Listeriolysin O antibodies detection in pregnant women: results from an Italian pilot study.

BACKGROUND: Listeriosis is a rare infection affecting primarily pregnant women, the elderly and individuals with a weakened immune system and is caused by the ubiquitous bacterium Listeria monocytogenes. Infection during pregnancy can cause severe consequences especially for the fetus, leading to sepsis, premature delivery, stillbirth and miscarriage. STUDY DESIGN: A pilot observational study has been conducted in order to establish the prevalence of seroconversion of specific antibodies against a peculiar toxin belonging to L. monocytogenes, listeriolysin O (LLO), in a population of pregnant women from Senigallia (Central Italy) and to find correlations between anti-LLO antibodies seropositivity and health and nutritional information. A total of 60 women were screened for anti-LLO antibody positivity and interviewed during their pregnancies. Statistical analyses were performed to evaluate antibody prevalence in serum samples and potential risk factors. RESULTS: The seroprevalence resulted 18% (95% CI, 8.2 - 27.7%), corresponding to 11 pregnant women. Categorical principal component analysis and hierarchical cluster analysis revealed a significant correlation between anti-LLO positivity and gastrointestinal pain events and vomit, fever and diarrhea episodes, and a possible association with consumption of pre-cooked meal. No significant correlation was observed in women with a previous miscarriage or with miscarriage cases in their families. CONCLUSIONS: Findings from this pilot study will be used to design a wider study focused on the prevalence of Listeria-specific antibodies in pregnant women and could allow to the identification of nutritional and behavioral habits related to Listeria infection which could lead to significant clinical implications.

Long-Term Functionality of Transversal Intraneural Electrodes Is Improved By Dexamethasone Treatment.

Neuroprostheses aimed to restore lost functions after a limb amputation are based on the interaction with the nervous system by means of neural interfaces. Among the different designs, intraneural electrodes implanted in peripheral nerves represent a good strategy to stimulate nerve fibers to send sensory feedback and to record nerve signals to control the prosthetic limb. However, intraneural electrodes, as any device implanted in the body, induce a foreign body reaction (FBR) that results in the tissue encapsulation of the device. The FBR causes a progressive decline of the electrode functionality over time due to the physical separation between the electrode active sites and the axons to interface. Modulation of the inflammatory response has arisen as a good strategy to reduce the FBR and maintain electrode functionality. In this study transversal intraneural multi-channel electrodes (TIMEs) were implanted in the rat sciatic nerve and tested for 3 months to evaluate stimulation and recording capabilities under chronic administration of dexamethasone. Dexamethasone treatment significantly reduced the threshold for evoking muscle responses during the follow-up compared to saline-treated animals, without affecting the selectivity of stimulation. However, dexamethasone treatment did not improve the signal-to-noise ratio of the recorded neural signals. Dexamethasone treatment allowed to maintain more working active sites along time than saline treatment. Thus, systemic administration of dexamethasone appears as a useful treatment in chronically implanted animals with neural electrodes as it increases the number of functioning contacts of the implanted TIME and reduces the intensity needed to stimulate the nerve.

Depresión en pacientes internados en servicios de clínica médica / Depression in patients admitted to medical clinic services

INTRODUCCIÓN La depresión es frecuente en pacientes internados por enfermedades clínicas. Sin embargo, la prevalencia reportada en la literatura es altamente variable. OBJETIVOS Determinar la prevalencia de depresión en tres hospitales del área metropolitana de la provincia de Buenos Aires; evaluar los factores asociados (clínico-epidemiológicos) y tres de las escalas más usadas para su diagnóstico. MÉTODOS Los pacientes fueron evaluados dentro de un estudio de corte transversal para medir depresión (según criterios del DSM-IV) por psiquiatras guiados por el examen MINI, comparando luego este valor con el arrojado por otros métodos de diagnóstico. Los factores de riesgo fueron analizados en análisis bivariado seguidos de un modelo de regresión logística multivariad. RESULTADOS La prevalencia de depresión por examen psiquiátrico en 257 sujetos fue del 27%, encontrando un resultado similar con la Escala de Ansiedad y Depresión Hospitalaria (HADS) (25%) y bastante mayor con el Inventario de Depresión de Beck (BDI) (44%) y con el Cuestionario de Salud del Paciente (PHQ-9) (56%). Entre los factores asociados a depresión, el tratamiento previo con psicofármacos, el sexo femenino, el número de hijos, así como el consumo de tabaco se asociaron significativamente y de forma independiente luego del análisis multivariado. Entre los trastornos médicos, el riesgo de depresión fue más alto en las enfermedades neoplásicas, urológicas e infecciosas, y más bajo en las pulmonares, neurológicas y hematológicas. Discusión Este estudio encontró alta prevalencia de depresión en los hospitales generales, la cual se asocia a varios factores; así como también, la existencia de gran variación en la estimación de la depresión entre los métodos de diagnóstico. Los resultados ratifican la necesidad de identificar depresión en los pacientes hospitalizados por enfermedades médicas utilizando métodos validados, fiables y rentables que contribuyan a la planificación racional para la utilización de recursos.

Cold-induced sweating syndrome type 1, with a CRLF1 level mutation, previously associated with Crisponi syndrome.

INTRODUCTION: Cold-induced sweating syndrome type 1 (CISS1) is a rare autosomal recessive genodermatosis caused by mutations in the CRLF1 gene, characterized by profuse sweating when the ambient temperature is below 22°C and morphological alterations. CRLF1 mutations also cause Crisponi syndrome (CS), which presents neonatal muscle contractions, morphological disorders and alterations in the autonomous nervous system. CASE REPORT: A 30-year-old man sought treatment for profuse sweating. His medical record included neonatal admission for generalized hypertonicity. Clinical examination revealed morphological alterations. A genetic study was requested, detecting a c.713dupC mutation in homozygosity in the CRLF1 gene. CONCLUSIONS: We report the case of a male with clinical and genetic diagnosis of CISS1 who in childhood presented clinical characteristics of CS. The mutation detected in CRLF1 has not been described in patients with CISS1, but in one with CS. These data seem to support the theory that CS and CISS1 are variants of the same disorder.

Validación del cuestionario de calidad de vida ConQol, en niños chilenos portadores de cardiopatías congénitas / Validation of quality of life questionnaire ConQol for Chilean children with congenital heart diseases

Background: ConQoL questionnaire assesses health related quality of life among children with congenital heart diseases. It has a version for children aged 8 to 11 years and anotherfor children aged 12 to 16years. Aim: To validate ConQol questionnaire for Chilean children with a congenital heart disease. Material and Methods: Using a multicentric cross sectional design, 334 children from four hospitals (54% males), were surveyed. Among them 45% were aged 8 to 11 years and 55%, 12 to 16 years. The study involved three stages: cross cultural adjustment of the original questionnaire, pre-test study, and estimation of its psychometric properties. Content, construct and criterion validity and internal consistency with Cronbach's alpha, were assessed. Results: The version for children aged 8 to 11 years and comprised by three domains (symptoms, activity and relationships), obtained and α ≥ 0.60. In the questionnaire for children aged 12 to 16years, there is one more domain called coping, which obtained an α of 0.53, that was different to the other three domains that obtained an α > 0.70. The correlation between Health Quality of Life and Perception of Health Quality of Life was statistically significant for both groups. The association between Health Quality ofLife and health capability was only significant among children aged 12 to 16years (p < 0.01). Conclusions: The adapted ConQol questionnaire matched properly with the original one. The adapted questionnaire is valid and reliable to assess Health Quality ofLife among Chilean children with congenital heart diseases.

Actualización en hiperhidrosis focal primaria / Update on primary focal hiperhidrosis

La hiperhidrosis focal primaria (HFP) es una patología de origen idiopático que afecta a un 2,8% de la población y que origina un fuerte impacto en la vida social, laboral y personal de los individuos que la padecen. Cuando sospechamos que un paciente puede presentar una HFP debemos realizar una anamnesis y exploración física minuciosas para descartar causas secundarias de hiperhidrosis. Posteriormente delimitaremos el área afectada mediante el test de Minor y podemos valorar la afectación que produce la enfermedad en la calidad de vida del paciente a través de distintos test. Existen múltiples tratamiento eficaces para la HFP: tratamientos tópicos, iontoforesis, infiltración de toxina botulínica, microondas, tratamientos sisté-micos y tratamientos quirúrgicos. Cada uno de estos tratamientos tiene características distintas, el conocimiento de estas características nos permitirá pautar a cada paciente el tratamiento más indicado en función de la severidad, localización y repercusión psicológica de la HFP y así obtener un resultado satisfactorio tanto para el paciente como para el médico (AU)

Primary focal hyperhidrosis (PFH) is an idiopathic pathology that affects 2.8% of the population and causes strong impact on social life, and daily activities of patients with the disease. When you suspect that a patient may suffer primary focal hyperhidrosis must perform a carefully history and physicalexamination to exclude secondary causes of hyperhidrosis. Afterwards the affected area is delimited by the Minor test and we can evaluate the effects of the disease in the patient’s quality of life through a variety of test. There are many effective treatments for PFH: topical treatments, iontophoresis, botulinum toxin injection, microwave, systemic treatments and surgical treatments. Each of these treatments has different characteristics, knowledge of these features will allow us to indicate to each patient the best treatment based on the severity, location and psychological impact of PFH and get a satisfactory outcome for both the patient and the physician (AU)

Discrimination of stable isotopes in fin whale tissues and application to diet assessment in cetaceans.

RATIONALE: In stable isotope research, the use of accurate, species-specific diet-tissue discrimination factors (i.e., Δ(13)C and Δ(15)N) is central to the estimation of trophic position relative to primary consumers and to the identification of the dietary sources of an individual. Previous research suggested that the diet of fin whales from the waters off northwestern Spain is overwhelmingly based on krill, thus permitting reliable calculation of discrimination values in this wild population. METHODS: After confirming that the stable isotope ratios (δ(13)C and δ(15)N values) in muscle from 65 aged fin whales remained constant through age classes (4-65 years), the signatures were determined in muscle, bone protein, skin, liver, kidney, baleen plates and brain, as well as food (krill), from a subset of individuals to calculate discrimination factors. Signatures were determined by means of elemental analysis isotope ratio mass spectrometry (EA-IRMS) using a ThermoFinnigan Flash 1112. RESULTS: The isotopic values remained constant regardless of age. The mean Δ(15)N values between krill and whale tissues ranged from 2.04 in bone protein to 4.27‰ in brain, and those of Δ(13)C ranged from 1.28 in skin to 3.11‰ in bone protein. This variation was consistent with that found in other groups of mammals, and is attributed to variation in tissue composition and physiology. CONCLUSIONS: Because discrimination factors are relatively constant between taxonomically close species, the results here obtained may be reliably extrapolated to other cetaceans to improve dietary reconstructions. The skin discrimination factors are of particular relevance to monitoring diet through biopsies or other non-destructive sampling methods. The large difference in bone protein discrimination factors from those of other tissues should be taken into consideration when bone collagen is used to determine trophic level or to assess diet in paleodietary isotopic reconstructions.

Deficiencia de vitamina A y síndrome de dermatosis-artritis asociado a intestino secundario a derivación biliopancreática por obesidad / Vitamin A Deficiency and Bowel-Associated Dermatosis-Arthritis Syndrome secondary to Biliopancreatic Diversion for Obesity

No disponible

No disponible

Metástasis cutánea por carcinoma pancreático como primera manifestación clínica / Skin metastases as the initial presentation of pancreatic carcinoma

No disponible

No disponible

Penfigoide ampolloso: cumplimiento del tratamiento tópico en pacientes con gran dependencia / Compliance with topical treatment for bullous pemphigoid in patients with a high level of dependency for daily activities

No disponible

No disponible

Micosis fungoide folicular. Estudio de cuatro casos / Folliculotropic mycosis fungoides. Study of four cases

La micosis fungoide folicular (MFF) es una variante de micosis fungoide (MF) caracterizada por la presencia de infiltrados foliculares, a menudo respetando la epidermis, y con afectación preferente de cabeza y cuello. Presentamos nuestra experiencia con 4 casos de MFF vistos en nuestro Servicio en los últimos años. Se trata de 4 pacientes (tres varones y una mujer) con edades comprendidas entre los 45 y 68 años. Clínicamente las lesiones se presentaron en forma de quistes, comedones, pápulas foliculares y placas con acentuación folicular. El estudio histopatológico mostró un infiltrado de distribución peri e intrafolicular con la epidermis parcial o totalmente respetada. Este infiltrado estaba formado principalmente por linfocitos atípicos. Se apreciaban también algunas formaciones quísticas. En tres casos se observaron depósitos de mucina y en uno siringotropismo. El análisis inmunohistoquímico fue positivo para los marcadores CD3, CD5 y CD4. Todos los pacientes recibieron diferentes tratamientos en función del estadio de su enfermedad. Uno de ellos falleció de shock séptico y el resto presentó respuestas parciales y recidivas frecuentes

Folliculotropic mycosis fungoides is a variant of mycosis fungoides characterized by the presence of folliculotropic infiltrates, often with sparing of the epidermis, and preferential involvement of the head and neck. We report our experience with four cases of folliculotropic mycosis fungoides followed in our department in the last years. There are four patients (three men and one woman) aged 45 to 68 years. Clinically the lesions presented as cysts, comedones, follicular papules and plaques with follicular plugging. The histopathological study showed a peri and intrafollicular infiltrate with partial or total sparing of the epidermis. This infiltrate was mainly composed of atypical lymphocytes. Some cystic formations were also observed. Three cases showed mucin deposits and one showed syringotropism. The immunohistochemical analysis was positive for CD3, CD5 and CD4. All patients received different treatments based on the stage of their disease. One of them died of septic shock and the rest showed partial responses and frequent relapses

[Folliculotropic mycosis fungoides. Study of four cases]. / Micosis fungoide folicular. Estudio de cuatro casos.

Folliculotropic mycosis fungoides is a variant of mycosis fungoides characterized by the presence of folliculotropic infiltrates, often with sparing of the epidermis, and preferential involvement of the head and neck. We report our experience with four cases of folliculotropic mycosis fungoides followed in our department in the last years. There are four patients (three men and one woman) aged 45 to 68 years. Clinically the lesions presented as cysts, comedones, follicular papules and plaques with follicular plugging. The histopathological study showed a peri and intrafollicular infiltrate with partial or total sparing of the epidermis. This infiltrate was mainly composed of atypical lymphocytes. Some cystic formations were also observed. Three cases showed mucin deposits and one showed syringotropism. The immunohistochemical analysis was positive for CD3, CD5 and CD4. All patients received different treatments based on the stage of their disease. One of them died of septic shock and the rest showed partial responses and frequent relapses.