[Primary plasma cell leukemia. Report of five cases]. / Leucemia de células plasmáticas primaria: experiencia en un hospital público chileno.

BACKGROUND: Primary plasma cell leukemia (pPCL) is uncommon, aggressive and has a different biology than multiple myeloma (MM). AIM: To report the features of patients with pPCL. MATERIAL AND METHODS: Review of databases of the Hematology Department and the Hematology laboratory. RESULTS: Of 178 patients with monoclonal gammopathies, five (2.8%) patients aged 33 to 64 years (three females) had a pPCL. The mean hemoglobin was 7.3 g/dL, the mean white blood cell count was 52,500/mm3, with 58% plasma cells, and the mean platelet count was 83,600/mm3. The mean bone marrow infiltration was 89%, LDH was 2,003 IU/L, serum calcium was 13 mg/dL, and creatinine 1.5 mg/dL. Two patients had bone lesions. Three were IgG, one IgA lambda and one lambda light chain. CD20 was positive in one, CD56 was negative in all and CD117 was negative in 3 cases. By conventional cytogenetic analysis, two had a complex karyotype. By Fluorescence in situ Hybridization, one was positive for TP53 and another for t (11; 14). One patient did not receive any treatment, three patients received VTD PACE and one CTD. None underwent transplant. Three patients are alive. The mean survival was 14 months. CONCLUSIONS: These patients with pPCL were younger and had a more aggressive clinical outcome than in multiple myeloma.

Stereodivergent Mannich reaction of bis(trimethylsilyl)ketene acetals with N-tert-butanesulfinyl imines by Lewis acid or Lewis base activation, a one-pot protocol to obtain chiral ß-amino acids.

We report a one-pot synthesis of chiral ß2,2,3-amino acids by the Mannich addition of bistrimethylsilyl ketene acetals to N-tert-butanesulfinyl imines followed by the removal of the chiral auxiliary. The synthesis and isolation of pure ß-amino acid hydrochlorides were conducted under mild conditions, without strong bases and this method is operationally simple. The stereoselective reaction was promoted by two different activation methods that lead to different stereoisomers: (1) Lewis Acid (LA) catalysis with boron trifluoride diethyl etherate and (2) Lewis Base (LB) catalysis with tetrabutylammonium difluorotriphenylsilicate. The reaction presented good diastereoselectivity with LB activation and moderate to good dr with LA catalysis. The exceptions in both protocols were imines with electron donating groups in the aromatic ring.

Programme Dementia Prevention (pdp): A Nationwide Program for Personalized Prevention in Luxembourg.

BACKGROUND: With continuously aging societies, an increase in the number of people with cognitive decline is to be expected. Aside from the development of causative treatments, the successful implementation of prevention strategies is of utmost importance to reduce the high societal burden caused by neurodegenerative diseases leading to dementia among which the most common cause is Alzheimer's disease. OBJECTIVE: The aim of the Luxembourgish "programme dementia prevention (pdp)" is to prevent or at least delay dementia in an at-risk population through personalized multi-domain lifestyle interventions. The current work aims to provide a detailed overview of the methodology and presents initial results regarding the cohort characteristics and the implementation process. METHODS: In the frame of the pdp, an extensive neuropsychological evaluation and risk factor assessment are conducted for each participant. Based on the results, individualized multi-domain lifestyle interventions are suggested. RESULTS: A total number of 450 participants (Mean age = 69.5 years; SD = 10.8) have been screened at different recruitment sites throughout the country, among whom 425 participants (94.4%) met the selection criteria. CONCLUSIONS: We provide evidence supporting the feasibility of implementing a nationwide dementia prevention program and achieving successful recruitment of the target population by establishing a network of different healthcare providers.

Stability of doubly and triply H-bonded complexes governed by acidity-basicity relationships.

We used our recently proposed acidity-basicity interplay (ABI) model (Chem. Sci., 2018, 9, 4402) and the Jorgensen secondary interactions hypothesis (JSIH) to rationalise the experimentally observed trends in the formation constants of doubly and triply H-bonded systems with -NHO[double bond, length as m-dash]C- and -NHN- interactions. Unlike the JSIH, the ABI interpretation can explain the trends in the complexation of amide/imide homo- and heterodimers as well as ADA-DAD clusters. We found that the strongest H-bonds play a very important role, a condition which offers an alternative to the well established JSIH to modulate the stability of these relevant systems.

Microbiology of acute sinusitis in Mexican patients.

Acute bacterial sinusitis is a common disorder affecting children and adults. We performed a study to assess the bacteriology of acute sinusitis in a community hospital in Mexico City. Patients with an acute exacerbation of persistent sinusitis or acute sinusitis were enrolled. Aspiration of sinus secretions was performed and aspirates were sent for culture. All patients received antibiotic treatment for the infection based on microbiologic sensitivity reports. Follow-up consultation included endoscopy and a computed tomography scan of paranasal sinuses to assess response to treatment. A total of 110 patients were enrolled for evaluation. Forty nine percent of patients were women; median age was 31 years. A total of 136 cultures were recovered for analysis. Twenty seven percent of cultures were negative. Isolated organisms were Haemophilus influenzae (26%), Moraxella catarrhalis (15%), Streptococcus pneumoniae (14%), methicillin-sensitive Staphylococcus aureus (7%), enterobacteriaceae (6%), Pseudomonas aeruginosa (2%) and miscellaneous (3%). Twenty eight percent of H. influenzae strains were resistant to ampicillin. Penicillin-sensitive S. pneumoniae (PSSP) and penicillin-intermediate-resistant S. pneumoniae (PISP) accounted for 21% and 79% of the S. pneumoniae strains, respectively. H. influenzae was the most common isolated organism. About 55% of those isolates were found in patients <18 years old and only 25% were resistant to ampicillin. Sinus endoscopy continues to be a useful diagnostic tool in addition to imaging studies in sinus infection and should be pursued by the clinician whenever feasible.

Leucemia de células plasmáticas primaria: experiencia en un hospital público chileno / Primary plasma cell leukemia: report of five cases

Background: Primary plasma cell leukemia (pPCL) is uncommon, aggressive and has a different biology than multiple myeloma (MM). Aim: To report the features of patients with pPCL. Material and Methods: Review of databases of the Hematology Department and the Hematology laboratory. Results: Of 178 patients with monoclonal gammopathies, five (2.8%) patients aged 33 to 64 years (three females) had a pPCL. The mean hemoglobin was 7.3 g/dL, the mean white blood cell count was 52,500/mm3, with 58% plasma cells, and the mean platelet count was 83,600/mm3. The mean bone marrow infiltration was 89%, LDH was 2,003 IU/L, serum calcium was 13 mg/dL, and creatinine 1.5 mg/dL. Two patients had bone lesions. Three were IgG, one IgA lambda and one lambda light chain. CD20 was positive in one, CD56 was negative in all and CD117 was negative in 3 cases. By conventional cytogenetic analysis, two had a complex karyotype. By Fluorescence in situ Hybridization, one was positive for TP53 and another for t (11; 14). One patient did not receive any treatment, three patients received VTD PACE and one CTD. None underwent transplant. Three patients are alive. The mean survival was 14 months. Conclusions: These patients with pPCL were younger and had a more aggressive clinical outcome than in multiple myeloma.

Obtención y procesamiento de células progenitoras hematopoyéticas periféricas / Obtention and processing of peripheral hematopoietic progenitor cells

Se realizó un estudio descriptivo de la totalidad de las colectas de células progenitoras hematopoyéticas realizadas en el Banco de Sangre del Hospital "Hermanos Ameijeiras" desde abril del 2001 hasta abril del 2002, mediante leucoféresis. Se utilizó un equipo de flujo continuo (FRESENIUS ASTEC 204) y se empleó el programa mononucleares con el set P1Y. Se determinó peso, talla, hematócrito, hemoglobina, conteo de leucocitos y plaquetas de los donantes previo a la colecta. En el producto de la leucoféresis se analizó el conteo de leucocitos con diferencial, conteo de células CD34+/ CD45+ (mediante técnica de inmunofluorescencia en citómetro de flujo) y determinación de viabilidad celular con yoduro de propidio en este mismo equipo (Facscan, Becton Dickinson). Recibieron trasplante autólogo 5 pacientes y 2 trasplantes alogénicos. Los primeros con diagnósticos de: linfoma no hodgkiniano (3), enfermedad de Hodgkin (1), artritis reumatoidea (1); y los segundos afectados de leucemia mieloide crónica (1) y linfoma no hodgkiniano (1) ; todos ellos atendidos en el Servicio de Hematología de nuestro centro. La media del conteo de células CD34+ por cada leucoféresis para trasplante autólogo fue 2,4 x 106 Kg y en el alogénico 2,96 x 106 Kg . Los resultados evidencian que mediante el ajuste del volumen de los ciclos, la velocidad centrífuga, el volumen de rebosado y el volumen celular, se obtuvo un conteo de células precursoras hematopoyéticas en la colecta similar a lo reportado por otros autores, lo que garantiza que el producto transfundido cuente con la celularidad necesaria para repoblar la médula ósea, luego que el paciente sea tratado con altas dosis de terapia inmunosupresora y/o radiaciones

Evaluación del riesgo aterogénico: estudio comparativo de dos metodologías / Evaluation of the atherogenic risk

MARCO TEORICO: La hiperlipidemia es una de las variables que interactúan en la etiología de la ateroesclerosis y por ende de las coronariopatías. Los estudios de química clínica son capaces de evaluar el riesgo aterogénico de un individuo de manera cómoda, rápida y confiable. a estos métodos se ha sumado la cuantificación inmunoquímica de las Apolipoproteínas (Apo A1, Apo B) las cuales probablemente ofrezcan ventajas sobre las determinaciones que se realizan en las fracciones de colesterol (HDL, LDL) por métodos de precipitación y espectrofotometría. OBJETIVO: Evaluar la potencia diagnóstica de los estudios de laboratorio en el establecimiento del riesgo aterogénico. Química clínica vs Inmunoquímica. (LDL/HDL vs APO-A1/APO-B). TIPO DE ESTUDIO: Clínico, prospectivo, observacional, transversal, comparativo en una muestra de 20 individuos adultos, de ambos sexos, ambulatorios, voluntarios y aparentemente sanos. RESULTADOS: Se trata de una muestra de pacientes con riesgo aterogénico normal-bajo determinado por ambas metodologías. los participantes del sexo masculino mostraron un riesgo más elevado que su contraparte femenino. En hombres no encontramos diferencias estadísticamente significativa cuando se establece el riesgo con métodos químicos o inmunoquímicos. En mujeres seencontró que el método químico (LDL/HDL) subestima el riesgo en comparación con la clasificación en base a apolipoproteínas (Apo-B/Apo-A1)(p<0.05). CONCLUSION: En sujetos aparentemente sanos del sexo masculino no resulta indispensable la cuantificación específica de las apolipoproteínas, quedando sujetas a indicación específica. en el sexo femenino sí conviene incluir esta determinación en forma rutinaria.