Allogeneic stem cell transplantation and CAR-T in B-cell Non-Hodgkin Lymphoma: a two-center experience and review of the literature.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still a potentially curative option for B-cell Non-Hodgkin Lymphoma (B-NHL) in the modern immunotherapy era. The objective of this study was to analyze long-term outcomes of patients with B-NHL who received allo-HSCT. We analyzed overall survival (OS), progression-free survival (PFS) and graft versus host disease (GVHD) relapse-free survival (GRFS) in 53 patients undergoing allo-HSCT from two institutions. The median follow-up of the study was 72 months (range 29-115 months). The median number of lines of therapy before allo-HSCT was 3 (range 1-6) and twenty-eight patients (53%) had received a previous autologous transplant. The 3-year PFS, OS and GRFS were 55%, 63%, and 55%, respectively. One-year non-relapse mortality was 26%. Karnofsky Performance Scale < 90 was associated with worse OS in multivariable analysis. A non-comparative analysis of a cohort of 44 patients with similar characteristics who received chimeric antigen receptor T-cell therapy was done, showing a 1-year PFS and OS were 60% and 66%, respectively. Our data shows that allo-HSCT is still a useful option for treating selected patients with R/R B-NHL. Our retrospective analysis and review of the literature demonstrate that allo-HSCT can provide durable remissions in a subset of patients with R/R B-NHL.

Knowledge, Perceptions, and Practices on Risks and Disasters Among Medical Students. A Multicenter Cross-Sectional Study in 9 Latin American and Caribbean Countries.

Purpose: The objective of this study was to describe the level of knowledge, perceptions, and practices in relation to risks and disasters in medical schools in Latin America and the Caribbean. Participants and Methods: Multicenter, observational, analytical, non-probabilistic convenience sample study with 2546 medical students in 9 countries of Latin America and the Caribbean. An online survey was conducted between October 2020 and November 2020, using an instrument validated in each country to assess knowledge, perceptions, and practices regarding risk and disaster prevention measures. Frequencies, percentages, mean and standard deviation (SD) were used for descriptive analysis. Differences resulting from the relationship between the variables studied and the level of knowledge were obtained using the Chi-square test. P-value <0.05 was accepted as statistically significant for all analyses. Results: The highest proportion of responses came from women, third-semester students, and those studying in public universities. Students from Colombia and Honduras had the highest percentage of high levels of knowledge about disasters, while Peruvian students had the highest percentage of low levels of knowledge. Women and students from public universities showed a higher proportion of high levels of knowledge. 52.7% considered that they live in a country with a medium risk of natural disasters, while 91.2% said that Latin American and Caribbean countries are not prepared to face natural disasters. Only 43.6% believe they are prepared to help in the event of a natural disaster. Conclusion: Most of medical students from Latin America and Latin America and the Caribbean have high and medium level of knowledge in risks and disasters. However, the implementation of disaster training programs for medical students has the potential to improve the preparedness, knowledge, and skills that are important for medical personnel to improve their self-confidence, and their ability to respond, resulting in more effective systems.

Eliminating Abortion from Criminal Law in Colombia: A Just Cause.

The two main legal models governing abortion provision, indications for abortion and time limits on the number of weeks of pregnancy, both limit recognition of women's reproductive autonomy. Each model restricts the circumstances under which women can access abortion. Yet, in most of the world these have been the main political goals for the feminist movement in the fight to make abortion legal and safe. Other strategies have also been incorporated into these goals. But in each case, abortion remains a crime, causing pervasive and profound damage for the providers and for women, and maintaining abortion as a part of an exceptionality regime suspended in its own illegality. This article discusses such limitations. It then focuses on Colombia and the experiences of feminist collective La Mesa por la Vida y la Salud de las Mujeres, which is campaigning to have abortion removed from the criminal law. In particular, this article examines a double standard in Colombian law: while abortion has been declared a fundamental right, it remains a crime in the penal code.

Framework for e-learning assessment in dental education: a global model for the future.

The framework presented in this article demonstrates strategies for a global approach to e-curricula in dental education by considering a collection of outcome assessment tools. By combining the outcomes for overall assessment, a global model for a pilot project that applies e-assessment tools to virtual learning environments (VLE), including haptics, is presented. Assessment strategies from two projects, HapTEL (Haptics in Technology Enhanced Learning) and UDENTE (Universal Dental E-learning), act as case-user studies that have helped develop the proposed global framework. They incorporate additional assessment tools and include evaluations from questionnaires and stakeholders' focus groups. These measure each of the factors affecting the classical teaching/learning theory framework as defined by Entwistle in a standardized manner. A mathematical combinatorial approach is proposed to join these results together as a global assessment. With the use of haptic-based simulation learning, exercises for tooth preparation assessing enamel and dentine were compared to plastic teeth in manikins. Equivalence for student performance for haptic versus traditional preparation methods was established, thus establishing the validity of the haptic solution for performing these exercises. Further data collected from HapTEL are still being analyzed, and pilots are being conducted to validate the proposed test measures. Initial results have been encouraging, but clearly the need persists to develop additional e-assessment methods for new learning domains.

Constituents of Hondurian propolis with inhibitory effects on Saccharomyces cerevisiae multidrug resistance protein Pdr5p.

Chemical investigation of a propolis sample collected in Honduras has led to the isolation of the new (E,Z)-cinnamyl cinnamate (2) together with 14 known compounds: 6 cinnamic ester derivatives, 2 flavanones, 1 chalcone, 2 triterpenes, and 3 aromatic acids. Structural determination was accomplished by spectroscopic analysis, particularly two-dimensional (2D) nuclear magnetic resonance (NMR) and electrospray ionization-tandem mass spectrometry (ESI-MS/MS) techniques. Futhermore, we checked the ability of the propolis extract and the most representative compounds of each class (1, 5, 8, and 10) to inhibit the activity of Pdr5p, a protein responsible for a multidrug resistance phenotype in yeast. The present study appears to be the first report on Honduras propolis. Isolated cinnamic ester derivatives indicated the possible relation between Honduras propolis and the genus Liquidambar .

Phenolic derivatives from the leaves of Martinella obovata (Bignoniaceae).

A new phenolic derivative, 4-methoxyphenol 1-O-beta-D-apiofuranosyl-(1 --> 6)-O-beta-D-glucopyranoside (1), has been identified together with uncommon 3,4-dimethoxyphenol 1-O-beta-D-apiofuranosyl-(1 --> 6)-O-beta-D-glucopyranoside (2) and 3-hydroxy, 4-methoxyphenol 1-O-beta-D-apiofuranosyl-(1 --> 6)-O-beta-D-glucopyranoside (3) from the leaves of Martinella obovata (Kunth) Bureau & K. Schum., an Honduran species used in folk medicine for the treatment of eyes diseases. Verbascoside, isoverbascoside, leucoceptoside A, vitexin, isovitexin, luteolin 8-C-beta-D-glucopiranoside and spireoside were also found. All structures were elucidated on the basis of mass spectrometry and 2D NMR techniques.

Detection of antibodies to West Nile virus in horses, Costa Rica, 2004.

We conducted a serosurvey for West Nile virus (WNV) infection in equines in Costa Rica in 2004. Antibodies to WNV were detected in 28% of the horses using an epitope blocking ELISA that is specific for WNV. WNV infection was confirmed for a subset of these sera by plaque reduction neutralization tests and Western blot. This is the first evidence of WNV activity in Costa Rica.

Trypanosoma rangeli genotypes association with Rhodnius prolixus and R. pallescens allopatric distribution in Central America.

Previous kDNA polymorphism-based reports have revealed the existence of two Trypanosoma rangeli genotypes (KP1+ and KP1-): SL and SSU rRNA gene polymorphism-based studies have revealed that five genotypes (A-E) are distributed throughout different Latin-American countries. Some evidence has shown that the genotypes' biogeographical distribution is associated with sympatric Rhodnius species. 12 T. rangeli isolates from humans and reservoirs from El Salvador, Guatemala, Honduras, Costa Rica and Panama were characterised by kDNA and mini-exon gene intergene spacer analysis and compared to 12 previously characterised isolates from humans and vectors from Colombia, Guatemala, Honduras and Venezuela. Central American isolates corresponded to genotypes called KP1(+) or lineage A and KP1(-) or lineage C. Such dimorphism was corroborated by randomly amplified polymorphic DNA (RAPD) in 22 selected isolates; a dendrogram was thus produced having two defined branches. One branch grouped KP1(-) or lineage C strains isolated from Rhodnius colombiensis (Colombia), humans (Panama), Procyon lotor and Choloepus hoffmanni (Costa Rica). The other group was formed by KP1(+) or lineage A strains isolated from Rhodnius prolixus (Colombia, Venezuela) and humans (El Salvador, Guatemala, Honduras). These results present evidence that both groups infect different mammals (humans, domestic and silvatic animals) having no association with any particular vertebrate species; however, T. rangeli KP1(+) or (A) strains have been isolated in Central America in areas where R. prolixus circulate (Honduras, El Salvador and Guatemala) and KP1(-) or (C) strains have been isolated in areas where Rhodnius pallescens is the main vector (Panama and Costa Rica) indicating a parasite-vector association. The same lineages circulate in Andean countries (Colombia, Venezuela, Ecuador and Peru), KP1+ being associated with members of the prolixus group (R. prolixus and Rhodnius robustus) and KP1- with members of the pallescens group (R. pallescens, R. colombiensis and Rhodnius ecuadoriensis).

Magnoflorine and phenolic derivatives from the leaves of Croton xalapensis L. (Euphorbiaceae).

The alkaloid magnoflorine 1, has been isolated for the first time from Croton xalapensis (Euphorbiaceae), in addition two phenylpropenols derivates, 3,4-dimethoxy-(E)-cinnamyl alcohol 2 and 3,4-dimethoxy-5-hydroxy-(E)-cinnamyl alcohol 3, 3,4,5-trimethoxycinnamic acid 4, gallic acid 5, methyl gallate 6 and 3,4-dihydroxybenzoic acid 7 have been also found; these compounds were identified by spectroscopic analysis particularly, 2D NMR and ESI-MS/MS techniques. The high concentration of magnoflorine, calculated with quantitative HPLC, of the aqueous extract, probably contributes to the remarkable medicinal properties of this plant. In addition this is the first phytochemical study on Croton xalapensis to be reported.

Estudio químico de la resina de la especie endémica Calophyllum pinetorum Bisse / Chemical study of the resin of the endemic species Calophyllum pinetorum Bisse

Objetivos: aislar e identificar los componentes principales presentes en el extracto metanólico de la resina de la especie Calophyllum pinetorum Bisse.Métodos: la cromatografía líquida de alta resolución se utilizó para la separación de los compuestos. Para la caracterización estructural se emplearon las técnicas de resonancia magnética nuclear y la espectrometría de masas.Resultados: el proceso de separación permitió el aislamiento de 3 compuestos que fueron reconocidos como derivados de cromonas. Los compuestos 1-3 fueron identificados como: ácido calolóngico, ácido apetálico y ácido isoapetálico.Conclusiones: la presencia de cromonas se corresponde con los estudios realizados con otras especies de este género, pero es la primera vez que estos compuestos se aíslan e identifican desde una misma especie. Por otra parte, es la primera vez que se informa la presencia de cromonas en la resina de este género.

Objectives: to isolate and identify the main components in the methanolic extract of the resin of the species Calophyllum pinetorum Bisse.Methods: high resolution liquid chromatography was used for the separation of the compounds. Magnetic resonance imaging and mass spectrometry were used for the structural characterization.Results: the separation process allowed the isolation of 3 compounds that were recognized as derivatives of chromans. The compounds 1-3 were identified as calolongic acid, apetalic acid and isoapetalic acid.Conclusions: the presence of chromans corresponds with the studies conducted with other species of this genus, but it is the first time that these compounds are isolated and identified from the same species. On the other hand, it is reported for the first time, too, the presence of chromans in the resin of this genus.

Estudio químico de la resina de la especie endémica Calophyllum pinetorum Bisse / Chemical study of the resin of the endemic species Calophyllum pinetorum Bisse

Objetivos: aislar e identificar los componentes principales presentes en el extracto metanólico de la resina de la especie Calophyllum pinetorum Bisse.Métodos: la cromatografía líquida de alta resolución se utilizó para la separación de los compuestos. Para la caracterización estructural se emplearon las técnicas de resonancia magnética nuclear y la espectrometría de masas.Resultados: el proceso de separación permitió el aislamiento de 3 compuestos que fueron reconocidos como derivados de cromonas. Los compuestos 1-3 fueron identificados como: ácido calolóngico, ácido apetálico y ácido isoapetálico.Conclusiones: la presencia de cromonas se corresponde con los estudios realizados con otras especies de este género, pero es la primera vez que estos compuestos se aíslan e identifican desde una misma especie. Por otra parte, es la primera vez que se informa la presencia de cromonas en la resina de este género(AU)

Objectives: to isolate and identify the main components in the methanolic extract of the resin of the species Calophyllum pinetorum Bisse.Methods: high resolution liquid chromatography was used for the separation of the compounds. Magnetic resonance imaging and mass spectrometry were used for the structural characterization.Results: the separation process allowed the isolation of 3 compounds that were recognized as derivatives of chromans. The compounds 1-3 were identified as calolongic acid, apetalic acid and isoapetalic acid.Conclusions: the presence of chromans corresponds with the studies conducted with other species of this genus, but it is the first time that these compounds are isolated and identified from the same species. On the other hand, it is reported for the first time, too, the presence of chromans in the resin of this genus(AU)

A survey on Triatoma dimidiata in an urban area of the province of Heredia, Costa Rica

Triatoma dimidiata has been found in several cities and towns of those countries where the insect is a domestic or peridomestic pest. In Central America, urban infestations occur in the capitals of at least five countries. During 2001 and 2002 a survey was carried out in the county of San Rafael, Heredia province, located 15 km northwest of San José, capital of Costa Rica, in order to determine the degree of infestation by T. dimidiata in an entire city block. Six peridomestic colonies of the insect were detected in the backyards of eight households. The ecotopes occupied by the insects consisted of store rooms with old objects, wood piles or firewood, and chicken coops. A total of 1917 insects were found in the six foci, during two sampling periods, and a mean infection rate by Trypanosoma cruzi of 28.4% was found in 1718 insects examined. The largest colony found in one of the households yielded 872 insects that were thriving mainly at the expenses of two dogs. Opossums and adult insects were common visitors of the houses and it became evident that this marsupial is closely related to the peridomestic cycle of the Chagas disease agent. Lack of colonization of the insect inside the human dwellings is explained by the type of construction and good sanitary conditions of the houses, in contrast to the situation in most peridomiciliary areas. Stomach blood samples from the insects showed that the main hosts were, in order of decreasing frequency: rodents, dogs, fowl, humans, opossums, and cats.

Effect of Echinacea purpurea (Asteraceae) aqueous extract on antibody response to Bothrops asper venom and immune cell response

The effect of aqueous extract of Echinacea purpurea roots on the murine antibody response to Bothrops asper snake venom in vivo was studied. Three groups were used. Group #1, baseline control, was treated with snake venom plus PBS. Group #2 was treated with snake venom plus sodium alginate as adjuvant (routine method used at Instituto Clodomiro Picado), and group #3 or experimental group, was treated with snake venom plus aqueous extract ofE. purpurea root as adjuvant. In all groups, the first inoculation was done with Freund's complete adjuvant (FCA). By the time of the second bleeding, mice in group #3 showed a remarkable increment in the level of anti-venom antibodies compared with those in groups #1 or #2. In vitro immune cell proliferation as a response to aqueous extract of E. purpurea root was studied using human lymphocytes activated with different lectins (Con A, PHA and PWM). In all cases, increase in percentage of lymphoproliferation was greater when E. purpurea root extract was used in addition to individual lectins.

Effect of Echinacea purpurea (Asteraceae) aqueous extract on antibody response to Bothrops asper venom and immune cell response.

The effect of aqueous extract of Echinacea purpurea roots on the murine antibody response to Bothrops asper snake venom in vivo was studied. Three groups were used. Group #1, baseline control, was treated with snake venom plus PBS. Group #2 was treated with snake venom plus sodium alginate as adjuvant (routine method used at Instituto Clodomiro Picado), and group #3 or experimental group, was treated with snake venom plus aqueous extract ofE. purpurea root as adjuvant. In all groups, the first inoculation was done with Freund's complete adjuvant (FCA). By the time of the second bleeding, mice in group #3 showed a remarkable increment in the level of anti-venom antibodies compared with those in groups #1 or #2. In vitro immune cell proliferation as a response to aqueous extract of E. purpurea root was studied using human lymphocytes activated with different lectins (Con A, PHA and PWM). In all cases, increase in percentage of lymphoproliferation was greater when E. purpurea root extract was used in addition to individual lectins.

A survey on Triatoma dimidiata in an urban area of the province of Heredia, Costa Rica.

Triatoma dimidiata has been found in several cities and towns of those countries where the insect is a domestic or peridomestic pest. In Central America, urban infestations occur in the capitals of at least five countries. During 2001 and 2002 a survey was carried out in the county of San Rafael, Heredia province, located 15 km northwest of San José, capital of Costa Rica, in order to determine the degree of infestation by T. dimidiata in an entire city block. Six peridomestic colonies of the insect were detected in the backyards of eight households. The ecotopes occupied by the insects consisted of store rooms with old objects, wood piles or firewood, and chicken coops. A total of 1917 insects were found in the six foci, during two sampling periods, and a mean infection rate by Trypanosoma cruzi of 28.4% was found in 1718 insects examined. The largest colony found in one of the households yielded 872 insects that were thriving mainly at the expenses of two dogs. Opossums and adult insects were common visitors of the houses and it became evident that this marsupial is closely related to the peridomestic cycle of the Chagas disease agent. Lack of colonization of the insect inside the human dwellings is explained by the type of construction and good sanitary conditions of the houses, in contrast to the situation in most peridomiciliary areas. Stomach blood samples from the insects showed that the main hosts were, in order of decreasing frequency: rodents, dogs, fowl, humans, opossums, and cats. The fact that no indication of infection with Chagas disease could be detected in the human occupants of the infested houses, vis a vis the high infection rate in dogs, is discussed.

A survey on Triatoma dimidiata in an urban area of the province of Heredia, Costa Rica

Triatoma dimidiata has been found in several cities and towns of those countries where the insect is a domestic or peridomestic pest. In Central America, urban infestations occur in the capitals of at least five countries. During 2001 and 2002 a survey was carried out in the county of San Rafael, Heredia province, located 15 km northwest of San José, capital of Costa Rica, in order to determine the degree of infestation by T. dimidiata in an entire city block. Six peridomestic colonies of the insect were detected in the backyards of eight households. The ecotopes occupied by the insects consisted of store rooms with old objects, wood piles or firewood, and chicken coops. A total of 1917 insects were found in the six foci, during two sampling periods, and a mean infection rate by Trypanosoma cruzi of 28.4 percent was found in 1718 insects examined. The largest colony found in one of the households yielded 872 insects that were thriving mainly at the expenses of two dogs. Opossums and adult insects were common visitors of the houses and it became evident that this marsupial is closely related to the peridomestic cycle of the Chagas disease agent. Lack of colonization of the insect inside the human dwellings is explained by the type of construction and good sanitary conditions of the houses, in contrast to the situation in most peridomiciliary areas. Stomach blood samples from the insects showed that the main hosts were, in order of decreasing frequency: rodents, dogs, fowl, humans, opossums, and cats. The fact that no indication of infection with Chagas disease could be detected in the human occupants of the infested houses, vis a vis the high infection rate in dogs, is discussed.