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High body mass index (BMI) is associated with neurocognitive impairments that contribute to overeating and interfere with weight loss efforts. Overweight and obesity at midlife can accelerate neurodegenerative changes and increase the risk of late-life dementia. Noninvasive neuromodulation represents a novel, affordable and scalable approach to improve neurocognitive function in this context. The purpose of this proof-of-concept study was to examine whether transcranial direct current stimulation (tDCS) aimed at enhancing prefrontal cortex activity could enhance weight loss, in combination with a hypocaloric diet, and study underlying mechanisms. Overall, 38 women with BMI 25–35 kg/m2 underwent a 4 week randomized, double-blinded, sham-controlled, and parallel-design intervention, during which they received eight sessions of tDCS (n = 18 sham, n = 20 active) in combination with a diet (caloric goal of 20 kcal/kg/day). We evaluated longitudinal changes in body weight, appetite and food craving. In addition, we examined the contribution of cognitive-executive processes via food-modified computerized tasks. We found that the active group had more reduction in body weight than the sham group throughout the study (p = 0.020) and significant weekly weight loss. At 4 weeks, the active group lost 2.32% of initial body weight (sham: 1.29%). Components of subjective appetite and food craving showed a trend toward more reduction in the active group. These changes were paralleled by significant improvements in task performance in the active group, particularly in a dual task that required inhibitory control and working memory (p = 0.007–0.031). Improvement in inhibitory control performance predicted reduction in lack of control overeating, explaining 43.5% of its variance at the end of the study (p = 0.003). No significant adverse effects were observed. Our results provide proof-of-concept validation of prefrontal-targeted tDCS, combined with a diet, in midlife women with excess body weight, paving the way for larger studies evaluating clinical efficacy and long-term effects of this intervention.

Introduction Acquired immunodeficiency syndrome AIDS caused by infection caused by the human immunodeficiency virus HIV it is characterized by severe and progressive impairment of cellular immunity leading to opportunistic infections and neoplasms Objective Estimatethe frequency of ophthalmologic complications in a cluster of patients with HIV AIDS Method A descriptive and cross sectional study was conducted in patients with HIV AIDS in the municipality of Santiago de Cuba in order to estimate the frequency of the occurrence of ophthalmic complications according to selected variables a sample of patients was selected through a random sampling epidemiological and clinical variables were used as criteria expert Results The predominant sex was male and the age group most epidemiological connotation was that of years to There was a high frequency of ophthalmologic complications with patients representing with higher prevalence of retinopathy HIV with patients Conclusion AIDS remains a health problem estimated changes in their appearance in terms of age and sex with a higher number of men being non negligible way ophthalmologic complications especially those produced by microangiopathic vascular involvement

Background Neutrophils are able to trap and kill microbes via the release of their DNA decorated with proteins from granule and histones into the extracellular environment; however, this mechanism has also emerged as a potential source of auto-antigens and inflammation during the course of many autoimmune diseases. It has been demonstrated that neutrophils from patients with rheumatoid arthritis (RA) have a greater propensity to release neutrophil extracellular traps (NETs). DNAse I, an endonuclease involved in the breakdown of chromatin, has been implicated in the pathophysiology of autoimmune diseases. Aim of the work To investigate the genetic associations of a non-synonymous single nucleotide polymorphism (SNP) in DNAse I with the risk of RA and its influence on clinical and radiographic features in an Argentinean population. Patients and methods The Q222R A/G DNAse I SNP was studied in 210 RA patients and 206 matched healthy controls. Disease activity score, health assessment questionnaire and the modified Sharp van der Heijde score were assessed. Results The patients’ median age was 56 years (48–64), disease duration 128 months (20–205) and 86.7% were females. Genotype distribution and G-allele frequency were comparable between patients and control. There was no significant association of the Q222R A/G genotypes with disease susceptibility, activity, functional status or radiological score among RA Argentine patients. Conclusions No significant genetic association was found between the carriage of the DNAse I Q222R G-allele and the risk of RA nor was there any association with the disease activity, functional capacity or severity in an Argentine patient cohort.

The aim of this study was to analyze the influence of nucleotide transition (G/A) in position -2518 of the MCP-1 gene related to the susceptibility of developing RA. Two hundred twenty-three consecutive RA patients according to 2010 ACR/EULAR criteria were included; 120 healthy subjects were used as controls. MCP-1 -2518 A/G polymorphism (AG + GG) was present in 162 (72.6 %) RA patients and in 63 (52.5 %) healthy subjects [OR 2.44 (IC95% 1.53-3.88, p = 0.0002)]; associations for heterozygotes and homozygotes were OR 1.92 (IC95% 1.19-3.15, p = 0.001) and OR 5.19 (IC95% 2.34-11.51, p = 0.001), respectively. In Argentine patients, MCP-1 gene polymorphism confers susceptibility for developing RA.

Objectives: Trypanosoma cruzi reactivation in HIV patients is considered an opportunistic infection, usually with a fatal outcome. The aim of this study was to describe the epidemiological and clinical features of T. cruzi infection in HIV patients and to compare these findings between patients with and without Chagas disease reactivation. Methods: The medical records of T. cruzi–HIV co-infected patients treated at the Muñiz Infectious Diseases Hospital from January 2005 to December 2014 were reviewed retrospectively. Epidemiological and clinical features were assessed and compared between patients with and without Chagas disease reactivation. Results: The medical records of 80 T. cruzi–HIV co-infected patients were reviewed. The most likely route of T. cruzi infection was vector-borne (32/80 patients), followed by intravenous drug use (12/80). Nine of 80 patients had reactivation. Patients without reactivation had a significantly higher CD4 T-cell count at diagnosis of T. cruzi infection (144 cells/μl vs. 30 cells/μl, p = 0.026). Chagas disease serology was negative in two of nine patients with reactivation. Conclusions: Serological assays for T. cruzi infection may be negative in severely immunocompromised patients. Direct parasitological techniques should be performed in the diagnosis of patients for whom there is a suspicion of T. cruzi reactivation. HIV patients with a lower CD4 count are at higher risk of reactivation. Fil: Benchetrit, Andres Guillermo. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina Fil: Fernández, Marisa. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina Fil: Bava, Amadeo Javier. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina Fil: Corti, Marcelo. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina Fil: Porteiro, Norma. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina Fil: Martinez Peralta, Liliana A.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; Argentina

Objetivo: Evaluar calidad de vida, estado funcional, aspectos cognitivos y afectivos en pacientes mayores a 65 años con enfermedad renal crónica estadio 5 en terapia dialítica Pacientes, Materiales y Metodos: Pacientes de 65 años ó más con enfermedad renal cronica estadio 5 en terapia dialítica por mas de 90 dias (hemodialisis o dialisis peritoneal), sin demencia ni reciente hospitalizacion. En ellos se evaluo variables sociodemográficas y se aplico escalas geriátricas validadas para los siguientes aspectos: discapacidad, fragilidad, deterioro cognoscitivo, depresión, comorbilidad. También se aplicó el instrumento específico KDQOL 1.3 (versión validada en español latino de uso libre) para evaluar calidad de vida en paciente con enfermedad renal crónica en terapia dialítica. Analisis Estadistico: Estudio analítico de corte transversal, descriptivo determinando distribución de frecuencias, medidas de tendencia central, medidas de dispersión; en el análisis bivariado calidad de vida y estado funcional en relación con variables: sociodemográficas, afectivas, cognitivas, fragilidad y comorbilidad y posteriormente se realizó una regresión logística múltiple. Resultados: 90 pacientes cumplieron los criterios de inclusion, de los cuales 60 pertenecian al programa de hemodiálisis y 30 a diálisis peritoneal. La edad promedio en hemodiálisis 74.1±6.1 y en peritoneal 72.6±6.49, 55% hombres en hemodiálisis y 43.7% en diálisis peritoneal, tiempo promedio en hemodiálisis 74.2±56.8 meses, y en diálisis peritoneal 46.5±33.9 meses. 51% de pacientes en hemodiálisis tenían criterios de depresión moderada y 5% de depresión severa. Para el grupo de peritoneal 56% con depresion moderada, Se encontró fragilidad en un 68% para el grupo de hemodiálisis y 53.3% para el grupo de peritoneal. 56 % de pacientes del grupo de hemodiálisis eran completamente independientes y 40% en el grupo peritoneal. En cuanto a calidad de vida con el uso del KDQOL 1.3 los dominios con deterioro en la calidad de vida según los resultados emanados de este estudio fueron: carga de enfermedad renal crónica, síntomas de enfermedad renal, trabajo, función física y dolor. Los determinantes de mejor calidad de vida por dominios fueron: ser hombre, estar en diálisis peritoneal, tener buen nivel de independencia medido por la escala de Barthel y la edad (a menor edad mejor calidad de vida). Mientras que los determinantes de peor calidad de vida fueron: ser mujer, tener síntomas depresivos (según tamizaje con escala Yesavage) tener compromiso en el ABC físico con algún grado de dependencia física según el Barthel, pertenecer al grupo de hemodiálisis, y la edad (a mayor edad peor calidad de vida). Conclusiones: en general el estado funcional de este grupo de pacientes muestra un adecuado nivel de independencia, en cuanto a la calidad de vida se encuentra que los dominios mas afectados para el grupo analizado son dolor, funcion fisica, sintomas de enfermedad renal y carga de enfermedad renal, al igual que trabajo, los cuales se relacionan con algunos predictores intervenibles como, sintomas depresivos y tipo de dialisis, esto hace presumir que la intervencion de dichas variables tendrian implicaciones directas en la calidad de vida de este grupo poblacional.

This theme review describes aspects related to bilingualism and its incidence in higher education. Specifically, the author shows a brief overview of what bilingualism means; what the National Bilingual Program started in 2004 and its evolution into Colombia, very well for 2015 entail in terms of their impact on both teaching and learning; and the importance for the Ministry to modify certain aspects regarding bilingualism in education in our country.The paper also includes some studies and theories which support the author’s statements as well as the introduction of some current events at a private university in Sogamoso, Colombia, which are directly related to the matter of bilingualism. Finally, the author presents some conclusions from the present paper.

Background: Depressive disorders are common during pregnancy. There is compelling evidence that the inflammatory response system is important in the pathophysiology of depression. Higher concentrations of proinflammatory cytokines including tumor necrosis factor-alpha (TNF-α) in depressed subjects have been described. Because several polymorphisms in the TNF-α promoter region are known to affect its gene expression, the aim of this study was determine whether TNF-α - 857C/T, -308G/A, and -238G/A polymorphisms confer susceptibility to depression during pregnancy in a Mexican mestizo population. Methods: This case-control study involved 153 depressed pregnant women and 177 controls. Polymorphisms were genotyped using real-time PCR. Odds ratios (OR) and 95% confidence intervals adjusted by age, body mass index, number of pregnancies, months of pregnancy and number of abortions were used to estimate risk. Results: The -857CT genotype was found to increase the risk for depression (OR= 1.73, 95% CI= 1.06-2.82). In contrast, the -238GA genotype reduced the risk (OR= 0.33, 95% CI= 0.14-0.72). The - 308G/A polymorphism was not associated with risk for depression. Finally, the C857-G308-A238 haplotype was associated with a decreased risk of depression (OR= 0.35, 95% CI= 0.15-0.82). Conclusion: Our results show for the first time an association between TNF-α -857C/T and -238G/A polymorphisms and prenatal depression in Mexican mestizo population.

The brain microenvironment imposes a particularly intense selective pressure on metastasis-initiating cells, but successful metastases bypass this control through mechanisms that are poorly understood. Reactive astrocytes are key components of this microenvironment that confine brain metastasis without infiltrating the lesion. Here, we describe that brain metastatic cells induce and maintain the co-option of a pro-metastatic program driven by signal transducer and activator of transcription 3 (STAT3) in a subpopulation of reactive astrocytes surrounding metastatic lesions. These reactive astrocytes benefit metastatic cells by their modulatory effect on the innate and acquired immune system. In patients, active STAT3 in reactive astrocytes correlates with reduced survival from diagnosis of intracranial metastases. Blocking STAT3 signaling in reactive astrocytes reduces experimental brain metastasis from different primary tumor sources, even at advanced stages of colonization. We also show that a safe and orally bioavailable treatment that inhibits STAT3 exhibits significant antitumor effects in patients with advanced systemic disease that included brain metastasis. Responses to this therapy were notable in the central nervous system, where several complete responses were achieved. Given that brain metastasis causes substantial morbidity and mortality, our results identify a novel treatment for increasing survival in patients with secondary brain tumors. Reactive astrocytes expressing STAT3 support the metastatic growth of tumor cells colonizing the brain and can be pharmacologically targeted to improve the clinical management of patients with secondary brain tumors.

Background Very little is known about the link of T. gondii infection and depression. Through an age-, gender-, and month of pregnancy-matched case-control study, we determined the association of T. gondii infection and depression in pregnant women. Methods We studied 200 pregnant women with depression and 200 pregnant women without depression attended in a public hospital in Durango City, Mexico. Pregnant women were tested for the presence of anti-Toxoplasma IgG antibodies using an enzyme-linked immunoassay (EIA), and IgG seropositive women were further tested for the presence of IgM using an EIA. IgM positivity by EIA was further analyzed by enzyme-linked fluorescence assay (ELFA). Results Anti-T. gondii IgG antibodies were found in 9 (4.5%) of the 200 cases and in 12 (6.0%) of the 200 controls (OR = 0.73; 95% CI: 0.30–1.79; P = 0.50). The frequency of high (>150 IU/ml) anti-T. gondii IgG levels was similar in cases and in controls (OR = 1.20; 95% CI: 0.36–4.01; P = 0.75). Two women were positive for IgM by EIA but both were negative by ELFA. Conclusions We did not find serological evidence of an association between T. gondii infection and depression in pregnant women attended in a public hospital in Durango City, Mexico. Since an association of T. gondii and depression in pregnancy has been reported in the U.S. previously, further research to elucidate the role of T. gondii in prenatal depression should be conducted. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2292-1) contains supplementary material, which is available to authorized users.

In the version of this article originally published, the names of three authors were incorrect. The authors were listed as “Coral Fustero-Torres”, “Elena Pineiro” and “Melchor Sanchez-Martinez”. Their respective names are “Coral Fustero-Torre”, “Elena Pineiro-Yanez” and “Melchor Sanchez-Martinez”. The errors have been corrected in the print, HTML and PDF versions of this article.

The aim is to estimate HBV prevalence and the associated risks among noninjecting cocaine users (NICUs). In 2002-2003, a total of 824 NICUs from Buenos Aires (Argentina) and Montevideo (Uruguay) were interviewed using a structured questionnaire. Serologic tests were carried out for Human Immunodeficiency Virus (HIV), hepatitis B (HBV), syphilis, and others. The population was divided into two serologic groups: HBV-infected and seronegative group. Univariate and binary logistic model were developed. The results seem to indicate that, among NICUs, HBV is transmitted through sexual contact. Prevention measures, including vaccine, are needed in order to control and minimize risks. The study's limitations are noted.

Objective: To determine human immunodeficiency virus (HIV) seroprevalence in a sample of men who have sex with men (MSM) in Buenos Aires City and to identify risk factors associated with HIV type 1 infection. Methods: Participants were invited to receive HIV counselling and testing at ‘NEXO’ (a gay non-governmental organization) by means of informative leaflets distributed in gay nightclubs porno cinemas gymnasiums and in the streets. During the encounter the study was explained by a trained social worker and individuals were invited to volunteer for the study. Diagnosis of HIV was performed using two screening tests and Western Blot assay was used as confirmatory. Results: Human immunodeficiency virus was detected in 96 (13.8%; 95% CI: 11.4–16.7) of 694 MSM. Fourteen (14.6%) of the 96 HIV-positive MSM were already aware of their HIV serostatus. In univariate analysis HIV-1 infection (odds ratio [OR] >1.5) was found to be associated with older age (30–39 years) being unemployed a previous sexually transmitted disease (STD) history and having an HIV-positive partner. Cocaine consumption and irregular use of condoms with occasional partners were also found to be risk factors. In multivariate logistic regression analysis being unemployed (OR = 3.42; 95% CI: 1.17–9.99) and having an HIV-positive partner (OR = 2.67; 95% CI: 1.09–6.52) remained significant risk factors. Discussion: The high HIV-1 prevalence observed suggests an urgent need for implementation of effective prevention campaigns. This represents the first cross-sectional epidemiological study of HIV among the high-risk group of MSM in Argentina. (authors)

This study evaluated the success of a national program for the prevention of mother-to-child transmission (MTCT) of HIV-1 in 874 mother-infant pairs from Buenos Aires and surroundings. This population was referred to the National Reference Center for AIDS for diagnosis of neonatal infection during 1993-2000. The data revealed an increase in the use of antiretroviral therapy during pregnancy from 3.2% in 1993-1994 to 73.1% in 1999-2000 and in the use of cesarean delivery (reaching 54.8% in 1999-2000). However, the proportion of HIV-infected women who continued to breast-feed their children remained steady (around 12%). General improvement of the conditions for decreasing MTCT resulted in a significant decrease in the proportion of infected infants from 37.3% before 1995 to 10.7% in 1999-2000 and even 6.5% during 2001. Data on the time of diagnosis indicated that only 42.7% of the women knew about their HIV status before pregnancy, 44.8 knew during pregnancy, and 12.3% knew after the birth of their child. The main risk factor for HIV infection in the mothers was heterosexual contact (73%), and in the fathers, it was injection drug use (67%). These results point out the urgent need to develop additional strategies for prevention of MTCT of HIV-1 to generalize education, counseling, and testing of young women.

This study determined the risk behaviors and viral subtypes of HIV-1 found in 134 heterosexual HIV-seroprevalent maternity patients, 41 of their sexual partners (men who have sex with women [MSW]), and 95 homosexual men (men who have sex with men [MSM]) from Buenos Aires, Argentina. Peripheral blood mononuclear cells (PBMCs) were purified from blood and used for DNA extraction, amplification, and genotyping by the envelope heteroduplex mobility assay (env HMA). Most of the women had been infected by having sex with an already infected partner (84%), whereas most of the male partners had been infected via drug use (76%). Both the patients and their sexual partners were poorly educated, only 30% having completed secondary school. The MSM study subjects, however, were significantly better educated and had a lower prevalence of injecting drug use.Env HMA subtype F was found in 77% (103 of 134) of the maternity patients, with similar rates in their partners (73%). Most of the remaining samples were env subtype B. All but one of the couples was concordant in subtype. In the MSM risk group, however, only 10% were env HMA subtype F. Ninety percent of the MSM samples were subtype B. There are at least two independent epidemics of HIV-1 infection in Buenos Aires, Argentina. One, in heterosexual men and women, is dominated by env subtype F whereas the other, in homosexual men, is dominated by env subtype B, as determined by env HMA.

Aim A polymorphism in the tumor necrosis factor-alpha (TNF-α) promoter region has been associated with disease susceptibility and progression in rheumatoid arthritis (RA). The presence of an adenosine (TNF2 allele) instead of a guanine (TNF1 allele) at position −308 may be responsible for a general increase in the transcriptional activity of the TNF-α gene. Our aim was to evaluate the association of the TNF2 allele with the risk of disease development and/or progression of RA in an Argentine population cohort. Methods Two hundred and twenty-three consecutive patients with RA according to the 1987 criteria of the American College of Rheumatology were included in the study. Clinical variables, Disease Activity Score 28, Health Assessment Questionnaire and Rheumatoid Arthritis Quality of Life were recorded. The radiographic erosions were determined by the method of Sharp/van der Heijde. A group of 111 healthy subjects matched by sex and age was used as a control. All samples were genotyped for the −308 G/A TNF-α polymorphism. Results No significant differences were observed either in the frequency of the TNF2 allele or in the genotypic distributions of the −308 G/A TNF-α polymorphism (P > 0.05) between the control group and the RA patients. No association was found between the TNF2 allele and the variables related to the course and outcome of the disease (P > 0.05). Conclusion In this cohort of Argentinean patients with RA, the TNF2 allele was neither associated with susceptibility to the disease nor was it associated with the variables related to the course and outcome of the disease.

Background Genetic characterization of HIV-1 in Argentina has shown that BF recombinants predominate among heterosexuals and injecting drug users, while in men who have sex with men the most prevalent form is subtype B. Objectives The aim of this work was to investigate the presence of HIV dual infections in HIV-infected individuals with high probability of reinfection Study design Blood samples were collected from 23 HIV positive patients with the risk of reinfection from Buenos Aires. A fragment of the HIV gene pol was amplified and phylogenetic analyses were performed. Antiretroviral drug resistance patterns of all the sequences were analyzed. Results Five dual infections were detected with four patients coinfected with subtype B and BF recombinants and one patient was coinfected with two BF recombinants presenting different recombination patterns. Prolonged infection with a stable clinical condition was observed in the five individuals. Resistance mutation patterns were different between the predominant and the minority strains. Conclusions Our results show that HIV dual infection can occur with closely related subtypes, and even with different variants of the same recombinant form in certain populations. Clinical observations showed neither aggressive disease progression nor impact on the resistance patterns in the dually-infected patients.

Conclusion These results correlate with previous studies conducted among IDUs from New York city, Vietnam and Southern Europe where HTLV-IIb was more frequently found. In contrast, IIa is found among IDUs from other regions of the USA, Europe and Brazil. This is the first time in which subtype b is described in Argentina among IDUs. Its presence may be due to migrations of aborigines to big cities and the introduction of drugs in this population. Lately, there was also a high rate of migration and tourism to Argentina, especially from southern Europe and USA, possibly contributing to the spread of HTLV-IIb in our country. Interestingly, the IIa sample described here was found to be related with Brazilian aborigine sequences in contrast to the previous Argentinian IDU which was closer to African isolates. from 2006 International Meeting of The Institute of Human Virology Baltimore, USA. 17–21 November, 2006

Injection drug use is the main mechanism of human immunodeficiency virus (HIV) transmission in Argentina (40% of reported AIDS cases in Argentina). This study was conducted among street-recruited injection drug users (IDUs) from Buenos Aires, with the aim of estimating seroprevalence and coinfection of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and human T-lymphotropic viruses (HTLVs). A total of 174 volunteers participated in this study; 137 were men (78.7% of volunteers). The average age of the participants was 30 years. Only 64 of participants (37%) had no viral infection, whereas 110 (63%) were infected with > or =1 viruses. Seroprevalences were 44.3% for HIV, 54.6% for HCV, 42.5% for HBV, 2.3% for HTLV-I, and 14.5% for HTLV-II. Among the 77 HIV-infected persons, only 6.5% (5 persons) were not coinfected with other viruses; 88.3% (68) were coinfected with HCV and 68.8% (53) were coinfected with HBV. We demonstrated the existence of multiple viral infections with a high rate of prevalence in IDUs in Buenos Aires, Argentina.

Detection of anti-HIV-1 IgA antibodies using a modified ELISA test for the early diagnosis of perinatally acquired HIV-1 infection in children treated with protocol ACTG 076 was evaluated. A total of 177 sera were obtained from 141 infants between 1 and 12 months of age (46 were treated and 95 were non-treated with protocol ACTG 076) and tested for HIV IgA antibodies by an ELISA test after removal of IgG with recombinant protein G. Infants were classified according to CDC's classification system after a follow-up until 20 months of age. Of the 46 treated children 22 turned out to be infected and in the group of 95 untreated children, 52 were infected. All 81 samples from uninfected children treated or untreated with protocol ACTG 076 were persistently IgA-negative. HIV IgA antibodies were detected in 14 of 25 plasma samples from infected children with treatment, and in 58 of 71 samples in infected children without treatment. Considering that the sensitivity of this test is lower in children younger than 6 months the population of children studied was divided into two groups; those under and those over 6 months of age. No significant differences were observed in the detection of IgA in treated or untreated children in both age groups. The overall specificity of the test was 100 per cent; sensitivity in children older than 6 months was 76.92 per cent in treated children and 93.10 per cent in untreated children. In spite of the small number of samples studied it could be demonstrated that treatment with zidovudine does not affect the detection of IgA antibodies. This is a simple and inexpensive method that could be used for diagnosis of treated and untreated children in developing countries.

An endodontic treatment generates high expectations for the patient due to the popular belief treatment be uncomfortable, painful, stressful it takes several sessions to complete it. When the pulp is symptomatic, these expectations rise and the professional expects to finish and to remove all the symptoms to ensure the success of therapy. Endodontic exacerbations are complications than can be presented during endodontic treatment to form periapical inflammatory processes that occur at the end of treatment. Some factors influence the development of these complications such as pulp diagnosis, the presence of sinus tracts, extensive instrumentation, lack of instrumentation and irrigation, among others. This article describes the case of a premolar with an initial diagnosis of chronic suppurative apical periodontitis, endodontic retreatment under which introduced an error in the preparation by subinstrumentation to determine a working length that caused insufficient and inadequate cleaning apical injury. Un tratamiento endodóntico genera muchas expectativas en el paciente debido a la creencia popular de ser un tratamiento incómodo, doloroso y tensionante que demanda varias sesiones para su realización. Cuando el diagnóstico pulpar es sintomático, estas expectativas aumentan y lo más deseable para el profesional es que el tratamiento sea superado, es decir, eliminar toda la sintomatología para garantizar el éxito de la terapia. Las agudizaciones endodónticas son complicaciones que se presentan durante la realización un tratamiento endodóntico al formar procesos inflamatorios periapicales que se presentan al finalizar el tratamiento. Algunos factores influyen significativamente en el desarrollo de la exacerbación de una endodoncia como el diagnóstico pulpar, la presencia de tractos fistulosos, instrumentación extensiva, única cita y falta de instrumentación y de irrigación, entre otros. Este artículo describe el caso clínico de un premolar superior con un diagnóstico inicial de periodontitis apical crónica no supurativa, sometido a un retratamiento endodóntico, el cual presentó un error en la preparación por subinstrumentación al determinar una longitud de trabajo insuficiente que ocasionó una limpieza deficiente y una lesión apical.[Martínez CL, Rodríguez L, Díaz AJ. Exacerbación apical posterior a tratamiento endodóntico. Ustasalud 2012; 11: 130 - 134]

Recombinant human erythropoietin (RHuEPO) is an erythropoiesis stimulating agent (ESA) used to treat anemia in patients with total or relative erythropoietin deficit. In cancer patients, it is administered to optimize hemoglobin (Hb) levels, correct anemia and reduce the need for transfusions. Cuba produces a RHuEPO, registered in 1998 as iorEPOCIM, that is widely used in the national public health system, mainly to treat patients with anemia due to chronic kidney disease (CKD).Evaluate the efficacy and safety of iorEPOCIM in pediatric cancer patients with anemia following chemotherapy or radiotherapy. The working hypothesis posed an Hb increaseor=15 g/l in 70% of patients receiving iorEPOCIM for 8 weeks.A Phase IV, multicenter, open clinical trial was conducted. Participants were 157 patients aged 1-19 years with anemia and cyto-histological diagnosis of cancer in any location. Patients received either 600 U/kg iorEPOCIM intravenously, once weekly, or 150 U/kg iorEPOCIM subcutaneously, 3 times a week, for 8 weeks. All patients had blood tests every week to determine hemoglobin and hematocrit, and reticulocyte and platelet counts. Mean number of transfusions required by patients during the treatment period was compared to the mean number of transfusions received in the preceding 8 weeks. Adverse events (AE) were recorded at the 4th and 8th weeks and classified by intensity and causality.Hb levels roseor=15 g/l in 68.8% of patients, and transfusion requirements decreased 17%. The most frequent adverse events were fever (19.3%), vomiting (10.2%) and flu-like syndrome (9.6%). Intensity of AE was predominantly mild. Only 7 AE were classified as very probably related to the product and none of those was severe.iorEPOCIM proved to be safe and effective at the doses and frequencies used in this patient population. As a result, this medication was recommended for use in all pediatric oncology and hematology services in the country.

In this article we describe two lethal cases of MTCT of HIV and T.cruzi in the province of Buenos Aires, Argentina. Child 1 was admitted to the hospital being 1 month old with respiratory difficulty and diarrhoea. Being six months old he was released but being 22 months old he presented sepsis and died. The mother was not treated during pregnancy, while the child was treated with combined HAART and benznidazol. Child 2 was admitted to a provincial Hospital being 20 days old, and referred to the Children´s Hospital. After 39 days at the ICU the child died with sepsis. His mother received ZDV late in her pregnancy. The child received was treated with HAART, interrupted at 3 months due to severe organic failure. The lack of diagnosis of T. cruzi in both mothers worsened the prognosis of these two children, since treatment with antiparasitic drugs is used since birth. Fil: Agosti, Maria Rosa. Hospital de Niños Sor María Ludovica, la Plata; Argentina Fil: Ercoli, Pablo. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina Fil: Dolcini, Guillermina Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina Fil: Andreani, Guadalupe. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Centro Nacional de Referencia para el Sida; Argentina Fil: Martinez Peralta, Liliana A.. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología; Argentina Fil: Gonzalez Ayala, Silvia Elena. Hospital de Niños Sor María Ludovica, la Plata; Argentina