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Von Willebrand disease is an inherited disorder characterized by deficiency of von Willebrand factor, which contributes to platelet adhesion to the endothelium. Patients with coagulation disorders present a challenge at the time of surgery due to the high risk of presenting heavy bleeding within the procedure or postoperative hematomas. We present a case of a 56-year-old woman with Type 1 von Willebrand's disease who was scheduled for breast explantation with autologous reconstruction, due to the presence of long-standing breast implants. The case was satisfactorily managed by a multidisciplinary team formed by plastic surgery, hematology, and anesthesiology, individualizing the management for the patient's case, obtaining good results and a safe procedure.
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Pseudomonas aeruginosa (PA) is an important opportunistic pathogen that causes different infections on immunocompromised patients. Within PA accessory genome, differences in virulence, antibiotic resistance and biofilm formation have been described between strains, leading to the emergence of multidrug-resistant strains. The genome sequences of 17 strains isolated from patients with healthcare-associated infections in a Mexican hospital were genomically and phylogenetically analyzed and antibiotic resistance genes, virulence genes, and biofilm formation genes were detected. Fifteen of the 17 strains were resistant to at least two of the carbapenems meropenem, imipenem, and the monobactam aztreonam. The antibiotic resistance (mexA, mexB, and oprM) and the biofilm formation (pslA and pslD) genes were detected in all strains. Differences were found between strains in accessory genome size. The strains had different sequence types, and seven strains had sequence types associated with global high risk epidemic PA clones. All strains were represented in two groups among PA global strains. In the 17 strains, horizontally acquired resistance genes to aminoglycosides and beta-lactams were found, mainly, and between 230 and 240 genes that encode virulence factors. The strains under study were variable in terms of their accessory genome, antibiotic resistance, and virulence genes. With these characteristics, we provide information about the genomic diversity of clinically relevant PA strains.
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Carbapenémicos , Infecciones por Pseudomonas , Humanos , Aztreonam , Pseudomonas aeruginosa/genética , Antibacterianos , Hospitales , Genómica , Atención a la Salud , Pruebas de Sensibilidad MicrobianaRESUMEN
This is a case report of a young adult who died of COVID-19 twelve days after admission, with coronavirus nucleocapsid protein and lipofuscin found in the heart and kidney tissues, providing further evidence of the role of SARS-CoV-2 in cellular senescence.
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Pseudomonas aeruginosa (PA) is considered the first causal agent of morbidity and mortality in people with cystic fibrosis (CF) disease. Multi-resistant strains have emerged due to prolonged treatment with specific antibiotics, so new alternatives have been sought for their control. In this context, there is a renewed interest in therapies based on bacteriophages (phages) supported by several studies suggesting that therapy based on lytic phages and biofilm degraders may be promising for the treatment of lung infections in CF patients. However, there is little clinical data about phage studies in CF and the effectiveness and safety in patients with this disease has not been clear. Therefore, studies regarding on phage characterization, selection, and evaluation in vitro and in vivo models will provide reliable information for designing effective cocktails, either using mixed phages or in combination with antibiotics, making a great progress in clinical research. Hence, this review focuses on the most relevant and recent findings on the activity of lytic phages against PA strains isolated from CF patients and hospital environments, and discusses perspectives on the use of phage therapy on the treatment of PA in CF patients.
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Bacteriófagos , Fibrosis Quística , Infecciones por Pseudomonas , Fagos Pseudomonas , Humanos , Pseudomonas aeruginosa , AntibacterianosRESUMEN
BACKGROUND: Heart failure (HF) is a deeply serious clinical problem that remains unsolved. Many reports highlight the cardioprotective properties of mesenchymal stem cells (MSCs), the factors contained in their secretome being particularly important for this function; these include the exosomal miRNAs (exo-miRNAs) secreted with or without stimulus which can modulate various biological processes. In search of new paradigms in heart failure, we wondered whether MSC-derived exosomal microRNAs could play a role in the management of clinical patients. METHODS: To analyze whether there is sufficient evidence to support this hypothesis we designed a systematic review of studies on exo-miRNAs in heart diseases causing HF during the last decade. RESULTS: The cardioprotective functions of twenty-four exo-miRNAs derived from bone marrow MSCs (BM-MSCs) are known and the functions of exo-miRNAs from other MSC sources such as adipose tissue, trophoblasts, amniotic fluid, and endometrium were also determined. Inhibition of apoptosis is the most reported biological function and the targets for thirty exo-miRNAs are known. CONCLUSIONS: The results from this systematic review support the initial hypothesis and encourage us to test it in future experimental research works but more importantly, we seek to encourage other researchers in the field to propose other hypotheses aimed at the possible use of exo-miRNAs in HF secondary to cardiac disease.
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BACKGROUND: Heart failure (HF) is a deeply serious clinical problem that remains unsolved. Many reports highlight the cardioprotective properties of mesenchymal stem cells (MSCs), the factors contained in their secretome being particularly important for this function; these include the exosomal miRNAs (exo-miRNAs) secreted with or without stimulus which can modulate various biological processes. In search of new paradigms in heart failure, we wondered whether MSC-derived exosomal microRNAs could play a role in the management of clinical patients. METHODS: To analyze whether there is sufficient evidence to support this hypothesis we designed a systematic review of studies on exo-miRNAs in heart diseases causing HF during the last decade. RESULTS: The cardioprotective functions of twenty-four exo-miRNAs derived from bone marrow MSCs (BM-MSCs) are known and the functions of exo-miRNAs from other MSC sources such as adipose tissue, trophoblasts, amniotic fluid, and endometrium were also determined. Inhibition of apoptosis is the most reported biological function and the targets for thirty exo-miRNAs are known. CONCLUSIONS: The results from this systematic review support the initial hypothesis and encourage us to test it in future experimental research works but more importantly, we seek to encourage other researchers in the field to propose other hypotheses aimed at the possible use of exo-miRNAs in HF secondary to cardiac disease.
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Exosomas , Insuficiencia Cardíaca , Células Madre Mesenquimatosas , MicroARNs , Apoptosis , Exosomas/genética , Femenino , Insuficiencia Cardíaca/genética , Insuficiencia Cardíaca/terapia , Humanos , MicroARNs/genéticaRESUMEN
To date, mother-to-fetus transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) pandemic, remains controversial. Although placental COVID-19 infection has been documented in some cases during the second- and third-trimesters, no reports are available for the first trimester of pregnancy, and no SARS-CoV-2 protein has been found in fetal tissues. We studied the placenta and fetal organs from an early pregnancy miscarriage in a COVID-19 maternal infection by immunohistochemical, reverse transcription quantitative real-time polymerase chain reaction, immunofluorescence, and electron microscopy methods. SARS-CoV-2 nucleocapsid protein, viral RNA, and particles consistent with coronavirus were found in the placenta and fetal tissues, accompanied by RNA replication revealed by double-stranded RNA (dsRNA) positive immunostain. Prominent damage of the placenta and fetal organs were associated with a hyperinflammatory process identified by histological examination and immunohistochemistry. The findings provided in this study document that congenital SARS-CoV-2 infection is possible during the first trimester of pregnancy and that fetal organs, such as lung and kidney, are targets for coronavirus. The infection and multi-organic fetal inflammation produced by SARS-CoV-2 during early pregnancy should alert clinicians in the assessment and management of pregnant women for possible fetal consequences and adverse perinatal outcomes.
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COVID-19/transmisión , Transmisión Vertical de Enfermedad Infecciosa , Placenta/virología , Complicaciones Infecciosas del Embarazo/virología , SARS-CoV-2/metabolismo , Aborto Espontáneo/virología , Adulto , COVID-19/patología , Femenino , Feto/patología , Feto/virología , Humanos , Placenta/patología , Embarazo , Resultado del Embarazo , Primer Trimestre del Embarazo , Mujeres Embarazadas , ARN Viral/análisisRESUMEN
Dengue virus (DENV) is an important flavivirus that is transmitted to humans by Aedes mosquitoes, where it can establish a persistent infection underlying vertical and horizontal transmission. However, the exact mechanism of persistent DENV infection is not well understood. Recently miR-927 was found to be upregulated in C6/36-HT cells at 57 weeks of persistent infection (C6-L57), suggesting its participation during this type of infection. The aim of this study was to determine the role of miR-927 during infection with DENV type 2. The results indicate an overexpression of miR-927 in C6-L57 cells and acutely infected cells according to the time of infection and the m.o.i. used. The downregulation of miR-927 in C6-L57 cells results in a reduction of both viral titre and viral genome copy number. The overexpression of miR-927 in C6-L40 and C6/36 cells infected at an m.o.i. of 0.1 causes an increase in both viral titre and viral genome copy number, suggesting a pro-viral activity of miR-927. In silico prediction analysis reveals target mRNAs for miR-927 are implicated in post-translational modifications (SUMO), translation factors (eIF-2B), the innate immune system (NKIRAS), exocytosis (EXOC-2), endocytosis (APM1) and the cytoskeleton (FLN). The expression levels of FLN were the most affected by both miR-927 overexpression and inhibition, and FLN was determined to be a direct target of miR-927 by a dual-luciferase gene reporter assay. FLN has been associated with the regulation of the Toll pathway and either overexpression or downregulation of miR-927 resulted in expression changes of antimicrobial peptides (Cecropins A and G, and Defensin D) involved in the Toll pathway response.
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Aedes/genética , Aedes/virología , Virus del Dengue/genética , Dengue/virología , MicroARNs/genética , Animales , Línea Celular , Enfermedades Transmisibles/genética , Enfermedades Transmisibles/virología , Genoma Viral/genética , Luciferasas/genética , Replicación Viral/genéticaRESUMEN
We characterized natural vertical transmission of Zika virus in pools of Aedes aegypti larvae hatched from eggs collected in Jojutla, Morelos, Mexico. Of the 151 pools analyzed, 17 tested positive for Zika virus RNA; infectious Zika virus was successfully isolated from 1 of the larvae pools (31N) in C6/36 cells. Real-time quantitative PCR and indirect immunofluorescence assays confirmed the identity of the isolate, named Zika virus isolate 31N; plaque assays in Vero cells demonstrated the isolate's infectivity in a mammalian cell line. We obtained the complete genome of Zika virus isolate 31N by next-generation sequencing and identified 3 single-nucleotide variants specific to Zika virus isolate 31N using the meta-CATS tool. These results demonstrate the occurrence of natural vertical transmission of Zika virus in wild Ae. aegypti mosquitoes and suggest that this transmission mode could aid in the spread and maintenance of Zika virus in nature.
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Aedes/virología , Mosquitos Vectores/virología , Virus Zika/fisiología , Animales , Línea Celular , Células Cultivadas , Chlorocebus aethiops , Microbiología Ambiental , Genoma Viral , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Larva , México/epidemiología , Filogenia , Vigilancia en Salud Pública , Células Vero , Carga Viral , Ensayo de Placa Viral , Secuenciación Completa del Genoma , Virus Zika/clasificación , Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virologíaRESUMEN
Dengue virus is the most prevalent arbovirus in Mexico, and although the diversity of this virus has been studied, the vast majority of sequences have been derived from viruses isolated from the human host. In this work, we aimed to sequence and to analyze DENVs derived from wild mosquitoes captured in Acapulco Guerrero, Mexico. We succeeded in determining three full genome sequences of such viruses and were able to compare them with other reported sequences from human and mosquito-derived DENVs. We found 15 nonsynonymous and 88 synonymous substitutions that were present more frequently in mosquito viruses than what would be expected by chance, although the limited number of genomes reported so far puts a constraint on the conclusions that can be derived from these analyses. Also, given the high depth of coverage attained in one of the genomes a variant analysis was carried out, finding 68 polymorphic sites in this genome. Interestingly, six of them corresponded to SNV that were detected as potentially differential between mosquitoes and humans, indicating that a that at least some positions may be maintained as polymorphic, which may facilitate host transmission.
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Aedes/virología , Virus del Dengue/genética , Dengue/transmisión , Mosquitos Vectores/virología , Animales , Genoma Viral/genética , Técnicas de Genotipaje , Humanos , México , Filogenia , Polimorfismo Genético , Secuenciación Completa del GenomaRESUMEN
BACKGROUND: The widespread use and development of smartphones and mHealth apps has the potential to overcome communication deficiencies in health care. OBJECTIVE: To carry out a literature review of studies that evaluate patients' experience on the use of perioperative mHealth apps. METHODS: An up-to-date systematic review on studies assessing patients' use of mHealth apps for communicating with the health care team in the perioperative period was performed following the PRISMA statement. RESULTS: Ten studies (in 11 articles) were identified: 8 feasibility studies and 2 randomized controlled trials. Nine studies included apps used for postoperative monitoring while 1 study also provided preoperative guidance. DISCUSSION: An analysis of barriers and motivations of patients and health care professionals to the use of perioperative mHealth apps was performed. Barriers included patients' lack of confidence when using apps and potential lack of time from health care professionals to monitor information submitted by patients. Motivations included patients' sense of being looked after and potential cost-effectiveness and increased efficiency of health care services. This analysis led to the concept of the "ideal app" that would need to be developed following adequate protocols and security standards. Features of the ideal app include preoperative advice on medications and investigations, information on surgery, and a remote follow-up tool to improve safety and to minimize unnecessary clinic appointments and associated costs. CONCLUSION: There is an overall positive impression of the use of perioperative mHealth apps. However, further studies are required to assess the impact that they have on patients' care and healthcare professional services.
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Comunicación en Salud/métodos , Aplicaciones Móviles , Teléfono Inteligente , Cirujanos , Telemedicina , Humanos , Relaciones Médico-Paciente , Telemedicina/instrumentación , Telemedicina/métodosRESUMEN
BACKGROUND: During pregnancy, the Zika virus (ZIKV) replicates in the placenta and central nervous system (CNS) of infected fetuses; nevertheless, the ability of ZIKV to replicate in other fetal tissues has not been extensively characterized. METHODS: We researched whether dissemination of congenitally-acquired ZIKV outside the CNS exists by searching for the accumulation of the viral envelope protein, ZIKV ribonucleic acid (RNA), and infectious viral particles in different organs of a deceased newborn with Congenital Zika Syndrome. A real-time qualitative polymerase chain reaction (qPCR) was used to detect ZIKV RNA in the brain, thymus, lungs, kidneys, adrenal glands, spleen, liver, and small intestine. The same tissues were analyzed by indirect immunofluorescence and immunoperoxidase assays using the monoclonal antibody 4G2 to detect ZIKV envelope antigens. Isolation of infectious ZIKV in a cell culture was carried out using brain and kidney samples. RESULTS: A postmortem, virological analysis of multiple organs, such as the kidneys (epithelial cells in the renal tubules), lungs (bronchial epithelia), thymus (epithelial cells inside the Hassall's corpuscles), and brain (neurons, ependymal cells, and macrophages) revealed the presence of ZIKV RNA and envelope antigens. Other tissues of the deceased newborn tested positive by qPCR for Epstein-Barr virus and human herpesvirus 6, including the brain cortex (Epstein-Barr) and the thymus, kidneys, and adrenal glands (human herpesvirus 6). The kidneys were identified as a significant niche for viral replication, given that infectious particles were successfully isolated from renal tissues. CONCLUSIONS: Our findings demonstrate the ability of congenitally-acquired ZIKV to produce disseminated infections and the viral tropism towards epithelial cells.
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Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/virología , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/virología , Virus Zika/genética , Antígenos Virales , Autopsia , Biopsia , Coinfección , Femenino , Humanos , Recién Nacido , Recien Nacido Prematuro , Transmisión Vertical de Enfermedad Infecciosa , Enfermedades Renales/patología , Enfermedades Renales/virología , México/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Vigilancia en Salud Pública , ARN Viral , Adulto Joven , Virus Zika/inmunología , Virus Zika/ultraestructura , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/transmisiónRESUMEN
The role of Ca2+ during dengue virus (DENV) replication is unknown; thus, changes in Ca2+ homeostasis in DENV infected human hepatic HepG2 and Huh-7 cells were analyzed. Infected HepG2 cells, but not Huh-7 cells, showed a significant increase in plasma membrane permeability to Ca2+, while both cell lines showed marked reduced levels of Ca2+ stored in the endoplasmic reticulum. While the expression levels of STIM1 and ORAI1 showed no changes, STIM1 and ORAI1 were shown to co-localized in infected cells, indicating activation of the store-operated Ca2+ entry (SOCE) pathway. Finally, manipulation in the infected cells of the intra and extracellular Ca2+ levels by chelators (BAPTA-AM and EGTA), SOC inhibitor (SKF96365), IP3 Receptor antagonist (2APB) or increase of extracellular [Ca2+], significantly reduced DENV yield, but not vesicular stomatitis virus yield, used as a control. These results show that DENV infection alters cell Ca2+ homeostasis and that such changes favor viral replication.
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Quelantes del Calcio/farmacología , Calcio/metabolismo , Virus del Dengue/efectos de los fármacos , Homeostasis/efectos de los fármacos , Interacciones Huésped-Patógeno , Replicación Viral/efectos de los fármacos , Animales , Compuestos de Boro/farmacología , Bloqueadores de los Canales de Calcio/farmacología , Línea Celular Tumoral , Membrana Celular/efectos de los fármacos , Membrana Celular/metabolismo , Membrana Celular/ultraestructura , Membrana Celular/virología , Permeabilidad de la Membrana Celular , Chlorocebus aethiops , Virus del Dengue/fisiología , Ácido Egtácico/análogos & derivados , Ácido Egtácico/farmacología , Retículo Endoplásmico/efectos de los fármacos , Retículo Endoplásmico/metabolismo , Retículo Endoplásmico/ultraestructura , Retículo Endoplásmico/virología , Expresión Génica , Células Hep G2 , Humanos , Imidazoles/farmacología , Receptores de Inositol 1,4,5-Trifosfato/antagonistas & inhibidores , Receptores de Inositol 1,4,5-Trifosfato/genética , Receptores de Inositol 1,4,5-Trifosfato/metabolismo , Transporte Iónico , Proteínas de Neoplasias/antagonistas & inhibidores , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Proteína ORAI1/antagonistas & inhibidores , Proteína ORAI1/genética , Proteína ORAI1/metabolismo , Molécula de Interacción Estromal 1/antagonistas & inhibidores , Molécula de Interacción Estromal 1/genética , Molécula de Interacción Estromal 1/metabolismo , Células Vero , Virus de la Estomatitis Vesicular Indiana/efectos de los fármacos , Virus de la Estomatitis Vesicular Indiana/fisiología , Replicación Viral/genéticaRESUMEN
Tissue expansion reconstruction in clinical practice has existed for over half a century. The technique was initially used for breast reconstruction but later found its use in reconstruction of excisional defects resulting from a variety of causes including surgery for post-burn/post-traumatic deformities, congenital giant naevi, skin cancer, etc. It offers an improved matching of skin colour and texture, and avoids the high infrastructure requirements of microsurgery for free flap transfers. We present a systematic literature review of 35 worldwide English language articles with representative cases of paediatric tissue expansion reconstruction of burn injuries of the head and neck. The review identified 68 children of an average age of 11.3 years. The most common burn aetiology was flame burn injury. The average area to be reconstructed was of 206 cm2 and patients went through expansion processes for an average of 99.7 days. Three articles included cases in which patients had more than one expansion session. Supportive techniques provide examples of developments in the area of tissue expansion reconstruction such as self-inflating expanders and endoscopic approaches. Further studies focussing on particular indications, age groups and anatomical locations of tissues to be expanded are required in order to improve the understanding of this technique's limitations and continue its development.
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Zika virus (ZIKV) is an emerging arthropod-borne flavivirus associated with severe congenital malformations and neurological complications. Although the ZIKV genome is well characterized, there is limited information regarding changes after cell isolation and culture adaptation. We isolated, and passaged in Vero cells, ZIKV from the serum of a symptomatic male patient and compared the viral genomes before and after culture. Single nucleotide polymorphisms were characteristic among serum-circulating genomes, while such diversity decreased after cell culture.
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Dengue virus (DENV) is the most important arbovirus in the world; DENV is transmitted by the Aedes genus of mosquitoes and can establish a life-long persistent infection in mosquitoes. However, the exact mechanism by which persistent infection is established remains unknown. In this study the differential expression of miRNAs was analysed by deep sequencing and RT-qPCR using a previously established C6/36-HT cell line persistently infected with DENV 2 (C6-L) as a model. miR-927, miR-87, miR-210, miR-2a-3p, miR-190 and miR-970 were up-regulated, whereas miR-252, miR-263a-3p, miR-92b, miR-10-5p miR-9a-5p, miR-9a-1, miR-124, miR-286a and miR-286b were down-regulated in C6-L cells compared with C6/36 cells acutely infected with the same virus or mock-infected cells. Deep sequencing results were validated by RT-qPCR for the highly differentially expressed miR-927 and miR-9a-5p, which were up- and down-regulated, respectively, compared with both acutely and mock-infected C6/36 cells. The putative targets of these miRNAs include components of the ubiquitin conjugation pathway, vesicle-mediated transport, autophagy, and the JAK-STAT cascade as well as proteins with endopeptidase activity. Other putative targets include members of the Toll signalling pathway and proteins with kinase, ATPase, protease, scavenger receptor or Lectin C-type activity or that participate in fatty acid biosynthesis or oxidative stress. Our results suggest that several specific miRNAs help regulate the cellular functions that maintain equilibrium between viral replication and the antiviral response during persistent infection of mosquito cells. This study is the first report of a global miRNA profile in a mosquito cell line persistently infected with DENV.
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Aedes/virología , Virus del Dengue/genética , Dengue/transmisión , Genoma Viral , MicroARNs/genética , Proteínas Virales/genética , Aedes/citología , Animales , Línea Celular , Dengue/virología , Regulación de la Expresión Génica , Ontología de Genes , Heterogeneidad Genética , Secuenciación de Nucleótidos de Alto Rendimiento , Interacciones Huésped-Patógeno , Humanos , Redes y Vías Metabólicas/genética , MicroARNs/metabolismo , Anotación de Secuencia Molecular , Transducción de Señal , Proteínas Virales/metabolismo , Replicación ViralRESUMEN
The human virome is composed by the set of all viruses, eukaryotic and prokaryotic, present in the human body; as each body compartment constitutes a different microenvironment, the virome varies with the body part. Additionally, other factors influence the virome composition, such as age, diet, and the presence of other components of the microbiome. The study of the virome takes advantage of the development of next generation sequencing, and has allowed the discovery of novel viruses, and the characterization of the virome in healthy and diseased individuals, allowing the association of viruses with specific diseases. Perhaps the most interesting development of the study of the virome is the interplay that viruses can have with other components of the microbiome, specifically bacteria, that can either up- or down-regulate the antiviral immune response and can therefore modulate viral infectivity. This relationship is reciprocal since viruses can in turn modulate bacterial infections. The complex interactions of the virome with other members of the microbiome in the context of host genetics, and their influence in the health status of the patient have just begun to be investigated and are not completely understood, but the findings so far indicate that the regulation of the immune response by viruses and other members of the microbiome can affect the outcome of infections.
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Microbiota/fisiología , Virus , Infecciones Bacterianas/inmunología , Infecciones Bacterianas/prevención & control , Infecciones Bacterianas/virología , Humanos , Virosis/inmunología , Virosis/microbiología , Virosis/prevención & control , Fenómenos Fisiológicos de los Virus , Virus/inmunologíaRESUMEN
Chromatin in cervical cancer (CC) undergoes chemical and structural changes that alter the expression pattern of genes. Recently, a potential mechanism, which regulates gene expression at transcriptional levels is the proteolytic clipping of histone H3. However, until now this process in CC has not been reported. Using HeLa cells as a model of CC and human samples from patients with CC, we identify that the H3 cleavage was lower in CC compared with control tissue. Additionally, the histone H3 clipping was performed by serine and aspartyl proteases in HeLa cells. These results suggest that histone H3 clipping operates as part of post-translational modification system in CC.
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BACKGROUND: The Interactive Systems Framework (ISF), a guide for translational research, encourages the balancing of traditional research and community-based participatory research (CBPR) approaches. OBJECTIVES: This paper focuses on the challenges, solutions, and lessons learned in applying the ISF to our translational research project. METHODS: A community-campus partnership translated evidence-based screening guidelines on sexually transmitted infections (STIs) and depression into culturally relevant educational materials. Community health workers (CHWs) disseminated the information through a cross-over design to Hispanic women in Pima County, Arizona. Challenges, solutions, and lessons learned were identified throughout this process. LESSONS LEARNED: We identified challenges in the areas of research design, and in the ISF systems of prevention synthesis and translation, prevention support, and prevention delivery. We successfully negotiate solutions between the scientific and local community that resulted in acceptable compromises for both groups. CONCLUSIONS: The model presented by the ISF is difficult to achieve, but we offer concrete solutions to community members and scientists to move toward that ideal.