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Veracruz, Mexico

Rosales R.,Virolab | Lopez-Contreras M.,Hospital de Cuautitlan | Rosales C.,National Autonomous University of Mexico | Magallanes-Molina J.-R.,Sanatorio San Francisco | And 9 more authors.
Human Gene Therapy | Year: 2014

Human papilloma viruses can induce warts, condylomas, and other intraepithelial cervical lesions that can progress to cancer. Cervical cancer is a serious problem in developing countries because early detection is difficult, and thus proper early treatment is many times missing. In this phase III clinical trial, we evaluated the potential use of MVA E2 recombinant vaccinia virus to treat intraepithelial lesions associated with papillomavirus infection. A total of 1176 female and 180 male patients with intraepithelial lesions were studied. They were injected with 107 MVA E2 virus particles directly into their uterus, urethra, vulva, or anus. Patients were monitored by colposcopy and cytology. Immune response was determined by measuring the antibody titer against MVA E2 virus and by analyzing the cytotoxic activity against cancer cells bearing papillomavirus DNA. Papillomavirus was determined by the Hybrid Capture method or by polymerase chain reaction analysis. By histology, 1051 (89.3%) female patients showed complete elimination of lesions after treatment with MVA E2. In 28 (2.4%) female patients, the lesion was reduced to CIN 1. Another 97 (8.3%) female patients presented isolated koilocytes after treatment. In men, all lesions were completely eliminated. All MVA E2-treated patients developed antibodies against the MVA E2 vaccine and generated a specific cytotoxic response against papilloma-transformed cells. Papillomavirus DNA was not detected after treatment in 83% of total patients treated. MVA E2 did not generate any apparent side effects. These data suggest that therapeutic vaccination with MVA E2 vaccine is an excellent candidate to stimulate the immune system and generate regression in intraepithelial lesions when applied locally. © Mary Ann Liebert, Inc. 2014.

Mendes L.,Hospital de Sao Bernardo | Silva D.,Hospital Militar | Miranda C.,Hospital de Sao Bernardo | Sa J.,Hospital de Sao Bernardo | And 5 more authors.
Revista Portuguesa de Cardiologia | Year: 2014

Aim The aim of this study was to detect abnormalities in left ventricular myocardial function due to HIV (human immunodeficiency virus) infection without established cardiovascular disease. Methods An echocardiogram was performed in 50 asymptomatic HIV-infected patients (age 41±6 years, 64% male) and in 20 healthy individuals. Conventional echocardiography and pulsed tissue Doppler imaging (TDI) were performed according to the guidelines. The strain rate of the basal segments was obtained with color tissue Doppler and used to evaluate systolic strain rate (SRS), early diastolic strain rate (SRE) and late diastolic strain rate (SRA). Longitudinal, radial and circumferential strain were assessed by 2D speckle tracking. Results The mean duration of HIV infection was 10±5 years, CD4 count was 579±286 cells/mm3, 32% had detectable viral load, and 86% were under treatment. Of the HIV-infected patients, one had grade 1 diastolic dysfunction. The groups were not different except for E wave (HIV 0.72±0.17 m/s vs. control 0.84±0.16 m/s, p=0.01), longitudinal strain (-19.5±1.9% vs. -21±2%, p=0.005), SRS (-1.1±0.28 s-1 vs. -1.3±0.28 s-1, p=0.02) and SRE (1.8±0.4 s-1 vs. 2.2±0.4 s-1, p<0.001), but only SRS (p=0.03, 95% CI 0.036; 0.67) and SRE (p=0.001, 95% CI -0.599; -0.168) had independent value. Conclusion In an HIV-infected population without established cardiovascular disease, myocardial deformation abnormalities can be detected with strain and strain rate, revealing markers of myocardial injury. © 2013 Sociedade Portuguesa de Cardiologia.

Baranchuk A.,Queens University | Femenia F.,Hospital Espanol | Lopez-Diez J.C.,Hospital Militar | Muratore C.,Hospital Fernandez | And 7 more authors.
Annals of Noninvasive Electrocardiology | Year: 2014

Background: Main causes of death in chronic Chagas' cardiomyopathy (CChC) are progressive congestive heart failure and sudden cardiac death. Implantable cardioverter defibrillators (ICD) have been proved an effective therapy to prevent sudden death in patients with CChC. Identification of predictors of sudden death remains a challenge. Objective: To determine whether surface fragmented ECG (fQRS) helps identifying patients with CChC and ICDs at higher risk of presenting appropriate ICD therapies. Methods: Multicenter retrospective study. All patients with CChC and ICDs were analyzed. Clinical demographics, surface ECG, and ICD therapies were collected. Results: A total of 98 patients were analyzed. Another four cases were excluded due to pacing dependency. Mean age was 55.5 ± 10.4 years, male gender 65%, heart failure New York Heart Association class I 47% and II 38%. Mean left ventricular ejection fraction (LVEF) 39.6 ± 11.8%. The indication for ICD was secondary prevention in 70% of patients. fQRS was found in 56 patients (59.6%). Location of fragmentation was inferior (57.1%), lateral (35.7%), and anterior (44.6%). Rsr pattern was the more prevalent (57.1%). Predictors of appropriate therapy in the multivariate model were: increased age (P = 0.01), secondary prevention indication (P = 0.01), ventricular pacing >50% of the time (P = 0.004), and LVEF <30% (P = 0.01). The presence of fQRS did not identify patients at higher risk of presenting appropriate therapies delivered by the ICD (P = 0.87); regardless of QRS interval duration. Conclusions: fQRS is highly prevalent among patients with CChC. It has been found a poor predictor of appropriate therapies delivered by the ICD in this population. ©2013 Wiley Periodicals, Inc.

Espinosa J.,Plastica Colombia | Valencia D.P.,Hospital Militar
Facial Plastic Surgery | Year: 2013

The neck has always been one of the most difficult areas to manage in rejuvenation surgery. Even patients with adequate results after a facelift may be dissatisfied because of the appearance of the neck. Moreover, not all neck problems are the same in all patients. Some cases only require fat removal to obtain good results, whereas others require complete neck- and facelift to achieve the desired results. This article offers a detailed step-by-step description of the approach to aesthetic pathologies of the neck, tailored to the needs of each individual patient. The article also includes a discussion of topics such as double chin liposuction, platysma plication, corset platysmaplasty, platysmal suspension to the mastoid, mentoplasty, and neck- and facelift. © 2013 by Thieme Medical Publishers, Inc.

Araya M.,University of Chile | Oyarzun A.,University of Chile | Lucero Y.,University of Chile | Espinosa N.,Hospital Militar | Perez-Bravo F.,University of Chile
Nutrients | Year: 2015

HLA-linked genes are relevant to celiac disease (CD); the potential genetic differences present worldwide are not fully understood. Previous results suggest that the distribution of HLA-DQ2/DQ7/DQ8 in Chile may differ from that in Europe and North America. In celiac patients and their first-degree relatives (FDRS), we assessed their clinical, serological and histological characteristics, determined HLA-DQ2, HLA-DQ7 and HLA-DQ8 alleles and genotypes, and evaluated the relations between them. A total of 222 individuals were assessed (56 cases, 166 FDRs). 16.9% of FDRs were tTG positive; 53.6% of them showed overweight/obesity and 3% undernourishment; they spontaneously declared being asymptomatic, but detailed questioning revealed that 60.7% experienced symptoms, which had not been investigated. DQ2 was present in 53.9% and 43.9.0% of cases and FDRs (p < 0.05). The most frequent genotype distribution was DQ2/DQ7 (fr 0.392 (cases) and 0.248 (FDRs), respectively, p < 0.02). The next most common genotypes were HLA-DQ2/DQ8 (fr 0.236 in FDRs and 0.176 in cases, p < 0.05). 3.92% cases were not HLA-DQ2/DQ8 carriers. Among tTG positive FDRs, 57.4%, 22.3% and 20.2% carried DQ2, DQ7 and DQ8, respectively. In cases, 72.7% of the biopsies classified Marsh ≥3 carried at least one DQ2; 91.7% of DQ2/DQ2 and 88.3% of DQ2/DQ7 were Marsh ≥3. Thus, DQ2 frequency is lower than reported; the higher frequency found for DQ8 and DQ7 concur with recent publications from Argentine and Brazil. These results suggest that although CD may manifest clinically in ways similar to those described in other populations, some genetic peculiarities in this region deserve further study. © 2015 by the authors; licensee MDPI, Basel, Switzerland.

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