Uncommon Association Between Gastrointestinal Stromal Tumors (GIST) and Pheochromocytoma With Abdominal Wall Relapse: Case Report and Literature Review.

Gastrointestinal stromal tumors (GISTs) represent a rare form of gastrointestinal neoplasm. This report details a medical case involving a 44-year-old woman who underwent bilateral pheochromocytoma resection, GIST gastrectomy, and laparoscopic adrenalectomy with intestinal resection. Despite an initially positive response to oral imatinib, treatment was delayed due to economic constraints. This delay resulted in a critical event marked by abdominal GIST metastasis to the abdominal wall, subsequent rupture leading to hemoperitoneum, and emergency surgery. Following an adequate postsurgical recovery, she was successfully discharged prior to medication adjustments.

Minimal epitope for Mannitou IgM on paucimannose-carrying glycoproteins.

Paucimannosidic glycans are restricted to the core structure [Man1-3GlcNAc2Fuc0-1] of N-glycans and are rarely found in mammalian tissues. Yet, especially [Man2-3GlcNAc2Fuc1] have been found significantly upregulated in tumors, including in colorectal and liver cancer. Mannitou IgM is a murine monoclonal antibody that was previously shown to recognize Man3GlcNAc2 with an almost exclusive selectivity. Here, we have sought the definition of the minimal glycan epitope of Mannitou IgM, initiated by screening on a newly designed paucimannosidic glycan microarray; among the best binders were Man3GlcNAc2 and its α1,6 core-fucosylated variant, Man3GlcNAc2Fuc1. Unexpectedly and in contrast to earlier findings, Man5GlcNAc2-type structures bind equally well and a large tolerance was observed for substitutions on the α1,6 arm. It was confirmed that any substitution on the single α1,3-linked mannose completely abolishes binding. Surface plasmon resonance for kinetic measurements of Mannitou IgM binding, either directly on the glycans or as presented on omega-1 and kappa-5 soluble egg antigens from the helminth parasite Schistosoma mansoni, showed submicromolar affinities. To characterize the epitope in greater and atomic detail, saturation transfer difference nuclear magnetic resonance spectroscopy was performed with the Mannitou antigen-binding fragment. The STD-NMR data demonstrated the strongest interactions with the aliphatic protons H1 and H2 of the α1-3-linked mannose and weaker imprints on its H3, H4 and H5 protons. In conclusion, Mannitou IgM binding requires a nonsubstituted α1,3-linked mannose branch of paucimannose also on proteins, making it a highly specific tool for the distinction of concurrent human tumor-associated carbohydrate antigens.

[Adult T cell lymphoblastic leukemia/lymphoma by HTLV-1 in a young woman]. / Leucemia/linfoma T del adulto tipo linfomatoso por HTLV-1 en una mujer joven.

Adult T cell lymphocyte leukemia/lymphoma (ATLL) is a subtype of T-cell lymphoma caused by infection of the human T-cell lymphotropic virus type 1 (HTLV-1); which generates a pro-viral integration into the host DNA, resulting in a clonal expansion of T lymphocytes. We present the case of a 20-year-old woman who developed multiple lymphadenopathies, hepatosplenomegaly and fever, serum positivity for HTLV-1 and proviral integration in the host DNA, demonstrated by polymerase chain reaction (PCR). Immunohistochemistry of lymphoid node was positive to CD4+ and CD8+ T cells. ATLL has been described in all HTLV-1 endemic areas, however, there are differences in the mean age of its presentation in such areas: 40 to 50 years in South America, 60 years in Japan. We showed one of few reported cases of the lymphoma type of ATLL in young adults.

Leucemia/linfoma T del adulto tipo linfomatoso por HTLV-1 en una mujer joven / Adult T cell lymphoblastic leukemia/lymphoma by HTLV-1 in a young woman

Resumen La leucemia/linfoma T del adulto (LLTA) de tipo linfomatoso es un subtipo del linfoma de las células T, causado por la infección del virus linfotrópico de células T humanas tipo 1 (HTLV-1); el cual genera una integración proviral en el ADN del hospedero y expansión clonal de linfocitos T. Presentamos el caso de una mujer de 20 años que desarrolló linfadenopatías múltiples, hepatoesplenomegalia y fiebre, con serología positiva para HTLV-1 y reacción de polimerasa en cadena (RPC) con la integración proviral en el ADN del hospedero. La inmunohistoquímica en un ganglio linfático fue positiva para células T CD4+ y CD8+. La LLTA ha sido descrito en todas las áreas endémicas del HTLV-1; sin embargo, existen diferencias en la edad de presentación según la región: 40 a 50 años en América del Sur y 60 años en Japón. Presentamos uno de los pocos casos reportados de LLTA de tipo linfomatoso en adultos jóvenes.

Adult T cell lymphocyte leukemia/lymphoma (ATLL) is a subtype of T-cell lymphoma caused by infection of the human T-cell lymphotropic virus type 1 (HTLV-1); which generates a pro-viral integration into the host DNA, resulting in a clonal expansion of T lymphocytes. We present the case of a 20-year-old woman who developed multiple lymphadenopathies, hepatosplenomegaly and fever, serum positivity for HTLV-1 and proviral integration in the host DNA, demonstrated by polymerase chain reaction (PCR). Immunohistochemistry of lymphoid node was positive to CD4+ and CD8+ T cells. ATLL has been described in all HTLV-1 endemic areas, however, there are differences in the mean age of its presentation in such areas: 40 to 50 years in South America, 60 years in Japan. We showed one of few reported cases of the lymphoma type of ATLL in young adults.

Relación entre CEOD y los malestares diarios en escolares de 6 años de Totoracocha, Cuenca-Ecuador / Relationship between CEOD and daily complains in 6-year-old schoolchildren in the Totoracocha parish, Cuenca-Ecuador

Objetivos: El objetivo de esta investigación es establecer la relación entre el índice CEOD y los malestares diarios en escol ares de 6 años de la parroquia Totoracocha de la ciudad de Cuenca-Ecuador, 2016. Materiales y métodos: Se realizó un estudio descriptivo observacional, de corte transversal. En el cual se evaluaron 103 escolares (51 mujeres y 52 hombres) de 6 años, pertenecientes a la parroquia de Totoracocha del cantón Cuenca, previa firma y aprobación del consentimiento informado por parte de los representantes para participar en el estudio. Todos los sujetos fueron examinados visual y clínicamente por examinadores capacitados y estandarizados. Resultados: Los datos recopilados de ceod dieron un promedio de 0,25 % obteniendo como resultado un nivel de ceod de "bajo riesgo"; según las actividades diarias al momento de percibir tenemos que afecto más al ingerir alimentos el 65 %, cepillarse los dientes 54 %, al reír 38 %, y al interactuar con las personas con el 35 % y va a ser más severa al comer 25 % y realizar labores escolares 20 %. Conclusiones: Posterior de haber obtenido los datos podemos concluir que los escolares sobredimensionan la presencia de la caries dental al momento de realizar sus actividades diarias. (AU)

Objectives: The objective of this research was to determine the relationship between CEOD and self-report in 6 year-old children in the Totoracocha parish, Cuenca-Ecuador, 2016. Materials and methods: The study was descriptive. For that, 103 schoolchildren (51 women and 52 men) of the age of 6, who belonged to the Totoracocha parish of the Cuenca canton, were evaluated. Two schools, the Ricardo Muñoz Chávez and the Immaculate Which prior to taking the samples the students were calibrated by the specialists of the University to be able to take this information, later they were communicated to the representatives through an information consent which had to be signed by said representatives to proceed to the data collection; at the same time the children had to sign an agreement approving the procedure, the samples were taken in children looking in front of the student and with the help of a mirror to be able to analyze Intraoral the same data were recorded in the pertinent files. Results: The data collected from ceod averaged 0.25, resulting in a "low risk" level of CEOD and self report according to the performance of the activities in the quality of life we have more affection when eating with the 65%, teeth cleaning 54%, smile 38%, socialize 35% and will be more severe when eating 25% and perform school work 20% Conclusions: After having obtained the data we can conclude that in self-perception of caries goes to be greater than children who do not self-perceive; the level of CEOD is low risk; according to the performances will affect more when eating, brushing teeth, smile; In terms of severity we have to eat and perform school work. (AU)

Mechanistic Insight into the Binding of Multivalent Pyrrolidines to α-Mannosidases.

Novel pyrrolidine-based multivalent iminosugars, synthesized by a CuAAC approach, have shown remarkable multivalent effects towards jack bean α-mannosidase and a Golgi α-mannosidase from Drosophila melanogaster, as well as a good selectivity with respect to a lysosomal α-mannosidase, which is important for anticancer applications. STD NMR and molecular modeling studies supported a multivalent mechanism with specific interactions of the bioactive iminosugars with Jack bean α-mannosidase. TEM studies suggested a binding mode that involves the formation of aggregates, which result from the intermolecular cross-linked network of interactions between the multivalent inhibitors and two or more dimers of JBMan heterodimeric subunits.

[OPINION OF HEALTH PROFESSIONALS ON ADHERENCE AND MANAGEMENT OF LONG-TERM TREATMENTS IN ADOLESCENTS]. / Opinión de los profesionales sanitarios sobre a adherencia y manejo de tratamientos de larga duración en adolescents.

OBJECTIVE: To assess opinion of health professionals about adherence and management of long-term treatments in adolescents in a tertiary hospital. METHOD: A cross-sectional study was carried out in the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were health professionals who care adolescents with solid organ transplant, hematologic disease, diabetes, cystic fibrosis or HIV+. Data collection was performed by self-administered questionnaire, developed specifically for this study. RESULTS: A total of 105 professionals (70%) participated in the study, 80% were nurses, 56% of them indicated that treatment compliance was good. 43% indicated that adherence was not addressed well and 79% of professionals did not have planned time to conduct health education related to treatment. 19.5% of nurses and 72.2% of physicians reported having adherence assessment tools. 39% of participants made suggestions for improvement. CONCLUSIONS: Almost half of the professional indicate that the adherence is not adequately addressed. It is important to evaluate adherence to treatment to identify causes of low compliance and establish and evaluate appropriate interventions.

Infección por HTLV-1 y HIV en pacientes con herpes zoster en Perú / HTLV-1 and HIV infection among patients with herpes zoster in Perú

Objetivos: Determinar la frecuencia de infección por el virus linfotrópico humano tipo 1 (HTLV-1) y VIH en pacientes con herpes zoster. Material y métodos: Estudio prospectivo observacional realizado entre agosto de 2005 y agosto de 2006. Se incluyeron pacientes adultos con diagnóstico de herpes zoster atendidos en los diferentes servicios del Hospital Nacional Cayetano Heredia. Un cuestionario de características clínicas y factores de riesgo asociados con infección por HTLV-1 y VIH fue completado previo a la toma de muestra. Se excluyeron los pacientes con resultados positivos previos para HTLV-1 y HIV. Resultados: Se incluyeron 44 pacientes, la edad promedio fue 48,1 ± 19,5; 24/44 (55%) fueron mujeres. Infección solo por VIH se encontró en 4/44 (9%) pacientes, todos menores de 35 años, mientras que infección solo por HTLV-1 se encontró en 2/44 (5%) pacientes, todas mujeres mayores de 50 años. Un caso de infección dual fue encontrado en una mujer de 56 años. La tasa de infección por HTLV-1 fue 25% (3/12) en mujeres mayores de 50 años con compromiso de múltiples dermatomas. Conclusiones: En nuestro escenario, la infección por HTLV-1 es ligeramente mas frecuente en mujeres mayores de 50 años con herpes zoster. Por ello, el despistaje de HTLV-1 debe ser recomendado en este grupo etario, mientras que el despistaje de VIH es aún particularmente importante en pacientes jóvenes.(AU).

Objectives: To determine the frequency of infection with human T-cell lymphotropic virus type 1 (HTLV-1) and VIH among patients with herpes zoster. Material and methods: Observational prospective study between august 2005 and august 2006. We included adult patients with diagnosis of herpes zoster attending different services at the HNCH. A questionnaire of clinical characteristics and risk factors associated with HTLV-1 and VIH infection was filled prior to blood testing. Patients with previous positive results of HTLV-1 or VIH were not included. Results: 44 patients were included. Age was 48,1 ± 19,5 years, and 24/44 (55%) were women. Isolated VIH infection was diagnosed in 4/44 (9%) patients, all of them under 35 years, whereas isolated HTLV-1 infection was diagnosed in 2/44 (5%) patients, all women over 50 years. A case of dual infection was found in a 56 year old woman. Rate of HTLV-1 infection was 25% (3/12) among women over 50 years with multi-dermatomic involvement. Conclusions: In our setting, HTLV-1 infection is rather frequent among women over the age of 50 presenting with herpes zoster. Thus, HTLV-1 screening should be recommended in this age group, whereas VIH testing is still particularly important among younger patients.(AU).