Correction: Role of growth arrest-specific gene 6-mer axis in multiple myeloma.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Relación entre automanejo y síntomas depresivos en personas con diabetes e hipertensión / Relationship between self-management and depressive symptoms in persons with diabetes and hypertension / Relação entre automanejo e sintomas depressivos em pessoas com diabetes e hipertensão

Resumen Introducción: Las personas con diabetes e hipertensión experimentan con mayor frecuencia sintomatología depresiva, lo cual contribuye a un inadecuado automanejo de la enfermedad, que implica tareas como: la toma de la medicación, asistir a las consultas médicas, el conocimiento de signos y síntomas, además de la toma de decisiones. Objetivo: Por lo anterior, el objetivo de este trabajo es identificar la relación entre automanejo en general y sus dimensiones con síntomas depresivos en personas con diabetes e hipertensión. Método: Estudio transversal-correlacional con n=205 pacientes con diagnóstico de diabetes (100) e hipertensión (105). Muestreo no probabilístico por conveniencia. Se utilizó la estadística descriptiva y r de Pearson. Se aplicaron los instrumentos Partners in Health (PIH) y The Patient Health Questionnaire (PHQ-8). Resultados: Se encontró correlación estadísticamente significativa entre la sintomatología depresiva y el automanejo (r=-0.308 ρ<0.001). Discusión y Conclusiones: Se concluye que la sintomatología depresiva se relaciona con el automanejo de la enfermedad de la siguiente manera: a mayor automanejo menor sintomatología de depresión, o a mayor sintomatología depresiva menor automanejo; dicha relación confirma que ambas variables se afectan mutuamente y/o mantienen una relación estrecha.

Abstract Introduction: Persons with diabetes and hypertension frequently suffer from depression as well, a situation which contributes to an inadequate management of the condition in terms of medication, medical consultations, signs, and decision making. Objective: To identify the relationship between general self-management and depression symptoms in persons with diabetes and hypertension. Method: This is a transversal and correlational study with a sample of 205 patients, 100 with a main diagnosis of diabetes, and 105 with a main diagnosis of hypertension. The sampling process was non-probabilistic and by convenience. Descriptive statistics, including Pearson's r were calculated. The Partners in Health (PIH) and Patient Health Questionnaire (PHQ-8) instruments were administered. Results: A statistically significant correlation between depression symptoms and diabetes and hypertension self-management was found (r=-0.308 ρ<0.001). Discussion and conclusions: Depression symptoms were related to how diabetes and hypertension are self-managed in a way that, the more self-management, the less depression symptoms, or the more depression symptoms, the less self-management.

Resumo Introdução: As pessoas com diabetes e hipertensão experimentam com maior frequência a sintomatologia depressiva, o qual contribui a um inadequado automanejo da doença, que envolve tarefas como: a toma da medicação, assistir às consultas médicas, o conhecimento de signos e sintomas, além da toma de decisões. Objetivo: Pelo anterior, o objetivo deste trabalho é identificar a relação entre automanejo em geral e suas dimensões com sintomas depressivos em pessoas com diabetes e hipertensão. Método: Estudo transversal-correlacional com n=205 pacientes com diagnóstico de diabetes (100) e hipertensão (105). Amostragem não probabilística por conveniência. Utilizou-se a estatística descritiva e r de Pearson. Aplicaram-se os instrumentos Partners in Health (PIH) e The Patient Health Questionnaire (PHQ-8). Resultados: Encontrou-se correlação estatisticamente significativa entre a sintomatologia depressiva e o automanejo (r=-0.308 ρ<0.001). Discussão e Conclusões: Conclui-se que a sintomatologia depressiva relaciona-se com o automanejo da doença da seguinte maneira: a maior automanejo, menor sintomatologia de depressão, ou a maior sintomatologia depressiva, menor automanejo; esta relação confirma que ambas variáveis afetam-se mutuamente e/ou mantem uma relação estreita.

Incompletely excised lentigo maligna melanoma is associated with unpredictable residual disease: clinical features and the emerging role of reflectance confocal microscopy.

BACKGROUND: Lentigo maligna/lentigo maligna melanoma (LM/LMM) poses a treatment and surgical challenge given unpredictable subclinical extension resulting in incomplete excision. OBJECTIVES: To describe the demographic, clinical and pathologic characteristics of incompletely excised LM/LMM. To evaluate the potential role of reflectance confocal microscopy (RCM). PATIENTS AND METHODS: A retrospective review of a melanoma database at a tertiary cancer centre for patients referred with 'incompletely excised LM/LMM' or 'incompletely excised melanoma' between October 2006 and July 2017. We recorded clinical and pathological data and surgical margins needed to clear the residual LM/LMM. The second part consisted of a prospective cohort of patients in which RCM was performed when presenting with incompletely excised LM/LMM. RESULTS: We included a total of 67 patients (retrospective + prospective cohort); mean age was 64.9 (standard deviation: 11.3) years and 52.2% were males. For the retrospective cohort (n = 53), the mean scar size was 3.4 cm. The average initial margins excised prior to presentation were 4.8 mm (range 3-7 mm). The average additional margin needed to clear the residual, incompletely excised LM/LMM was 7.8 mm. For the prospective cohort (n = 14), there were no differences in age, gender or size when compared to the retrospective cohort. RCM had a diagnostic accuracy of 78.6%, a sensitivity of 90.9%, a specificity of 33.3% and a positive predictive value of 83.3% for the detection of incompletely excised LM/LMM. CONCLUSIONS: Incompletely excised LM/LMM is a poorly characterized clinical-pathological scenario that may require considerable extra margins for microscopic clearance. RCM may emerge as a valuable tool for the evaluation of patients with incompletely excised LM/LMM.

Reflectance confocal microscopy and dermoscopy aid in evaluating repigmentation within or adjacent to lentigo maligna melanoma surgical scars.

BACKGROUND: Determining whether repigmentation within or adjacent to lentigo maligna or lentigo maligna melanoma (LM/LMM) scars represents recurrence of melanoma is challenging. The use of reflectance confocal microscopy (RCM) and dermoscopy may aid in differentiating true melanoma recurrence from other causes of repigmentation. OBJECTIVES: To describe the characteristics of repigmentation within or adjacent to LM/LMM scars observable on RCM and dermoscopy. METHODS: We retrospectively analysed patients who presented with new pigmentation within or adjacent to scars from surgically treated LM/LMM between January 2014 and December 2018. Clinical and demographic characteristics and time to recurrence were recorded. RCM was used to evaluate areas of pigmentation before biopsy. If available, dermoscopic images were also evaluated. RESULTS: In total, 30 confocal studies in 29 patients were included in the study cohort. Twenty-one patients had biopsy-confirmed recurrent LM/LMM; the remainder had pigmented actinic keratosis (n = 4) or hyperpigmentation/solar lentigo (n = 5). RCM had sensitivity of 95.24% (95% CI, 76.18-99.88%), specificity of 77.7% (95% CI, 39.99-97.19%), positive predictive value of 90.91% (95% CI, 74.58-97.15%) and negative predictive value of 87.5% (95% CI, 50.04-98.0%). The most common dermoscopic feature observed among patients with recurrent LM/LMM was focal homogeneous or structureless areas of light-brown pigmentation (92.8% vs. 37.5% in patients with other diagnoses; P = 0.009). LM-specific dermoscopic criteria were present in only 28.5% of patients with recurrent LM/LMM. CONCLUSIONS: Reflectance confocal microscopy and dermoscopy are valuable tools for the comprehensive evaluation of repigmentation within or adjacent to LM scars.

Predictores del comportamiento de automanejo en personas con enfermedades crónicas de Tamaulipas / Self-management behavior predictors among persons with chronic diseases in Tamaulipas / Preditores do comportamento de automanejo em pessoas com doenças crônicas de Tamaulipas

Resumen Introducción: Dado el carácter prioritario de atención a las enfermedades no transmisibles, la Organización Mundial de la Salud propuso el Modelo de Cuidados Crónicos. En este modelo incluye el automanejo como un elemento principal en el combate de dichas enfermedades. Objetivo: Identificar las variables predictoras del comportamiento de automanejo en usuarios con Diabetes Mellitus, Hipertensión Arterial y Obesidad. Métodos: La muestra no probabilística e intencional fue de 386 usuarios de la Secretaría de Salud de Tamaulipas (Ciudad Victoria y Tampico). El diseño de estudio fue no experimental, transversal. Resultados: casi la mitad (42.2%) de los participantes con ECNT refieren síntomas de trastorno depresivo en el continuo de leve a grave, la categoría que obtuvo mayor porcentaje de IMC fue sobrepeso con 33.2% y más de un tercio de la población (36.8%) percibe algún grado de disfunción familiar. Así también se aplicó un análisis de Regresión Lineal Múltiple con el método de pasos, el modelo indica que fueron siete predictores del comportamiento de Automanejo (varianza explicada R2=.325); la variable autoeficacia fue el más importante (β=38) y el apoyo social percibido el predictor con carga más baja (β=.10). Conclusiones: estos predictores representan elementos importantes para ampliar el conocimiento y entender el comportamiento del automanejo, área que es promovida en el modelo de atención a crónicos de la Organización Mundial de la Salud y en la actualidad es liderada por el área de enfermería.

Abstract Introduction: Considering the priority regarding the attention of non transmissible diseases, the World Health Organization proposed the Chronic Care Model which, by encompassing self-management as one main element, is intended to address these diseases. Objective: To identify predictor variables related to behavior on self-management among patients with Diabetes Mellitus, Hypertension, and Obesity. Methods: The intentional and non probabilistic simple included 386 patients from the Health Secretariat in Tamaulipas, Mexico (Ciudad Victoria and Tampico). The study design was non experimental and transversal. Results: About half (42.2%) of the participants with Chronic Non Transmissible diseases referred having depressive disorder ranging from mild to severe. Regarding the BMI, 33.2% showed overweight. Moreover, 36.8% perceived some degree of family dysfunction. A Multiple Linear Regression was calculated. The model indicated that there were seven predictors of the behavior on self-management (explained variance R2 =.325); being self-efficacy the most important (β=38), and perceived social support the lowest in load (β=.10). Conclusions: These predictors represent important elements to consider when building on the knowledge and understanding the behavior related to self-management, an area which is highlighted in the Chronic Care Model of the World Health Organization, particularly within nursing.

Resumo Introdução: Dado o caráter prioritário de atenção às doenças não transferíveis, a Organização Mundial da Saúde propôs o Modelo de Cuidados Crônicos. Neste modelo inclui-se o automanejo como um elemento principal no combate de tais doenças. Objetivo: identificar as variáveis preditoras do comportamento de automanejo em usuários com Diabetes Mellitus, Hipertensão Arterial e Obesidade. Métodos: A amostra não probabilística e intencional foi de 386 usuários da Secretaría de Salud de Tamaulipas (Ciudad Victoria e Tampico). O desenho de estudo foi não experimental, transversal. Resultados: quase a metade (42.2%) dos participantes com ECNT referem sintomas de transtorno depressivo no continuo de leve a grave, a categoria que obteve maior porcentagem de IMC foi sobrepeso com 33.2% e mais de um terço da população (36.8%) percebe algum grau de disfunção familiar. Assim também se aplicou uma análise de Regressão Linear Múltipla com o método de passos, o modelo indica que foram sete preditores do comportamento de Automanejo (variância explicada R 2 =.325); a variável autoeficácia foi a mais importante (β=38) no apoio social percebido e o preditor com carga mais baixa (β=.10). Conclusões: estes preditores representam elementos importantes para ampliar o conhecimento e entender o comportamento de automanejo, área que é promovida no modelo de atenção a crônicos da Organização Mundial da Saúde e na atualidade é liderada pela área de enfermagem.

Phenolic profile and antioxidant activity of Jasonia glutinosa herbal tea. Influence of simulated gastrointestinal in vitro digestion.

In order to value J. glutinosa DC (rock tea), we characterised its phenolic profile and antioxidant activity. The study was performed in aqueous extracts before and after a simulated in vitro digestion to obtain data regarding phenolics bioavailability. Methanolic extracts were also analysed for comparison purposes. Phytochemical profiles were determined by high-performance liquid chromatography with mass spectrometric detection, whereas total phenolic content (TPC) and antioxidant assays were performed by conventional spectrophotometric methods. The most abundant compounds were dicaffeoylquinic acids, representing more than 90% of phenolics in tea infusions. Statistically significant differences were observed for all parameters except for TPC in methanol and aqueous extracts. Both phenolics amount and antioxidant activities were lower after the in vitro digestion of the infusions. However, although phenolics were lost during the simulated digestion, rock tea is still a good source of bioactive compounds with potential applications in the pharmaceutical or nutraceutical industries.

Peri-operative delineation of non-melanoma skin cancer margins in vivo with handheld reflectance confocal microscopy and video-mosaicking.

BACKGROUND: The surgical removal of non-melanoma skin cancers (NMSCs) is guided by the pathologic examination of margins. However, the preparation of histopathology is time consuming, labour-intensive and requires separate laboratory infrastructure. Furthermore, when histopathology indicates positive margins, patients must return for re-excisions. Reflectance confocal microscopy (RCM) with a new video-mosaicking approach can noninvasively delineate margins directly on patients and potentially guide surgery in real-time, augmenting the traditional approaches of histopathology. OBJECTIVE: To assess a new peri-operative RCM video-mosaicking approach for comprehensive delineation of NMSC margins on patients in vivo. METHODS: Thirty-five patients undergoing Mohs micrographic surgery (MMS) in the Mohs surgery unit at Memorial Sloan Kettering Cancer Center, New York, NY were included in the study. RCM imaging was performed before and after the first staged excision by acquiring videos along the surgical margins (epidermal, peripheral and deep dermal) of each wound, which were subsequently processed into video-mosaics. Two RCM evaluators read and assessed video-mosaics, and subsequently compared to the corresponding Mohs frozen histopathology. RESULTS: Reflectance confocal microscopy videos and video-mosaics displayed acceptable imaging quality (resolution and contrast), pre-operatively in 32/35 (91%) NMSC lesions and intra-operatively in 29/35 lesions (83%). Pre-operative delineation of margins correlated with the histopathology in 32/35 (91%) lesions. Intra-operative delineation correlated in 10/14 (71%) lesions for the presence of residual tumour and in 18/21 (86%) lesions for absence. Sensitivity/specificity were 71%/86% and 86%/81% for two RCM video-mosaic evaluators, and overall agreement was 80% and 83% with histopathology, with moderate inter-evaluator agreement (k = 0.59, P ≤ 0.0002). CONCLUSIONS: Peri-operative RCM video-mosaicking of NMSC margins directly on patients may potentially guide surgery in real-time, serve as an adjunct to histopathology, reduce time spent in clinic and reduce the need for re-excisions. Further testing in larger studies is needed.

Distribución nerviosa interna del músculo temporal humano: consideraciones anatómicas y quirúrgicas / Internal nervous distribution of the human temporal muscle: anatomical and surgical considerations

Resumen Introducción: Conocer en detalle la inervación interna del músculo temporal humano permite realizar múltiples técnicas quirúrgicas y tratamientos de patologías que involucran al territorio craneofacial. Si bien en la literatura se ha descrito la inervación interna del músculo temporal humano basado en micro-disección directa, la técnica de tinción de Sihler es una herramienta ventajosa para el estudio anatómico ya que permite observar ramos nerviosos pequeños sin perder su relación tridimensional con las fibras musculares. Objetivo: Describir la distribución nerviosa al interior del músculo temporal humano en cadáveres al aplicar el método de Sihler y analizar su asociación anátomo quirúrgica. Materiales y Método: Ocho músculos temporales humanos previamente disecados fueron sometidos al método de tinción de Sihler. Cada una de las muestras se observó bajo lupa estereoscópica y transiluminación; finalmente para su descripción se dividió al músculo en tres regiones. Resultados: Se determinó la presencia de tres troncos nerviosos principales: el temporal profundo anterior, el temporal profundo medio y temporal profundo posterior, los que discurren de profundo a superficial. Además, se observaron ramos colaterales de menor calibre del nervio temporal profundo posterior que en forma de arco comunican las tres regiones del músculo. Conclusión: Se describió una distribución nerviosa interna común para los músculos estudiados en las tres dimensiones del espacio, conocimiento útil para innovar en terapias clínico-quirúrgicas del territorio craneofacial.

Introduction: Knowing in detail the inner innervation of the human temporal muscle allows to perform multiple surgical techniques and treatments of pathologies that involve the craniofacial territory. Although the internal innervation of the human temporal muscle based on direct microdissection has been described in the literature, the Sihler staining technique is an advantageous tool for anatomical study since it allows observing small nerve branches without losing its three-dimensional relationship with muscle fibers. Aim: To describe the nervous distribution within the human temporal muscle in cadavers by applying the Sihler method and analyzing its surgical anatomical association. Materials and Method: Eight previously dissected human temporal muscles were subjected to the Sihler staining method. Each one of the samples was observed under stereoscopic magnification and transillumination, finally for its description the muscle was divided into three regions. Results: The presence of three main nervous trunks was determined: the anterior deep temporal, the deep medium temporal and the posterior deep temporal, those that run from deep to superficial. In addition, collateral branches of lesser caliber of the posterior deep temporal nerve that in the form of an arc communicate the three regions of the muscle were observed. Conclusion: A common internal nervous distribution was described for the muscles studied in the three dimensions of space, useful knowledge to innovate in clinical-surgical therapies of the craniofacial territory.

A fuzzy approach for feature extraction of brain tissues in Non-Contrast CT / Un enfoque difuso para la extracción de características de tejidos cerebrales en TC no contrastada

Abstract: In neuroimaging, brain tissue segmentation is a fundamental part of the techniques that seek to automate the detection of pathologies, the quantification of tissues or the evaluation of the progress of a treatment. Because of its wide availability, lower cost than other imaging techniques, fast execution and proven efficacy, Non-contrast Cerebral Computerized Tomography (NCCT) is the most used technique in emergency room for neuroradiology examination, however, most research on brain segmentation focuses on MRI due to the inherent difficulty of brain tissue segmentation in NCCT. In this work, three brain tissues were characterized: white matter, gray matter and cerebrospinal fluid in NCCT images. Feature extraction of these structures was made based on the radiological attenuation index denoted by the Hounsfield Units using fuzzy logic techniques. We evaluated the classification of each tissue in NCCT images and quantified the feature extraction technique in synthetic images from real tissues with a sensitivity of 92% and a specificity of 96% for images from cases with slice thickness of 1 mm, and 96% and 98% respectively for those of 1.5 mm, demonstrating the ability of the method as feature extractor of brain tissues.

Resumen: En neuroimagen, la segmentación de tejidos cerebrales es una parte fundamental de las técnicas que buscan automatizar la detección de patologías, la cuantificación de tejidos o la evaluación del progreso de un tratamiento. Debido a su amplia disponibilidad, menor costo que otras técnicas de imagen, rápida ejecución y eficacia probada, la tomografía computarizada cerebral sin contraste (TCNC) es la técnica mayormente utilizada en emergencias para el examen neurorradiológico, sin embargo, la dificultad inherente que representa la segmentación de los tejidos cerebrales, hace que la mayoría de las investigaciones sobre la segmentación del cerebro se centren en la resonancia magnética. En este trabajo se realizó la caracterización de tres tejidos cerebrales: sustancia blanca, sustancia gris y líquido cefalorraquídeo en imágenes TCNC. Dichas estructuras fueron caracterizadas con base en el índice de atenuación radiológica denotadas por las Unidades Hounsfield utilizando técnicas de lógica difusa. Se evaluó la caracterización de cada tejido en diversos cortes de TCNC y se cuantificó la técnica de extracción de características en imágenes sintéticas a partir de tejidos reales con una sensibilidad de 92% y una especificidad de 96% para tejidos en cortes de 1 mm de grosor y 96% y 98% para los de 1.5 mm demostrando la habilidad del método como extractor de características de los tejidos cerebrales.

Mast cells decrease efficacy of anti-angiogenic therapy by secreting matrix-degrading granzyme B.

Resistance towards VEGF-centered anti-angiogenic therapy still represents a substantial clinical challenge. We report here that mast cells alter the proliferative and organizational state of endothelial cells which reduces the efficacy of anti-angiogenic therapy. Consequently, absence of mast cells sensitizes tumor vessels for anti-angiogenic therapy in different tumor models. Mechanistically, anti-angiogenic therapy only initially reduces tumor vessel proliferation, however, this treatment effect was abrogated over time as a result of mast cell-mediated restimulation of angiogenesis. We show that mast cells secrete increased amounts of granzyme b upon therapy, which mobilizes pro-angiogenic laminin- and vitronectin-bound FGF-1 and GM-CSF from the tumor matrix. In addition, mast cells also diminish efficacy of anti-angiogenic therapy by secretion of FGF-2. These pro-angiogenic factors act beside the targeted VEGFA-VEGFR2-axis and reinduce endothelial cell proliferation and angiogenesis despite the presence of anti-angiogenic therapy. Importantly, inhibition of mast cell degranulation with cromolyn is able to improve efficacy of anti-angiogenic therapy. Thus, concomitant mast cell-targeting might lead to improved efficacy of anti-angiogenic therapy.Resistance towards VEGF-centered anti-angiogenic therapy is an important clinical challenge. Here, the authors show that mast cells mediate resistance to anti-angiogenetic inhibitors by altering the proliferative and organizational state of endothelial cells through mobilization of FGF-1 and GM-CSF from the tumor matrix and secretion of FGF-2.

Potencial uso terapéutico de cannabis / Therapeutic potential of Cannabis sativa

Cannabis sativa (marihuana) is considered an illicit drug due to its psychoactive properties. Recently, the Chilean government opened to the use cannabis in the symptomatic treatment of some patients. The biological effects of cannabis render it useful for the complementary treatment of specific clinical situations such as chronic pain. We retrieved scientific information about the analgesic properties of cannabis, using it as a safe drug. The drug may block or inhibit the transmission of nervous impulses at different levels, an effect associated with pain control. Within this context and using adequate doses, forms and administration pathways, it can be used for chronic pain management, considering its effectiveness and low cost. It could also be considered as an alternative in patients receiving prolonged analgesic therapies with multiple adverse effects.

Carbon dioxide laser ablation of basal cell carcinoma with visual guidance by reflectance confocal microscopy: a proof-of-principle pilot study.

BACKGROUND: Laser ablation is an alternative, nonsurgical treatment modality for low-risk basal cell carcinoma (BCC). However, lack of confirmative tumour destruction or residual tumour presence has been a limiting factor to its adoption. Reflectance confocal microscopy (RCM) provides noninvasive, cellular-level resolution imaging of the skin and is capable of identifying tumour. OBJECTIVES: To evaluate the use of RCM to guide carbon dioxide (CO2 ) laser ablation of BCC, confirm destruction and correlate findings with histology. METHODS: RCM was used preablation to evaluate for features of BCC. Ablation was performed with a CO2 laser, and the response rapidly assessed using handheld RCM to evaluate for residual tumour. Confirmative pathology was used to verify confocal imaging. RESULTS: Preablation RCM imaging identified tumour with features not identified on normal, surrounding skin. Postablation, RCM documented complete removal of tumour in six cases and residual tumour in two. Histological examination identified the ablated area and confirmed clearance of tumour in the six aforementioned cases and corroborated confocal findings for residual tumour in the other two cases. CONCLUSIONS: We report successful treatment of superficial and nodular BCC using CO2 laser ablation augmented by RCM imaging for preablation guidance and verification of tumour removal postablation. Akin to complete circumferential and deep margin control techniques, using RCM helps to map peripheral and deep BCC margins to hone in on areas exhibiting persistent tumour after ablation. CO2 laser ablation visually guided by RCM can help circumvent previously cited limiting factors of laser ablation for tumour destruction by providing cellular-level resolution imaging of tumour and margin assessment in between each laser pass and postablation.

Role of Growth arrest-specific gene 6-Mer axis in multiple myeloma.

Multiple myeloma is a mostly incurable malignancy characterized by the expansion of a malignant plasma cell (PC) clone in the human bone marrow (BM). Myeloma cells closely interact with the BM stroma, which secretes soluble factors that foster myeloma progression and therapy resistance. Growth arrest-specific gene 6 (Gas6) is produced by BM-derived stroma cells and can promote malignancy. However, the role of Gas6 and its receptors Axl, Tyro3 and Mer (TAM receptors) in myeloma is unknown. We therefore investigated their expression in myeloma cell lines and in the BM of myeloma patients and healthy donors. Gas6 showed increased expression in sorted BMPCs of myeloma patients compared with healthy controls. The fraction of Mer(+) BMPCs was increased in myeloma patients in comparison with healthy controls whereas Axl and Tyro3 were not expressed by BMPCs in the majority of patients. Downregulation of Gas6 and Mer inhibited the proliferation of different myeloma cell lines, whereas knocking down Axl or Tyro3 had no effect. Inhibition of the Gas6 receptor Mer or therapeutic targeting of Gas6 by warfarin reduced myeloma burden and improved survival in a systemic model of myeloma. Thus, the Gas6-Mer axis represents a novel candidate for therapeutic intervention in this incurable malignancy.

Melanocytic naevi with globular and reticular dermoscopic patterns display distinct BRAF V600E expression profiles and histopathological patterns.

BACKGROUND: BRAF (v-raf murine sarcoma viral oncogene homologue B) V600E mutations have been detected with high frequency in melanocytic naevi. Few studies have stratified analyses by naevus dermoscopic pattern. OBJECTIVES: To determine the frequency of BRAF V600E expression and histopathological pattern in acquired melanocytic naevi distinguished by a globular vs. reticular dermoscopic pattern. METHODS: We retrospectively identified histologically proven melanocytic naevi with banal reticular or globular dermoscopic patterns and evaluated BRAF V600E expression using immunohistochemistry. RESULTS: BRAF V600E expression was detected in 11 of 12 globular naevi vs. four of 13 reticular naevi (91·7% vs. 30·1%, P = 0·004). A predominantly dermal growth pattern (P < 0·001) and the presence of large junctional nests (P = 0·017) were each associated with a globular dermoscopic pattern. The presence of either a predominantly dermal growth pattern or large junctional nests was found in 13 of 15 naevi positive for BRAF V600E and in two of 10 naevi negative for BRAF V600E (86·7% vs. 20%, P = 0·002). CONCLUSIONS: The frequency of BRAF V600E mutations differs in naevi distinguished by unique dermoscopic structures and microanatomical growth patterns. Globular naevi, which most often histologically correspond to a predominantly dermal growth pattern and/or the presence of large junctional nests, are significantly more likely to express BRAF V600E than reticular naevi. These preliminary results require validation, but may directly inform future studies of naevogenesis and melanoma genesis.

Factores que influyen en la prevalencia de patologías bucales de tejidos blandos y duros de niños y adolescentes: revisión de la literatura / Factors affecting the prevalence of oral soft tissue pathology and hard of children and teens: literature review

El objetivo de este trabajo es hacer una revisión bibliográfica del tema, con el fin de actualizar los conocimientos relativos al mismo, considerando las variables involucradas y presentar una propuesta de línea de investigación, ya que como señalan algunos autores la edad pediátrica es una etapa de crecimiento rápido, desarrollo, de múltiples aptitudes en los campos de las áreas motoras, de la inteligencia, del lenguaje, de la personalidad y de la emocionalidad, por lo que constituye una edad crucial que requiere ser atendida eficazmente en la prevención de sus múltiples aspectos. La Organización Mundial de la Salud, (OMS), ha incrementado las recomendaciones epidemiológicas en los últimos años a este grupo poblacional, además los signos y síntomas de la mucosa bucal de los infantes pueden cambiar con la edad y son a menudo diferentes a las del adulto. Metodología: Se revisaron 34 publicaciones en revistas especializadas, todas referidas a escolares con edades comprendidas entre 6 y 14 años, aunque algunos se refieren a edades puntuales. Resultados: las patologías de los adolescentes difieren de la de los adultos, aunque existen pocas referencias; no hay acción definida en los planes y proyectos nacionales ni regionales para esta población; la mayoría de las patologías que ocurren en la cavidad bucal de esta población, son relativamente inocuas, no necesitan tratamiento, presentándose de forma asintomática y limitándose al desarrollo cronológico del niño. Conclusión: definir una línea de investigación, e incorporar la población de niños, niñas y adolescentes, por cuanto en Venezuela y América Latina, la investigación en esta área es limitada

The goal is to make a literature review of the subject, in order to update the knowledge relating to the subject, considering the variables involved and submit a proposal for a line of research, as some authors point out the Pediatric is rapid growth, development of multiple skills in the fields of motor areas, intelligence, language, personality and emotionality, for what constitutes a crucial age requiring to be dealt with effectively in the prevention of its multiple aspects. The World Health Organization, (who), the epidemiological recommendations has increased in recent years to this population group, also the signs and symptoms of the buccal mucosa of infants can change with age and are often different from the adult. Methodology: We reviewed 34 publications in specialized magazines, all relating to school children aged between 6 and 14 years old, although some refer to specific ages. Results: pathologies of adolescents differ from that of adults, although there are few references; There is no action defined in the plans and national and regional projects for this population; the majority of diseases that occur in the oral cavity of this population, are relatively harmless, do not need treatment, presenting of asymptomatic form and limited to the chronological development of the child. Conclusion: define a line of research, and to incorporate the population of children and adolescents, as in Venezuela and Latin America, research in this area is limited

[Prospective study on the anthropometrical variables of body dimension and composition in primary school children. Caracas. Venezuela]. / Estudio longitudinal de las variables antropométricas de dimensión y composición corporal en escolares de educación básica. Caracas-Venezuela.

The variables were analyzed longitudinal anthropometric that measures the dimension and corporal composition of students of the first Stage of Basic Education of the Educative of the Grand Colombia Educational Unit. The analyzed variables they were: Age, Sex, Weight (W), Height (H), Circumference (AC), Index of Corporal Mass (CMI), cutaneous fold: Triceps (TrP) and Subescapular (SeP), Muscular Area (AM) and fatty Area (FA). 141 children were evaluated with age of beginning to the 6 and 8 years with pursuit of four annual measurements. It was applied a sampling stratified random with equal afijación. The scholars were measured following the techniques established and accepted internationally he stops such aim. One settled down as point of cut between percentiles 10 and 90. Used values of reference were those of the Cross-sectional Study of Caracas (ETC) and of the Longitudinal Study of Caracas (CSCMA). In the analysis longitudinal it was applied to the method "Tracking" and the statistical Kappa in order to determine the channel of growth in each boy and the speed was evaluated of growth of the students. In the four evaluated groups, W and the H have biggest trackng indices with respect to the others variables. The tracking index was constant (Kappa = 0.25) for all the variables and all the groups, opposite situation to the global Kappa, as it was located in the category of "G ood" (Kappa = 0.40 to 0.75) for the W and H in all the groups of evaluated scholars. The AC in the girls of both series of ages and in CMI, only in the girls with follow-up at 6 years canalization is observed "Good". One stayed in "Low" (Kappa = < 0,40) in all the sample of students the TrP, SeP, MA and FA. Variables of corporal dimension register good canalization, unlike the variables that measure corporal composition, which are located in loss canalization. The girls of both groups register greater speed of growth in Weight that the boys. The values of the average in the W and H, in evaluated students, end speed (S3) he is superior to initial speed (S1), therefore, the speed of growth it increases with the age. The maximum speed of growth is registered in the S3. In the evaluated students the variables that better they canalize are those of corporal dimension, is inferred, that corresponds to a growth pattern hoped.

Evaluación de la toxicidad aguda y la acción hipolipemiante del aceite de Plukenetia volúbilis, Sacha Inchi / Evaluation of acute toxicity and hypolipemic action of Plukenetia volúbilis, Sacha Inchi

Se evaluó el efecto tóxico agudo del aceite de Plukenetia volúbilis (Sacha Inchi), determinando la Dosis Letal -50 (DL50) en 42 ratones de la cepa Nish, distribuidos en siete grupos de seis ratones cada uno, a los cuales se les administró, vía oral, dosis crecientes del aceite. Para evaluar el efecto hipolipemiante utilizamos 55 ratas albinas machos de la raza Holtzman, con un peso entre 194 g y 290 g y dos meses de edad. Se utilizó una dieta con 15 por ciento de grasas saturadas para elevar los lípidos séricos durante todo el tiempo del experimento. Utilizamos tres dosis diferentes de aceite de Sacha Inti, administradas durante 14 días consecutivos, comparando sus efectos con un control positivo (Lovastatina) y un control negativo (SF). Se controló el peso de los animales y los valores de colesterol, HDL y triglicéridos sanguíneos en tres tiempos diferentes. El análisis estadístico se realizó mediante el programa STATA 8.2. La DL50 fue de 111,65 mg/kg; hubo una reducción significativa de los valores sanguíneos de triglicéridos y LDL, mas no de colesterol y peso de los animales.

The acute toxic of Plukenetia volúbilis (Sacha Inchi) oil was evaluated. We calculated the Medial Lethal Dose (DL50) on 42 mice of the Nish strain, distributed in seven groups of six mice each, to whom a different and increasing dose was administered by oral route. To determine the hypolipidemic effect, we used 55 male albino rats of the Holtzman breed, whose weight fluctuateed between 194 and 290 g. The animals were fed with 15% of a saturateed fat diet for 14 days to produce hyperlipidemia during the whole period of the experiment. Treatment with Sacha Inchi oil in three different doses during 14 consecutive days was compared to the effects of a positive (lovastatine) and a negative control (physiological serum). The weight, cholesterol, HDL, LDL, VLDL, and triglycerides, were controlled in three different periods of time. Statistics analysis was made using the STATA 8.2 program. The DL50 was detrmined at 111,65 mg/Kg and the level of tryclicerides and LDL were statistically reduced, but not the cholesterol values or the animals' weight.

Dosificación de anticuerpos IgM e IgA anti-trypanosoma cruzi en sangre de recién nacidos de madres con serología positiva para Chagas / Serum levels for IgM and IgA antibodies to anti-trypanosoma cruzi in samples of blood from newborns from mothers with positive serology for Chagas disease

This study compares the levels of specific antibodies IgM and IgA for Chagas in samples of blood from newborns. Three groups of cord blood samples have been analysed: a group of 42 samples from newborns, displaying positive parasitemia, of seropositive mothers (M+B+), 68 samples from newborns with negative parasitemia whose mothers were seropositive (M+B-) and a group of 45 control newborns coming from mothers with negative serology for Chagas. From the 42 M+B+ samples with congenital Chagas disease, 81 and 82.9% displayed detectable levels of IgM and IgA antibodies, respectively In the M+B- group, 70.6 and 33.8% presented antibodies of IgM and IgA classes, respectively, whereas in the control group M-B-, we detected 6% and 11.1% of IgM and IgA antibodies, respectively. The calculated sensitivity of detection of congenital cases using IgM or IgA antibodies was of 82.9% and 80.9% respectively, whereas the specificity of detection was of 29.4% for IgM antibodies and of 66.1% for IgA antibodies.