The anti-CD6 antibody itolizumab provides clinical benefit without lymphopenia in rheumatoid arthritis patients: results from a 6-month, open-label Phase I clinical trial.

Itolizumab is a humanized anti-CD6 monoclonal antibody (mAb) that has previously shown encouraging results, in terms of safety and positive clinical effects, in a 6-week monotherapy clinical trial conducted in rheumatoid arthritis (RA) patients. The current Phase I study evaluated the safety and clinical response for a longer treatment of 12 itolizumab intravenous doses in subjects with active RA despite previous disease-modifying anti-rheumatic drug (DMARD) therapy. Twenty-one subjects were enrolled into four dosage groups (0·1, 0·2, 0·4 and 0·8 mg/kg). Efficacy end-points including American College of Rheumatology (ACR)20, ACR50 and ACR70 response rates and disease activity score in 28 joints (DAS28) were monitored at baseline and at specific time-points during a 10-week follow-up period. Itolizumab was well tolerated up to the highest tested dose. No related serious adverse events were reported and most adverse events were mild. Remarkably, itolizumab treatment did not produce lymphopenia and, therefore, was not associated with infections. All patients achieved a clinical response (ACR20) at least once during the study. Eleven subjects (55%) achieved at least a 20% improvement in ACR just 1 week after the first itolizumab administration. The clinical response was observed from the beginning of the treatment and was sustained during 24 weeks. The efficacy profile of this 12-week treatment was similar to that of the previous study (6-week treatment). These results reinforce the safety profile of itolizumab and provide further evidence on the clinical benefit from the use of this anti-CD6 mAb in RA patients.

Nature of the observed ν(NO) band shift and splitting during the 3D to 2D structural change in transition metal nitroprussides.

The electronic structure and related optical properties of the nitroprusside ion, [Fe(CN)5NO]2-, are dominated by the nitrosyl (NO+) group. The light-induced 2b2(xy) â†’ 7e(π*NO) (Fe â†’ NO) and related appearance of meta-stable isomers for the NO group supports many of the functional properties of metal nitroprussides. In recent studies on the preparation of 2D transition metal nitroprussides from their 3D analogs, we have observed that such a structural change is concomitant with a decrease for the ν(NO) frequency and certain band splitting (unfolding). The 3D to 2D structural modification leads to an increase in the electron density at the iron atom. This results in an enhancement for the π*-back donation, which increases the electron population at the π*2px and π*2py orbitals. These last orbitals are doubly degenerated, and the increase for the π*-back bonding induces the removal of that degeneration via the Jahn-Teller effect. This intuitive mechanism explains the mentioned band unfolding related to the structural change. Such explanation was herein supported by a model based on the normal modes for the FeNO fragment derived from the small oscillation formalism around the equilibrium positions for the involved atoms. This model shows that there is a very close relationship between the deformation of the nitrosyl group (NO+) and the splitting of the IR bands. That is, the less linear the nitrosyl group, the greater the shift and splitting of the mentioned IR band. An excellent coincidence between the frequency values calculated using the model and the experimental ones was observed. The largest difference between the theoretically calculated ν(NO) frequencies and the experimental ones was only 6 cm-1 and 5 cm-1 in representative samples of 2D and 3D transition metal nitroprussides, respectively. The understanding of such an effect could be relevant for the functional properties of these 2D coordination polymers.

Thymoglobulin Induction Therapy in Deceased Donor Kidney Transplantation: Single-Center Experience in Mexico.

BACKGROUND: Induction therapy is used to reduce the incidence of graft rejection and delayed graft function. Thymoglobulin is the most used inductor agent in deceased donor kidney transplantation due to its lower rejection and delayed graft function rates. METHODS: Retrospective study of patients who underwent deceased donor kidney transplantation from 2011 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes, the lowest leukocyte count during the induction, adverse effects, eGFR, and patient and graft survival. P < .05 was considered statistically significant. RESULTS: A total of 42 patients were registered. Of these, 51.7% were female, with a mean age of 36.4 ± 11.1 years. Mean dialysis time was 112.4 ± 365 months. Mean donor age was 33.7 ± 13.1 years. Of the registered patients, 14.3% were extended criteria donors and 23.8% high-risk. Mean thymoglobulin dose was 4.4 ± 0.8 mg/kg. Primary graft nonfunction was 2.4%. Nineteen percent presented with delayed graft function and 19% with acute rejection. Mean lowest leukocyte count was of 4.6 ± 1.5 × 10(3) cells/mm(3). Mean hospital stay was 11.3 ± 6.3 days. Adverse effects were seen in 59.5% of registered patients, whereas graft survival 1 year and 3 years after transplantation was 85.3% and 56.9%, respectively. Patient survival 1 year and 3 years after transplantation was 85.3% and 53.8%, respectively. Patients who received a higher dose (>4.4 mg/kg) had a shorter hospital stay (9.4 ± 4.6 and 8.1 ± 2.3) than those who received lower dose (13.6 ± 7.9 and 12.8 ± 7.4; P < .05). CONCLUSION: Thymoglobulin induction at doses near 5 mg/kg in deceased donor kidney transplant is efficient and secure at our center.

Induction Immunosuppressive Therapy Use in Deceased Donor Kidney Transplantation: 11-Year Experience in Veracruz, Mexico.

BACKGROUND: Induction therapy reduces the frequency of acute rejection and delayed graft function in renal transplantation. Basiliximab and Thymoglobulin are most commonly used agents for induction. METHODS: A retrospective study of two transplant centers in Veracruz, Mexico compared induction therapy in deceased donor renal transplantation from 2003 to 2014. Efficacy and safety outcomes evaluated were primary graft nonfunction, delayed graft function, acute rejection episodes and hospitalizations during first year, and patient and graft survival. P < .05 was considered statistically significant. RESULTS: Seventy deceased kidney donors (40 male) were studied. Mean donor age was 32.9 ± 14.3 years, mean donor BMI 25.6 ± 4.3 kg/m(2), and mean donor creatinine 1.13 ± 0.58 mg/dL. Main cause of death was trauma (62.9%). In total, 125 kidney transplantations were performed, with female predominance (53.6%) and mean age 33.8 ± 11.8 years. Of these, 66.4% used basiliximab and 33.6% Thymoglobulin. Thymoglobulin patients were significantly older, with lower weight and BMI, and were on dialysis longer than basiliximab patients. DGF was present in 19.3% of basiliximab patients vs 16.7% in Thymoglobulin patients, acute rejection occurred in 16.9% of basiliximab patients vs 19% Thymoglobulin patients. A total of 33.7% basiliximab patients were hospitalized during the first year vs 47.6% Thymoglobulin-induced patients (P > .05). Mean graft survival was 84.2 ± 5.3 months (73.8-94.7) basiliximab vs 32.4 ± 28.7 months (28.7-36.1) Thymoglobulin, Kaplan-Meier survival did not show statistically significant differences between groups (P = .276; CI 95%). CONCLUSION: Similar transplant outcomes were obtained using basiliximab or Thymoglobulin induction in our population.

[The value of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) in diagnosis of neoplastic diseases]. / Valor de la tomografía por emisión de positrones mediante 18F-fluoro-2-desoxi-D-glucosa (PET-FDG) en el diagnóstico de las neoplasias.

Positron emission tomography (PET) has the ability to detect cancer based on molecular and biochemical processes within the tumor tissues. The most widely used radiotracer in oncology at this time is the glucose analogue 18F-fluoro-2-deoxy-D-glucose (18F-FDG). Like glucose, 18F-FDG is transported into cells by a glucose transporter protein and rapidly converted into 18F-FDG-6-phosphate. PET imaging with 18F-FDG is able to diagnose, stage, and restage many cancers with accuracies ranging from 80% to 90%. Responses to therapy can be identified earlier and with greater accuracy than is possible with anatomic imaging modalities. The prognostic information available through 18F-FDG PET is superior to that of conventional imaging for many cancers. The aim of this review article is to show the most promising clinical indications for the use of PET in oncology.

Enfermedad de Hailey-Hailey, una familia diagnosticada a partir de un caso propositus / Hailey-Hailey diseases, a family diagnosed starting from a case propositus

RESUMEN Introducción: La enfermedad de Hailey-Hailey, también conocida como pénfigo benigno familiar, es una enfermedad de muy baja frecuencia de aparición, aunque es una genodermatosis,las manifestaciones clínicas se manifiestan en la adolescencia o adultez temprana. Objetivo: Profundizar en los elementos que permiten el diagnóstico temprano de la enfermedad de Hailey-Hailey. Presentación del caso: En Las Tunas, provincia oriental de Cuba, es atendida en consulta especializada multidisciplinaria de genodermatosis, una mujer de 50 años de edad, quien presentabalesiones eritematosas, vesiculosas y erosivas, localizadas en zonas de pliegues, que habían aparecido desde la adolescencia, siendo tratadas en varias ocasiones como una micosis superficialo dermatitis. Se lerealiza estudio histopatológico que constató el diagnósticode enfermedad de Hailey-Hailey. Se estudiaron los demás miembros de la familia afectados con similareslesiones dermatológicasy se corrobora el diagnóstico familiar. La paciente fue tratada con esteroides en dosis antinflamatorias, vitaminoterapia y terapéutica tópica consistente en uso de fomentos antisépticos naturales y crema antinflamatoria de aloe, con buena respuesta a la terapéutica. Conclusiones: Se presenta el caso porque la enfermedad de Hailey Hailey es infrecuente, las manifestaciones comienzan en la adolescencia, pudiendo confundirse con otras dermatosis. En la investigación se determinó el diagnóstico de los demás miembros de la familia afectados a partir del caso propositus.

ABSTRACT Introduction: The Hailey-Hailey diseases,also known asbenign familial pemphigus, is an disease of very low appearance frequency,although it is a genodermatoses, the clinical manifestations are manifested in the adolescence or early adulthood. Objective: To deepen in the elements that allows the early diagnosis of Hailey-Hailey diseases. Case presentation: In Las Tunas, oriental county of Cuba, is assisted in multidisciplinary specialized consultation of genodermatoses, a 50-year-old woman who presented lesions erytmematous, vesiculous and erosive, located in areas of pleats that had appeared from the adolescence, being treated in several occasions like a superficial mycosis or dermatitis. She is carried out study histopathologyc that verified the diagnosis of Hailey-Hailey diseases. The other members of the family were studied affected with similar injure dermatological and the family diagnosis is corroborated. The patient was treated with steroids in dose antinflammatory, vitamintherapy and topical therapeutic consistentin use of antiseptic natural foments and cream antinflammatory of aloe, with good answer to the therapy. Conclusions: The case is presented because the Hailey-Hailey diseases areuncommon; the manifestations begin in the adolescence, being able to make a mistake with other dermatomes.In the investigation the diagnosis of the other members of the family was determined affected starting from the case propositus.

Predicting outcome in acute stroke: a comparison between QEEG and the Canadian Neurological Scale.

OBJECTIVE: To determine and compare the predictive value of quantitative EEG (QEEG) and the Canadian Neurological Scale (CaNS), in patients with an acute cerebral stroke. METHODOLOGY: Twenty-eight patients were studied with the diagnosis of acute ischemic middle cerebral artery stroke, within the first 72 hours of clinical evolution. Thirty-seven EEGs and clinical evaluations were collected: 13 during the first 24 hours after stroke onset, 9 between 24-48 hours and 15 between 48-72 hours. The QEEG studied variables were: the Z values (maximum, minimum and the Z medians from the 5 nearest points to each one) of absolute energies (AE) from the 4 classic frequencies bands. The clinical scale showed a smaller percent of correct prognosis than QEEG variables. CONCLUSIONS: QEEG was demonstrated to be a powerful tool to predict the degree of residual functional disabilities after an acute ischemic stroke and showed a higher prognostic value than CaNS when they are performed within the first 72 hours of brain infarct.

Adrenocortical scintigraphy with 131I-6-beta-iodomethyl-norcholesterol (NP 59) in bilateral adrenocortical carcinoma.

A case of a 49-year-old man suffering from bilateral adrenocortical carcinoma with local and secondary rapid progression is reported. The results of adrenocortical scintigraphy (NP 59) and histological findings allowed the diagnosis. This case report and a literature review showed the importance of using adrenocortical scintigraphy as a complementary imaging procedure of CT or MR images.

Pelvic and lumbar metastasis detected by bone scintigraphy in malignant pleural mesothelioma.

A case of a 43-year-old man suffering from pleural mesothelioma with distant bone metastasis is reported. The results of bone scintigraphy and NMR findings allowed the diagnosis. The current case describes a hematogenous metastasis to the pelvis and vertebral column from a malignant pleural mesothelioma that was detected initially by bone scintigraphy.

QEEG prognostic value in acute stroke.

The objective of our study is to determine the predictive value of QEEG in patients suffering from an acute ischemic cerebral stroke. Twenty-eight patients were studied within the first 72 hours of clinical evolution of middle cerebral artery territory ischemic stroke. Thirty-seven QEEG recordings were obtained: 13 in the first 24 hours after cerebral stroke onset, 9 between 24-48 hours and 15 between 48-72 hours. Absolute Energies (AE) were the QEEG selected variables for statistical analysis: first, AE Z values were calculated using the Cuban QEEG norms, then the maximum and minimum AE Z values were selected within each frequency band and total power. The medians of the five neighboring Z values were also chosen. Regression models were estimated using the RANKIN scores as dependent variables and the selected QEEG variables as independent, then outcome predictions at hospital discharge and 3 months later were calculated. Percentages of concordance and errors between the estimated and real outcome scores were obtained. Alpha and theta AE were the best predictor for short-term outcome and delta AE for long-term outcome. We conclude that QEEG performed within the first 72 hours of ischemic stroke might be a powerful tool predicting short- and long-term outcome.

Valor de la tomografía por emisión de positrones mediante 18 F-fluoro-2-desoxi-D-glucosa (PET-FDG) en el diagnóstico de las neoplasias / The value of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography ( 18 F-FDG PET) in diagnosis of neoplastic diseases

La tomografía por emisión de positrones (PET) tiene la habilidad de detectar el cáncer a través de mecanismos basados en procesos moleculares y bioquímicos dentro de los tejidos tumorales. El radio trazador más utilizado en oncología es un análogo de la glucosa marcado con flúor, 18 F-fluoro-2-desoxi-D-glucosa ( 18 F-FDG). Al igual que la glucosa, la 18 F-FDG pasa al interior de las células mediante proteínas transportadoras y rápidamente se convierte en 18 F-glucosa-6-fosfato.Mediante PET-FDG se diagnostica, estadifica y reestadifica la mayoría de los cánceres, con exactitudes diagnósticas entre el 80 y el 90%.Mediante la PET se puede conocer la respuesta al tratamiento tempranamente y con mayor precisión que con los métodos anatómicos de imagen, con información pronostica superior a la de los métodos convencionales, para la mayoría de los cánceres. El objetivo de este artículo de revisión es mostrar las indicaciones clínicas más prometedoras de la PET-FDG en oncología

Positron emission tomography (PET) has the ability to detect cáncer based on molecular and biochemical processes within the tumor tissues. The most widely used radiotracer in oncology at this time is the glucose analogue 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG). Like glucose, 18 F-FDG is transported into cells by a glucose transporter protein and rapidly converted into 18 F-FDG-6-phosphate. PET imaging with 18 F-FDG is able to diagnose, stage, and restage many cancers with accuracies ranging from 80% to 90%. Responses to therapy can be identified earlier and with greater accuracy than is possible with anatomic imaging modalities. The prognostic information available through 18 F-FDG PET is superior to that of conventional imaging for many cancers. The aim of this review article is to show the most promising clinical indications for the use of PET in oncology

Gastroenteritis aguda por vibrio fluvialis: reporte de un caso / Acute gastroenteritis due to vibrio fluvialis: case report

V. flubialis ha sido asociado con diarrea, pero no es muy frecuentemente aislado en nuestro medio. Se reporta un caso de gastroenteritis aguda en un niño de nueve años de edad. Dicho caso resulta inusual debido a que no involucra los probables factores de riesgo epidemiológico. Puesto que se han reportado otros casos en niños, V.fluvialis debe ser considerado en el diagnóstico diferencial de gastroenteritis infantil

Prevalencia y resistencia antimicrobiana de especies de shigella aisladas de niños con diarrea en Maracaibo Venezuela / Prevalence and antimicrobial resistence of shigella species isolated in children with diarrhea in Maracaibo Venezuela

Para determinar la prevalencia de shigelosis en niños menores de 6 años de edad, en la ciudad de Maracaibo, durante los años 1995-1999, se procesaron 789 muestras fecales. En 358 (45,4 por ciento) especímenes se detectaron bacterias enteropatógenas. Shigella spp. representó el 72,3 por ciento de las mismas. 174 (67,2 por ciento) aislamientos correspondieron a S.flexneri, 79 (30,5 por ciento) a S. sonnei, 4 (1,5 por ciento) y 2 (0,8 por ciento) a S. boydii S. dysenteriae, respectivamente. El 68 por ciento de los casos se detectó en niños menores de 3 años de edad, produciendose el 36 por ciento en niños menores de 1 año. S. flexneri y S. sonnei se presentaron en todos los grupos etarios. Los dos aislamientos de S. dysenteriae se encontraron en pacientes menores de 1 año de edad. Al estudiar la sensibilidad y resistencia a trimethoprim-sulfametoxazol, ampicilina, carbenicilina, cefalotin, tetraciclinas, piperacilina, cefoperazone, cefamandol, ceftazidima, gentamicina, ampicilina sulbactam, amikacina, aztreonam, netilmicina, colimicina, cloranfenicol y ácido nalidixico, se observó que el 92 por ciento de las 259 cepas de Shigella spp. fue multirresistente (3 a 8 antimicrobianos). El porcentaje de resistencia encontrado para trimethoprim-sulfametoxazol fue 72,2 por ciento, mientras que, para ampicilina y carbenicilina fue del orden del 64,8 por ciento. Las dos cepas de S. dysenteriae fueron resistentes a los tres antimicrobianos mencionados. Los 4 aislamientos de S. boydii desarrollaron resistencia sólo a trimethopim-sulfametoxazol. Para cefalotin la resistencia encontrada fue 34,4 por ciento. Con relación a las cefalosporinas de segunda y tercera generación, los porcentajes de resistencia fueron menores: cefamandol (7,3 por ciento), cepoferazone (7,3 por ciento) y ceftazidima (6,2 por ciento). 4, 6 por ciento de las cepas fueron resistentes a ampicilina sulbactam, 1,5 por ciento a aztreonam y el 10 por ciento a piperacilina. La resistencia desarrollada a los aminoglucosidos fue baja: gentamicina 5,4 por ciento y amikacina 5,8 por ciento, la resistencia para tetraciclinas fue de 28,6, mientras que, para cloranfenicol, ácido nalidixico, colimicina y netilmicina, no se observó resistencia

Gammagrafía con 67Galio en un caso de sarcoidosis / Scintigraphy with 67Galium in a case of sarcoidosis

No disponible