Ultrasonographic liver nodules are more often benign lesions in dogs with hemoperitoneum secondary to splenic tumor rupture.

OBJECTIVE: To evaluate the reliability of preoperative abdominal ultrasonography as a staging tool for dogs with hemoperitoneum due to presumed splenic tumor rupture, focusing on the detection of metastatic lesions in the liver. ANIMALS: 99 dogs from 20 emergency and specialty hospitals across the US. METHODS: Dogs with nontraumatic hemoperitoneum secondary to splenic tumor rupture were included. A post hoc analysis was conducted on data from a nationwide prospective trial investigating novel treatments for canine hemangiosarcoma. The accuracy of preoperative staging was assessed by comparing ultrasonographic findings with intraoperative observations and histologic findings. RESULTS: On preoperative ultrasonography, there was a 20% incidence of liver lesions identified, with no association to liver lesions seen during operation. Notably, 22% of liver lesions observed during operation were missed on preoperative ultrasonography. The presence of liver lesions on preoperative ultrasonography was associated with a higher likelihood of a benign splenic tumor diagnosis. There was no association between the identification of liver lesions on preoperative ultrasonography and the presence of metastatic disease on liver biopsy, with a sensitivity and specificity of 19% and 82%, respectively. Additionally, ultrasound had low sensitivity in detecting intra-abdominal lesions beyond the liver and spleen, with 82% of these lesions missed preoperatively. CLINICAL RELEVANCE: This study challenges conventional perceptions around the approach to staging in dogs with hemoperitoneum. These findings advocate for a reevaluation of the staging approach, with more comprehensive modalities like whole-body CT or MRI potentially being more warranted.

Estudio del ganglio centinela en el cáncer de mama por el método OSNA (One-Step Nucleic Acid Amplification) tras neoadyuvancia en el Hospital Universitario de Navarra / Sentinel lymph node study in breast cancer using the OSNA (one-step nucleic acid amplification) method after neoadjuvant treatment at Hospital Universitario de Navarra

Introducción: la biopsia selectiva de ganglio centinela (GC) es la técnica estándar para la estadificación axilar en el cáncer de mama. No hay consenso en el empleo del método OSNA (One-Step Nucleic Acid Amplification) para el análisis del GC en las pacientes que recibieron el tratamiento neoadyuvante (TNA). En este trabajo analizamos los resultados obtenidos con OSNA en estas pacientes para justificar su implantación en nuestro centro. Material y métodos: se seleccionaron 42 casos del grupo de 163 pacientes con CM tratadas con TNA en nuestro centro, a las que se realizó OSNA del GC, obteniéndose una media de 2,1 ganglios por paciente. Se analizó además la expresión de citoqueratina 19 (CK19), grado tumoral, fenotipo molecular y el grado de respuesta al TNA de estas pacientes. Se estudiaron los GC mediante técnica OSNA y los no centinelas por el método tradicional. Resultados: el grado tumoral fue 2-3 en el 97,6% de los casos, el fenotipo luminal A (17%), luminal B (38%), triple-negativo (26,1%) y HER2 (19%). La respuesta al TNA fue completa en el 59,5% de las pacientes y la expresión de CK19 no se vio modificada. Los ganglios estudiados fueron positivos en 9 pacientes (21,4%) en las que posteriormente se realizó una linfadenectomía y un único caso presentó ganglio no centinela afecto (2,3%). Conclusiones: el método OSNA para el estudio del GC tras el TNA es muy superior al método tradicional, ya que permite la detección intraoperatoria de grupo celular aislado y micrometástasis no detectables con los métodos tradicionales, evitando segundas intervenciones y falsos negativos al analizarse completo el GC, y demuestra que no se altera la expresión de CK19 con el TNA. (AU)

Background: Selective sentinel node (SN) biopsy is the standard technique for axillary staging in breast cancer (BC). There is no consensus on the use of OSNA (One-Step Acid Nucleic Amplification) method for SN in patients undergoing neoadjuvant treatment (NAT). We have studied the results obtained in our centre to justify the advantages of its implementation. Material and methods: 42 cases were selected from the group of 163 patients with BC treated with NAT, who underwent OSNA of the SN, obtaining a mean of 2.1 nodes per patient. We also analyzed cytokeratin 19 (CK19) expression, tumour grade, molecular phenotype and the degree of response to NAT in these patients. The SN were studied using the OSNA technique and non-sentinel nodes using the traditional method. Results: Tumour grade was 2-3 in 97.6% of cases, phenotype luminal A (17%), luminal B (38%), triple-negative (26.1%) and HER2 (19%). The response to NAT was complete in 59.5% of patients and CK19 expression was unchanged. The nodes studied were positive in 9 patients (21.4%) in whom lymphadenectomy was performed and only one case had a non-sentinel node involvement (2.3%). Conclusions: The OSNA method for the study of SN after NAT is far superior to the traditional method as it: It allows intraoperative detection of isolated cell group and micrometastases not detectable with traditional methods, avoiding second interventions. It avoids false negatives when the whole SN is analyzed. It shows that CK19 expression is not altered by NAT. (AU)

[Multiple myeloma with laryngeal affectation: an uncommon cause of dysphonia].

Plasma cell proliferation leads to the formation of a single tumour (plasmacytoma) or to systemic disease (myeloma). Plasma cell myeloma involving laryngeal cartilage is unusual and clinical manifestations are similar to those of laryngeal carcinoma. We report the case of a 70-year-old man with disphonia after a recent diagnosis of multiple myeloma. Radiological and immunohistochemical studies showed laryngeal involvement. The patient is currently under treatment with lenalidomide, dexamethasone, and bortezomib.

Mieloma múltiple con afectación laríngea: causa atípica de disfonía / Multiple myeloma with laryngeal affectation: an uncommon cause of dysphonia

Las neoplasias de células plasmáticas suponen un conjunto de enfermedades caracterizadas por la proliferación tumoral de dichas células en forma de lesión única (plasmocitoma) o enfermedad sistémica (mieloma). La afectación cartilaginosa laríngea es inusual y su manifestación clínica es similar a la de un carcinoma laríngeo. Describimos el caso de un paciente varón de 70 años con disfonía tras un diagnóstico reciente de mieloma múltiple. Después de realizar los estudios radiológico e inmunohistoquímico se diagnosticó la afectación laríngea por este tumor. Actualmente el paciente está siendo tratado con lenalidomida, dexametasona y bortezomib.(AU)

Plasma cell proliferation leads to the formation of a single tumour (plasmacytoma) or to systemic disease (myeloma). Plasma cell myeloma involving laryngeal cartilage is unusual and clinical manifestations are similar to those of laryngeal carcinoma. We report the case of a 70-year-old man with disphonia after a recent diagnosis of multiple myeloma. Radiological and immunohistochemical studies showed laryngeal involvement. The patient is currently under treatment with lenalidomide, dexamethasone, and bortezomib.(AU)

Total gastrectomy due to emphysematous and necrotizing gastritis associated with Sarcina ventriculi in an 18-year-old patient.

An 18-year-old woman with no pathological history, admitted to Emergency Department with abdominal pain and vomiting after consuming alcohol and cannabis in the last 36 hours. On physical examination, she presented with abdominal distention, signs of peritoneal irritation and sepsis. Abdominal computed tomography showed gastric, esophageal and duodenal distension, gastric and portal pneumatosis and the presence of free intra-abdominal fluid. An exploratory laparotomy was performed revealing extensive gastric necrosis. Then, total gastrectomy with stapled Roux-en-Y anastomosis was required. Histopathology of the gastric tissue confirmed extensive images of transmural emphysematous and necrotizing gastritis, and allowed to identify established Sarcina ventriculi infection.

[Intraepidermal Merkel cell carcinoma with INSM1 expression. A case report]. / Carcinoma de Merkel intraepidérmico. Presentación de un caso con expresión de INSM1.

We report the case of a 90-year-old male who presented with an erythematous desquamative plaque on his left cheek. Histopathology demonstrated an epidermal lesion with multifocal epithelial growth. The cells were small, with scant cytoplasm and hyperchromatic nuclei with molding and a high mitotic and apopototic rate. Immunohistochemistry showed positivity for CK20, CK7, synaptophysin and INMS1. These findings are consistent with a Merkel cell carcinoma in situ. This tumor corresponds to a primary neuroendocrine neoplasm of the skin, which usually affects elderly people with sun-exposed skin. Usually, it presents as a dermal tumor but intraepidermal involvement alone is extremely rare. In this scenario, a broad differential diagnosis should be considered, excluding all neoplasms that may present intraepidermal forms. The evolution of this entity is unknown.

Dubin-Johnson syndrome as a laparoscopic finding.

We present the case of a 35-year-old female with a history of polycystic ovary syndrome, treated with oral contraceptives. She was under study due to nine months evolution of pain in the right iliac fossa, associated with hyporexia and mild hyperbilirubinemia with a predominance of the conjugated fraction (total Bi 3.7 mg/dl, conjugated Bi 2.9 mg/dl). An abdominal computed tomography (CT) was performed showing homogeneous hepatosplenomegaly and adenopathies in both iliac chains, the largest in the right external iliac chain of 1.6 x 3.6 cm.

Peripheral Blood Mitochondrial DNA Levels Were Modulated by SARS-CoV-2 Infection Severity and Its Lessening Was Associated With Mortality Among Hospitalized Patients With COVID-19.

Introduction: During severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the virus hijacks the mitochondria causing damage of its membrane and release of mt-DNA into the circulation which can trigger innate immunity and generate an inflammatory state. In this study, we explored the importance of peripheral blood mt-DNA as an early predictor of evolution in patients with COVID-19 and to evaluate the association between the concentration of mt-DNA and the severity of the disease and the patient's outcome. Methods: A total 102 patients (51 COVID-19 cases and 51 controls) were included in the study. mt-DNA obtained from peripheral blood was quantified by qRT-PCR using the NADH mitochondrial gene. Results: There were differences in peripheral blood mt-DNA between patients with COVID-19 (4.25 ng/µl ± 0.30) and controls (3.3 ng/µl ± 0.16) (p = 0.007). Lower mt-DNA concentrations were observed in patients with severe COVID-19 when compared with mild (p= 0.005) and moderate (p= 0.011) cases of COVID-19. In comparison with patients with severe COVID-19 who survived (3.74 ± 0.26 ng/µl) decreased levels of mt-DNA in patients with severe COVID-19 who died (2.4 ± 0.65 ng/µl) were also observed (p = 0.037). Conclusion: High levels of mt-DNA were associated with COVID-19 and its decrease could be used as a potential biomarker to establish a prognosis of severity and mortality of patients with COVID-19.

Intraocular pressure changes following topical ocular hypotensive medications washout.

BACKGROUND: To review the changes in intraocular pressure (IOP) following topical hypotensive medications washout in patients with primary open angle glaucoma (POAG), ocular hypertension (OHT) and uveitic glaucoma (UG)/OHT. METHODS: The study included 120 patients with POAG, OHT and UG recruited from prospective clinical trials between February 2013 and July 2017. We excluded 20 eyes with IOP of ≤21 mm Hg, 11 eyes with previous incisional surgery and 17 eyes with incomplete data. UG eyes with active inflammation and on steroid treatment were excluded. Participants underwent a 1-month washout period from topical ocular hypotensive medications before IOP phasing. Comparisons were made between pre/post-washout IOP, and highest-recorded (peak) and post-washout IOP. RESULTS: A total of 110 eyes with POAG, 33 eyes with OHT and 43 eyes with UG were included for analysis. The mean pre-washout IOP was 18.1±3.3 mm Hg in POAG, 18.8±3.3 mm Hg in OHT and 17.9±8.8 mm Hg in UG; the mean post-washout IOP was 26.6±4.8 mm Hg, 26.4±3.9 mm Hg, 23.1±10.1 mm Hg in POAG, OHT and UG, respectively. The mean increase in IOP after washout was significantly lower in UG compared with POAG and OHT eyes (p=0.01). The percentage of eyes with post-washout IOP <22 mm Hg was 12.7% in POAG, 6.1% in OHT and 51.2% in UG. CONCLUSION: Active inflammation and steroid treatment contributes to elevated IOP in uveitis. Therefore, IOP may revert to normal once inflammation subsides. We recommend ocular hypotensive treatment washout to be considered in UG eyes that have IOP under control in the absence of recurrence of uveitis.

Carcinoma adenoide quístico de mama, 22 años de experiencia / Adenoid cystic carcinoma of the breast, 22 years of experience

INTRODUCCIÓN: El carcinoma adenoide quístico (CAQ) es una neoplasia infrecuente en la mama (menos del 0,1%). Típicamente es triple negativo con un pronóstico favorable. Su baja frecuencia y su curso indolente provocan dificultades en el convenio de la evaluación y el consenso terapéutico, así como en el uso de la técnica del ganglio centinela en estos carcinomas. OBJETIVO: Aportar una serie nueva de casos procedentes del Complejo Hospitalario de Navarra, mediante la revisión retrospectiva en un periodo de 22 años. MATERIAL Y MÉTODOS: Se revisan todos los casos de CAQ mamario diagnosticados entre 1998 y 2020. Analizamos los datos clínicos y anatomopatológicos y los comparamos con la literatura. RESULTADOS: Identificamos 12 CAQ, de un total de 18.241 pacientes con diagnóstico de carcinoma de mama, con un tamaño tumoral medio de 23,8mm y una edad media de 63,5 años. Todos ellos se encontraban en un estadio I-II al diagnóstico. Un caso presentó una micrometástasis ganglionar. Un caso presentó recidiva local y un caso presentó metástasis a distancia a los 5 meses del diagnóstico (93,5 meses de seguimiento medio). Según el grado histológico de Nottingham, 8 casos tuvieron un grado 1, 2 casos un grado 2 y 2 pacientes un grado 3. Según la clasificación de Ro et al., 3 casos fueron grado 1, 4 casos grado 2 y 5 casos grado 3. Un caso fue RE positivo (10%). Ningún caso presentó positividad para BRAF V600E con inmunohistoquímica. CONCLUSIÓN: El manejo y pronóstico del CAQ mamario, dentro de la benignidad, sigue siendo incierto, siendo necesarios más datos para comprender la evolución clínica y realizar un adecuado manejo terapéutico

INTRODUCTION: Adenoid cystic carcinoma (ACC) is an uncommon neoplasm in the breast (less than 0.1%). ACC is typically triple negative with a favourable prognosis. Its low frequency and indolent course cause difficulties in the agreement of the evaluation and therapeutic consensus, as well as the use of the sentinel node excision in these carcinomas. OBJECTIVE: Our goal is to provide a new series of cases from the Complejo Hospitalario de Navarra, through retrospective review over a period of 22 years. MATERIAL AND METHODS: Every case of breast ACC diagnosed between 1998-2020 is reviewed. We analyze the clinical and pathological characteristics, and compare them with the literature. RESULTS: We identified twelve cases of ACC, from a total of 18,241 patients diagnosed with breast carcinoma, with an average tumor size of 23.8mm and mean of 63.5 years. All of them were in a stage I-II at diagnosis. One case presented a lymph node micrometastases. One of them presented local recurrences and one case presented metastases 5 months after diagnosis (93.5 months of mean follow-up). According to Nottingham Histological Score, eight cases had a grade 1, two grade 2 and two grade 3. According to the classification of Ro et al., three were grade 1, four grade 2 and five grade 3. One case was ER positive (10%). No case presents positivity for BRAF-V600E in immunohistochemistry. CONCLUSION: The management and prognosis ACC of breast, within benignity, remains uncertain, with more studies being needed to understand the clinical evolution and perform adequate therapeutic management

Prevalence of hyperlipidemia and its associated factors in university students in Colombia.

The present study aimed to determine the prevalence of hyperlipidemia and its associated factors in the students of the Faculty of Health of Universidad Santiago de Cali in 2017. A descriptive cross-sectional study was performed in a sample of 361 students, with an average age of 21 (16-40) years. A sociodemographic survey was conducted, and blood samples and lipid profiles were obtained. The participants were predominantly female (77%), single (92.5%), and young adults (62.3%) and with an average socioeconomic level (55.1%). The overall prevalence of hyperlipidemia was 33.8%, with the following risk values: triglyceride (TG), 12.8%; hypercholesterolemia, 16.1%; high density lipoprotein cholesterol (cHDL), 15.0%; and low-density lipoprotein cholesterol (cLDL), 42.2%. Using the theory of the logistic regression models and chi-square likelihood ratio tests, the factors that were significantly associated with the risk of hyperlipidemia were male sex and consumption of alcoholic beverages (P-value < 0.05). In the two-way ANOVA, it was observed that the interaction of these two factors for TG was significant (P-value < 0.05), being higher in men who consume intoxicating beverages (Tukey's test, P value <0.05). Regarding cHDL and cLDL, only sex presented a significant effect on their values (P-value < 0.05), while for total cholesterol, none was significant (P-value > 0.05). The results obtained indicate the importance of early detection of blood lipid levels in young people to prevent the early development of noncommunicable diseases.

Endoscopic submucosal dissection of colonic anisakiasis

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[Adenoid cystic carcinoma of the breast, 22 years of experience]. / Carcinoma adenoide quístico de mama, 22 años de experiencia.

INTRODUCTION: Adenoid cystic carcinoma (ACC) is an uncommon neoplasm in the breast (less than 0.1%). ACC is typically triple negative with a favourable prognosis. Its low frequency and indolent course cause difficulties in the agreement of the evaluation and therapeutic consensus, as well as the use of the sentinel node excision in these carcinomas. OBJECTIVE: Our goal is to provide a new series of cases from the Complejo Hospitalario de Navarra, through retrospective review over a period of 22 years. MATERIAL AND METHODS: Every case of breast ACC diagnosed between 1998-2020 is reviewed. We analyze the clinical and pathological characteristics, and compare them with the literature. RESULTS: We identified twelve cases of ACC, from a total of 18,241 patients diagnosed with breast carcinoma, with an average tumor size of 23.8mm and mean of 63.5 years. All of them were in a stage I-II at diagnosis. One case presented a lymph node micrometastases. One of them presented local recurrences and one case presented metastases 5 months after diagnosis (93.5 months of mean follow-up). According to Nottingham Histological Score, eight cases had a grade 1, two grade 2 and two grade 3. According to the classification of Ro et al., three were grade 1, four grade 2 and five grade 3. One case was ER positive (10%). No case presents positivity for BRAF-V600E in immunohistochemistry. CONCLUSION: The management and prognosis ACC of breast, within benignity, remains uncertain, with more studies being needed to understand the clinical evolution and perform adequate therapeutic management.

Endoscopic submucosal dissection of colonic anisakiasis.

A 61-year-old male with no relevant past medical history underwent a colonoscopy for routine screening of colorectal cancer. Colonoscopy revealed a pearly and hard submucosal lesion of less than 10 mm in diameter in the ascending colon, with normal mucosa. An abdominopelvic computed tomography (CT) scan was performed, which was normal. Endoscopic submucosal dissection (ESD) was performed and the lesion appeared to originate from the muscularis propia. Thus, the muscularis propia and part of the serosa of the colonic wall were cut and the perforation was finally closed with hemoclips.

One-step nested RT-PCR for COVID-19 detection: A flexible, locally developed test for SARS-CoV2 nucleic acid detection.

INTRODUCTION: Due to the coronavirus pandemic, identifying the infected individuals has become key to limiting its spread. Virus nucleic acid real-time RT-PCR testing has become the current standard diagnostic method but high demand could lead to shortages. Therefore, we propose a detection strategy using a one-step nested RT-PCR. METHODOLOGY: The nucleotide region in the ORF1ab gene that has the greatest differences between the human coronavirus and the bat coronavirus was selected. Primers were designed after that sequence. All diagnostic primers are species-specific since the 3´ end of the sequence differs from that of other species. A primer set also creates a synthetic positive control. Amplified products were seen in a 2.5% agarose gel, as well as in an SYBR Green-Based Real-Time RT-PCR. RESULTS: Amplification was achieved for the positive control and specific regions in both techniques. CONCLUSIONS: This new technique is flexible and easy to implement. It does not require a real-time thermocycler and can be interpreted in agarose gels, as well as adapted to quantify the viral genome. It has the advantage that if the coronavirus mutates in one of the key amplification nucleotides, at least one pair can still amplify, thanks to the four diagnostic primers.

The Effect of High-Intensity Focused Ultrasound on Aqueous Humor Dynamics in Patients with Glaucoma.

PURPOSE: To investigate the effects of high-intensity focused ultrasound (HiFU) on aqueous humor dynamics in patients with glaucoma. DESIGN: Comparative, nonrandomized, interventional study. PARTICIPANTS: Adult patients with a diagnosis of open-angle glaucoma or ocular hypertension with suboptimal intraocular pressure (IOP) control despite maximum medical treatment who required further IOP optimization. METHODS: All patients underwent comprehensive ophthalmic examination before aqueous humor dynamics study measurements, including fluorophotometry and digital Schiøtz tonography. All patients received 6 seconds of HiFU therapy. Aqueous humor dynamics studies were repeated 3 months after the treatment (patients had 4-week washout from their glaucoma medication before their aqueous humor dynamics study measurements at baseline and the 3-month visit). MAIN OUTCOME MEASURES: Intraocular pressure, facility of topographic outflow, aqueous flow rate, and uveoscleral outflow. RESULTS: Thirty eyes of 30 patients were included in the study. At the 3-month postoperative visit, the mean postwashout IOP was reduced by 16% (31.7±5.3 vs. 26.6±4.8 mmHg, P = 0.004), and aqueous flow rate was decreased by 15% (2.07±0.73 vs. 1.77±0.55 µl/min, P = 0.05) from baseline. Neither the tonographic outflow facility nor the uveoscleral outflow was significantly different from baseline. There is a 20% risk of treatment failure (those who needed further glaucoma surgical intervention) within 1 month after a single HiFU treatment (n = 6). Only 25 patients (80%) were able to undergo post-treatment washout measurements, and in these eyes, only 26.6% of eyes achieved >20% IOP reduction at 3 months compared with baseline. CONCLUSIONS: We investigated the aqueous humor dynamics effects of a cyclodestructive procedure and specifically HiFU in patients with uncontrolled open-angle glaucoma on maximum tolerated medical therapy. High-intensity focused ultrasound reduced IOP 3 months postoperatively by 16% and aqueous flow decreased by 15% without any significant effect on tonographic outflow facility and uveoscleral outflow.

Factores sociodemográficos asociados al consumo de drogas de recolectores de basura en San José / Socio demographic factors associated with the consumption of drugs from garbage collectors in San José / Fatores sociodemográficos associados a o consumo de drogas de coletores de lixo em San José

Objetivo: determinar los posibles factores sociodemográficos asociados al consumo de drogas de recolectores de basura en de San José, Costa Rica. Método : el estudio es cualitativo y fenomenológico . La investigación se llevó a cabo mediante la aplicación de entrevistas en profundidad con preguntas generadoras sobre la temática. Se incluyeron todos los trabajadores del departamento que en total fueron 35 personas de lo s cuales se escogió una muestra de 16 acorde con los criterios de selección: personas que voluntariamente aceptaran ser parte del estudio. Resultados : el estudio logró evidenciar la influencia relacional entre los factores sociodemográficos y el posible u so de drogas lícitas e ilícitas, a excepción de la variable estado civil. Conclusión : los resultados permiten dilucidar la relación entre la problemática de la drogadicción de grupos vulnerables como los recolectores de basura, con factores sociodemográfic os, lo que deriva en la necesidad de investigaciones que evidencien la problemática.

Objective: to determine the possible sociodemographic factors associated with the drug use of garbage collectors in San José, Costa Rica. Method: the study is qualitative and phenomenological. The research was carried out through the application of in depth interviews with generating questions on the subject. We included all the workers in the dep artment, who in total were 35 people from whom a sample of 16 was chosen according to the selection criteria: people who voluntarily accepted to be part of the study. Results: the study showed the relational influence between social, economic and demograph ic factors and the possible use of licit and illicit drugs, except for the civil status variable. Conclusion: the results allow us to elucidate the relationship between the problematic of drug addiction of vulnerable groups such as garbage collectors, with demographic, social and economic factors, which results in the need for investigations that highlight the problem.

Objetivo: determinar os possíveis fatores demográficos associados ao c onsumo de drogas de coletores de lixo em San José, Costa Rica. Método: o estudo é qualitativo e fenomenológico. A pesquisa foi realizada através da aplicação de entrevistas em profundidade com a geração de perguntas sobre o assunto. Foram inclusos todos os trabalhadores do departamento que no total foram 35 pessoas, dos quais uma amostra de 16 foram escolhidos de acordo com os criterios de seleção: pessoas que aceitaram participar voluntariamente do estudo. Resultados: o estudo foi capaz de demonstrar a inf luência relacional entre fatores sociais, econômicos e demográficos e possível uso de drogas lícitas e ilícitas, exceto para a variável estado civil. Conclusão: os resultados obtidos permitiram elucidar a relação entre a problemas de abuso de droga dos gru pos mais vulneráveis, tais como colectores de lixo, com factores tais como demográfico, social e económico, o que resulta na necessidade de pesquisas que demonstram o problema.

Resistance-modifying Activity in Vinblastine-resistant Human Breast Cancer Cells by Oligosaccharides Obtained from Mucilage of Chia Seeds (Salvia hispanica).

The multidrug resistance (MDR) phenotype is considered as a major cause of the failure in cancer chemotherapy. The acquisition of MDR is usually mediated by the overexpression of drug efflux pumps of a P-glycoprotein. The development of compounds that mitigate the MDR phenotype by modulating the activity of these transport proteins is an important yet elusive target. Here, we screened the saponification and enzymatic degradation products from Salvia hispanica seed's mucilage to discover modulating compounds of the acquired resistance to chemotherapeutic in breast cancer cells. Preparative-scale recycling HPLC was used to purify the hydrolysis degradation products. All compounds were tested in eight different cancer cell lines and Vero cells. All compounds were noncytotoxic at the concentration tested against the drug-sensitive and multidrug-resistant cells (IC50  > 29.2 µM). For the all products, a moderate vinblastine-enhancing activity from 4.55-fold to 6.82-fold was observed. That could be significant from a therapeutic perspective. Copyright © 2017 John Wiley & Sons, Ltd.

Contribuciones de enfermería a la anestesiología en Costa Rica / Contribution nursing to the anesthesiology in Costa Rica

ResumenIntroducción. En el presente artículo se presentan los resultados de un estudio que cuyo objetivo fue identificar la participación de la enfermería en el desarrollo de la anestesiología en Costa Rica.Método. Se aplicó la metodología de la investigación histórica para determinar los sucesos ocurridos en el pasado relacionados con el desarrollo de la anestesia, así como las contribuciones de enfermería. Se analizó fuentes primarias y secundarias que fueron sistematizadas, valoradas, ordenadas y sintetizadas. Se aplicó la técnica de grupo focal y entrevistas en profundidad a 23 enfermeras (os) técnicos en anestesia que laboran actualmente y a las enfermeras (os) pensionados.Resultados. Durante más de 90 años la administración de anestesia a las personas fue llevada a cabo por enfermeras (os), no obstante, la formación de enfermería en anestesia fue suspendida en 1981.Conclusión. El estudio determinó que este personal tenía una preparación formal dada por el doctor Sotela que luego fue ampliada a año y medio por la Escuela de Medicina de la Universidad de Costa Rica, institución de la que egresaban como técnicos en anestesia.

AbstractIntroduction. In this article the results of a study that aimed to identify the nursing involvement in the development of anesthesiology in Costa Rica are presented.Method. Historical research methodology is applied to determine the events related to the development of anesthesia as well as the contributions of nursing. The primary and secondary sources were systematized, evaluated, ordered and synthesized. The technique of focal group and interviews in depth with 23 nurses anesthesia technicians that currently working and pensioners was applied.Result. During more than 90 years staff of the discipline conducted the administration of anesthesia to people and training in anesthesia nursing was suspended in 1981.Conclusion. The study found that the staff had formal training given by Dr. Sotela which was later extended to one and a half by the School of Medicine of the University of Costa Rica, an institution that were teaching as technicians in anesthesia.