Pyogenic liver abscess caused by an atypical hypervirulent Klebsiella pneumoniae K1-ST23 in Mexico.

Hypervirulent K. pneumoniae infection has been raising worldwide and is one of the major causes of community-acquired pyogenic liver abscess. We described a case report of pyogenic liver abscess caused by an atypical hypervirulent (non-hypermucoviscous) K. pneumoniae K1 ST23 in a diabetic Asian patient who resided in Mexico. The susceptibility to antimicrobials, pathogenicity, molecular and genomic analysis were determined. A man from Guangdong (China) with a recent diagnosis of diabetes mellitus was admitted to the hospital, and he denied traveling in the last 3 months. A computed tomography revealed a right lobe liver abscess. On the third day after admission a Klebsiella pneumoniae isolate (14652) was obtained. The isolate corresponded to a susceptible K. pneumoniae with capsular type K1 and ST23 (CG23) and exhibited a non-hypermucoviscous phenotype. The isolate 14652 was genetically related to the globally distributed lineage ST23-KL1. This study describes the first case in Mexico of K. pneumoniae capsular type K1 and ST23 with an atypical hypervirulent phenotype.

Do conditional cash transfers reduce hypertension?

Progresa, an anti-poverty conditional cash transfer program, has been a model for similar programs in more than 60 countries. Numerous studies have found positive impacts on schooling, the nutritional and health status of children and adolescents, and household consumption. However, the effects on the health of older adult beneficiaries have been particularly understudied. In this paper we analyze the effects of Progresa on middle-aged and older adult health, focusing on a high prevalence chronic condition: hypertension. Our results show that Progresa had significant benefits in terms of improved hypertension diagnosis and use of treatment drugs. However, we did not find significant changes in uncontrolled hypertension as measured by systolic and diastolic blood pressure biomarkers in household survey data. Thus, while cash transfer programs may facilitate financial access to healthcare visits and the ability to buy prescribed medicines, by itself the program might not improve hypertension outcomes without complementary healthcare system follow-up to ensure dosage titration and medication adherence.

Assigning lifetime occupation domains for older Mexicans: MHAS-O*NET linkage protocol.

OBJECTIVE: We developed a MHAS (Mexican Health and Aging Study) and O*NET (Occupational Information Network) linkage to allow global researchers using MHAS data to assign lifetime occupation domains for older Mexicans. MATERIALS AND METHODS: Three bilingual raters independently matched 440 records with 132 unique occupation codes from the 2012 MHAS. We used a modified Delphi technique to reach agreements. To assess reliability, we compared the distribution of observations between the MHAS file and the MHAS-O*NET linked file across five job categories (upper white collar, lower white collar, upper blue collar, low blue collar, and agriculture/fishing/forestry). The Institutional Review Board at the University of Texas Medical Branch reviewed and approved the research (IRB # 21-0268). RESULTS: Using the developed 1:1 MHAS-ONET linkage, consistency between MHAS and ONET was 97.4% across the five job categories. CONCLUSION: This MHAS-O*NET linkage will allow researchers to analyze the association between lifetime occupation and multiple dimensions of health, functionality, and retirement determinants for a low-middle income country with a large proportion of workers in the informal sector.

Total Elbow Arthroplasty and Antegrade Posterior Interosseous Flap for Infected Posttraumatic Arthritis with an Active Fistula. A Rationale for Comprehensive Treatment. Case Report.

The indication for total elbow arthroplasty (TEA) for primary and posttraumatic elbow arthritis has increased, however, its indication after infection remains elusive. Wound closure about the elbow increases the challenge of treating a previously infected elbow, often necessitating soft tissue coverage with local or regional flaps. We present a 75-year-old male patient with an elbow infection following a failed complex intraarticular fracture open reduction and internal fixation of the distal humerus. Initially, he presented with severe functional impairment and pain, also with an active fistula with serous exudate, whose culture was positive for Cutinebacterium acnes. Septic hardware loosening, and septic nonunion with intraarticular involvement of the left elbow was diagnosed. The patient underwent hardware removal, fistulectomy, serial irrigation and debridement and a pedicled antegrade posterior interosseous artery (PIA) flap on staged surgical treatment. Finally, after ruling out infection persistence, a TEA was performed. We aim to report the outcome of a patient treated with a TEA in the context of a previously infected elbow with soft tissue coverage with an antegrade PIA flap. Comprehensive treatment must be done in an appropriate manner, to obtain an expedited and desirable outcome.

p53 codon 72 polymorphism, DNA damage and repair, and risk of non-melanoma skin cancer.

A very common polymorphism of p53, that of codon 72, codes either for a proline (P72) or an arginine (R72). The two alleles differ in their biological properties: P72 is a stronger inducer of p21, while R72 induces 5-10 times more apoptosis. It is not known, however, whether this polymorphism influences genome stability. The influence of p53 codon 72 polymorphism on cancer risk has been studied for different types of cancer with mixed and inconsistent results. With respect to sporadic non-melanoma skin cancer (NMSC), there are few studies, with small sample sizes, and none in a Latinoamerican population. These studies have found no association between p53 genotype at codon 72 and NMSC. We analyzed whether p53 codon 72 genotype influences genomic stability and the sensitivity of cells to UVB. We also carried out a case-control study of NMSC in a Mexican population which included 204 BCC cases, 42 SCC cases, and 238 controls. There was no association between p53 genotype and basal levels of DNA damage, oxidative DNA damage sensitivity, or DNA repair capacity. R72 dominantly increased the in vitro sensitivity of cells to UVB-induced apoptosis. There was no significant association either between p53 genotype and basal cell carcinoma (BCC), squamous cell carcinoma (SCC) or both combined.

Balanitis pseudoepiteliomatosa, queratósica y micácea: comunicación de un caso / Queratotic and micaceus pseudoepitheliomatous balanitis: report of a case

Se comunica el caso de un paciente de 39 años de edad con balanitis pesudoepiteliomatosa, queratósica y micácea, con placa hiperqueratósica de aspecto verrugoso a nivel del glande.

Lipoma y angiolipomas: estudio clínico patológico, comparativo y retrospectivo en 260 pacientes / Lipomas and angiolipomas. Clinical and pathological study in 260 cases

Estudio clínico-patológico, comparativo y retrospectivo en 260 pacientes con lipomas y angiolipomas, en un periodo de 18 años. El 52.6 por ciento de los casos correspondieron a lipomas y el 47.3 por ciento a angiolipomas. A diferencia de los lipomas, los angiolipomas mostraron una mayor tendencia a presentarse como tumores múltiples y dolorosos, ocurriendo en individuos relativamente más jovenes

Linfangioma circunscrito / Limphangioma circumscriptum

El linfangioma circunscrito constituye la forma más frecuente de las malformaciones linfáticas cutáneas. Clínica e histológicamente se clasifica en dos grupos: 1. Linfangioma circunscrito clásico y 2. Linfangioma circunscrito localizado. Aparece habitualmente a temprana edad y se confina a una sola región. Se caracteriza por lesiones de aspecto vesicular acompañadas de aumento de volumen regional. Son lesiones benignas que tienden a persistir indefinidamente. Dada la elevada frecuencia de recurrencias del componente superficial, plantean un problema terapéutico

Eritema necrolítico migratorio asociado a glucagonoma / Necrolytic migratory erythema asociated with glucagonoma

Se estudia y comenta el caso de un hombre de 36 años que presentó lesiones cutáneas qeu clínica e histológiamente fueron diagnosticadas como eriterma necrolítico migratorio, que a su vez determinó el diagnóstico de glucagnoma. Se destaca la rareza de estos casos y la importancia de las lesiones cutáneas como mercadores de este tipo de neoplasia pancreático que puede secretar múltiples hormonas. También se hace hincapié en que es más frecuente en la mujer, sin embargo, en este caso se trata de un hombre que desgraciadamente lleva 10 meses con estaneoplasia no diagnosticada.

Queratoacantoma centrífugo gigante tratado con 5-fluorouracilo intralesional / Large keratoacanthoma treated with intralesional 5-fluorouracil

El queratoacantoma es un tumor originado en los folículos pilosebáceos, de crecimiento rápido, situado en las áreas expuestas de la piel, principalmente cara y dorso de manos. Se consideran tres tipos clínicos y diversas variantes clínicas. No obstante su comportamiento benigno, debe ser tratado. Se presenta el caso de un hombre de 87 años, con un queratoacantoma centrífugo gigante en dorso de mano, en el cual se ensayó el uso del 5-fluorouracilo intralesional, obteniéndose buenos resultados sin efectos secundarios