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Background: Epstein-Barr virus (EBV) causes endemic Burkitt lymphoma (eBL). EBV control was improved by magnesium (Mg 2+ ) supplementation in XMEN, an X-linked genetic disease associated with Mg 2+ deficiency, high circulating EBV levels (viral loads), and EBV-related lymphomas. We, therefore, investigated the relationship between Mg 2+ levels and EBV levels and eBL in Uganda., Methods: Plasma Mg 2+ was measured in 45 women with low or high circulating EBV levels, 40 pediatric eBL cases, and 79 healthy children. Mg 2+ uptake by T-lymphocytes was evaluated in samples from healthy donors., Results: Plasma Mg 2+ deficiency (plasma level <1.8 mg/dl) was more likely in women with high- vs. low-EBV levels (76.0% vs. 35%; odds ratio [OR] 11.3, 95% CI 2.14-60.2), controlling for age, and in eBL cases than controls (42.0% vs. 13.9%; OR 3.61, 95% CI 1.32-9.88), controlling for sex, age group, and malaria status. Mg 2+ uptake by T-lymphocytes was related to extracellular Mg 2+ concentration., Interpretation: Plasma Mg 2+ deficiency is associated with high EBV levels and eBL., (Published by Elsevier Ltd.)

This paper introduces a new approach for upper limb neurorehabilitation based on customized devices for monitoring and interacting with virtual environments. A proof-of-concept test involving eight patients at the Guttmann Neurorehabilitation Hospital shows patient's good acceptance and usability scores and demonstrates the technically feasibility of the devices. The final goal is to achieve a more personalized, monitored, intensive and ecological rehabilitation procedures for ABI patients.

Purpose: Combined immunodeficiency (CID) presents a unique challenge to clinicians. Two patients presented with the prior clinical diagnosis of common variable immunodeficiency (CVID) disorder marked by an early age of presentation, opportunistic infections, and persistent lymphopenia. Due to the presence of atypical clinical features, next generation sequencing was applied documenting RAG deficiency in both patients., Methods: Two different genetic analysis techniques were applied in these patients including whole exome sequencing in one patient and the use of a gene panel designed to target genes known to cause primary immunodeficiency disorders (PIDD) in a second patient. Sanger dideoxy sequencing was used to confirm RAG1 mutations in both patients., Results: Two young adults with a history of recurrent bacterial sinopulmonary infections, viral infections, and autoimmune disease as well as progressive hypogammaglobulinemia, abnormal antibody responses, lymphopenia and a prior diagnosis of CVID disorder were evaluated. Compound heterozygous mutations in RAG1 (1) c256&#95;257delAA, p86VfsX32 and (2) c1835A>G, pH612R were documented in one patient. Compound heterozygous mutations in RAG1 (1) c.1566G>T, p.W522C and (2) c.2689C>T, p. R897X) were documented in a second patient post-mortem following a fatal opportunistic infection., Conclusion: Astute clinical judgment in the evaluation of patients with PIDD is necessary. Atypical clinical findings such as early onset, granulomatous disease, or opportunistic infections should support the consideration of atypical forms of late onset CID secondary to RAG deficiency. Next generation sequencing approaches provide powerful tools in the investigation of these patients and may expedite definitive treatments.

Purpose of Review: To describe the role of the magnesium transporter 1 (MAGT1) in the pathogenesis of 'X-linked immunodeficiency with magnesium defect, Epstein-Barr virus (EBV) infection, and neoplasia' (XMEN) disease and its clinical implications., Recent Findings: The magnesium transporter protein MAGT1 participates in the intracellular magnesium ion (Mg) homeostasis and facilitates a transient Mg influx induced by the activation of the T-cell receptor. Loss-of-function mutations in MAGT1 cause an immunodeficiency named 'XMEN syndrome', characterized by CD4 lymphopenia, chronic EBV infection, and EBV-related lymphoproliferative disorders. Patients with XMEN disease have impaired T-cell activation and decreased cytolytic function of natural killer (NK) and CD8 T cells because of decreased expression of the NK stimulatory receptor 'natural-killer group 2, member D' (NKG2D). Patients may have defective specific antibody responses secondary to T cell dysfunction, but B cells have not been shown to be directly affected by mutations in MAGT1., Summary: XMEN disease has revealed a novel role for free intracellular magnesium in the immune system. Further understanding of the MAGT1 signaling pathway may lead to new diagnostic and therapeutic approaches.

Objective: to build, validate and apply a test that explores and evaluates the clinical aptitudes of Gynecology and Obstetrics (Ob/Gyn) residents., Material and Methods: the test included five actual clinical cases representing the main obstetric conditions associated with obstetric bleeding. The validation process included rounds with experts and the final version of the test included 100 items in which the answers had the options "true." "false " and "don't know." A pilot study and the 21 Kuder-Richardson formula served to increase the consistency of the test. Then, 33 Ob/Gyn residents (8 of 2nd year; 14 of 3rd year and 11 of 4th year) answered the test., Results: According to the 21 Kuder-Richardson formula the consistency of the test was 0.80; regarding the clinical aptitudes, 18 % of residents scored in the middle level, 66 % in the low level and 15 % in the very low level. No resident scored in the high or very high levels or by chance answers level. The Kruskal-Wallis test did not show statistically significant differences among the three groups and with the U test of Mann-Whitney no differences between groups were observed after comparing 2nd year versus 3rd year; 3rd year versus 4th year, and 2nd year versus 4th year residents., Conclusions: The years of residence did not show differences to developing clinical aptitudes. Most of the residents were located in the low level of these clinical aptitudes. This study underlined the need to reconsider our educative processes in a qualitative different manner.