Aldo-Keto Reductases as Early Biomarkers of Hepatocellular Carcinoma: A Comparison Between Animal Models and Human HCC.

BACKGROUND: The intrinsic heterogeneity of hepatocellular carcinoma (HCC) represents a great challenge for its molecular classification and for detecting predictive biomarkers. Aldo-keto reductase (Akr) family members have shown differential expression in human HCC, while AKR1B10 overexpression is considered a biomarker; AKR7A3 expression is frequently reduced in HCC. AIMS: To investigate the time-course expression of Akr members in the experimental hepatocarcinogenesis. METHODS: Using DNA-microarray data, we analyzed the time-course gene expression profile from nodules to tumors (4-17 months) of 17 Akr members induced by the resistant hepatocyte carcinogenesis model in the rat. RESULTS: The expression of six members (Akr1c19, Akr1b10, Akr7a3, Akr1b1, Akr1cl1, and Akr1b8) was increased, comparable to that of Ggt and Gstp1, two well-known liver cancer markers. In particular, Akr7a3 and Akr1b10 expression also showed a time-dependent increment at mRNA and protein levels in a second hepatocarcinogenesis model induced with diethylnitrosamine. We confirmed that aldo-keto reductases 7A3 and 1B10 were co-expressed in nine biopsies of human HCC, independently from the presence of glypican-3 and cytokeratin-19, two well-known HCC biomarkers. Because it has been suggested that expression of Akr members is regulated through NRF2 activity at the antioxidant response element (ARE) sequences, we searched and identified at least two ARE sites in Akr1b1, Akr1b10, and Akr7a3 from rat and human gene sequences. Moreover, we observed higher NRF2 nuclear translocation in tumors as compared with non-tumor tissues. CONCLUSIONS: Our results demonstrate that Akr7a3 mRNA and protein levels are consistently co-expressed along with Akr1b10, in both experimental liver carcinogenesis and some human HCC samples. These results highlight the presence of AKR7A3 and AKR1B10 from early stages of the experimental HCC and introduce them as a potential application for early diagnosis, staging, and prognosis in human cancer.

A compilation of field surveys on gaseous elemental mercury (GEM) from contrasting environmental settings in Europe, South America, South Africa and China: separating fads from facts.

Mercury is transported globally in the atmosphere mostly in gaseous elemental form (GEM, [Formula: see text]), but still few worldwide studies taking into account different and contrasted environmental settings are available in a single publication. This work presents and discusses data from Argentina, Bolivia, Bosnia and Herzegovina, Brazil, Chile, China, Croatia, Finland, Italy, Russia, South Africa, Spain, Slovenia and Venezuela. We classified the information in four groups: (1) mining districts where this contaminant poses or has posed a risk for human populations and/or ecosystems; (2) cities, where the concentration of atmospheric mercury could be higher than normal due to the burning of fossil fuels and industrial activities; (3) areas with natural emissions from volcanoes; and (4) pristine areas where no anthropogenic influence was apparent. All the surveys were performed using portable LUMEX RA-915 series atomic absorption spectrometers. The results for cities fall within a low GEM concentration range that rarely exceeds 30 ng m(-3), that is, 6.6 times lower than the restrictive ATSDR threshold (200 ng m(-3)) for chronic exposure to this pollutant. We also observed this behavior in the former mercury mining districts, where few data were above 200 ng m(-3). We noted that high concentrations of GEM are localized phenomena that fade away in short distances. However, this does not imply that they do not pose a risk for those working in close proximity to the source. This is the case of the artisanal gold miners that heat the Au-Hg amalgam to vaporize mercury. In this respect, while GEM can be truly regarded as a hazard, because of possible physical-chemical transformations into other species, it is only under these localized conditions, implying exposure to high GEM concentrations, which it becomes a direct risk for humans.

Dermatological Manifestations in Patients With Chronic Kidney Disease: A Review.

Chronic kidney disease (CKD) is a progressive disease and has multiple clinical manifestations; when CKD reaches the end stage, at least one cutaneous manifestation appears due to some increased toxin levels or a constant proinflammatory state. Nonspecific manifestations include pruritus, xerosis, pigmentation disorders, acquired ichthyosis, purpuric spots, and nail disorders. Some specific manifestations are bullous dermatoses, acquired perforating dermatoses (APD), eruptive xanthoma, access site infections, calcifying disorders, and nephrogenic systemic fibrosis (NSF). All these cutaneous changes negatively impact patients; early recognition and diagnosis of these dermatoses will make a difference in their quality of treatment. Exploring a patient's skin is fundamental to suspect some diseases and increased toxin levels; pruritus occurs when uremic toxins are raised, and nail disorders are associated with hypoalbuminemia. This review provides the clinician with information on the clinical manifestations that occur in CKD, including epidemiology, pathophysiology, clinical manifestations, diagnosis, histopathology, treatment, and life impact of the dermatoses in CKD.

Sexually Transmitted Infections in the Community of Santa Ana Batha, Hidalgo, Mexico / Infecciones de Transmisión Sexual en la Comunidad de Santa Ana Batha, Hidalgo, México

Sexually transmitted infections [STI] represent a serious public health problem, which triggers different biological, economic and social complications, which is also related to migration, prostitution, and other factors. The present investigation was carried out with the aim of establishing an endemic channel on Sexually Transmitted Infections and its association with migration, vacation periods and other factors of risk.Methods. A retrospective descriptive observational study was carried out from a bibliographic review of the subject on the internet network retrospectively from 2016 to 2010 collected from SUIVE, in order to establish the endemic ITS channel of the Santa Ana Batha region, Chilcuautla Municipality, Hidalgo, compared with the influx of spas in the study region, it was also taken into account that the region is a migration step from the south to the north, and the epidemiological weeks were also related to the vacation periods.Results. it was obtained as a result that during these periods the number of cases increased considerably and exceeded the alert zone.Conclusion. The results obtained allow to establish as risk factors for STI the phenomenon of migration, the vacation periods and the influx to spas during vacation periods. This study allows us to establish that if we do not pay attention to risk factors, STIs will continue to mean negative results in the health of those involved.(AU)

Las infecciones de transmisión sexual [ITS] representan un grave problema de salud pública, que desencadena distintas complicaciones biológicas, económicas y sociales, que también se relacionan con la migración, la prostitución y otros factores. La presente investigación se realizó con el objetivo de establecer un canal endémico sobre Infecciones de Transmisión Sexual y su asociación con la migración, los periodos vacacionales y otros factores de riesgo.Métodos. Se realizó un estudio Observacional descriptivo de caracter retrospectivo a partir de una revisión bibliográfica del tema en la red de internet de forma retrospectiva del año 2016 al 2010 recolectada del SUIVE, con el fin de establecer el canal ITS endémico de la región Santa Ana Batha, Municipio Chilcuautla, Hidalgo, comparado con la afluencia de balnearios en En la región de estudio, también se tomó en cuenta que la región es un paso migratorio de sur a norte, y las semanas epidemiológicas también se relacionaron con los períodos vacacionales.Resultados. Se obtuvo como resultado que durante estos períodos el número de casos aumentó considerablemente y superó la zona de alerta.Conclusión. Los resultados obtenidos permiten establecer como factores de riesgo de ITS el fenómeno de la migración, los períodos vacacionales y la afluencia a balnearios durante los períodos vacacionales.(AU)

Arteritis de células gigantes con compromiso de aorta y grandes vasos / Aortitis and large vessel involvement in giant cell arteritis

La arteritis de células gigantes (ACG) es una vasculitis sistémica de grandes vasos que no solo puede afectar a vasos craneales, si no que cada vez más frecuentemente se ha asociado a compromiso de vasos extracraneales. Este compromiso puede ser asintomático por lo que puede pasar inadvertido al estudio clínico básico y llevar a importantes complicaciones. Se presentan dos casos clínicos de ACG, ambos con aortitis y uno, además, con compromiso de grandes vasos del cayado aórtico y del cuello. Se discuten aspectos fisiopatológicos, clínicos y terapéuticos, con el objetivo de vislumbrar estrategias de abordaje de futuros pacientes con presentaciones similares.

Giant cell arteritis (GCA) is a age related, large vessels systemic vasculitis that not only affect cranial vessels, but is increasingly associated with extracranial vessel involvement. This extracranial involvement can be asymptomatic, so it can go unnoticed after basic clinical and laboratory study and lead to serious complications. We report two cases of GCA, both presenting aortitis and one of them presenting also involvement of aortic arch and of neck large vessels. We discuss physiopathologic, clinic and therapeutic aspects, with the aims of developing management strategies for the future patients with similar manifestations.

Toxicidad severa asociada a metotrexato: caso clínico / Severe toxicity associated with methotrexate: clinical case

El metotrexato (MTX) es un agente anti folato con actividad antineoplásica e inmunosupresora que ha alcanzado gran aceptación y uso debido a su eficacia en distintos desórdenes reumatológicos. Sin embargo, tiene el potencial para causar complicaciones serias y, a veces, mortales, principalmente hematológicas, hepáticas o pulmonares. Los factores de riesgo para el desarrollo de pancitopenia incluyen edad avanzada, alteración de la función renal, niveles bajos de ácido fólico y uso concomitante de otros fármacos que modifiquen el metabolismo del folato. Presentamos un caso de pancitopenia severa y estomatitis, secundaria a una dosis estándar de MTX, en una paciente de 53 años de edad, con Artritis Reumatoídea (AR) de 10 años de evolución y enfermedad renal crónica en hemodiálisis trisemanal. Es muy importante prestar atención a los factores de riesgo asociados a la aparición de efectos adversos antes de iniciar terapia con MTX en pacientes reumatológicos. Además, los pacientes con MTX deben ser monitorizados durante su tratamiento para identificar efectos adversos hematológicos severos, como la pancitopenia.

Methotrexate (MTX) is an agent for anti-folate with antineoplastic activity and immunosuppressive that has achieved wide acceptance and use due to its efficacy in various rheumatologic disorders. However, it has the potential to cause complications serious and sometimes deadly, primarily hematologic, hepatic or pulmonary. The factors of risk for the development of pancytopenia include advanced age, renal function, low levels of folic acid and concomitant use of other drugs that alter the metabolism of folate. We present a case of severe pancytopenia and stomatitis, secondary to a standard dose of MTX in patient of 53 years, with rheumatoid arthritis (RA) of 10 years of evolution and chronic kidney disease on hemodialysis immediately. It is very important to pay attention to the risk factors associated with the occurrence of adverse effects, before initiating therapy with MTX in rheumatologic patients. In addition MTX patients should be monitored during treatment to identify severe haematological adverse effects such as pancytopenia.

Neumatosis intestinal secundaria a esclerosis sistémica: caso clínico / Intestinal pneumatosis secondary to systemic sclerosis: clinical case

Intestinal pneumatosis is a rare complication that can occur in systemic sclerosis (ES), its pathogenesis is not entirely specified and is characterized by the presence of gas in the submucosa wall and / or bowel subserosa. For a 37 year old woman presented with a diagnosis of diffuse variety EN who consults repeatedly by pain, bloating and intermittent episodes of chronic diarrhea associated with weight loss. The imaging study revealed an intestinal pneumatosis and pneumoperitoneum as the source of the picture...

La neumatosis intestinal es una complicación rara que puede presentarse en la Esclerosis Sistémica (ES), su etiopatogenia no está del todo precisada y se caracteriza por presencia de gas en la pared submucosa y/o subserosa del intestino. Se presenta el caso de una mujer de 37 años, con diagnóstico de ES variedad difusa quien consulta en repetidas ocasiones por dolor, distensión abdominal y episodios de diarrea crónica intermitente asociado a disminución de peso. El estudio con imágenes reveló una neumatosis intestinal y neumoperitoneo como origen del cuadro...