Role of hyperthermic intraperitoneal chemotherapy in ovarian cancer.

Epithelial ovarian cancer (EOC), has the highest worldwide mortality of all gynecological tumors, in 75% of cases is diagnosed in advanced stages. Despite of treatments with maximal cytoreductive surgery (CRS) and platinum-based chemotherapy (CT), approximately 70% of patients with advancedstage disease relapse within 18 months, given this high number of recurrences, new approaches are needed to improve outcomes for these patients. Hyperthermic intraperitoneal chemotherapy (HIPEC) has fundamentally changed the treatment of patients with ovarian cancer, with complete CRS and locoregional administration of chemotherapy. The purpose of this review is to find the most relevant, reliable published evidence of the use of HIPEC in ovarian cancer, together with an overview of peritoneal carcinomatosis (PC), procedures, therapeutic approaches in first-line and recurrent disease, the benefit of hyperthermia, selection of the ideal patient for the HIPEC procedures as well to analyze the disease free survival (DFS), morbidity, mortality and overall survival (OS) in patients with ovary cancer. So far, the small amount of evidence points favorably to the use of CRS and HIPEC as a first line of therapy, but more prospective randomized trials are needed to officially adopt this procedure as a standard of care, additionally patients need to know this option exists.

Effects of azinphos-methyl on enzymatic activity and cellular immune response in the hemolymph of the freshwater snail Chilina gibbosa.

The use of a battery of biomarkers, especially those more closely related to species integrity, is desired for more complete ecotoxicological assessments of the effects of pesticide contamination on aquatic organisms. The phosphorodithioate azinphos-methyl has been intensively used in agriculture worldwide and have been found in the habitat of Chilina gibbosa, a freshwater snail endemic to South America. This snail has been proposed as a good model organism for ecotoxicity bioassays on the basis of studies focused mainly on enzymatic responses in whole tissue homogenates. Our aim was to evaluate the effect of an acute 48 h exposure to an environmental concentration of azinphos-methyl on C. gibbosa hemolymph enzymatic activity and cellular immune response. Our results show that cholinesterase activity was strongly inhibited (94%) in hemolymph of exposed snails. Carboxylesterase activity measured with p-nitrophenyl butyrate and glutathione S-transferase activity were augmented 47% and 89% respectively after exposure. No differences were found for hemolymph carboxylesterase activity measured with p-nitrophenyl acetate. These results differ from those reported for whole tissue homogenates and reveal that tissue-specific responses of enzymatic biomarkers exist in this species. Regarding immune cell response, hemocytes were identified for the first time for C. gibbosa. Their viability and phagocytic activity decreased after azinphos-methyl exposure although total number of circulating cells did not differ between treatments. We conclude that concentrations of azinphos-methyl that can be found in the environment can compromise both hemolymph cholinesterase activity and the immune system of C. gibbosa. Furthermore, we propose that carboxylesterase and glutathione S-transferase activities measured in hemolymph and hemocyte viability and phagocytic activity could be incorporated as sensitive biomarkers to evaluate the effects of pesticide exposure on this and related species.

Immune and biochemical responses in hemolymph and gills of the Patagonian freshwater mussel Diplodon chilensis, against two microbiological challenges: Saccharomyces cerevisiae and Escherichia coli.

Immune cell characterization, immunological response and the associated gill oxidative balance were studied in the Patagonian freshwater mussel, Diplodon chilensis, using two microbiological immunostimulant models: Saccharomyces cerevisiae and Escherichia coli. Mussels were collected out of the breeding season in Paimún Lake and acclimated in the laboratory. Two exposure experiments were performed during two consecutive weeks: (1) mussels challenged with 500 yeast cells mL-1; and (2) mussels challenged with 1000 bacteria cells mL-1. Microorganisms were added in the water every two days, alternating with 6000 lyophilized cells of the green algae Scenedesmus vacuolatus mL-1. A control group, fed with S. vacuolatus, was set for each treatment. Morphological cell characterization was carried out in adherent hemocytes of D. chilensis hemolymph under control conditions. The most important cell type observed were the hyalinocytes (representing ca. 98% of the circulating cells), agranular cells with non-central polymorphic nucleus surrounded by cytoplasm; granulocytes (cells with cytoplasmic granules and non-central rounded nucleus) represented ca. 2%. Another two cell types were occasionally detected, binucleated hyalinocytes and hemoblast-like cells but were not considered for the analyses. Both adherent hyalinocytes and granulocytes exhibit phagocytic activity towards Congo red stained yeast, which was two-fold higher in granulocytes than in hyalinocytes, regardless of the applied challenge. Total hemocyte counts were diminished in mussels challenged with S. cerevisiae or E. coli. Hydrolytic and defense cellular enzyme activities were analyzed only for hyalinocytes. Both, S. cerevisiae and E. coli increased acid phosphatase activity. E. coli challenge diminished hemocyte lysosomal membrane stability and increased humoral phenoloxidase activity, while S. cerevisiae challenge did not affect any of these variables. Mussels challenged with E. coli showed increased gill antioxidant response without oxidative damage, while those challenged with S. cerevisiae showed no change in these variables.

Modulation of immune and antioxidant responses by azinphos-methyl in the freshwater mussel Diplodon chilensis challenged with Escherichia coli.

The aim of the present study was to characterize the immune response-total hemocyte number, cell type proportion, hemocyte viability, lysosomal membrane stability, phagocytic activity, cellular acid and alkaline phosphatase activity, and humoral bacteriolytic and phenoloxidase activity--in Diplodon chilensis exposed to 0.2 mg/L of azinphos-methyl (AZM), using Escherichia coli as immunological and pro-oxidant challenges. In addition, glutathione-S-transferase and lipid peroxidation thiobarbituric acid reactive substances were analyzed in gill tissue. Mussels from an unpolluted site were treated for 3 d as follows: 1) experimental control; 2) solvent effects control (acetone 0.01%); 3) bacterial challenge effects control (E. coli, 5 cells/mL × 104 cells/mL); 4) pesticide effects control (AZM in acetone); 5) control for combined effects of solvent and bacterial challenge; and 6) exposed to AZM, then challenged with E. coli. The results showed increased granulocyte proportion and phagocytic activity. Partial reversion of deleterious effects of E. coli on lysosomal membranes was observed in mussels exposed to AZM and then challenged with E. coli. Total hemocyte number and humoral bacteriolytic activity were increased only by E. coli challenge. Acid phosphatase activity was increased by both E. coli and AZM, whereas the stimulating effect of E. coli on alkaline phosphatase activity was negatively modulated by AZM. Azinphos-methyl inhibited phenoloxidase activity regardless of the E. coli challenge. Gill glutathione-S-transferase activity was increased by E. coli treatment either alone or pretreated with acetone or AZM and by AZM alone. Thiobarbituric acid reactive substance levels were reduced by AZM alone or combined with the E. coli challenge and by acetone followed by the E. coli challenge. Both acetone and AZM seem to be important modulators of immune and antioxidant responses in D. chilensis. Environ Toxicol Chem 2017;36:1785-1794. © 2016 SETAC.

Children and Adolescent Obesity Associates with Pressure-Dependent and Age-Related Increase in Carotid and Femoral Arteries' Stiffness and Not in Brachial Artery, Indicative of Nonintrinsic Arterial Wall Alteration.

Aim. To analyze if childhood obesity associates with changes in elastic, transitional, and/or muscular arteries' stiffness. Methods. 221 subjects (4-15 years, 92 females) were assigned to normal weight (NW, n = 137) or obesity (OB, n = 84) groups, considering their body mass index z-score. Age groups were defined: 4-8; 8-12; 12-15 years old. Carotid, femoral, and brachial artery local stiffness was determined through systodiastolic pressure-diameter and stress-strain relationships. To this end, arterial diameter and peripheral and aortic blood pressure (BP) levels and waveforms were recorded. Carotid-femoral, femoropedal, and carotid-radial pulse wave velocities were determined to evaluate aortic, lower-limb, and upper-limb regional arterial stiffness, respectively. Correlation analysis between stiffness parameters and BP was done. Results. Compared to NW, OB subjects showed higher peripheral and central BP and carotid and femoral stiffness, reaching statistical significance in subjects aged 12 and older. Arterial stiffness differences disappeared when levels were normalized for BP. There were no differences in intrinsic arterial wall stiffness (elastic modulus), BP stiffness relationships, and regional stiffness parameters. Conclusion. OB associates with BP-dependent and age-related increase in carotid and femoral (but not brachial) stiffness. Stiffness changes would not be explained by intrinsic arterial wall alterations but could be associated with the higher BP levels observed in obese children.

Tiempo libre en adolescentes escolarizados de dos clases sociales de Costa Rica / Tempo livre em adolescentes estudantes de duas classes sociais de Costa Rica / Leisure time among adolescents students from two social classes of Costa Rica

Este artículo indaga la relación entre tiempo libre, clase social y género en adolescentes costarricenses de educación secundaria. Se aplicó un cuestionario a 219 adolescentes de Costa Rica, entre los 16 y 17 años, de una institución educativa pública y una institución educativa privada. Los resultados muestran diferencias de clase y género pertinentes en la organización del tiempo libre. Las diferencias se asocian con la estructuración capitalista del género y los efectos conexos de la industria cultural y la dominación social. Los resultados son una contribución al estudio de los nuevos patrones de reproducción capitalista en la vida cotidiana.

Este estudo analisa a relação entre tempo livre, classe social e gênero em adolescentes costarriquenhos, de educação secundarista. Aplicouse um questionário a 219 adolescentes de Costa Rica, entre 16 e 17 anos, de uma instituição educativa pública e de uma instituição educativa privada. Os resultados mostram diferenças de classe e gênero pertinentes na organização do tempo livre. As diferenças estão associadas com a estruturação capitalista do gênero e os efeitos conexos da indústria cultural e da dominação social. Os resultados são uma contribuição ao estudo dos novos padrões de reprodução capitalista na vida cotidiana.

This study inquires the relationship between leisure time, social class and gender among Costa Rican high school adolescents. A survey was administered to 219 Costa Rican adolescents, between 16 and 17 years old, recruited from a public and a private educational institution. Results show relevant differences across class and gender in the organization of leisure time. Such differences are associated with the capitalistic structuration of gender as well as the related impact of the cultural industry and the social domination. These results are a contribution to the study of the new patterns of the capitalistic reproduction in everyday life.

[Open splenectomy: ten-year experience in an oncological referral center]. / Esplenectomía a cielo abierto. Experiencia de 10 años en un centro oncológico.

BACKGROUND: Open splenectomy is a useful procedure for some diseases with splenomegaly >1500 g. We undertook this study to evaluate open splenectomy morbidity and mortality at the Instituto Nacional de Cancerologia in Mexico City. METHODS: We reviewed the clinical files of patients with benign and malignant hematological diseases, as well as other diseases, who underwent splenectomy from 1994 to 2005. RESULTS: Twenty five patients with a mean age of 38.5 years were submitted for open splenectomy. Splenomegaly was found in 12 patients (48%). The most frequent abdominal wall incision was transverse left subcostal (64%). Average surgical time was 125 min, bleeding 485 ml, spleen weight 1553.6 g and mean size 15 x 11 x 12 cm. Mean hospital stay was 7.5 days. Eighteen patients (72%) did not have immediate complications. One patient (4%) developed surgical wound infection, two patients (8%) had significant pain, three patients (12%) had bleeding and one patient (4%) developed intraabdominal fluid collection. Twenty one patients (84%) did not have further complications. One patient (4%) developed multiple organ failure, another patient (4%) developed thrombocytopenia and another (4%) developed severe pain. During an average 81-month follow-up we found 14 patients (56%) asymptomatic, two patients (8%) with documented tumoral activity (angiosarcoma and non-Hodgkin's lymphoma) and one patient (4%) developed a second neoplasm. Six patients (24%) died due to underlying disease (chronic myeloid leukemia and lymphoma), one patient (4%) with active disease (Hodgkin's disease) and one patient (4%) died due to other causes. CONCLUSIONS: With a spleen >1500 g, open surgery offers better visibility and, in fact, less morbidity and mortality.

[Maffucci's syndrome. Case reports and literature review]. / Síndrome de Maffucci. Informe de dos pacientes y revisión de la literatura.

Maffucci syndrome is a rare, congenital disease, which is associated with the appearance of multiple enchondromas (possibility of malignant transformation in 20 to 100%), soft tissue hemangiomas and other mesenchymatous injuries. Case 1 is a 33-year-old female who presented with multiple nodules predominantly in upper extremities. Upon examination, there was deformity in articulation and nodules on the hands, which were soft and moveable. There were bony shavings in the second and fourth fingers of the left hand (enchondromas and atypical cells associated with hemangioma esclerosante). Maffucci syndrome was diagnosed. Later, excision of subcutaneous nodules in superior extremities was performed along with excision of nodules in both hands and hypochondrium (enchondroma injuries of left hand and hypochondrium, hemangioma in right hand). There was dysarticulation of the second finger at the metacarpal level of the phalanges of the left hand (chondrosarcoma). The patient is being followed up currently. Case 2 is a 26-year-old female. The patient had a history of subcutaneous abdominal tumor, exostosis, nodules and nodule in right breast. Upon examination, a tumor was found in the right breast, exostosis of right tibia, injury to the right wrist and left thyroid nodule. A simple mastectomy and axillary dissection was performed (fibroadenoma to intracanalicular and 14 negative lymph nodes). Later, left thyroidectomy and lumpectomy in right wrist were performed (hyperplasia to nodular thyroid and hemangioma cavernous). There was injury in the carpus of the right hand and elbow (hemangioma cavernous and synovial tissue with fibrosis and enchondroma). A diagnosis was made of Marffucci syndrome associated with mesenchymatous tumors. The patient was in poor general health and did not survive this hospitalization.

Adjusted carbohydrate antigen 19-9. Correlation with histological grade in pancreatic adenocarcinoma.

BACKGROUND: The serum level of carbohydrate antigen 19-9 (CA 19-9) depends on the tumor size and differentiation grade. Jaundice can cause an elevation of serum CA 19-9, although the nature of this interaction is not fully understood. PATIENTS AND METHODS: This was a retrospective study of 26 patients with potentially resectable pancreatic adenocarcinoma. Serum CA 19-9 was correlated with the histological differentiation. CA 19-9 adjusted for serum bilirubin was determined and analyzed. RESULTS: No correlation between CA 19-9 and histological differentiation was determined (p>0.05). The median adjusted CA 19-9 level was significantly lower (p=0.01) in patients with normal biliary excretion than those with bilirubin levels >2 mg/dL. CONCLUSION: These data are consonant with the theory of a dual contribution to the serum CA 19-9 level from biliary obstruction and tumor cell synthesis.

Angiomiolipoma de hígado no asociado a esclerosis tuberosa / Liver angiomyolipoma non associated to tuberous sclerosis

El angiomiolipoma es un tumor benigno del hígado poco frecuente. Se presenta el caso de una paciente de 32 años de edad, a quien se le realizó ultrasonido abdominal por sospecha de embarazo, detectándose masa hiperecoica en el lóbulo izquierdo del hígado, misma que se corroboró por tomografía. La biopsia percutánea reportó neoplasia maligna compatible con liposarcoma, por lo que se decidió realizar laparotomía exploradora, efectuando resección hepática, que evolucionó sin complicaciones. El informe anatomopatológico fue de angiomiolipoma de hígado. Este caso demuestra la dificultad para realizar el diangóstico preoperatorio de lesiones grasas en hígado, por lo que se revisó la literatura y se discutió el diagnóstico, así como el tratamiento de estas lesiones