Acetic-acid guided visual inspection vs. cytology-based screening for cervical cancer in the Philippines

OBJECTIVES

To compare the validity and acceptability of acetic-acid visualization (VIA), magnified acetic-acid visualization (VIAM), spatula+cotton swab-Papanicolaou (Pap) smear (SS), and cervical brush-Pap smear (CB) in the detection of precursor/early cervical cancer lesions.

METHODS

A total of 12992 women aged between 25 and 65 years from 14 Philippine centers were randomly allocated to the four tests. The gold standard was colposcopy with biopsy for positive/suspicious cases.

RESULTS

Sensitivity rates [95% confidence intervals (CIs)] were 37 (CI, 26.8-48.5), 34.1 (CI, 24.8-44.8), 14.3 (CI, 6.4-27.8), and 19.1 (CI, 9.2-34.6) for VIA, VIAM, SS, and CB, respectively. Specificity rates were 90.7 (CI, 89.6-91.7), 90.7 (CI, 89-91.1), 97.5 (CI, 96.8-98), and 97.9 (CI, 97.3-98.4), respectively. Kappa for the Pap smear (PS) within centers ranged from -0.154 to 0.783, and between centers from -0.028 to 0.364. Screeners preferred CB; screened-women preferred VIA.

CONCLUSIONS

The acetic-acid visualization and VIAM methods are recommended for initial cervical cancer screening in the Philippines.

Reoperation for secondary hyperparathyroidism in chronic renal failure

From 1972 to 1987, 112 parathyroidectomy (PTX) operations were carried out in 105 haemodialysis or transplant patients by the same surgeon. Twelve had to be reoperated on (19 operations in all) for persistent (9 cases) or recurrent (3 cases) hyperparathyroidism. In six patients morphological tests (echography and technetium-thallium scintigraphy) contributed usefully by detecting parathyroid masses. Repeated surgery was finally effective in nine cases.

Regulating the dorsal neural tube expression of Ptf1a through a distal 3' enhancer

Generating the correct balance of inhibitory and excitatory neurons in a neural network is essential for normal functioning of a nervous system. The neural network in the dorsal spinal cord functions in somatosensation where it modulates and relays sensory information from the periphery. PTF1A is a key transcriptional regulator present in a specific subset of neural progenitor cells in the dorsal spinal cord, cerebellum and retina that functions to specify an inhibitory neuronal fate while suppressing excitatory neuronal fates. Thus, the regulation of Ptf1a expression is critical for determining mechanisms controlling neuronal diversity in these regions of the nervous system. Here we identify a sequence conserved, tissue-specific enhancer located 10.8kb 3' of the Ptf1a coding region that is sufficient to direct expression to dorsal neural tube progenitors that give rise to neurons in the dorsal spinal cord in chick and mouse. DNA binding motifs for Paired homeodomain (Pd-HD) and zinc finger (ZF) transcription factors are required for enhancer activity. Mutations in these sequences implicate the Pd-HD motif for activator function and the ZF motif for repressor function. Although no repressor transcription factor was identified, both PAX6 and SOX3 can increase enhancer activity in reporter assays. Thus, Ptf1a is regulated by active and repressive inputs integrated through multiple sequence elements within a highly conserved sequence downstream of the Ptf1a gene.

[Validity and reliability of the Spanish version of Yale-Brown obsessive-compulsive rating scale for children and adolescents]

INTRODUCTION

The Children Yale-Brown Obsessive- Compulsive Scale (CY-BOCS) constitutes a very good instrument for the evaluation of obsessive-compulsive disorder (OCD) symptoms, by a clinical interview administered to the patient and parent, that includes summary score of the clinician.

OBJECTIVE

We are proposing a Spanish version of instrument, which is rated during a brief clinical interview to the parents and the patients. We are presenting data reliability and validity using two out-patient samples.

METHODS

After the translation to Spanish, a back translation and adaptation to Spanish of the CY-BOCS, twenty eight out-patients (75 % male) with a mean age 12.1 (+/- 2.7) from two clinical settings on Mexico City evaluated. Reliability was evaluated by computing the internal consistency (Cronbach's alpha) on all interviews. assess interrater agreement, the interviews were videotaped and scored by three independent raters and all of them included both the child and the parent interview. The CY-BOCS total scored was correlated with the K-SADS-PL diagnosis.

RESULTS

The CY-BOCS total score for all subjects was 16.5 +/- 9.8. Cronbach's alpha coefficient was 0.87; Pearson correlation of total CY-BOCS score with the K-SADS-PL diagnosis was 0.60 (p < or = 0.05). The intraclass correlations coefficients for the parents, youngsters and clinician 0.96, 0.94 and 0.92, respectively.

CONCLUSIONS

The Spanish version of the CY-BOCS reliable and valid instrument, useful for both clinicians and researchers in child and adolescent OCD assessment.

Additional markers for the type I reactional states of borderline leprosy

The histological course of reaction in borderline leprosy has been described by Ridley and Radia. They are dermal edema, dilatation of the lymphatics, swelling of the granulomas, changes in the concentration and distribution of lymphocytes and giant cells, maturity of the histiocytes, and presence of neutrophils. New markers for the condition are spongiosis of the epidermal and follicular epithelium with exocytosis of mononuclear cells, parakeratosis, focal interface changes with occasional individual cell necrosis of keratinocytes, and lastly, follicular mucinosis. Recognition of this reaction is vital in the prevention of deformities secondary to nerve damage.

Gene editing-based targeted integration for correction of Wiskott-Aldrich syndrome

Wiskott-Aldrich syndrome (WAS) is a severe X-linked primary immunodeficiency resulting from a diversity of mutations distributed across all 12 exons of the WAS gene. WAS encodes a hematopoietic-specific and developmentally regulated cytoplasmic protein (WASp). The objective of this study was to develop a gene correction strategy potentially applicable to most WAS patients by employing nuclease-mediated, site-specific integration of a corrective WAS gene sequence into the endogenous WAS chromosomal locus. In this study, we demonstrate the ability to target the integration of WAS2-12-containing constructs into intron 1 of the endogenous WAS gene of primary CD34+ hematopoietic stem and progenitor cells (HSPCs), as well as WASp-deficient B cell lines and WASp-deficient primary T cells. This intron 1 targeted integration (TI) approach proved to be quite efficient and restored WASp expression in treated cells. Furthermore, TI restored WASp-dependent function to WAS patient T cells. Edited CD34+ HSPCs exhibited the capacity for multipotent differentiation to various hematopoietic lineages in vitro and in transplanted immunodeficient mice. This methodology offers a potential editing approach for treatment of WAS using patient's CD34+ cells.

[Nutritional planning of menus of public schools of the community of Madrid]

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates.

[Cardiovascular risk factors in an Arab and Hispanic working population]

318 records of male workers, 169 Spanish and 149 Arab were retrospectively studied in 1987 at the "Gabinete de Seguridad e Higiene en el Trabajo" (Council for Safety and Hygiene in the Workplace) in Ceuta in order to prove the hypothesis that 2 different ethnic groups living in the same geographic area have a non-equal distribution of cardiovascular risk factors. The Spanish group showed a higher prevalence in blood hypertension, diabetes, glucose intolerance, obesity and alcohol intake, compared to the Arab group. Smoking and high levels of seric cholesterol were similar in both groups, however, medium levels of seric cholesterol were lower in the Arab group. Family histories of cardiovascular disease were very rare in the latter mentioned group. These observations suggested a major predisposition to ischemic cardiopathy in the Spanish group.