Pediatric perianal Crohn's disease behavior in the era of biologic therapy. / Comportamiento de la afectación perianal en pacientes pediátricos con enfermedad de Crohn en la era de la terapia biológica.

AIM OF THE STUDY: To describe perianal Crohn's disease behavior and the role of biological therapy in a sample of pediatric patients. METHODS: A retrospective study of pediatric patients with Crohn's disease (CD) treated in our institution from 2017 to 2021, with a minimum follow up period of 6 months, was conducted. Patients were divided whether they had perianal disease (PD) or not. Baseline characteristics, extension of disease, growth failure rate, aggressive pattern rate, use of biological therapy and need for surgery, among other variables, were compared between both groups. Clinical and/or radiological improvement in the last 6 months of follow up was considered good control of PD. RESULTS: Seventy eight pediatric patients with CD were included. Median age at diagnosis was 10.5 years, and median follow up time was 3.8 years. 64.1% patients were male. Of all, 15 (19.2%) had perianal disease, of which 10 had fistulizing findings and 5 had non fistulizing findings. PD was presented at diagnosis in 8 patients, and the rest developed it in a median time of 1 year from diagnosis. PD was associated with growth failure (p = 0.003), use of biological therapies (p = 0.005), and need for second line of biologics (p = 0.005). Most patients (12/15, 80%) had good control of PD with the treatment received. CONCLUSIONS: CD patients with PD seem to need a more aggressive treatment, with biological therapies playing a key role for its handling nowadays. These patients require close nutritional evaluation that ensures proper development and growth.

OBJETIVO DEL ESTUDIO: Describir el comportamiento de la enfermedad de Crohn perianal y el papel de la terapia biológica en una muestra de pacientes pediátricos. METODOS: Estudio retrospectivo de pacientes pediátricos con enfermedad de Crohn (EC) tratados en nuestro centro entre 2017 y 2021, con un seguimiento mínimo de seis meses. Los pacientes se dividieron en función de si tenían enfermedad perianal (EP) o no. Se compararon entre ambos grupos las características iniciales, la extensión de la enfermedad, el índice de retraso en el crecimiento, el índice de patrón agresivo, el empleo de terapia biológica y la necesidad de cirugía, entre otras variables. Se consideró un buen control de la EP una mejoría clínica o radiológica en los 6 últimos meses de seguimiento. RESULTADOS: Se incluyeron 78 pacientes pediátricos con EC. La edad mediana en el momento del diagnóstico fue de 10,5 años, y el tiempo mediano de seguimiento fue de 3,8 años. El 64,1% de los pacientes eran varones. Del total, 15 (19,2%) tenían enfermedad perianal, de los cuales 10 presentaban hallazgos fistulizantes y 5 no fistulizantes. La EP estaba presente en el momento del diagnóstico en 8 pacientes, y el resto la desarrolló en una mediana de 1 año desde el diagnóstico. La EP se asoció con retraso en el crecimiento (p = 0,003), empleo de terapias biológicas (p = 0,005) y necesidad de una segunda línea de terapia biológica (p = 0,005). La mayoría de los pacientes (12/15, 80%) tuvieron un buen control de la EP con el tratamiento recibido. CONCLUSIONES: Los pacientes de EC con EP parecen necesitar un tratamiento más agresivo, en el que las terapias biológicas desempeñan hoy en día un papel fundamental. Estos pacientes precisan de una estrecha evaluación nutricional que garantice su correcto crecimiento y desarrollo.

Barreras para la implementación de la Atención Farmacéutica en establecimientos farmacéuticos de Cusco, Perú / Barriers to the implementation of pharmaceutical care in pharmacies in Cusco, Peru

Introducción: Después de más de 25 años de la propuesta de Atención Farmacéutica, un gran porcentaje de establecimientos farmacéuticos no logran la implementación, siendo necesario determinar las barreras usuales para formular estrategias que permitan la implementación y desarrollo. Objetivos: Determinar los factores que impiden la implementación de la Atención Farmacéutica en establecimientos farmacéuticos en los distritos de Cusco y Wanchaq, departamento de Cusco. Material y métodos: Estudio observacional, descriptivo y transversal, realizado mediante una encuesta dirigida a 95 químicos farmacéuticos colegiados en Cusco (distrito Cusco: 44; distrito Wanchaq: 51) y que laboran en farmacias y boticas y asimismo a 46 propietarios de farmacias y boticas. Se elaboraron dos fichas de recolección de datos (cuestionario y encuesta) que fueron validados por expertos. Los resultados obtenidos se procesaron en el programa estadístico SPSS V.22. Resultados: El 63,2% de los químico farmacéuticos fueron mujeres, la edad promedio fue 32.2 (DE: 6.027). Ninguno de los químicos farmacéuticos realizaron maestría o doctorado en Atención Farmacéutica; solo es 7.4% realizó un diplomado en Atención Farmacéutica. El 88.4% estaba satisfecho con la elección de su profesión; el 93.7% afirma que la formación universitaria no es suficiente para realizar la Atención Farmacéutica. El 81.1% está insatisfecho con el ingreso mensual que percibe. Conclusión: La falta de materiales e infraestructura, insuficiente tiempo, mal salario y la necesidad de aprobación de los propietarios fueron los factores fundamentales que impiden la implementación de la Atención Farmacéutica

Introduction: More than 25 years after the pharmaceutical care proposal, a large percentage of pharmacies fail to its implementation which makes necessary to determine the usual barriers to create strategies that contribute to its setting-up and its development. Objectives: To determine the factors impeding the implementation of pharmaceutical care in pharmacies in Cusco and Wanchaq districts, Cusco’s department. Methods: It was carried out an observational, descriptive and cross-sectional study based on a survey addressed to 95 pharmaceutical chemists registered in Cusco (Cusco district: 44; Wanchaq district: 51) who work in pharmacies and also to 46 pharmacies’ owners. Two pieces of data collection (questionnaire survey) validated by experts were developed. The results were processed in SPSS V.22. Results: 63.2% of the pharmaceutical chemists were women, the mean age was 32.2 (SD: 6.027). None of them did a master or a doctorate in pharmaceutical care. Just 7.4% held a diploma in pharmaceutical care. 88.4% were satisfied with the occupation of their choice; 93.7% said that university education is not enough for pharmaceutical care development. 81.1% are dissatisfied with the monthly income received. Conclusion: The lack of materials and infrastructure, the insufficient time, the poor wages and the need for approval of the owners were the key factors that prevent the implementation of pharmaceutical care

Experimental study of the anticancer effect of gemcitabine combined with sirolimus on chemically induced urothelial lesions.

BACKGROUND: The purpose of this study was to determine the efficacy of a combination of gemcitabine and sirolimus in a mouse model of invasive bladder cancer. MATERIALS AND METHODS: Gemcitabine (50 mg/kg) and sirolimus (1.5 mg/kg) were administered to animals previously exposed to N-butyl-N-4(hydroxybutyl)nitrosamine in drinking water. Tumour development was determined by histopathological evaluation. RESULTS: Both drugs were well tolerated by animals. The incidence of lesions in mice treated with gemcitabine was lower in comparison to those not treated, however this result was not statistically significant. The incidence of invasive bladder cancer in animals treated with sirolimus was statistically lower (20%) than in animals not treated (54%) (p=0.008). The results indicate that this drug combination has no statistical significance on the development of pre-neoplastic urothelial lesions and had only a minor impact on invasive bladder cancer incidence in mice. CONCLUSION: The combination of gemcitabine and sirolimus had only a marginal impact on invasive bladder cancer in a mouse model.

Measurements of the neutron cross sections of hydrogen and deuterium in H2O-D2O mixtures using the deep inelastic neutron-scattering technique.

We investigated the neutron cross sections of hydrogen and deuterium by means of the deep inelastic neutron-scattering technique in H2O-D2O mixtures. The interest in this work was to examine the anomalous behavior in the hydrogen neutron cross section reported in the past in similar experiments that raised a yet unsettled controversy. The measurements were made at the Bariloche pulsed neutron source (Argentina) in pure H2O and D2O, with mixtures of molar concentrations of deuterium of xD=0.3 and 0.4, at room temperature, under the same experimental conditions as the former experiments. The results are in good agreement with the standard cross sections and are incompatible with the anomalies pointed out.

Preservación de eritrocitos y cambios físicos ocurridos durante el almacenamiento / Preservation of erythrocytes and happened physical changes during storage

La preservación de sangre y de sus derivados ha sido una constante en el desarrollo de los bancos de sangre modernos. Los dos métodos actualmente utilizados son la fase líquida y la criopreservación. Se revisaron las generalidades de cada uno de ellos, así como los cambios físicos ocurridos a los eritrocitos durante su almacenamiento

Alteraciones bioquímicas de los eritrocitos almacenados en condiciones estándar de banco de sangre / Erythrocytes blood bank storage

La forma más habitual de almacenamiento de eritrocitos es en fase líquida. Durante el almacenamiento se producen cambios deletéreos que disminuyen la viabilidad y funcionalidad en el receptor y conllevan a efectos colaterales. Se revisaron los mecanismos que generan los cambios bioquímicos de los eritrocitos

[Human peripheral neurolymphomatosis (reticuloendothelial polyradiculoneuritis)]. / Neurolymphomatose périphérique humaine (polyradiculonévrite réticuloendothéliosique)

This is the clinico-pathological report of a case of reticulo-endotheliosis of the nervous system in a 53-year-old white female. She had a history of transient facial palsy followed 6 months later by progressive weakness, paresthesiae and severe pain in both lower limbs. Clinical examination revealed signs of sensory and motor polyradiculoneuritis with involvement of the oculomotor, facial and trigeminal cranial nerves. She died 10 months after the onset because of bronchopneumonia. Pathological findings in the nervous system were limited to the cranial and spinal roots and ganglia. Histopathological examination showed intense infiltration by lymphocytes, histiocytes, plasmocytes and macrophages and a large amount of reticulin. The left oculomotor nerve, both Gasserian ganglia, the right trigeminal nerve and the lumbosacral nerves and ganglia were particularly involved. The previous literature on human peripheral neurolymphomatosis is reviewed and its differential diagnosis from Marek's disease, sarcomas, leukaemic polyradiculoneuritis, sarcoidosis and Hodgkin's disease of the nervous system is discussed. The importance of recognizing this variety of polyradiculoneuritis, and methods of treating it are emphasized.