Severe Cutaneous Adverse Reactions to Drugs in Latin America: The RACGRAD Study.

BACKGROUND AND OBJECTIVE: Severe cutaneous adverse reactions to drugs (SCARs) are associated with high morbidity and mortality and with sequelae. Objective: To characterize patients with SCARs in 8 health care institutions in Latin America. METHODS: We performed a cross-sectional, descriptive, multicenter study of patients diagnosed with SCARs in Latin America between January 2009 and December 2018. The analysis was carried out using a database in BD Clinic. RESULTS: We collected 70 patients, of whom 42 (60%) were women. Mean age was 38.7 years. Forty-two patients (60%) had DRESS-DIHS, 12 (17.1%) TEN, 5 (7.1%) SJS, 6 (8.5%) AGEP, 4 (5.7%) other reactions not classified as SCARs, and 1 (1.4%) overlapping SJS-TEN. The main causative drugs were aromatic anticonvulsants in 31 cases (44.3%), ß-lactam antibiotics in 11 cases (15.7%), and non-ß-lactam antibiotics in 6 cases (8.6%). In all of the cases, the suspected drug was withdrawn at the first sign of a SCAR. Sixty-six patients (94.2%) received anti-inflammatory treatment, mostly systemic corticosteroids. Complications occurred in 53 cases (75.7%), and 3 patients died (4.3%). Thirteen patients (18.6%) had sequelae. CONCLUSIONS: This is the first multicenter report on SCARs in Latin America. DRESS-DIHS was the most frequently reported clinical entity, and anticonvulsants were the main triggers. Most of the patients received systemic corticosteroids. Complications were frequent, and 3 patients died.

Histological analysis of the reproductive system and gonad maturity of octopus rubescens / Análisis histológico del aparato reproductor y la madurez gonadal del pulpo octopus rubescens

This study described the reproductive system and gonadal development of Octopus rubescens from Bahía de Todos Santos, Baja California, Mexico. A total of 65 organisms, 35 males weighing 7.2 to 543.4 g and 30 females from 9.4 to 87.7 g where analyzed. The gonad development was defined through histological methods using Hematoxylin-eosin and Arteta- trichrome stains. We describe macroscopically the reproductive system of males and females, and characterized each of the anatomic components. Eight stages of maturity were recognized in females: 1. Immature, 2. Initial folliculogenesis, 3. Final folliculogenesis, 4. Previtelogenesis, 5. Early vitelogenesis, 6. Final vitelogenesis, 7. Maturing and 8. Spawn. In males five stages were identified: 1. Immature, 2. Maturing A, 3. Maturing B, 4. Mature type 1 and 5. Mature type 2. This work is the first histological description of the reproductive system of this species and the beginning for future research on its basic biology.

En el presente estudio se describió el aparato reproductor y el desarrollo gonadal del pulpo Octopus rubescens de la Bahía de Todos Santos en Baja California, México. Se realizó la descripción macroscópica del aparato reproductor de hembras y machos y se caracterizó cada una de las partes que lo integran. Para la descripción del desarrollo gonadal se utilizaron las técnicas histológicas de Hematoxilina-Eosina y la tinción tricrómica de Arteta. Se analizaron histológicamente un total de 65 organismos de los cuales 35 machos tuvieron un intervalo de peso de 7,2 a 543,4 g y las 30 hembras de 9,4 a 87,7 g. La escala de madurez en las hembras se caracterizó con ocho estadios: 1. Inmaduro, 2. Foliculogénesis inicial, 3. Foliculogénesis final, 4. Previtelogénesis, 5. Vitelogénesis inicial, 6. Vitelogénesis final, 7. Maduros y 8. Desovados. En los machos se identificaron cinco estadios: 1. Inmaduro, 2. En maduración A, 3. En maduración B, 4. Maduro tipo 1 y 5. Maduro tipo 2. Este trabajo constituye la primera descripción histológica del aparato reproductor de esta especie y sienta las bases para futuras investigaciones sobre su biología básica.

[Delirium rating scale-revised-98 (DRS-R-98): Colombian adaptation of the Spanish version]. / Escala revisada-98 para valoración del delirium (DRS-R-98): adaptación colombiana de la versión española.

INTRODUCTION: Delirium is associated with high morbidity and mortality. There are no available instruments validated for evaluation and follow-up of this syndrome in Columbia. METHODS: An expert's panel adapted the Spanish DRSR- 98. In 110, randomly selected, medical-surgical hospitalized patients, 17 (15.5 %) of them with delirium diagnosed with DSM-IV-TR criteria, the inter-rater reliability, validity and sensitivity to clinical change of the new adaptation of the scale were measured. RESULTS: Internal consistency (Cronbach's alpha: 0.956), inter- rater reliability (ICC: 0.95) and validity (94.8 % under the ROC curve area) were very good. For the Cut-off score of 14 for the total scale score, sensitivity was 82.4% and specificity 97.8 %. The scale was sensitive to clinical change, with a mean difference of 12.9 (t: 4.071; p=0.007). CONCLUSIONS: The Colombian adaptation of the Spanish DRS-R-98 is sensitive, specific and reliable for assessment of delirium in hospitalized adults in medical surgical settings.

Vitamin D dependent rickets type II and normal vitamin D receptor cDNA sequence. A cluster in a rural area of Cauca, Colombia, with more than 200 affected children.

Vitamin D dependent rickets type II is an autosomal recessive disease caused by the vitamin D defective receptor. More than 200 patients with different types of lower limb deformities were detected in a rural area of the Cauca department in the southwest part of Colombia. Patients were well nourished and in good physical condition in spite of their deformities. None of them presented alopecia, myopathy, seizures or aminoaciduria. Serum analysis showed significantly lower serum calcium as compared to normal relatives, though in the normal low range, normal phosphorus, high alkaline phosphatase, normal 25-hydroxyvitamin D3 and high 1,25-dihydroxyvitamin D3, indicating target organ resistance. The cDNA analysis showed normal nucleotide sequence. We suggest that our patients represent a distinct form of receptor-positive resistance to vitamin D. This report is the first extensive study on this class of patients.