Post-laser in situ keratomileusis interface Arthrographis kalrae keratitis / Interface de pós-laser ceratomileuse in situ Arthographis Kalrae ceratite

ABSTRACT We describe a case of keratomycosis caused by Arthographis kalrae after excimer laser keratomileusis. A 38-year-old female developed stromal keratitis eight weeks after refractive surgery. She developed severe corneal stromal infiltration and mild anterior segment inflammation, which could not be treated with topical voriconazole 1%, but topical natamycin 5% ameliorated her condition. A reactivation of keratomycosis symptoms was observed; therefore, longer treatment was administered to the patient. It has been reported that A. kalrae keratomycosis is associated with exposure to soil and contact lens usage. However, the patient, who lived in a rural location, was neither involved in gardening activities nor had a history of wearing contact lenses. This is the first case of post-refractive A. kalrae keratomycosis.

RESUMO Descrevemos um caso de ceratomicose por Arthographis kalrae após ceratomileusis por excimer laser. Uma mulher de 38 anos desenvolveu ceratite estromal oito semanas após a cirurgia refrativa. Ela desenvolveu infiltração estromal grave da córnea e uma leve inflamação do segmento anterior, que não pode ser tratada com voriconazol tópico a 1%, mas a natamicina tópica a 5% melhorou sua condição. Uma reativação dos síntomas de ceratomicose foi observada; portanto, tratamento mais prolongado foi administrado a paciente. Tem sido relatado que a ceratomicose por A. kalrae está associada à exposição ao solo e ao uso de lentes de contato. No entanto, a paciente, que vivía em um local rural, não estava envolvida em atividades de jardinagem e nem tinha histórico de uso de lentes de contato. Este é o primeiro caso de ceratomicose pós-refrativa por A. kalrae.

Post-laser in situ keratomileusis interface Arthrographis kalrae keratitis.

We describe a case of keratomycosis caused by Arthographis kalrae after excimer laser keratomileusis. A 38-year-old female developed stromal keratitis eight weeks after refractive surgery. She developed severe corneal stromal infiltration and mild anterior segment inflammation, which could not be treated with topical voriconazole 1%, but topical natamycin 5% ameliorated her condition. A reactivation of keratomycosis symptoms was observed; therefore, longer treatment was administered to the patient. It has been reported that A. kalrae keratomycosis is associated with exposure to soil and contact lens usage. However, the patient, who lived in a rural location, was neither involved in gardening activities nor had a history of wearing contact lenses. This is the first case of post-refractive A. kalrae keratomycosis.

Apoptotic signalling targets the post-endocytic sorting machinery of the death receptor Fas/CD95.

Fas plays a major role in regulating ligand-induced apoptosis in many cell types. It is well known that several cancers demonstrate reduced cell surface levels of Fas and thus escape a potential control system via ligand-induced apoptosis, although underlying mechanisms are unclear. Here we report that the endosome associated trafficking regulator 1 (ENTR1), controls cell surface levels of Fas and Fas-mediated apoptotic signalling. ENTR1 regulates, via binding to the coiled coil domain protein Dysbindin, the delivery of Fas from endosomes to lysosomes thereby controlling termination of Fas signal transduction. We demonstrate that ENTR1 is cleaved during Fas-induced apoptosis in a caspase-dependent manner revealing an unexpected interplay of apoptotic signalling and regulation of endolysosomal trafficking resulting in a positive feedback signalling-loop. Our data provide insights into the molecular mechanism of Fas post-endocytic trafficking and signalling, opening possible explanations on how cancer cells regulate cell surface levels of death receptors.

High-content screening of drug-induced mitochondrial impairment in hepatic cells: effects of statins.

A frequent mechanism for drug-induced liver injury (DILI) is mitochondrial impairment, and early evaluation of new drugs for their potential to cause mitochondrial dysfunction is becoming an important task for drug development. To this end, we designed a high-content screening assay to study mitochondrial-induced hepatotoxicity in HepG2 cells in detail. Simultaneous assessment of mitochondrial mass and cell viability in cells exposed for 24 h to compounds provides preliminary information on the mitochondrial- or nonmitochondrial-related hepatotoxic potential of compounds. To fully address the mechanisms implicated in mitochondrial impairment, prelethal changes in mitochondrial superoxide production, mitochondrial membrane potential, mitochondrial permeability transition, intracellular calcium concentration and apoptotic cell death were studied in cells incubated for 1 h with compounds. The assay correctly classified a set of well-known mitochondrial toxicants and negative controls and revealed high sensitivity for the detection of mitochondrial DILI and the establishment of different mitochondrial toxicity risks (low to high). This procedure was used for analysing the potential mitochondrial impairment of six statins to determine their clinical risk. All the tested statins produced mitochondrial impairment, although they showed different levels of toxicity (low-medium toxicity risk). The results suggest that this cell-based assay is a promising in vitro approach to predict the potential of drug candidates to induce mitochondrial-associated hepatotoxicity.

Diagnóstico del embolismo pulmonar, a propósito del Pioped II y de las nuevas técnicas isotópicas / Diagnosis of pulmonary embolism: about of Pioped II and the new isotopic techniques

Con la reciente publicación del estudio del Pioped II sobre la utilidad del Tac multicorte (CTA) en el diagnostico de embolismo pulmonar y con su inconsistencia diagnostica en los casos discordantes con la probabilidad clínica o pretest vuelve la atención a los estudios isotópicos de ventilación y perfusion a sus ventajas y a sus adelantos tecnológicos. Esta revisión incluye el análisis de los resultados del pioped II y los compara con los estudios más recientes utilizando technegas, spect y tres dimensiones. El Pioped II tenia dos objetivos, ver la utilidad del Tac multicorte toráxico (CTA) en descartar o diagnosticar embolismo pulmonar y el de comparar dos modalidades diagnosticas relacionadas pero diferentes, el Tac multicorte toráxico (CTA) solo y el CTA toráxico combinado con la fase venosa (CTA-CVT). Las sensibilidades obtenidas fueron, 83 por ciento para el CTA y 90 por ciento para el CTA-CVT con especificidades a su vez del 96 por ciento para el primero y de 95 por ciento para el Segundo. Sin embargo en los pacientes con baja probabilidad pretest la presencia de falsos positivos fue del 42 por ciento y en los pacientes con alta probabilidad pretest la presencia de falsos negativos fue del 40 por ciento. Esto indica que el Tac multicorte per. se no descarta el embolismo pulmonar y no tiene la trascendencia de una gamagrafia pulmonar de V-Q normal. El Tac toráxico multicorte produce de tres hasta 10 veces mas radiación que la que produce una gamagrafia pulmonar de ventilación perfusion y la adición del estudio venoso mediante Tac multicorte multiplica 1.5 veces la tasa de exposición radiológica del Tac toráxico solo. La gamagrafia de ventilación pulmonar se ha modificado al utilizar ahora compuestos marcados con tecnecio 99m, ya sea technegas o micro aerosoles que brindan mejores imágenes que el Xe 133 y el Kr 81m y que facilitan un mayor numero de proyecciones. También es posible ahora realizar spect ventilatorio con technegas. El spect pulmonar con re...

Hemangioma hepático, diagnóstico por gammagrafía hepática

Se presenta un caso de un paciente de 39 años de edad, a quien se hizo el diagnóstico imagenológico de hemangioma hepático solo con gamagrafía hepática con tecnecio - glóbulos rojos marcados. (99 Tc GRM) Se revisa la literatura y procedimientos diagnósticos haciendo énfasis en los estudios por medicina nuclear

Enfermedad de graves y carcinoma anaplásico de tiroides

Se presenta el caso de un paciente de 34 años con diagnóstico de enfermedad de Graves y quien desarrolla enn un nódulo palpable un carcinoma anaplásico. Se revisa la incidencia de carcinomas tiroideos y enfermedad de Graves

Tumor glomico: revisión clinico patológica / Glomus tumors: clinical pathologic review

El tumor glómico es una neoplasia benigna, poco frecuete, que e deriva de shunts arteriovenosos especializados, descubriéndose casos de malignidad cuando se localizan en el estómago o el duodeno. Se revisaron la historias clínicas de los pacietes (5) con tumor glómico, confirmados por biopsia entre los años 1981-1991 en el Hospital Militar "Dr. Carlos Arvelo", correlacionandose desde el punto de vista clínico-patológico, revisando además la bibliografía correspondiente

Espironolactona topica en el tratamiento del acne / Topic spironolactone in the treatment of acne

Tomando en consideracion que el acné es una condición andrógeno dependiente, realizamos un estudio preliminar en 50 pacientes con acné, utilizando espironolactoma tópica de 0,3%y 0,6%. Treinta y tres mostraron significativamente, 12 abandonaron el tratamiento y 5 pacientes sin modificaciones. Estos resultados en ausencia de efectos colaterales, puede significar un avance valioso en la terapeútica del acné