Global REACH 2018: dysfunctional extracellular microvesicles in Andean highlander males with excessive erythrocytosis.

High altitude-related excessive erythrocytosis (EE) is associated with increased cardiovascular risk. The experimental aim of this study was to determine the effects of microvesicles isolated from Andean highlanders with EE on endothelial cell inflammation, oxidative stress, apoptosis, and nitric oxide (NO) production. Twenty-six male residents of Cerro de Pasco, Peru (4,340 m), were studied: 12 highlanders without EE (age: 40 ± 4 yr; BMI: 26.4 ± 1.7; Hb: 17.4 ± 0.5 g/dL, Spo2: 86.9 ± 1.0%) and 14 highlanders with EE (43 ± 4 yr; 26.2 ± 0.9; 24.4 ± 0.4 g/dL; 79.7 ± 1.6%). Microvesicles were isolated, enumerated, and collected from plasma by flow cytometry. Human umbilical vein endothelial cells were cultured and treated with microvesicles from highlanders without and with EE. Microvesicles from highlanders with EE induced significantly higher release of interleukin (IL)-6 (89.8 ± 2.7 vs. 77.1 ± 1.9 pg/mL) and IL-8 (62.0 ± 2.7 vs. 53.3 ± 2.2 pg/mL) compared with microvesicles from healthy highlanders. Although intracellular expression of total NF-κB p65 (65.3 ± 6.0 vs. 74.9 ± 7.8.9 AU) was not significantly affected in cells treated with microvesicles from highlanders without versus with EE, microvesicles from highlanders with EE resulted in an ∼25% higher (P < 0.05) expression of p-NF-κB p65 (173.6 ± 14.3 vs. 132.8 ± 12.2 AU). Cell reactive oxygen species production was significantly higher (76.4.7 ± 5.4 vs. 56.7 ± 1.7% of control) and endothelial nitric oxide synthase (p-eNOS) activation (231.3 ± 15.5 vs. 286.6 ± 23.0 AU) and NO production (8.3 ± 0.6 vs. 10.7 ± 0.7 µM/L) were significantly lower in cells treated with microvesicles from highlanders with versus without EE. Cell apoptotic susceptibility was not significantly affected by EE-related microvesicles. Circulating microvesicles from Andean highlanders with EE increased endothelial cell inflammation and oxidative stress and reduced NO production.NEW & NOTEWORTHY In this study, we determined the effects of microvesicles isolated from Andean highlanders with excessive erythrocytosis (EE) on endothelial cell inflammation, oxidative stress, apoptosis, and NO production. Microvesicles from highlanders with EE induced a dysfunctional response from endothelial cells characterized by increased cytokine release and expression of active nuclear factor-κB and reduced nitric oxide production. Andean highlanders with EE exhibit dysfunctional circulating extracellular microvesicles that induce a proinflammatory, proatherogenic endothelial phenotype.

Síndrome POEMS: a propósito de un caso y revisión de la literatura / POEMS syndrome: report of a case and review of literature

El síndrome POEMS es un síndrome paraneoplásico raro asociado a discrasia de células plasmáticas. Se presenta el caso de un paciente masculino de 37 años de edad, quien consultó por presentar de 38.5 C°, precedida de escalofríos, predominio nocturno y frecuencia diaria/interdiaria, de tres meses de evolución; concomitante parestesias en región plantar bilateral, ascendente, con disminución de fuerza muscular simétrica en miembros inferiores. Durante su estancia hospitalaria se evidencia trombocitosis y eritrocitosis. Se realizó ecosonograma abdominal que evidencia hepatomegalia; tomografía computarizada (TC) de cuello que reportó adenopatías submandibulares, laterocervicales y parayugulares; TC de tórax donde se evidencia lesión ocupante de espacio de características osteolíticas expansivas a nivel de segunda costilla izquierda; electromiografía de miembros superiores e inferiores con radiculopolineuropatía de tipo mixto en miembros inferiores y polineuropatía sensitivo motora de tipo mixto en miembros superiores; electroforesis de proteínas con discreto aumento de gammaglobulinas, a expensas de IgG y aspirado de médula ósea con serie plasmática aumentada (3%) de apariencia madura. Se realizó biopsia de lesión en segundo arco costal izquierdo sin evidenciar atipias. En vista de hallazgos clínicos y paraclínicos se planteó síndrome POEMS.

POEMS syndrome is a rare paraneoplastic syndrome due to an underlying plasma cell disorder. We present a male patient of 37 years old with fever 38.5°C, preceded by chills, nocturnal predominance and daily frequency of three months of evolution, as well as paresthesias in plantar region, bilateral, ascendant with decrease in muscle strength of legs. During his hospitalization, he presented thrombocytosis and erythrocytosis. The abdominal ecosonography evidenced hepatomegaly; thorax computerized tomography evidenced space osteolytic occupying lesion in second left rib. The electromyography demonstrated radiculo polineuropathy in legs, and sensory motor polineuropathy in upper limbs. The protein electrophoresis with elevated of gammaglobulins ;bone marrow aspirate evidenced (3%) mature increased plasma cells. The biopsy of second rib evidenced no atypia.

Estabilización de los indicadores hematológicos en paciente con policitemia absoluta secundaria tratado con Vimang® / Stabilization of the hematologic indicators in a patient with absolute secondary polycythemia treated with Vimang®

Se reporta un caso del sexo masculino, de 72 años de edad con antecedentes de hipertensión arterial (con un período de evolución de 5 años) que fue remitido en el 2001 a la Consulta de Hematología por presentar cifras elevadas de hemoglobina (Hb) y hematócrito (Hto). Las cifras elevadas de Hb y Hto se detectaron durante un chequeo médico como resultado de que el paciente presentara pérdida de conocimiento y fuera hospitalizado. El paciente se remitió al Instituto de Hematología e Inmunología (Ciudad de La Habana) para realizarle un estudio de volemia y ferrocinética, el cual mostró que presentaba policitemia absoluta moderada. Se descartó policitemia vera y se buscaron causas de policitemia absoluta secundaria sin que hayan encontrado ninguna hasta el presente. Desde este momento el paciente se ha seguido en la Consulta de Hematología del Hospital General Docente Ernesto Che Guevara (Las Tunas) y cada 6 meses es chequeado en el Instituto de Hematología e Inmunología, Ciudad de La Habana. A partir del mes de abril de 2004 el paciente recibió 600 mg de Vimang® (extracto de Mangifera indica L.) y se incrementó 2 meses después a 900 mg en 3 dosis separadas de 300 mg (tabletas) diariamente. El presente estudio analizó la historia clínica del paciente y los resultados de todos los estudios que se le practicaron en los años precedentes al tratamiento con Vimang® y los observados durante el año que estaba bajo tratamiento. Como resultado se observó una reducción en un 50 por ciento del número de flebotomías necesarias para mantener el paciente bajo control con respecto a los valores de Hto y Hb. Se encontraron además diferencias significativas (p < 0,05) con respecto a las desviaciones estándar de los indicadores Hto y Hb, que fueron menores en el periodo en que el paciente fue tratado con el extracto natural.

We present the case of a man aged 72 with backgrounds of high blood pressure (course: 5 years) referred in 2001 to Hematology consulting room presenting high figures of hemoglobin (hb) and hematocrit (Hto). The above mentioned high figures were detected during the medical checkup because this patient had a loss of consciousness and was admitted. Patient was referred to Hematology and Immunology Institute (Havana City) to make a study of blood volume and ferrokinetics, demonstrating the presence of a moderate absolute polycythemia. Polycythemia vera was ruled out and it was necessary to look for the causes of a secondary absolute polycythemia without some success until nowadays. From this moment, patient has been followed in the consulting room of "Ernesto Ché Guevara" Teaching and General Hospital (Las Tunas province), and each 6 months hi is seen in the Hematology and Immunology Institute of Havana City. From April month, 2004, patient has been treated con Vimang® (600 mg) (Mangifera indica L extract) and afterwards, doses were increased until 900 mg in three doses apart of 300 mg (tablets) daily. Present study analyzed the patient's medical record as well as results of all studies performed in the previous years to treatment with Vimang® and those observed during the period under treatment. As result, there was a 50 percent decrease in number of phlebotomies needed to maintain the patient under control according to Hto and Hb values. We found also significant differences (p < 0,05) regarding SD of this values, which were lower during the treatment with natural extract.

A histomorphometric study of alveolar bone modeling and remodeling under experimental anaemia and polycythaemia in rats.

UNLABELLED: Alveolar bone is the least stable of the periodontal tissues, because it is subjected to continuous modeling and remodeling. OBJECTIVE: To perform a histological and histomorphometric evaluation of bone modeling and remodeling of periodontal alveolar bone under experimental anaemia and polycythaemia. METHODS: Thirty Wistar rats were divided into three groups: control (C), animals were i.p. injected with 0.5 mL of saline solution; anaemia (A), animals were injected with 6 mg/100 b.w. of phenylhydrazine every 48 h; polycythaemia (P), animals were transfused with 2.5 mL/100 b.w. of 80% suspension of homologous erythrocytes. All the animals were sacrificed 14 days after the onset of the experiment. The mandibles were resected, fixed in formalin, radiographed, processed and embedded in paraffin. Bucco-lingually oriented sections were obtained at the level of the mesial root of the first lower molar, and stained with hematoxylin-eosin. Histological and histomorphometric studies were performed on the buccal and lingual plates of periodontal alveolar bone. RESULTS: Histological and histomorphometric studies showed a statistically significant decrease in bone formation both in buccal and lingual plates in group A (anaemia) as compared to group C (control). An increase in active bone formation was found in the lingual plate in group P (polycythaemia) as compared to group C (control). CONCLUSION: The results obtained using this experimental model evidenced alterations in bone modeling and remodeling under conditions of anaemia and polycythaemia and/or associated factors.

Transient globus pallidus T1 shortening associated with polycythaemia and dystonia.

We report a child who concurrently developed polycythaemia, dystonia, and T1 shortening in the globus pallidus, medial cerebral peduncle and superior cerebellar peduncles on MRI. With spontaneous resolution of the polycythaemia after about 2 1/2 years, the dystonia and MRI abnormalities also resolved. Although the physiological cause of the T1 shortening is not known, this appears to be another cause of T1 shortening in the basal ganglia.

Microhematocrito venoso en recien nacidos hijos de hipertensas / Venous microhematocrit in neonales of toxemia mothers

Con el objeto de conocer los valores de hematocrito venoso y la incidencia de policitemia en el recien nacido hijo de hipertensa, se les realizó determinación de microhematocrito a 200 neonatos atendidos en la Sala de Partos del Hospital Central "DR. Antonio María Pineda" en el lapso comprendido entre Octubre de 1991 y Mayo de 1992. Se excluyeron aquellos que presentaron malfomaciones congénitas o producto de embarazo gemelar. Las muestras fueron obtenidas de la vena anticubetal y fueron considerados policitémicos aquellos neonatos con valor de microhermatocrito mayor o igual a 65 por ciento. Se encontró un promedio de hematocrito de 55,3 por ciento con DE ñ 6,03. La incidencia de policitemia fue de 4 por ciento, siendo neonatos asintomáticos, a término (75 por ciento pequeños para la edad gestacional), con antecedente materno de hipertensión arterial inducida por el embarazo y fueron tratados con exanguinotransfusión parcial evolucionando satisfactoriamente y sin complicaciones hasta su egreso