behçet's disease, so it should be taken into account in the differential diagnosis with inflammatory, infectious or demyelinating diseases of the central nervous system. This case report describes a female patient with acute severe neurological manifestations, unusual in this disease(AU)