Prevalence of hepatitis C virus infection according to the year of birth: identification of risk groups.

Hepatitis C virus (HCV) screening according to the year of birth is recommended is some countries based on epidemiological data. The aim of this study was to analyze anti-HCV prevalence among people born between 1905 and 2015 in Argentina. Patients attending a tertiary care hospital in Buenos Aires, Argentina, from 2001 to 2015, who had a determination of anti-HCV, were included. Of 22,079 patients analyzed, 1,152 (5.2%; 95% confidence interval [CI]: 4.9%-5.5%) patients showed positive anti-HCV and 729 (3.3%; 95% CI: 3.1%-3.5%) patients showed detectable viremia. Three risk groups were identified (HCV prevalence): low-risk group-outpatient clinics/emergencies (2.8%); intermediate-risk group-in-patients (8%); and high-risk group-dialysis/transplants (27.2%). In the low-risk group, being born in 1973 or before was identified as a cut-off value for the risk of anti-HCV acquisition (area under the receiver-operator characteristic curve: 75.1 [95% asymptotic CI: 0.732-0.770; p < 0.001]). Ninety-one patients born after 1973 (0.8%) showed positive anti-HCV versus 457 individuals born in 1973 or before (5.8%), p < 0.001. In this group, positive anti-HCV was observed in 252 females (2.1%) and 296 males (4.1%), p < 0.001. In a multivariate analysis adjusted for gender, alanine-aminotransferase levels and HIV coinfection, being born in 1973 or before was independently identified as a risk for positive anti-HCV (adjusted odds ratio: 14.234 [95% CI: 9.993-20.277]; p < 0.001). People born in 1973 or before without other risk factors should be included in screening programs to link the highest possible number of HCV-infected patients to appropriate care and treatment.

Epidemiology of Pancreatic Cancer in Puerto Rico (1987-2010): Incidence, Mortality and Survival.

BACKGROUND & OBJECTIVE: Pancreatic cancer is an uncommon type of cancer worldwide. Nonetheless, even with early diagnosis, mortality rates are high. This study aims to perform an epidemiologic profile of pancreatic cancer in Puerto Rico (PR) from 1987-2010. METHODS: Using data from the Puerto Rico Central Cancer Registry, age-standardized incidence and mortality rates of pancreatic cancer in PR were compared with Hispanics, non-Hispanic Whites, and non-Hispanic Blacks in the United States of America (USA). Incidence and mortality trends of pancreatic cancer were estimated, and survival analyses were also performed. RESULTS: In 2005-2010, 5.8 per 100,000 persons were diagnosed with pancreatic cancer in PR and mortality rates were similar. Pancreatic cancer was more frequent in men (6.5 per 100,000 men) than women (5.2 per 100,000 women), and in persons older than 65 years (32.0 per 100,000 persons). Moreover, the median survival for the people diagnosed with pancreatic cancer in PR during 2006-2007 was 4 months and at the end of the third year after diagnosis, only 13% of the patients survived. Incidence trends of pancreatic cancer showed an increase for men (APC=13.0%, p<0.05) from 2006 to 2010, but not for women (APC=-0.4, p>0.05). However, mortality trends showed a slight decrease for men (APC=-1.0%, p<0.05), but not for women (APC=1.4, p>0.05) in the period of 1987 to 2010. Meanwhile, Puerto Ricans in comparison to other racial/ethnic groups living in the USA showed a lower risk for being diagnosed and of dying from pancreatic cancer. CONCLUSION: Our results highlight the need for additional research in pancreatic cancer, in order to have an impact in disease survival in PR.

GVHD prophylaxis with sirolimus-tacrolimus may overcome the deleterious effect on survival of HLA mismatch after reduced-intensity conditioning allo-SCT.

Large studies, mostly based on series of patients receiving CSA/tacrolimus (TKR) plus MTX as immunoprophylaxis, have demonstrated a deleterious effect on survival of the presence of a single mismatch out of eight loci after allogeneic hematopoietic SCT (alloHSCT). We retrospectively analyzed a series of 159 adult patients who received sirolimus(SRL)/TKR prophylaxis after alloHSCT. We compared overall outcomes according to HLA compatibility in A, B, C and DRB1 loci at the allele level: 7/8 (n=20) vs 8/8 (n=139). Donor type was unrelated in 95% vs 70% among 7/8 vs 8/8 pairs, respectively (P=0.01). No significant differences were observed in 3-year OS (68 vs 62%), 3-year EFS (53 vs 49%) and 1-year non-relapse mortality (9 vs 13%). Cumulative incidence of grades II-IV acute GVHD (aGVHD) was significantly higher in 7/8 alloHSCT (68% vs 42%, P<0.001) but no significant differences were found for III-IV aGVHD (4.5% vs 11%), overall (35% vs 53%) and extensive (20% vs 35%) chronic GHVD in 7/8 vs 8/8 subgroups, respectively. In summary, the present study indicates favorable outcomes after alloHSCT using the combination of SRL/TKR combination as GVHD prophylaxis with OS in the range of 55-70%, and non-significant differences in overall outcomes, irrespective of the presence of any mismatches at obligatory loci.

Study of the regional air quality south of Mexico City (Morelos state).

Results from the first study of the regional air quality in Morelos state (located south of Mexico City) are presented. Criteria pollutants concentrations were measured at several sites within Morelos in February and March of 2007 and 2009; meteorological data was also collected along the state for the same time periods; additionally, a coupled meteorology-chemistry model (Mesoscale Climate Chemistry Model, MCCM) was used to gain understanding on the atmospheric processes occurring in the region. In general, concentrations of almost all the monitored pollutants (O(3), NO(x), CO, SO(2), PM) remained below the Mexican air quality standards during the campaign; however, relatively high concentrations of ozone (8-hour average concentrations above the 60 ppb level several times during the campaigns, i.e. exceeding the World Health Organization and the European Union maximum levels) were observed even at sites with very low reported local emissions. In fact, there is evidence that a large percentage of Morelos vegetation was probably exposed to unhealthy ozone levels (estimated AOT40 levels above the 3 ppm h critical limit). The MCCM qualitatively reproduced ozone daily variations in the sites with an urban component; though it consistently overestimated the ozone concentration in all the sites in Morelos. This is probably because the lack of an updated and detailed emission inventory for the state. The main wind patterns in the region corresponded to the mountain-valley system (downslope flows at night and during the first hours of the day, and upslope flows in the afternoon). At times, Morelos was affected by emissions from surrounding states (Distrito Federal or Puebla). The results are indicative of an efficient transport of ozone and its precursors at a regional level. They also suggest that the state is divided in two atmospheric basins by the Sierras de Tepoztlán, Texcal and Monte Negro.

Tumor mesenquimal de vesícula biliar / Gastrointestinal stromal tumor of the gallbladder

No disponible

Evaluation of human exposure to ambient PM10 in the metropolitan area of Mexico City using a GIS-based methodology.

The main goal of this study was to evaluate the magnitude of outdoor exposure to fine particulate matter (PM10) potentially experienced by the population of metropolitan Mexico City. With the use of a geographic information system (GIS), spatially resolved PM10 distributions were generated and linked to the local population. The PM10 concentration exceeded the 24-hr air quality standard of 150 microg/m3 on 16% of the days, and the annual air quality standard of 50 microg/m3 was exceeded by almost twice its value in some places. The basic methodology described in this paper integrates spatial demographic and air quality databases, allowing the evaluation of various air pollution reduction scenarios. Achieving the annual air quality standard would represent a reduction in the annual arithmetic average concentration of 14 microg/m3 for the typical inhabitant. Human exposure to particulate matter (PM) has been associated with mortality and morbidity in Mexico City; reducing the concentration levels of this pollutant would represent a reduction in mortality and morbidity and the associated cost of such impacts. This methodology is critical to assessing the potential benefits of the current initiative to improve air quality implemented by the Environmental Metropolitan Commission of Mexico City.

The roles of the glycosylphosphatidylinositol anchor on the production and immunogenicity of recombinant ookinete surface antigen Pbs21 of Plasmodium berghei when prepared in a baculovirus expression system.

Malarial ookinetes express an immunodominant surface protein (P28) that is a priority candidate for the development of transmission-blocking vaccines. The full length P28 gene from Plasmodium berghei [Pbs21(1-213)] and a deletion construct [Pbs21(1-188)] encoding a protein that lacks the 25 C-terminal amino acids, including the glycosylphosphatidylinositol (GPI) anchor signal, were expressed in insect cells using baculovirus vectors. Pbs21(1-213) protein is strongly hydrophobic, found in the cytoplasm and on the surface of Spodoptera Sf21 cells, and in the culture medium. Pbs21(1-188) protein was largely found in the aqueous phase of the medium and in the cytoplasm of Sf21 cells, but was not detected on the cell surface. The presence of 25 C-terminal amino acids is therefore critical to the attachment of recombinant Pbs21 to the parasite plasma membrane. Mice were immunized subcutaneously or intramuscularly with affinity purified recombinant Pbs21(1-213), Pbs21(1-188) or native Pbs21 proteins. Following two immunizations, native Pbs21 induces higher titres when administered by either route, than the recombinant protein bearing an insect GPI anchor, which in turn is markedly more immunogenic than the recombinant polypeptide lacking a GPI anchor. When specific anti Pbs21 antibody titres exceeded 1 mg/ml all three antigens were capable of inducing transmission blockade > or = 90%, below 1 mg/ml blockade did not correlate with antibody concentration.

Hemorrhagic syndrome and acute renal failure in a pregnant woman after contact with Lonomia caterpillars: a case report.

A case of a 37-week pregnant woman who developed a hemorrhagic syndrome and acute renal failure after contact with Lonomia caterpillars is reported. The accident also initiated labour and the patient gave birth to an alive child. Some pathophysiological aspects of the genital bleeding and of the acute renal failure are discussed.

Trends in suicide (1983-1987).

From over 20,000 autopsies performed by the Department of Forensic Medicine of The London Hospital Medical College over a period of 5 years from 1983 to 1987, 7.4 per cent were classified as unnatural deaths, and from these 659 (3.2 per cent) were suicides. The object of this paper is to study the different methods of self-destruction, the incidence of these methods by sex and age, and evidence left by the deceased.

Second-generation 1,2,4-benzotriazine 1,4-di-N-oxide bioreductive anti-tumor agents: pharmacology and activity in vitro and in vivo.

SR 4233 (1,2,4-benzotriazine-3-amine 1,4-dioxide) will soon be entering Phase I clinical trials as a new bioreductive cytotoxic agent for the treatment of solid tumors in combination with fractionated radiotherapy. We have selected 3 from over 50 analogues of SR 4233 which showed particular promise as second generation bioreductive antitumor agents. These compounds, when compared to SR 4233, have higher hypoxic toxicity and comparable or higher oxic to hypoxic cytotoxicity ratios in vitro and similar animal toxicity. We have compared the effectiveness of these three compounds with SR 4233 in two tumor systems and have examined some pharmacokinetic properties. The results show that replacement of the amino group at the 3-position of SR 4233 with either a hydrogen or an N,N-dialkylaminoalkylamino group shortens the half-life of these compounds in the blood because of the combined effects of partition coefficients, basicity, and higher reactivity. SR 4754 and SR 4755, the N,N-dialkylaminoalkylamino derivatives, exhibited shorter plasma half-lives than SR 4233 but exhibited lower anti-tumor activity than SR 4233 based on equal mouse toxicity in a fractionated regimen. SR 4482, with the hydrogen substitution and very high electron affinity, possessed a very short blood half life yet retained similar anti-tumor activity as SR 4233.

Factor VIII-associated antigen in human lymphatic endothelium.

Lymphatic vascular endothelium both on tissue section and in culture exhibits positivity for Factor VIII-associated antigen although staining is generally less intense and more spotty than in comparable blood vascular endothelium. Lymphatic endothelium also exhibits Weibel-Palade bodies. Neither marker, therefore, reliably distinguishes blood vascular endothelium from lymphatic endothelium.

A technical modification to improve experimental production of hepatogenic ascites.

Constriction of the thoracic inferior vena cava is a useful experimental maneuver to reproduce massive ascites. Unfortunately, the margin of safety of this technique is narrow in that too much constriction overly restricts venous return with subsequent shock and death, and lesser constriction is often associated with extensive venous collateralization via the azygos system and failure to sustain hepatic congestion. By combining azygos vein ligation with 50% constriction of the supradiaphragmatic inferior vena caval circumference at the time of the initial thoracotomy, we have found that intense hepatic congestion is sustained and that dogs consistently develop massive ascites within 2-3 weeks.

Potential antitumor agents. Some sulfur-substituted derivatives of alpha- and beta-2'-deoxythioguanosine.

A series of ten S-substituted derivatives of the alpha and beta anomers (1a and 1b) of 2'-deoxy-6-thioguanosine has been prepared by S-alkylation of the parent nucleosides and/or by mercaptide displacement reactions on 6-chloro intermediates. Against L1210 murine leukemia all beta anomers were active but potency was reduced relative to 1b. Most S-alkyl alpha anomers were inactive in this test. Limited testing against P388 murine leukemia showed all alpha-anomer derivatives to be inactive but the beta anomers were more effective than the parent. S-Substitution sharply reduced acute toxicity in both series. In vitro DNA and RNA synthesis inhibition data are also reported. The antitumor activity of these derivatives and of the 2',5'-di-O-acetyl derivatives of 1a and 1b against lymphoid leukemia L1210 is reported. Some results with the lymphocytic leukemia P388 and an in vitro assay of the inhibition of nucleic acid synthesis are also given.