A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions / Serie de 69 dermatosis relacionadas con la COVID con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19

Background Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. Material and method We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. Results After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. Conclusions Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions (AU)

Antecedentes A pesar del gran número de artículos publicados sobre las lesiones cutáneas relacionadas con la COVID-19, no se ha realizado una correlación clinicopatológica de manera consistente, y no ha sido validado el estudio de inmunohistoquímica para demostrar la expresión de la proteína spike 3 mediante RT-PCR. Material y métodos Recopilamos 69 casos de pacientes con COVID-19 confirmada, en los que se estudiaron las lesiones cutáneas a nivel clínico e histopatológico, habiéndose realizado la prueba inmunohistoquímica (IHQ) y RT-PCR en las biopsias cutáneas. Resultados Tras una revisión detallada de los casos, en 15 de ellos se encontró que la dermatosis no guardaba relación con la COVID-19, mientras que el resto de las lesiones podrían clasificarse de acuerdo con sus características clínicas como vesiculares (4), erupciones maculopapulares (41), urticariformes (9), livedo y necrosis (10) y de tipo perniosis (5). Aunque las características histopatológicas fueron similares a los resultados previamente reportados, encontramos dos hallazgos no reportados previamente: erupciones maculopapulares con siringometaplasia ecrina escamosa y epiteliotropismo neutrofílico. La IHQ reflejó en ciertos casos tinción endotelial y epidérmica, pero la prueba RT-PCR fue negativa en todos los casos probados. Por ello no pudo demostrarse el compromiso viral directo. Conclusiones A pesar de presentar la mayor serie de pacientes con COVID-19 confirmada y manifestaciones cutáneas histopatológicamente estudiadas, el compromiso viral directo fue difícil de establecer. Las lesiones vasculopáticas e urticariformes parecen ser las más claramente relacionadas con la infección viral, a pesar de que los resultados negativos de la IHQ o RT-PCR no pudieron demostrar la presencia viral (AU)

[Articulo traducido] Serie de 69 dermatosis relacionadas con la COVID-19 con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19 / A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions

Antecedentes A pesar del gran número de artículos publicados sobre las lesiones cutáneas relacionadas con la COVID-19, no se ha realizado una correlación clinicopatológica de manera consistente, y no ha sido validado el estudio de inmunohistoquímica para demostrar la expresión de la proteína spike 3 mediante RT-PCR. Material y métodos Recopilamos 69 casos de pacientes con COVID-19 confirmada, en los que se estudiaron las lesiones cutáneas a nivel clínico e histopatológico, habiéndose realizado la prueba inmunohistoquímica (IHQ) y RT-PCR en las biopsias cutáneas. Resultados Tras una revisión detallada de los casos, en 15 de ellos se encontró que la dermatosis no guardaba relación con la COVID-19, mientras que el resto de las lesiones podrían clasificarse de acuerdo con sus características clínicas como vesiculares (4), erupciones maculopapulares (41), urticariformes (9), livedo y necrosis (10) y de tipo perniosis (5). Aunque las características histopatológicas fueron similares a los resultados previamente reportados, encontramos dos hallazgos no reportados previamente: erupciones maculopapulares con siringometaplasia ecrina escamosa y epiteliotropismo neutrofílico. La IHQ reflejó en ciertos casos tinción endotelial y epidérmica, pero la prueba RT-PCR fue negativa en todos los casos probados. Por ello no pudo demostrarse el compromiso viral directo. Conclusiones A pesar de presentar la mayor serie de pacientes con COVID-19 confirmada y manifestaciones cutáneas histopatológicamente estudiadas, el compromiso viral directo fue difícil de establecer. Las lesiones vasculopáticas e urticariformes parecen ser las más claramente relacionadas con la infección viral, a pesar de que los resultados negativos de la IHQ o RT-PCR no pudieron demostrar la presencia viral (AU)

Background Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. Material and method We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. Results After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. Conclusions Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions (AU)

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions. / [Articulo traducido] Serie de 69 dermatosis relacionadas con la COVID-19 con biopsia, estudio inmunohistoquímico con anti-spike 3, hibridación in situ y PCR: Una revisión crítica de la afectación cutánea relacionada con la COVID-19.

BACKGROUND: Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS: We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS: After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS: Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

A Series of 69 COVID-related Dermatoses With Biopsy, Immunohistochemistry With Anti-spike 3, in situ Hybridization and PCR: A Critical Reappraisal of Viral Involvement in COVID-19 Skin Lesions.

BACKGROUND: Despite the large number of articles published on skin lesions related to COVID-19, clinicopathological correlation has not been performed consistently and immunohistochemistry to demonstrate spike 3 protein expression has not been validated through RT-PCR. MATERIAL AND METHODS: We compiled 69 cases of patients with confirmed COVID-19, where skin lesions were clinically and histopathologically studied. Immunohistochemistry (IHC) and RT-PCR was performed in skin biopsies. RESULTS: After a careful review of the cases, 15 were found to be dermatosis not related to COVID-19, while the rest of the lesions could be classified according to their clinical characteristics as vesicular (4), maculopapular eruptions (41), urticariform (9), livedo and necrosis (10) and pernio-like (5). Although histopathological features were similar to previously reported results, we found two previously unreported findings, maculopapular eruptions with squamous eccrine syringometaplasia and neutrophilic epitheliotropism. IHC showed in some cases endothelial and epidermal staining but RT-PCR was negative in all the tested cases. Thus, direct viral involvement could not be demonstrated. CONCLUSIONS: Despite presenting the largest series of confirmed COVID-19 patients with histopathologically studied skin manifestations, direct viral involvement was difficult to establish. Vasculopathic and urticariform lesions seem to be those more clearly related to the viral infection, despite IHC or RT-PCR negative results failed to demonstrate viral presence. These findings, as in other dermatological areas, highlight the need of a clinico-pathological correlation to increase knowledge about viral involvement in COVID-19 skin-related lesions.

MicroBooNE and the ν_{e} Interpretation of the MiniBooNE Low-Energy Excess.

A new generation of neutrino experiments is testing the 4.7σ anomalous excess of electronlike events observed in MiniBooNE. This is of huge importance for particle physics, astrophysics, and cosmology, not only because of the potential discovery of physics beyond the standard model, but also because the lessons we will learn about neutrino-nucleus interactions will be crucial for the worldwide neutrino program. MicroBooNE has recently released results that appear to disfavor several explanations of the MiniBooNE anomaly. Here, we show quantitatively that MicroBooNE results, while a promising start, unquestionably do not probe the full parameter space of sterile neutrino models hinted at by MiniBooNE and other data, nor do they probe the ν_{e} interpretation of the MiniBooNE excess in a model-independent way.

Hamartoma fibroso de la infancia: una serie de 21 casos y revisión de la literatura / Fibrous Hamartoma of Infancy: A Series of 21 Cases and Review of the Literature

Introducción El hamartoma fibroso de la infancia (HFI) es tumor poco frecuente de tejidos blandos en lactantes y niños, caracterizado histopatólogicamente por su morfología trifásica y curso benigno. Métodos Presentamos las características histopatológicas e inmunohistoquímicas de una serie de 21 casos de HFI y revisamos sus principales diagnósticos diferenciales. Resultados Las lesiones predominaron en varones con una edad media de 3,7 años (5 meses-24 años) en localizaciones previamente descritas. Histopatológicamente, se caracterizaron por proporciones variables de tejido fibroblástico, mesenquimal y adiposo maduro. Tres casos (21%) mostraron zonas hialinizadas con artefactos en grietas, que imitaban al fibroblastoma de células gigantes. Presentaron tinción positiva para actina de músculo liso 8/13 (61%) en el componente fibroblástico, CD34 en 6/8 (75%) en el mesenquimal inmaduro y fibroblástico; y S100 en el tejido adiposo en 7/7 (100%). Conclusión Nuestros hallazgos histopatológicos son superponibles a los descritos en series amplias. No obstante, la heterogeneidad clínica obliga a conocer las variantes de esta entidad dentro de su típica histomorfología trifásica, para lograr un correcto diagnóstico y manejo terapéutico (AU)

Background Fibrous hamartoma of infancy (FHI) is a rare soft-tissue tumor usually seen in infants and young children. Histologically, the tumor is characterized by a triphasic morphology, and the clinical course is benign. Methods We described the histopathologic and immunohistochemical features in a series of 21 cases of FHI and reviewed the main entities to consider in differential diagnosis. Results Most patients in the series were male. The mean age was 3.7 years (range, 5 months–24 years), and lesions were found in locations that have been previously reported. Histopathologically, the tumors were composed of variable proportions of fibroblastic, mesenchymal, and mature adipose tissue. Three of the 13 immunohistochemically stained biopsies (14%) contained hyalinized zones with cracking artifacts, mimicking giant cell fibroblastoma. Eight of the 13 stained with smooth-muscle actin (61%) were positive in the fibroblastic component, 6 of the 8 stained with CD34 (75%) were positive in the immature mesenchymal and fibroblastic components, and all 7 stained with S100 were positive (100%) in adipose tissue. Conclusions Our histopathologic findings are consistent with those described in larger series. However, in order to reach a precise diagnosis and plan treatment, clinical heterogeneity obliges us to become familiar with variations in the characteristic triphasic histology of FHI (AU)

Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occusion - Part II: Coagulation Disorders, Emboli, and Other. / Dermatopatología de la oclusión intraluminal vascular: parteII (coagulopatías, émbolos y miscelánea).

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in partI of this review. In this second part, we look at additional causes of vascular occlusion.

Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occlusion - Part I: Thrombi. / Dermatopatología de la oclusión intraluminal vascular: parte I (trombos).

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi.

Nódulo asintomático facial / Asymptomatic facial nodule

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Frecuencia de desnutrición pediátrica en hospitales de Cuba / Incidence of hospital pediatric malnutrition in Cuba

Introducción: La desnutrición es un problema de salud generalizado. En combinación con una enfermedad subyacente, reduce la calidad de vida e incrementa la mortalidad general y la de grupos específicos. Objetivo: Determinar la frecuencia de desnutrición pediátrica en hospitales de Cuba. Métodos: Estudio prospectivo, multicéntrico y descriptivo, que se desarrolló en 8 hospitales de Cuba. La población de estudio estuvo constituida por todos los niños de ambos sexos, de entre 1 mes y 19 años de edad, que ingresaron en el hospital, durante un periodo de 3 meses (desde el 1 de julio al 31 de septiembre de 2011). A todos los pacientes incluidos en el estudio se les realizó una encuesta en las primeras 48 horas de su ingreso. Las variables antropométricas utilizadas fueron el peso y la talla. Con ambos datos de determinó el índice de masa corporal (IMC), que nos permitió clasificar el estado nutricional, según las curvas de crecimiento de la Organización Mundial de la Salud: de 2006 para los menores de 5 años y de 2007 para los de ≥5 años. El análisis de datos se realizó con el paquete estadístico SPSS versión 18.0. Resultados: Se encontró una frecuencia de desnutrición del 12,1% según el Z Score IMC/edad, y un 30,1% de sobrepesoobesidad. De los pacientes desnutridos, el 18% correspondió al grupo de escolares, seguidos por los adolescentes (15%) y los lactantes (9%). El 82,9% de los niños ingresó por causas médicas. Conclusiones: El estudio demostró que la herramienta utilizada permitió evaluar y clasificar el estado nutricional al ingreso hospitalario (AU)

Title: Incidence of hospital pediatric malnutrition in Cuba Introduction: Malnutrition is a generalized health problem. There is an increased morbimortality when it appears combined with another disease, mainly in some specific groups of patients. Objective: To determine how frequent is the hospital pediatric malnutrition in Cuba. Methods: A descriptive, prospective and multicentre study was conducted in 8 cubans hospitals. Population included children from 1 month to 19 years old who were interned at hospital from July 1 to September 31, 2011. Interviews were made in the first 48 hours at hospital. Anthropometrics variable were collected. Body mass index (BMI) was calculated and nutrition state was determined with WHO curves, 2006 and 2007 in patients with less and 5 or more than 5 years old respectively. Statistic analysis was made with SPSS version 18.0. Results: Malnutrition incidence was 12.1% according to Z Score BMI/age and obesity or overweigh was 30.1%. Malnutrition were more frequent in scholar group (18%) followed by teenagers (15%) and infants 9%. Medical causes were the main indication of hospitals admissions (82.9%). Conclusions: The study demonstrated that the tool used allowed to evaluate and classify the nutritional status at admission (AU)

Elementos teóricos-conceptuales útiles para comprender las estrategias y la mercadotecnia de los servicios / Theoretical and conceptual elements to understand the service strategies and marketing

Se expone un conjunto de elementos teóricos sobre estrategia y mercadotecnia de servicios útiles para la comprensión de las bases de esta actividad en la empresa. Se estudian los aspectos estratégicos de la administración de servicios, el marketing de los servicios; así como la mezcla de mercadotecnia, entre otros aspectos de interés.

A group of theoretical elements on service strategy and marketing, which are useful to understand the bases of this activity in an enterprise is exposed. The strategic aspects of the service management, the service marketing, as well as the marketing mixture, are studied, among other aspects of interest.

Elementos teóricos-conceptuales útiles para comprender las estrategias y la mercadotecnia de los servicios / Theoretical and conceptual elements to understand the service strategies and marketing

Se expone un conjunto de elementos teóricos sobre estrategia y mercadotecnia de servicios útiles para la comprensión de las bases de esta actividad en la empresa. Se estudian los aspectos estratégicos de la administración de servicios, el marketing de los servicios; así como la mezcla de mercadotecnia, entre otros aspectos de interés(AU)

A group of theoretical elements on service strategy and marketing, which are useful to understand the bases of this activity in an enterprise is exposed. The strategic aspects of the service management, the service marketing, as well as the marketing mixture, are studied, among other aspects of interest(AU)

Caracterización clínico molecular del síndrome Frágil X en una familia / Clinical molecular features of the X Fragile syndrome in a family

Se realizó un estudio de serie de casos en una familia con síndrome de Frágil X tomando como punto de partida un paciente propósito seleccionado luego de una pesquisa realizada en 200 casos de riesgo entre los que se diagnosticaron dos con la enfermedad a través de estudios moleculares. Se confeccionó el árbol genealógico y se estudiaron los casos de riesgo de acuerdo con el patrón de herencia de la enfermedad de tres generaciones. Se detectaron tres hembras con mutaciones completas y sin fenotipo y otra con una premutación y con estigmas de la enfermedad.Se encontraron dos varones de cuarta generación con las características clínicas del síndrome Frágil X, uno con una mutación completa y otra con una premutación (AU)