Adenocarcinoma polimorfo de labio superior: presentación de un raro caso y revisión de la literatura

En el presente trabajo presentamos un caso de adenocarcinoma polimorfo de labio superior de rara localización donde analizamos su patrón histológico y evaluamos con Ki67 la capacidad de crecimiento tumoral por medio del índice de proliferación celular, que marca la proporción de las células incluidas en el ciclo celular y el comportamiento agresivo del tumor. Los cortes histológicos de la pieza tumoral se estudiaron con H/E. Los epiteliocitos tumorales se organizaban en patrones citoarquitectónicos cribiforme, papilar y tubular. Luego del estudio anatomopatológico se descartó el diagnóstico previo de carcinoma adenoide quístico con un diagnóstico definitivo de adenocarcinoma polimorfo de glándulas salivales labiales. La inmunomarcación con Ki67 fue de 16-30%. El adenocarcinoma polimorfo es una neoplasia maligna rara de buen pronóstico, ocasionalmente mencionada en la literatura estomatológica. Un diagnóstico diferencial riguroso es esencial para programar su abordaje terapéutico y precisar su pronóstico. Los pacientes tienen un buen pronóstico. Sin embargo, las evaluaciones periódicas permiten detectar eventuales recurrencias y metástasis cervicales a posteriori del tratamiento primario

Detection of aedes aegypti mosquitoes infected with dengue virus as a complementary method for increasing the sensitivity of surveillance: identification of serotypes 1, 2, and 4 by rt-pcr in Quintana Roo, Mexico

Abstract. Sensitivity of monitoring Aedes aegypti (L.) populations was determined to identify the distribution of dengue virus (DENV) during epidemics in Quintana Roo. From September to November 2012, we used a motorized aspirator to collect 2,144 female Ae. aegypti from 569 homes. These were grouped into 220 to use semi-nested RT-PCR for DENV, and positive groups were analyzed individually. Five groups (2.27%) were positive for DENV. Individual analysis yielded eight groups that tested positive, six with DENV-2, one DENV-1, and one DENV-4. The latter was not reported by the surveillance system that year. The mean number of female mosquitoes per household was 3.77 ± 5.71, and the rate of viral infection of Ae. aegypti was 0.4%. Most infected mosquitoes (49%) were concentrated in 10% of the houses. Monitoring Ae. aegypti infected with DENV has the potential to complement the current system of clinical and entomological surveillance

Relationship between renal function and renal volume in autosomal dominant polycystic kidney disease: cross-sectional study

Objetivo Determinar en pacientes con poliquistosis renal autosómica dominante la relación entre el volumen renal total (suma de ambos riñones, VRT) medido con resonancia magnética y la función renal; y su comportamiento según el sexo y la presencia de hipertensión arterial, hipercolesterolemia e hiperuricemia. Método Estudio transversal en el que se incluyen pacientes con poliquistosis renal autosómica dominante que realizan revisiones periódicas en las consultas externas de Nefrología del Hospital Virgen de las Nieves de Granada, a quienes entre enero de 2008 y marzo de 2011 se les realizó una resonancia magnética para estimar el volumen renal. Resultados Se evaluaron 67 pacientes (59,7% mujeres, edad media 48 ± 14,4 años). Encontramos asociación positiva significativa entre VRT y creatinina sérica o urea, que resultó inversa frente al filtrado glomerular estimado por MDRD-4 y Cockcroft-Gault. Las mujeres mostraron un nivel medio de creatinina sérica y VRT inferior respecto al varón de forma significativa. Los subgrupos afectos de hipertensión arterial e hiperuricemia mostraron valores medios de creatinina sérica, urea y VRT más altos y filtrados glomerulares estimados inferiores. El subgrupo con hipercolesterolemia mostró valores medios de urea más altos y filtrados glomerulares estimados inferiores sin detectarse diferencias significativas respecto al VRT. Conclusión El volumen de los riñones poliquísticos medido por resonancia magnética se asocia con la función renal, y puede ser útil como estudio complementario para monitorizar la progresión de la enfermedad. La presencia de hipertensión arterial, hiperuricemia o hipercolesterolemia están asociados a una peor función renal.Objective: To determine in patients with autosomal dominant polycystic kidney disease the relationship between total renal volume (the sum of both kidneys, TRV) as measured by magnetic resonance and renal function; and its behaviour according to sex and the presence of arterial hypertension, hypercholesterolaemia and hyperglycemia. Method: Cross-sectional study including patients with autosomal dominant polycystic kidney disease who underwent periodic reviews at Nephrology external consultations at Hospital de las Nieves de Granada, and who underwent an magnetic resonance to estimate renal volume between January 2008 and March 2011. Results: We evaluated 67 patients (59.7% women, average age of 48±14.4 years) and found a significant positive association between TRV and serum creatinine or urea, which was reversed compared with estimated glomerular filtration by MDRD-4 and Cockcroft-Gault. Women showed an average serum creatinine level and a significantly lower TRV level compared with males. Subgroups affected by arterial hypertension and hyperuricemia presented average values for serum creatinine and urea, higher for TRV and lower for estimated glomerular filtration. The hypercholesterolaemia subgroup showed higher average values for urea and lower for estimated glomerular filtration, without detecting significant differences compared with TRV. Conclusion: The volume of polycystic kidneys measured by magnetic resonance is associated with renal function, and can be useful as a complementary study to monitor disease progression. The presence of arterial hypertension, hyperuricemia or hypercholesterolaemia is associated with a poorer renal function

Personalized Evaluation of Atrial Complexity of Patients Undergoing Atrial Fibrillation Ablation: A Clinical Computational Study

Current clinical guidelines establish Pulmonary Vein (PV) isolation as the indicated treatment for Atrial Fibrillation (AF). However, AF can also be triggered or sustained due to atrial drivers located elsewhere in the atria. We designed a new simulation workflow based on personalized computer simulations to characterize AF complexity of patients undergoing PV ablation, validated with non-invasive electrocardiographic imaging and evaluated at one year after ablation. We included 30 patients using atrial anatomies segmented from MRI and simulated an automata model for the electrical modelling, consisting of three states (resting, excited and refractory). In total, 100 different scenarios were simulated per anatomy varying rotor number and location. The 3 states were calibrated with Koivumaki action potential, entropy maps were obtained from the electrograms and compared with ECGi for each patient to analyze PV isolation outcome. The completion of the workflow indicated that successful AF ablation occurred in patients with rotors mainly located at the PV antrum, while unsuccessful procedures presented greater number of driving sites outside the PV area. The number of rotors attached to the PV was significantly higher in patients with favorable long-term ablation outcome (1-year freedom from AF: 1.61 ± 0.21 vs. AF recurrence: 1.40 ± 0.20; p-value = 0.018). The presented workflow could improve patient stratification for PV ablation by screening the complexity of the atria

Salivary duct carcinoma: a clinicopathologic and inmunohistochemical study of 5 cases

Fil: Samar, María Elena. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Ávila, Rodolfo Esteban. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Biología Celular, Histología y Embriología; Argentina.Fil: Corball, Alberto Gustavo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; ArgentinaFil: Fonseca, Ismael Bernardo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Patología; Argentina.El carcinoma del conducto salival es un tumor epitelial maligno agresivo, que involucra principalmente a la glándula parótida, con características histológicas semejantes al carcinoma ductal de glándula mamaria. El propósito de este trabajo fue presentar los resultados clínico-patológicos de cinco casos de carcinoma del conducto salival primario de glándula parótida y evaluar la expresión de Ki67. Histológicamente, el carcinoma del conducto salival presentó nidos epiteliales con patrones papilar, sólido y cribiforme, comedonecrosis tanto en la lesión primaria como en los nodos linfoides metastásicos y, además, invasión perineural. Se demostró con Ki 67 una alta proliferación celular en cuatro (80 %) de los cinco casos estudiados. Se concluyó que: el carcinoma del conducto salival es una lesión maligna de mal pronóstico, raramente informado en la literatura odontológica, con características histológicas semejantes a las del carcinoma ductal de alto grado de la mama; la comedonecrosis es un signo específico de esta enfermedad; puede desarrollarse ?de novo? o en un adenoma pleomórfico preexistente; su diagnóstico diferencial histopatológico es fundamental para planificar su tratamiento y determinar su pronóstico, a pesar de su tratamiento quirúrgico y radioterapia postoperatoria es un tumor agresivo con alta proliferación celular, infiltración perineural, recurrencias y metástasis.https://www.johamsc.cominfo:eu-repo/semantics/publishedVersionFil: Samar, María Elena. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Fernández, Javier Elías. Universidad Nacional de Córdoba. Facultad de Odontología. Cátedra de Histología y Embriología A; Argentina.Fil: Ávila, Rodolfo Esteban. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Biología Celular, Histología y Embriología; Argentina.Fil: Corball, Alberto Gustavo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; ArgentinaFil: Fonseca, Ismael Bernardo. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Cátedra de Patología; Argentina.Otras Ciencias de la Salu

Vaccine breakthrough infections with SARS-CoV-2 Alpha mirror mutations in Delta Plus, Iota, and Omicron

Replication of SARS-CoV-2 in the human population is defined by distributions of mutants that are present at different frequencies within the infected host and can be detected by ultra-deep sequencing techniques. In this study, we examined the SARS-CoV-2 mutant spectra of amplicons from the spike-coding (S-coding) region of 5 nasopharyngeal isolates derived from patients with vaccine breakthrough. Interestingly, all patients became infected with the Alpha variant, but amino acid substitutions that correspond to the Delta Plus, Iota, and Omicron variants were present in the mutant spectra of the resident virus. Deep sequencing analysis of SARS-CoV-2 from patients with vaccine breakthrough revealed a rich reservoir of mutant types and may also identify tolerated substitutions that can be represented in epidemiologically dominant variants.This work was supported by the Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (COVID-19 Research Call COV20/00181) and co-financed by the European Development Regional Fund “A way to achieve Europe.” The work was also supported by grants CSIC-COV19-014 from the CSIC, project 525/C/2021 from the Fundació La Marató de TV3; PID2020-113888RB-I00 from the Ministerio de Ciencia e Innovación; BFU2017-91384-EXP from the Ministerio de Ciencia, Innovación y Universidades (MCIU);PI18/00210 and PI21/00139 from the Instituto de Salud Carlos III; and S2018/BAA-4370 (PLATESA2) from the Comunidad de Madrid/ FEDER. This research work was also funded by the European Commission – NextGenerationEU (regulation EU 2020/2094), through the CSIC’s Global Health Platform (PTI Salud Global). CP and PM are supported by the Miguel Servet programme of the Instituto de Salud Carlos III (CPII19/00001 and CP16/00116, respectively), cofinanced by the European Regional Development Fund (ERDF). CIBERehd is funded by the Instituto de Salud Carlos III. Institutional grants from the Fundación Ramón Areces and Banco Santander to the CBMSO are also acknowledged. The team at CBMSO belongs to the Global Virus Network (GVN). BMG is supported by predoctoral contract PFIS FI19/00119 from the Instituto de Salud Carlos III (Ministerio de Sanidad y Consumo), cofinanced by the Fondo Social Europeo (FSE). CGC is supported by predoctoral contract PRE2018- 083422 from the MCIU. BS was supported by a predoctoral research fellowship (Doctorados Industriales, DI-17-09134) from the Spanish Ministry of Economy and Competitiveness (MINECO).Peer reviewe

SARS-CoV-2 mutant spectra reveal differences between COVID-19 severity categories

Trabajo presentado en el XVI Congreso Nacional de Virología, celebrado en Málaga (España) del 06 al 09 de septiembre de 2022.RNA virus populations are composed of complex mixtures of genomes that are termed mutant spectra. SARS-CoV-2 replicates as a viral quasispecies, and mutations that are detected at low frequencies in a host can be dominant in subsequent variants. We have studied mutant spectrum complexities of SARS-CoV-2 populations derived from thirty nasopharyngeal swabs of patients infected during the first wave (April 2020) in the Hospital Universitario Fundación Jiménez Díaz. The patients were classified according to the COVID-19 severity in mild (non-hospitalized), moderate (hospitalized) and exitus (hospitalized with ICU admission and who passed away due to COVID-19). Using ultra-deep sequencing technologies (MiSeq, Illumina), we have examined four amplicons of the nsp12 (polymerase)-coding region and two amplicons of the spike-coding region. Ultra-deep sequencing data were analyzed with different cut-off frequency for mutation detection. Average number of different point mutations, mutations per haplotype and several diversity indices were significantly higher in SARS-CoV-2 isolated from patients who developed mild disease. A feature that we noted in the SARS-CoV-2 mutant spectra from diagnostic samples is the remarkable absence of mutations at intermediate frequencies, and an overwhelming abundance of mutations at frequencies lower than 10%. Thus, the decrease of the cut-off frequency for mutation detection from 0.5% to 0.1% revealed an increasement (50- to 100 fold) in the number of different mutations. The significantly higher frequency of mutations in virus from patients displaying mild than moderate or severe disease was maintained with the 0.1% cut- off frequency. To evaluate whether the frequency repertoire of amino acid substitutions differed between SARS-CoV-2 and the well characterized hepatitis C virus (HCV), we performed a comparative study of mutant spectra from infected patients using the same bioinformatics pipelines. HCV did not show the deficit of intermediate frequency substitutions that was observed with SARS-CoV-2. This difference was maintained when two functionally equivalent proteins, the corresponding viral polymerases, were compared. In conclusion, SARS-CoV-2 mutant spectra are rich reservoirs of mutants, whose complexity is not uniform among clinical isolates. Virus from patients who developed mild disease may be a source of new variants that may acquire epidemiological relevance.This work was supported by Instituto de Salud Carlos III, Spanish Ministry of Science and In-novation (COVID-19 Research Call COV20/00181), and co-financed by European Development Regional Fund ‘A way to achieve Europe’. The work was also supported by grants CSIC-COV19-014 from Consejo Superior de Investigaciones Científicas (CSIC), project 525/C/2021 from Fundació La Marató de TV3, PID2020-113888RB-I00 from Ministerio de Ciencia e Innovación, BFU2017-91384-EXP from Ministerio de Ciencia, Innovación y Universidades (MCIU), PI18/00210 and PI21/00139 from Instituto de Salud Carlos III, and S2018/BAA-4370 (PLATESA2 from Comunidad de Madrid/FEDER). C.P., M.C., and P.M. are supported by the Miguel Servet programme of the Instituto de Salud Carlos III (CPII19/00001, CPII17/00006, and CP16/00116, respectively) co-financed by the European Regional Development Fund (ERDF). CIBERehd (Centro de Investi-gación en Red de Enfermedades Hepáticas y Digestivas) is funded by Instituto de Salud Carlos III. Institutional grants from the Fundación Ramón Areces and Banco Santander to the CBMSO are also acknowledged. The team at CBMSO belongs to the Global Virus Network (GVN). B.M.-G. is supported by predoctoral contract PFIS FI19/00119 from Instituto de Salud Carlos III (Ministerio de Sanidad y Consumo) cofinanced by Fondo Social Europeo (FSE). R.L.-V. is supported by predoctoral contract PEJD-2019-PRE/BMD-16414 from Comunidad de Madrid. C.G.-C. is sup-ported by predoctoral contract PRE2018-083422 from MCIU. BS was supported by a predoctoral research fellowship (Doctorados Industriales, DI-17-09134) from Spanish MINECO

Detection of dengue virus serotype 2 in aedes aegypti in Quintana Roo, Mexico, 2011

Abstract. In October 2011, the State Health Department announced that several laboratory-confirmed cases of dengue had occurred among residents in two neighborhoods of Benito Juarez, Quintana Roo State, Mexico. To identify the dengue virus serotype(s) temporally and spatially associated with the cases, entomologic-based virus surveillance was initiated in October 2011 in both neighborhoods. Adult mosquitoes were collected from 88 houses by CDCbackpack aspirator, and all female Aedes aegypti L. (n = 419) were individually homogenized and assayed in pools of as many as 10 by reverse transcriptionpolymerase chain reaction (RT-PCR) using dengue virus-specific primers. Five (12%) of 41 pools were positive for dengue virus RNA. The individual mosquitoes that comprised the pools were analyzed separately by RT-PCR using dengue virus serotype-specific primers. Six mosquitoes were positive for dengue virus serotype-2 (DENV-2) RNA, three of which were collected in the same house. The mean number of female Ae. aegypti collected in each house was 4.76 ± 6.19. The overall dengue virus-infection rate in female Ae. aegypti was 1.4%. Interestingly, most (60%) of mosquito females were collected only from 15 (17%) houses. In summary, we provide evidence of recent DENV-2 transmission in Quintana Roo State

Population-based colorectal cancer screening programmes using a faecal immunochemical test:Should faecal haemoglobin cut-offs differ by age and sex?

Abstract Background The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Methods Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50–69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. Results We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). Conclusions This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting the f-Hb cut-off