Is Iron Overload Associated with Worse Outcomes in Patients with Chronic Liver Disease Undergoing Liver Transplantation?

ABSTRACT Background: Iron overload is frequent in patients with chronic liver disease, associated with shorter survival after liver transplantation in patients with hereditary hemochromatosis. Its effect on patients without hereditary hemochromatosis is unclear. The aim of the study was to study the clinical impact of iron overload in patients who underwent liver transplantation at an academic tertiary referral center. Methods: We performed a retrospective cohort study including all patients without hereditary hemochromatosis who underwent liver transplantation from 2015 to 2017 at an academic tertiary referral center in Mexico City. Explant liver biopsies were reprocessed to obtain the histochemical hepatic iron index, considering a score ≥ 0.15 as iron overload. Baseline characteristics were compared between patients with and without iron overload. Survival was estimated using the Kaplan-Meier method, compared with the log-rank test and the Cox proportional hazards model. Results: Of 105 patients included, 45% had iron overload. Viral and metabolic etiologies, alcohol consumption, and obesity were more frequent in patients with iron overload than in those without iron overload (43% vs. 21%, 32% vs. 22%, p = 0.011; 34% vs. 9%, p = 0.001; and 32% vs. 12%, p = 0.013, respectively). Eight patients died within 90 days after liver transplantation (one with iron overload). Complication rate was higher in patients with iron overload versus those without iron overload (223 vs. 93 events/100 person-months; median time to any complication of 2 vs. 3 days, p = 0.043), without differences in complication type. Fatality rate was lower in patients with iron overload versus those without iron overload (0.7 vs. 4.5 deaths/100 person-months, p = 0.055). Conclusion: Detecting iron overload might identify patients at risk of early complications after liver transplantation. Further studies are required to understand the role of iron overload in survival.

SPECT/CT con 99mTc-pirofosfato en la evaluación de la amiloidosis cardíaca: estudio preliminar / SPECT/CT with 99mTc-pyrophosphate in the evaluation of cardiac amyloidosis: a preliminary study / SPECT/CT com pirofosfato de 99mTc na avaliação de amiloidose cardíaca: estudo preliminar

Introducción: la amiloidosis cardíaca (AC) es una miocardiopatía infiltrativa producida por depósito miocárdico extracelular de amiloide. Las variantes más frecuentes son debidas a cadenas ligeras de inmunoglobulinas o transtiretina (ATTR). El centellograma con 99mTc-pirofosfato (99mTc-PYP) es una técnica de imagen molecular que permite diferenciar los subtipos más frecuentes de AC. El presente estudio analizó el rol del 99mTc-PYP y el SPECT-CT en la evaluación de pacientes con sospecha clínica de AC. Materiales y métodos: se realizó 99mTc-PYP y SPECT-CT en 16 pacientes con sospecha clínica de AC, con edad promedio de 63 años. Se realizó análisis cualitativo de las imágenes planares y del SPECT-CT (Mediso, AnyScan), adquiridas 1-3 horas tras la inyección del radiotrazador. Para el análisis cuantitativo de las imágenes planares se calculó la relación H/CL (cuentas promedio obtenidas sobre las regiones de interés del corazón y el hemitórax contralateral). El estudio se consideró positivo para ATTR cuando la relación H/CL fue ≥1.5. Las imágenes de SPECT-CT fueron interpretadas para observar la distribución del trazador a nivel cardíaco y extracardíaco. Resultados: se identificó captación miocárdica de 99mTc-PYP en el ventrículo izquierdo en 6 pacientes y en el ventrículo derecho en 3 pacientes. En estos casos, la relación H/CL fue >1.5. En el resto se descartó la captación miocárdica, con relación H/CL<1.5. Se detectó actividad de pool vascular en las imágenes tomográficas de 7 pacientes y captación extracardíaca ósea anormal de causas traumáticas/degenerativas en 9 pacientes. Cinco pacientes presentaron captación hepática difusa, sin alteración estructural en el TC. Conclusiones: el 99mTc-PYP es una técnica clínicamente relevante en pacientes con sospecha de AC. Constituye una herramienta mínimamente invasiva, ampliamente disponible, de bajo costo y útil en el diagnóstico, pudiendo orientar al subtipo de AC. La información que aporta permite además orientar las opciones terapéuticas y brindar información pronóstica adicional.

Introduction: Cardiac amyloidosis (CA) is an infiltrative cardiomyopathy caused by extracellular myocardial amyloid deposition. The most frequent variants are due to immunoglobulin light chains or transthyretin (ATTR). 99mTc-pyrophosphate (99mTc-PYP) scintigraphy is a molecular imaging technique that allows differentiation of the most common subtypes of AC. The present study analyzed the role of 99mTc-PYP and SPECT-CT in the evaluation of patients with clinical suspicion of CA. Materials and methods: 99mTc-PYP and SPECT-CT were performed in 16 patients with clinical suspicion of AC, with an average age of 63 years. Qualitative analysis was performed on the planar and SPECT-CT images (Mediso, AnyScan), acquired 1-3 hours after the injection of the radiotracer. For the quantitative analysis of the planar images, the H/CL ratio (average counts obtained over the regions of interest of the heart and the contralateral hemithorax) was calculated. The study was considered positive for ATTR when the H/CL ratio was ≥1.5. The SPECT-CT images were interpreted to observe the distribution of the tracer at the cardiac and extracardiac level. Results: Myocardial uptake of 99mTc-PYP was identified in the left ventricle in 6 patients and in the right ventricle in 3 patients. In these cases, the H/CL ratio was >1.5. In the rest, myocardial uptake was ruled out, with a H/CL ratio of 1.5. Vascular pool activity was detected in the tomographic images of 7 patients and abnormal extracardiac bone uptake of traumatic/degenerative causes in 9 patients. Five patients presented diffuse hepatic uptake, without structural alteration on CT. Conclusions: 99mTc-PYP is a clinically relevant technique in patients with suspected CA. It constitutes a minimally invasive tool, widely available, low cost and useful in diagnosis, and can guide the AC subtype. The information it provides also makes it possible to guide therapeutic options and provide additional prognostic information.

Introdução: a amiloidose cardíaca (AC) é uma cardiomiopatia infiltrativa causada pela deposição extracelular de amiloide no miocárdio. As variantes mais frequentes são devidas a cadeias leves de imunoglobulina ou transtirretina (ATTR). A cintilografia com 99mTc-pirofosfato (99mTc-PYP) é uma técnica de imagem molecular que permite a diferenciação dos subtipos mais comuns de QA. O presente estudo analisou o papel do 99mTc-PYP e do SPECT-CT na avaliação de pacientes com suspeita clínica de AC. Materiais e métodos: foram realizados 99mTc-PYP e SPECT-CT em 16 pacientes com suspeita clínica de QA, com idade média de 63 anos. A análise qualitativa foi realizada nas imagens planas e SPECT-CT (Mediso, AnyScan), adquiridas 1-3 horas após a injeção do radiotraçador. Para a análise quantitativa das imagens planas, foi calculada a relação H/CL (contagens médias obtidas nas regiões de interesse do coração e do hemitórax contralateral). O estudo foi considerado positivo para ATTR quando a relação H/CL era ≥1,5. As imagens SPECT-CT foram interpretadas para observar a distribuição do traçador em nível cardíaco e extracardíaco. Resultados: a captação miocárdica de 99mTc-PYP foi identificada no ventrículo esquerdo em 6 pacientes e no ventrículo direito em 3 pacientes. Nestes casos, a relação H/CL foi >1,5. Nos demais, foi descartada captação miocárdica, com relação H/CL de 1,5. Atividade do pool vascular foi detectada nas imagens tomográficas de 7 pacientes e captação óssea extracardíaca anormal de causas traumáticas/degenerativas em 9 pacientes. Cinco pacientes apresentaram captação hepática difusa, sem alteração estrutural na TC. Conclusões: o 99mTc-PYP é uma técnica clinicamente relevante em pacientes com suspeita de AC. Constitui uma ferramenta minimamente invasiva, amplamente disponível, de baixo custo e útil no diagnóstico, podendo orientar o subtipo AC. A informação que disponibiliza permite também orientar opções terapêuticas e fornecer informação prognóstica adicional.

Computer visual syndrome in medical students in virtual education of a Peruvian university during 2021 / Síndrome visual informático en estudiantes de medicina en educación virtual de una universidad peruana durante el 2021

Introduction: During virtual classes in the context of COVID-19, students were exposed to digital screens for many hours, so they could present computer vision syndrome. Objective: To determine the frequency of computer vision syndrome in sixth-year medical students at Ricardo Palma University during virtual education due to COVID-19 in October and November 2021. Methods: Cross-sectional descriptive study in 147 sixth-year medical students who received virtual education at a Peruvian university during 2021. A non-probability sampling was used for convenience and the SVI was evaluated with the SVI-Q questionnaire, in addition characteristics were evaluated. demographics, visual preventive measures and eye diseases. The results were analyzed with SPSS v.21 for Windows. The study was approved by the Ethics Committee. Results: Most of the students were young adults (54%) and female (60%). The frequency of computer vision syndrome was 93%, it occurred in (94%) women and (90%) men. Most of the students reported having myopia (44%) and astigmatism (22%). The most common visual symptoms were tearing (7.9%), itching (7.6%) and headache (7.6%). Conclusions: A high frequency of SVI was found in medical students who took virtual classes.

Introducción: Durante las clases virtuales en el contexto del COVID-19 los estudiantes estuvieron expuestos muchas horas a pantallas digitales, por lo que podrían presentar síndrome visual informático. Objetivo: Determinar la frecuencia del síndrome visual informático en estudiantes de sexto año de medicina de la Universidad Ricardo Palma durante la educación virtual por COVID-19 en octubre y noviembre de 2021. Métodos: Estudio descriptivo transversal en 147 estudiantes de medicina de sexto año que recibieron educación virtual en una universidad del Perú durante el 2021. Se utilizó un muestreo no probabilístico por conveniencia y el SVI se evaluó con el cuestionario SVI-Q, además se evaluaron características demográficas, medidas preventivas visuales y enfermedades oculares. Los resultados se analizaron con SPSS v.21 para Windows. El estudio fue aprobado por el Comité de Ética. Resultados: La mayoría de los estudiantes fueron adultos jóvenes (54%) y del sexo femenino (60%). La frecuencia de síndrome visual informático fue de 93%, se presentó en el (94%) de mujeres y el (90%) de hombres. La mayoría de las estudiantes refirió tener miopía (44%) y astigmatismo (22%). Los síntomas visuales más comunes fueron lagrimeo (7,9%), picor (7,6%) y dolor de cabeza (7,6%). Conclusiones: Se encontró una elevada frecuencia de SVI en estudiantes de medicina que llevaron clases virtuales.

Dosis efectivas asociadas a estudios híbridos SPECT-CT en pacientes adultos / Effective dose associated to hybrid SPECT-CT imaging in adult patients / Doses eficazes associadas a estudos de SPECT-CT híbridos em pacientes adultos

Introducción: la técnica de imagen híbrida de SPECT-CT combina la imagen de la tomografía por emisión de fotón único (SPECT) con el estudio de tomografía computada (TC), obteniendo información funcional y anatómica en un mismo estudio. La dosis efectiva total de radiación ionizante recibida en los estudios SPECT-CT puede ser estimada a partir de la dosis efectiva atribuible a la actividad administrada del radiofármaco y la dosis efectiva del componente de tomografía computada (TC). Objetivos: estimar la dosis efectiva total en los protocolos SPECT-CT utilizados en población adulta y determinar el aporte adicional del estudio TC sobre la dosis efectiva total. Método: se evaluaron 258 estudios SPECT-CT para estimar la dosis efectiva total aportada por la administración de los radiofármacos y los estudios de TC de baja dosis. Para estimar el aporte de ambos componentes se utilizaron factores de conversión específicos de cada radiofármaco y región explorada mediante TC. Resultados: la dosis efectiva total (media ± DS) en los estudios SPECT-CT fueron: 12,4 ± 1,44 mSv en el estudio de perfusión miocárdica, 1,14 ± 0,25 mSv en ganglio centinela de mama, 8,6 ± 0,6 mSv paratiroides, 1,48 ± 1,02 mSv tiroides y los estudios óseos de las regiones de cuello 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdomen y pelvis 6,1 ± 0,3 mSv. La dosis de radiación aportada por el estudio TC se encuentra entre 0,46 mSv para la región del tórax en el estudio de ganglio centinela de mama y 2,3 mSv para el SPECT-CT óseo en la región de abdomen y pelvis. Conclusión: se logró estimar la dosis efectiva en los protocolos SPECT-CT de uso clínico más frecuente en población adulta y el aporte de los estudios TC a la dosis efectiva total siendo relativamente baja comparado con la dosis aportada por los radiofármacos administrados con la excepción del estudio de ganglio centinela donde la contribución del componente TC es aproximadamente la mitad de la dosis efectiva total.

Introduction: SPECT-CT Hybrid image technique combines the SPECT (single-photon emission computed tomography) image with the CT (computerized tomography) image to obtain both functional and anatomical images in the same study. The total effective ionizing radiation dose received in SPECT-CT studies may be estimated based on the effective dose from the radiopharmaceutical administered and the effective dose from the CT (computerized tomography) component. Objectives: the study aims to estimate the total effective dose in SPECT-CT protocols applied for the adult population, and to determine the additional contribution from the CT component to the total effective dose. Method: 258 SPECT-CT studies were evaluated to estimate the total effective dose from the administration of radiopharmaceuticals and low dose CT studies. Specific conversion factors for each radiopharmaceutical and area of the body explored with the CT were used to estimate radiation doses from both components. Results: total effective dose (average ± SD) in the SPECT-CT studies was: 12.4 ± 1.44 mSv in the myocardial perfusion study, 1.14 ± 0.25 mSv in the breast sentinel lymph node study, 8.6 ± 0.6 mSv in the parathyroid study, 1.48 ± 1.02 mSv in the thyroid study. As to bone studies, doses found were: 4.5 ± 0.3, in neck studies, 6.07 ± 0.3 mSv in thoracic studies and 6.1 ± 0.3 mSv in abdominal and pelvic studies. The radiation dose from the CT study ranges from 0.46 mSv for the thoracic region on the breast sentinel lymph node study to 2.3 mSv for the bone SPECT-CT study of the abdominal and pelvic region. Conclusions: we managed to estimate the effective dose in the the most frequently used SPECT-CT protocols for the adult population and the contribution of CT studies to the total effective dose. It was found to be relatively low when compared to the dose contributed by the radiopharmaceuticals administered, with the exception of the sentinel lymph node study for which the contribution from the CT study is approximately half the total effective dose.

Introdução: a técnica de imagem híbrida SPECT-CT combina a imagem de tomografia por emissão de fóton único (SPECT) com o estudo de tomografia computadorizada (TC), obtendo informações funcionais e anatômicas no mesmo estudo. A dose efetiva total de radiação ionizante recebida em estudos SPECT-CT pode ser estimada a partir da dose efetiva atribuível à atividade administrada do radiofármaco e da dose efetiva do componente de tomografia computadorizada (TC). Objetivos: estimar a dose efetiva total nos protocolos SPECT-CT utilizados na população adulta e determinar a contribuição adicional do estudo de TC na dose efetiva total. Método : 258 estudos SPECT-CT foram avaliados para estimar a dose efetiva total fornecida pela administração de radiofármacos e estudos de TC de baixa dose. Para estimar a contribuição de ambos os componentes, foram utilizados fatores de conversão específicos para cada radiofármaco e região explorada pela TC. ⁠ Resultados: a dose efetiva total (média ± DP) nos estudos SPECT-CT foi: 12,4 ± 1,44 mSv no estudo de perfusão miocárdica, 1,14 ± 0,25 mSv no linfonodo sentinela mamário, 8,6 ± 0,6 mSv paratireoide, 1,48 ± 1,02 mSv estudos de tireoide e ossos das regiões do pescoço 4,5 ± 0,3, tórax 6,07 ± 0,3 mSv, abdômen e pelve 6,1 ±0,3mSv. A dose de radiação fornecida pelo estudo de TC está entre 0,46 mSv para a região do tórax no estudo do linfonodo sentinela da mama e 2,3 mSv para o SPECT-CT ósseo na região do abdome e pelve. Conclusão: foi possível estimar a dose efetiva nos protocolos de SPECT-CT mais utilizados clinicamente na população adulta e a contribuição dos estudos de TC para a dose efetiva total, sendo relativamente baixa em relação à dose fornecida pelos radiofármacos administrados com a exceção do estudo do linfonodo sentinela onde a contribuição do componente TC é aproximadamente metade da dose efetiva total.

Caracterización clínico-epidemiológica del cáncer de ovario

RESUMEN Fundamento: el cáncer de ovario constituye un problema de salud pública en Cuba y en el mundo por su elevada morbilidad y mortalidad. Objetivo: caracterizar las pacientes diagnosticadas con cáncer de ovario atendidas en el Servicio de Ginecología Oncológica del Hospital Universitario Docente Celestino Hernández Robau en el periodo 2015 - 2018. Método: se realizó un estudio descriptivo de corte transversal con una muestra de 71 pacientes diagnosticadas de cáncer de ovario en el Hospital Universitario Docente Celestino Hernández Robau. Se consideraron las variables: edad, nivel de escolaridad, hábito de fumar, obesidad, antecedentes patológicos familiares de cáncer de ovario, antecedentes ginecostétricos, clasificación histológica, estadio clínico, tratamiento monoespecífico y respuesta al tratamiento primario. Se determinaron frecuencias absolutas y relativas. Resultados: predominaron las pacientes entre 50-59 años (36,6 %), las multíparas (92 %), en etapa clínica IIIC con un 35,22 %, los adenocarcinomas serosos representaron el tipo histológico más frecuente (64,79 %). La cirugía subóptima se practicó al 52,11 % y la quimioterapia adyuvante al 45,07 %. El 35 % de las pacientes alcanzaron respuesta completa al tratamiento inicial. Conclusiones: los resultados obtenidos se comportan, en general, de acuerdo a patrones epidemiológicos reportados internacionalmente. Las pacientes entre 50-59 años, multíparas, en etapa clínica IIIC y con adenocarcinomas serosos, son prevalentes. La cirugía y la quimioterapia fueron los tratamientos estándar. Se obtuvo respuesta completa en la mayoría de las pacientes después del tratamiento inicial.

ABSTRACT Background: ovarian cancer constitutes a public health problem in Cuba and the world due to its high morbidity and mortality. Objective: to characterize the patients diagnosed with ovarian cancer treated at the Gynecol Oncology Service of the Celestino Hernández Robau Teaching University Hospital in the period 2015 - 2018. Method: a descriptive cross-sectional study was carried out with a sample of 71 patients diagnosed with ovarian cancer at the Celestino Hernández Robau Teaching University Hospital. Variables were considered: age, level of education, smoking, obesity, family pathological history of ovarian cancer, gynecostal history, histological classification, clinical stage, monospecific treatment and response to primary treatment. Absolute and relative frequencies were determined. Results: patients between 50-59 years (36.6 %), multiparous (92 %), in clinical stage IIIC with 35.22 %, serous adenocarcinomas represented the most frequent histological type (64.79 %). Suboptimal surgery was performed in 52.11 % and adjuvant chemotherapy in 45.07 %. 35 % of the patients achieved a complete response to the initial treatment. Conclusions: the results obtained behave, in general, according to epidemiological patterns reported internationally. Patients between 50-59 years of age, multiparous, in clinical stage IIIC and with serous adenocarcinomas are prevalent. Surgery and chemotherapy are standard treatments. Complete response was obtained in most patients after initial treatment.

Cost-effectiveness of the regimen proposed by the International Consortium on Acute Promyelocytic Leukemia for the treatment of newly diagnosed patients with Acute Promyelocytic Leukemia

ABSTRACT Introduction: We performed cost-effectiveness and cost-utility analyses of the modified International Consortium on Acute Promyelocytic Leukemia protocol in Mexico for the treatment of acute promyelocytic leukemia Acute Promyelocytic Leukemia. Methods: We performed a three-state Markov analysis: stable disease (first line complete response [CR]), disease event (relapse, second line response and CR) and death. The modified IC-APL protocol is composed of three phases: induction, consolidation and maintenance. Cost and outcomes were used to calculate incremental cost-effectiveness ratios (ICERs); quality-adjusted life-years were used to calculate incremental cost-utility ratios (ICURs). Results: The CR was achieved in 18 patients (90%), treated with the IC-APL protocol as the first-line option; one patient (5%) died in induction, another one never achieved CR (5%); of the 18 patients that achieved CR, 1 relapsed (5.5%). The median treatment cost of the IC-APL protocol was $21,523 USD. The average life-year in our study was 7.8 years, while the average quality-adjusted life-year (QALY) was 6.1 years. When comparing the ICER between the IC-APL and the all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) protocols, we found the different costs of $6497, $19,133 and $17,123 USD in Italy, the USA and Canada, respectively. In relation to the ICUR, we found the different costs to be $13,955 and $11,979 USD in the USA and Canada, respectively. Conclusion: Taking into account the similar response rates, lower cost and easy access to the modified IC-APL regimen, we consider it a cost-effective and cost-utility protocol, deeming it the treatment of choice for our population.

Bienestar psicológico y sentimiento de individuación laboral en trabajadores chilenos / Psychological wellbeing and sense of labor individuation in chilean workers / Bem-estar psicológico e sentimentos de individualização do trabalho em trabalhadores chilenos

La presente investigación estableció la relación entre Bienestar Psicológico y Sentimiento de Individuación Laboral. Además, verificó un modelo predictivo entre ambos constructos. Metodológicamente, ocupó una muestra de tipo no probabilística intencional conformada por 314 trabajadores del sector salud, educación y minería.Bienestar Psicológico fue medido mediante la adaptación española de la Escala de Bienestar Psicológico de Ryff (Diaz et al, 2006), por su parte, el Sentimiento de Individuación Laboral se describió a través del Cuestionario de Evaluación del Sentimiento de Individuación Laboral (Jorquera, 2016; Jorquera & González, 2018a). El análisis evidencia una estrecha relación entre bienestar psicológico y sentimiento de individuación laboral. El modelo propuesto del Bienestar Psicológico y el Sentimiento de Individuación Laboral mostró una adecuada bondad de ajuste (χ2 = 72,316, gl=30, p<,01; χ2/gl=2,411; CFI=,961; TLI=,942; GFI=,957; SRMR=,053; RMSEA=,067). Se discute respecto a la contribución de los resultados para comprender algunos procesos psicosociales, en el plano laboral, propios de un contexto cultural influido por procesos individualizadores.

The present investigation established the relationship between Psychological Wellbeing and Sense of Labor Individuation. In addition, he verified a predictive model between both constructs. Methodologically, it occupied an intentional non-probabilistic sample made up of 314 workers in the health, education and mining sector. Psychological Wellbeing was measured by the spanish adaptation of the Ryff Psychological Wellbeing Scale (Diaz et al, 2006), meanwhile, the Sense of Labor Individuation was described through the Questionnaire for the Evaluation of Sense of Labor Individuation (Jorquera, 2016; Jorquera & González, 2018a). The analysis shows a close relationship between the Sense of Labor Individuation and Psychological Wellbeing. The proposed model of Psychological Wellbeing and the Sense of Labor Individuation showed an adequate goodness of fit (χ2 = 72,316, gl = 30, p <,01; χ2/gl = 2,411; CFI =,961; TLI =,942; GFI = ,957; SRMR =,053; RMSEA =,067). We discuss the contribution of results to understand some psychosocial processes, in the workplace, typical of a cultural context influenced by individualizing processes.

A presente investigação estabeleceu a relação entre Bem-estar Psicológico e Sentimentos de Individualização do Trabalho. Além disso, verificou um modelo preditivo entre os dois construtos. Metodologicamente, ocupou uma amostra não probabilística intencional composta por 314 trabalhadores dos setores de saúde, educação e mineração. O Bem-estar Psicológico foi medido por meio da adaptação espanhola da Escala de Bem-Estar Psicológico Ryff (Diaz et al, 2006), por sua vez, o Sentimento de Individuação do Trabalho foi descrito por meio do Questionário para Avaliação do Sentimento de Individuação do Trabalho (Jorquera, 2016; Jorquera & González, 2018a). A análise mostra uma relação estreita entre o bem-estar psicológico e o sentimento de individuação no trabalho. O modelo proposto de Bem-estar Psicológico e Sentimento de Individuação do Trabalho mostrou um ajuste adequado (χ2 =72,316, gl = 30, p <0,01; χ2 / gl = 2,411; CFI = 0,961; TLI = 0,942; GFI =,957; SRMR = 0,053; RMSEA = 0,067). Discute-se a respeito da contribuição dos resultados para a compreensão de alguns processos psicossociais, no ambiente de trabalho, típicos de um contexto cultural influenciado por processos individualizantes.

Larval fish assemblages in nearshore waters of southeast Gulf of California: vertical and temporal patterns

The influence of salinity and temperature on larval fish assemblages, as well as, temporal and vertical patterns on larval fish assemblages off the inlet of the Presidio River, southeast coast of the Gulf of California were evaluated. Samplings for ichthyoplankton and environmental parameter measurements were carried out at three depths, in five sampling sites, during September and December 1994, and April and June 1995. Anchovies and herrings (Clupeiformes) were the most abundant larval fish accounting for 77% of the total abundance. A significant relationship between salinity and the abundance of larval herrings (Opisthonema medirastre and O. dovii) and between the water temperature and the abundance of the weakfish (Cynoscion reticulatus) was found. Anchovies (Anchoa lucida, A. walkeri, and A. nasus) were present in all sampled months, while O. medirastre and O. dovii occurred in December and June, and C. reticulatus in September. Larvae of pelagic fish were more abundant near the surface, while larvae of demersal fish were more abundant near the bottom. The present study, by emphasising the importance of considering temporal and vertical changes in larval fish assemblages in coastal environments with ecological and economic importance, will be useful for designing more efficient sampling programs.(AU)

Se evaluó la influencia de la salinidad y la temperatura, así como patrones temporales y verticales en la comunidad de larvas de peces enfrente del río Presidio, costa sudeste del Golfo de California. Los muestreos de ictioplancton y las mediciones de los parámetros ambientales fueron realizados a tres profundidades, en cinco sitios de muestreo, durante septiembre y diciembre de 1994, y abril y junio de 1995. Las anchoas y sardinas (Clupeiformes) fueron las larvas de peces más abundantes representando el 77% de la abundancia total. Se encontró una relación significativa entre la salinidad y la abundancia de larvas de sardinas (Opisthonema medirastre and O. dovii), y entre la temperatura del agua y la abundancia de la corvina rayada (Cynoscion reticulatus). Las anchoas (Anchoa lucida, A. walkeri y A. nasus) estuvieron presentes en todos los meses muestreados, mientras que O. medirastre y O. dovii ocurrieron en diciembre y junio, y C. reticulatus en septiembre. Las larvas de peces pelágicos fueron más abundantes cerca de la superficie, mientras que las larvas de peces demersales fueron más abundantes cerca del fondo. El presente estudio, al enfatizar la importancia de considerar los cambios temporales y verticales en el ensamblaje de larvas de peces en ambientes costeros con importancia ecológica y económica, será útil para diseñar programas de muestreo más eficientes.(AU)

Divulgación de la experiencia de un modelo de utilidad de transferencia, apropiación y adopción tecnológica de siembra bajo invernadero en productores rurales caso: El Edén de Cris del corregimiento de La Elvira del municipio de Cali / Dissemination of the experience of a utility model of transfer, appropriation and technological adoption of seeding under greenhouse in rural producers: Case El Eden de Cris del corregimiento de La Elvira del municipio de Cali / Divulgação da experiência de um modelo de utilidade de transferência, apropriação e adoção tecnológica de plantio sob estufa em produtores rurais: Caso O Éden de Cris do correção de La Elvira do município de Cali

Resumen El artículo muestra los resultados del estudio cuyo propósito es divulgar la experiencia de la transferencia y apropiación tecnológica del modelo de utilidad en la siembra bajo invernadero mediante la aplicación de la metodología investigación social, caso El Edén de Cris, corregimiento de La Elvira, período 2012 - 2016. Los resultados revelan que al aplicar la metodología en el proyecto, se logró la transferencia tecnológica, la apropiación y adopción de siembra bajo invernadero por medio de un modelo de utilidad; sin embargo, la continuidad del proyecto involucrando más productores agrícolas generaría un impacto socioeconómico en la localidad. El modelo de utilidad permitió aplicar nuevas formas de producción agrícola a través de las Unidades Productivas Agrícolas Sostenibles, la réplica a más productores podría contribuir a disminuir las brechas de exclusión social e inequidad existentes en la localidad de la Elvira, reconfigurar el territorio a partir del diseño de un micro-circuito productivo sostenible con el agroecosistema, mediante la construcción social de relaciones productivas en redes de productores rurales. Clasificación JEL: F18, J43, L83, 013, Q57

Abstract This article shows the results of the study whose purpose is to disseminate the experience of the transfer and technological appropriation of the utility model in greenhouse sowing through the application of the social research methodology. El Edén de Cris case, corregimiento of the Elvira, period 2012 - 2016. The results revealsthat when applying the methodology in the project, the technological tranfer appropriation and adoption of sowing under greenhouse was achieved through a utility model; however the continuity of the project involving more agricultural producers would generate a socioeconomic impact in the town.The utility model allowed the application of new forms of agricultural production through the Sustainable Agricultural Productive Units, the replication of more producers could contribute to reducing the gaps of social exclusion and inequality existing in the town of Elvira, reconfiguring the territory from design of a sustainable productive micro-circuit with agroecosystems, through the social construction of forms of productive relations in networks of rural producers. JEL Classification: F18, J43, L83, 013, Q57

Resumo O artigo apresenta os resultados do estudo, cujo objetivo é disseminar a experiência da transferência e apropriação tecnológica do modelo de utilidade na semeadura em estufa através da aplicação da metodologia de pesquisa social, caso El Edén de Cris, corregimiento (é usado na Colômbia para definir um tipo de subdivisão da área rural dos diferentes municípios do país) de La Elvira, período de 2012 - 2016. Os resultados revelam que, ao aplicar a metodologia no projeto, a transferência tecnológica, a apropriação e a adoção da semeadura em casa de vegetação foram realizadas por meio de um modelo de utilidade; no entanto, a continuidade do projeto envolvendo mais produtores agrícolas geraria um impacto socioeconómico na localidade. O modelo de utilidade permitiu a aplicação de novas formas de produção agrícola por meio das Unidades Produtivas Agrícolas Sustentáveis, a replicação de mais produtores poderia contribuir para reduzir as lacunas de exclusão social e desigualdade existentes no corregimiento de La Elvira, reconfigurando o território de projeto de um microcircuito produtivo sustentável com agroecossistemas, através da construção social de relações Produtivas Em Redes De Produtores Rurais. Classificações JEL: F18, J43, L83, 013, Q57

Monitoreo ambulatorio de la presión arterial en pacientes diabéticos con o sin hipertensión arterial / Ambulatory blood pressure monitoring in diabetic patients with or without high blood pressure

Resumen: ANTECEDENTES El monitoreo ambulatorio de la presión arterial (MAPA) predice de forma más precisa el riesgo de complicaciones cardiovasculares que la presión arterial en el consultorio. El parámetro del MAPA que se asocia de forma más estrecha es el promedio de presión arterial nocturna. OBJETIVO Determinar la prevalencia y los factores asociados de las alteraciones en los parámetros del monitoreo ambulatorio de la presión arterial (MAPA) de 24 horas en pacientes diabéticos. MATERIAL Y MÉTODO Estudio descriptivo, transversal, realizado de enero a junio de 2017 en pacientes con diabetes mellitus tipo 2 con o sin antecedente de hipertensión arterial. Se realizó evaluación clínica y de laboratorio para la identificación de factores de riesgo cardiovascular. Para el monitoreo ambulatorio de la presión arterial se utilizaron monitores Watch BP 03. RESULTADOS Se incluyeron 127 pacientes. Se encontró hipertensión de 24 horas en 46.5% e hipertensión diurna en 35.4%. La prevalencia de hipertensión nocturna fue de 66.1% y de hipertensión nocturna aislada de 32.3%. La prevalencia de patrón no dipper fue de 49.6%, del patrón riser de 24.4%, dipper 22.8% y dipper extremo 3.1%. Los factores asociados de forma significativa con la hipertensión nocturna fueron tabaquismo, tiempo de evolución de la diabetes mellitus, edad y concentración de creatinina sérica. CONCLUSIONES Se encontró prevalencia elevada de alteraciones nocturnas de la presión arterial.

Abstract: BACKGROUND Ambulatory blood pressure monitoring (ABPM) more accurately predicts the risk of cardiovascular complications than blood pressure in the office. The ABPM parameter that is associated most closely is the average nighttime blood pressure. OBJECTIVE To determine the prevalence and factors associated of alterations in the ABPM parameters of 24 hours in diabetic patients. MATERIAL AND METHOD A descriptive, cross-sectional study was done from Ja-nuary to June 2017 in patients with type 2 diabetes mellitus with or without a history of arterial hypertension. A clinical and laboratory evaluation was carried out to identify cardiovascular risk factors. For ABPM, Watch BP 03 monitors were used. RESULTS 127 patients were included. 24-hours hypertension was found in 46.5% and daytime hypertension in 35.4%. The prevalence of nocturnal hypertension was 66.1% and of isolated nocturnal hypertension of 32.3%. The prevalence of non-dipper pattern was 49.6%, Riser pattern 24.4%, Dipper 22.8% and extreme Dipper 3.1%. The factors significantly associated with the presence of nocturnal hypertension were smoking, time of evolution of diabetes mellitus, age and serum creatinine concentration. CONCLUSIONS A high prevalence of nocturnal alterations in blood pressure was found.

Estado nutricional antropométrico, bioquímico e ingesta alimentaria en niños escolares de 6 a 14 años, General Pueyrredón, Buenos Aires, Argentina / Anthropometric and biochemical assessment of nutritional status and dietary intake in school children aged 6-14 years, Province of Buenos Aires, Argentina

Introducción: La obesidad infantil es una epidemia global. La edad escolar y la adolescencia son etapas cruciales para la implementación de hábitos alimentarios y estilo de vida. Objetivo: Evaluar el estado nutricional, antropométrico, bioquímico e ingesta alimentaria de niños, su relación con factores socioeconómicos y georreferenciación. Métodos: Estudio transversal en escolares de 6 a 14 años, del Partido de General Pueyrredón, durante agosto-noviembre de 2013. Se evaluó la ingesta por recordatorio de 24 horas; se georreferenció con el programa gvSIG. Resultados: Se incluyeron 1296 niños para evaluación antropométrica y socioeconómica. Una sub muestra incluyó 362 niños para parámetros bioquímicos e ingesta. El 42,97% (IC 95%: 40,3-45,7) presentó exceso de peso y el 18,5% (IC 95%: 16,3-20,5), obesidad. Desayunar se relacionó con menor riesgo de exceso de peso (OR: 0,7; IC 95%: 0,5-0,9) y obesidad (OR: 0,7; IC 95%: 0,5-0,9). Concurrir al secundario se asoció a menor prevalencia de exceso de peso (OR: 0,45; IC 95%: 0,3-0,7); el sexo masculino presentó mayor riesgo de obesidad (OR: 1,7; IC 95%: 1,3-2,3). Presentaron anemia 4,44%, hipercolesterolemia 19,6% e hipertrigliceridemia 21,3%. La ingesta de lípidos y grasas saturadas fue alta y de colesterol dietario y fibra, baja. La distribución geográfica fue homogénea. Conclusiones: La prevalencia de exceso de peso fue elevada. El riesgo de obesidad fue mayor en varones; el desayuno surgió como factor protector para sobrepeso/obesidad. La baja ingesta de fibras y elevada de grasas, y los niveles altos de colesterol y triglicéridos en sangre, reflejan que la malnutrición por exceso es un problema de salud pública prevalente.

Introduction: Childhood obesity is a global epidemic. School age and adolescence are critical stages for the implementation of eating and lifestyle habits. Objective: To assess anthropometric and biochemical assessment of nutritional status and dietary intake in children, their relationship with socioeconomic factors and georeferencing. Methods: Cross-sectional study in schoolchildren aged 6-14 years from the District of General Pueyrredon, during August-November 2013. Dietary intake was assessed using a 24-hour dietary recall interview, and georeferencing was done using the gvSIG software. Results: A total of 1296 children were included for anthropometric and socioeconomic assessment. A sub-sample included 362 children for intake and biochemical parameters. Overweight was observed in42.97% (95% confidence interval --#91;CI--#93;: 40.3-45.7) and obesity, in 18.5% (95% CI: 16.320.5). Breakfast was related to a lower risk for overweight (OR: 0.7, 95% CI: 0.5-0.9) and obesity (OR: 0.7, 95% CI: 0.5-0.9). Attending high school was related to a lower prevalence of weight excess (OR: 0.45, 95% CI: 0.3-0.7); male sex posed a higher risk for obesity (OR: 1.7, 95% CI: 1.3-2.3). Also, 4.44% of participants had anemia; 19.6%, hypercholesterolemia; and 21.3%, hypertriglyceridemia. Lipid and saturated fat intake was high, whereas dietary cholesterol and fiber intake was low. Geographic distribution was homogeneous. Conclusions: The prevalence of overweight was high. The risk for obesity was higher among boys; breakfast appeared as a protective factor against overweight/obesity. A low-fiber and high-fat intake, and high blood cholesterol and triglyceride levels reveal that overnutrition is a prevalent public health problem.

Sentimiento de individuación laboral: procesos del pensamiento en el contexto sociolaboral actual / Sense of labor individuation: thought processes in the current sociolaboral context

El Sentimiento de Individuación Laboral es un proceso del pensamiento social que hace referencia a la conciencia que el trabajador posee de su proyecto de vida laboral y al sentimiento de que puede autodeterminarlo. En este proceso actuaría la disposición a revisar el curso del proyecto de vida en el trabajo y de utilizar la autobiografía laboral (Jorquera, 2012, 2016). El presente artículo, de tipo teórico-empírico, realiza un desarrollo conceptual acerca de este constructo y una descripción de este proceso en una muestra de trabajadores y estudiantes universitarios chilenos. Los resultados muestran diferencias entre la muestra de trabajadores y estudiantes; además, evidencian diferencias según la edad de los sujetos. Se discuten los resultados estableciendo la conexión entre este tipo de procesos del pensamiento social y la estructura social propia de la moderna tardía o segunda modernidad (Giddens, 1995; Beck, 2002) (AU)

The sense of labor Individuation is a process of social thought that refers to the awareness that the worker has of his life work project and the feeling that he can selfdetermine it. In this process takes part the willingness to review the course of the life project at work and to use the labor autobiography (Jorquera, 2012, 2016). This article, theoretical/empirical, focuses on a conceptual development of this construct and a description of this process in a sample of Chilean workers and university students. The results show differences between the sample of workers and students. In addition, they show differences regarding the age of the subjects. The results are discussed establishing the connection between this type of social thought processes and the social structure of late modernity or second modernity (Giddens, 1995, Beck, 2002).(AU)

Warm autoimmune hemolytic anemia: experience from a single referral center in Mexico City

BACKGROUND: Autoimmune hemolytic anemia (AIHA) is characterized by an autoimmune-mediated destruction of red blood cells. Warm AIHA (wAIHA) represents 60% of AIHA cases and is associated with the positive detection of IgG and C3d in the direct antiglobulin test (DAT). This study aimed to assess the clinical and laboratorial differences between primary and secondary wAIHA patients from a referral center in Mexico City. METHODS: All patients diagnosed with wAIHA in our institution from January 1992 to December 2015 were included and received corticosteroids as the first-line treatment. We analyzed the response to the first-line treatment, relapse-free survival, and time to splenectomy. RESULTS: Eighty-nine patients were included. Secondary wAIHA represented 55.1% of the cases. At diagnosis, secondary wAIHA patients showed a DAT mixed pattern more frequently than primary wAIHA patients (36.7 vs. 17.5%, P<0.001). In the survival analysis, patients with secondary wAIHA had a lower time to response (18 vs. 37 days, P=0.05), median disease-free survival (28.51 vs. 50.95 weeks, P=0.018), and time to splenectomy (43.5 vs. 61 wks, P=0.029) than those with primary wAIHA. Due to economic constraints, rituximab was considered as the third-line treatment in only two patients. CONCLUSION: Secondary wAIHA may benefit from a longer low-dose steroid maintenance period mainly due to its shorter time to relapse and time to splenectomy than primary wAIHA.

Uréter retrocavo e infección recurrente de vías urinarias: A propósito de un caso / Retrocaval Ureter and Recurrent Urinary Tract Infection: Case Report

El uréter retrocavo es una anomalía poco frecuente de etiología congénita, la cual causa sintomatología en pacientes adultos; se caracteriza por hidronefrosis en diferentes grados, además de otras patologías relacionadas con lesión renal. El abordaje terapéutico es principalmente quirúrgico y se aplicará de acuerdo con el grado de disfunción renal. A continuación se presenta el caso de una mujer de 27 años de edad, a quien se le practicó un estudio imaginológico por infección recurrente de vías urinarias que no respondió a la farmacoterapia habitual.

Retrocaval ureter is a rare anomaly of congenital etiology, which causes symptoms in adults and is characterized by hydronephrosis in different degrees, in addition to other diseases related to renal injury. The therapeutic approach is mainly surgical and decided according to degree of related renal dysfunction. We present a case of a woman aged 27 who is sent to the radiology service of Hospital San Rafael Tunja for an imaging study after refractory urinary tract infection that did not respond to standard drug therapy

Sentimiento de Individuación Laboral: Propuesta Conceptual y Psicométrica

En el presente artículo es propuesto el concepto Sentimiento de Individuación Laboral para comprender los procesos psicológico-sociales que estarían implicados en la construcción de la trayectoria y biografía laboral de trabajadores, en el contexto de una estructura social individualizadora. Sus dimensiones serían: Conciencia del Proyecto de Vida Laboral, Elección de Estilo de Vida Laboral (Autodeterminación), Reflexividad del yo, y Autobiografía laboral. Además, se desarrolló un instrumento de medición de este constructo. La evaluación de sus características psicométricas se efectuó en una muestra de 283 trabajadores de diversos tipos de industrias. Los resultados son favorables al modelo hipotético propuesto, evidenciándose una aceptable bondad de ajuste (Chi2=176,408, gl=71, p=,000; Chi²/gl= 2,485; GFI=,919; NFI=,901; CFI=,938; RMSEA=,073). La confiabilidad del instrumento resulta adecuada, observándose que los estadígrafos alfa de cronbach de las cuatro dimensiones muestran valores entre ,78 y ,85. Es discutida la utilidad de usar este constructo e instrumento para realizar estudios descriptivos, comparativos y relacionales, orientados a entender la heterogeneidad del impacto de la individualización en la vida de los trabajadores.

This article proposes the concept of Feeling of Labor Individuation to understand the psychological-social processes that would be involved in the construction of the career path and labor biography of workers, in the context of an individualized social structure. Its dimensions would be: Work Life Project Awareness, Labor Lifestyle Choice (Self-Determination), Reflexivity of the Self, and Autobiography. In addition, a measuring instrument forthis constructwas developed. The evaluation of their psychometric characteristics was carried out in a sample of 283 workers of different types of industries. The results are favorable to the proposed hypothetical model, showing an acceptable good fit (Chi2=176,408, gl=71, p=,000; Chi²/gl= 2,485; GFI=,919; NFI=,901; CFI=,938; RMSEA=,073). The reliability of the instrument is adequate, observing that the alpha cronbach statisticians of the four dimensions show values between ,78 and ,85. The usefulness of using this construct and instrument to perform descriptive, comparative and relational studies, aimed at understanding the heterogeneity of the impact of individualization on workers' lives, is discussed.

Neste artigo, propõese o conceito de sentimento de discriminação do trabalho para entender os processos psicológico-sociais que estarão envolvidos na construção da trajetória e biografía de trabalho dos trabalhadores, no contexto de uma estrutura social individualizadora. Suas dimensões seriam: Consciência do Projeto Vida Profissional, Escolha do Estilo de Vida do Trabalho (Autodeterminação), Reflexividade do eu e Autobiografía Laboral. Além disso, um instrumento de medição para esta construção foi desenvolvido. A avaliação de suas características psicométricas foi realizada em uma amostra de 283 trabalhadores de diferentes tipos de indústrias. Os resultados são favoráveis ao modelo hipotético proposto, evidenciando uma bondade de ajuste aceitável (Chi2 = 176,408, gl = 71, p = 000, Chi2 /df =2,485, GFI =, 919, NFI = 901, CFI =, 938; RMSEA =, 073). A confiabilidade do instrumento é adequada, observando que os estatísticos alfa de Cronbach das quatro dimensões mostram valores entre, 78 e 85. A utilidade de usar esta construção e instrumento para realizar estudos descritivos, comparativos e relacionais, visando a compreensão da heterogeneidade do impacto da individualização sobre a vida dos trabalhadores é discutida.

Georreferenciación de la oferta de programas de salud pública en cuatro ciudades en el contexto del mercado competitivo del sistema de salud, Colombia 2014 / Georreferenciamento da oferta de programas de saúde pública em quatro cidades no contexto do mercado competitivo do sistema de saúde, Colômbia / Georeferencing provision of public health programs in four Colombian cities within the context of the competitive market of the health system, 2014

Objetivo: georreferenciar la oferta de programas de salud pública de las Instituciones Prestadoras de Servicios de Salud (IPS) públicas y privadas en cuatro ciudades colombianas. Metodología: estudio descriptivo de corte transversal, desarrollado a partir de la base de datos de IPS habilitadas del Ministerio de Salud y Protección Social, que ofrecen programas de salud pública. Resultados: es mayor el número de IPS privadas que ofrecen programas de salud pública; sin embargo, estas se concentran en atender a la población y las zonas de la ciudad con mejor nivel socioeconómico. La población de las zonas más pobres está siendo atendida casi exclusivamente por las IPS del sector público. Conclusión: en un sistema de mercado competitivo la población y las zonas de la ciudad se segmentan según su nivel socioeconómico y no es atractivo para el sector privado proveer servicios de salud pública a las poblaciones más pobres.

Objective: To describe the geographical location of public health programs offered by public and private institutions providing health services in four Colombian cities. Methodology: Descriptive cross-sectional study based on information from the Ministry of Health of institutions that provide public health programs. Results: More private than public institutions offer public health programs, but the former are concentrated on the population and zones with better socioeconomic conditions. In contrast, poor population depends almost exclusively on public sector institutions. Conclusion: In a competitive market system, population and city zones are segmented according to their socioeconomic level, and it is not attractive for the private sector to provide public health services to poorer populations.

Objetivo: georreferenciar a oferta de programas de saúde pública das instituições prestadoras de serviços de saúde (IPS) públicas e privadas em quatro cidades colombianas. Metodologia: estudo descritivo de corte transversal, desenvolvido a partir da base de dados de IPS habilitadas do Ministério de Saúde e Proteção Social, que oferecem programas de saúde pública. Resultados: é maior o número de IPS privadas que oferecem programas de saúde pública; no entanto, estas se concentram em atender à população e as zonas da cidade com melhor nível socioeconômico. A população das zonas mais pobres está sendo atendida quase exclusivamente pelas IPS do setor público. Conclusão: num sistema de mercado competitivo a população e as zonas da cidade se segmentam segundo seu nível socioeconômico e não é atraente para o setor privado prover serviços de saúde pública às populações mais pobres.

The efficacy of 2-nitrovinylfuran derivatives against Leishmania in vitro and in vivo

Despite recent advances in the treatment of some forms of leishmaniasis, the available drugs are still far from ideal due to inefficacy, parasite resistance, toxicity and cost. The wide-spectrum antimicrobial activity of 2-nitrovinylfuran compounds has been described, as has their activity against Trichomonas vaginalis and other protozoa. Thus, the aim of this study was to test the antileishmanial activities of six 2-nitrovinylfurans in vitro and in a murine model of leishmaniasis. Minimum parasiticide concentration (MPC) and 50% inhibitory concentration (IC50) values for these compounds against the promastigotes of Leishmania amazonensis, Leishmania infantum and Leishmania braziliensis were determined, as were the efficacies of two selected compounds in an experimental model of cutaneous leishmaniasis (CL) caused by L. amazonensis in BALB/c mice. All of the compounds were active against the promastigotes of the three Leishmania species tested. IC50 and MPC values were in the ranges of 0.8-4.7 µM and 1.7-32 µM, respectively. The compounds 2-bromo-5-(2-bromo-2-nitrovinyl)-furan (furvina) and 2-bromo-5-(2-methyl-2-nitrovinyl)-furan (UC245) also reduced lesion growth in vivo at a magnitude comparable to or higher than that achieved by amphotericin B treatment. The results demonstrate the potential of this class of compounds as antileishmanial agents and support the clinical testing of Dermofural(r) (a furvina-containing antifungal ointment) for the treatment of CL.

Sarcoma de Kaposi clásico en un paciente joven e inmunocompetente: reporte de un caso / Classic Kaposi's sarcoma in a young, immunocompetent patient: a case report

El sarcoma de Kaposi (SK) es un cáncer que se desarrolla a partir de las células de los vasos sanguíneos o linfáticos. Fue descrito, en 1872, por Moriz Kaposi, y por muchos años se consideró una neoplasia de curso poco agresivo, lo cual cambió con la epidemia del sida. Se han descrito clásicamente cuatro grupos de SK: clásico, endémico, iatrogénico y epidémico. El SK clásico, aparece con mayor frecuencia en pacientes de 60 a 70 años y de origen mediterráneo. Se presenta el caso de un paciente joven de 27 años, inmunocompetente que desarrolla un SK clásico con inicio inusual.

Kaposi's sarcoma is a type of cancer that develops from blood cells or lymphatic vessels. It was described in 1872 by Moriz Kaposi, and for many years was considered an aggressive neoplasm, which changed with the AlDS epidemic. lt has been classically described into four groups of Kaposi's sarcoma: classic, endemic, iatrogenic and epidemic. The classic Kaposi sarcoma occurs more frequent in patients from 60 to 70 years old and Mediterranean origin. We report the case of a young patient of 27 years old, immunocompetent who developed classic Kaposi sarcoma with an un usual start.

Identificación de microRNAs en carcinoma cutáneo de células escamosas (CCE) / Identification of microRNAs in cutaneous squamous cell carcinoma (cSCC)

El carcinoma cutáneo de células escamosas (CCE) es el segundo cáncer de piel ms común en humanos, el cual puede llegar a ser invasivo y mostrar un curso agresivo. El CCE inicia en las células escamosas de la capa epidérmica. Así mismo, la epidermis se compone de tejido queratinizado que se regenera continuamente a partir de células basales y reemplaza a las células muertas. Estudios sobre el proceso de diferenciación celular, muestran que los microRNAs (miRNAs) están involucrados en el proceso de formación de la piel, y se ha reportado que alteraciones en la transcripción, procesamiento y expresión de los miRNAs afecta a la señalización celular, esencial en la proliferación, invasión, apoptosis y diferenciación células malignas. Los miRNAs son una familia de reguladores epigenéticos de pequeñas moléculas endógenas no codificantes de RNAs de aproximadamente 25 nucleótidos de longitud, y están involucrados en la patogénesis de cáncer en humanos como reguladores de factores de crecimiento transformantes y metástasis. Se hizo una revisión sistemática usando las principales bases de datos bibliográficas (PubMed/MEDLINE, Science) y revistas públicas en internet. Los criterios de inclusión y exclusión fueron predefinidos (carcinoma cutáneo, miRNAs, biogénesis) y también un conjunto de variables para analizar las características de los artículos seleccionados (expresión y el papel de los miRNAs en el CCE, que no han sido bien estudiadas).

The cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer in humans, which can become invasive and show an aggressive course. CSCC starts in the epidermal layer of squamous cells. Also, the epidermis is composed of keratinized tissue that continuously regenerate from basal cells and replace the dead cells. Studies about cell differentiation process, shows that microRNAs (miRNAs) are involved in the process of skin formation, and has been reported that alterations intranscription, processing and expression of miRNAs, affect the function of the cell signaling, essential the proliferation, invasion, apoptosis and differentiation of malignant cells. MiRNAs are an epigenetic regulators family of small noncoding endogenous molecules of RNAs, about 25 nucleotides in length, and are involved in the pathogenesis of human cancer in the regulation of transformant growth factors and metastasis. We performed a systematic review using major electronic bibliographic databases (PubMed/MEDLINE, Sciencie) and public journals on the internet. Inclusion and exclusion criteria were pre-defined (cutaneous carcinoma, miRNAs, and biogenesis) and also a set of variables to analyze the characteristics of the selected reports (the expression and role of miRNAs in the cSCC, what has not been well studied).

Dermatitis liquenoide anular de la juventud en un adulto: presentación de un caso clínico / Annular lichenoid dermatitis of youth (ALDY) in an adult patient: a clinic case

La dermatitis liquenoide anular es una entidad clínica recientemente descrita que se presenta como placas circularesceritematosas con centro hipopigmentado y evolución crónica. A pesar de que los diagnósticos diferenciales puedencser diversos la histopatología es muy característica. Siendo la mayor parte de los casos descritos en niños, se le dio el nombre de ALDY, aunque se han visto casos en la adultez. Presentamos el caso de un paciente varón adulto, de 41 años, como aporte al conocimiento de esta patología.

Annular lichenoid dermatitis of youth is a clinical entity recently described that presents as circular plaques hipopigmented centre and chronic evolution. Despite of several differential diagnoses, this pathology is characterized by its histopathology. As most cases has been described in children, it was named as ALDY;but has seen cases in adults. A case of a 41 years old male is presented as a contribution for the knowledge of this pathology.