Patients Age 40 Years and Younger With Multiple Myeloma Have the Same Prognosis as Older Patients: An Analysis of Real-World Patients' Evidence From Latin America.

PURPOSE: Multiple myeloma (MM) is a highly heterogeneous, incurable disease most frequently diagnosed in the elderly. Therefore, data on clinical characteristics and outcomes in the very young population are scarce. PATIENTS AND METHODS: We analyzed clinical characteristics, response to treatment, and survival in 103 patients with newly diagnosed MM age 40 years or younger compared with 256 patients age 41-50 years and 957 patients age 51 years or older. RESULTS: There were no statistical differences in sex, isotype, International Scoring System, renal involvement, hypercalcemia, anemia, dialysis, bony lesions, extramedullary disease, and lactate dehydrogenase (LDH). The most used regimen in young patients was cyclophosphamide, bortezomib, dexamethasone, followed by cyclophosphamide, thalidomide, dexamethasone and bortezomib, thalidomide, dexamethasone. Of the patients age 40 years or younger, only 53% received autologous stem-cell transplant (ASCT) and 71.1% received maintenance. There were no differences in overall survival (OS) in the three patient cohorts. In the multivariate analysis, only high LDH, high cytogenetic risk, and ASCT were statistically associated with survival. CONCLUSION: In conclusion, younger patients with MM in Latin America have similar clinical characteristics, responses, and OS compared with the elderly.

Water reclamation from anodizing wastewaters by removing reactive silica with adsorption and precipitation methods.

Water stress is a current environmental menace mainly driven by over exploitation of aquifers, which is triggering poor water quality with high concentration of minerals in extracted groundwater. Particularly, silica is widespread in natural water supplies due to weathering processes of silicates occurring in contact with water, light, air, and other factors. However, due to groundwater over extraction the concentration of silica has increased during the last years in aquifer reservoirs from Aguascalientes State (México). In this context, it is very important to note that the removal of silica compounds from water is challenging and different methods can be used to avoid embedding problems in different industries. In the present work, the removal of reactive silica from synthetic solutions as well as from real wastewaters from an industrial anodizing process was studied using adsorption and chemical precipitation methods. Twelve commercial materials of different nature were used for adsorption tests, while seven precipitant agents were applied in the precipitation experiments. Adsorption tests were performed in batch systems with constant stirring at 30 °C and at different pH values (7 and 9). Precipitation experiments were carried out in batch systems and the best conditions for silica removal were found using an L9 orthogonal array of the Taguchi method employing molar ratio, pH of wastewater, stirring time and temperature as experimental factors. Adsorption results showed that Ferrolox (Iron (III) hydroxide-base adsorbent) was the most efficient sorbent for reactive silica removal from synthetic solutions and the anodizing wastewater. Also, the reactive silica adsorption was higher at pH 9 as compared to that measured at pH 7 and the adsorbed quantity at pH 9 was 16.22 and 11.25 mg/g for the synthetic solution and anodizing wastewater, respectively. According to molecular simulation, the main interaction between Ferrolox and silica species was related to the formation of hydroxo-complexes and to the interaction of Fe with oxygen of silica species. Additionally, magnesium chloride was the best precipitating reagent for reactive silica achieving up to 87% removal. According to ANOVA analysis of Taguchi method, pH was the most influential factor during the precipitation of reactive silica with a variance value of 81.42, while values lower than 3 were obtained for the rest of parameters. Overall, the present work is reporting for the first time the removal of reactive silica from anodizing wastewaters with promising results that can be implemented at full scale for water reclamation, which may significantly contribute to manage water reservoir in the region sustainably.

Real-World Evidence of Epidemiology and Clinical Outcomes in Multiple Myeloma, Findings from the Registry of Hemato-Oncologic Malignancies in Colombia, Observational Study.

INTRODUCTION/BACKGROUND: Multiple Myeloma (MM) is a plasma cell derived clonal disorder that represents around 1% of all newly diagnosed neoplasms. Limited data regarding MM treatment in Latin America is available, and access to novel agents for a substantial portion of the population is limited by their high costs. MATERIALS (OR PATIENTS) AND METHODS: RENEHOC is a bidirectional (retrospective and prospective) multicenter observational registry of hematological malignancies in Colombia. MM patients included up to July 2020 were analyzed on this report. RESULTS: 890 are reported with a median follow-up of 18 months (IQR: 7-42 months). Patients were classified by age group (≤ or > 65 years). Median age at diagnosis was 67 years (IQR: 59-75 years) and 47.1% of patients were women. 709 patients (79.6%) received Bortezomib-based schemes as part of the first line. Two hundred and fifty-two patients (28.3%) were consolidated with Autologous Stem Cell Transplantation (ASCT) in first-line. ASCT consolidation and age were the main independent factors influencing outcomes; in the non-ASCT cohort, 5-year overall survival was 48.7% (CI 41.8-55.2) compared to 80.7% (CI 73-86.4) in ASCT patients. CONCLUSION: This data depicts the reality of MM in Colombia, which likely reflects other Latin American countries, where access barriers to diagnosis and treatment are echoed in advanced stage diagnosis and a low rate of transplants. These seem to negatively impact survival despite the availability of most novel drugs approved for this disease. Thus, emphasizing the paradox that prevails in most of the region: availability without equitable access.

Adsorption of impurities from nickel-plating baths using commercial sorbents to reduce wastewater discharges.

The presence of moderate concentrations of impurities in the nickel-plating baths generates failures on the coated pieces. This situation entails the necessity of replacing the electroplating bath, which implies the generation of large volumes of wastewater with metallic species and high quantity of sludge. For this reason, the adsorption of the principal impurities of nickel-plating baths of an industry was analyzed in this work. Particularly, the removal of Zn2+ was studied in more detail since the presence of this metal in the baths generates black spots on the coated pieces. Different commercial materials were used as adsorbents and Zn2+ adsorption studies were carried out using both standard solutions and industrial water from the nickel-plating baths. All the adsorption tests were performed in batch systems under constant agitation and the quantification of the impurities was made by ICP-MS analysis. The bone char (BC) was an efficient adsorbent for the removal of the principal impurities of nickel-plating baths. The use of molecular simulation tools helped to understand the preferences of the hydroxyapatite (the principal component of bone char) for different metallic ions present in the industrial waters. According to both the experimental adsorption and molecular simulation results, hydroxyl and phosphate groups of bone char are responsible of the adsorption of impurities of nickel-plating baths.

Precisión del diagnóstico dermatoscópico para el carcinoma basocelular en el Servicio de Dermatología: policlínico Colón / Accuracy of the dermatoscopic diagnosis for basal cell carcinoma in the Service of Dermatology. East-Colón

La dermatoscopía se considera como un paso intermedio entre la clínica y la histopatología en el diagnóstico de Carcinoma basocelular, sin embargo se desconoce si es útil en manos de una persona que esté especializada en el dermatoscopio. Objetivo: Describir los criterios epidemiológicos, clínicos y dermatoscópicos de una serie de casos con diagnóstico clínico de carcinoma basocelular y evaluar la precisión dermatoscopía-histopatología. Metodología: Se realizó un estudio observacional descriptivo de corte transversal en 25 pacientes que acudieron a la consulta de Dermatología con diagnóstico clínico de carcinoma basocelular, con un total de 36 lesiones observadas a las que se le realizó la técnica de dermatoscopía. En todos los casos se tomó biopsia de la lesión y se realizó la correlación clínico-dermatoscópica e histopatológica. Resultados: Predominó el sexo masculino, los mayores de 71 años y el fototipo de piel II. Las lesiones se localizaron preferentemente en cabeza y cuello, prevaleciendo las de alto riesgo. La variedad clínica más frecuente fue el nodular y el de mayor confusión dermatoscópica fue el pigmentado. Las estructuras dermatoscópicas más representadas fueron los múltiples nidos ovoides, los vasos arborescentes, las hojas de arce y la ulceración. Existió una concordancia entre el diagnóstico dermatoscópico y el histológico. Conclusiones: La precisión diagnóstica dermatoscópica-histopatológica fue demostrada lo que refuerza su utilidad previa a la toma de decisiones(AU)

Dermoscopy is considered as an intermediate step between clinical and histopathology in the diagnosis of basal cell carcinoma, however it is unknown whether it is useful in the hands of a person who is specialized in the dermatoscope. Objective: To describe the epidemiological, clinical and dermatoscopic criteria of a series of cases with clinical diagnosis of basal cell carcinoma and evaluate the dermoscopy-histopathology accuracy. Methodology: A descriptive, observational, cross-sectional study was performed on 25 patients who attended the dermatology consultation with a clinical diagnosis of basal cell carcinoma, with a total of 36 lesions observed at which the technique of dermoscopy was undergone. In all cases a lesion biopsy was taken and the clinical and histopathologic correlation was performed. Results: There was a predominance of male gender, age 71 and skin phototype II. The lesions were preferentially located in the head and neck, prevailing high risk lesions. The most common clinical range was nodular and the highest dermoscopic confusion was pigmented. The most represented dermoscopic structures were multiple ovoid nests, arborescent vessels, maple leaves and ulceration. There was a correlation between dermoscopic and histological diagnosis. Conclusions: The diagnostic, dermoscopic-histopathologic accuracy was demonstrated what reinforces its previous utility at decision making(AU)

Precisión del diagnóstico dermatoscópico para el carcinoma basocelular en el Servicio de Dermatología. Policlínico Colón-Este. 2012 / Accuracy of the dermatoscopic diagnosis for basal cell carcinoma in the Service of Dermatology. East-Colón Polyclinic. 2012

Fundamento: La dermatoscopía se considera como un paso intermedio entre la clínica y la histopatología en el diagnóstico de Carcinoma basocelular, sin embargo se desconoce si es útil en manos de una persona que esté especializada en el dermatoscopio. Objetivo: Describir los criterios epidemiológicos, clínicos y dermatoscópicos de una serie de casos con diagnóstico clínico de carcinoma basocelular y evaluar la precisión dermatoscopía-histopatología. Metodología: Se realizó un estudio observacional descriptivo de corte transversal en 25 pacientes que acudieron a la consulta de Dermatología con diagnóstico clínico de carcinoma basocelular, con un total de 36 lesiones observadas a las que se le realizó la técnica de dermatoscopía. En todos los casos se tomó biopsia de la lesión y se realizó la correlación clínico-dermatoscópica e histopatológica. Resultados: Predominó el sexo masculino, los mayores de 71 años y el fototipo de piel II. Las lesiones se localizaron preferentemente en cabeza y cuello, prevaleciendo las de alto riesgo. La variedad clínica más frecuente fue el nodular y el de mayor confusión dermatoscópica fue el pigmentado. Las estructuras dermatoscópicas más representadas fueron los múltiples nidos ovoides, los vasos arborescentes, las hojas de arce y la ulceración. Existió una concordancia entre el diagnóstico dermatoscópico y el histológico. Conclusiones: La precisión diagnóstica dermatoscópica-histopatológica fue demostrada lo que refuerza su utilidad previa a la toma de decisiones.

Background: Dermoscopy is considered as an intermediate step between clinical and histopathology in the diagnosis of basal cell carcinoma, however it is unknown whether it is useful in the hands of a person who is specialized in the dermatoscope. Objective: To describe the epidemiological, clinical and dermatoscopic criteria of a series of cases with clinical diagnosis of basal cell carcinoma and evaluate the dermoscopy-histopathology accuracy. Methodology: A descriptive, observational, cross-sectional study was performed on 25 patients who attended the dermatology consultation with a clinical diagnosis of basal cell carcinoma, with a total of 36 lesions observed at which the technique of dermoscopy was undergone. In all cases a lesion biopsy was taken and the clinical and histopathologic correlation was performed. Results: There was a predominance of male gender, age 71 and skin phototype II. The lesions were preferentially located in the head and neck, prevailing high risk lesions. The most common clinical range was nodular and the highest dermoscopic confusion was pigmented. The most represented dermoscopic structures were multiple ovoid nests, arborescent vessels, maple leaves and ulceration. There was a correlation between dermoscopic and histological diagnosis.

"Pig in a poke (gato por liebre)": the "mota" (Calophysus macropterus) fishery, molecular evidence of commercialization in Colombia and toxicological analyses.

Overfishing has affected the population abundance trends of many commercial fish species. In the Amazon, the fishery of a catfish commonly known as "mota" or "piracatinga" (Calophysus macropterus) has become an important economic activity in the region as this species has replaced a number of other overexploited great catfish species in the markets. Due to this high exploitation, ways in which to increase captures have been identified. One strategy is to use decomposing animal carcasses as bait. Such strategy has increased the hunting pressure on endangered species such as caimans and river dolphins. We investigated which catfish species are currently commercialized in Colombian fish markets using DNA barcoding, and measured mercury concentration in the tissues of fish molecularly identified as C. macropterus. We collected 86 fish samples in markets of four Colombian cities. Sixty-eight of these were identified molecularly as C.macropterus. The mercury concentration of 29 such samples was analyzed. Samples presented total Hg concentrations higher than the limit for human consumption established by the WHO (0.5 µg/g). These results are worrisome and suggest that (1) C. macropterus is a widely used fish species for human consumption in Colombia and (2) C. macropterus has high concentrations of total Hg, making its consumption a public health risk. Results presented here suggest that C. macropterus has replaced capaz in most Colombian markets. This fishery threatens wild species of river dolphins and caimans, and is also a public health risk given the high mercury levels we found in a subsample of these fishes.

Eficacia de la dermatoscopia en el diagnóstico de malignidad de lesiones circunscritas de la piel, mucosas y anexos cutáneos / Effectiveness of dermoscopy in the diagnosis of malignancy of circumscribed lesions on skin, mucous membranes and skin appendages

OBJETIVO. Evaluar la eficacia de la dermatoscopia en el diagnóstico de las lesiones circunscritas de la piel, las mucosas y los anexos cutáneos en comparación con el diagnóstico clínico convencional. MATERIAL y MÉTODOS. Estudio descriptivo transversal en pacientes de la consulta de Dermatoscopia del Hospital Hermanos Ameijeiras en el período de julio de 2010 a julio de 2012. Se realizó la estimación de la sensibilidad, la especificidad, los valores predictivos positivos (VPP), valores predictivos negativos (VPN), razón de verosimilitud positiva (RV+) y negativa (RV-) del diagnóstico de la malignidad clínico y dermatoscópico de las lesiones circunscritas cutáneas, mucosas y de anexos cutáneos separándolas según su naturaleza melanocítica y no melanocítica. RESULTADOS. La sensibilidad del examen clínico para el diagnóstico de lesiones melanociticas fue de 81,82 %, la especificidad de 93,20 %, el VPP fue de 56,25 % Y el VPN de 97,96 %; mientras que, para la dermatoscopia, la sensibilidad fue de 100 %, la especificidad de 91,26 %, el VPP fue de 55 % Y el VPN de 100 %. Para las lesiones no melanocíticas, el examen clínico mostró una sensibilidad de 86,75 %, especificidad de 94,86 %, VPP de 91,72 % Y VPN de 91,60 %; mientras que, para la dermatoscopia, la sensibilidad fue 98,8 %; la especificidad, 98,02 %; el VPP, 97,04 % Y el VPN, 99,2 %. CONCLUSIÓN. La dermatoscopia muestra sensibilidad más alta que el examen clínico para el diagnóstico de malignidad de las lesiones de naturaleza melanocítica y es más sensible y específica que el examen clínico para el diagnóstico de malignidad de las lesiones no melanocíticas.

OBJECTlVE. To evaluate the effectiveness of dermoscopy in the diagnosis of circumscribed lesions of the skin, mucous membranes and skin appendages compared with conventional clinical diagnosis. MATERIAL AND METHODS. Cross-sectional study in consulting patients of the Service of Dermatoscopy at Ameijeiras Hermanos Hospital since July 2010 to July 2012. It was performed to estimate the sensitivity, specificity, positive predictive values (PPV), negative (NPV), positive likelihood ratio (LR+) and negative (RV-) diagnosis of malignancy clinical and dermoscopic of circumscribed lesions skin, mucous membranes and skin appendages separated by type melanocytic and non- melanocytic. RESULTS. The sensitivity of clinical examination for the diagnosis of melanocytic lesions was 81,82 %, specificity 93,20 %, PPV was 56,25 % and NPV of 97,96 %, while for the dermoscopy, the sensitivity was 100 %, specificity of91,26 %, PPV was 55 % and NPV of 100 %. For non-melanocytic lesions, clinical examination showed a sensitivity of86,75 %, specificity 94,86 %, PPV 9 1,72 % and NPV of 91,60%, while that for dermoscopy, the sensitivity was 98,8%, specificity of 98,02%, PPV was 97,04% and the NPV was 99,2%. CONCLUSION. Dermoscopy shows higher sensitivity than clinical examination for the diagnosis of malignant melanocytic lesions nature and is more sensitive and specific than clinical examination for the diagnosis of malignant melanocytic lesions nature and is more sensitive and specific than clinical examination for the diagnosis of malignancy of melanocytic lesions.

Valor del método dermatoscópico ®Lista Recapitulativa de los Tres Puntos de Soyer¼ en el diagnóstico de las lesiones cutáneas pigmentadas en pacientes del Hospital Hermanos Ameijeiras, La Habana-Cuba, 2008 / Value of the Soyer´s Three Point Checklist dermoscopic method in the diagnosis of pigmented skin lesions in patients from ®Hermanos Ameijeiras¼ Hospital, Havana City, Cuba during 2008

OBJETIVO: Determinar el valor diagnóstico del método dermatoscópico ®Lista Recapitulativa de los Tres Puntos de Soyer¼ (LRTPS) en el diagnóstico de las lesiones cutáneas pigmentadas en pacientes del Hospital Hermanos Ameijeiras (La Habana-Cuba) durante el año 2008. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo transversal con 102 pacientes que asistieron a la Consulta de Dermatoscopía en el Hospital ®Hermanos Ameijeiras¼ de Ciudad de la Habana, Cuba, en el año 2008 para caracterizar la relación de este método de diagnóstico dermatoscópico y el comportamiento biológico de las lesiones cutáneas pigmentadas en el período estudiado. Se calcularon las tasas de sensibilidad y especificidad del método para el puntaje extremo de las lesiones y de las proporciones de malignidad / benignidad para las puntuaciones intermedias. RESULTADOS: La Lista de los Tres Puntos se comportó como un confiable método de alta sensibilidad y especificidad para el diagnóstico de benignidad de las lesiones con puntuación de cero. La sensibilidad para el diagnóstico de malignidad de lesiones con puntuación de tres fue baja, mientras que la especificidad fue alta. Existieron lesiones benignas y malignas con puntuación de 1 y 2, siendo mayor la proporción de lesiones benignas en el primer grupo y de lesiones malignas en el segundo grupo. CONCLUSIÓN: El método demuestra ser una herramienta útil y sencilla para determinar elcomportamiento biológico de las lesiones cutáneas pigmentadas.

OBJECTIVE: To determine the diagnostic value of dermatoscopic method ®Value of the Soyer´s Three Point Checklist¼ in the diagnosis of pigmented skin lesions in patients from ®Hermanos Ameijeiras¼ Hospital (La Habana-Cuba) during 2008. MATERIAL AND METHODS: A descriptive and transversal study was carried out with 102 patients from dermoscopy consultation at ®Hermanos Ameijeiras¼ Hospital, Havana City, Cuba during the year 2008 to characterize the relationship between the diagnostic method and the biological behavior of the pigmented skin lesion in the period studied. The sensibility and specificity rate for the extreme pointed pigmented skin lesions were calculated and also the proportions between malignancy and benignity for the middle pointed lesions. RESULTS: The Three Point Checklist was taken as a reliable method of high sensibility and specificity for the diagnosis of the benignity of the lesion having cero-point. The sensibility to the malignancy diagnosis of three-points lesions was low mean while the specificity was high.There were malignant and benign lesions with one and two points, being higher the proportion of benign lesions in the first group and of malignant lesions in the second one. CONCLUSION: The method shows to be a useful and easy tool to determine the biological behavior of a pigmented skin lesion.

Prolactin-like hormone in the nematode Trichinella spiralis larvae.

Expression of prolactin (PRL) or prolactin-like hormone has been reported in invertebrates. We investigated the larval phase of Trichinella spiralis: (a) to express 23 kDa PRL, (b) to define its localization and (c) to test its possible biological activity. Immunostaining in isolated larvae demonstrated positive material to 23 kDa PRL by all along the stichosome, specifically in the stichocytes. Homogenized immunoblot larvae showed a 23 kDa protein band. To assess PRL release and its biological activity, larvae were incubated in culture medium and the excretory/secretory products were analyzed by the Nb2 cells bioassay. A cellular growth equivalent until 10 nM PRL and using antibody against 23 kDa PRL, the growth was blocked. In conclusion our result provides evidence that PRL-like hormone is expressed and secreted by the larvae of T. spiralis.

Comportamiento de la Micosis fungoide hipopigmentada en pacientes del Hospital Hermanos Ameijeiras: 1996-2006

Se realizó un estudio descriptivo retrospectivo para caracterizar el comportamiento de la Micosis Fungoide Hipopigmentada en pacientes del Hospital "Hermanos Ameijeiras" en el periodo de 1996 al 2006, para lo cual el universo estuvo constituido por los pacientes con diagnóstico de Micosis Fungoide y la muestra por aquellos que presentaron la variedad hipopigmentada. Se obtuvieron los datos de las historias clínicas de los pacientes, procesándose los mismos utilizando el método estadístico de los porcientos. Se obtuvo como resultados que la Micosis Fungoide Hipopigmentada no es una entidad rara en los casos estudiados entre los años 2003 al 2005. La mayoría de los casos estudiados tenían un promedio de edad mayor de 40 años, con predominio en pacientes de piel oscura. Hubo presencia de máculas hipocrómicas como única lesión elemental y los pacientes en su mayoría se encontraban en los estadios iniciales de la enfermedad. Hubo respuesta satisfactoria al uso de Interferón alfa y a cremas esteroideas(AU)

Queratosis seborreica clonal a propósito de un caso / Clonal seborrheic keratosis. A purpose of a case

La queratosis seborreica clonal es una variante histológica rara de queratosis seborreica. Se informa sobre una paciente de sexo femenino, de 87 años de edad, que acudió a consulta de dermatología por presentar lesión tumoral única, de 10 centímetros de diámetro, localizada en abdomen, de 40 años de evolución y crecimiento lento, asociada a intenso prurito. Se diagnosticó clínicamente queratosis seborreica gigante y, desde el punto de vista histopatológico, una variante clonal. Se realizó extirpación quirúrgica de la lesión, con resultados satisfactorios.

Clonal seborrheic keratosis is a rare histological type of seborrheic keratosis. An 87 year-old female patient is presented that came for dermatology consultation due to a lone tumoral lesion, 10 cm in diameter, located in the abdomen, with 40 years of slow growth, associated to intense pruritus. It was clinically diagnosed as giant seborrheic keratosis, and the biopsy showed clonal variant. She had surgical extirpation of the lesion with satisfactory results.