Metabolomics and triple-negative breast cancer: A systematic review.

Triple-negative breast cancer stands out as the most aggressive subtype of breast malignancy and is characterized by an unfavourable prognosis. Objective: This systematic review summarizes the insights gleaned from metabolomic analyses of individuals afflicted with this cancer variant. The overarching goal was to delineate the molecular alterations associated with triple-negative breast cancer, pinpointing potential therapeutic targets and novel biomarkers. Methods: We systematically searched for evidence using the PubMed database and followed the PRISMA and STARLITE guidelines. The search parameters were delimited to articles published within the last 13 years. Results: From an initial pool of 148 scrutinized articles, 17 studies involving 1686 participants were deemed eligible for inclusion. The current body of research shows a paucity of studies, and the available evidence presents conflicting outcomes. Notwithstanding, Pathway Enrichment Analysis identified the urea and glucose-alanine cycles as the most affected metabolic pathways, followed by arginine, proline, and aspartate metabolism. Conclusion: Future investigations need to focus on elucidating which of those metabolites and/or pathways might be reliable candidates for novel therapeutic interventions or reliable biomarkers for diagnosis and prognosis of this subtype of breast cancer.

Metabolic adaptations in severe obesity: Insights from circulating oxylipins before and after weight loss.

BACKGROUND: The relationship between lipid mediators and severe obesity remains unclear. Our study investigates the impact of severe obesity on plasma concentrations of oxylipins and fatty acids and explores the consequences of weight loss. METHODS: In the clinical trial identifier NCT05554224 study, 116 patients with severe obesity and 63 overweight/obese healthy controls matched for age and sex (≈2:1) provided plasma. To assess the effect of surgically induced weight loss, we requested paired plasma samples from 44 patients undergoing laparoscopic sleeve gastrectomy one year after the procedure. Oxylipins were measured using ultra-high-pressure liquid chromatography coupled to a triple quadrupole mass spectrometer via semi-targeted lipidomics. Cytokines and markers of interorgan crosstalk were measured using enzyme-linked immunosorbent assays. RESULTS: We observed significantly elevated levels of circulating fatty acids and oxylipins in patients with severe obesity compared to their metabolically healthier overweight/obese counterparts. Our findings indicated that sex and liver disease were not confounding factors, but we observed weak correlations in plasma with circulating adipokines, suggesting the influence of adipose tissue. Importantly, while weight loss restored the balance in circulating fatty acids, it did not fully normalize the oxylipin profile. Before surgery, oxylipins derived from lipoxygenase activity, such as 12-HETE, 11-HDoHE, 14-HDoHE, and 12-HEPE, were predominant. However, one year following laparoscopic sleeve gastrectomy, we observed a complex shift in the oxylipin profile, favoring species from the cyclooxygenase pathway, particularly proinflammatory prostanoids like TXB2, PGE2, PGD2, and 12-HHTrE. This transformation appears to be linked to a reduction in adiposity, underscoring the role of lipid turnover in the development of metabolic disorders associated with severe obesity. CONCLUSIONS: Despite the reduction in fatty acid levels associated with weight loss, the oxylipin profile shifts towards a predominance of more proinflammatory species. These observations underscore the significance of seeking mechanistic approaches to address severe obesity and emphasize the importance of closely monitoring the metabolic adaptations after weight loss.

Serum Arylesterase, Paraoxonase, and Lactonase Activities and Paraoxonase-1 Concentrations in Morbidly Obese Patients and Their Relationship with Non-Alcoholic Steatohepatitis.

Paraoxonase-1 (PON1) is an antioxidant enzyme associated with high-density lipoproteins (HDL). Reduced serum PON1 activity is found in diseases marked by oxidative stress and inflammation, but its role in obesity remains unclear. This study investigated PON1 activities and concentrations in morbidly obese individuals and explored the impacts of the genetic polymorphism PON1 rs662 and non-alcoholic fatty liver disease on enzymatic properties. We recruited 1349 morbidly obese patients undergoing bariatric surgery and 823 non-obese volunteers. PON1-related variables, including arylesterase, paraoxonase, and lactonase activities and PON1 concentrations, were examined. Our results showed that morbidly obese individuals exhibited higher PON1 concentrations but lower enzymatic activities than non-obese individuals. We observed inverse associations of arylesterase and paraoxonase activities with waist circumference (rho = -0.24, p < 0.001, and rho = -0.30, p < 0.001, respectively) and body mass index (rho = -0.15, p = 0.001, and rho = -0.23, p < 0.001), as well as direct associations of arylesterase, paraoxonase, and lactonase activities with HDL cholesterol (rho = 0.11, p = 0.005, rho = 0.20, p < 0.001, and rho = 0.20, p < 0.001). No significant differences were observed regarding metabolic syndrome, type 2 diabetes mellitus, hypertension, dyslipidemia, rs662 polymorphism allele frequencies, or the diagnosis of non-alcoholic steatohepatitis. Nevertheless, correlations were found between certain PON1-related variables, steatosis, and ballooning. In conclusion, changes in PON1-related variables in morbidly obese patients are dependent on the disease itself and HDL levels. The relationships between these variables and specific liver histological changes raise intriguing questions for consideration in future studies.

Paraoxonase-1: How a xenobiotic detoxifying enzyme has become an actor in the pathophysiology of infectious diseases and cancer.

Both infectious and non-infectious diseases can share common molecular mechanisms, including oxidative stress and inflammation. External factors, such as bacterial or viral infections, excessive calorie intake, inadequate nutrients, or environmental factors, can cause metabolic disorders, resulting in an imbalance between free radical production and natural antioxidant systems. These factors may lead to the production of free radicals that can oxidize lipids, proteins, and nucleic acids, causing metabolic alterations that influence the pathogenesis of the disease. The relationship between oxidation and inflammation is crucial, as they both contribute to the development of cellular pathology. Paraoxonase 1 (PON1) is a vital enzyme in regulating these processes. PON1 is an enzyme that is bound to high-density lipoproteins and protects the organism against oxidative stress and toxic substances. It breaks down lipid peroxides in lipoproteins and cells, enhances the protection of high-density lipoproteins against different infectious agents, and is a critical component of the innate immune system. Impaired PON1 function can affect cellular homeostasis pathways and cause metabolically driven chronic inflammatory states. Therefore, understanding these relationships can help to improve treatments and identify new therapeutic targets. This review also examines the advantages and disadvantages of measuring serum PON1 levels in clinical settings, providing insight into the potential clinical use of this enzyme.

Comparison between p-distance and single-locus species delimitation models for delineating reproductively tested strains of pennate diatoms (Bacillariophyceae) using cox1, rbcL and ITS.

Several automated molecular methods have emerged for distinguishing eukaryote species based on DNA sequence data. However, there are knowledge gaps around which of these single-locus methods is more accurate for the identification of microalgal species, such as the highly diverse and ecologically relevant diatoms. We applied genetic divergence, Automatic Barcode Gap Discovery for primary species delimitation (ABGD), Assemble Species by Automatic Partitioning (ASAP), Statistical Parsimony Network Analysis (SPNA), Generalized Mixed Yule Coalescent (GMYC) and Poisson Tree Processes (PTP) using partial cox1, rbcL, 5.8S + ITS2, ITS1 + 5.8S + ITS2 markers to delineate species and compare to published polyphasic identification data (morphological features, phylogeny and sexual reproductive isolation) to test the resolution of these methods. ASAP, ABGD, SPNA and PTP models resolved species of Eunotia, Seminavis, Nitzschia, Sellaphora and Pseudo-nitzschia corresponding to previous polyphasic identification, including reproductive isolation studies. In most cases, these models identified diatom species in similar ways, regardless of sequence fragment length. GMYC model presented smallest number of results that agreed with previous published identification. Following the recommendations for proper use of each model presented in the present study, these models can be useful tools to identify cryptic or closely related species of diatoms, even when the datasets have relatively few sequences.

Retrospective Analysis of Vaccination Status and Predominant Viral Variants in Patients Hospitalized with COVID-19 in Reus, Spain.

SARS-CoV-2 infection in already-vaccinated individuals is still possible and may require hospitalization. The aim of the present study was to evaluate the clinical evolution of patients with COVID-19 admitted to a public hospital. The outcomes were assessed in relation to the predominant viral variant and the vaccination status. This retrospective study was performed on 1295 COVID-19-positive patients who attended a 352-bed university hospital between 2021 and 2022. Clinical variables and vaccination status were recorded. Of the patients, 799 had not been vaccinated (NV, 61.7%), 449 were partially vaccinated (PV, 34.7%), and 47 were completely vaccinated (CV, 3.6%). The mean age of the CV patients was significantly higher than that of PV and NV. Additionally, they had higher percentages of chronic diseases. The outcomes depended on age but not on vaccination status. There were 209 patients admitted during the Omicron-infection period, of whom 70 (33.5%) were NV, 135 (64.6%) were PV, and 4 (1.9%) were CV. In conclusion, correct vaccination greatly reduces the risk of acquiring severe COVID-19. Partial vaccination does not guarantee protection of the population. This highlights the need for continuous vaccination promotion with all recommended doses, while also investigating alternative treatments for those patients who do not respond to the vaccines.

Cryptophytes: An emerging algal group in the rapidly changing Antarctic Peninsula marine environments.

The western Antarctic Peninsula (WAP) is a climatically sensitive region where foundational changes at the basis of the food web have been recorded; cryptophytes are gradually outgrowing diatoms together with a decreased size spectrum of the phytoplankton community. Based on a 11-year (2008-2018) in-situ dataset, we demonstrate a strong coupling between biomass accumulation of cryptophytes, summer upper ocean stability, and the mixed layer depth. Our results shed light on the environmental conditions favoring the cryptophyte success in coastal regions of the WAP, especially during situations of shallower mixed layers associated with lower diatom biomass, which evidences a clear competition or niche segregation between diatoms and cryptophytes. We also unravel the cryptophyte photo-physiological niche by exploring its capacity to thrive under high light stress normally found in confined stratified upper layers. Such conditions are becoming more frequent in the Antarctic coastal waters and will likely have significant future implications at various levels of the marine food web. The competitive advantage of cryptophytes in environments with significant light level fluctuations was supported by laboratory experiments that revealed a high flexibility of cryptophytes to grow in different light conditions driven by a fast photo-regulating response. All tested physiological parameters support the hypothesis that cryptophytes are highly flexible regarding their growing light conditions and extremely efficient in rapidly photo-regulating changes to environmental light levels. This plasticity would give them a competitive advantage in exploiting an ecological niche where light levels fluctuate quickly. These findings provide new insights on niche separation between diatoms and cryptophytes, which is vital for a thorough understanding of the WAP marine ecosystem.

Combining Semi-Targeted Metabolomics and Machine Learning to Identify Metabolic Alterations in the Serum and Urine of Hospitalized Patients with COVID-19.

Viral infections cause metabolic dysregulation in the infected organism. The present study used metabolomics techniques and machine learning algorithms to retrospectively analyze the alterations of a broad panel of metabolites in the serum and urine of a cohort of 126 patients hospitalized with COVID-19. Results were compared with those of 50 healthy subjects and 45 COVID-19-negative patients but with bacterial infectious diseases. Metabolites were analyzed by gas chromatography coupled to quadrupole time-of-flight mass spectrometry. The main metabolites altered in the sera of COVID-19 patients were those of pentose glucuronate interconversion, ascorbate and fructose metabolism, nucleotide sugars, and nucleotide and amino acid metabolism. Alterations in serum maltose, mannonic acid, xylitol, or glyceric acid metabolites segregated positive patients from the control group with high diagnostic accuracy, while succinic acid segregated positive patients from those with other disparate infectious diseases. Increased lauric acid concentrations were associated with the severity of infection and death. Urine analyses could not discriminate between groups. Targeted metabolomics and machine learning algorithms facilitated the exploration of the metabolic alterations underlying COVID-19 infection, and to identify the potential biomarkers for the diagnosis and prognosis of the disease.

Combining Dietary Intervention with Metformin Treatment Enhances Non-Alcoholic Steatohepatitis Remission in Mice Fed a High-Fat High-Sucrose Diet.

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are serious health concerns for which lifestyle interventions are the only effective first-line treatment. Dietary interventions are effective in body weight reduction, but not in improving insulin sensitivity and hepatic lipid mobilization. Conversely, metformin increases insulin sensitivity and promotes the inhibition of de novo hepatic lipogenesis. In this study, we evaluated the metformin effectiveness in NASH prevention and treatment, when combined with dietary intervention in male mice fed a high-fat high-sucrose diet (HFHSD). Eighty 5-week-old C57BL/6J male mice were fed a chow or HFHSD diet and sacrificed at 20 or 40 weeks. The HFHSD-fed mice developed NASH after 20 weeks. Lipoprotein and lipidomic analyses showed that the changes associated with diet were not prevented by metformin administration. HFHSD-fed mice subject to dietary intervention combined with metformin showed a 19.6% body weight reduction compared to 9.8% in those mice subjected to dietary intervention alone. Lower hepatic steatosis scores were induced. We conclude that metformin should not be considered a preventive option for NAFLD, but it is effective in the treatment of this disorder when combined with dietary intervention.

Gradient Boosting Machine Identified Predictive Variables for Breast Cancer Patients Pre- and Post-Radiotherapy: Preliminary Results of an 8-Year Follow-Up Study.

Radiotherapy (RT) is part of the standard treatment of breast cancer (BC) because of its effects on relapse reduction and survival. However, response to treatment is highly variable, and some patients may develop disease progression (DP), a second primary cancer, or may succumb to the disease. Antioxidant systems and inflammatory processes are associated with the onset and development of BC and play a role in resistance to treatment. Here, we report our investigation into the clinical evolution of BC patients, and the impact of RT on the circulating levels of the antioxidant enzyme paraoxonase-1 (PON1), cytokines, and other standard biochemical and hematological variables. Gradient Boosting Machine (GBM) algorithm was used to identify predictive variables. This was a retrospective study in 237 patients with BC. Blood samples were obtained pre- and post-RT, with samples of healthy women used as control subjects. Results showed that 24 patients had DP eight years post-RT, and eight patients developed a second primary tumor. The algorithm identified interleukin-4 and total lymphocyte counts as the most relevant indices discriminating between BC patients and control subjects, while neutrophils, total leukocytes, eosinophils, very low-density lipoprotein cholesterol, and PON1 activity were potential predictors of fatal outcome.

Machine learning and semi-targeted lipidomics identify distinct serum lipid signatures in hospitalized COVID-19-positive and COVID-19-negative patients.

BACKGROUND: Lipids are involved in the interaction between viral infection and the host metabolic and immunological responses. Several studies comparing the lipidome of COVID-19-positive hospitalized patients vs. healthy subjects have already been reported. It is largely unknown, however, whether these differences are specific to this disease. The present study compared the lipidomic signature of hospitalized COVID-19-positive patients with that of healthy subjects, as well as with COVID-19-negative patients hospitalized for other infectious/inflammatory diseases. METHODS: We analyzed the lipidomic signature of 126 COVID-19-positive patients, 45 COVID-19-negative patients hospitalized with other infectious/inflammatory diseases and 50 healthy volunteers. A semi-targeted lipidomics analysis was performed using liquid chromatography coupled to mass spectrometry. Two-hundred and eighty-three lipid species were identified and quantified. Results were interpreted by machine learning tools. RESULTS: We identified acylcarnitines, lysophosphatidylethanolamines, arachidonic acid and oxylipins as the most altered species in COVID-19-positive patients compared to healthy volunteers. However, we found similar alterations in COVID-19-negative patients who had other causes of inflammation. Conversely, lysophosphatidylcholine 22:6-sn2, phosphatidylcholine 36:1 and secondary bile acids were the parameters that had the greatest capacity to discriminate between COVID-19-positive and COVID-19-negative patients. CONCLUSION: This study shows that COVID-19 infection shares many lipid alterations with other infectious/inflammatory diseases, and which differentiate them from the healthy population. The most notable alterations were observed in oxylipins, while alterations in bile acids and glycerophospholipis best distinguished between COVID-19-positive and COVID-19-negative patients. Our results highlight the value of integrating lipidomics with machine learning algorithms to explore the pathophysiology of COVID-19 and, consequently, improve clinical decision making.

Future Developments in Charged Particle Therapy: Improving Beam Delivery for Efficiency and Efficacy.

The physical and clinical benefits of charged particle therapy (CPT) are well recognized. However, the availability of CPT and complete exploitation of dosimetric advantages are still limited by high facility costs and technological challenges. There are extensive ongoing efforts to improve upon these, which will lead to greater accessibility, superior delivery, and therefore better treatment outcomes. Yet, the issue of cost remains a primary hurdle as utility of CPT is largely driven by the affordability, complexity and performance of current technology. Modern delivery techniques are necessary but limited by extended treatment times. Several of these aspects can be addressed by developments in the beam delivery system (BDS) which determines the overall shaping and timing capabilities enabling high quality treatments. The energy layer switching time (ELST) is a limiting constraint of the BDS and a determinant of the beam delivery time (BDT), along with the accelerator and other factors. This review evaluates the delivery process in detail, presenting the limitations and developments for the BDS and related accelerator technology, toward decreasing the BDT. As extended BDT impacts motion and has dosimetric implications for treatment, we discuss avenues to minimize the ELST and overview the clinical benefits and feasibility of a large energy acceptance BDS. These developments support the possibility of advanced modalities and faster delivery for a greater range of treatment indications which could also further reduce costs. Further work to realize methodologies such as volumetric rescanning, FLASH, arc, multi-ion and online image guided therapies are discussed. In this review we examine how increased treatment efficiency and efficacy could be achieved with improvements in beam delivery and how this could lead to faster and higher quality treatments for the future of CPT.

Disfunción sexual femenina: una mirada a los últimos 44 años. Análisis bibliométrico / Female Sexual Dysfunction: Looking Back at the Last 44 Years. A Bibliometric Analysis

Objetivo La disfunción sexual femenina (DSF) es un trastorno prevalente que afecta la calidad de vida de las mujeres y combina factores biológicos, psicológicos e interpersonales. Su estudio ha sido de poco interés, en campos como la investigación y el tratamiento, debido a la dificultad en la medición de las respuestas sexuales en las mujeres y otros factores, como el tabú acerca de la sexualidad femenina. Este estudio caracteriza las tendencias de publicaciones científicas acerca del tema, para que los urólogos puedan comprender la necesidad de realizar la búsqueda de este trastorno en la práctica diaria. Métodos Se realizó una búsqueda de la literatura en las bases de datos PubMed, FABUMED y Scopus, utilizando la estrategia «((«female sexual dysfunction¼ [Title/Abstract])¼. Se realizó un análisis bibliométrico descriptivo, de corte retrospectivo, de la literatura médica obtenida en MEDLINE. A través de las herramientas estadísticas FABUMED, PubReminer y Scopus, se recopilaron los datos y se obtuvo los resultados de las variables que posteriormente fueron analizadas de forma estadística y descriptiva. Con base en esta información, elaboramos tablas y gráficas en Microsoft Office Excel 2017. Adicionalmente, realizamos un análisis de mapeo bibliométrico utilizando el programa VOSviewer. Para la obtención del factor de impacto (FI), utilizamos el Journal Citation Reports 2017/2018. Resultados Desde 1975 hasta 2019, se publicaron 1.292 estudios, y la tasa anual de publicación permaneció estable entre 1975 y 2000. Pero, a partir del año 2000, se evidenció un aumento en el número de publicaciones, con un crecimiento del 92,1%. De las veinte revistas con más publicaciones, sólo cuatro son de urología. Los países con más publicaciones fueron: Estados Unidos (31,4%), Reino Unido (12,9%), Italia (8,9%), Turquía (5,9%), y Australia (4%). Estos datos son muy diferentes a los de los países de América Latina, en los que se encontraron muy pocas publicaciones, como Colombia, con tan sólo tres estudios. Conclusiones Este análisis bibliométrico mostró las diferentes tendencias y tasas de publicación de estudios sobre DSF, y evidenció una baja tasa de producción con relación a otras temáticas, sobre todo en las revistas urológicas, con predominio de mujeres como autores, aunque en los últimos años se ha identificado un crecimiento importante y sostenido. Se hace evidente la necesidad de desarrollar estrategias para mejorar la formación tanto en los niveles de posgrado como de pregrado y, así, generar más adhesión a este tema en una especialidad quirúrgica como la nuestra.

Objectives Female sexual dysfunction (FSD) is a prevalent disorder that affects the quality of life of women and combines biological, psychological, and interpersonal factors. There has been a lack of interest in studying FSD in such fields as research and treatment, due to the difficulty in measuring the sexual responses of women and other factors such as the taboo surrounding female sexuality. The present study portrays the trends in the scientific publications on the subject, so urologists can perceive and understand the need for research about this disorder in the daily practice. Methods A comprehensive review on the topic was performed through a PubMed, FABUMED, and Scopus databases using the search strategy "female sexual dysfunction", as well as a retrospective, descriptive, bibliometric analysis of the medical literature retrieved from MEDLINE. Data was collected through the FABUMED, PubReMiner, and Scopus statistical tools, and, based on the results obtained for the variables, which were later submitted to a statistical and descriptive analysis. Based on this data, tables and graphs were developed using the Microsoft Office Excel 2017 software. Moreover, we performed a bibliometric mapping analysis using the VOSviewer software. In order to obtain the impact factor (IF), we used the Journal Citation Reports 2017/2018. Results From 1975 to 2019, 1,292 studies were published; yearly publication rate remained stable from1975 to 2000, but after year 2000, an increase in the number of publications was evidenced, with a growth of 92.1%. But as of the year 2000, an increase in the number of publications was evidenced, with a growth of 92.1%. Of the twenty journals with the most publications, only four are on urology. The countries with the greatest number of publications were: the United States (31.4%), the United Kingdom (12.9%), Italy (8.9%), Turkey (5.9%), and Australia (4%). This data differs from that of Latin American countries, in which few publications were found, such as in Colombia, with only three studies. Conclusions The present bibliometric analysis showed the different trends and publication rates of studies on FSD, showing a low production rate as compared with that of other urological topics, especially in Urological journals, with a predominance of women as authors, although in recent years an important and sustained growth has been identified. The need to develop strategies to improve training at both the graduate and undergraduate levels and thus generate more adherence to these issues in a surgical specialty like ours is evident.

Optimization of synchrotron based ion beam therapy facilities for treatment time reduction, options and the MedAustron development roadmap.

A faster treatment reduces the risk of intra-fraction movement of organs, offers a more comfortable treatment to the patient, allows to treat lesion of larger volumes in a reasonable time and most of all expands the capacity of the facility. This work presents possible machine upgrades for synchrotron based ion beam therapy centers to shorten the irradiation time. The expected delivery times for each scenario are simulated for the study case of proton beams of MedAustron. The second part of the work focuses on the MedAustron development roadmap, where recently increase of ring fillings and delivered intensities were implemented for proton treatments achieving an average irradiation time of ~50% since start of operation.

Exploring Diversity, Taxonomy and Phylogeny of Diatoms (Bacillariophyta) from Marine Habitats. Novel Taxa with Internal Costae.

In many marine littoral and sublittoral benthic habitats, we find small diatoms with few features resolvable with light microscopy (LM) other than internal costae across their valves. While classically those internal costae have defined their identification and classification, the use of electron microscopy and of molecular data have started to reveal the true diversity of unrelated forms and genera (e.g., Anaulus, Eunotogramma, Hustedtiella, or Plagiogramma) which possess these structures. Here we describe the new genus Ambo, in an attempt to clarify some of the polyphyly of taxa with internal costa by formally transferring Anaulus balticus, Anaulus simonsenii, and Plagiogramma tenuissimum as well as Ambo gallaeciae, described here. Related to this, we attempt to document and characterize the genus Anaulus itself, which was formally described by Ehrenberg with an illustration. A search by LM of mica designated by Ehrenberg as the holotype of Anaulus scalaris, the generitype of Anaulus, failed to recover a specimen which adequately describes the genus to the exclusion of other genera with internal costa. We also present morphological and molecular data for Anaulus creticus and suggest a new genus-Ceratanaulus-to reflect the distinct morphological and molecular characters we documented.

Chagas congénito en atención primaria de la salud en la Provincia de Santa Fe / Congenital Chagas disease in primary health care in Santa Fe province

Actualmente, la transmisión transplacentaria es la vía más frecuente de infección por Trypanosoma cruzi. El diagnóstico y tratamiento temprano de hijos infectados evita el riesgo de desarrollar miocardiopatía y las niñas dejan de ser potenciales fuentes de transmisión congénita. En este estudio se evaluó el seguimiento de hijos de mujeres infectadas por T. cruzi en Centros de Salud de la provincia de Santa Fe. Se estudiaron 19 madres y sus 51 hijos. 45% (23/51) de los hijos no habían sido estudiados previamente, y de éstos 21/23 resultaron negativos mientras que dos niñas de 3 y 7 años estaban infectadas. Los 28 niños restantes ya habían sido estudiados en los Centros de Salud, siendo positivas dos gemelas de 22 meses y una niña de 9 años; los otros 25/28 hijos no estaban infectados. Un 47% (9/19) de las madres tenían como único antecedente la serología materna positiva, y de las 4 mujeres que transmitieron la infección, tres pertenecían a este grupo. La edad promedio de diagnóstico fue: 20±6 años en las madres y 7,4±6,7 años en los hijos. Se requieren estrategias sanitarias que favorezcan el estudio para la infección por T. cruzi en mujeres antes del embarazo y el seguimiento de todos los hijos para no perder la oportunidad de tratamiento

Transplacental transmission is currently the most frequent route of infection by Trypanosoma cruzi. Early diagnosis and treatment of infected children avoids the risk of developing cardiomyopathy, and girls are no longer potential sources of congenital transmission. This study evaluated the follow-up of children of women infected with T. cruzi in Primary Care Centres of the province of Santa Fe. Nineteen mothers and their 51 children were studied. Among the 51 children, 23 had no previous diagnosis (45%). Of these, 21 were negative while 2 girls, ages 3 and 7, were infected. The remaining 28 children already had a diagnosis at the Health Centres, with 2 twins of 22 months and a 9-year-old girl who were positive; the other 25 children were not infected. Among the 19 mothers, 9 (47%) had the positive maternal serology as the only antecedent. Of the 4 women who transmitted the infection, 3 belonged to this group. The average age of diagnosis was: 20 ± 6 years in mothers and 7.4 ± 6.7 years in children. Health strategies are required to promote the detection of infected women before pregnancy and the monitoring of all children so as not to miss the opportunity for treatment

Myrtle Seeds (Myrtus communis L.) as a Rich Source of the Bioactive Ellagitannins Oenothein B and Eugeniflorin D2.

The increasing popularity of "Mirto" liqueur, produced from Myrtus communis berries, has led to the planting of domesticated cultivars, expanding myrtle berry production. To promote the use of cultivated berries, the content in the nutraceutical compounds ellagitannins has been investigated both in spontaneous and cultivated fruits. Oenothein B and eugeniflorin D2, characterized by 1H and 13C NMR, were isolated and quantified using ultrahigh-performance liquid chromatography-diode array detector-tandem mass spectrometry (UPLC-DAD-MS/MS). The antifungal and anti-inflammatory activities of oenothein B were assayed in vitro. Large amounts of oenothein B and eugeniflorin D2 were detected in seeds (12 ± 2.4 and 5.8 ± 1.2 mg/g). The oenothein B concentration in liqueurs was 194 ± 22 mg/L. This macrocyclic ellagitannin dimer showed anti-Candida (minimal inhibitory concentration <8-64 µg/mL) and anti-inflammatory properties. Cultivated myrtle berries are a source of nutraceutical compounds. The high concentration of oenothein B in liqueur suggests a possible contribution to the organoleptic and biological properties of the beverage.

Plasmacytoid Urothelial Carcinoma of the Bladder: Case Report and Review of the Literature / Carcinoma urotelial de vejiga, variante plasmocitoide: Reporte de un caso y revisión de la literatura

Introduction Plasmacytoid urothelial carcinoma (PUC) of the bladder is a rare histological variant, accounting for 1 to 3% of the invasive urothelial carcinomas, and it is typically aggressive. So far, it has not been well characterized, and the literature is based on reports and case series. Case Report A 70-year-old male patient presenting with 4 months of constitutional and urinary symptoms, with an ultrasound finding of bilateral hydronephrosis and diffuse thickening of the bladder walls. In the cystoscopy, trigone of infiltrated appearance, a biopsy wass performed, whose immunohistochemistry revealed a PUC. The abdominopelvic image showed an infiltrative lesion that compromised the muscle of the bladder and extended to the perivesical fat, without adequate plane of cleavage with the prostate and a single hypogastric adenopathy suspected of malignancy. It was classified as cT3b vs cT4aN1M0 (chest computed tomography [CT] negative for malignancy), and the patient was submitted to a radical cystoprostatectomy, extended pelvic lymphadenectomy and non-continent urinary diversion with ileal conduit. The pathology revealed a diffuse PUC with prostatic stromal involvement and 22 of 39 lymph nodes positive for malignancy. Finally, the patient presented a series of postoperative complications and died. Conclusion Plasmacytoid urothelial carcinoma of the bladder is a rare entity, characterized by high aggressiveness, an advanced stage at the time of diagnosis, and a poor prognosis. Currently, an aggressive approach is recommended due to its high invasive potential.

Introducción El carcinoma urotelial plasmocitoide (CUP) de la vejiga es una variante histológica poco frecuente; representa el 1 al 3% de los carcinomas uroteliales invasivos y es típicamente agresiva. Hasta el momento no ha sido bien caracterizada, y la literatura se basa en reportes y series de casos. Reporte de Caso Paciente masculino de 70 años presentando por 4 meses síntomas constitucionales y urinarios, con hallazgo ecográfico de hidronefrosis bilateral y engrosamiento difuso de las paredes vesicales. En la cistoscopia, trígono de apariencia infiltrada, se realizó biopsia cuya inmunohistoquímica reveló un CUP. En imagen abdominopélvica, se evidenció lesión infiltrativa que comprometía la muscular de la vejiga y se extendía a la grasa perivesical, sin adecuado plano de clivaje con la próstata y un único ganglio hipogástrico sospechoso de malignidad. Se clasificó como cT3b vs cT4aN1M0 (TAC tórax negativo para malignidad) y fue llevado a cistoprostatectomía radical, linfadenectomía pélvica extendida y derivación urinaria no continente con conducto ileal. La patología reveló un carcinoma urotelial variante difusa plasmocitoide con compromiso de estroma prostático y 22 de 39 ganglios positivos para malignidad. Finalmente, el paciente presentó una serie de complicaciones posoperatorias y falleció. Conclusión El carcinoma urotelial de vejiga variante plasmocitoide es una entidad poco frecuente, caracterizada por alta agresividad, un estadio avanzado al momento del diagnóstico, y un pobre pronóstico. En la actualidad, se recomienda un enfoque agresivo dado su alto potencial invasivo.

Complicaciones infecciosas después de prostatectomía abierta y resección transuretral de próstata en pacientes con hiperplasia prostática benigna / Postoperative infectious complications after open prostatectomy and transurethral resection of the prostate in patients with benign prostatic hyperplasia

RESUMEN La hiperplasia prostática benigna (HPB) es la neoplasia más común en hombres y puede requerir tratamiento quirúrgico cuando hay retención urinaria, uropatía obstructiva, hematuria a repetición, cistolitiasis o falta de mejoría de los síntomas con las terapias farmacológicas. Las opciones quirúrgicas más frecuentes son la prostatectomía abierta y la resección transuretral de próstata, entre cuyas complicaciones están las infecciones del tracto urinario (ITU) hasta en 12,9 % de los pacientes. Sin embargo, este porcentaje es variable porque no siempre se especifica la diferencia entre ITU y bacteriuria. Los siguientes son factores de riesgo: bacteriuria preoperatoria, tiempo quirúrgico mayor de 60 minutos y manipulación posoperatoria de la sonda vesical. Es importante que los profesionales de la salud que participan en la atención de pacientes con HPB conozcan e intervengan estas complicaciones infecciosas y sus factores de riesgo.

SUMMARY Benign prostatic hyperplasia (BPH) is the most common tumor in men and may require surgical treatment when there is urinary retention, obstructive uropathy, recurrent hematuria, cystolithiasis or lack of improvement of symptoms with drug therapies. The most common surgical options are open prostatectomy and transurethral resection of the prostate. Urinary tract infections (UTI) are among the complications of these procedures, and may occur in up to 12.9 % of patients. However, this percentage is variable because the difference between UTI and bacteriuria is not always specified. Risk factors are: preoperative bacteriuria, operating time longer than 60 minutes and handling of postoperative bladder catheter. It is important that health professionals involved in the care of patients with BPH know these infectious complications and their risk factors.