A rare case of hepatoid gastric adenocarcinoma.

Hepatoid gastric adenocarcinoma (HGA) is a rare subtype of gastric cancer. It usually presents with non-specific digestive tract symptoms and is usually diagnosed in advanced stages. It has radiological and histological similarities to hepatocarcinoma (HCC), and serum elevation of alpha-fetoprotein (AFP) is characteristic, as is positive staining for this marker on immunohistochemistry. Given the low incidence and poor prognosis of this type of tumour, it is essential to make a correct differential diagnosis and to initiate early surgical treatment in localised stages and systemic treatment in those where the disease is disseminated. In this context, we present the case of a GHA diagnosed this year in our centre.

Late recurrence of lobular breast carcinoma presented as gastric metastasis.

A 81-year-old woman with a history of mild chronic heart failure and invasive lobular breast carcinoma pT2N0M0 diagnosed in 2009 and treated by mastectomy, chemotherapy, radiotherapy and adjuvant endocrine therapy with letrozole until 2016. Since then the patient has been disease-free. She presented to the Emergency Room in April 2023 due to severe postprandial epigastric pain and a 7 kg weight loss in the last 3 months. Abdominal computed tomography was performed showing thickening of the gastric antrum and proximal duodenum walls, peritoneal implants and ascites that suggested primary gastric tumor or lymphoma as the first possibility. An endoscopic ultrasound was schedule, performing a biopsy of the gastric lesion and placing a Hot-Axios® stent. The sample showed infiltration by lobular breast carcinoma CK7 (+), CK20 (-), CDX2 (-), GATA3 (+) GCDFP15 (+) RE (+) RP (-) HER2 (-). Treatment with capecitabine was started, with which it continues currently.

Asociación entre niveles séricos de vitamina D y factores de riesgo cardiometabólicos en pacientes pediátricos del noroeste de México

RESUMEN Introducción: Actualmente se ha observado que la hipovitaminosis D y la obesidad pueden influir en el desarrollo de enfermedad cardiovascular en el futuro. Objetivo: Identificar la asociación entre deficiencia de vitamina D y factores de riesgo cardiometabólicos en los pacientes pediátricos del noroeste de México. Materiales y métodos : se incluyeron niños de 6 a 15 años, se les midieron variables somatométricas, niveles séricos de colesterol total, C-HDL, C-LDL, triglicéridos, glucosa, insulina, vitamina D e índice HOMA-IR. Se identificó la asociación de factores de riesgo cardiometabólicos y la deficiencia de vitamina D, mediante la prueba de Chi cuadrado. Resultados: De los 114 pacientes evaluados, se detectó eutrofia en 42.1%, sobrepeso en 12.3%, obesidad en 41.2% y desnutrición en 4.4%. La prevalencia de deficiencia en vitamina D, insuficiencia y suficiencia fueron 18.4%, 27.2% y 54.4% respectivamente. La deficiencia de vitamina D mostró mayor predominio en pacientes con obesidad (27 %). La hipertrigliceridemia se asoció estadísticamente con deficiencia de vitamina D (p 0.041). Se observaron correlaciones inversas entre niveles de vitamina D con HOMA (r=-0.191; p=0.41), score Z IMC (r=-0.210; p=0.025) e insulina (r=-0.227; p=0.015). Conclusiones: La deficiencia de vitamina D se asocia en niños con un IMC elevado y resistencia a la insulina, lo cual puede acelerar el desarrollo de síndrome metabólico, diabetes mellitus tipo 2 y enfermedad cardiovascular.

ABSTRACT Introduction: It has currently been observed that hypovitaminosis D and obesity can influence the future development of cardiovascular disease. Objective: To identify the association between vitamin D deficiency and cardiometabolic risk factors in pediatric patients from northwestern Mexico. Materials and methods: Children aged 6 to 15 years were included, somatometric variables, serum levels of total cholesterol, HDL-C, LDL-C, triglycerides, glucose, insulin, vitamin D and HOMA-IR index were measured. The association of cardiometabolic risk factors and vitamin D deficiency was identified using the Chi square test. Results: Of the 114 patients evaluated, normal body-mass index was detected in 42.1%, 12.3% were overweight, 41.2% were obese and 4.4% were malnourished. The prevalence of vitamin D deficiency, insufficiency and sufficiency were 18.4%, 27.2% and 54.4% respectively. Vitamin D deficiency was more prevalent in obese patients (27%). Hypertriglyceridemia was statistically associated with vitamin D deficiency (p = 0.041). Inverse correlations were observed between vitamin D levels with HOMA (r = -0.191; p = 0.41), BMI Z score (r = -0.210; p = 0.025) and insulin (r = -0.227; p = 0.015). Conclusions: Vitamin D deficiency is associated with a higher BMI and insulin resistance in children, which can accelerate the development of metabolic syndrome, type 2 diabetes mellitus and cardiovascular disease.

Análise do conhecimento e consumo de alimentos fontes de fósforo por pacientes portadores de insuficiência renal crônica em tratamento dialítico / Analysis of knowledge and consumption of food sources of phosphorus by patients with chronic renal failure in dialysis treatment

Introdução: O controle inadequado no consumo de fósforo é correlacionado com o aumento do risco da morbi e mortalidade em pacientes com doença renal crônica (DRC) dialítica. Objetivo: Avaliar o conhecimento e o consumo de alimentos fontes de fósforo por estes pacientes. Método: A pesquisa foi desenvolvida entre julho e agosto de 2016, com 51 pacientes que faziam hemodiálise em uma clínica situada no município de Campinas-SP, mediante a aplicação de um questionário para obter dados de sexo, idade, escolaridade, tempo de diálise, tratamento medicamentoso e presença de comorbidades, além da avaliação do consumo de fósforo por meio de um questionário de frequência de alimentos. Resultados: Os resultados demonstraram o predomínio da doença entre adultos e idosos do sexo masculino, sendo a hipertensão arterial sistêmica (HAS) e diabetes mellitus (DM) as principais comorbidades. O teste estatístico Qui-quadrado demonstrou que a escolaridade não interferiu no conhecimento quanto aos alimentos fontes de fósforo e no de consumo alimentar. Houve consumo deficiente de carnes, ovos e leguminosas e excessivo de laticínios, refrescos em pó, molhos, bolos prontos, hambúrgueres e refrigerantes à base de cola. Conclusão: Avaliar o conhecimento e os hábitos alimentares na fase dialítica direciona as ações educativas do nutricionista, permitindo a adequação de suas condutas.

Single nucleotide variations in cultured cancer cells: Effect of mismatch repair.

We assessed single nucleotide variations (SNVs) between individual cells in two cancer cell lines; DU145, from brain metastasis of prostate tumor with deficient mismatch repair; and HT1080, a fibrosarcoma cell line. Clones of individual cells were isolated, and sequenced using Ion Ampliseq comprehensive cancer panel that covered the exomes of 409 oncogenes and tumor suppressor genes. Five clones of DU145 and four clones of HT1080 cells were analyzed. We found from 7 to 12 unique SNVs between DU145 clones, while HT1080 clones showed no more than one unique SNV. We then sub-cloned individual cells from some of these isolated clones of DU145 and HT1080 cells. The sub-clones were expanded from a single cell to approximately one million cells after about 20 cell divisions. The sub-clones of DU145 cells had from one to four new unique SNVs within the sequenced regions. No unique SNVs were found between sub-clones of HT1080 cells. Our data demonstrate that the extent of genetic variation at the single nucleotide level in cultured cancer cells is significantly affected by the status of the DNA mismatch repair system.

Cytotoxicity and intracellular dissolution of nickel nanowires.

The assessment of cytotoxicity of nanostructures is a fundamental step for their development as biomedical tools. As widely used nanostructures, nickel nanowires (Ni NWs) seem promising candidates for such applications. In this work, Ni NWs were synthesized and then characterized using vibrating sample magnetometry, energy dispersive X-Ray analysis, and electron microscopy. After exposure to the NWs, cytotoxicity was evaluated in terms of cell viability, cell membrane damage, and induced apoptosis/necrosis on the model human cell line HCT 116. The influence of NW to cell ratio (10:1 to 1000:1) and exposure times up to 72 hours was analyzed for Ni NWs of 5.4 µm in length, as well as for Ni ions. The results show that cytotoxicity markedly increases past 24 hours of incubation. Cellular uptake of NWs takes place through the phagocytosis pathway, with a fraction of the dose of NWs dissolved inside the cells. Cell death results from a combination of apoptosis and necrosis, where the latter is the outcome of the secondary necrosis pathway. The cytotoxicity of Ni ions and Ni NWs dissolution studies suggest a synergistic toxicity between NW aspect ratio and dissolved Ni, with the cytotoxic effects markedly increasing after 24 hours of incubation.

Cytotoxic effects of nickel nanowires in human fibroblasts.

The increasing interest in the use of magnetic nanostructures for biomedical applications necessitates rigorous studies to be carried out in order to determine their potential toxicity. This work attempts to elucidate the cytotoxic effects of nickel nanowires (NWs) in human fibroblasts WI-38 by a colorimetric assay (MTT) under two different parameters: NW concentration and exposure time. This was complemented with TEM and confocal images to assess the NWs internalization and to identify any changes in the cell morphology. Ni NWs were fabricated by electrodeposition using porous alumina templates. Energy dispersive X-ray analysis, scanning electron microscopy and transmission electron microscopy imaging were used for NW characterization. The results showed decreased cell metabolic activity for incubation times longer than 24 h and no negative effects for exposure times shorter than that. The cytotoxicity effects for human fibroblasts were then compared with those reported for HCT 116 cells, and the findings point out that it is relevant to consider the cellular size. In addition, the present study compares the toxic effects of equivalent amounts of nickel in the form of its salt to those of NWs and shows that the NWs are more toxic than the salts. Internalized NWs were found in vesicles inside of the cells where their presence induced inflammation of the endoplasmic reticulum.