Simulated Performance of Laser-Machined Metamaterial Anti-reflection Coatings.

Lenslet-coupled antenna arrays have been used in CMB experiments and are the baseline technology for the next-generation satellite missions such as LiteBIRD and PICO. Lenslets are small hemispherical lenses mounted on the focal plane that couple light to the detectors and are typically made of silicon or alumina due to their high focusing power and low absorption loss. To minimize reflection at the vacuum-dielectric interface, lenslets require anti-reflection (AR) coatings. Metamaterials have been used in large microwave optical components because they avoid any mismatch on the thermal expansion between the lens and its coating, but so far they have only been machined on surfaces of comparatively large radius of curvature. As a first step to understand the feasibility of machining metamaterial AR layers in lenslets through laser-etching for the LiteBIRD mission, a model in ANSYS HFSS was developed. The goal of the simulation was to optimize transmission in three frequency bands while meeting assumed laser machinability constraints and optical requirements. Simulation results from flat silicon show that an AR metamaterial coating made under the assumed conditions is feasible, and the baseline parameters for further curved-surface studies are provided.

Antiparasitic Effects of Asteraceae Species Extracts on Echinococcus granulosus s.s.

Cystic echinococcosis is a zoonotic disease caused by the parasite Echinococcus granulosus sensu lato (s.l.), which is worldwide distributed and causes long-lasting infections in animals and humans. The existing treatment is limited to the use of benzimidazoles, mainly albendazole (ABZ). However, it has unwanted side effects and its efficacy is about 50%. The Asteraceae family includes plants that have therapeutic applications (medicinal species) and has an important role in new drug development. The species belonging to a different genus of this family show a wide range of anti-inflammatory, antimicrobial, antioxidant, hepatoprotective, and antiparasitic activities, among others. The aim of the present study was to evaluate the in vitro efficacy of extracts of four Asteraceae species against protoscoleces of E. granulosus sensu stricto (s.s.). On the other hand, the Stevia aristata extract was assessed on the murine cyst of E. granulosus (s.s.) and the efficacy of S. aristata extract was investigated in a murine model of CE. Stevia satureiifolia, S. aristata, Grindelia pulchella, and G. chiloensis extracts at 100 µg/mL caused a decrease in protoscoleces viability; however, S. aristata extract produced the greatest in vitro protoscolicidal effect. After 20 days of treatment with the highest concentration (100 µg/mL) of S. aristata extract, protoscoleces viability decreased to 0%. The tegumental changes observed by scanning electron microscopy were consistent with the reduction in vitality. The collapse of the germinal layer was registered in 60 ± 5.8% and 83.3 ± 12.0% of cysts treated during 4 days with 50 and 100 µg/ml, respectively. The half maximal effective concentration (EC50) value of the S. aristata extract against E. granulosus (s.s.) cysts was 47.86 µg/mL (96 h). The dosage of infected animals with the 50 mg kg-1 dose of S. aristata extract resulted in a significant reduction in cyst weight in comparison with the control group. In conclusion, S. aristata extract was demonstrated to exert a marked effect, both in vitro and in the murine model.

Anthelmintic activity of Stevia multiaristata extract against Echinococcus granulosus sensu stricto.

Cystic echinococcosis is a zoonotic disease caused by the larval stage of the parasite Echinococcus granulosus sensu lato. The available anti-parasitic treatment is mostly limited to a continuous administration of albendazole. However, due to its numerous side-effects and efficacy of around 50%, there is a need to find new drugs to improve the treatment for this disease. In the current study, the in vitro and in vivo efficacy of a Stevia multiaristata extract against E. granulosus sensu stricto (s.s.) was demonstrated. Stevia multiaristata extract (100 and 50 µg mL−1) caused a quick viability decrease on protoscoleces which was consistent with the observed tegumental alterations. Loss of turgidity was detected in 95 ± 3.4% of cysts incubated with S. multiaristata extract during 2 days (100 µg mL−1) and the collapse of the germinal layer was observed in 60 ± 9.3% of cysts treated with 100 µg mL−1 of the S. multiaristata extract during 4 days. The half maximal effective concentration value was 69.6 µg mL−1 and the selectivity index for E. granulosus s.s. cysts was 1.9. In this clinical efficacy study, the treatment of infected mice with the S. multiaristata extract (50 mg kg−1) caused a significant decrease in the weight of the cysts compared with the control group. These results coincided with the tissue damage observed in the cysts at the ultrastructural level. In conclusion, we observed high protoscolicidal and cysticidal effects, and significant reduction in the weight of the cysts in experimentally infected mice following treatment with the S. multiaristata extract.

Characterization of neurogenic niches in the telencephalon of juvenile and adult sharks.

Neurogenesis is a multistep process by which progenitor cells become terminally differentiated neurons. Adult neurogenesis has gathered increasing interest with the aim of developing new cell-based treatments for neurodegenerative diseases in humans. Active sites of adult neurogenesis exist from fish to mammals, although in the adult mammalian brain the number and extension of neurogenic areas is considerably reduced in comparison to non-mammalian vertebrates and they become mostly reduced to the telencephalon. Much of our understanding in this field is based in studies on mammals and zebrafish, a modern bony fish. The use of the cartilaginous fish Scyliorhinus canicula (representative of basal gnathostomes) as a model expands the comparative framework to a species that shows highly neurogenic activity in the adult brain. In this work, we studied the proliferation pattern in the telencephalon of juvenile and adult specimens of S. canicula using antibodies against the proliferation marker proliferating cell nuclear antigen (PCNA). We have characterized proliferating niches using stem cell markers (Sex determining region Y-box 2), glial markers (glial fibrillary acidic protein, brain lipid binding protein and glutamine synthase), intermediate progenitor cell markers (Dlx2 and Tbr2) and markers for migrating neuroblasts (Doublecortin). Based in the expression pattern of these markers, we demonstrate the existence of different cell subtypes within the PCNA immunoreactive zones including non-glial stem cells, glial progenitors, intermediate progenitor-like cells and migratory neuroblasts, which were widely distributed in the ventricular zone of the pallium, suggesting that the main progenitor types that constitute the neurogenic niche in mammals are already present in cartilaginous fishes.

Serum biochemical profile, enzymatic activity and lipid peroxidation in organs of laying hens fed diets containing cashew nut shell liquid.

The objective of this study was to evaluate the effect of feeding laying hens diets containing cashew nut shell liquid (CNSL) as a source of anacardic acid on the blood biochemical parameters as well as the enzymatic activity and lipid peroxidation of liver and tissues of the reproductive system (ovary, magnum, and uterus). A total of 216 Hisex White commercial laying hens were distributed randomly into six treatments, with six replicates of six birds. Treatments consisted of a diet without growth promoter (GP); a diet with GP; and diets without GP, with addition of increasing levels of CNSL (0.25, 0.50, 0.75 and 1.0%). Addition of CNSL to the diet did not affect the blood biochemical parameters (uric acid, creatinine, alanine aminotransferase, aspartate aminotransferase, total cholesterol, high density lipoproteins, low-density lipoproteins and triglycerides), the enzymatic activity (superoxide dismutase and nonprotein sulphydryl groups) in the organs (liver, ovary, magnum and uterus) or the peroxidation of lipids from the blood serum, liver, magnum and uterus (p > 0.05). However, the addition of 0.75% and 1.00% CNSL provided a lower thiobarbituric acid reactive substances content in the birds' ovary (p < 0.001) compared to birds of other treatments, whereas the treatment without the GP provided a higher value. Addition of up to 1% of the CNSL as a source of anacardic acid in the laying hens' diets does not influence blood biochemical parameters or the endogenous enzymatic activity in the liver, ovary, magnum and uterus, but affects the lipid peroxidation in the ovary, although the problem is reduced from the inclusion of 0.75% CNSL.

Dichloroacetate affects proliferation but not survival of human colorectal cancer cells.

Dichloroacetate (DCA) is a metabolic reprogramming agent that reverses the Warburg effect, causing cancer cells to couple glycolysis to oxidative phosphorylation. This has been shown to induce apoptosis and reduce the growth of various types of cancer but not normal cells. Colorectal cancer cells HCT116, HCT116 p53(-/-), and HCT116 Bax(-/-), were treated with DCA in vitro. Response to treatment was determined by measuring PDH phosphorylation, apoptosis, proliferation, and cell cycle. Molecular changes associated with these responses were determined using western immunoblotting and quantitative PCR. Treatment with 20 mM DCA did not increase apoptosis, despite decreasing levels of anti-apoptotic protein Mcl-1 after 6 h, in any of the cell lines observed. Mcl-1 expression was stabilized with MG-132, an inhibitor of proteasomal degradation. A decrease in Mcl-1 correlated with a decrease in proliferation, both of which showed dose-dependence in DCA treated cells. Cells showed nuclear localization of Mcl-1, however cell cycle was unaffected by DCA treatment. These data suggest that a reduction in the prosurvival Bcl-2 family member Mcl-1 due to increased proteasomal degradation is correlated with the ability of DCA to reduce proliferation of HCT116 human colorectal cancer cells without causing apoptosis.

Isolation and pathogenicity of Toxoplasma gondii in naturally infected (rustic farm) pigs in southern Brazil.

This study reported a serological test for Toxoplasma gondii infection in 100 pigs from 58 rural farms in the state of Rio Grande do Sul, Brazil. Thirty-six pigs were seropositive (IFAT≥1:64). Bioassays were performed for all 36 seropositive pigs, and 17 isolates were obtained (47.2%). Seven of these isolates (41.2%) were highly pathogenic to mice, as clinical signs of acute infection were observed, and tachyzoites were found in the peritoneal exudates, livers, and lungs. The remaining 10 isolates were able to establish a chronic infection in mice, therefore, they were not highly virulent. The results of this study indicate that pork is a potential source of T. gondii transmission to humans.

Parasitism of gallus gallus (linnaeus, 1758) by species of phthiraptera on free-range chickens in the southern region of Rio Grande do Sul, Brazil / Parasitismo de Gallus Gallus (Linnaeus, 1758) por espécies de Phthiraptera em criações coloniais na região sul do Rio Grande Do Sul, Brasil

This study was conducted in order to identify the species of biting lice (order Phthiraptera: Amblycera suborders and Ischnocera) that infest free-range chickens in southern Rio Grande do Sul, Brazil. Fifty adult females from 10 farms located in 5 different municipalities were examined for ectoparasites. The chickens were euthanized and then washed with water and detergent for the collection of ectoparasites by filtration using a 150-µm mesh sieve, then separated into pellet and supernatant, which were preserved in ethanol 70% for the screening procedures and identification. A total of 19,437 lice were examined, presenting the following breakdown by species: Menopon gallinae (85.9%), Goniodes dissimilis (6.1%), Lipeurus caponis (3.0%), Goniocotes gallinae (2.5%), Menacanthus pallidus (2.1%) and Menacanthhus stramineus (0.1%). It was found that all the chickens examined were parasitized by one or more species of Phthiraptera, the multiple and moderate level of infestation (101 to 1,000 lice/chicken) being the most frequent. M. gallinae was the most frequent and abundant species (100% of the chickens parasitized and an average of 334.1 lice/chicken). The degree of infestation of chickens varied among the farms, averaging 41.2 to 680 lice/chicken.

Este estudo foi realizado com o objetivo de conhecer os piolhos (ordem Phthiraptera: Subordens Amblycera e Ischnocera) infestantes de galinhas de criações coloniais no Sul do Rio Grande do Sul. Cinquenta fêmeas adultas foram examinadas, de 10 propriedades rurais localizadas em 5 diferentes municípios. As aves foram eutanasiadas e posteriormente lavadas com água e detergente para coleta dos ectoparasitos através de filtragem por passagem em tamis com malha de 150 µm, separando-se em sedimento e sobrenadante, os quais foram preservados em etanol 70% até os processos de triagem e identificação. Cerca de 19.437 piolhos foram examinados e apresentaram a seguinte composição específica: os resultados indicam que a fauna de Phthiraptera em galinhas caipiras na região é composta por: Menopon gallinae (85,9%), Goniodes dissimilis (6,1%), Lipeurus caponis (3,0%), Goniocotes gallinae (2,5%), Menacanthus pallidus (2,1%) e Menacanthus stramineus (0,1%). Constatou-se que todas as aves examinadas estavam parasitadas por uma ou mais espécies de Phthiraptera, com predomínio de infestações múltiplas e moderadas (101 a 1.000 piolhos/ave). M. gallinae é a espécie mais prevalente e abundante (100% das aves parasitadas e média de 334,1 espécimes/ave). O grau de infestação das aves variou entre as propriedades, com médias de 41,2 a 680 piolhos/ave.

Efecto de la dieta en psoriasis moderada a severa, en pacientes con sobrepeso y obesos con tratamiento tópico y sistémico con metotrexato / Effect of diet on moderate or severe psoriasis in patients with obese and overweight under treatment with topical and systemic methotrexate

INTRODUCTION: Psoriasis is a chronic inflammatory disease with significant impact on quality of life. There are environmental factors that can change the course of the disease. OBJECTIVE: To investigate whether moderate weight loss, improves response to methotrexate in obese or overweight patients who suffer from the disease. METHODOLOGY: A controlled pilot project of 8 weeks was performed in 15 patients with moderate to severe psoriasis under treatment with Methotrexate and topical therapy. The intervention corresponded to a nutritional assessment, a strict diet and physical activity suggestion. Patients were evaluated using PASI, at 0, 4 and 8 weeks. RESULTS: After 8 weeks, mean PASI decreased by 13% and a decrease in weight, BMI and waist circumference was achieved, but without statistical significance. CONCLUSION: Further studies are required to demonstrate the importance of weight loss in obese or overweight psoriatic patients under methotrexate treatment.

INTRODUCCIÓN: La Psoriasis es una enfermedad inflamatoria crónica con importante impacto en la calidad de vida.Existen factores ambientalesque pueden modificar el curso de la enfermedad. OBJETIVO: Investigar si una pérdida moderada de peso, aumenta la respuesta a Metotrexato en pacientes obesos o con sobrepeso que padecen la enfermedad. METODOLOGÍA: Proyecto Piloto, controlado, de 8 semanas en 15 pacientes con psoriasis moderada a severa,en tratamiento con Metotrexato y terapia tópica, atendidos en Santiago de Chile. La intervención correspondió a una evaluación nutricional, una dieta estricta y sugerencia de actividad física. Los pacientes fueron evaluadas con PASI, a las 0, 4 y 8 semanas. RESULTADOS: Después de 8 semanas, se logró una disminución del PASI promedio en un 13% y una disminución del peso, IMC y circunferencia abdominal, pero sin significancia estadística. CONCLUSIÓN: Se requieren realizar estudios con un mayor número de pacientes para demostrar la importancia de una disminución de peso en el tratamiento con metotrexato en pacientes psoriáticos obesos o con sobrepeso.

[AA amyloidosis with cutaneous manifestations. Report of one case]. / Manifestaciones cutáneas de amiloidosis sistémica como clave diagnóstica. Caso clínico.

BACKGROUND: Systemic amyloidosis is a rare disease that can affect any organ. Its clinical manifestations are varied and nonspecific. The skin involvement of this disease is common and can be easily recognized on physical examination. We report a 57-year-old male presenting with a two years history of malaise, dyspnea and myalgias. On physical examination, ungueal dystrophy, orange pigmentation of eyelids with periocular petechiae and mild macroglossia were observed. Incisional biopsies of the eyelids, cheeks and hands were obtained. The pathological study demonstrated amyloid deposits. Since protein electrophoresis was normal, the diagnosis of AA amyloidosis was postulated.

Manifestaciones cutáneas de amiloidosis sistémica como clave diagnóstica: Caso clínico / AA amyloidosis with cutaneous manifestations: Report of one case

Background: Systemic amyloidosis is a rare disease that can affect any organ. Its clinical manifestations are varied and nonspecific. The skin involvement of this disease is common and can be easily recognized on physical examination. We report a 57-year-old male presenting with a two years history of malaise, dyspnea and myalgias. On physical examination, ungueal dystrophy, orange pigmentation of eyelids with periocular petechiae and mild macroglossia were observed. Incisional biopsies of the eyelids, cheeks and hands were obtained. The pathological study demonstrated amyloid deposits. Since protein electrophoresis was normal, the diagnosis of AA amyloidosis was postulated.

Remisión de la psoriasis luego de bypass gástrico / Psoriasis remission after gastric bypass

Psoriasis is a frequent skin disease affecting 1-3 percent of the population. Recent studies have found that psoriasis is linked to higher rate of obesity, and that obesity itself is a risk factor for the development and severity of psoriasis. The common link between psoriasis and obesity may be a state of chronic inflammation, including elevated serum levels of cytokines such as tumor necrosis factor. Consequently, weight loss has been proposed as a useful adjunctive therapy for obese patients with psoriasis. We present a 43-year old man with body mass index greater than 40kg/m² who had marked improvement in his psoriasis after Roux-en-Y gastric bypass surgery. Weight loss following bariatric surgery could play a role on the treatment for psoriasis on morbid obese patients.

La psoriasis es una patología dermatológica frecuente que afecta entre 1 al 3 por ciento de la población. Estudios recientes han identificado mayor índice de obesidad en los pacientes con psoriasis. También se ha reportado que la obesidad, por si sola, constituye un factor de riesgo, tanto del desarrollo como de la severidad, de la psoriasis. Ambas enfermedades estarían ligadas por un estado inflamatorio crónico caracterizado por aumento de los niveles plasmáticos de citoquinas, tal como el factor de necrosis tumoral. Consecuentemente, la baja de peso se ha propuesto como una herramienta complementaria al tratamiento de los pacientes obesos con psoriasis. Se presenta un paciente de sexo masculino, de 43 años de edad, con índice de masa corporal mayor a 40 kg/m², quien presentó una marcada mejoría de su psoriasis luego de la realización de un bypass gástrico. El tratamiento de la obesidad por medio de la cirugía bariátrica podría tener un rol en el manejo de la psoriasis en pacientes con obesidad mórbida.

Beneficio de los probióticos en prevención primaria de dermatitis atópica / Probiotics for primary prevention of pediatric atopic dermatitis

La dermatitis atópica (DA) corresponde a la enfermedad inflamatoria crónica de la piel más frecuente en la infancia. Su aparición parece ser el resultado de la interacción entre la predisposición genética y múltiples factores ambientales. Además, la disfunción de la barrera cutánea jugaría un rol esencial en las exacerbaciones de la presentación clínica. Los probióticos corresponden a microorganismos vivos cuya administración en la cantidad adecuada es beneficiosa para la salud del paciente. La administración oral de probióticos muestra diversos efectos positivos tanto en la homeostasis del tubo digestivo como en el sistema inmune. Recientemente, numerosos investigadores se han enfocado en el efecto de los probióticos en la supresión de la respuesta alérgica, y han evaluado su efecto profiláctico y/o terapéutico en DA, asma y alergias alimentarias. La suplementación prenatal con probióticos para la prevención primaria de DA se ha estudiado en diversos ensayos clínicos con cierta evidencia que sustenta su eficacia. Dado que los probióticos son reconocidos como un ingrediente seguro de los alimentos, éstos podrían ofrecer una alternativa para reducir la respuesta alérgica en una mujer embarazada de un niño con alto riesgo de DA.

Atopic dermatitis (AD) is the most frequent chronic inflammatory skin desease in childhood. Its onset seems to be the result of the interaction between genetic predispose and multiple environmental factors. Furthermore, barrier dysfunction of atopic skin is likely to play an essential role in the exacerbation of clinical presentation. Probiotics are live microorganisms which when in adequate amounts confer health benefits to the patient. Orally administered probiotics exhibit many positive effects on gut homeostasis and immune system. Recently, many researchers have focused on the suppressive effect of probiotic agents on allergic responses, and have evaluated its prophylactic and/or therapeutic efficacy for AD, asthma and food allergy. Prenatal probiotic supplementation for primary prevention of pediatric AD has been studied in clinical trials with some evidence to support its efficacy. Because probiotics are recognized as safe food ingredients, they may offer an alternative to reduce allergic responses for pregnant women carrying high-risk children for AD.

Estudio transversal: evaluación de prevalencia de comorbilidades metabólicas y factores de riesgo cardiovascular, y su correlación con la severidad clínica, en 106 pacientes con psoriasis / Prevalence of metabolic comorbidities and cardiovascular risk factors in patients with psoriasis: cross-sectional study

Introducción: Diversos estudios epidemiológicos han demostrado que los pacientes con psoriasis presentan mayor mortalidad general, mortalidad cardiovascular (CV) e incidencia de infarto al miocardio que la población general. Esto se explican o sólo por la mayor prevalencia de factores de riesgo CV clásicos (obesidad, diabetes, hipertensión arterial, entre otros) en estos pacientes, sino que también la psoriasis constituye un factor de riesgo CV independiente en directa relación con su severidad, con mayor impacto en pacientes jóvenes. Objetivos: Evaluar la prevalencia de comorbilidades metabólicas y factores de riesgo CV en 106 pacientes con psoriasis, y su correlación su severidad clínica. Además de comparar dichas prevalencias con las reportadas por la Encuesta Nacional de Salud (ENS) 2010 para la población chilena. Material y método: Se realizó una evaluación antropométrica y una encuesta sobre antecedentes mórbidos y de la psoriasis a 106 pacientes. Se definieron dos grupos de severidad. Se compararon prevalencias entre los grupos de severidad, así como entre la muestra total y la población chilena. Posteriormente se realizó la comparación considerando exclusivamente al grupo etario de 25 a 64 años (84,8 por ciento, tanto para hombres y mujeres. También se compararon prevalencias entre el grupo de pacientes jóvenes con psoriasis severa y la ENS, siendo éste el grupo de mayor riesgo CV asociado a la psoriasis. Resultados: La muestra correspondió a 106 pacientes, 47 mujeres y 59 hombres, con edad media de 43,5 +/- 14 años. La mitad presentó sobrepeso, un 26 por ciento peso normal y un 34 por ciento obesidad, con IMC promedio de 27,8 kg/m2 y gran prevalencia de comorbilidades metabólicas y factores de riesgo CV, siendo los más frecuentes el tabaquismo (41 por ciento) y la hipertensión arterial...

Background: Epidemiologic studies have demonstrated that patients with psoriasis have an increased risk of mortality, cardiovascular (CV) mortality and myocardial infarction, than general population. Some explanation for this is related to an increased incidence of classical CV risk factors (e.g: obesity, diabetes, blood hypertension) on psoriasis patients. Additionally, psoriasis itself is considered as an independent CV risk factor, directly related to its severity and with higher impact on young patients. Objective: To determinate the prevalence of metabolic comorbidities and CV risk factors in patients with psoriasis, and its correlation with the severity of the psoriasis. To compare such prevalence with those reported by the national health database for Chilean population developed in 2010. Materials and Methods: An observational and analytic study was conduced at the Dermatology Department of the Pontificia Universidad Católica de Chile. Patients with psoriasis were evaluated and classified as having as severity in two groups. The prevalence of metabolic comorbidities was determined, comparing outcomes among patients with mild and severe psoriasis and between all psoriasis patients and Chilean population. Results: One hundred and six patients with psoriasis were included in the study. The mean (SD) age was 43.5 (14) years and 55.6 percent were male. Overweight was present on half of the patients, normal weight was present on 26 percent, and obesity was present on 34 percent. Mean body mass index (IMC) was 27.8kg/m2. The most frequent CV risk factor was tabaquism (41 percent), followed by blood hypertension (22.6 percent). The group with severe psoriasis presented higher prevalence of obesity (31.6 vs.13 percent, p=0.02) and abdominal obesity (86.7 vs. 76 percent, p=0.04),that the group with mild psoriasis...

Pilomatrixoma: una presentación clínica inusual / Pilomatrixoma: unusual clinical presentation

El pilomatrixoma, una neoplasia benigna poco frecuente, se origina de la matriz del folículo piloso. Es más frecuente durante la infancia, especialmente entre los 5 y 15 años de edad. La forma múltiple de pilomatrixoma es rara y su presencia se asocia a síndromes sistémicos, entre los cuales destaca la distrofa miotónica. El diagnóstico de pilomatrixoma es fundamentalmente clínico. Estudios complementarios como la ecografía pueden ser útiles para confrmar su diagnóstico. La resección quirúrgica de la lesión corresponde el tratamiento curativo, con baja tasa de recurrencia. Se presenta una paciente de sexo femenino, de 17 años de edad, por su pilomatrixoma de características clínicas inusuales en edad pediátrica: variante anetodérmica, forma múltiple y crecimiento rápido.

Pilomatrixoma is a rare, benign neoplasm that is derived from hair matrix cells. It is more frequent during childhood, especially between the ages of 5 and 15 years. Pilomatrixoma is usually a hard, well circumscribed, solitary lesion, and can be located on any part of the body, except palms and soles, with a predilection for maxilofacial region. Multiple pilomatrixomas are rare and they have been associated with various systemic syndromes, of which myotonic dystrophy has been the most described. The diagnosis of pilomatrixoma is fundamentally clinical. Complementary studies such as ultrasound can be useful to confrm the diagnosis. Excisional surgery is the standard curative treatment. We present a 17-year-old female patient with an extremely uncommon clinical presentation of pilomatrixoma: multiple lesions, anetodermic, and rapid growth.

Microbiota intestinal: rol en obesidad / Gut microbiota: role in obesity

Obesity and diabetes have become major public health issues in our country. The increasing prevalence of obesity and its association with diabetes might not only be explained by genetic contribution, nutritional habits or decreased physical activity. In addition, recent studies have focused on the intestinal microbiota as environmental factors that increase energy yield from diet, regulate synthesis of gut hormones, peripheral metabolism and systemic inflammatory tone. Obesity is associated with substantial changes in composition of gut microbiota, suggesting that the development of obesity on some people may be due to these changes. Existing evidence warrants further investigation of the microbial ecology oh the human gut and points to modification of the gut microbiota, by functional foods or antibiotics, as one means to treat and prevent obesity.

La obesidad es una patología metabólica altamente prevalente en nuestro país y constituye un gran problema de salud pública. Según lo han demostrado recientes estudios, la obesidad y su asociación con la diabetes no son únicamente el resultado de la contribución genética, los hábitos alimentarios o la falta de actividad física, sino que también se ha comprobado que la microbiota intestinal constituye un factor ambiental determinante en el desarrollo de estas patologías. Este vínculo estaría relacionado con una modulación, por parte de la mi-crobiota, en la extracción energética de los alimentos, la secreción de hormonas intestinales, el metabolismo a nivel periférico y el tono inflamatorio sistémico. Lo anterior se refleja en las diferencias significativas en cuanto a la composición de la microbiota intestinal que se observa en quienes padecen obesidad. En relación a la evidencia actual, resulta importante investigar los efectos en la modificación de la microbiota intestinal, mediante el uso alimentos funcionales y antibióticos, a fin de aplicar tanto tratamientos terapéuticos como preventivos contra el desarrollo de la obesidad.

Nuevas emulsiones lipídicas enriquecidas con omega-3: beneficios reales en nutrición parenteral / New lipid emulsions enriched with omega-3: Is there a real benefit on parenteral nutrition?

Total parenteral nutrition allows nutritional supports for patients who are not able to receive oral intake or enteral nutrition. Fatty acids are administrated as lipid emulsions and a lower inflammatory cytokine level has been described after administration of Omega-3. This could be a benefit for critical patients by a potential antiinflamatory and immunomodulation effect. Also, for patients with respiratory distress syndrome, the lower cytokine effect may directly affect pulmonary vessels by vasodilatation and consequently improve respiratory function. Different studies have shown positive clinical outcomes after Omega-3 administration, while other studies have failed to demonstrate significant results. Mechanisms involved with this possible immunomodulation by fish oil are well known, although further research is necessary to clarify the clinical relevance of these mechanisms.

La nutrición parenteral es la técnica de soporte nutricional por vía endovenosa a pacientes que no pueden alimentarse por vía enteral u oral. El aporte de lípidos se realiza a través de emulsiones lipídicas, que poseen diferentes ácidos grasos. Se ha descrito que la administración de ácidos grasos Omega-3 determina una disminución de citoquinas proinflamatorias a nivel plasmático, lo cual supondría beneficios en los pacientes críticos mediante una posible modulación de la respuesta inflamatoria e inmunológica. Además, en los pacientes con distress respiratorio agudo, la disminución de citoquinas proinflamatorias ejercería un efecto directo sobre el lecho vascular pulmonar estableciendo una mejoría de la función respiratoria. Los estudios clínicos son contradictorios respecto a si la suplementación con Omega-3 se asocia con resultados clínicos favorables en forma significativa. Existe gran avance en el conocimiento de los mecanismos involucrados en la posible inmunomodulación que se le atribuye al aceite de pescado, pero futuras investigaciones son necesarias para elucidar la relevancia clínica de estos mecanismos.

Diabetes mellitus y piel: lesiones cutáneas y su significado clínico / Skin lesions associated with diabetes mellitus

Approximately 30 to 70 percent of patients with diabetes will suffer a skin disorder during the course of their disease. The vast majority of these cases arise during the course of the disease. However, the skin disorder occasionally precedes the diagnosis of diabetes. Many of these lesions are highly associated with diabetes. Moreover, some of them are considered as markers of the disease. The most common skin lesion is diabetic dermopathy that presents as red or purple papules that last one to three weeks. Necrobiosis lipoidica diabeticorum is seen in 0.3 percent of diabetic patients, may precede the development of the disease and appears as oval or irregularly shaped, indurated plaques with central atrophy and yellow pigmentation. Granuloma annulare is seen in 10 to 24 percent of diabetic patients and appears as a skin-colored or erythematous, annular or arciform plaque with a moderately firm, rope-like border and central clearing. Physicians should be able to recognize these and other lesions associated with diabetes mellitus.

[Pilomatrixoma: unusual clinical presentation]. / Pilomatrixoma: una presentación clínica inusual.

Pilomatrixoma is a rare, benign neoplasm that is derived from hair matrix cells. It is more frequent during childhood, especially between the ages of 5 and 15 years. Pilomatrixoma is usually a hard, well circumscribed, solitary lesion, and can be located on any part of the body, except palms and soles, with a predilection for maxillofacial region. Multiple pilomatrixomas are rare and they have been associated with various systemic syndromes, of which myotonic dystrophy has been the most described. The diagnosis of pilomatrixoma is fundamentally clinical. Complementary studies such as ultrasound can be useful to confirm the diagnosis. Excisional surgery is the standard curative treatment. We present a 17-year-old female patient with an extremely uncommon clinical presentation of pilomatrixoma: multiple lesions, anetodermic, and rapid growth.