Severe Neurologic Disorders in 2 Fetuses with Zika Virus Infection, Colombia.

We report the results of pathologic examinations of 2 fetuses from women in Colombia with Zika virus infection during pregnancy that revealed severe central nervous system defects and potential associated abnormalities of the eye, spleen, and placenta. Amniotic fluid and tissues from multiple fetal organs tested positive for Zika virus.

Reliability of age estimation from iliac auricular surface in a subactual Chilean sample.

The aim of this study was to test the reliability of Osborne et al. (2004) [8] age estimation based on the iliac auricular surface of the ilium. We selected 172 skeletons with documented sex and age-at-death and established six uniformly distributed age intervals for analysis. ANOVA was employed to assess the association of the documented age with sex and the auricular surface classification. We employed Bonferroni post-hoc tests to find any statistical differences across documented ages within each phase of Osborne's criteria. While the ANOVA showed a significant association between the documented age and the auricular surface classification, post-hoc tests found that phases 2 and 3 were the only consecutive phases with significant differences. We argue that a lack of statistical significance between consecutive phases undermines the reliability of this method for forensic purposes especially in middle adults. It may be possible that the collapse of intermediate phases would increase the accuracy of this method.

Dietary practices in ancient populations from northern Chile during the transition to agriculture (Tarapacá region, 1000 BC-AD 900).

OBJECTIVE: The goal of this research is to understand the relevance of diet diversity during the transition to agriculture, in ancient populations from northern Chile, especially considering the significance of marine resources and crops in a lesser degree. METHODS: A total of 14 human individuals were sampled from the Tarapacá 40 cemetery. Both bone and tooth samples were collected. Samples were studied from bone/dentine collagen for carbon and nitrogen isotopic analysis; and bone/enamel apatite for carbon isotope analysis. Inferential statistical analyses were performed in order to compare Tarapacá 40 stable carbon and nitrogen isotope values with other Formative and Late Intermediate Period groups. A nonparametrical hypothesis Kruskal-Wallis test was used. RESULTS: The results show that the individuals from Tarapacá 40 are intermediate to the values observed for terrestrial and marine fauna as well as C3 and C4 plants. CONCLUSIONS: A gradual transition to crop consumption, especially maize, is suggested. This complemented the earlier hunter-gatherer tradition of marine resources and wild fruit consumption. Contrarily to the predictions made by some archaeologists, the results obtained for northern Chile contrast with the classical perspective of a "Neolithic Revolution" in which transition to agriculture occurred more abruptly and linearly.

Pancreatitis aguda severa y precoz por liraglutide / Liraglutide-induced severe early acute pancreatitis

Los agonistas GLP-1 presentan como efectos secundarios más frecuentes las náuseas y vómitos que son de carácter leves y moderados, siendo transitorios y dosis dependiente sin necesidad de suspender el fármaco en la mayoría de casos. Estos efectos ocurren más frecuentemente con exenatide y raramente con liraglutide, sin conocer un caso clínico de tal severidad y sobre todo precocidad. Se describe una mujer de 55 años caucasiana con diabetes mellitus tipo 2 de larga evolución asociadas que presentó cuadro de dolor abdominal, náuseas, vómitos incoercibles e hiperlipasemia de aparición súbita tras la primera dosis de titulación de liraglutide, completando solo 2 dosis en 48 horas, consultando en urgencias donde se apreció fracaso renal agudo y descompensación hiperosmolar que requirió su ingreso en unidad de cuidados intensivos. Al emplear la escala de probabilidad de reacción a fármaco de Naranjo obtenemos dicha reacción como probable, sin encontrar otras alternativas justificables clinicamente.

The most frequent side effects seen with GLP-1 agonists are mild and moderate nausea and vomiting, which are typically transient and dose-dependent, in most cases not requiring discontinuation of the drug. These effects occur most frequently with exenatide, and rarely with liraglutide; no clinical cases with such a severity -and especially with such an early occurrence- had been previously reported. The case herein described is that of a 55-year-old Caucasian female with a long-standing Type 2 diabetes mellitus, who presented with sudden abdominal pain, nausea, relentless vomiting an increased lipase serum levels after the first dosage of liraglutide, after completing only 2 dosages in 48 hours. The patient was seen at the emergency room, where she was diagnosed acute renal failure and hyperosmolar decompensation that required admission at the intensive care unit. According to Naranjo’s odds scale, the reaction was considered to be likely related to the drug; no other alternatives were considered to be clinically justified.

Enfermedad celíaca y su patogenia / An update on the pathogenesis of celiac disease

Celiac disease (CD), with a 1 percent worldwide prevalence, is an enteropathy caused by an autoimmune reaction to gluten in genetically susceptible individuals, which codify for histocompatibility molecules HLA DQ-2/DQ-8. From the anatomical point of view, CD is characterized by intestinal villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis (IELs) and leukocyte infiltration of the lamina propriety. Patients achieve a complete clinical and endoscopic remission with a gluten free diet. However, symptoms and anatomical alterations recur when this protein is reintroduced in the diet. The pathogenic mechanisms in this disease are not yet well understood, but it is clear that genetic, environmental and immunological factors play a role. The latter are the focus of this review, since this is the only autoimmune disease whose precipitating factor for immunological tissue damage is known.

[An update on the pathogenesis of celiac disease]. / Enfermedad celíaca y su patogenia.

Celiac disease (CD), with a 1% worldwide prevalence, is an enteropathy caused by an autoimmune reaction to gluten in genetically susceptible individuals, which codify for histocompatibility molecules HLA DQ-2/DQ-8. From the anatomical point of view, CD is characterized by intestinal villous atrophy, crypt hyperplasia, intraepithelial lymphocytosis (IELs) and leukocyte infiltration of the lamina propriety. Patients achieve a complete clinical and endoscopic remission with a gluten free diet. However, symptoms and anatomical alterations recur when this protein is reintroduced in the diet. The pathogenic mechanisms in this disease are not yet well understood, but it is clear that genetic, environmental and immunological factors play a role. The latter are the focus of this review, since this is the only autoimmune disease whose precipitating factor for immunological tissue damage is known.