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Background: Multiple Sclerosis (MS) is a common neurological disease among white populations of European origin. Frequencies among Latin Americans continue to be studied, however, epidemiologic, and clinical characterization studies lack from Central American and Caribbean countries. Ethnicity in these countries is uniformly similar with a prevalent Mestizo population. Methods and results: Data from January 2014 to December 2019 from Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, Panama, Dominican Republic, and Aruba on demographic, clinical, MRI and phenotypic traits were determined in coordinated studies: ENHANCE, a population-based, retrospective, observational study on incidence and clinical characteristics, and from the subgroup with MS national registries (Aruba, Dominican Republic, Honduras, and Panama), data on prevalence, phenotypes and demographics. Expanded Disability Status Scale (EDSS), and therapeutic schemes were included. ENHANCE data from 758 patients disclosed 79.8% of Mestizo ethnicity; 72.4% female; median age at onset 31.0 years and 33.2 at diagnosis. The highest incidence rate was from Aruba, 2.3-3.5 × 100,000 inhabitants, and the lowest, 0.07-0.15 × 100,000, from Honduras. Crude prevalence rates per 100,000 inhabitants fluctuated from 27.3 (Aruba) to 1.0 (Honduras). Relapsing MS accounted for 87.4% of cases; EDSS <3.0 determined in 66.6% (mean disease duration: 9.1 years, SD ± 5.0); CSF oligoclonal bands 85.7%, and 87% of subjects hydroxyvitamin D deficient. Common initial therapies were interferon and fingolimod. Switching from interferon to fingolimod was the most common escalation step. The COVID-19 pandemic affected follow-up aspects of these studies. Conclusion: This is the first study providing data on frequencies and clinical characteristics from 8 countries from the Central American and Caribbean region, addressing MS as an emergent epidemiologic disorder. More studies from these areas are encouraged.
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Currently, there is an intense effort to find an alternative hormone to eCG to induce ovulation after estrus synchronization treatments in sheep. One of the proposed alternatives is based on the use of hCG, but the results are controversial since fertility rates are commonly affected. The present study aims to evaluate, therefore, the adequacy of hCG in protocols for the synchronization of estrus and ovulation. Ovarian follicle dynamics, occurrence of estrus behavior and subsequent ovulation, quality of corpora lutea, and pregnancy rate after controlled natural mating were assessed in two consecutive trials. The findings indicate that the low fertility rates reported for the protocols based on the administration of hCG for inducing ovulation during estrus synchronization in sheep may be related to a high occurrence of abnormal follicular growth patterns, disturbances, and retardments of ovulation and concomitant formation of follicular cysts in the treated females. These results preclude their practical application to induce ovulation concomitantly to estrous synchronization treatments.
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La leptospirosis es la enfermedad zoonótica más frecuente a nivel mundial y requiere de una vigilancia epidemiológica eficiente. Se evaluaron las definiciones operativas del protocolo para la prevención y control de la leptospirosis de Costa Rica. Método: Estudio transversal en dos etapas, una descriptiva y otra analítica, mediante un modelo clínico-predictivo por regresión logística. Los datos se obtuvieron del Centro Nacional de Referencias de Virología y Leptospira del INCIENSA (enero de 2001 a junio de 2003). Resultados: De 568 registros, se eliminaron 154 por no contar con la información para la correcta clasificación del protocolo de leptospirosis. De los 414 registros analizados ninguno cumplió con los criterios de caso confirmado, por lo que se utilizó una definición ampliada tomada de la bibliografía (caso confirmado =serología>1:800);así, hubo 52 casos confirmados y 368 sospechosos. Solamente la cefalea (OR=0.5;IC95 por ciento 0.2-1.1) y el sexo masculino (OR 3,01;IC 95 por ciento 1.1-8.1) mostraron asociación significativa con el diagnóstico de leptospirosis. Al agrupar las variables clínicas y epidemiológicas, las combinaciones cefalea + mialgias + antecedentes epidemiológicos (OR 3,8; IC 95 por ciento 1,1-14,9) y síntomas sistémicos + antecedentes epidemiológicos (OR 0,01; IC 95 por ciento 1,2-18,9), mostraron asociación con el diagnóstico de leptospirosis, aunque entre ellas hubo alta correlación (kappa>0,8)...
Assuntos
Humanos , Masculino , Animais , Feminino , Leptospirose , Costa RicaRESUMO
In teleosts, the lateral line system is composed of neuromasts containing hair cells that are analogous to those present in the inner ear of all vertebrates. In the zebrafish embryo and early larva, this system is composed of the anterior lateral line (ALL), which covers the head, and the posterior lateral line (PLL), present in the trunk and tail. The mechanosensory hair cells found in neuromasts can be labeled in vivo using fluorescent dyes such as 4-di-2-Asp (DiAsp) or FM1-43. We have studied the effects of water-borne copper exposure on the function of the lateral line system in zebrafish larvae. Our results show that transient incubation of post-hatching larvae for 2h with non-lethal concentrations of copper (1-50 microM CuSO4) induces cellular damage localized to neuromasts, apoptosis, and loss of hair cell markers. This effect is specific to copper, as other metals did not show these effects. Since hair cells in fish can regenerate, we followed the reappearance of viable hair cells in neuromasts after copper removal. In the PLL, we determined that there is a threshold concentration of copper above which regeneration does not occur, whereas, at lower concentrations, the length of time it takes for viable hair cells to reappear is dependent on the amount of copper used during the treatment. The ALL behaves differently though, as regeneration can occur even after treatments with concentrations of copper an order of magnitude higher than the one that irreversibly affects the PLL. Regeneration of hair cells is dependent on cell division within the neuromasts as damage that precludes proliferation prevents reappearance of this cell type.
Assuntos
Cobre/toxicidade , Sistema da Linha Lateral/efeitos dos fármacos , Mecanorreceptores/efeitos dos fármacos , Animais , Morte Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Células Ciliadas Auditivas/efeitos dos fármacos , Imuno-Histoquímica , Sistema da Linha Lateral/citologia , Mecanorreceptores/fisiologia , Compostos de Piridínio , Regeneração , Coloração e Rotulagem , Poluentes Químicos da Água/toxicidade , Peixe-ZebraRESUMO
Para el odontólogo es importante el diagnóstico integral del paciente; este debe tener en cuenta el estado sistémico, así como las diferentes manifestaciones de la patología presente y sus repercusiones en cavidad oral. Debido a las implicaciones odontológicas en el diagnóstico y tratamiento del paciente, se presenta el caso de un niño de 6 años de edad con síndrome de Down en el que se relacionan varias entidades como leucemia aguda indiferenciada, cardiopatía congénita, sarcoma granulocítico e hipotiroidismo.