Severe Inflammatory and Disseminated Cutaneous Leishmaniasis in a Pregnant Woman: A Case Report from Portoviejo, Ecuador.

BACKGROUND Leishmaniasis is a zoonosis with worldwide prevalence that causes dermal lesions and can be serious in humans. This report presents a case of cutaneous leishmaniasis (CL) that was apparently associated with a zoonotic transmission in a peri-urban area of the city of Portoviejo, Ecuador, close to mountainous and forested sites. CASE REPORT For 37 years, we have studied transmission of leishmaniasis in Ecuador, and have seen a wide variety of clinical presentations of the disease caused by different strains of the parasite Leishmania in patients, including pregnant women, without marked difference among them. CL without complications causes painless lesions of different clinical aspect. The present study reports a case of a 25-year-old woman presenting with severely inflamed, disseminated, and painful lesions of CL. The patient was not given antimonial treatment; however, local cryotherapy was given, together with topical anti-inflammatory and antibiotic ointment. All the lesions were observed to heal, and no amastigotes were found in smear stains after clinical healing. Since there was no reactivation after 1.5 years of follow-up, conventional antileishmanial treatment with meglumine antimoniate was not given to the patient. CONCLUSIONS This report shows the importance of a properly done epidemiological and clinical presumtive diagnosis, followed by parasitological confirmation, and the benefit of using an alternative treatment for vulnerable patients, such as this pregnant woman, for whom the therapy with pentavalent antimonials is not indicated. All observed lesions healed and no amastigotes were found in the smears after clinical healing.

CYCU-3: an Al(III)-based MOF for SO2 capture and detection.

The Al(III)-based MOF CYCU-3 exhibits a relevant SO2 adsorption performance with a total uptake of 11.03 mmol g-1 at 1 bar and 298 K. CYCU-3 displays high chemical stability towards dry and wet SO2 exposure. DRIFTS experiments and computational calculations demonstrated that hydrogen bonding between SO2 molecules and bridging Al(III)-OH groups are the preferential adsorption sites. In addition, photoluminescence experiments demonstrated the relevance of CYCU-3 for application in SO2 detection with good selectivity for SO2 over CO2 and H2O. The change in fluorescence performance demonstrates a clear turn-on effect after SO2 interaction. Finally, the suppression of ligand-metal energy transfer along with the enhancement of ligand-centered π* → π electronic transition was proposed as a plausible fluorescence mechanism.

Koilonychia: an update on pathophysiology, differential diagnosis and clinical relevance.

Koilonychia, a concave nail dystrophy, has multiple aetiologies and may be hereditary, acquired or idiopathic. Within dermatology, koilonychia is often a manifestation of an inflammatory dermatosis such as psoriasis or lichen planus, or a sign of onychomycosis. Other disease associations include iron store abnormalities, Plummer-Vinson Syndrome, nutritional deficiencies and occupational or traumatic aetiologies. In young children, koilonychia of the toenails is commonly transient and idiopathic, although familial and syndromic cases are reported. The dermatologist must be aware of the potential cutaneous and systemic associations with koilonychia in order to guide appropriate workup, treatment and/or referral. An algorithm for evaluation of koilonychia is presented along with discussion of common causes of koilonychia and a comprehensive list of all known associations.

Association study between salivary levels of interferon (IFN)-gamma, interleukin (IL)-17, IL-21, and IL-22 with chronic periodontitis.

OBJECTIVE: To investigate if the salivary levels of IL-17, IL-21, IL-22, and its ratio regarding salivary IFN-γ may be linked with the periodontal clinical status. DESIGN: One hundred and five chronic periodontitis (CP) subjects and 44 healthy controls (HC) were recruited. Periodontal status was assessed based on full-mouth clinical periodontal measurements. Cytokine salivary levels were analyzed by ELISA. The association between the analytes with CP was analyzed using a binary logistic regression model. RESULTS: A statistically significant increase in salivary levels of IFN-γ and IFN-γ/IL-22 ratio in CP group could be detected, but there was no significant domination of any Th17 cytokine that could be of predictive value for health/disease status. Univariate and binary logistic regression analyses revealed a strong and independent association of IFN-γ salivary levels and IFN-γ/IL-22 ratio with disease status. An interaction effect of ageing on IFN-γ levels also could be noted. CONCLUSION: While salivary levels of IFN-γ and IFN-γ/IL-22 ratio may act as strong/independent indicators of the amount and extent of periodontal breakdown, the low detection frequency of Th17 cytokines in saliva samples make these determinations useless for the detection of disease presence and/or its severity.

Sand fly fauna (Diptera, pcychodidae, phlebotominae) in different leishmaniasis-endemic areas of ecuador, surveyed using a newly named mini-shannon trap.

To study the sand fly fauna, surveys were performed at four different leishmaniasis-endemic sites in Ecuador from February 2013 to April 2014. A modified and simplified version of the conventional Shannon trap was named "mini-Shannon trap" and put to multiple uses at the different study sites in limited, forested and narrow spaces. The mini-Shannon, CDC light trap and protected human landing method were employed for sand fly collection. The species identification of sand flies was performed mainly based on the morphology of spermathecae and cibarium, after dissection of fresh samples. In this study, therefore, only female samples were used for analysis. A total of 1,480 female sand flies belonging to 25 Lutzomyia species were collected. The number of female sand flies collected was 417 (28.2%) using the mini-Shannon trap, 259 (17.5%) using the CDC light trap and 804 (54.3%) by human landing. The total number of sand flies per trap collected by the different methods was markedly affected by the study site, probably because of the various composition of species at each locality. Furthermore, as an additional study, the attraction of sand flies to mini-Shannon traps powered with LED white-light and LED black-light was investigated preliminarily, together with the CDC light trap and human landing. As a result, a total of 426 sand flies of nine Lutzomyia species, including seven man-biting and two non-biting species, were collected during three capture trials in May and June 2014 in an area endemic for leishmaniasis (La Ventura). The black-light proved relatively superior to the white-light with regard to capture numbers, but no significant statistical difference was observed between the two traps.

Sand Fly Fauna (Diptera, Pcychodidae, Phlebotominae) in DifferentLeishmaniasis- Endemic Areas of Ecuador, Surveyed by Using a Newly Named Mini-Shannon Trap

To study the sand fly fauna, surveys were performed atfour different leishmaniasis-endemic areas of Ecuador, during February 2013 andApril 2014. The conventional Shannon trap was modified and simplified to anewly named mini-Shannon trap for its multiple uses at different study sites,such as limited, forested and narrow spaces. The mini-Shannon, CDC light trapsand the protected human landing method were employed for sand fly collection.The species identification of sand flies was performed mainly based on themorphology of spermathecae and cibarium, after dissection of freshsamples.  In this study, therefore, onlyfemale samples were used for analysis. A total of1,480 female sand flies belonging to 25<i> Lutzomyia</i> species were collected. Numbers of the female sand fliescollected by each trap were 417 (28.2%) by the mini-Shannon trap, 259 (17.5%)by CDC light trap and 804 (54.3%) by human landing. The total number of sand flies per trap collected bydifferent methods was markedly affected by study sites, probably because ofdifferent species compositions at each locality. Further, as an additionalstudy, the attractiveness of sand flies against the mini-Shannon traps poweredwith LED White-light and LED Black-light, waspreliminary tested, together with CDC light trap and human landing. In the test,a total of 426 sand flies of nine <i>Lutzomyia</i> species, seven man-biting and two non-man-biting species, were collected by threecapture trials during May and June 2014 in an area endemic for leishmaniasis(La Ventura). The Black-light equipped trap was relatively superior in capturenumbers to the White-light equipped one, but no significant difference wasobserved statistically between the two traps.

Sand Fly Fauna (Diptera, Pcychodidae, Phlebotominae) in Different Leishmaniasis-Endemic Areas of Ecuador, Surveyed Using a Newly Named Mini-Shannon Trap

To study the sand fly fauna, surveys were performed at four different leishmaniasis-endemic sites in Ecuador from February 2013 to April 2014. A modified and simplified version of the conventional Shannon trap was named “mini-Shannon trap” and put to multiple uses at the different study sites in limited, forested and narrow spaces. The mini-Shannon, CDC light trap and protected human landing method were employed for sand fly collection. The species identification of sand flies was performed mainly based on the morphology of spermathecae and cibarium, after dissection of fresh samples. In this study, therefore, only female samples were used for analysis. A total of 1,480 female sand flies belonging to 25 <i>Lutzomyia</i> species were collected. The number of female sand flies collected was 417 (28.2%) using the mini-Shannon trap, 259 (17.5%) using the CDC light trap and 804 (54.3%) by human landing. The total number of sand flies per trap collected by the different methods was markedly affected by the study site, probably because of the various composition of species at each locality. Furthermore, as an additional study, the attraction of sand flies to mini-Shannon traps powered with LED white-light and LED black-light was investigated preliminarily, together with the CDC light trap and human landing. As a result, a total of 426 sand flies of nine <i>Lutzomyia</i> species, including seven man-biting and two non-biting species, were collected during three capture trials in May and June 2014 in an area endemic for leishmaniasis (La Ventura). The black-light proved relatively superior to the white-light with regard to capture numbers, but no significant statistical difference was observed between the two traps.

La biopsia pulmonar en el diagnóstico de la enfermedad pulmonar intersticial difusa / Lung biopsy in the diagnosis of diffuse interstitial lung disease

La enfermedad pulmonar intersticial difusa (EPID) representa un grupo heterogéneo de enfermedades que suponen un desafío terapéutico. En muchas ocasiones es necesaria la realización de una biopsia pulmonar quirúrgica para su diagnóstico. El objetivo de este estudio es valorar la eficacia de este tipo de técnica y si tras alcanzar el diagnóstico por este método se produce un cambio en la terapéutica. Material y métodos: estudio descriptivo retrospectivo de los pacientes a los que se les ha realizado una biopsia pulmonar quirúrgica en los últimos 10 años en el Hospital Universitario Virgen Macarena, analizando diferentes variables y comparando el tratamiento pre y postquirúrgico. Resultados: se obtuvo un diagnóstico histopatológico definitivo en el 98% de los casos y un cambio en la actitud terapéutica en el 78,4% (p<0,01) de los casos con una morbilidad del 9% y una mortalidad nula. Conclusiones: la biopsia pulmonar quirúrgica es un método seguro y eficaz que influye en la decisión terapéutica de los pacientes con EPID (AU)

Interstitial lung disease (ILD) is a heterogeneous group of diseases that involve a therapeutic challenge. Frequently, a surgical biopsy is needed to obtain a definitive diagnosis. The aim of this study was to assess the accuracy of surgical lung biopsy in the diagnosis of ILD, and to what extent, such a biopsy leads to changes in treatment options. Patients and methods: all patients undergoing a surgical lung biopsy for suspected ILD at the Virgen Mararena University Hospital over the last 10 years were retrospectively analysed. Several pre- and post-operative variables were collected. Differences between pre- and post-lung biopsy treatments were assessed. Results: a definitive diagnosis was obtained in 98% of cases. The lung biopsy led to changes in medical treatment in 78,4% of patients (p<0,01). Morbidity of the series was 9%, with no cases mortality. Conclusions: the surgical lung biopsy is a safe and effective method to guide the therapeutic decision in patients with ILD (AU)

The effect of moderate impact exercise on skeletal integrity in master athletes.

UNLABELLED: We measured bone mineral density (BMD) in senior athletes competing in running and swimming events and compared results to those of sedentary controls. Total body BMD was greatest among runners suggesting that moderate impact activities continue to play a role in maintaining skeletal integrity with age. INTRODUCTION: The role of moderate impact exercise in maintaining skeletal integrity as we age remains unclear. METHODS: To determine the effect of moderate impact exercise on skeletal integrity in the elderly, we recruited master athletes, including 44 runners (moderate impact exercise) and 43 swimmers, competing in the 2005 National Senior Olympic Games and 87 non-athletes, all over the age of 65 years. Height, weight, calcium, vitamin D intake, bone mineral density (BMD) of the total body, spine, hip (total hip, femoral neck, trochanter, intertrochanter), forearm (1/3 distal radius), and heel ultrasound, and Z-scores were characterized by mean +/- SD and compared by analysis of variance. T-scores were used to determine sites of osteopenia and osteoporosis. RESULTS: Total body BMD of runners was significantly greater than that of controls (1.11 +/- 0.13 versus 1.10 +/- 0.13 g/cm(2), p < 0.05) and marginally greater than that of swimmers when adjusted for age and weight. Heel ultrasound bone mass of runners was significantly greater than that of swimmers or controls. Runners also had higher BMD in the total hip, intertrochanter and 1/3 distal radius when compared to swimmers. CONCLUSION: These findings suggest that moderate impact exercise contributes to skeletal integrity in older age.

Indicadores de sintomas depresivos en una muestra de jóvenes de 12 a 17 años de edad con diabetes mellitus tipo I / Indicators of depression symptoms in a sample of 12 to 17 year-old youths with diabetes mellitus type I

The purpose of this study was to find out what percent of a group of patients 12 to 17 years old and with a diagnosis of Diabetes Mellitus type I have depressive symptomatology. We also wanted to know if there were gender differences in regard to depressive symtomatology in this group. We used a revised and adapted spanish translation of the Beck Depression Inventory, the IDB-R. It was administered to a group of 49 patients ages 12 to 17 with Diabetes Mellitus type I. The mean score of the group at the IDR-R was 9.33, which according to the instrument represents absence of depressive symptomatology. We found that 36.7of this group obtained a score greater than 10 in the IDB-R which according to this instrument, it means that depressive symptomatology was present. The symptoms most reported by the females were difficulties taking decisions and sleep problems. The symptom most reported by the males was change in appetite.

Soybean phytophthora resistance gene Rps8 maps closely to the Rps3 region.

Root and stem rot is one of the major diseases of soybean. It is caused by the oomycete pathogen Phytophthora sojae. A series of resistance genes (Rps) have been providing soybean with reasonable protection against this pathogen. Among these genes, Rps8, which confers resistance to most P. sojae isolates, recently has been mapped. However, the most closely linked molecular marker was mapped at about 10 cM from Rps8. In this investigation, we attempted to develop a high-density genetic map of the Rps8 region and identify closely linked SSR markers for marker-assisted selection of this invaluable gene. Bulk segregant analysis was conducted for the identification of SSR markers that are tightly linked to Rps8. Polymorphic SSR markers selected from the Rps8 region failed to show cosegregation with Phytophthora resistance. Subsequently, bulk segregant analysis of the whole soybean genome and mapping experiments revealed that the Rps8 gene maps closely to the disease resistance gene-rich Rps3 region.

[Sexual violence and related problems in women attending a health care center]. / Violencia sexual y problemas asociados en una muestra de usuarias de un centro de salud.

OBJECTIVE: To estimate the frequency of different forms of sexual violence and its association with mental health problems, such as depressive symptoms, suicidal ideation and attempt, and alcohol and drug use. MATERIAL AND METHODS: From February to March 1998, a cross-sectional study was conducted among 345 women attending a healthcare center in Mexico City. All women were living with a partner/spouse at the time of the study. The proportions of three different types of sex life were obtained and compared with the chi-squared test. RESULTS: Nineteen per cent of women reported that they had been sexually fondled against their will at least once in their lifetime, 11% had been raped, and 5% had been forced to touch the sex organs of another person against their will. One in every five women reported that they had experienced sexual violence in the context of an intimate relationship. An association was found between some forms of sexual violence and depression, suicidal ideation, suicide attempts, and use of psychoactive drugs. CONCLUSIONS: Sexual violence is a severe public health problem that requires implementing specific programs to sensitize and train healthcare providers to prevent it.

Diagnostic and interventional ultrasound for breast disease.

The availability of reliable, portable computer-enhanced ultrasonography with high-frequency transducers has improved breast ultrasonography such that its role has increased dramatically. Diagnostic characteristics of breast lesions may be used to categorize these lesions according to their relative risk for malignancy. Furthermore, breast ultrasonography may be used to guide needle aspiration and biopsy of lesions so indicated by diagnostic evaluation. Results of ultrasound-guided aspiration and core biopsy accurately diagnose specific histopathology thereby avoiding unnecessary open biopsy for benign lesions and facilitating therapeutic planning for malignant lesions.

The effect of prolonged bottle feeding on cow's milk intake and iron stores at 18 months of age.

Thirty-four toddlers were studied in a prospective, convenience sample comparison at their 18-month health supervision visit to examine the effect of prolonged (i.e., to 18 months of age) bottle feeding on both the daily volume of cow's milk intake and the toddler's iron stores (serum ferritin concentrations.) Seventeen toddlers had been weaned from the bottle by approximately 1 year of age, and 17 toddlers who remained on the bottle at 18 months of age were the compared group. The toddlers who remained on the bottle had significantly greater (P < 0.001) cow's milk intake (mean 26.3 oz vs 16.1 oz). The mean ferritin concentrations were lower in the persistent bottle group (17.3 micrograms/L vs 23.4 micrograms/L), but not significantly so. Questioning parents about their toddlers' continued bottle use at 18 months can provide a marker for potentially excessive cow's milk intake.