[Anogenital lesions produced by Human Papillomavirus. Prevalence study in children and adolescent not vaccinated]. / Lesiones anogenitales por Virus Papiloma Humano. Estudio de prevalencia en niños, niñas y adolescentes no vacunados.

In Chilean children and adolescents, human papillomavirus (HPV) infection prevalence is unknown. In 2014, the HPV vaccine was incorporated into the National Immunization Program for girls, and since 2019 for boys. OBJECTIVE: To determine the prevalence, genotypes, and characteristics of HPV infection in children and adolescents with anogenital lesions not vaccinated against HPV. PATIENTS AND METHOD: Children and adolescents with anogenital lesions who consulted at the Luis Calvo Mackenna Children's Hospital between 2013 and 2017 were studied. The reason for consultation, age, sex, family history of HPV lesions, history of sexual abuse, and consensual sexual activity were recorded. HPV was detected by PCR and typification by reverse hybridization of the L1 gene. The samples were analyzed in the Oncogenic Virus Section of the Institute of Public Health. RESULTS: 110 patients were studied; 44.5% were children. HPV was detected in 34 cases (30.9% [CI95% 22.4- 40.4]), 22 (44.9%) were children and 12 (19.7%) adolescents. Eleven (91.7%) adolescents had a history of sexual con tact (p < 0.005); 4 (18.2%) children disclosed sexual abuse. HPV was found in 25% of patients with genital lesions and 50% with perianal lesions (p < 0.015). The most frequent genotypes were 59, 58, 16, 18, 6, and 11. Only low-risk genotypes were detected in children and high-risk genotypes were detected in 11/12 (91.7%) of HPV (+) adolescents. CONCLUSION: The prevalence of HPV infection was 30%. In adolescents, the infection was related to sexual contact and high-risk HPV. In children, it was associated with low-risk genotypes. Perianal lesions are more frequently associated with HPV infec tion than genital lesions in children and adolescents. The visual inspection does not allow to specify the etiology of the genital lesions, so it is necessary to perform a PCR test for HPV.

Unveiling the tartrazine binding mode with ds-DNA by UV-visible spectroscopy, electrochemical, and QM/MM methods.

Here, we studied the interaction between the food colorant tartrazine (TZ) and double stranded DNA (dsDNA), using spectroscopic, electrochemical, and computational methods such as QM/MM combined with TD-DFT. Despite the UV-vis spectroscopy is widely used to study the interaction between molecules, for the case of TZ there are discrepancies in the analyses presented in the literature available, presenting both hyperchromic and hypochromic effects and consequently different rationalizations for their results. Herein we propose the combination of UV-vis experiments with the design of high-level computational models capable of reproducing the experimental behavior to finally define the proper binding mode at the molecular scale together with the rationalization of the experimental optical response due to the complex formation. To complement the UV-vis experiments, we propose the use of electrochemical measurements, to support the results obtained through UV-vis spectroscopy, as it has been successfully used for the determination of interaction modes between small molecules and biomolecules in any condition. Our UV-vis spectroscopy experiments showed only a hypochromic effect of the absorption spectra of TZ after interaction with DNA, indicative of TZ being deeply buried in the DNA structure. The effect of ionic strength in the experimental procedures led to the dissociation of TZ, thus indicating that the interaction mode was groove binding. On the other hand, the electrochemical studies showed an irreversible reduction peak of TZ, which after the interaction with DNA exhibited a positive shift in potential that can be attributed to groove binding. The binding constant for TZ-DNA was calculated as 4.45x104M-1 (UV-vis) and 5.75x104M-1 (electrochemistry), in line with other groove binder azo dyes. Finally, through the QM/MM calculations we found that the minor-groove binding mode interacting in zones rich in adenine and thymine was the model best suited to reproduce the experimental UV-vis response.

Impact of BK Polyomavirus Plasma Viral Load in Kidney Transplant Outcomes.

BACKGROUND: BK polyomavirus infection (BKVi) is an important cause of kidney transplant (KT) loss, but there is scarce evidence on the impact of BK plasma viral load on graft function and long-term KT survival. METHODS: A retrospective cohort study including all KT recipients with BKVi (BK viremia identified in ≥3 consecutive samples by polymerase chain reaction) in our center from January 2010 to December 2020 was performed. A case-control study (1:2) was performed. We grouped the cases according to their highest peak viral load: low-level viremia (<10,000 copies/mL) and high-level viremia (≥10,000 copies/mL). To identify risk factors for BKVi, a logistic regression analysis was achieved, and a multivariable Cox regression was used to describe risk factors for graft loss. RESULTS: A total of 849 KTs were performed, and 67 presented BKVi (low-level viremia, n = 35 and high-level viremia, n = 26). In logistic regression analysis male sex (odds ratio [OR], 4.226; 95% CI, 1.660-10.758, P = .002), age (OR, 1.047; 95% CI, 1.008-1.088; P = .018), and retransplant (OR, 4.162; 95% CI, 1.018-17.015; P = .047) were predictors of BKVi. Acute rejection was more frequent in the BKVi group (18% vs 4.9%, P = .004), and graft survival was lower in patients with BKVi and high-level viremia (P = .027). In Cox regression analysis, BKVi (hazard ratio, 3.657; 95% CI, 1.146-11.670; P = .029) and specific BKV (BK polyomavirus) high-level viremia (hazard ratio, 1.988; 95% CI, 1.012-3.907; P = .046) were predictors of shorter graft survival. CONCLUSIONS: BKV high-level viremia was associated with BKV nephropathy and poorer graft survival. Additionally, acute rejection is more frequent after BKVi. It is necessary to develop strategies safe and effective for these patients.

[Prevalence of asthma and associated risk factors in schoolchildren from an area of indigenous population]. / Prevalencia de asma y factores de riesgo asociados en escolares provenientes de una zona de pueblos indígenas.

INTRODUCTION: The prevalence of asthma in Chile ranges from 10.2 to 14.9%. In previous studies, the Araucanía Region has not been included. OBJECTIVE: To determine the prevalence of asthma in the school po pulation of the Araucanía Region. SUBJECTS AND METHOD: The ISAAC questionnaires were used for asthma symptoms in addition to a questionnaire for recording sociodemographic data, belonging to the Mapuche ethnicity, type of heating, exposure to indoor air pollution, and family history. The Binomial Regression Model was used to evaluate the effect of each of the different variables of inter est, adjusting by age groups (6-7 and 13-14 years). The model also evaluated the additive interaction between these variables and age. RESULTS: 823 surveys were applied, where the prevalence of asthma was 14.2% and 23.2% in the 6-7 year old group and the 13-14 year old group, respectively. 43.7% de clare to be Mapuche, 32.9% live in rural areas, and 81.4% use firewood as a heating method. Through binomial regression model analysis, where for the study group, living in the coastal commune was significantly associated with a lower prevalence of asthma (-13.2% [CI: -17.7 to -8.6]. The history of an asthmatic mother was significantly associated with a higher prevalence of asthma (17.9% [CI: 2.7 to 33.1]. Living in a rural area, to be Mapuche or the type of heating used, showed differences statistically significant (p 0.18, p 0.609 and p 0.480, respectively) Conclusion: 13-14 year-olds school children in the Araucanía Region presented a higher prevalence of asthma. There was an association with asthma in the mother where this increase is not associated with living in a rural area, to be Ma puche or type of heating.

Hábitos alimenticios en comerciantes del mercado campesino. Sucre, Bolivia. 2019 / Food habits in traders of the campesino marketplace. Sucre, Bolivia. 2019

OBJETIVO: describir los hábitos alimenticios y estilo de vida de los comerciantes del mercado Campesino. MÉTODOS: se realizó un estudio descriptivo, transversal con 170 personas comprendidas entre 14 a 80 años. Para la recolección de datos se aplicó una encuesta. RESULTADOS: la mayor parte de la población encuestada es del sexo femenino, comparando el número de veces durante la semana del consumo de comida chatarra entre hombres y mujeres se encontró que con más frecuencia las mujeres consumen de 1 a 3 veces por semana la comida chatarra. Hay más jóvenes de entre 14 y 21 años que realizan actividad deportiva que el resto de las edades, hay más sujetos en la población de entre 38 a 45 años que consumen sustancias como alcohol, nicotina y tabaco.

OBJECTIVE: describe the eating habits and lifestyle of the farmers of the peasant market. METHODS: a descriptive, cross - sectional study was carried out with 170 people between 14 and 80 years old. For data collection, a survey was applied. RESULTS: most of the surveyed population is female, comparing the number of times during the week of junk food consumption between men and women, it was found that women consume junk food more frequently 1 to 3 times a week. There are more young people between 14 and 21 years of age who perform sports activity than the rest of the ages, there are more subjects in the population between 38 and 45 years of age who consume substances such as alcohol, nicotine and tobacco.

Characterization of a ripening-related transcription factor FcNAC1 from Fragaria chiloensis fruit.

Fragaria chiloensis is a strawberry endemic from Chile with attractive white-pink fruit, pleasant aroma and taste. However, this fruit has a limited post-harvest period due to fast softening. Several transcription factors (TFs) are involved in the regulation of fruit ripening, and members of the NAC family have been implicated in cell wall remodeling. FcNAC1 was isolated from F. chiloensis fruit, coding a protein of 332 amino acid residues and displaying a characteristic NAC domain at the N terminus. FcNAC1 protein showed nuclear localization. An increase in transcript level was observed during ripening. A sequence of 1488 bp of FcNAC1 promoter was obtained. In silico analysis identified cis elements able to respond to some hormones and Secondary wall NAC binding elements (SNBE), and responding to auxin and ABA. A structural model of FcNAC1 provided evidence for interaction with DNA sequences containing SNBE, while a dual luciferase assay confirmed the transcriptional activation by FcNAC1 of the promoter of FcPL, a gene involved in cell wall remodeling in F. chiloensis fruit. The results suggest the participation of FcNAC1 during ripening development of strawberry fruit, by regulating pectin metabolism during softening.

Differential involvement of synovial adipokines in pain and physical function in female patients with knee osteoarthritis. A cross-sectional study.

OBJECTIVE: Adipokines have been reported to play a role in the development, progression and severity of knee osteoarthritis but the influence of the different adipokines are not well known. The aim of this study was to evaluate the association between different synovial fluid adipokines with pain and disability knee osteoarthritis patients. METHODS: Cross-sectional study with systematic inclusion of 115 symptomatic primary knee osteoarthritis female patients with ultrasound-confirmed joint effusion. Age, physical exercise, symptoms duration and different anthropometric measurements were collected. Radiographic severity was evaluated according to Kellgren-Lawrence scale. Pain and disability were assessed by WOMAC-total, -pain, -function subscales and Knee injury and Osteoarthritis Outcome Score (KOOS) pain and function scales. Seven adipokines and three inflammatory markers were measured by ELISA in synovial fluid. Partial Correlation Coefficient (PCC) and corresponding 95% confidence interval were used as a measure of association. RESULTS: Leptin, osteopontin and inflammatory factors, especially TNF-alpha, were associated to pain and function. After adjustment for potential confounders including inflammatory factors and all adipokines, an association was found for adiponectin with pain (PCC 0.240 [0.012, 0.444]) and for resistin and visfatin with function (PCC 0.336 [0.117, 0.524] and -0.262 [-0.463, -0.036]). No other adipokines or inflammatory markers were statistically and independently associated. An association between physical exercise and pain and disability remained after adjustment, whereas an attenuation of the influence of anthropometric measurements was observed. CONCLUSIONS: Different patterns of association between synovial fluid adipokines were observed regarding pain and disability in knee osteoarthritis patients. Specifically, adiponectin was associated to pain while resistin and visfatin were mainly related to function.

Encefalopatía traumática crónica, definición, diagnóstico y prevención: revisión de la literatura / Chronic traumatic encephalopathy, definition, diagnosis and prevention: review of literature

La encefalopatía traumática crónica (ETC) es una enfermedad neurodegenerativa que se produce como consecuencia traumatismos cerebrales repetitivos; concusiones, que son un síndrome clínico que se caracteriza por una alteración de la función cerebral. Una concusión, bajo su estricta definición, no debiese causar cambios estructurales en el cerebro por lo que no sería visible a través de imágenes, sí existen cambios a nivel microscópicos, bioquímicos y biomecánicos. La mayoría de los pacientes tienen completa resolución de sus síntomas dentro de 10 días (90 por ciento), pero existe un pequeño porcentaje que persiste con estos, pudiendo presentarse como un síndrome postconcusional, síndrome de segundo impacto o una encefalopatía traumática crónica. La ETC se caracteriza por la acumulación de prot-tau hiperfosforilada en neuronas y astrocitos. Estas se van a presentar en forma de ovillos o hilos neurofibrilares. En etapas iniciales las encontraremos de forma focalizada en la corteza frontal y en las formas más severas su distribución será más generalizada, distribuyéndose en la mayoría de las regiones del cerebro. Su diagnóstico se realiza a través de histopatología, por lo que hasta el momento sólo se ha logrado post-mortem. Se está trabajando en nuevas tecnologías asociadas a biomarcadores y PET para lograr una diagnostico premortem. El mayor énfasis en el manejo de esta taupatía es la prevención y adecuado manejo de las concusiones.

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease which is produced as a consequence of repeated brain trauma: concussions, which are a clinical syndrome characterized by an alteration in brain functions. A concussion, understrict definition, should not cause structural changes to the brain. Therefore, it would not be possible to see through images if there were changes at a microscopic, biochemical level. Most patients see their symptoms completely resolved within 10 days (90 percent), but there is a small percentage which persists, and these might cause a post-concussional syndrome, second impact syndrome of chronic traumatic encephalopathy. CTE is characterized by the accumulation of hyper-phosphorylated Tau protein in neurons and astrocytes. These appear in the form of neurofibrillary tangles. During the initial stages they are focalized in the frontal cortex and, in more severe cases, their distribution is more generalized, spreading through the majority of the regions in the brain. It is diagnosis is done through histopathology. Thus, it has only been possible to do post mortem. New technologies associated with bio-markers and PET are being worked on to achieve a pre-mortem diagnosis. The greatest emphasis in the handling of this tauopathy lies in the prevention and the adequate handling of concussions.

Descripción de la Cronología del Dolor de las Contracciones Uterinas para Analgesia del Trabajo de Parto, una tarea pendiente / Description of the chronology of the pain of uterine contractions for analgesia of labor, a pending task

Propósito: Describir la periodicidad del momento de máxima intensidad del dolor de las contracciones uterinas (CUs) durante el trabajo de parto (TDP) para eventualmente permitir el desarrollo de nuevos modelos de administración de analgesia endovenosa. Material y método: Embarazadas de término en TDP, reclutadas desde marzo 2014 por 18 meses, de manera no probabilística consecutiva. Se obtuvo el momento de máximo dolor por autoreporte de las pacientes con cronómetros, previa capacitación. Análisis: Regresión para medidas repetidas de efectos mixtos a los 3-5, 6-7 y 8-10cm de dilatación. La variable respuesta es el intervalo de tiempo desde el momento de máximo dolor de la CU basal al de la contracción siguiente. Resultados: En 64 pacientes, se obtuvo 5 intervalos de tiempo. Para la dilatación de 3-5cm una mediana=140.92 segundos y los coeficientes de regresión (CR) en 4 intervalos de tiempo con respecto al basal de 4.2, 15.9, -2.7 y -5.8 segundos. Para 67cm una mediana=131.16 seg y CR 13.4, 11.3, 2 y -10 seg. Para 8-10cm una mediana=129.3 seg y CR -6.7, 0.49, -2.5 y -7.7 seg. No hubo diferencias significativas entre los coeficientes de regresión. Conclusiones: Con los datos obtenidos podemos señalar que no hubo diferencias estadísticas significativas entre los intervalos de tiempo de los momentos de máximo dolor durante el TDP en fase activa. Esta información es relevante para apoyar el desarrollo de un modelo predictivo del dolor.

Aim: To describe the timing of the moment of maximum intensity of uterine contraction (UC) pain in labor to possibly enable the development of new models for administering endovenous analgesia. Materials and Methods: Full-term pregnant women in labor, recruited from March 2014 for 18 months, using consecutive nonprobability sampling. The moment of maximum pain was ascertained as self-reported by patients previously trained with chronometers. Analysis: Regression for repeated measurements from mixed results at 3-5, 6-7 and 8-10cm of dilation. The response variable was the time interval from the moment of maximum pain of the baseline UC to the following contraction. Results: In 64 patients, 5 time intervals were obtained. For the dilation of 3-5cm, a median=140.92 seconds and regression coefficients (RC) in 4 time intervals relative to the baseline of 4.2, 15.9, -2.7 and -5.8 seconds. For 6-7cm, a median =131.16 sec and RC 13.4, 11.3, 2 and -10 sec. For 8-10cm, a median =129.3 sec and RC -6.7, 0.49, -2.5 and -7.7 sec. There were no significant differences among the regression coefficients. Conclusions: With the data collected we can report that there were no statistically significant differences between the time intervals of the moments of maximum pain during active labor. This information is relevant to support the development of a predictive model for this pain.

High prevalence of cardiovascular co-morbidities in patients with symptomatic knee or hand osteoarthritis.

OBJECTIVES: To evaluate the frequency of cardiovascular events (CVEs) and metabolic syndrome (MetS) in patients with symptomatic knee or hand osteoarthritis (OA). METHOD: A cross-sectional study conducted by rheumatologists in a primary care setting. Consecutive symptomatic patients with primary knee or hand OA were included and patients with soft tissue conditions served as the control group. Hypertension, diabetes mellitus, obesity, dyslipidaemia, and CVEs consisting of myocardial infarction, angina, or cerebrovascular disease were recorded. RESULTS: A total of 254 OA patients (184 with knee OA and 70 with hand OA) and 254 control patients were included. The frequency of obesity was higher in all OA groups and hypertension was more frequent in knee OA. MetS was significantly more frequent in patients with OA as a whole group and in knee or hand OA groups separately (p < 0.001, p = 0.002, and p = 0.007, respectively, vs. control group), with odds ratio (OR) 2.4, 95% confidence interval (CI) 1.26-4.55 in the OA group, OR 2.29, 95% CI 1.15-4.54 in the knee OA group, and OR 2.67, 95% CI 1.15-6.19 in the hand OA group. A higher prevalence of CVEs in the three OA groups was observed compared with the control group. CONCLUSIONS: A high frequency of MetS and CVEs was observed in OA patients in a primary care setting.

Crossed cerebrocerebellar language lateralization: an additional diagnostic feature for assessing atypical language representation in presurgical functional MR imaging.

BACKGROUND AND PURPOSE: Determining language dominance with fMRI is challenging in patients with brain tumor, particularly in cases of suspected atypical language representation. Supratentorial activation patterns must be interpreted with great care when the tumor is in or near the presumed language areas, where tumor tissue or mass effect can lead to false-negative fMRI results. In this study, we assessed cerebrocerebellar language fMRI lateralization in healthy participants and in patients with brain tumors with a focus on atypical language representation. MATERIALS AND METHODS: Twenty healthy participants and 38 patients with a brain tumor underwent fMRI with a verb-generation task. Cerebral and cerebellar language lateralizations were separately classified as left-sided, right-sided, or symmetric. Electrocortical stimulation was performed in 19 patients. With the McNemar test, we evaluated the dependency between language lateralization in the cerebrum and cerebellum, and with Pearson correlation analysis, the relationship between the cerebral and cerebellar lateralization indices. RESULTS: There was a significant dependency between cerebral and cerebellar language activation, with moderate negative correlation (Pearson r = -0.69). Crossed cerebrocerebellar language activation was present in both healthy participants and patients, irrespective of handedness or typical or atypical language representation. There were no discordant findings between fMRI and electrocortical stimulation. CONCLUSIONS: Language lateralization in the cerebellum can be considered an additional diagnostic feature to determine language dominance in patients with brain tumor. This is particularly useful in cases of uncertainty, such as the interference of a brain tumor with cerebral language activation on fMRI and atypical language representation.

Variables que afectan la satisfacción con la alimentación según nivel socioeconómico: un estudio exploratorio en el sur de Chile / Variables affecting food satisfaction according to socioeconomic status: an exploratory study in southern Chile

In order to identify variables that influence in food satisfaction for people belonging to different socioeconomic status (SES) in southern Chile, a survey was administered to a sample of 400 people living in the major cities of this region. The questionnaire included the SWFL (Satisfaction with Food-related Life) scale and the IQLRH (Index of Quality of Life Related to Health). Demographic characteristics and dietary habits were also consulted. Four ordinal logit models were proposed, where the dependent variable was satisfaction with food-related life, considering the total sample and three subsamples: medium and medium-high strata (ABC1), medium-medium (C2) and medium-low (C3), low (D) and very low (E) as a whole. The four models were significant (p<0.001), but differed in the explanatory variables that were significant. Regardless of SES, satisfaction with food-related life decreases if the person does not have a good perception of their own health. Other variables that influence satisfaction with food-related life, which differed according to the SES, are related to the gender, the family composition, the time available for family dining, frequency of consumption of meat and use of fast food outlets and the restriction of alcohol consumption.

Con el objetivo de identificar variables que influyen en la satisfacción con la alimentación en personas pertenecientes a distintos niveles socioeconómicos (NSE) del sur de Chile, se aplicó una encuesta a 400 personas residentes en las principales ciudades de esta parte del país. El cuestionario incluyó la escala SWFL (Satisfaction with Food-related Life) y el Indice de Calidad de Vida relativo a la Salud (ICVRS). Se consultaron características demográficas y hábitos alimentarios. Se plantearon cuatro modelos logit ordinales, en los cuales la variable dependiente fue la satisfacción con la alimentación, considerando la muestra total y tres submuestras: estratos alto y medio-alto (ABC1), medio-medio (C2) y en conjunto los niveles medio-bajo (C3), bajo (D) y muy bajo (E). Los cuatro modelos resultaron significativos (p<0,001), pero difirieron en las variables explicativas significativas. Independientemente del NSE, la satisfacción con la alimentación disminuye si la persona no tiene una buena auto percepción de su salud. Otras variables que influyen en la satisfacción con la alimentación, que difirieron según el NSE, corresponden al género, composición de la familia, tiempo disponible para cenar en familia, frecuencia de consumo de carne y en locales de comida rápida y, la restricción del consumo de alcohol.

Antígenos HLA de clase ii en pacientes con artritis reumatoide ecuatorianos y asociación con el factor reumatoide, anticuerpos anti-citrulinados y nódulos reumatoides / HLA antigens class ii in patients with ecuadorian rheumatoid arthritis and association with the rheumatoid factor, anti-citrulinated antibodies and rheumatoid nodules

Objetivo Determinar los antígenos de Clase II en 52 pacientes con artritis reumatoide (AR) y 52 controles, y establecer la asociación de los antígenos de Clase II DRB1* con el factor reumatoide (FR), anticuerpos anti-péptido cíclico citrulinados (anti-CCP) y nódulos reumatoides. Material y Métodos Estudio de casos y controles, realizado en pacientes del Hospital Vicente Corral Moscoso y José Carrasco Arteaga de la ciudad de Cuenca-Ecuador; se incluyeron 52 pacientes con AR que cumplen los criterios del Colegio Americano de Reumatología (ACR) y 52 controles. Se identificaron a través de la Reacción en Cadena de la Polimerasa (PCR), los diferentes tipos de HLA que tienen cada uno de los 52 pacientes con AR y controles. Se buscó asociación de los HLA-DR1* con la AR y las pruebas de laboratorio: FR, anticuerpos anti-CCP y con nódulos reumatoides. El análisis estadístico se realizó con el cálculo de OR (IC 95%) y 2 de Pearson con corrección de Fisher y la información se procesó en SPSS v15. Resultados Los alelos más frecuentes fueron HLA-DRB1*09 (17,3%) OR 3,42 (IC95% 1,21 ­ 10,14) y HLADRB1*04 (32,7%) OR 1,81 (IC95% 0,93 ­ 3,55). Tanto el factor reumatoide como los anticuerpos anti-péptido cíclico citrulinados estuvieron presentes en el 82,7% de pacientes con artritis reumatoide y los nódulos reumatoides se detectaron en el 19,2% de pacientes con AR. Se encontró asociación entre los nódulos reumatoides con valores altos de FR y anti-CCP y estos a su vez con los alelos HLA-DRB1*14 y HLADRB1*04. La mayoría de pacientes con alelos HLA-DRB1*09 con predominio heterocigoto tuvieron anticuerpos anti-CCP y FR positivo. Conclusión La presencia de los alelos HLA-DRB1*04 y HLADRB1*09 está relacionada con la susceptibilidad de presentar AR en pacientes ecuatorianos, además se relaciona con valores elevados de factor reumatoide y anticuerpos anti-péptido cíclico citrulinados.

Objective To determine Class II antigens in 52 patients with rheumatoid arthritis (RA) and 52 controls and establish the association of Class II antigens DRB1* with rheumatoid anti- cyclic citrullinated peptide (anti-CCP) rheumatoid factor (RF), and antibodies rheumatoid nodules. Methods and Materials Case and control study in patients from the Hospital Vicente Corral Moscoso and José Carrasco Arteaga of Cuenca-Ecuador; 52 patients with rheumatoid arthritis who satisfy the criteria of ACR-American College of Rheumatology and 52 healthy patients. The different types of HLA from each 52 patients with rheumatoid arthritis and controls were identified through PCR - Polymerase Chain Reaction. Association of HLA-DR1* with rheumatoid arthritis and rheumatoid factor, anti-citrullinated and rheumatoid nodules. The statistical analysis was done by the OR (IC 95%) and 2 of Pearson with Fisher correction and the information was processed in SPSS v15. Results The most frequency alleles were HLA-DRB1*09 (17,3%) OR 3,42 (IC95% 1,21 ­ 10,14) and HLADRB1*04 (32,7%) OR 1,81 (IC95% 0,93 ­ 3,55). The rheumatoid factor and anti-cyclic citrullinated peptide antibodies were presented in 82,7% of patients with rheumatoid arthritis and rheumatoid nodules was detected in the 19.2% of patients with rheumatoid arthritis . An association between rheumatoid nodules with high values of rheumatoid factor and anti-ccp and these in turn with HLA-DRB1*14 y HLA-DRB1*04 alleles were found. The majority of patients with HLA-DRB1*09 alleles with heterozygote predomination had positive anti-ccp and rheumatoid factor. Conclusion The presence of HLA-DRB1*04 and HLA-DRB1*09 alleles is related with the susceptibility of present rheumatoid arthritis in Ecuadorian patients, and it is related with higher values of rheumatoid factor and anti-cyclic citrullinated peptide.

Utilidad de HistoScanning™ previo a biopsia prostática para el diagnóstico de adenocarcinoma de próstata / Utility of HistoscanningTM prior to prostate biopsy for the diagnosis of prostate adenocarcinoma

Objetivos: HistoScanning™ (HS) es un método de diagnóstico ecográfico del cáncer de próstata. Analizamos la eficacia de la realización de HS previo a las biopsias para el diagnóstico de adenocarcinoma de próstata. Material y métodos: Entre agosto y octubre de 2012 hemos realizado estudio con HS previo a las biopsias en 32 pacientes. En todos los casos se realizaron biopsias transrectales por sextantes (2 tomas en cada sextante) de la zona periférica. En aquellos sextantes en los que hubo áreas sospechosas con HS las biopsias se dirigieron a dichas áreas. Se añadieron biopsias transperineales en aquellas áreas situadas en la zona media-anterior o apical prostática. La edad media fue de 63,7 años (rango: 40-82), con un PSA medio de 8,0 ng/ml (rango: 3,5-36,2) y un volumen prostático medio de 46,6 cc (rango: 18,2-103,2). En 8 casos se trataba de primera biopsia, en 14 de biopsias de repetición y 10 pacientes tenían diagnóstico previo de adenocarcinoma de próstata (8 en programa de vigilancia activa y 2 T1a en RTU de próstata previa). Resultados: En los 32 pacientes se biopsiaron una media de 7,5 zonas (rango: 6-9) con un total de 239 zonas estudiadas. Se identificaron una media de 3,2 zonas con áreas sospechosas (ZS) con HS (rango: 2-5), con un total de 103 ZS. Se encontró adenocarcinoma o PIN en 72 zonas de 25 pacientes (2 PIN, 11 score Gleason 6, 7 score Gleason 7, 3 score Gleason 8 y 2 score Gleason 9). Hubo 35 zonas falsos positivos en 20 pacientes (11 parénquima normal y 9 inflamación crónica). Se produjeron falsos negativos en 5 zonas en 5 pacientes (2 PIN, 2 score Gleason 6 y un score Gleason 7), aunque en los 5 casos se descubrió adenocarcinoma en otras zonas. El HS presentó una sensibilidad del 93,5% con una especificidad del 79,5%. El valor predictivo positivo fue del 67,35% con un valor predictivo negativo del 96,5%. Conclusiones: A pesar de tratarse de una serie seleccionada, con alta tasa de pacientes con adenocarcinoma, la exploración con HS ha presentado una gran sensibilidad y un elevado valor predictivo negativo. Estos datos, aunque deben ser confirmados en series menos seleccionadas, indican que la exploración previa con HS puede ayudar tanto al diagnóstico en las biopsias como en el seguimiento en programas de vigilancia activa (AU)

Objectives: HistoScanning™ (HS) is a method of ecographic diagnosis of prostate cancer. We analyze the effectiveness of the HS realization prior to the biopsys for the prostate adenocarcinoma diagnosis. Material and methods: From August to October 2012 we have carried out a study with HS prior to the biopsys in 32 patients. In all cases sextants transrectalbiopsys have been realized (two cores in each sextant) in the periphery zone. In those sextants in which there were suspicious areas with HS, the biopsys were addressed to those areas. Transperinealbiopsys were added to those zones placed in the half-front or apical prostatic zone. The medium age was 63.7 years (range 40-82) with a medium PSA of 8.0ng/ml (range 3.5-36.2) and a medium prostatic volume of 46.6 cc (range 18.2-103.2). In eight cases it was the first biopsy, in 14 cases they were repetition biopsys and 10 patients had a previous diagnosis of prostate adenocarcinoma (8 in a program of active surveillance and 2 T1a in RTU of previous prostate). Results: In the 32 patients a medium of 7,5 zones were biopsed (range 6-9) with a total of 239 zones studied. There were identified a medium of 3.2 zones with suspictious areas (ZS) with HS (range 2-5) with a total of 103 ZS. In 72 zones of 25 patients it was found adenocarcinoma or PIN (2 PIN, 11 score Gleason 6, 7 score Gleason 7, 3 score Gleason 8 and 2 score Gleason 9). There were 35 positive falses zones in 20 patients (11 normal parenquima and 9 cronic inflammation). Negative falses were produced in 5 zones in 5 patients (2 PIN, 2 score Gleason 6 and 1 score Gleason 7) although in all 5 cases adenocarcinoma was encountered (o discovered) in other zones. The HS presented a sensibility of a 93.5% with a specificity of 79.5%. The positive predictive value was of the 67.35% with a negative predictive value of 96.5%. Conclusions: In spite of being a selected serie, with a high rate of patients with adenocarcinoma, the exploration with HS has presented a great sensibility and a high negative predictive value. These data, although they must be confirmed in less selected series, state that the prior exploration with HS can help as in the diagnostic in the biopsies as in the follow-up of programs of active surveillance (AU)

Study of the effect of breast tissue density on detection of masses in mammograms.

One of the parameters that are usually stored for mammograms is the BI-RADS density, which gives an idea of the breast tissue composition. In this work, we study the effect of BI-RADS density in our ongoing project for developing an image-based CAD system to detect masses in mammograms. This system consists of two stages. First, a blind feature extraction is performed for regions of interest (ROIs), using Independent Component Analysis (ICA). Next, in the second stage, those features form the input vectors to a classifier, neural network, or SVM classifier. To train and test our system, the Digital Database for Screening Mammography (DDSM) was used. The results obtained show that the maximum variation in the performance of our system considering only prototypes obtained from mammograms with a concrete value of density (both for training and test) is about 7%, yielding the best values for density equal to 1, and the worst for density equal to 4, for both classifiers. Finally, with the overall results (i.e., using prototypes from mammograms with all the possible values of densities), we obtained a difference in performance that is only 2% lower than the maximum, also for both classifiers.

Utility of Histoscanning™ prior to prostate biopsy for the diagnosis of prostate adenocarcinoma.

OBJECTIVES: HistoScanning™ (HS) is a method of ecographic diagnosis of prostate cancer. We analyze the effectiveness of the HS realization prior to the biopsies for the prostate adenocarcinoma diagnosis. MATERIAL AND METHODS: From August to October 2012 we have carried out a study with HS prior to the biopsies in 32 patients. In all cases sextants transrectal biopsies have been realized (two cores in each sextant) in the periphery zone. In those sextants in which there were suspicious areas with HS, the biopsies were addressed to those areas. Transperineal biopsies were added to those zones placed in the half-front or apical prostatic zone. The medium age was 63.7 years (range 40-82) with a medium PSA of 8.0 ng/ml (range 3.5-36.2) and a medium prostatic volume of 46.6cc (range 18.2-103.2). In eight cases it was the first biopsy, in 14 cases they were repetition biopsies and 10 patients had a previous diagnosis of prostate adenocarcinoma (8 in a program of active surveillance and 2 T1a in RTU of previous prostate). RESULTS: In the 32 patients a medium of 7,5 zones were biopsied (range 6-9) with a total of 239 zones studied. There were identified a medium of 3.2 zones with suspicious areas (ZS) with HS (range 2-5) with a total of 103 ZS. In 72 zones of 25 patients it was found adenocarcinoma or PIN (2 PIN, 11 score Gleason 6, 7 score Gleason 7, 3 score Gleason 8 and 2 score Gleason 9). There were 35 positive false zones in 20 patients (11 normal parenquima and 9 chronic inflammation). Negative falses were produced in 5 zones in 5 patients (2PIN, 2 score Gleason 6 and 1 score Gleason 7) although in all 5 cases adenocarcinoma was encountered (o discovered) in other zones. The HS presented a sensibility of a 93.5% with a specificity of 79.5%. The positive predictive value was of the 67.35% with a negative predictive value of 96.5%. CONCLUSIONS: In spite of being a selected serie, with a high rate of patients with adenocarcinoma, the exploration with HS has presented a great sensibility and a high negative predictive value. These data, although they must be confirmed in less selected series, state that the prior exploration with HS can help as in the diagnostic in the biopsies as in the follow-up of programs of active surveillance.

Mutation screening of AURKB and SYCP3 in patients with reproductive problems.

Mutations in the spindle checkpoint genes can cause improper chromosome segregations and aneuploidies, which in turn may lead to reproductive problems. Two of the proteins involved in this checkpoint are Aurora kinase B (AURKB), preventing the anaphase whenever microtubule-kinetochore attachments are not the proper ones during metaphase; and synaptonemal complex protein 3 (SYCP3), which is essential for the formation of the complex and for the recombination of the homologous chromosomes. This study has attempted to clarify the possible involvement of both proteins in the reproductive problems of patients with chromosomal instability. In order to do this, we have performed a screening for genetic variants in AURKB and SYCP3 among these patients using Sanger sequencing. Only one apparently non-pathogenic deletion was found in SYCP3. On the other hand, we found six sequence variations in AURKB. The consequences of these changes on the protein were studied in silico using different bioinformatic tools. In addition, the frequency of three of the variations was studied using a high-resolution melting approach. The absence of these three variants in control samples and their position in the AURKB gene suggests their possible involvement in the patients' chromosomal instability. Interestingly, two of the identified changes in AURKB were found in each member of a couple with antecedents of spontaneous pregnancy loss, a fetal anencephaly and a deaf daughter. One of these changes is described here for the first time. Although further studies are necessary, our results are encouraging enough to propose the analysis of AURKB in couples with reproductive problems.

Structural elucidation of supramolecular alpha-cyclodextrin dimer/aliphatic monofunctional molecules complexes.

The structural elucidation of 2α-cyclodextrin/1-octanethiol, 2α-cyclodextrin/1-octylamine and 2α-cyclodextrin/1-nonanoic acid inclusion complexes by nuclear magnetic resonance (NMR) spectroscopy and molecular modeling has been achieved. The detailed spatial configurations are proposed for the three inclusion complexes based on 2D NMR method. ROESY experiments confirm the inclusion of guest molecules inside the α-cyclodextrin (α-CD) cavity. On the other hand, the host-guest ratio observed was 2:1 for three complexes. The detailed spatial configuration proposed based on 2D NMR methods were further interpreted using molecular modeling studies. The theoretical calculations are in good agreement with the experimental data.

Independent component analysis to detect clustered microcalcification breast cancers.

The presence of clustered microcalcifications is one of the earliest signs in breast cancer detection. Although there exist many studies broaching this problem, most of them are nonreproducible due to the use of proprietary image datasets. We use a known subset of the currently largest publicly available mammography database, the Digital Database for Screening Mammography (DDSM), to develop a computer-aided detection system that outperforms the current reproducible studies on the same mammogram set. This proposal is mainly based on the use of extracted image features obtained by independent component analysis, but we also study the inclusion of the patient's age as a nonimage feature which requires no human expertise. Our system achieves an average of 2.55 false positives per image at a sensitivity of 81.8% and 4.45 at a sensitivity of 91.8% in diagnosing the BCRP_CALC_1 subset of DDSM.