Artículos científicos

Diagnostic Performance of a Multiantigen Print ImmunoAssay (MAPIA) for Antibody Detection in Human Neurocysticercosis

Thu, 01 Jan 2026 00:00:00 GMT

Diagnostic Performance of a Multiantigen Print ImmunoAssay (MAPIA) for Antibody Detection in Human Neurocysticercosis Toribio, Luz M.; Guzman, Carolina; Vasquez, Alessandra; Saavedra, Herbert; Gonzales, Isidro; Bustos, Javier A.; García, Hector H. Background Neurocysticercosis (NCC) is the most prevalent helminth infection affecting the human central nervous system. Although neuroimaging is required for definitive diagnosis, serology supports case confirmation and clarifies diagnostic doubts. Serology gold standard is antibody detection using the enzyme-linked immunoelectrotransfer blot assay, which uses 7 antigenic lentil-lectin purified parasite glycoproteins (LLGP-EITB). LLGP-EITB is poorly accessible to low-resource settings due to its technical complexity and costs, and it is inaccessible in many settings in which parasitic material to produce antigens is not readily available. We recently developed a 3-Antigen multiantigen print immunoassay (MAPIA) based on recombinant/synthetic antigens (rGP50, rT24H, and sTs14), corresponding to the 3 principal diagnostics antigenic families from LLGP-EITB, that is simpler and does not require parasite-derived materials. Methods MAPIA performance was evaluated using a well-defined set of serum samples from NCC patients confirmed by imaging, including 73 samples from subarachnoid NCC, 72 with >5 parenchymal cysts, 59 with 3-5 parenchymal cysts, 95 with 1-2 parenchymal cysts, and 77 healthy negative controls and compared it with the LLGP-EITB performance. Results Overall, our MAPIA presented a sensitivity of 97.7% and a specificity of 97.4%. Subgroup analyses by NCC type demonstrated a sensitivity of 100% for subarachnoid and parenchymal NCC with >5 cysts and a slight decrease for the groups with 3-5 cysts (96.6%) and 1-2 cysts (94.7%). Observed agreement with the LLGP-EITB assay was 98.33%. Conclusions Our 3-Antigen MAPIA obtained comparable results to LLGP-EITB and emerges as a simpler, reproducible, and easy-Access alternative tool for antibody diagnosis in NCC.

Taenia solium neurocysticercosis: lts current epidemiological, diagnostic, therapeutic, and control landscapes

Sun, 01 Feb 2026 00:00:00 GMT

Taenia solium neurocysticercosis: lts current epidemiological, diagnostic, therapeutic, and control landscapes Bustos, Javier A.; Coyle, Christina M.; Thakur, Kiran T.; Guzman, Carolina; Toribio, Luz M.; Arroyo, Gianfranco; Saavedra, Herbert; Mwape, Kabemba E.; Rajshekhar, Vedantam; Garcia, Hector H.; the Cysticercosis Working Group in Peru (cwgp) Neurocysticercosis is the most common helminthic parasitic disease affecting the human central nervous system and is pleomorphic in its presentation. It is frequently encountered in daily practice in most parts of the world, and also commonly seen in industrialized countries in immigrant populations. In the past decade, new treatment (combined anti-parasitic drugs, increased attention to reducing treatment-associated inflammation and damage, new surgical strategies), and diagnostic (more specific antigen and antibody detection concepts and tools, more sensitive magnetic resonance imaging sequences) approaches, new animal models, and data on control of transmission have emerged. Still, diagnostic challenges persist and treatment approaches for some types of disease may differ, affecting clinical practice. This review provides clinicians in endemic and non-endemic countries with a comprehensive and practical reference to understand the variabilities in clinical expression of the disease and the optimal diagnostic and treatment approaches.

On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations

Sun, 01 Mar 2026 00:00:00 GMT

On the need for patient-centered approaches to Helicobacter pylori management in geriatric populations Badell, Camila S.; Ruiz, Eloy F. El artículo examina críticamente la pertinencia de adoptar enfoques centrados en el paciente en el tratamiento de la infección por Helicobacter pylori en adultos mayores, subrayando la necesidad de integrar variables clínicas, comorbilidades y factores de calidad de vida en la toma de decisiones terapéuticas.

Oncoplastic Approach to Juvenile Giant Fibroadenoma: A Case Series

Wed, 01 Apr 2026 00:00:00 GMT

Oncoplastic Approach to Juvenile Giant Fibroadenoma: A Case Series Chávez Díaz, Marcelo; de La Cruz Ku, Gabriel; Cedrón Lenci, Carla Carina; Cueva Perez, Maria del Rosario Juvenile giant fibroadenoma (GFA) is defined as a benign tumor larger than 5 cm, 500 grams, and/or involving at least 80% of the breast. It typically occurs in young patients and causes breast deformity and asymmetry. Surgical treatment involves resection of the tumor (enucleation), rearrangement of the skin envelope, and repositioning of the nipple-areola complex. However, the expected re-expansion of the breast following tumor removal, often managed through periareolar approaches, can be unpredictable and prolonged in certain cases. For this reason, oncoplastic surgery techniques have been developed, which allow for immediate partial reconstruction and are now among the available therapeutic options. This report describes three cases in which an oncoplastic approach was used for the treatment of GFA.

CLO26-131: Hematologic-IHC Prognostic Score for Therapeutic Prioritization in Breast Cancer: Multicenter Validation in Peru (2010-2020)

Tue, 31 Mar 2026 00:00:00 GMT

CLO26-131: Hematologic-IHC Prognostic Score for Therapeutic Prioritization in Breast Cancer: Multicenter Validation in Peru (2010-2020) Malpartida, Robert; Benites, Vladimir; Malpartida, Jesús Miguel; Matos, Joseph; Leiva, Silvia; Arroyo, Jorge Luis Introduction: Early treatment selection in breast cancer is often delayed in Latin America due to limited access to advanced biomarkers. We propose an accessible score based on baseline complete blood count and standard immunohistochemistry (IHC) to stratify risk at first consultation. Objective: To internally develop and validate a hematologic–IHC prognostic score to estimate 5-year overall survival. Methods: Multicenter retrospective cohort across four public hospitals in Lima-Peru (2010–2020). A total of 883 patients with histologic confirmation, baseline blood counts and complete IHC (ER, PR, HER2, Ki-67) were included. The Hematologic–IHC Prognostic Score (SPHIQ) integrates six routinely available clinicopathologic and hematologic parameters, yielding a total score ranging from 0 to 12 points: PIV: <250 (0), 250–399 (1), ≥400 (2); PLR: <150 (0), 150–199 (1), ≥200 (2); Hemoglobin (g/dL): >12 (0), 11–12 (1), ≤11 (2); Stage: I–II (0), III (1), IV (2); Histologic grade: G1 (0), G2 (1), G3 (2); Molecular subtype: Luminal A (0), Luminal B (1), HER2+/HR- or TNBC (2). The cumulative SPHIQ score reflects tumor biological aggressiveness, where higher scores correlate with poorer prognosis. This integrated index enables early pre-consultation risk stratification by combining systemic inflammation, hematologic status, and molecular subtype into a single, reproducible prognostic tool. Risk groups: low 0–4, intermediate 5–8, high 9–12. Statistics: Kaplan–Meier, log-rank, multivariate Cox, bootstrap, AUC and C-index. Results: Risk distribution: low n=290 (32.8%), intermediate n=394 (44.6%), high n=199 (22.5%). 5-year OS: 83%, 61% and 34% (log-rank p<0.001). Independent predictors of lower OS: * PIV≥310 aHR 4.94 (95%CI 1.59–15.38; p=0.006) * PLR≥150 aHR 2.33 (95%CI 1.22–4.44; p<0.05) * Triple-negative and HER2+ HR-negative with worst prognosis Model performance: C-index 0.72, AUC 0.71. Calculation time: <5 minutes in clinic. Conclusion: SPHIQ enables immediate prognostic stratification using standard CBC and IHC, optimizing therapeutic prioritization and resource allocation in Latin American healthcare systems.

Safety and clinical outcomes of mechanical thrombectomy for acute stroke in pregnant patients: A systematic review

Thu, 01 Jan 2026 00:00:00 GMT

Safety and clinical outcomes of mechanical thrombectomy for acute stroke in pregnant patients: A systematic review Calisaya-Madariaga, Irving Gabriel; Carbajal-Galarza, Meiling; Castillo-Granda, Jhosely Ibeth; Abanto-Florez, Leonardo Marcelo; Navarro Salcedo, Maria Fernanda; Suárez Rodríguez, José Alejandro; Ramos Maguiña, Edward Sebastian; Meca-Bayona, Matias Daniel; Pacheco-Barrios, Niels; Acurio-Ortiz, Karlos Mechanical thrombectomy (MT) is an established and guideline-endorsed treatment for acute ischemic stroke (AIS) due to large vessel occlusion. Intravenous thrombolysis (IVT) with alteplase remains the first-line therapy within the approved time window, often used alone or as a bridging strategy before MT. However, both interventions have been systematically understudied in pregnant patients, as this population has been excluded from most pivotal clinical trials. This systematic review critically evaluates the procedural feasibility, safety, and maternal-fetal outcomes of MT in pregnant patients experiencing AIS. A comprehensive literature search using PubMed, Embase, and Web of Science yielded 16 studies encompassing 26 cases. In 20 of these, the occlusions involved the M1 segment of the middle cerebral artery, with 58% receiving combined IVT and MT, and 42% undergoing MT alone. Successful reperfusion (TICI 2b-3) was attained in 84% of cases. The median times were 120 min from onset to hospital arrival, 92 min from arrival to puncture, and 330 min from onset to recanalization. Favorable maternal outcomes (mRS 0-1) were observed in 91% of cases at follow-up, and no direct MT-related fetal mortalities occurred. Radiological protection practices, though inconsistently reported, commonly included abdominal shielding and optimized fluoroscopic protocols. Despite limited high-level evidence, MT in pregnancy appears technically feasible and clinically beneficial, warranting prompt multidisciplinary coordination and robust imaging protocols. Future prospective research is essential to better define safety parameters and optimize guidelines for this vulnerable subgroup of patients.