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Bacterial viruses (bacteriophages or phages) are the most abundant and diverse biological entities on Earth. There is a renewed worldwide interest in phage-centered research motivated by their enormous potential as antimicrobials to cope with multidrug-resistant pathogens. An ever-growing number of complete phage genomes are becoming available, derived either from newly isolated phages (cultivated phages) or recovered from metagenomic sequencing data (uncultivated phages). Robust comparative analysis is crucial for a comprehensive understanding of genotypic variations of phages and their related evolutionary processes, and to investigate the interaction mechanisms between phages and their hosts. In this chapter, we present a protocol for phage comparative genomics employing tools selected out of the many currently available, focusing on complete genomes of phages classified in the class Caudoviricetes. This protocol provides accurate identification of similarities, differences, and patterns among new and previously known complete phage genomes as well as phage clustering and taxonomic classification.

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Xylella fastidiosa is the causal agent of several plant diseases affecting fruit and nut crops. Methylobacterium mesophilicum strain SR1.6/6 was isolated from Citrus sinensis and shown to promote plant growth by producing phytohormones, providing nutrients, inhibiting X. fastidiosa, and preventing Citrus Variegated Chlorosis. However, the molecular mechanisms involved in the interaction among these microbes are still unclear. The present work aimed to analyze physiological and molecular aspects of M. mesophilicum SR1.6/6 and X. fastidiosa 9a5c in co-culture. The transcriptome and secretome analyses indicated that X. fastidiosa down-regulates cell division and transport genes and up-regulates stress via induction of chaperones and pathogenicity-related genes including, the lipase-esterase LesA, a protease, as well as an oligopeptidase in response to M. mesophilicum competition. On the other hand, M. mesophilicum also down-regulated transport genes, except for iron uptake, which was up-regulated. Secretome analysis identified four proteins in M. mesophilicum exclusively produced in co-culture with X. fastidiosa, among these, three are related to phosphorous uptake. These results suggest that M. mesophilicum inhibits X. fastidiosa growth mainly due to nutrient competition for iron and phosphorous, thus promoting X. fastidiosa starvation, besides producing enzymes that degrade X. fastidiosa cell wall, mainly hydrolases. The understanding of these interactions provides a direction for control and management of the phytopathogen X. fastidiosa, and consequently, helps to improve citrus growth and productivity.

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PURPOSE: The introduction of fiber-guided lasers was a breakthrough in laryngology practice, opening the path for treating different pathologies with minimally invasive procedures, both in the operating room and in the office. The most recent technology in the area is the blue laser, which combines photoangiolytic and cutting properties, characteristics that make this equipment suitable for its use in upper aerodigestive tract surgery. However, there is not enough experience in this area. The authors present a case series of patients with different pharyngeal, laryngeal, and tracheal pathologies who were treated by means of transoral procedures using fiber-guided blue laser. METHODS: The surgical records of patients with different upper aerodigestive tract pathologies who were treated with fiber-guided blue laser in the operating room, under general anesthesia with jet ventilation or supraglottic ventilation using suspension laryngotracheoscopy techniques between February 2018 and March 2022 were reviewed. RESULTS: A total of 80 surgical interventions in a group of 38 patients were performed. A wide variety of procedures was executed, either using the laser alone or in combination with other techniques to treat different pathologies of the aero-digestive tract safely and effectively, with adequate functional results. CONCLUSIONS: Following all necessary precautions, blue laser is a reliable tool to perform minimally invasive surgeries in the operating room using TOFLS techniques. It can be used alone or in combination with other devices to achieve the desired goals.

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Surface adhesion strategies are widely employed by bacterial pathogens during establishment and systemic spread in their host. A variety of cell-surface appendages such as pili, fimbriae, and afimbrial adhesins are involved in these processes. The phytopathogen Xylella fastidiosa employs several of these structures for efficient colonization of its insect and plant hosts. Among the adhesins encoded in the X. fastidiosa genome, three afimbrial adhesins, XadA1, Hsf/XadA2, and XadA3, are predicted to be trimeric autotransporters with a C-terminal YadA-anchor membrane domain. We analyzed the individual contributions of XadA1, XadA2, and XadA3 to various cellular behaviors both in vitro and in vivo. Using isogenic X. fastidiosa mutants, we found that cell-cell aggregation and biofilm formation were severely impaired in the absence of XadA3. No significant reduction of cell-surface attachment was found with any mutant under flow conditions. Acquisition by insect vectors and transmission to grapevines were reduced in the XadA3 deletion mutant. While the XadA3 mutant was hypervirulent in grapevines, XadA1 or XadA2 deletion mutants conferred lower disease severity than the wild-type strain. This insight of the importance of these adhesive proteins and their individual contributions to different aspects of X. fastidiosa biology should guide new approaches to reduce pathogen transmission and disease development. [Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

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Xylella fastidiosa causes diseases in many plant species. Originally confined to the Americas, infecting mainly grapevine, citrus, and coffee, X. fastidiosa has spread to several plant species in Europe causing devastating diseases. Many pathogenicity and virulence factors have been identified, which enable the various X. fastidiosa strains to successfully colonize the xylem tissue and cause disease in specific plant hosts, but the mechanisms by which this happens have not been fully elucidated. Here we present thorough comparative analyses of 94 whole-genome sequences of X. fastidiosa strains from diverse plant hosts and geographic regions. Core-genome phylogeny revealed clades with members sharing mostly a geographic region rather than a host plant of origin. Phylogenetic trees for 1605 orthologous CDSs were explored for potential candidates related to host specificity using a score of mapping metrics. However, no candidate host-specificity determinants were strongly supported using this approach. We also show that X. fastidiosa accessory genome is represented by an abundant and heterogeneous mobilome, including a diversity of prophage regions. Our findings provide a better understanding of the diversity of phylogenetically close genomes and expand the knowledge of X. fastidiosa mobile genetic elements and immunity systems.

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Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease has spread globally, causing more than 161.5 million cases and 3.3 million deaths to date. Surveillance and monitoring of new mutations in the virus' genome are crucial to our understanding of the adaptation of SARS-CoV-2. Moreover, how the temporal dynamics of these mutations is influenced by control measures and non-pharmaceutical interventions (NPIs) is poorly understood. Using 1,058,020 SARS-CoV-2 from sequenced COVID-19 cases from 98 countries (totaling 714 country-month combinations), we perform a normalization by COVID-19 cases to calculate the relative frequency of SARS-CoV-2 mutations and explore their dynamics over time. We found 115 mutations estimated to be present in more than 3% of global COVID-19 cases and determined three types of mutation dynamics: high-frequency, medium-frequency, and low-frequency. Classification of mutations based on temporal dynamics enable us to examine viral adaptation and evaluate the effects of implemented control measures in virus evolution during the pandemic. We showed that medium-frequency mutations are characterized by high prevalence in specific regions and/or in constant competition with other mutations in several regions. Finally, taking N501Y mutation as representative of high-frequency mutations, we showed that level of control measure stringency negatively correlates with the effective reproduction number of SARS-CoV-2 with high-frequency or not-high-frequency and both follows similar trends in different levels of stringency.

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Since the identification of SARS-CoV-2, a large number of genomes have been sequenced with unprecedented speed around the world. This marks a unique opportunity to analyze virus spreading and evolution in a worldwide context. Currently, there is not a useful haplotype description to help to track important and globally scattered mutations. Also, differences in the number of sequenced genomes between countries and/or months make it difficult to identify the emergence of haplotypes in regions where few genomes are sequenced but a large number of cases are reported. We propose an approach based on the normalization by COVID-19 cases of relative frequencies of mutations using all the available data to identify major haplotypes. Furthermore, we can use a similar normalization approach to tracking the temporal and geographic distribution of haplotypes in the world. Using 171,461 genomes, we identify five major haplotypes or operational taxonomic units (OTUs) based on nine high-frequency mutations. OTU_3 characterized by mutations R203K and G204R is currently the most frequent haplotype circulating in four of the six continents analyzed (South America, North America, Europe, Asia, Africa, and Oceania). On the other hand, during almost all months analyzed, OTU_5 characterized by the mutation T85I in nsp2 is the most frequent in North America. Recently (since September), OTU_2 has been established as the most frequent in Europe. OTU_1, the ancestor haplotype, is near to extinction showed by its low number of isolations since May. Also, we analyzed whether age, gender, or patient status is more related to a specific OTU. We did not find OTU's preference for any age group, gender, or patient status. Finally, we discuss structural and functional hypotheses in the most frequently identified mutations, none of those mutations show a clear effect on the transmissibility or pathogenicity.

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Xanthomonas arboricola pv. juglandis (Xaj) is the most significant aboveground walnut bacterial pathogen. Disease management uses copper-based pesticides which induce pathogen resistance. We examined the genetic repertoire associated with adaptation and virulence evolution in Xaj. Comparative genomics of 32 Xaj strains reveal the possible acquisition and propagation of virulence factors via insertion sequences (IS). Fine-scale annotation revealed a Tn3 transposon (TnXaj417) encoding copper resistance genes acquired by horizontal gene transfer and associated with adaptation and tolerance to metal-based pesticides commonly used to manage pathogens in orchard ecosystems. Phylogenomic analysis reveals IS involvement in acquisition and diversification of type III effector proteins ranging from two to eight in non-pathogenic strains, 16 to 20 in pathogenic strains, besides six other putative effectors with a reduced identity degree found mostly among pathogenic strains. Yersiniabactin, xopK, xopAI, and antibiotic resistance genes are also located near ISs or inside genomic islands and structures resembling composite transposons.

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Xylella fastidiosa subsp. pauca, once confined to South America and infecting mainly citrus and coffee plants, has been found to be associated with other hosts and in other geographic regions. We present high-quality draft genome sequences of X. fastidiosa subsp. pauca strains J1a12, B111, U24D, and XRB isolated from citrus plants in Brazil, strain Fb7 isolated from a citrus plant in Argentina and strains 3124, Pr8x, and Hib4 isolated, respectively, from coffee, plum, and hibiscus plants in Brazil. Sequencing was performed using Roche 454-GS FLX, MiSeq-Illumina or Pacific Biosciences platforms. These high-quality genome assemblies will be useful for further studies about the genomic diversity, evolution, and biology of X. fastidiosa.

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Xylella fastidiosa subsp. pauca , once confined to South America and infecting mainly citrus and coffee plants, has been found to be associated with other hosts and in other geographic regions. We present high-quality draft genome sequences of X. fastidiosa subsp. pauca strains J1a12, B111, U24D and XRB isolated from citrus plants in Brazil, strain Fb7 isolated from a citrus plant in Argentina and strains 3124, Pr8x and Hib4 isolated, respectively, from coffee, plum and hibiscus plants in Brazil. Sequencing was performed using Roche 454-GS FLX, MiSeq-Illumina or Pacific Biosciences platforms. These high-quality genome assemblies will be useful for further studies about the genomic diversity, evolution, and biology of X. fastidiosa.

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Resumen: Los pacientes con síndrome de Brugada pueden presentar arritmias ventriculares malignas y muerte súbita, por lo que frecuentemente tienen indicación de implante de cardiodesfibrilador. Ocasionalmente, estos pacientes pueden tener choques recurrentes difíciles de manejar en la práctica clínica. Estudios recientes han mostrado que la ablación por radiofrecuencia en los pacientes con síndrome de Brugada es posible y efectiva.A una mujer de 55 años con síndrome de Brugada afectada por una tormenta eléctrica, se le efectuó mapeo cardíaco electroanatómico tridimensional y ablación por radiofrecuencia. Durante el estudio electrofisiológico no se observaron arritmias espontáneas o inducidas. Un mapeo de voltaje cardíaco en ritmo sinusal, precedió al uso de ablación por radiofrecuencia para modificación del sustrato arritmogénico en endocardio y epicardio del tracto de salida del ventrículo derecho. El patrón de Brugada desapareció de su electrocardiograma en el período posablativo inmediato. En cuatro meses de seguimiento la paciente no ha tenido arritmias ventriculares ni evidencia electrocardiográfica de patrón de Brugada.La modificación del sustrato arritmogénico por medio de ablación por radiofrecuencia en pacientes con síndrome de Brugada y tormenta eléctrica, puede ser de utilidad en el manejo crítico.

Summary: Patients with Brugada syndrome may have malignant ventricular arrhythmias and sudden cardiac death. Thus, these patients frequently have indication of implantable cardioverter defibrillator. Occasionally, these patients may experience recurrent appropriate cardioverter defibrillator shocks refractory to medical treatment. Recent reports indicate that radiofrequency ablation in Brugada syndrome is feasible, and effective.A 55-year-old woman with Brugada syndrome and an electrical storm, underwent three-dimensional electroanatomic mapping and radiofrequency ablation. During electrophysiological study there were no spontaneous or inducible arrhythmias. Voltage mapping of the right ventricle was created in sinus rhythm and both, endocardial and epicardial substrate modification of right ventricular outflow tract was performed. Brugada ECG pattern resolved post procedure. Follow up at 4 months revealed no recurrence of ventricular arrhythmias or Brugada electrocardiographic pattern.Radiofrequency mediated therapy for substrate modification in patients with Brugada syndrome and an electrical storm, may be useful in their critical care management.

Resumo: Os pacientes com síndrome de Brugada podem apresentar arritmias ventriculares malignas e morte súbita, de modo que frequentemente têm indicação de implante de cardiodefibrilador. Ocasionalmente, esses pacientes podem ter choques recorrentes difíceis de lidar na prática clínica. Estudos recentes mostraram que a ablação por radiofrequência em pacientes com síndrome de Brugada é possível e eficaz.Uma mulher de 55 anos com síndrome de Brugada afetada por uma tempestade elétrica apresentava mapeamento cardíaco eletroanatômico tridimensional e ablação por radiofrequência. Durante o estudo eletrofisiológico não foram observadas arritmias espontâneas ou induzidas. O mapeamento da tensão cardíaca em ritmo sinusal antecedeu o uso da ablação por radiofrequência para modificação do substrato arritmogênico no endocárdio e no epicárdio da via de saída do ventrículo direito. O padrão de Brugada desapareceu de seu eletrocardiograma no período pós-ablativo imediato. Em 4 meses de acompanhamento, o paciente não apresentou arritmias ventriculares ou evidências eletrocardiográficas do padrão de Brugada.A modificação do substrato arritmogênico por meio da ablação por radiofrequência em pacientes com síndrome de Brugada e tempestade elétrica pode ser muito útil no manejo crítico.

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Primary laryngeal tuberculosis is a rare disease with a wide variety of clinical manifestations. We report the case of an ear-nose and throat diabetic physician with primary laryngeal tuberculosis. The diagnosis of laryngeal cancer had been considered before in another institution, and at the patient's admission, he only presented dysphonia with a six-month evolution. The vocal cord histological examination showed granulomas, giant cells, fibrosis and necrosis, and the Ziehl-Neelsen staining showed acid-alcohol resistant bacilli. The culture from vocal cord tissue was positive for mycobacteria, and IS 6110 -PCR was positive too. The Mycobacterium tuberculosis strain was sensitive to first line drugs. Treatment using directly observed therapy short-course (DOTS) was initiated. Clinical presentation, differential diagnosis, diagnostic workup, associated risk factors and a brief literature revision are discussed in this article.

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La tuberculosis laríngea primaria es una enfermedad rara con una amplia gama de manifestaciones clínicas. Se reporta el caso de un médico otorrinolaringólogo con diabetes de tipo II y con diagnóstico de tuberculosis laríngea primaria. El diagnóstico de cáncer de cuerda vocal se había considerado en otra institución, y al ingreso el paciente sólo presentaba disfonía de seis meses de evolución. En el estudio histopatológico se encontraron granulomas, células gigantes multinucleadas, fibrosis y necrosis, y en la tinción de Ziehl-Neelsen, bacilos ácido-alcohol resistentes. El cultivo del tejido de cuerda vocal para micobacterias y la PCR-IS6110 fueron positivos. La cepa de Mycobacterium tuberculosis demostró sensibilidad a todos los medicamentos de primera línea. Se inició tratamiento según la estrategia DOTS ( Directly Observed Treatment, Short -course ). Se discute la presentación clínica, los diagnósticos diferenciales, el abordaje diagnóstico y los factores de riesgo asociados y se hace una breve revisión de la literatura.

Primary laryngeal tuberculosis is a rare disease with a wide variety of clinical manifestations. We report the case of an ear-nose and throat diabetic physician with primary laryngeal tuberculosis. The diagnosis of laryngeal cancer had been considered before in another institution, and at the patient´s admission, he only presented dysphonia with a six-month evolution. The vocal cord histological examination showed granulomas, giant cells, fibrosis and necrosis, and the Ziehl-Neelsen staining showed acid-alcohol resistant bacilli. The culture from vocal cord tissue was positive for mycobacteria, and IS 6110 -PCR was positive too. The Mycobacterium tuberculosis strain was sensitive to first line drugs. Treatment using directly observed therapy short-course (DOTS) was initiated. Clinical presentation, differential diagnosis, diagnostic workup, associated risk factors and a brief literature revision are discussed in this article.

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Los continuos desarrollos tecnológicos, en los años recientes, han permitido un mejor entendimiento de la anatomía y fisiología de los pliegues vocales y del tracto digestivo superior. Técnicas de diagnóstico como la laringoscopia de alta velocidad, la videoquimografía, la laringoscopia de acercamiento de alta resolución en la oficina y la impedanciometría esofágica con manometría, son herramientas muy importantes en la práctica clínica moderna. En lo que respecta a tratamiento, el desarrollo de equipos de láser acoplados a sistemas robóticos, fibras para la aplicación de rayos láser de diferentes longitudes de onda a sitios específicos, e instrumentos para ser usados a través de endoscopios flexibles, ampliaron las posibilidades terapéuticas, y, en casos seleccionados, las perspectivas para la ejecución de procedimientos mínimamente invasivos sin necesidad de hospitalización. El proposito de este estudio es realizar una revision y un análisis de los avances tecnológicos dirigidos al diagnóstico y tratamiento de las enfermedades del tracto aerodigestivo superior, sus posibles aplicaciones y limitaciones. Es un estudio descriptivo de una revisión de la literatura concerniente al tema. Se presenta una monografía y una revisión de la literatura relevante, disponible en publicaciones indexadas, con respecto a los diferentes métodos actualmente disponibles para el estudio de las enfermedades del tracto aerodigestivo superior, así como de las nuevas alternativas desde el punto de vista de posibilidades terapéuticas. Se hace un análisis de los aspectos técnicos importantes de cada una de las opciones, tanto diagnósticas como terapéuticas, con el fin de tener claridad sobre sus posibles aplicaciones clínicas, ventajas, desventajas y contraindicaciones.

Continuous technological developments in recent years have allowed a better understanding of the anatomy and physiology of the vocal folds and the upper digestive tract. Diagnostic techniques such as high speed laryngoscopy, videokymography, in office high resolution close up laryngoscopy and esophageal impedance with manometry are very important tools in modern day clinical practice. As far as treatment is concerned, development of laser equipments coupled to robotic systems, fibers to deliver different laser wavelengths to specific places, and instruments to be used through flexible scopes, broadened therapeutic possibilities and, in selected cases, have made it possible to perform minimally invasive procedures with no need for hospitalization. The purpose of this study is to review and analyze technological advancements for diagnosis and treatment of the diseases of the upper aerodigestive tract, their feasible applications and limitations. It is a descriptive study of literature review regarding the topic. A monograph and a revision of relevant literature accessible on indexed publications related to different currently available methods for studying the upper aerodigestive tract diseases, as well as new alternatives from the therapeutic point of view are presented. An analysis of important technical aspects of each option, either diagnostic or therapeutic is performed with the aim of elucidating their possible clinical applications, advantages, disadvantages and contraindications.

Os contínuos desenvolvimentos tecnológicos, nos anos recentes, permitiram um melhor entendimento da anatomia fisiologia das pregas vocais e do trato digestivo superior. Técnicas de diagnóstico como a laringoscopia de alta velocidade, a vídeoquimografia, a laringoscopia de aproximação de alta resolução e a impedânciometria esofágica com manometria, são ferramentas muito importantes na prática clínica moderna. No que diz respeito ao tratamento, o desenvolvimento de equipamentos de laser acoplados a sistemas robóticos, fibras para a aplicação de raios laser de diferentes longitudes de onda em locais específicos, e instrumentos para ser usados através de endoscópios flexíveis, ampliaram as possibilidades terapêuticas, e, em casos selecionados, as perspectivas para a execução de procedimentos minimamente invasivos sem a necessidade de hospitalização. O propósito deste estudo é realizar uma revisão e uma análise dos avanços tecnológicos dirigidos ao diagnóstico e tratamento das doenças do trato aerodigestivo superior, suas possíveis aplicações e limitações. É um estudo descritivo de uma revisão da literatura concernente ao tema. Apresenta-se uma monografia e una revisão da literatura relevante, disponível em publicações indexadas, com respeito aos diferentes métodos disponíveis atualmente para o estudo das doenças do trato aerodigestivo superior, bem como das novas alternativas desde o ponto de vista de possibilidades terapêuticas. É feita uma análise dos aspectos técnicos importantes de cada uma das opções, tanto diagnósticas como terapêuticas, com o fim de ter claridade sobre suas possíveis aplicações clínicas, vantagens, desvantagens e contraindicações.

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Endomyocardial biopsy (EB) is often used in the clinical evaluation of several cardiac disease. Hundred-seventy-six consecutive procedures were performed in 65 patients, 43 men and 22 women mean age was 29.86 +/- 11.53 (range 4 days to 66 years). Group A, 26 postcardiac transplantation patients in whom 137 EB were performed (39 heterotopic and 98 orthotopic), average sample 5.2 biopsy for each patient. Group B (n = 39) was studied for several cardiac diseases during cardiac diagnostic catheterism. The jugular venous approach was performed in 3 patients (1.7%), femoral in 173 patients. Major complications were found in 3 (1.7%) cases consisting in cerebrovascular accident (stroke) and coronary fistula into the right ventricle. Endomyocardial biopsy provides a low incidence of adverse reactions, mortality was 0%.

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Endomyocardial biopsy (EB) is often used in the clinical evaluation of several cardiac disease. Hundred-seventy-six consecutive procedures were performed in 65 patients, 43 men and 22 women mean age was 29.86 +/- 11.53 (range 4 days to 66 years). Group A, 26 postcardiac transplantation patients in whom 137 EB were performed (39 heterotopic and 98 orthotopic), average sample 5.2 biopsy for each patient. Group B (n = 39) was studied for several cardiac diseases during cardiac diagnostic catheterism. The jugular venous approach was performed in 3 patients (1.7%), femoral in 173 patients. Major complications were found in 3 (1.7%) cases consisting in cerebrovascular accident (stroke) and coronary fistula into the right ventricle. Endomyocardial biopsy provides a low incidence of adverse reactions, mortality was 0%.

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Se revisa y analiza las creencias referentes a la epilepsia, conocida en vocablo quechua como sonko-nanay (enfermedad del corazón). La apreciación de conjunto dada por el indígena permite bosquejar la tradición peruana. Desarrollo. Incluye concepciones mitológicas quechuas, sus interpretaciones con nombres comprensibles y/o con analogía a la descripción de los diferentes tipos de crisis de la clasificación moderna, diagnóstico, las práticas curativas con elementos de los tres reinos así con la primera cirugía ficticia y la real, dada ésta por la trapanación de cráneo. Conclusión. En el periodo virreinal, partiendo del conocimiento médico español, se describen las diversas acepciones, su confusión con el tétanos e histeria y las pautas que se daban en el tratamiento.

We review and discuss beliefs regarding epilepsy, known in the Quechua language as sonko-nanay (disease of the heart), an overall view giben by the indigenous people allows and outline to be drawn of tradition in Perú. Development. This includes Quechua mythological beliefs, with understandable names and/or analogy with the different types of crises acording to modern diagnostic classific ation, methods of treatment under the three different systems of government as well as real and fictitious surgery by trepanation of the skuss. Conclusion. During the period of the Viceroys (based on Spanish medical knowledge) the different meanings are considered together with the confusion with tetanus and hysteria, and the outlines of treatment used.

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Recientemente, se describió una nueva entidad de apariencia tumoral en los tejidos blandos (extremidades, tronco, escroto, nunca y axila) así como en la pleura, que se denomina seudotumor fibroso pleura, que se denomina seudotumor fibroso calcificado. No conocemos reportes previos en el mediastino. El caso que informamos es de un hombre de 44 años de edad que acudió al Hospital por dolor torácico y opacidad hiliar izquierda en la radiografía de tórax. La tomografía computarizada, muestra un tumor en el mediastino medio, de 7.6 X 6.1 cm de diámetro mayor con 1380 UH en las zonas de calcificación. Asienta arriba del cayado de la arteria pulmonar y bronquio principal izquierdo. Histopatológicamente está circunscrita, encapsulada y compuesta de tejido fibroso hialinizado, con infiltrado linfoplasmocitario, calcificaciones sammomatosas y distróficas, es menester distinguirlo del tumor fibroso de la pleura, del granuloma hializado y del seudotumor inflamatorio. Su tratamiento es la resección y no conocemos hasta el momento reportes de recidiva

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El virus del papiloma humano (VHP), tiene una asociación predisponente como cofactor en la etiopatogenia del cáncer cervicouterino, también se sabe que la infección viral no es suficiente y hay otros agentes, entre los que se encuentran la Chlamydia trachomatis. El objetivo de este estudio, fue investigar la asociación de estos cofactores, como predisponentes para la neoplasia intraepitelial cervical (NIC). Prospectivamente en la Clínica de Colposcopia del Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala", IMSS, a 37 pacientes con diagnóstico citológico, colposcópico e histológico de NIC sólo a asociado a VPH, se les realizaron citologías endocervicales y mediante el método de inmunofluorescencia, utilizando aticuerpos monoclonales de fluorescencia conjugada, se trató de demostrar la presencia de Chlamydia trachomatis. Del total de pacientes, 12(32.4 por ciento) fueron positivas para Chlamydia trachomatis, porcentualmentes significativo, y con una chi cuadrada de 0.32, no significativa para este grupo de población estudiada, Se concluye que existe una asociación importante de Chlamydia trachomatis y VPH, la que debe ser tomada en cuenta en el diagnóstico y tratamiento de la neoplasia intraepitelial cervical

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