Autoimmune myelofibrosis and systemic lupus erythematosus: a case report

Bone marrow fibrosis is a rare disorder that can be associated with autoimmune diseases such as systemic lupus erythematosus (SLE), and can be confused with the manifestations of that disease. The case is presented on a patient with autoimmune myelofibrosis in the context of SLE.

La fibrosis de la médula ósea es una enfermedad rara que se puede ver asociada con enfermedades autoinmunes como el lupus eritematoso sistémico (LES) y que puede llegar a ser confundida con las manifestaciones propias de la enfermedad. Se presenta el caso de una paciente con mielofibrosis autoinmune en el contexto de LES.

Incidence and Prognostic Significance of High-Risk Cytogenetically Abnormalities in Multiple Myeloma Patients in Colombia.

INTRODUCTION: Multiple Myeloma (MM) is the second most common hematological cancer, several cytogenetics abnormalities such as t(4;14), del (17p), and t(14;16) were identified as a high-risk for survival, in Latin America, we have very little data on cytogenetic alterations in MM. This study describes the incidence of high-risk cytogenetically abnormalities in a Colombian population and prognostic significance. METHODS: In a retrospective cohort of new diagnostic Multiple Myeloma between 2016 and 2020, we identified a high-risk cytogenetically abnormalities t(4;14), t(14;16), and 17p deletions by FISH techniques and described incidence. We followed patients until progression or death and comparing progression free survival (PFS) and overall survival (OS), according with high- risk cytogenetically features. RESULTS: We included 135 newly diagnosed MM patients, the incidence of high-risk cytogenetically abnormalities were 30.3%, with 17.1% of 17p deletions, 14.1% of t(4;14) and 2.25% of t(14;16). According to the high risk cytogenetically abnormalities, the median PFS for the group of no abnormalities were 50.2 months 95% CI [25.2-62.4] and for the group of high-risk cytogenetic abnormalities 33.9 months 95% CI [23.6-NA] (P = .2). For OS the median were 76.9 months, 95% CI [67.5-NA] and 42.7 months 95% CI [33.3-NA], respectively (P = .009). CONCLUSION: High-risk cytogenetically abnormalities were independent risk factor for OS but not PFS in this cohort of patients, and the incidence of del (17p) was slightly higher than the literature reports.  MICROABSTRACT: Prognostic significance of high-risk cytogenetic abnormalities in Multiple Myeloma in Colombia is unknown. In a retrospective cohort study of 135 newly, diagnostic Multiple Myeloma we found incidence of high-risk cytogenetic abnormalities was 30.3%. The hazard ratio (HR) for disease progression or death compared high-risk cytogenetic group vs. control was 1.22, (95% CI, 0.73-2.05) (P = .2), and The HR for death for the group of high-risk cytogenetic abnormalities was 2.17, (95% CI, 1.19-3.97). In the group of high-risk cytogenetic abnormalities, if the patient received VRD as induction treatment the median PFS were 41.2 months 95% CI [13.3-NA] and 33.9 months 95% CI [24.9-NA] for patients with different induction treatment (P = .56).

Measurable Residual Disease Assessment and Allogeneic Transplantation as Consolidation Therapy in Adult Acute Lymphoblastic Leukemia in Colombia.

INTRODUCTION: Detectable minimal residual disease (MRD) after therapy for acute lymphoblastic leukemia (ALL) is the strongest predictor of hematologic relapse. The objective of the study was to assess disease-free survival (DFS) and overall survival (OS) of patients with ALL according with MRD status at the end of induction therapy in a Colombian population. PATIENTS AND METHODS: We assessed a retrospective cohort to compare DFS and OS in adults with de novo ALL according to MRD status at the end of induction chemotherapy, and the type of postinduction consolidation strategy used. RESULTS: A total of 165 adults with ALL were included in the MRD part of the study, 73 patients in the MRD-negative group and 92 in the MRD-positive group. Median DFS for the MRD-positive group was 11 months (95% confidence interval, 11.7-22.2) and was not reached for the MRD-negative group (P < .001). At 3 years, DFS was 18% and 55%, respectively (P < .001). The median OS for MRD-positive patients was 16 months (95% confidence interval, 8.8-23.15) and was not reached in the MRD-negative group. At 3 years, OS was 26% and 51% for the former and latter group, respectively. Among subjects who did not receive a transplant, median DFS was 21 months for MRD-negative patients and 9 months for MRD-positive patients (P < .001). The median DFS was not reached in either group, whereas 3-year DFS was 64% for MRD-negative and 70% for MRD-positive patients who underwent transplantation in first remission (P = .861). CONCLUSION: MRD status at the end of induction is an independent prognostic factor for DFS and OS in adult ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD.

Impactos de la COVID-19 en la violencia contra las mujeres. El caso de Bogotá (Colombia) / impacts of COVID-19 on violence against women. The case of Bogotá (Colombia)

Resumen La literatura reconoce que las condiciones estructurales de vulnerabilidad de las mujeres que se derivan de los roles asociados al cuidado y al trabajo doméstico y de su precarización laboral, entre otros, favorecen el aumento de la violencia en su contra, y esta se exacerba en las condiciones de confinamiento y aislamiento social generadas por la pandemia de la COVID-19. El artículo estudia los mecanismos dispuestos en Bogotá (Colombia) para enfrentar la violencia contra las mujeres y los desafíos que aún se presentan.

Abstract The literature recognizes that the structural conditions of women's vulnerability derived from the roles associated with care and domestic work and their job insecurity, among others, allow the violence increase against them, which is exacerbated in confinement conditions and social isolation generated by the Covid-19 pandemic. The article studies the mechanisms developed in Bogotá (Colombia) to face violence against women and the challenges related.

Solid-State Treatment of Castor Cake Employing the Enzymatic Cocktail Produced from Pleurotus djamor Fungi.

In this work, the enzymatic cocktail produced by Pleurotus djamor fungi extracted at pH of 4.8 and 5.3 was employed for castor cake solid-state treatment. Proximal, X-ray powder diffraction and scanning electron microscopy analysis of the pristine castor cake were carried out. First, Pleurotus djamor stain was inoculated in castor cake for the enzymatic production and the enzymatic activity was determined. The maximum enzymatic activity was identified at days 14 (65.9 UI/gss) and 11 (140.3 UI/gss) for the enzymatic cocktail obtained at pH 5.3 and 4.8, respectively. Then, the enzymatic cocktail obtained at the highest enzymatic activity days was employed directly over castor cake. Lignin was degraded throughout incubation time achieving a 47 and 45% decrease for the cocktail produced at pH 4.8 and 5.3, correspondingly. These results were corroborated by the SEM and XRD analysis where a higher porosity and xylan degradation were perceived throughout the enzymatic treatment.

Effects of glyphosate on hepatic tissue evaluating melanomacrophages and erythrocytes responses in neotropical anuran Leptodactylus latinasus.

Glyphosate (GLY) is the most used herbicide worldwide and its effects on anurans are well known. Pollutants can cause physiological and morphological effects. Therefore, this study evaluated the effects of GLY on hepatic melanomacrophages as a response to environmental stressors. Three treatments were exposed to different concentrations of pure GLY (100, 1000, and 10,000 µg g(-1), respectively), and there was also a control group. After the experimental time, liver and blood were analyzed. Melanomacrophages (MMCs) were located between the hepatocyte cordons, close to sinusoids. GLY increased the melanin area in MMCs of Leptodactylus latinasus exposed since lowest concentration until highest concentration. GLY also changed the occurrence of hepatic catabolism pigments into melanomacrophages and erythrocyte nuclear abnormalities; therefore, it can interfere with the hepatic metabolism. In conclusion, GLY promotes alterations in the hepatic tissue and erythrocyte nuclear abnormalities. Furthermore, MMCs may be useful as morphological responses of GLY effects.

Manifestaciones otorrinolaringológicas de la granulomatosis con poliangitis (Wegener) / Otolaryngological manifestations of granulomatosis with polyangitis (Wegener's)

La Granulomatosis con Poliangitis (GPA) se caracteriza por una vasculitis granulomatosa de vías aéreas y glomerulonefritis. Han surgido múltiples avances en su diagnóstico y tratamiento, sin embargo su etiología permanece sin aclarar. Objetivos: Esta revisión guía a los otorrinolaringólogos a las manifestaciones clínicas principalmente las que se ubican en la región de cabeza y cuello, formas de diagnóstico y bases de tratamiento, las cuales deben realizarse de forma precoz para mejorar el pronóstico, evitar la progresión y disminuir las complicaciones. Metodología: Revisión de la literatura a través de las bases de datos Scielo, Science Direct y Pubmed, entre los años 1993 y 2014. Se incluyeron revisiones, artículos, reportes de casos clínicos, tratados de Otorrinolaringología. Resultados: Las alteraciones más frecuentemente identificadas en la GPA son: obstrucción nasal, costras nasales, rinorrea, otalgia, tinnitus, otitis media de difícil manejo, disfonía y disnea. Conclusiones: Las manifestaciones de la Granulomatosis con Poliangitis son múltiples y frecuentes en la región de la cabeza y cuello, su sospecha como diagnóstico diferencial en pacientes con presentaciones poco comunes y de difícil manejo o evolución tórpida siempre debe estar presente...

Granulomatosis with polyangiitis (GPA), also known as Wegener’s granulomatosis, is characterized by granulomatous vasculitis of the respiratory tract and glomerulonephritis. There have been many advances directed towards its diagnosis and treatment, even though its etiology remains unclear. Objectives: This review summarizes the clinical manifestations of the disease, focused on the ones located in the head and neck region. GPA´s diagnosis and treatment, which must be done as early as possible in order to improve the prognosis. Methods: Review of the literature by searching SciELO, PubMed and ScienceDirect databases between 1993 and 2014. Reviews, original research articles, case reports and otolaryngology treaties were included. Results: GPA’s frequent alterations are: nasal scabs and obstruction, rhinorrhea, earache, tinnitus, otitis media unwieldy, dysphonia and dyspnea. Conclusions: GPA’s clinical manifestations are usually multiple and very common in the head and neck. GPA has to be kept in mind as differential diagnosis in patients with unusual presentations and those who are difficult to manage...

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellin, Colombia / Caracterización del trauma ocular por minas antipersonales en soldados atendidos en un hospital Universitario en Medellín, Colombia

Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

Introducción: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final. Métodos: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012. Resultados: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital. Conclusiones: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia.

INTRODUCTION: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes. METHODS: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012. RESULTS: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge. CONCLUSIONS: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

INTRODUCCIÓN: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final. MÉTODOS: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012. RESULTADOS: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital. CONCLUSIONES: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Lethal effect of dehydroleucodine (DhL) on amphibian Bufo arenarum embryos.

The dehydroleucodine is a sesquiterpene lactone isolated from Artemisia douglasiana Besser which is used in popular medicine. Toxicity tests using embryos of amphibian have been widely used in order to predict toxic effects of different compounds. However, to our knowledge, there are not studies focussed on the toxic effects of dehydroleucodine on Bufo arenarum, which is an anuran widely distributed in South America. The effect of dehydroleucodine on the survival of embryos was evaluated in an acute test during the early life stage of B. arenarum embryos. Lethality and the degree of adverse effects were dehydroleucodine dose-dependent. Overall, amphibian early life stages appeared to be more susceptible to the embryotoxicity associated with exposure to dehydroleucodine, especially at concentration greater that 3mM. This increased susceptibility may result from the relatively high rate of cellular differentiation and morphogenesis that occurs at this early stage of development.

Magnesium valproate in learning disabled children with interictal paroxysmal EEG patterns: Preliminary report.

Previous studies have investigated whether routine use of antiepileptic drugs is adequate to improve cognitive abilities in children who are learning disabled not otherwise specified (LD NOS) and who display interictal paroxysmal patterns in the electroencephalogram (EEG) but do not have epilepsy, and the findings of these studies have been controversial. In the current study, 112 LD children without epilepsy were assessed; however, only 18 met the strict inclusion/exclusion criteria in order to obtain a homogeneous sample. These children showed interictal paroxysmal patterns in the EEG, and a randomized, double-blind trial was carried out on them. The children were treated with either magnesium valproate (MgV; 20mg/kg/day) or a placebo for six months, and differences in WISC subtests, in a computerized reading skills battery (BTL) and EEG recordings were evaluated between groups before and after the treatment period. Performance IQ score and several items of the BTL (rhymes and ordering of words) improved in children who received MgV, whereas no changes were observed in the placebo group. No changes in the number of interictal paroxysmal patterns were observed in any group; however increased EEG currents at 10.92 and 12.87Hz (alpha band) in posterior regions and decreased currents in frequencies within the theta band (3.90, 4.29 and 5.07Hz) in frontal regions and at 4.68 and 5.46Hz in the parietal cortex were observed, suggesting an improvement in EEG maturation.

Macrophage migration inhibitory factor in acute lung injury: expression, biomarker, and associations.

The macrophage migration inhibitory factor (MIF), a pro-inflammatory cytokine central to the response to endotoxemia, is a putative biomarker in acute lung injury (ALI). To explore MIF as a molecular target and candidate gene in ALI, the MIF gene and protein expression were examined in murine and canine models of ALI (high tidal volume mechanical ventilation, endotoxin exposure) and in patients with either sepsis or sepsis-induced ALI. MIF gene expression and protein levels were significantly increased in each ALI model, with serum MIF levels significantly higher in patients with either sepsis or ALI compared with healthy controls (African- and European-descent). The association of 8 MIF gene polymorphisms (single-nucleotide polymorphisms (SNPs)) (within a 9.7-kb interval on chromosome 22q11.23) with the development of sepsis and ALI in European-descent and African-descent populations was studied next. Genotyping in 506 DNA samples (sepsis patients, sepsis-associated ALI patients, and healthy controls) revealed haplotypes located in the 3' end of the MIF gene, but not individual SNPs, associated with sepsis and ALI in both populations. These data, generated via functional genomic and genetic approaches, suggest that MIF is a relevant molecular target in ALI.

Uso tradicional y actual de spirulina sp. (arthrospira sp.) / Traditional and present use of spirulina sp. (arthrospira sp.)

Spirulina sp. (Arthrospira sp.) es una cianobacteria filamentosa no diferenciada, habitante de lagos alcalinos, que se cultiva para consumo humano debido a su contenido nutricional. En México, el consumo de esta cianobacteria se remonta a tiempos prehispánicos, cuando era conocida como tecuitlatl, siendo conocida como dihé por las tribus nativas de la región del lago de Chad, en Africa. En los últimos años se le han atribuido diversos efectos positivos en el tratamiento de algunos tipos de alergias, anemia, cáncer, enfermedades virales y cardiovasculares. Muchas de sus propiedades son consecuencia de la presencia de pigmentos como las ficobiliproteínas y los carotenoides, así como de otros compuestos como polisacáridos, ácidos grasos (destacando el ácido gama linoleico), proteínas, vitaminas y minerales. Las propiedades y aplicaciones de este organismo hacen de él un alimento promotor de la salud o nutracéutico

Prevalencia de lesiones cervicales premalignas y malignas / Prevalence of cervical premalignant and malignant lesions

En el Hospital de San José desde diciembre de 2001 se viene realizando el control de calidad de las citologías cervicovaginales(CCV) del programa de Promoción y Prevención (P y P) de una EPS, que tiene por objetivo identificar en formaoportuna las lesiones precancerosas del cuello uterino. Este estudio se realizó para determinar la prevalencia de las lesionespremalignas y malignas en las CCV del programa entre enero de 2002 y diciembre de 2003. Se evaluaron 162.487CCV, clasificadas según las categorías del sistema Bethesda, se determinó la prevalencia anual de citologías positivas y laprevalencia anual por cada categoría de lesión. Se encontró similitud de la prevalencia anual de cada lesión, lo que indicaresultados satisfactorios para el programa de P y P. Adicionalmente se realizaron comparaciones con cifras nacionales dela Liga de Lucha Contra el Cáncer y La Secretaría Distrital de Salud de Bogotá.

Dexamethasone prevents virus-induced hyperresponsiveness via multiple mechanisms.

In the lungs, neuronal M2 muscarinic receptors inhibit acetylcholine release from the parasympathetic nerves. Parainfluenza virus infection causes loss of M2 receptor function, which increases acetylcholine release and vagally mediated bronchoconstriction. Because glucocorticoids are known to inhibit airway hyperresponsiveness, we tested whether dexamethasone (6.5 or 65 microg/kg i.p.) prevents virus-induced hyperresponsiveness and M2 receptor dysfunction in guinea pigs. In controls, pilocarpine, a muscarinic agonist, inhibited vagally induced bronchoconstriction, demonstrating functional M2 receptors. However, in virus-infected animals, pilocarpine failed to inhibit vagally induced bronchoconstriction, demonstrating M2 receptor dysfunction. Frequency-dependent bronchoconstriction was greater in virus-infected animals than in controls, indicating airway hyperresponsiveness. Low-dose dexamethasone (6.5 microg/kg i.p.) treatment prevented virus-induced airway hyperresponsiveness, ameliorated M2 receptor dysfunction, and decreased viral content in the lungs without inhibiting virus induced inflammation. High-dose dexamethasone (65 microg/kg i.p.) prevented virus-induced hyperresponsiveness, completely reversed M2 receptor dysfunction, decreased viral titers, and decreased virus-induced inflammation. This high-dose dexamethasone also increased M2 receptor function in uninfected animals. In conclusion, dexamethasone prevented virus-induced hyperresponsiveness and M2 receptor dysfunction via multiple mechanisms.

Importancia médica de los alergenos de ácaros domésticos / Medical importance of the domestic mites allergens

En la actualidad, los trastornos respiratorios están entre los problemas de salud más frecuentes y, entre ellos, el asma aparece como una entidad muy común en niños y adultos. El asma alérgica es una enfermedad multifactorial. El componente ambiental es de gran importancia, lo cual ha sido ampliamente documentado gracias a los avances científicos que en los últimos años se han dado en el campo de la alergología experimental. Los ácaros domésticos son la principal fuente de alergenos en el polvo casero; dichos alergenos son considerados, hoy en día, como los principales inductores de las manifestaciones alérgicas respiratorias. Estos animales son artrópodos de distribución mundial, siendo Dermatophagoides pteronyssinus y Blomia tropicalis los que más frecuentemente se encuentran en el ambiente doméstico. Las mencionadas especies ejercen un gran impacto clínico porque la mayoría de la población asmática y rinítica presenta altos niveles de IgE contra sus alergenos lo cual, sin duda, influye en la patogénesis de la inflamación crónica que caracteriza a esas enfermedades. La presente revisión decribe la biología, epidemiología y aspectos moleculares de los alergenos de Dermatophagoides pteronyssinus y Blomia tropicalis, como una información muy útil para los médicos y demás integrantes del equipo de salud que tengan el interés y la oportunidad de efectuar un manejo integral de estos problemas