Integration of T-cell clonality screening using TRBC-1 in lymphoma suspect samples by flow cytometry.

BACKGROUND: The diagnosis of T-cell non-Hodgkin lymphomas (NHL) is challenging. The development of a monoclonal antibody specific for T-cell receptor ß constant region 1 (TRBC1) provides an alternative to discriminate clonal T cells. The aim of this study was to evaluate the diagnostic potential of an anti-TRBC1 mAb for the identification of T-NHL. METHODS: We performed a cross-sectional diagnostic analytic study of samples tested for lymphoma. All samples sent for lymphoma screening were first evaluated using the standard Euroflow LST, to which a second additional custom-designed T-cell clonality assessment tube was added CD45/TRBC1/CD2/CD7/CD4/TCRγδ/CD3. Flow cytometry reports were compared with morphological and molecular tests. RESULTS: Fifty-nine patient samples were evaluated. Within the T-cell population, cut-off percentages in the CD4+ cells were from 29.4 to 54.6% and from 23.9 to 52.1% in CD8+ cells. Cut-off ratios in CD4+ T cells were from 0.33 to 1.1, and in CD8+ cells between 0.22 and 1.0. Using predefined normal cut-off values, 18 of 59 (30.5%) samples showed a restricted expression of TRBC1. A final diagnosis of a T-NHL was confirmed clinically and/or by histopathological studies in 15 of the 18 cases (83.3%). There were no cases of T-NHL by morphology/IHC with normal TRBC1 expression. Non-neoplastic patient samples behaved between predefined TRBC1 cut-off values. CONCLUSIONS: Expression of TRBC1 provides a robust method for T-cell clonality assessment, with very high sensitivity and good correlation with complementary methods. TRBC1 can be integrated into routine lymphoma screening strategies via flow cytometry.

Surgical Management of Infected Pancreatic Necrosis. Case Series in a Quaternary Care Hospital in Bogotá, Colombia, 2014-2021 / Manejo quirúrgico de la necrosis pancreática infectada. Serie de casos en un hospital de cuarto nivel en Bogotá, Colombia, 2014-2021

Abstract Introduction: Pancreatitis is a frequent pathology in our environment, mostly related to benign biliary pathology. It can progress to severe forms in 10-15 % of cases, where the pancreatic tissue becomes necrotic and forms large collections with risk of infection. We do not have epidemiological data about the incidence or management of this complication in Colombia. Aim: This study aims to study the prevalence of infected pancreatic necrosis and describe the cases identified in a quaternary care hospital between 2014 and 2021. Materials and methods: A cross-sectional observational study. We analyzed records of patients diagnosed with stage 2 pancreatitis. Those cases with infected pancreatic necrosis that underwent debridement plus laparoscopic and open surgical drainage at Hospital Universitario Mayor Méderi in Bogotá, Colombia, between January 2014 and January 2021 were studied. A convenience sampling was carried out without calculating the sample size. We collected the patients' demographic and clinical variables, performing a descriptive statistical analysis in Excel. Qualitative variables were described through absolute and relative frequencies, while quantitative ones were expressed through measures of central tendency and dispersion based on their distribution. Results: We analyzed 1020 episodes of pancreatitis, finding pancreatic necrosis in 30 patients, i.e., a period prevalence of 2.9 %. Of the patients, 83 % (n = 25) underwent open drainage, with 48 % (n = 12) mortality. About laparoscopic management, the reduction in postoperative organ failure was 40 % (n = 2), with a 30 % shorter hospital stay than the open drainage approach. Those patients with a level of procalcitonin (PCT) lower than 1.8 ng/mL had less mortality. Conclusions: The laparoscopic approach shows promising results regarding final morbidity and mortality.

Resumen Introducción: la pancreatitis es una patología frecuente en nuestro medio, mayormente relacionada con la patología biliar benigna. Esta puede progresar a formas severas en 10 %-15 % de los casos, en donde el tejido pancreático se necrosa y forma grandes colecciones, con riesgo de infección. En Colombia no conocemos los datos epidemiológicos acerca de la incidencia de este tipo de complicaciones, ni del manejo de las mismas. Objetivo: este estudio tiene como objetivo estudiar la prevalencia de la necrosis pancreática infectada y describir los casos identificados en un hospital de alto nivel de complejidad entre 2014 y 2021. Métodos: estudio observacional de corte transversal. Se analizaron los registros de pacientes diagnosticados con pancreatitis en segunda etapa. Se estudiaron aquellos casos que presentaron necrosis pancreática infectada y se sometieron a desbridamiento más drenaje quirúrgico por vía laparoscópica y abierta en el Hospital Universitario Mayor Méderi de Bogotá, Colombia, entre enero de 2014 y enero de 2021. Se realizó un muestreo por conveniencia, sin cálculo de tamaño de muestra. Se recolectaron variables demográficas y clínicas de los pacientes. Se realizó un análisis estadístico descriptivo de las variables obtenidas en Excel. Las variables cualitativas se describieron a través de frecuencias absolutas y relativas; mientras que las cuantitativas se expresaron mediante medidas de tendencia central y de dispersión en función de su distribución. Resultados: se analizaron 1020 episodios de pancreatitis y se evidenció necrosis pancreática en 30 pacientes, es decir, una prevalencia de período de 2,9 %. De los pacientes, 83 % (n = 25) se llevó a drenajes por vía abierta, con un 48 % (n = 12) de mortalidad. En relación con el manejo por vía laparoscópica, la reducción en la falla orgánica posoperatoria fue de 40 % (n = 2), con un 30 % menos de duración en la estancia hospitalaria, comparado con la vía abierta. Aquellos pacientes que presentaron un nivel de procalcitonina (PCT) menor de 1,8 ng/mL tuvieron menos mortalidad. Conclusiones: el abordaje laparoscópico muestra resultados prometedores en cuanto a la morbilidad y mortalidad final observada.

Tickbite-associated chronic pruritic lesions in an Afro-descendant population in the Cauca Department, Colombia. I. Clinical features and impact on health.

BACKGROUND: During a health survey in a remote area in southwest Colombia, it became apparent that a high percentage of the population suffered from chronic pruritus in association with high numbers of ticks and tickbites. OBJECTIVE: To determine the clinical features and severity of tickbite-associated pruritus. METHOD: At twotime points - 8 weeks apart to account for seasonal effects - a cross-sectional study was conducted encompassing physical examination of the population, histological analysis of skin biopsies, and determining serum for antibodies against spotted fever (SFG) rickettsiae and typhus group (TG) rickettsiae. Ticks were identified using morphological criteria, and infection by rickettsiae was determined by PCR. RESULTS: About 94.5% of the population (95% CI 92-97%) showed clinical signs of a pruritic arthropod reaction and of chronic pruritus with lichenoid papules and hyper- and hypopigmented nodules on otherwise noninflamed skin. Pruritus markedly impaired the quality of life in terms of sleeping disturbances. No signs for other diseases were observed. Chronic pruritus appeared to be because of repeated tickbites and scratching, but not because of other dermatological or medical conditions. Antibodies against SFG and TG-rickettsiae were detected at 79.0% (95% CI 73-86) and 3.6% (95% CI 0.7-6), respectively. Ticks were identified as Amblyomma cajennense. CONCLUSION: Remarkably high exposure to tick bites caused an unusually high rate of acute and chronic pruritus and markedly impaired quality of life of the investigated rural community. This underlines the necessity of public health measures and surveillance of rickettsial disease.

Effects of Phaseolus vulgaris Extract on Lipolytic Activity and Differentiation of 3T3-L1 Preadipocytes into Mature Adipocytes: A Strategy to Prevent Obesity.

BACKGROUND: Overweight and obesity are defined as abnormal or excessive fat accumulation that may be harmful for health. A global trend in this area is the search for natural compounds that have a proven beneficial effect and no clinical complications. Phaseolus vulgaris (bean) is a vegetable highly consumed worldwide. One of its effects, the most reported, is weight reduction in overweight individuals. OBJECTIVE: The objective of this study was to investigate the antiobesity activity of this legume in mature 3T3-L1 adipocytes and in rat white adipose tissue in an ex vivo model. DESIGN: Mature adipocytes 3T3-L1 and rat adipose tissue were treated with bean extracts. We quantified lipolysis in mature 3T3-L1 adipocytes and in rat white adipose tissue in an ex vivo model. RESULTS: In an ex vivo assay with adipose tissue, methanolic and aqueous green bean extracts increased glycerol release to the medium compared to control (p < 0.05 and p < 0.001 respectively). Treatment of 3T3-L1 adipocytes with green bean extracts (800 and 1000 µg/mL) increased glycerol release significantly (p < 0.0001). Extracts at concentrations between 500 and 1000 µg/mL reduced intracellular triglyceride accumulation by 34.4% and 47.1% compared to control (p < 0.0001). DISCUSSION: Our results propose that bioactive compounds of green beans exert a direct mechanism on adipocytes through lipolysis. CONCLUSION: We have identified a novel capacity of bean extracts related to lipolytic activity both in vitro and ex vivo, resulting in a powerful lipolytic effect. Moreover, we also found that bean extracts has an antiadipogenic effect during the differentiation of 3T3-L1 preadipocytes. These results suggest that bean is a good candidate for the development of functional ingredients that can help reduce the high rates of death from cardiovascular diseases associated with obesity.

Incidental venous thromboembolism detected by PET-CT in patients with cancer: prevalence and impact on survival rate.

INTRODUCTION: People with cancer are at increased risk of incidental venous thromboembolism (VTE) and PET-CT imaging is commonly used in this population. However, the prevalence of incidental VTE detected by PET-CT in patients with cancer and its impact on survival are unknown. MATERIALS AND METHODS: This retrospective study was approved by the local Institutional Review Board. 1331 consecutive adult patients with cancer who underwent PET-CT examination between 2009 and 2012 were included in the study (mean age: 57 ± 15 years). PET-CT reports were reviewed to identify patients with incidental VTE at the time of examination. Survival rates were assessed with Kaplan-Meier curves. The Cox proportional hazards model was used to determine the association between incidental VTE and overall survival, after controlling for clinical variables. RESULTS: Incidental VTE was detected in 19 patients (1.4%). Patients with genitourinary malignancies, colorectal cancer and lung cancer had the highest rates of incidental VTE at PET-CT. At multivariate analysis, incidental VTE detected by PET-CT was associated with worse overall survival independently of patient age, hospitalization status at time of PET-CT examination, and the presence of metastatic disease (Hazard ratio=2.03; 95% confidence interval=1.08-3.81, p=0.028). CONCLUSION: Incidental VTE was detected in 1.4% of adult patients with cancer undergoing PET-CT imaging. Diagnosis of incidental VTE at PET-CT imaging was associated with worse overall survival in this population.

Cincha de prolene suburetral por vía trans obturatriz en pacientes obesas: experiencia del Hospital del Salvador / Transobturator prolene sling in obese patients: single center experience

La incontinencia urinaria de esfuerzo (IOE) ha sido asociada a obesidad en numerosos estudios. A pesar de que la baja de peso puede mejorar la IOE en estas pacientes, la cirugía como tratamiento definitivo permite obtener mejores resultados. La cincha suburetral por vía trans obturatriz (TOT), ha tenido excelentes resultados como cirugía inicial para el manejo de IOE, pero hay escasos reportes acerca de su uso en pacientes obesas. Objetivo: Evaluar el efecto de la obesidad en el éxito de TOT para el tratamiento de la IOE. Materiales y Métodos: Estudio de cohorte retrospectivo que identificó a 25 pares de pacientes sometidos a TOT en la Unidad de Urología del Hospital del Salvador entre enero de 2002 y mayo de 2005. Las pacientes obesas (definidas como un IMC > o = a 30 Kg/m2) fueron comparadas con pacientes no obesas (IMC < a 30 Kg/m2). Se comparó según edad (dentro de 5 años) y cirugía previa de incontinencia. El seguimiento fue realizado en forma objetiva con el test de estrés inducido por tos y subjetivamente a través de una encuesta telefónica que evaluaba mejoría. Cura fue definida como la ausencia de IOE después de la cirugía. El análisis estadístico fue realizado a través de regresión logística para cada control. Resultados: El seguimiento promedio varió entre 6 y 24 meses. Existieron 5 fallas, 3 en pacientesobesas y 2 en no obesas, resultando en una tasa de cura de 88,6 por ciento y 91,4 por ciento respectivamente. Esta diferencia no logró diferencia estadística (p>0,05). Existió una perforación de pared vaginal lateral en el grupo no obeso. Conclusión: Estos datos no demuestran una diferencia respecto al éxito de TOT en pacientes obesas v/s no obesas. Dadas las escasas complicaciones encontradas, este procedimiento podría ser el tratamiento quirúrgico ideal para el manejo de la IOE en pacientes obesas.

Stress urinary incontinence (SUI) has classically been associated with numerous studies. Reducing body mass index (BMI) may benefit some patients; however complete remission of SUI is often obtained by surgical means. Transobturator sling (TOT) has become a standard practice with clear benefits; nevertheless series in obese patients are scarce. We evaluate the success of TOT in obese patients. Materials and Methods: A retrospective cohort study was performed in 25 patients that under went TOT between January 2002 and May 2005 at our institution. Obese patients (BMI > or = 30 Kg/m2) were compared with non obese patients. Patients were monitored with office control and by telephone. Cure was established in the absence of SUI. Logistic regression was performed for each case. Results: Follow up was between 6 and 24 months. TOT failed in 5 patients (3 obese). Cure was obtained in 88.6 percent and 91.4 percent for obese and non obese patients respectively; however this difference was not statistically significant (p>0.05). Vaginal wall perforation occurred in one case of the non obese group. Conclusion: There is no difference in TOT success rate between obese and non obese patients. Due to its low complication rate, we relieve TOT to be the ideal treatment of obese patients with SUI.

High-salt diet inhibits expression of angiotensin type 2 receptor in resistance arteries.

Recent studies suggested that type 2 angiotensin receptor (AT2R) could contribute to regulation of blood pressure and/or vascular remodeling. A key question relates to the effects of potential modulators of vascular AT2R expression. In the present work, we evaluated if high salt intake (70 mmol/L NaCl in drinking water) could modulate rat mesenteric artery AT2R function and expression. Angiotensin II dose-response curves were studied in rat perfused pressurized small-diameter arteries in the presence of losartan (AT1R antagonist). Arteries were precontracted with phenylephrine, yielding approximately 30% decrease in resting diameter. AT2R activation by angiotensin-induced dose-dependent relaxation of precontracted arteries (60.1+/-9.1% of phenylephrine-induced contraction, P<0.05). In contrast, AT2R-dependent relaxation was not observed in arteries obtained from rats on high-salt diet. Semi-quantitative reverse-transcription polymerase chain reaction experiments demonstrated reduced amount of AT2R mRNA in arteries of rats on high-salt diet (65.5+/-7.5% of control levels, P<0.05). Western blot studies demonstrated decreased AT2R in mesenteric artery protein fractions of high-salt diet rats (60.0+/-18.0 of control levels, P<0.05). In a second set of experiments, adrenalectomy (4 days) blunted AT2R-mediated vasorelaxation and decreased AT2R mRNA (72.0+/-11.0% of control levels, P<0.05). AT2R abundance in protein fractions of mesenteric arteries of ADX rats was also diminished (64.0+/-13% of control levels, P<0.05). Both, AT2R mRNA and protein downregulation were prevented by mineralocorticoid replacement therapy. Finally, physiological concentrations of aldosterone caused a dose-dependent increase in AT2R mRNA of small diameter mesenteric artery explants. The results are consistent with aldosterone-mediated upregulation AT2R.