LMO2-negative Expression Predicts the Presence of MYC Translocations in Aggressive B-Cell Lymphomas.

MYC translocation is a defining feature of Burkitt lymphoma (BL), and the new category of high-grade B-cell lymphomas with MYC and BCL2 and/or BCL6 translocations, and occurs in 6% to 15% of diffuse large B-cell lymphomas (DLBCLs). The low incidence of MYC translocations in DLBCL makes the genetic study of all these lymphomas cumbersome. Strategies based on an initial immunophenotypic screening to select cases with a high probability of carrying the translocation may be useful. LMO2 is a germinal center marker expressed in most lymphomas originated in these cells. Mining gene expression profiling studies, we observed LMO2 downregulation in BL and large B-cell lymphoma (LBCL) with MYC translocations, and postulated that LMO2 protein expression could assist to identify such cases. We analyzed LMO2 protein expression in 46 BLs and 284 LBCL. LMO2 was expressed in 1/46 (2%) BL cases, 146/268 (54.5%) DLBCL cases, and 2/16 (12.5%) high-grade B-cell lymphoma cases with MYC and BCL2 and/or BCL6 translocations. All BLs carried MYC translocation (P<0.001), whereas LMO2 was only positive in 6/42 (14%) LBCL with MYC translocation (P<0.001). The relationship between LMO2 negativity and MYC translocation was further analyzed in different subsets of tumors according to CD10 expression and cell of origin. Lack of LMO2 expression was associated with the detection of MYC translocations with high sensitivity (87%), specificity (87%), positive predictive value and negative predictive value (74% and 94%, respectively), and accuracy (87%) in CD10 LBCL. Comparing LMO2 and MYC protein expression, all statistic measures of performance of LMO2 surpassed MYC in CD10 LBCL. These findings suggest that LMO2 loss may be a good predictor for the presence of MYC translocation in CD10 LBCL.

Características del consumo de sustancias recreactivas en establecimientos noturnos del Valle de Aburrá / Characteristics of recreational substance consumption in night clubs in the Aburra Valley

Objetivo: explorar las características demográficas y de consumo de sustancias recreativas de las personas que acuden a establecimientos nocturnos de algunos municipios del Valle de Aburrá. Metodología: estudio de corte transversal, la población estuvo compuesta por personas de ambos sexos y mayores de edad que frecuentan establecimientos nocturnos en el Valle de Aburrá. Se aplicó el cuestionario sonar 98smodificado y adaptado por los investigadores. Resultados: se realizó en 17 centros nocturnos; participaron 789 personas; mujeres 57,7%; edad promedio 23 años; estudiantes 61,0%. La mayoría de los encuestados había consumido alguna vez en su vida alcohol 95%, cigarrillo 46,0%, cannabis 25,0%, nitrito de amilo “popper” 10,0%, “drogas de diseño” como anfetaminas y metanfetaminas 9,0% y sedantes e hipnóticos 10,0%. El primer consumo, se inició de manera temprana con las llamadas drogas sociales: alcohol 14 años, y tabaco 15 años. Discusión: a diferencia de los resultados obtenidos en el ámbito mundial, este estudio exploratorio mostró que el consumo de drogas recreativas se inicia con sustancias socialmente aceptadas, como el alcohol y el tabaco, mientras que las drogas de diseño y otras tienen un uso más restringido, y su consumo se ve relegado a edades más tardías.

Objective: to explore the demographic characteristics and the features of “recreational substance” consumption in people attending night clubs located in some of the municipalities of the Aburrá Valley. Methodology: we designed a crosssectional study; the population was made-up of adult males and females that attend night clubs in the Aburrá Valley. The sonar 98 modified survey was adapted by the researchers for use in this study. Results: we studied 17 night clubs. A total of 789 people participated, 57.7% of them were female, and the mean age was 23 years; 61.0% of the subjects were students. Most of the surveyed population had consumed at some point of their lives: alcohol (95%), cigarette (46.0%), cannabis (25.0%), amylnitrite or “Popper” 10.0%, “designed drugs” such as amphetamines and methamphetamines (9.0%) and sedatives and hypnotics (10.0%). Consumption first started early in life with the so-called social drugs: alcohol (at 14) and cigarette smoking (at 15). Discussion: unlike results from other worldwide studies, our exploratory survey showed that recreational drug consumption starts with socially accepted substances such as alcohol and cigarette, whereas designed drugs and other drugs have a more restricted use, and their consumption starts at older ages.

GUÍA PARA LA IMPLEMENTACIÓN DEL PROGRAMA NACIONAL DE TECNOVIGILANCIA EN EL HOSPITAL GENERAL DE MEDELLÍN / GUIDE FOR THE IMPLEMENTATION OF THE NATIONAL TECHNO-SURVEILLANCE PROGRAM AT THE MEDELLÍN GENERAL HOSPITAL

Este caso de estudio propone una guía al Hospital General de Medellín (HGM) para dar cumplimiento al Programa Nacional de Tecnovigilancia. Este programa fue diseñado por el Ministerio de la Protección Social, con al apoyo del Instituto Nacional de Vigilancia de Medicamentos y Alimentos (INVIMA), está reglamentado por la Resolución 4816 de 2008 y tiene un enfoque centrado principalmente en la Seguridad del Paciente. Para el desarrollo de este proyecto, se efectuaron visitas de referenciación a diferentes instituciones del sector salud de Medellín. Durante estas, se realizó una consulta guiada acerca de la tecnovigilancia en Colombia y el mundo y el marco normativo que encierra este programa en el país. A partir de esta información y del Sistema de Gestión Integral de la Calidad del HGM, se realizó un diagnóstico de la situación del Hospital frente al programa de Tecnovigilancia. Además, se diseñó un plan de mejoramiento con estrategias, acciones y herramientas que le permitieran impulsar el programa interno, direccionado al mejoramiento continuo de la calidad de sus servicios y a la seguridad de los pacientes.

This case of study offers to Medellín General Hospital (MGH) a guide to comply with the National Techno-Surveillance Program. The Ministry of Social Protection with the support of the National Drug and Food Surveillance Institute (INVIMA) designed this program. It is regulated by the 4816 Resolution of 2008 and its mainly focused on patient safety. For the development of this project, reference visits at different health institutions in the city of Medellín-Colombia were made. During these, a guided consultation was carried out to establish the current state of techno- surveillance programs and regulatory schemes in Colombia and the world. Using this information and the institutional quality management system at the MGH, the authors performed an analysis of the hospital techno- surveillance situation. Further, it was possible to design an improvement plan with strategies, actions and tools that are to be taken into account by the MGH to implement the planned institutional program and that are expected to improve their health care quality services and strengthen patient safety.