Optical coherence tomography measures correlate with brain and spinal cord atrophy and multiple sclerosis disease-related disability.

BACKGROUND AND PURPOSE: Both optical coherence tomography (OCT) and magnetic resonance imaging (MRI) volumetric measures have been postulated as potential biomarkers of multiple sclerosis (MS)-related disability. The aim of the study was to investigate the association between OCT and brain volume and spinal cord area (SCA) parameters in patients with relapsing MS and to assess their independent associations with disability. METHODS: This was a cross-sectional analysis of 90 patients with MS who underwent OCT and MRI examination. Values of peripapillary retinal nerve fibre layer (pRNFL), ganglion cell/inner plexiform layer (GCIPL) and inner nuclear layer of eyes without previous optic neuritis were obtained. SCA and brain parenchymal fraction (BPF), grey and white matter fractions were obtained. Multivariable regression analyses were conducted with disability as dependent variable. RESULTS: Lower pRNFL thickness and lower GCIPL volume as well as lower BPF, grey matter fraction and SCA were associated with a longer disease duration and a higher Expanded Disability Status Scale score. Lower pRNFL thickness and GCIPL volumes were associated with lower BPF and SCA. In the multivariable logistic regression analyses, pRNFL thickness and GCIPL volume outperformed MRI in predicting disability. CONCLUSIONS: The OCT measures correlate with brain and spinal cord atrophy and appear more closely associated with disability than MRI volumetric measures.

Influence of Pectin as a green polymer electrolyte on the transport properties of Chitosan-Pectin membranes.

Novel blend membranes have been prepared from Chitosan (CH), Pectin (PEC) and their mixtures. The obtained samples were cross-linked and sulfonated before characterization. The results show that CH/PEC membranes display structural changes on the chemical and physical properties as a function of composition. DSC analysis reveals an endothermic peak due to the scission of the ionic pairs between carboxylic groups and ammonium groups, which produces a strong change on physical properties such as methanol permeability and proton conductivity. The methanol permeability decreases with the amount of Pectin from (4.24±0.04)×10-6cm2/s for pure Chitosan membrane to (1.51±0.03)×10-6cm2/s for blend CH/PEC membranes when the amount of Pectin is 50% (v/v). The proton conductivities of the blend membranes follow a similar behavior. For a pure CH membrane the conductivity is 2.44×10-3S/cm, decreasing with pectin content until the composition 50/50 (v/v), in which the conductivity drops almost one order of magnitude.

[Metaplastic carcinoma of the breast and the impact of the p63 and cytokeratin 5/6: experience of 40 patients]. / Carcinoma metaplásico de mama y repercusión de la expresión de p63 y citoqueratina 5/6: experiencia de 40 pacientes.

BACKGROUND: Metaplasic carcinoma of the breast was initially described by Huvos in 1974. It is a rare and aggressive entity characterized by the presence of mesenchymal and epithelial components. OBJECTIVE: To know the incidence and biologic behaviour of the metaplasic carcinoma of the breast at the Instituto de Enfermedades de la Mama, FUCAM, AC. METHODS: Data on women diagnosed with metaplasic carcinoma of the breast between January 2005 and December 2014 was collected by retrospectively reviewing in FUCAM. Clinical, pathological and immunohistochemical characteristics were assessed. The five-year disease-free survival (DFS) and overall survival (OS) were evaluated. RESULTS: a total of 4198 patients have been diagnosed with breast cancer in our institution, 40 (0.95%) of them with metaplasic carcinoma. The median age of the patients was 46 years (27-73). 60% of the patients were diagnosed with an advanced clinical stage (III) and the triple-negative subtype was the most frequently found. A mean follow-up of 24 months showed rates of overall survival and disease-free survival of 80% and 69.9%, respectively. The presence of both, cytokeratins 5/6 and p63, seems to have a negative impact in local recurrence. CONCLUSION: this study demonstrates that metaplasic carcinoma is a rare and aggressive disease. Expression of both tumor cytokeratins was associated with a worse outcome.

[Breast Cancer Survival: Clinical andPathological Prognostic Factors Analysis]. / Supervivencia de pacientes con cáncer de mama. Análisis por factores pronóstico, clínicos y patológicos.

Background: Breast cancer is the leading cause of cancer death in women in Mexico, is a heterogeneous disease, and knowledge of prognostic factors are critical in making treatment decisions. Objetive: determine the overall survival (OS) and disease-free survival (DFS) at 5 years, analyzed by risk groups. Material and methods: Patients diagnosed with breast treated at the Institute of Breast Diseases FUCAM from July 2005 to December 2014 were included. Simple frequencies were used for analysis of the general characteristics, and 5- year OS and DFS were analyzed using Kaplan-Meier curves. A subset analysis of the clinical stage and comparing survival in those patients diagnosed by mammography screening program was performed. Results: 4,902 patients with breast cancer were included, general clinical and pathological features are described and 3,762 patients were included for analysis of 5-year OS and DFS. The average age at diagnosis was 53.7 years; 13.3% were <40 years, which deleteriously reflects on the supervivencia global 76 vs 84% in >40. At diagnosis predominated locally advanced stages (45%), OS and DFS at 5 years was 96.8 ± 0.6% and 93.4%±0.9 respectively for early stages, 74.6 ± 1.7% and 68.7 ± 2% for locally advanced and 35.9 ± 5.1% and 37.4 ± 10.3% for metastatic tumors. Women diagnosed in the screening program had significantly better OS and DFS compared with symptomatic patients (95 and 93% vs 79 and 77%). For biological subtypes, OS and DFS was 89 and 84% for luminal, 81 and 81% for luminal Her +, 74 and 78% for pure Her 2, and 69 and 73% for triple negative. Conclusion: Knowledge of the prognostic factors that affect survival of patients with breast cancer is essential for categorizing risk groups and to individualize treatment in order to improve life expectancy.

Piriformospora indica antagonizes cyst nematode infection and development in Arabidopsis roots.

The beneficial endophytic fungus Piriformospora indica colonizes the roots of many plant species, including the model plant Arabidopsis thaliana. Its colonization promotes plant growth, development, and seed production as well as resistance to various biotic and abiotic stresses. In the present work, P. indica was tested as potential antagonist of the sedentary plant-parasitic nematode Heterodera schachtii. This biotrophic cyst-forming nematode induces severe host plant damage by changing the morphogenesis and physiology of infected roots. Here it is shown that P. indica colonization, as well as the application of fungal exudates and cell-wall extracts, significantly affects the vitality, infectivity, development, and reproduction of H. schachtii.

A new era in the treatment of melanoma: from biology to clinical practice.

Melanoma is the deadliest cutaneous malignancy and its incidence continues to grow. Until 2011, the treatment options for metastatic melanoma were scarce and without any overall survival benefit. The emergence of new targeted therapies for BRAF mutant melanoma (vemurafenib) and immunotherapy (ipilimumab) has changed the standard of care for this disease. The objective of the present review is to summarise the biological background of the new therapeutic approaches in melanoma, focusing on apoptosis resistance, immune modulation and angiogenesis, and the direct translation into clinical practice.

A new era in the treatment of melanoma: from biology to clinical practice

Melanoma is the deadliest cutaneous malignancy and its incidence continues to grow. Until 2011, the treatment options for metastatic melanoma were scarce and without any overall survival benefit. The emergence of new targeted therapies for BRAF mutant melanoma (vemurafenib) and immunotherapy (ipilimumab) has changed the standard of care for this disease. The objective of the present review is to summarise the biological background of the new therapeutic approaches in melanoma, focusing on apoptosis resistance, immune modulation and angiogenesis, and the direct translation into clinical practice (AU)

Esferocitosis hereditaria: presentación y evolución en un lactante menor: reporte de un caso / Hereditary spherocytosis: presentation and evolution in an infant: report of a case

Introducción: La esferocitosis hereditaria es la causa más común de anemia hemolítica crónica en Estados Unidos y Europa, con una incidencia de 1 cada 5.000 nacimientos. Se debe a una alteración de la membrana eritrocitaria. Los pacientes afectados pueden permanecer asintomáticos, con una hemólisis mínima, o desarrollar una anemia hemolítica severa. Presentación del caso: Lactante menor de 3 meses, con antecedentes de ictericia neonatal prolongada hasta la fecha de la consulta en policlínico de San Ignacio por regurgitación postprandial. Se realiza hemograma por presentar intensa palidez e ictericia, detectándose anemia severa, signos de hemólisis de eritrocitos e hiperbilirrubinemia de tipo indirecta. Se decide su hospitalización en Hospital Clínico Herminda Martin (HCHM), encontrándose hipoactivo, sin otros síntomas. Se transfunden 50cc de glóbulos rojos, evolucionando favorablemente. Durante la hospitalización se averigua el antecedente de prima que hace 6 años fue esplenectomizada por cuadros de anemia hemolítica recurrente durante 5 años. Se decide alta, tratamiento con ácido fólico e interconsulta con hematólogo. Discusión: Aunque la esferocitosis hereditaria se trata de la anemia hemolítica congénita más frecuente en Chile, su diagnóstico se dificulta de no conocerse antecedentes familiares o si no existe reticulocitosis ni esplenomegalia (como en este caso), lo que lleva a pensar en otras causas de anemia. Por esto, fue de importancia el antecedente familiar conocido tras su ingreso, pues orientó a un diagnóstico que en este caso no tenía una presentación típica.

Introduction: Hereditary spherocytosis is a common cause of hemolytic anemia due to an alteration of the erythrocyte membrane. Affected patients can remain asymptomatic, with a minimum hemolysis, or develop a severe hemolytic anemia. It is transferred as an autosomal dominant disease, less frequent as an autosomal recessive one, or with no medical history in the family. Case report: 3 month-old infant, with a medical history of neonatal ictericy lengthy so far, consultation at San Ignacio polyclinic because of a postprandial regurgitation, a hemogramis carried out by presenting intense paleness and ictericy, detecting severe anemia and indirect hyperbilirubinemia. It is decided to hospitalize him into Herminda Martin Clinic Hospital, being hypoactive, with no other symptoms. 50 cc red corpuscles are transfused, progressing favorably. During hospitalization it is found out the medical history of a cousin who was splenectomized due to hemolytic anemia symptoms recurring for 5 years. It is decided the discharge with a folic acid treatment and an interconsult with a hematologist. Discussion: Although the hereditary spherocytosis is the congenital hemolytic anemia more frequent in Chile, its diagnosis turns more complicated for an unknown medical history in the family, or if it does not present reticulocytosis nor splenomegaly (as in this case), which leads to think of other causes of anemia. Because of that it was very important the medical history of the family known after his admission into the hospital, because it directed towards a diagnosis that in this case did not have a typical presentation.

Ecocardiografía fetal en el Plan Auge Servicio Salud Ñuble-2005 / Fetal echocardiography in the Plan Auge Health Service Ñuble-2005

La implementación del Plan de Acceso Universal y de garantías explícitas (Plan AUGE) del Ministerio de Salud de Chile, ha generado un cambio profundo en el quehacer de la medicina en nuestro país. Uno de los temas prioritarios en este nuevo sistema, es el diagnóstico precoz de las cardiopatías congénitas operables. En este trabajo se presenta la experiencia del semestre enero-junio del 2005, que ha permitido mejorar el diagnóstico precoz de la patología cardiaca fetal y en ello una mejora en la calidad de atención y de referencia a centros terciarios.

On-line preconcentration/determination of copper in parenteral solutions using activated carbon by inductively coupled plasma optical emission spectrometry.

A method for the on-line preconcentration of copper using a minicolumn packed with activated carbon and its subsequent determination by inductively coupled plasma optical emission spectrometry (ICP-OES) coupled with flow injection (FI) was studied. In order to determinate the copper concentration present in parenteral solutions; it was retained on activated carbon (AC) at pH 9.5. A sensitivity enrichment factor of 30-fold was obtained with respect to the copper determination by ICP-OES without preconcentration. The detection limit for the preconcentration of 25 ml of sample was 0.1 microgl(-1). The precision for the ten replicate determinations at the 2.5 microgl(-1) Cu level was 3.0% relative standard deviation (R.S.D.), calculated with the peak heights. The calibration graph using the preconcentration method for cooper species was linear with a correlation coefficient of 0.9996 at levels near the detection limits up to at least 200 microgl(-1). The method was successfully applied to the determination of copper in parenteral solutions.

Mitochondrial diseases in children: neuroradiological and clinical features in 17 patients.

Mitochondrial diseases result from structural, biochemical or genetic defects of mitochondria, which contain the respiratory chain. They usually affect children and young adults. We report the CT and MRI findings in 17 patients under 14 years of age, the youngest reported to date, with various mitochondrial diseases. Although imaging studies may be normal negative in the early stages, follow-up usually shows many abnormalities, which depend on clinical status and the disease. We have recognised a spectrum of findings that can be divided into four patterns: nonspecific myelin lesions (8/17); grey-matter nuclei involvement (6/17); a leukodystrophic pattern; and calcification of the brain (1/17), although mixed forms, particularly myelin and grey-matter lesions are frequent.