Emergence and circulation of azole-resistant C. albicans, C. auris and C. parapsilosis bloodstream isolates carrying Y132F, K143R or T220L Erg11p substitutions in Colombia.

Methods: Over a four-year period, 123 Candida bloodstream isolates were collected at a quaternary care hospital. The isolates were identified by MALDI-TOF MS and their fluconazole (FLC) susceptibility patterns were assessed according to CLSI guidelines. Subsequently, sequencing of ERG11, TAC1 or MRR1, and efflux pump activity were performed for resistant isolates. Results: Out of 123 clinical strains,C. albicans accounted for 37.4%, followed by C. tropicalis 26.8%, C. parapsilosis 19.5%, C. auris 8.1%, C. glabrata 4.1%, C. krusei 2.4% and C. lusitaniae 1.6%. Resistance to FLC reached 18%; in addition, a high proportion of isolates were cross-resistant to voriconazole. Erg11 amino acid substitutions associated with FLC-resistance (Y132F, K143R, or T220L) were found in 11/19 (58%) of FLCresistant isolates. Furthermore, novel mutations were found in all genes evaluated. Regarding efflux pumps, 8/19 (42%) of FLC-resistant Candida spp strains showed significant efflux activity. Finally, 6/19 (31%) of FLC-resistant isolates neither harbored resistance-associated mutations nor showed efflux pump activity. Among FLC-resistant species, C. auris 7/10 (70%) and C. parapsilosis 6/24 (25%) displayed the highest percentages of resistance (C. albicans 6/46, 13%). Discussion: Overall, 68% of FLC-resistant isolates exhibited a mechanism that could explain their phenotype (e.g. mutations, efflux pump activity, or both). We provide evidence that isolates from patients admitted to a Colombian hospital harbor amino acid substitutions related to resistance to one of the most commonly used molecules in the hospital setting, with Y132F being the most frequently detected.

Effect of a Diet Supplemented with Sphingomyelin and Probiotics on Colon Cancer Development in Mice.

Previous studies have reported that dietary sphingomyelin could inhibit early stages of colon cancer. Lactic acid-producing bacteria have also been associated with an amelioration of cancer symptoms. However, little is known about the potential beneficial effects of the combined administration of both sphingomyelin and lactic acid-producing bacteria. This article analyzes the effect of a diet supplemented with a combination of the probiotics Lacticaseibacillus casei and Bifidobacterium bifidum (108 CFU/ml) and sphingomyelin (0.05%) on mice with 1,2-dimethylhydrazine (DMH)-induced colon cancer. Thirty-six BALB/c mice were divided into 3 groups: one healthy group (group C) and two groups with DMH-induced cancer, one fed a standard diet (group D) and the other fed a diet supplemented with sphingomyelin and probiotics (DS). The number of aberrant crypt foci, marker of colon cancer development, was lower in the DS. The dietary supplementation with the synbiotic reversed the cancer-induced impairment of galactose uptake in enterocyte brush-border-membrane vesicles. These results confirm the beneficial effects of the synbiotic on the intestinal physiology of colon cancer mice and contribute to the understanding of the possible mechanisms involved.

Microencapsulated Bifidobacterium bifidum and Lactobacillus gasseri in Combination with Quercetin Inhibit Colorectal Cancer Development in ApcMin/+ Mice.

Recent studies have suggested that flavonoids such as quercetin and probiotics such as Bifidobacterium bifidum (Bf) and Lactobacillus gasseri (Lg) could play a relevant role in inhibiting colon cancer cell growth. Our study investigated the role of dietary supplementation with microencapsulated probiotics (Bf and Lg) along with quercetin in the development of mouse colorectal cancer (CRC). Methods: Adenomatous polyposis coli/multiple intestinal neoplasia (ApcMin/+) mice were fed a standard diet or the same diet supplemented with microencapsulated probiotics (Bf and Lg strains, 107 CFU/100 g food) or both probiotics strains plus microencapsulated quercetin (15 mg/100 g food) for 73 days. Changes in body and organ weights, energy metabolism, intestinal microbiota, and colon tissue were determined. The expression of genes related to the Wnt pathway was also analyzed in colon samples. Results: Dietary supplementation with microencapsulated probiotics or microencapsulated probiotics plus quercetin reduced body weight loss and intestinal bleeding in ApcMin/+ mice. An improvement in energy expenditure was observed after 8 weeks but not after 10 weeks of treatment. A supplemented diet with microencapsulated Bf and Lg reduced the number of aberrant crypt foci (ACF) and adenomas by 45% and 60%, respectively, whereas the supplementation with Bf, Lg and quercetin decreased the number of ACF and adenomas by 57% and 80%, respectively. Microencapsulated Bf and Lg in combination with quercetin could exert inhibition of the canonical Wnt/ß-catenin signaling pathway in the colon of ApcMin/+ mice Conclusions: The administration of microencapsulated Bf and Lg, individually or in combination with quercetin, inhibits the CRC development in ApcMin/+ mice.

Environmentally Friendly Valorization of Solieria filiformis (Gigartinales, Rhodophyta) from IMTA Using a Biorefinery Concept.

Marine macroalgae (seaweed) are an excellent source of novel bioactive metabolites. The biorefinery concept applied to seaweed facilitates the extraction of many chemical constituents from the same biomass ensuring that the resource is used fully, generating few residues through a succession of extraction steps. In the present study, the biomass of the carragenophyte Solieria filiformis (Rhodophyta, Gigartinales) cultured in an integrated multi-trophic aquaculture (IMTA) system was evaluated to obtain valuable products by a biorefinery approach. Enzymatic-assisted extraction (EAE) and microwave-assisted extraction (MAE) were the eco-friendly technologies used to ensure an environmentally friendly valorization of the biomass. Three valuable products were successfully recovered: a water-soluble extract rich in proteins and sulfated polysaccharides suitable as a food supplement; a lipid fraction rich in polyunsaturated fatty acids (PUFAs) with potential to be used in the nutraceutical industry; and a pure ι-carrageenan with a powerful antiviral activity against Herpes simplex virus (EC50 = 6.3 µg mL-1) comparable to the commercial antiviral acyclovir (EC50 = 3.2⁻5.4 µg mL-1).

Efecto del plasma autógeno rico en plaquetas sobre el infarto de miocardio en ovejas / Effect of autologous platelet-rich plasma on heart infarction in sheep

Objetivo: El infarto de miocardio es la causa más común de fallo cardíaco congestivo. El objetivo de este trabajo es evaluar, en el animal de experimentación, los efectos morfológicos e histológicos de la implantación de plasma autógeno rico en plaquetas en el corazón de ovejas previamente infartadas. Métodos: Se utilizaron 24 ovejas lacha hembras, en las que se produjo quirúrgicamente un infarto agudo de miocardio, mediante toracotomía izquierda y ligadura permanente de 2 arterias coronarias (primera y segunda diagonal). Tras la ligadura de las arterias coronarias 3 ovejas fallecieron por fibrilación ventricular. Pasadas 3 semanas de la ligadura coronaria, las ovejas fueron reoperadas por esternotomía media vertical. En 6 de ellas (grupo control) se inyectó suero fisiológico en la zona del infarto. En 15 se inyectó gel plaquetario. Todas las ovejas fueron sacrificadas a las 9 semanas de evolución de la segunda cirugía. Resultados: En los corazones tratados con plasma rico en factores de crecimiento (PRGF) destaca la neoformación vascular en los cortes de hematoxilina-eosina y de factor VIII, a diferencia de los no tratados. Conclusiones: La inyección de factores de crecimiento plaquetarios, PRGF, en el corazón de ovejas previamente infartadas favorece la mitogénesis y la angiogénesis. El uso de PRGF autógeno es sencillo y seguro, no provocando toxicidad ni desencadenando reacciones inmunológicas ni inflamatorias.

Objective: Myocardial infarction is the most common cause of congestive heart failure. The objective of this work is to evaluate, in experimental animals, morphological and histological effects of the implantation of autologous platelet-rich plasma in infarcted heart sheep. Methods: Twenty-four ewes were used, they were surgically infarcted through left thoracotomy and two coronary arteries were ligated (first and second diagonal). After coronary artery ligation three sheep died of ventricular fibrillation. Three weeks after coronary ligation, sheep were reoperated through median sternotomy. Normal saline solution was injected in the infarcted zone in 6 of them (control group) whereas platelet gel was injected in 15 of them. All sheep were euthanized at 9 weeks of evolution of the second surgery. Results: Noteworthy is the formation of new vessels in hematoxylin-eosin-stained sections and factor VIII in plasma rich in growth-factors (PRGF)-treated hearts. Conclusions: Injection of platelet growth factors, PRGF, in previously infarcted sheep hearts promotes mitogenesis and angiogenesis. The use of autologous PRGF is simple and safe, causing no toxicity or immune-inflammatory reactions.

[Effect of autologous platelet-rich plasma on heart infarction in sheep]. / Efecto del plasma autógeno rico en plaquetas sobre el infarto de miocardio en ovejas.

OBJECTIVE: Myocardial infarction is the most common cause of congestive heart failure. The objective of this work is to evaluate, in experimental animals, morphological and histological effects of the implantation of autologous platelet-rich plasma in infarcted heart sheep. METHODS: Twenty-four ewes were used, they were surgically infarcted through left thoracotomy and two coronary arteries were ligated (first and second diagonal). After coronary artery ligation three sheep died of ventricular fibrillation. Three weeks after coronary ligation, sheep were reoperated through median sternotomy. Normal saline solution was injected in the infarcted zone in 6 of them (control group) whereas platelet gel was injected in 15 of them. All sheep were euthanized at 9 weeks of evolution of the second surgery. RESULTS: Noteworthy is the formation of new vessels in hematoxylin-eosin-stained sections and factor viii in plasma rich in growth-factors (PRGF)-treated hearts. CONCLUSIONS: Injection of platelet growth factors, PRGF, in previously infarcted sheep hearts promotes mitogenesis and angiogenesis. The use of autologous PRGF is simple and safe, causing no toxicity or immune-inflammatory reactions.

Prognostic value of clinical, morphologic, and immunohistochemical factors in patients with bronchiolitis obliterans-organizing pneumonia.

Bronchiolitis obliterans-organizing pneumonia (BOOP) is an inflammatory and fibrosing disease involving the distal bronchioles, bronchiolar ducts, and alveoli. We studied 91 patients with BOOP. Univariate analysis was used to relate age, sex, smoking, morphology, and expression of immunohistochemical markers CD68, D2-40, CD31, CD34, collagen IV, collagen III, platelet-derived growth factor receptor, and vascular endothelial growth factor (VEGF) with the response to corticosteroid therapy. Seventy-two patients had idiopathic BOOP and 19 secondary BOOP. The median age of the patients was 59.54 years. Most patients were current or former smokers. All cases had a patchy lesion consisting of small buds of fibromyxoid tissue in small bronchioles, bronchiolar ducts, and alveoli. The buds contained collagen and reticulin fibers, fibroblasts, macrophages, mononuclear inflammatory cells, and vessels in different proportions. We found no morphologic differences between primary and secondary BOOP. Patients younger than 38 years and nonsmokers had a significant good response to corticosteroid therapy. Favorable morphologic predictors were the presence of large bronchial plugs and mild inflammatory reaction (P = .093). By immunohistochemistry, the presence of collagen IV with the absence of collagen III, CD68-positive cells and positive VEGF were associated with a good response to corticosteroid therapy. We conclude that age, smoking, localization, and extension of proliferative intrabronchiolar plugs and positive immunostains for CD68, VEGF, and collagen IV with negative collagen III were useful to predict response to corticosteroid therapy and relapse.

Metastatic meningioma: The role of whole­body diffusion-weighted imaging.

We report the case of a 74-year-old male patient with a completely resected anaplastic meningioma who developed multiple metastases two years later (subcutaneous tissue near the surgical area, cervical lymph nodes, lung, pleura and bones). The primary tumor and all of the metastases showed a significant restricted diffusion. Whole­body diffusion-weighted imaging (DWI) was performed for assessment of the metastases. This case demonstrated the usefulness of this technique in screening extracranial metastases in patients with malignant meningiomas.

[Primary adenocarcinoma of the seminal vesicles]. / Adenocarcinoma primario de vesículas seminales.

OBJECTIVES: To report one case of primary adenocarcinoma of the seminal vesicles. METHODS/RESULTS: We report the case of a 69-year-old man with obstructive voiding symptoms. Digital rectal examination reveals a marked enlargement of posterior area of the prostate and surrounding tissues. Transrectal needle biopsy shows a primary adenocarcinoma of the seminal vesicles. CONCLUSION: Primary adenocarcinoma of the seminal vesicles is an extremely uncommon neoplasm that is often difficult to diagnose as it has in specific morphology and can be confused with other primary adenocarcinomas from prostate, bladder or colon.

Viabilidad de un aislado de Escherichia coli O157: H7 en queso tipo guayanés usando separación inmunomagnética como herramienta de recuperación / The viability of an Escherichia coli O157: H7 strain in guayanés Ccheese using immunomagnetic separation as a tool for recovery

Se determinó la viabilidad de Escherichia coli O157:H7 en queso guayanés de manufactura artesanal, evaluando distintos esquemas de aislamiento basados en separación inmunomagnética (SIM). Unidades de queso (25 g) fueron inoculadas con 25 y 250 cel/g del patógeno y almacenadas a 4°C. Las piezas se analizaron los días 0, 2, 6, 8 y 10 post-inoculación a través de distintos esquemas de separación inmunomagnética (SIM) que incluían dos caldos de enriquecimiento: agua de peptona buferada sin inhibidores (APB-SI) y agua de peptona buferada con vancomicina, cefixime y telurito (APB-VCT) y dos agares de aislamiento del inmunoseparado: agar MacConkey sorbitol (MCS) y agar MacConkey sorbitol con telurito y cefixime (MCS-TC). Los resultados demostraron la viabilidad del patógeno hasta por 10 días post-inoculación y en el transcurso de este tiempo, para algunos de los esquemas aplicados sobre la base de SIM, se logró un incremento en los porcentajes de recuperación, lo que indica que el número de células inoculadas se elevó con el tiempo. En cuanto a la utilidad de la SIM para la recuperación del patógeno, se observó variaciones en los porcentajes de aislamiento en función del caldo de enriquecimiento y el nivel de células inoculadas. Los mayores porcentajes de recuperación se obtuvieron en las piezas inoculadas con 250 cel/g, con rangos del 35 al 85 por ciento (día 0 y 10 respectivamente) en el mejor de los esquemas SIM (APB-SI/SIM/MCS), mientras que para niveles de 25 cel/g, en el mejor de los casos (APB-SI/SIM/MCS), durante los primeros 6 días no superó el 15 por ciento. El caldo de enriquecimiento de mejor desempeño fue APB-SI (p <0,05) y no se observó diferencias en los porcentajes de recuperación (p>0,05) en función de los agares utilizados (MCS y MCS-TC) para la siembra del inmunoseparado

The viability of an Escherichia coli O157:H7 strain in cottage-industry Guayanes cheese was determined by evaluating several isolation protocols based on immunomagnetic separation (IMS). Cheese units (25 g) were inoculated with 25 and 250 cel/g of this pathogen and stored at 4°C. The pieces were analized at 0, 2, 6, 8 and 10 days post-inoculation through several IMS protocols including two enrichment broths: buffered peptone water without inhibitors (BPW-WI) and buffered peptone water with vancomicyn, cefixime and telurite (BPW-VCT) and two immunoseparation isolation agars: MacConkey-sorbitol agar (MSA) and MacConkey-sorbitol agar with cefixime and telurite (MSA-CT). Results demonstrated the viability of the pathogen for up to 10 days post-inoculation, and during this time, for some of the schemes applied on the IMS base, an increase in recovery percentages was achieved, indicating that the number of inoculated cells increased with time. In terms of the utility of IMS for recovering the pathogen, variations in the isolation percentages were observed in terms of the enrichment broth and the level of inoculated cells. The biggest recovery percentages were obtained in pieces inoculated with 250 cel/g, with ranges between 35 and 85 percent (days 0 and 10 respectively) in the best IMS scheme (BPW-WI/IMS/MSA), while, at levels of 25 cel/g, in the best case (BPW-WI/IMS/MSA), 15 percent was not surpassed during the first six days. The best performing enrichment broth was BPW-WI (p<0.05) and differences in the recovery percentages (p>0.05) were not observed in relation to the agars (MSA and MSA-CT) used for sowing the immunoseparator

Large cell carcinoma of the lung: an endangered species?

This study aims to evaluate large cell carcinomas (LCC) of the lung with a panel of immunohistochemical markers in an attempt to identify tumors belonging to other categories. We analyzed a tissue microarray platform of 101 LCC with a panel of 31 monoclonal antibodies. The tumors were 82 (81.3%) classic LCC, 7 (6.9%) neuroendocrine LCC, 6 (5.9%) lymphoepithelioma-like LCC, 3 (2.9%) basaloid LCC, 2 (2%) clear cell LCC, and 1 (1%) LCC with rhabdoid phenotype. Characteristic classic LCC immunophenotype was loss of staining with CK5/6, CK14 positive in most squamous cell carcinoma (SCC), lack of MOC 31 positive in most adenocarcinomas, and positive immunoreactivity to EGFR, PDGFR-alpha and c-kit. 27 of 82 classic LCC (32.9%) were re-classified as adenocarcinomas, because they coexpressed TTF-1, CK7, and CK19, and were negative for p63. 31 (37.8%) of 82 classic LCC were reclassified as poorly differentiated SCC, based on their immunoreactivity with 34betaE12, p63, thrombomodulin, and CD44v6. 16 (19.5%) of 82 classic LCC correspond to undifferentiated adenosquamous carcinomas, since they displayed conflicting immunostaining for markers of both SCC and adenocarcinomas. The use of 7 immunohistochemical markers, consisting of TTF-1, CK7, CK19, p63, 34betaE12, thrombomodulin, and CD44v6, markedly reduces dramatically to less than 10%, the number of classic LCC by readily identifying cases of poorly differentiated SCCs, adenosquamous carcinoma and adenocarcinomas.

Pseudomesotheliomatous carcinoma of the lung with a distinct morphology, immunohistochemistry, and comparative genomic hybridization profile.

We report 4 cases of pseudomesotheliomatous carcinoma of the lung, which has clinical and microscopic features similar to malignant mesothelioma, but with ultrastructural, immunohistochemical, and molecular characteristics suggestive of a histogenesis from type II pneumocytes. Neoplasm grows as a diffuse or solid pattern of large polygonal cells with sharply defined borders. Hale's colloidal iron is positive in the cytoplasm of small groups of cells and, focally, in some intercellular spaces. Ultrastructure showed short microvilli in the surface. Immunohistochemically, tumor cells were positive for thyroid transcription factor-1, podoplanin, mesothelin, pan-cytokeratin, CK-7, CK-19, Ber-EP4, epithelial membrane antigen, apoprotein surfactant A, epidermal growth factor receptor, Leu-M1, carcinoembryonic antigen, E-cadherin, and CD-44 and negative for mesothelioma markers thrombomodulin and calretinin. In some areas, there were small cysts which contained a concentric fibrilar basophilic material apoprotein surfactant A positive. Chromosomal imbalances with comparative genomic hybridization technique were identified with a median of 15 abnormalities per case (range, 1-26): 51 gains, 6 losses, and 1 high-level amplification. The most frequent aberrations among the cases were gains on chromosomes regions 1q, 3q, 5p, 8q, 16p, and 18q and losses in 17p11-13 and 17q 22-q25. High-level amplifications were detected on 7p13-p21. In all cases, there was a characteristic association between the gains on 16p and those on 18q. The 4 cases resulted in death in less than 14 months, in spite of complete surgery and chemotherapy in 2 cases. Our aim is to complement the current understanding of this pseudomesotheliomatous "pneumocytic" carcinoma and alert pathologists to this rare entity to avoid misdiagnosis.

Incidental findings in negative sentinel lymph nodes of patients with malignant melanoma: report of three cases.

We present three cases of benign SLN that were clinically suspicious for involvement by metastatic melanoma and where found to be involved with other diseases or deposits previously unknown.

Control de liquidos hospital San Rafael de Girardot / Liquid control Hospital San Rafael de Girardot

El objetivo del presente trabajo es determinar la forma como realiza la auxiliar de enfermeria los procedimietos relacionados con el contro de liquidos en el Hospita San Rafael de Girardot. La siguiente publicacion contiene las siguientes conclusiones: un alto porcentaje de las auxiliares de enfermeria , no conocen y/o no siguen las recomendaciones generales y universales del control y administracion de liquidos a pacientes hospitalarios. No existen diferencias mas o menos significativas entre los conocimientos y procedimientos seguidos por las auxiliares de enfermeria de los tres servicios estudiados. Existen diferencias mas o menos significativas entre los conocimientos de las auxiliares de enfermeria en lo referente al control y administracion de liquidos a pacientes hospitalarios y su grado de escolaridad o nivel educativo..