Abnormal coronary reserve and left ventricular wall motion during cold pressor test in patients with previous left ventricular ballooning syndrome

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Apicificação de incisivos centrais superiores usando hidróxido de cálcio: relato de caso

When there is the pulp necrosis in permanent teeth with open root apex, there is the need to induce the root development aiming to create a barrier of mineralized tissue at the apical third, making it easy, subsequently, definitive filling of the root canal. This technique is called apexification. The following work aimed to describe a successful treatment with calcium hydroxide at the 11 and 21 teeth, which suffered pulp necrosis after a trauma.Quando ocorre a necrose pulpar em dentes permanentes com ápice incompleto, há necessidade de induzir o desenvolvimento radicular com a finalidade de criar uma barreira de tecido mineralizado no terço apical facilitando posteriormente a obturação definitiva do canal radicular. Esta técnica é denominada de apicificação. O objetivo deste trabalho foi descrever um tratamento bem sucedido de apicificação nos dentes 11 e 21 que sofreram necrose pulpar após a ocorrência de um trauma

Divergencia genética en poblaciones peruanas detectada a partir de las frecuencias haplotípicas del mtDNA y del gen nuclear MBL

Objectives: To advance in the knowledge of Peruvian populations’ origin in a phylogeographical context. Design: Population genetics study. Setting: Human Genetics Laboratory, Biological Sciences Faculty, Universidad Nacional Mayor de San Marcos, and Genetics and Molecular Biology Institute, Faculty of Medicine, Universidad San Martin de Porras, Lima, Peru. Participants: Seven Peruvian populations. Methods: Comparative analysis of mtDNA and MBL nuclear gene study results in seven Peruvian populations processed separately and then combined using PHYLYP 3.65 Program in order to obtain FST values of genetic differentiation; construction of distance trees by applying UPGMA algorithm and subsequent generated clusters’ analysis. Main outcome measures: Genetic trees. Results: Trees generated for each genetic marker had proper and distinct topologies among them. Combined processing resulted in a tree with higher values of genetic differentiation in Lago Titicaca Islands (Puno, Peru) Taquile, Amantani y Anapia, graded as very high because they showed 0.3113, 0.2949 y 0.3348 FST values with respect to the populations studied outside of Puno Department -like Chachapoyas, Pucallpa and Chiclayo-, as well as those of both Uro’s in same Puno and Lago Titicaca’s populations (0.2837). Out of Puno, the pair Chachapoyas-Pucallpa population was the least divergent with 0.0108 FST value between them, classifying as small. Conclusions: The tree obtained from markers by a combined matrix process determined that populations inhabiting in Taquile, Amantani y Anapia islands possess notable genetic divergence respect to the four remainders studied in Peru, including the Uro’s population geographically very close to them and within the same Lago Titicaca. Our next objective will be to explain these findings initially by increasing genetic markers and number of populations analyzed in Peru.Objetivos: Avanzar en el conocimiento del origen de las poblaciones peruanas estudiadas en un contexto filogeográfico. Diseño: Estudio genético poblacional. Instituciones: Laboratorio de Genética Humana, Facultad de Ciencias Biológicas, Universidad Nacional Mayor de San Marcos, e Instituto de Genética y Biología Molecular, Facultad de Medicina, Universidad San Martín de Porras, Lima, Perú. Participantes: Siete poblaciones peruanas. Metodología: Análisis comparativo de los resultados a partir del estudio del mtDNA y el gen nuclear MBL de siete poblaciones peruanas, procesados de manera separada y luego combinados, utilizando el programa PHYLYP 3.65, para obtener valores FST de diferenciación genética y la construcción de árboles de distancias por aplicación del algorritmo UPGMA y el análisis subsecuente de los agrupamientos (clusters) generados. Principales medidas de resultados: Árboles genéticos generados. Resultados: De manera separada, los árboles generados para cada marcador genético tuvieron topologías propias y diferentes entre sí. Procesados de manera combinada, el árbol resultante demostró que los mayores valores de diferenciación genética se hallaron en las Islas del Lago Titicaca (Puno, Perú) conocidas -Taquile, Amantani y Anapia-, que fue calificada como muy alta, porque mostró valores de FST de 0.3113, 0.2949 y 0.3348 respecto de las poblaciones estudiadas, tanto fuera del Departamento de Puno -como Chachapoyas, Pucallpa y Chiclayo, respectivamente-, así como a la de los Uro del mismo Puno y del mismo Lago Titicaca (0.2837). Fuera de Puno, el par de poblaciones Chachapoyas-Pucallpa fue el menos divergente, al alcanzar entre ellas un valor de FST de 0.0108, calificándosele de pequeña. Conclusiones: El árbol obtenido del procesamiento de los marcadores vía una matriz combinada demostró que las poblaciones que habitan las islas de Taquile, Amantani y Anapia, divergen notablemente de las restantes cuatro procesadas del Perú, incluyendo la más próxima a ellas dentro del mismo Lago Titicaca, como es la de los Uro. Explicar estos hallazgos será el siguiente objetivo de nuestras investigaciones, en principio, mediante la ampliación de los marcadores genéticos empleados y del número de poblaciones analizadas a nivel del Perú

Cancer genetic counseling.

La asesoría genética en cáncer permite reducir la morbimortalidad en pacientes con cáncer hereditario y sus familiares mediante un manejo multidisciplinario que establezca medidas preventivas, detección precoz y control de riesgos.</p

Correlation between B7-H4 and Survival of Non-Small-Cell Lung Cancer Patients Treated with Nivolumab

Reliable predictors of benefit from immune checkpoint inhibitors in non-small-cell lung cancer (NSCLC) are still limited. We aimed to evaluate the association between the expression of selected molecules involved in immune response and clinical outcomes in NSCLC patients receiving nivolumab. In our study, the outcomes of 46 NSCLC patients treated with nivolumab in second or subsequent lines (Nivolumab Cohort) were compared with the expression of PD-L1, PD-L2, PD-1, B7-H3, and B7-H4 assessed by immunohistochemistry (IHC). Samples from 17 patients (37.0%) in the Nivolumab Cohort were positive for B7-H4 expression. At univariate analyses, only B7-H4 expression was associated with significantly decreased progression-free survival (PFS; 1.7 vs. 2.0 months; p = 0.026) and with a disadvantage in terms of overall survival (OS) close to statistical significance (4.4 vs. 9.8 months; p = 0.064). At multivariate analyses, B7-H4 expression was significantly associated with decreased PFS (hazard ratio (HR) = 2.28; p = 0.021) and OS (HR = 2.38; p = 0.022). Subsequently, B7-H4 expression was compared with clinical outcomes of 27 NSCLC patients receiving platinum-based chemotherapy (Chemotherapy Cohort), but no significant association was observed. Our results suggest a negative predictive role of B7-H4 in a population of NSCLC treated with immune checkpoint inhibitors, which deserves further research

Cáncer Medular de Tiroides familiar: reporte de un caso y revisión de la literatura

El cáncer medular de tiroides (CMT) es un tumor maligno de las células C parafoliculares secretoras de calcitonina. Se estima que el 25% de los casos de CMT se asocian a variantes patogénicas a nivel de línea germinal en el protooncogen RET (locus 10q11.2), que son las causantes del desarrollo de Carcinoma Medular de Tiroides Familiar (CMTF) o de la Neoplasia Endocrina Múltiple tipo 2 (NEM2); condiciones genéticas con patrón de herencia autosómico dominante. Presentamos el primer reporte de una familia peruana con CMTF y con variante patogénica identificada a nivel de línea germinal en el gen RET, mediante secuenciamiento Sanger. Este manuscrito también muestra una revisión de la literatura de este síndrome hereditario oncológico, donde se resalta su importancia en la prevención primaria y potencial efecto en la salud pública en casos de portadores de variantes patogénicas germinales aparentemente sanos.</p

Simple Objective Detection of Human Lyme Disease Infection Using Immuno-PCR and a Single Recombinant Hybrid Antigen

A serology-based tiered approach has, to date, provided the most effective means of laboratory confirmation of clinically suspected cases of Lyme disease, but it lacks sensitivity in the early stages of disease and is often dependent on subjectively scored immunoblots. We recently demonstrated the use of immuno-PCR (iPCR) for detecting Borrelia burgdorferi antibodies in patient serum samples that were positive for Lyme disease. To better understand the performance of the Lyme disease iPCR assay, the repeatability and variability of the background of the assay across samples from a healthy population (n = 36) were analyzed. Both of these parameters were found to have coefficients of variation of \u3c 3%. Using eight antigen-specific iPCR assays and positive call thresholds established for each assay, iPCR IgM and/or IgG diagnosis from Lyme disease patient serum samples (n = 12) demonstrated a strong correlation with that of 2-tier testing. Furthermore, a simplified iPCR approach using a single hybrid antigen and detecting only IgG antibodies confirmed the 2-tier diagnosis in the Lyme disease patient serum samples (n = 12). Validation of the hybrid antigen IgG iPCR assay using a blinded panel of Lyme disease and non-Lyme disease patient serum samples (n = 92) resulted in a sensitivity of 69% (95% confidence interval [CI], 50% to 84%), compared to that of the 2-tier analysis at 59% (95% CI, 41% to 76%), and a specificity of 98% (95% CI, 91% to 100%) compared to that of the 2-tier analysis at 97% (95% CI, 88% to 100%). A single-tier hybrid antigen iPCR assay has the potential to be an improved method for detecting host-generated antibodies against B. burgdorferi

Continent-wide decoupling of Y-chromosomal genetic variation from language and geography in native South Americans

Numerous studies of human populations in Europe and Asia have revealed a concordance between their extant genetic structure and the prevailing regional pattern of geography and language. For native South Americans, however, such evidence has been lacking so far. Therefore, we examined the relationship between Y-chromosomal genotype on the one hand, and male geographic origin and linguistic affiliation on the other, in the largest study of South American natives to date in terms of sampled individuals and populations. A total of 1,011 individuals, representing 50 tribal populations from 81 settlements, were genotyped for up to 17 short tandem repeat (STR) markers and 16 single nucleotide polymorphisms (Y-SNPs), the latter resolving phylogenetic lineages Q and C. Virtually no structure became apparent for the extant Y-chromosomal genetic variation of South American males that could sensibly be related to their inter-tribal geographic and linguistic relationships. This continent-wide decoupling is consistent with a rapid peopling of the continent followed by long periods of isolation in small groups. Furthermore, for the first time, we identified a distinct geographical cluster of Y-SNP lineages C-M217 (C3*) in South America. Such haplotypes are virtually absent from North and Central America, but occur at high frequency in Asia. Together with the locally confined Y-STR autocorrelation observed in our study as a whole, the available data therefore suggest a late introduction of C3* into South America no more than 6,000 years ago, perhaps via coastal or trans-Pacific routes. Extensive simulations revealed that the observed lack of haplogroup C3* among extant North and Central American natives is only compatible with low levels of migration between the ancestor populations of C3* carriers and non-carriers. In summary, our data highlight the fact that a pronounced correlation between genetic and geographic/cultural structure can only be expected under very specific conditions, most of which are likely not to have been met by the ancestors of native South Americans

A survey of the clinicopathological and molecular characteristics of patients with suspected Lynch syndrome in Latin America

Background: Genetic counselling and testing for Lynch syndrome (LS) have recently been introduced in several Latin America countries. We aimed to characterize the clinical, molecular and mismatch repair (MMR) variants spectrum of patients with suspected LS in Latin America. Methods: Eleven LS hereditary cancer registries and 34 published LS databases were used to identify unrelated families that fulfilled the Amsterdam II (AMSII) criteria and/or the Bethesda guidelines or suggestive of a dominant colorectal (CRC) inheritance syndrome. Results: We performed a thorough investigation of 15 countries and identified 6 countries where germline genetic testing for LS is available and 3 countries where tumor testing is used in the LS diagnosis. The spectrum of pathogenic MMR variants included MLH1 up to 54%, MSH2 up to 43%, MSH6 up to 10%, PMS2 up to 3% and EPCAM up to 0.8%. The Latin America MMR spectrum is broad with a total of 220 different variants which 80% were private and 20% were recurrent. Frequent regions included exons 11 of MLH1 (15%), exon 3 and 7 of MSH2 (17 and 15%, respectively), exon 4 of MSH6 (65%), exons 11 and 13 of PMS2 (31% and 23%, respectively). Sixteen international founder variants in MLH1, MSH2 and MSH6 were identified and 41 (19%) variants have not previously been reported, thus representing novel genetic variants in the MMR genes. The AMSII criteria was the most used clinical criteria to identify pathogenic MMR carriers although microsatellite instability, immunohistochemistry and family history are still the primary methods in several countries where no genetic testing for LS is available yet. Conclusion: The Latin America LS pathogenic MMR variants spectrum included new variants, frequently altered genetic regions and potential founder effects, emphasizing the relevance implementing Lynch syndrome genetic testing and counseling in all of Latin America countries.Radium Hospital Foundation (Oslo, Norway) in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript, Helse Sør-Øst (Norway) in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript, the French Association Recherche contre le Cancer (ARC) in the analysis, and interpretation of data, the Groupement des Entreprises Françaises dans la Lutte contre le Cancer (Gefluc) in the analysis, and interpretation of data, the Association Nationale de la Recherche et de la Technologie (ANRT, CIFRE PhD fellowship to H.T.) in the analysis, and interpretation of data and by the OpenHealth Institute in the analysis, and interpretation of data. Barretos Cancer Hospital received financial support by FINEP-CT-INFRA (02/2010)info:eu-repo/semantics/publishedVersio

Rapid identification and typing of Mycobacterium avium complex using Matrix Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF) library and biomarker based approaches.

Bacteria associated with the Mycobacterium avium complex (MAC) cause significant problems in animal agriculture and cause large economic losses and morbidity of livestock. Two clinically important subspecies of M. avium are M.avium ssp paratuberculosis (MAP) and M. avium ssp hominissuis (MAH). MAP is the etiologic agent of Johne’s disease, a chronic and fatal enteritis in ruminants, that has been linked to Crohn’s disease in humans.1 MAH has zoonotic potential as it is one of the leading causes of secondary infections in AIDS patients. Identification of M. avium in clinical samples is challenging as they have overlapping host ranges and clinical signs. Information about the restriction of host specificity of M.avium also have not been determined. Available diagnostic tests for M. avium, such as blood and biochemical tests are labor intensive, time consuming, and lack sensitivity. Advanced methods such as matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) could provide rapid, low-cost, and more accurate diagnostic test to differentiate MAP which can be implemented into diagnostic workflows in veterinary diagnostic labs. The purpose of this project is to differentiate using M. avium from field isolates, particularly MAP and MAH and other members of MAC using a library based approach, and to examine the host specificity and tropism of isolates using these methods