Critical digital ischemia and biliary cholangitis related to graft versus host disease: A case report and systematic literature review.

RATIONALE: Chronic graft versus host disease (cGVHD) is a systemic immune-mediated complication that occurs in approximately half of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT), and remains the leading cause of late morbidity and mortality. cGVHD involves a heterogeneous group of organic manifestations, many of which mimic autoimmune diseases such as scleroderma, primary biliary cholangitis, Sjögren syndrome and polymyositis. PATIENT CONCERNS: A 60-years-old female with a history of allo-HCT developed de novo cGVHD 11 months after allo-HCT with isolated liver involvement. The patient presented with jaundice, cytolysis, cholestasis and concomitant acute digital ischemia. Liver biopsy and autoimmunity tests were performed and were found to be compatible with immune-mediated liver damage. Nailfold capillaroscopy revealed microangiopathy, characterized by avascular areas and some enlarged capillaries resembled an early systemic sclerosis pattern. DIAGNOSIS: Biliary cholangitis-like and digital ischemia related to cGVHD. INTERVENTIONS: The patient was treated with high-dose prednisone and ursodeoxycholic acid, and extracorporeal photopheresis. The patient required hospital admission for administration of intravenous prostacyclin due to refractory Raynaud syndrome. OUTCOMES: After 6 to 8 weeks, the patient achieved a good response, with evident clinical improvement and progressive normalization of liver function. LESSONS: cGVHD is a multiorgan pathological condition, and this case emphasizes that a multidisciplinary team, including rheumatologists, should be involved in the follow-up of allo-transplant patients to ensure that the clinical complications are adequately addressed. Early intervention is critical for improving patient' prognosis.In addition, we performed a systemic literature review based on published case articles on hepatic cGVHD and digital ischemia published up to August 2022. To the best of our knowledge, this is the first reported case of such an association.

Efecto del aceite esencial de Chrysactinia mexicana A. Gray sobre aislados clínicos de Candida glabrata / Effect of the essential oil of Chrysactinia mexicana A. Gray on clinical isolates of Candida glabrata

El objetivo del trabajo fue evaluar el efecto del aceite esencial Chrysactinia mexicana A. Gray en aislados clínicos de C. glabrata. Se obtuvo aceite esencial por arrastre de vapor de las flores, hojas y ramas secundarias de C. mexicana. Se realizó cromatografía de gases y espectrometría de masas para conocer la composición del aceite. Se hicieron ensayos de microdilución en fase logarítmica y fase estacionaria con Saccharomyces cerevisiae y aislados clínicos de C. glabrata para determinar la Concentración Mínima Inhibitoria (CMI) en presencia del aceite esencial. Los principales compuestos del aceite esencial fueron la piperitona (29.57 %), eucaliptol (26.86 %), a-terpineol (14.65 %), delta-3-careno (12.37 %) y linalool (3.56 %). Se determinaron las CMI del aceite esencial, para las cinco cepas utilizadas en las dos fases de crecimiento, siendo menor la CMI para S. cerevisiae que para los diferentes aislados clínicos de C. glabrata. El aceite esencial de C. mexicana tiene efecto fungicida en S. cerevisiae y los aislados clínicos de C. glabrata.

Ocronosis y osteoporosis: a propósito de un caso / Ochronosis and osteoporosis: a case report

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Manifestaciones trombóticas en el síndrome SAPHO. Revisión de la literatura / Thrombotic manifestations in SAPHO syndrome. Review of the literature

El síndrome SAPHO (sinovitis, acné, pustulosis, hiperostosis y osteítis) comprende un conjunto de manifestaciones cutáneo-osteoarticulares. Se han descrito algunas complicaciones graves que pueden aparecer durante la evolución de la enfermedad, como la trombosis venosa, principalmente en pacientes que desarrollan afectación inflamatoria grave de la pared torácica anterior. El objetivo de la presente revisión fue analizar los casos descritos en la literatura médica relacionados con la presencia de complicaciones trombóticas en pacientes diagnosticados de síndrome SAPHO e intentar establecer los probables factores de riesgo y su posible mecanismo patogénico. Se analizaron 11 artículos publicados de casos clínicos aislados o series de casos, con un total de 144 pacientes, que describen en total 15 casos de trombosis venosa. Se exponen las características clínicas de estos pacientes, se evalúa si cumplen los criterios de clasificación ASAS para espondiloatritis axial y periférica, y se resalta la necesidad de realizar un diagnóstico y tratamiento precoces (AU)

SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a cluster of osteo-cutaneous manifestations that can lead to serious complications such as thrombosis of the subclavian vein or superior vena cava, mainly in patients with significant inflammatory involvement of the anterior-chest-wall. The objective of this study was to review the cases published in the medical literature related with the presence of thrombotic complications in patients diagnosed with SAPHO syndrome and to try to determine their possible pathogenic mechanism and risk factors. We analyzed 11 published reports of isolated clinical cases or case series, a total of 144 patients, which described a total of 15 cases of venous thrombosis. The clinical characteristics of these patients, evaluated to determine whether they meet the ASAS criteria for axial and peripheral spondyloarthritis, is analyzed the need for early diagnosis and treatment is highlighted (AU)

Thrombotic manifestations in SAPHO syndrome. Review of the literature.

SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome is a cluster of osteo-cutaneous manifestations that can lead to serious complications such as thrombosis of the subclavian vein or superior vena cava, mainly in patients with significant inflammatory involvement of the anterior-chest-wall. The objective of this study was to review the cases published in the medical literature related with the presence of thrombotic complications in patients diagnosed with SAPHO syndrome and to try to determine their possible pathogenic mechanism and risk factors. We analyzed 11 published reports of isolated clinical cases or case series, a total of 144 patients, which described a total of 15 cases of venous thrombosis. The clinical characteristics of these patients, evaluated to determine whether they meet the ASAS criteria for axial and peripheral spondyloarthritis, is analyzed the need for early diagnosis and treatment is highlighted.

Pharmacodynamic evaluation and physical/chemical analysis of two formulations of propofol used in target-controlled infusion.

BACKGROUND AND OBJECTIVES: There are several formulations of propofol available to the anesthesiologist for clinical use. The aim of this study was to analyze the physicochemical properties, pharmacodynamic effect, and pharmaceutical and clinical equivalence of the reference drug propofol as well as a similar formulation. METHOD: Sixteen volunteers were enrolled in this randomized, double-blind, and paired study of Diprivan and Propovan formulations. Formulations were given as target-controlled infusion with target concentration of 3.0 µg.mL(-1) for 15 minutes. Variables studied were the area under the curve (AUC) of the bispectral index (BIS) graph regarding time, minimum BIS reached and time to reach it, and recovery time. The two formulations were sent to analysis of particle size of lipid emulsion, surface potential, and active principle quantification. RESULTS: There was no difference between the formulations when comparing AUC, minimum BIS reached and time to reach it. The similar formulation recovery time was lower compared to the reference formulation (eight and 10 min, respectively, p=0.014). Mean particle size of lipid emulsion, surface potential, and active ingredient quantification were similar for both formulations. CONCLUSION: There was no clinically significant difference between the use of propofol, reference Diprivan, and the similar Propovan during infusion. However, the recovery time was longer with the reference drug. Although analysis of both formulations studied show similar results regarding its physicochemical characterization, further studies should be conducted to justify this difference.

Pharmacodynamic evaluation and physical/chemical analysis of two formulations of propofol used in target-controlled infusion.

BACKGROUND AND OBJECTIVES: There are several formulations of propofol available to the anesthesiologist for clinical use. The aim of this study was to analyze the physicochemical properties, pharmacodynamic effect, and pharmaceutical and clinical equivalence of the reference drug propofol as well as a similar formulation. METHOD: Sixteen volunteers were enrolled in this randomized, double-blind, and paired study of Diprivan® and Propovan® formulations. Formulations were given as target-controlled infusion with target concentration of 3.0 µg.mL(-1) for 15 minutes. Variables studied were the area under the curve (AUC) of the bispectral index (BIS) graph regarding time, minimum BIS reached and time to reach it, and recovery time. The two formulations were sent to analysis of particle size of lipid emulsion, surface potential, and active principle quantification. RESULTS: There was no difference between the formulations when comparing AUC, minimum BIS reached and time to reach it. The similar formulation recovery time was lower compared to the reference formulation (eight and 10 min, respectively, p = 0.014). Mean particle size of lipid emulsion, surface potential, and active ingredient quantification were similar for both formulations. CONCLUSION: There was no clinically significant difference between the use of propofol, reference Diprivan®, and the similar Propovan® during infusion. However, the recovery time was longer with the reference drug. Although analysis of both formulations studied show similar results regarding its physicochemical characterization, further studies should be conducted to justify this difference.

Osteotomía periacetabular en el manejo de displasia de cadera asistida con fluoroscopia: resultados clínicos tempranos y radiológicos / Fluoroscopy assisted periacetabular osteotomy for hip dysplasia: early roentgenologic and clinical results

Introducción: la osteotomía periacetabular está indicada como tratamiento para las secuelas de displasia de la cadera en adultos jóvenes; permite la reorientación acetabular para dar cubrimiento a la cabeza femoral. Se considera un procedimiento técnicamente demandante, lo que ha llevado a realizar varias modificaciones de la técnica original descrita por Ganz. Materiales y métodos: para describir el resultado radiológico y funcional de pacientes sometidos a osteotomía periacetabular Bernesa asistido por fluoroscopia, se realizó una serie de casos entre enero de 2008 y septiembre de 2011. El seguimiento mínimo para el análisis clínico fue de 6 meses y para el análisis radiológico fue de 60 días. Resultados: se evaluaron 32 caderas. La mediana del ángulo CB posoperatorio fue de 34°, el 3,2 % de los casos presentaron fracturas articulares y el 3,2 % tuvieron un tornillo en posición intraarticular. La media preoperatoria de la escala funcional WOMAC fue de 38 puntos, con mejoría en el posoperatorio a una media de 11 puntos para el grupo de pacientes con seguimiento clínico. Discusión: la osteotomía periacetabular es un procedimiento que mejora la condición clínica y radiológica de los pacientes con displasia de cadera; es un procedimiento reproducible en el cual el uso de fluoroscopia intraoperatoria busca mejorar los resultados radiológicos, con baja incidencia de complicaciones.

Molecular identification of two strains of Cercospora rodmanii isolated from water hyacinth present in Yuriria lagoon, Guanajuato, Mexico and identification of new hosts for several other strains.

Water hyacinth is a beautiful monocotyledon plant that has been dispersed all over the world by humans. The plant has been present in Mexico since 1907, and many water bodies have become infested with it since then. In 2001, we initiated a survey in Yuriria lagoon in southern Guanajuato state to isolate fungi able to biocontrol the plant. We isolated 25 morphologically distinct fungal cultures, of which two were identified as members of the genus Cercospora. Cercospora species are among the most prevalent and destructive of plant pathogens and can be found on leaves, pedicels, stems, fruits, and bracts. Only two species of Cercospora, Cercospora piaropi, and Cercospora rodmanii, have been described on water hyacinth; however, the classification of these species has been controversial. Several molecular approaches have been used for Cercospora identification, and some candidate genes have been identified for use in Cercospora species determination. Although the nrRNA genes alone do not show sufficient resolution for species determination, histone H3, translation elongation factor1-α, ß-tubulin, actin, and calmodulin have been shown in previous studies to have an adequate number of nucleotide changes to allow species identification. In the present study, we used partial sequences of the histone H3, actin, and calmodulin genes to identify our two isolates as C. rodmanii. Our two strains are not specific to water hyacinth, as they are also pathogenic to beet and sugar beet. Similar host ranges were found for C. rodmanii strains isolated from Tabasco in México, Zambia, and Brazil, however, the specificity for water hyacinth persists in Cercospora piaropi Tharp and C. rodmanii Conway, the latter being the most pathogenic.

Efecto de sustitutos de grasa en propiedades sensoriales y texturales del queso crema / Effect of fat substitute in sensory and texture propperties of cream cheese

Introducción. El queso crema (QC) es un producto que tiene buena aceptación, pero con un aporte calórico alto, lo que hace que muchas personas con trastornos metabólicos o que desean cuidar su figura deban suprimirlo de la dieta normal. La producción de QC bajo en grasa, es un atractivo para este tipo de consumidores, ofreciendo nuevas oportunidades en el mercado. Objetivo. Elaborar y caracterizar la textura y las características sensoriales de queso crema bajo en grasa, adicionado con dos sustitutos (Z-trim y Passelli SA2)en tres porcentajes diferentes. Materiales y métodos. Se desarrollaron seis formulaciones con bajo contenido graso, mediante la utilización de dos sustitutos de grasa a tres concentraciones: Z-trim (0,5, 1,0 y 1,5%) y Paselli SA2 (1, 2 y 3%). Se registró el pH y la acidez al final de la fermentación; así como, el rendimiento del QC con relación a la cantidad de materia prima utilizada. Las variables respuestas para evaluar el efecto de los sustitutos de grasa fueron: evaluación sensorial, aplicándose un análisis descriptivo cuantitativo y mediciones de textura con una esfera de 0.5mm de diámetro usando el texturometro TA-XT2i midiéndose dureza, adhesividad, gomosidad y masticabilidad. Resultados. El sustituto de grasa Z-trim (0,5%) tuvo el mejor comportamiento en las pruebas instrumentales y sensoriales, ya que la calificación fue la más cercana al valor del queso testigo con un rendimiento del 23,91% y una reducción calórica del 30%. Conclusión. El sustituto de grasa Z-trim tuvo el mejor comportamiento en las pruebas instrumentales y sensoriales y el sustituto de grasa Paselli SA2 tuvo el mejor comportamiento en cuanto al rendimiento y al contenido de grasa en los quesos elaborados.

Introduction. Cream cheese is a well accepted product, but it contents a high number of calories and this is the reason why many people with metabolism problems or trying to be in shape, take it out from their normal diet. Producing cream cheese with a low fat content is an attractive choice for these people, offering new market opportunities. Objective. To elaborate and characterize the texture and sensory characteristics of low fat cream cheese, with two additions (Z-trim and Passelli SA2) in three different percentages. Materials and methods: Six formulas were developed with different fat contents, by using two fat substitutes at three concentrations: (0,5, 1,0 and 1,5%) and Passelli SA2 (1, 2 and 3%). The pH and acidity levels were registered at the end of the fermentation, and also was the cream cheese performance related to the quantity of raw material used. The variable to evaluate the effect of the fat substitutes was the sensorial evaluation, by the application of a cualitative descriptive analysis and texture measures with a sphere of 0,5 mm of diameter using the TA-XT2i texturometer measuring hardness, adhesivity, gumminess and chewability. Results: The fat substitute Z-trim (0,5%) had the best behavior in the instrumental and sensory tests, because its grade was the closest to the value of the witness cheese with a 23,91% performance and a calories reduction of 30%. Conclusion. Z-trim fat substitute had the best behavior in the instrumental and sensory tests applied and the Passelli SA2 fat substitute had the best behavior under performance and fat content terms, for the cheeses elaborated.