Salt-tolerance mechanisms in quinoa: Is glycinebetaine the missing piece of the puzzle?

Salinization of arable land has been progressively increasing, which, along with the effects of climate change, poses a serious risk to food production. Quinoa is a halophyte species that grows and is productive in highly saline soils. This study addresses the mechanisms of response and adaptation to high salinity. We show that the differential distribution of sodium in plants depends on the variety, observing that varieties such as Pandela Rosada limit the passage transit of sodium to the aerial part of the plant, a mechanism that seems to be regulated by sodium transporters such as HKT1s or SOS1. Like other halophytes of the Amaranthaceae family, quinoa plants have salt glands (bladder cells), which have been reported to play an important role in salt tolerance. However, our study shows that the contribution of bladder glands to salt accumulation is rather low. The 1H-NMR metabolome study of quinoa subjected to salt stress showed important modifications in the contents of amino acids, sugars, organic acids, and quaternary ammonium compounds (glycinebetaine). The compound with a higher presence was glycinebetaine, which makes up 6% of the leaf dry matter under saline conditions. Our findings suggest that glycinebetaine can act as an osmolyte and/or osmoprotectant, facilitating plant development under high saline ambient.

[Initial management of the patients with psychiatric involvement in hospital emergency departments: a systematic review].

This article is a systematic review of studies that have investigated the initial management of patients with psychiatric conditions in hospital emergencies services in order to establish practical recommendations. A systematic review of the literature was carried out, consisting of studies published from 2010 to 2020, available in any language, consulting Cochrane Library Plus, PubMed, IBECS, LILACS and MEDLINE. The quality of the studies included in this review was assessed by the AMSTAR2 tool and the FCL 3.0 platform, together with the PRISMA statement. Results from the eleven papers selected showed that improvements in staff training, available resources, appropriate use of restraint and appropriate choice of medication can help to improve the care of patients with mental pathology in hospital emergency services. The same management for any other patient is recommended. However, if the patient is agitated or uncooperative, verbal, pharmacological and/or mechanical restraint (in this order) may be necessary. Keywords. Psychiatry. Psychomotor agitation. Crisis intervention. Hospital emergency service.

Manejo inicial del paciente con afectación psiquiátrica en urgencias hospitalarias: revisión sistemática / Initial management of the patients with psychiatric involvement in hospital emergency departments: a systematic review

Se revisaron los estudios que han investigado el manejo inicial del paciente con afectación psiquiátrica en urgencias hospitalarias a fin de establecer recomendaciones prácticas. Se realizó una revisión sistemática de artículos publicados entre 2010 y 2020, en cualquier idioma, mediante consulta en Biblioteca Cochrane Plus, Pubmed, IBECS, LILACS y MEDLINE. La calidad de los artículos revisados se evaluó mediante la herramienta AMSTAR2 y la plataforma FCL 3.0, junto con la declaración PRISMA. Los resultados de los once artículos seleccionados mostraron que mejorar la formación del personal, los recursos disponibles, el uso adecuado de la contención y la elección adecuada de la medicación puede ayudar a mejorar la atención del paciente con patología mental en el servicio de urgencias hospitalarias. Se recomienda el mismo manejo que en cualquier otro paciente, pero si está agitado o no colaborativo será necesario aplicar contención verbal, farmacológica y/ o mecánica, en ese orden

This article is a systematic review of studies that have investigated the initial management of patients with psychiatric conditions in hospital emergencies services in order to establish practical recommendations. A systematic review of the literature was carried out, consisting of studies published from 2010 to 2020, available in any language, consulting Cochrane Library Plus, PubMed, IBECS, LILACS and MEDLINE. The quality of the studies included in this review was assessed by the AMSTAR2 tool and the FCL 3.0 platform, together with the PRISMA statement.Results from the eleven papers selected showed that improvements in staff training, available resources, appropriate use of restraint and appropriate choice of medication can help to improve the care of patients with mental pathology in hospital emergency services. The same management for any other patient is recommended. However, if the patient is agitated or uncooperative, verbal, pharmacological and/or mechanical restraint (in this order) may be necessary

Hallazgos en imagen en los tumores mucinosos de abdomen y pelvis / Imaging findings for mucinous tumors of the abdomen and pelvis

El objetivo de este artículo es describir los hallazgos en imagen de los tumores mucinosos de abdomen y pelvis que, por su composición, comparten características radiológicas independientemente del órgano de origen. Debido al alto contenido hídrico del moco, generalmente muestran un aspecto similar al agua en la ecografía, la tomografía computarizada y la resonancia magnética. Otra característica común de los tumores productores de mucina es la frecuente presencia de calcificaciones. La rotura de estas lesiones con acumulación de material mucinoso en la cavidad peritoneal da lugar al pseudomixoma peritoneal. La importancia de la identificación de las neoplasias mucinosas radica en el diferente manejo, pronóstico y evolución clínica con respecto a las no mucinosas; en función de su localización anatómica y las características de imagen, la actitud varía desde el seguimiento a la cirugía radical en combinación con quimio y/o radioterapia

This article aims to describe the imaging findings for mucinous tumors of the abdomen and pelvis, which have a similar appearance on imaging tests regardless of the organ in which they develop. Due to the high water content of mucus, the appearance of these tumors is generally similar to that of water on ultrasonography, computed tomography, and magnetic resonance imaging. Another common feature of mucin-producing tumors is that calcifications are often present. The rupture of these lesions and accumulation of mucinous material in the peritoneal cavity gives rise to pseudomyxoma peritonei. It is important to identify mucinous tumors because they have a different prognosis and clinical course than non-mucinous tumors and require different management. Depending on their anatomic location and their imaging characteristics, the treatment approach varies from follow-up to radical surgery together with chemotherapy or radiotherapy or both

Imaging findings for mucinous tumors of the abdomen and pelvis. / Hallazgos en imagen en los tumores mucinosos de abdomen y pelvis.

This article aims to describe the imaging findings for mucinous tumors of the abdomen and pelvis, which have a similar appearance on imaging tests regardless of the organ in which they develop. Due to the high water content of mucus, the appearance of these tumors is generally similar to that of water on ultrasonography, computed tomography, and magnetic resonance imaging. Another common feature of mucin-producing tumors is that calcifications are often present. The rupture of these lesions and accumulation of mucinous material in the peritoneal cavity gives rise to pseudomyxoma peritonei. It is important to identify mucinous tumors because they have a different prognosis and clinical course than non-mucinous tumors and require different management. Depending on their anatomic location and their imaging characteristics, the treatment approach varies from follow-up to radical surgery together with chemotherapy or radiotherapy or both.

Resonancia magnética en las demencias / Magnetic resonance imaging in dementia

Objetivo: describir los hallazgos de imagen clave en los estudios de RM estructural de las demencias de origen neurodegenerativo más frecuentes: enfermedad de Alzheimer, demencia vascular, demencia de cuerpos de Lewy, variantes de la demencia frontotemporal, parálisis supranuclear progresiva, variantes de la atrofia multisistémica, parkinson-demencia y degeneración corticobasal. Conclusión: El papel de la resonancia magnética hoy en día ya no está limitado a excluir causas subyacentes de deterioro cognitivo, sino que puede mostrar patrones de atrofia y otros datos con un alto valor predictivo para determinadas demencias que, aunque no son específicos ni únicos de cada patología, pueden ayudar a confirmar una sospecha diagnóstica o a identificar inicios tempranos de determinados procesos. Por ello es importante que los radiólogos conozcan los hallazgos típicos de las demencias más frecuentes

Objective: To describe and illustrate the key findings on structural magnetic resonance imaging (MRI) in the most common dementias of neurodegenerative origin: Alzheimer's disease, vascular dementia, dementia with Lewy bodies, variants of frontotemporal dementia, progressive supranuclear palsy, variants of multiple system atrophy, Parkinson dementia, and corticobasal degeneration. Conclusion: Today the role of MRI is no longer limited to ruling out underlying causes of cognitive deterioration. MRI can show patterns of atrophy with a predictive value for certain dementias which, although not specific or unique to each disease, can help to confirm diagnostic suspicion or to identify certain processes. For this reason, it is important for radiologists to know the characteristic findings of the most common dementias

Resultados a medio plazo de la artroplastia total de cadera metal-metal con cabeza de gran tamaño Magnum / Midterm results of Magnum large head metal-on-metal total hip arthroplasty

Objetivos: A raíz de las alertas sanitarias surgidas por la alta incidencia de recambios en la artroplastia de cadera metal-metal, se presentan los resultados obtenidos del seguimiento prospectivo de la serie de nuestro centro con cabezas de gran tamaño. Material y métodos: Se incluyeron todos los pacientes tratados con el cotilo Recap-M2a-Magnum, Biomet de 2008 a 2011. Se revisaron prospectivamente todos los pacientes registrando Harris Hip Score y síntomas de intoxicación por cromo-cobalto y se solicitaron niveles séricos de estos iones, radiografía y ecografía. Se solicitó resonancia magnética en caso de ecografía positiva. Resultados: Se incluyeron 26 varones de 48,54 años de edad media [32-62, DE: 7,18]. Se utilizó un abordaje anterolateral y vástagos Bimetric (7) o F40 (19). La moda de los diámetros cefálicos fue 46 [42-52]. La inclinación media del cotilo fue 39,35° [21-59°, DE: 9,78]. Durante el seguimiento (7,3 años [5,9-9,4 años, DE: 0,78]), 3 pacientes (11,5%) precisaron revisión (2 por movilización aséptica, un pseudotumor). El tiempo medio hasta la revisión fue 5,4 años [3,1-8,0, DE: 2,48]. La probabilidad acumulada de supervivencia fue del 88,5% (IC95% 76,3-100%). El Harris Hip Score fue de 94,47 [66,5-100, DE: 8,94] y los pacientes no mostraron ningún síntoma de intoxicación metálica, con niveles de cromo 1,88 mcg/dl [0,6-3,9] y cobalto 1,74 mcg/dl [0,5-5,6]. Se encontró un pseudotumor en un paciente asintomático y pequeñas cantidades de líquido periprotésico en 5 pacientes (19,2%). Discusión y conclusiones: Seguimos encontrando altas tasas de revisión al extender el seguimiento de los pacientes debido a la movilización aséptica y la formación de pseudotumores. La resonancia nuclear magnética no parece la prueba más adecuada para el estudio de las complicaciones de este tipo de prótesis

Objectives: We present the results of the prospective follow up of a sample of large head metal-metal total hip arthroplasty obtained after the safety alert regarding a higher incidence of revision of these implants. Material and methods: All patients implanted with the Recap-M2a-Magnum cup between 2008 and 2011 were included. They were prospectively reviewed recording Harris Hip Score, clinical symptoms of chromium or cobalt intoxication. Serum levels of these ions were requested as well as X-Rays and ultrasonography. An MRI was performed in the cases of positive ultrasonography. Results: Twenty-six males with a mean age of 48.54 years [32-62, SD: 7.18] were included. An anterolateral approach and Bi-Metric (7) and F-40 (19) stems were used. Cephalic diameters ranged 42-52 (mode: 46) and the mean cup inclination was 39.35° [21-59°, SD: 9.78]. During follow-up (7.3 years [5.9-9.4; SD: .78]), 3 patients (11.5%) underwent revision (2 cases aseptic loosening, 1 pseudotumour). Mean time until revision was 5.4 years [3.1-8.0; SD: 2.48]. The accumulated survival probability was 88.5% (95% CI 76.3-100%). Harris Hip Score was 94.47 [66.5-100; SD: 8.94] and the patients showed no metallic intoxication symptoms. The levels of chromium were 1.88 mcg/dl [0.6-3.9] and cobalt 1,74 mcg/dl [0.5-5,6]. One pseudotumour was found in an asymptomatic patient, and small amounts of periarticular liquid were found in 5 patients (19.2%) Discussion and conclusions: High revision rates are still found when follow up is extended due to aseptic loosening and pseudotumour formation. MRI might not be the most adequate test to study the complications of these prostheses

Midterm results of Magnum large head metal-on-metal total hip arthroplasty. / Resultados a medio plazo de la artroplastia total de cadera metal-metal con cabeza de gran tamaño Magnum.

OBJECTIVES: We present the results of the prospective follow up of a sample of large head metal-metal total hip arthroplasty obtained after the safety alert regarding a higher incidence of revision of these implants. MATERIAL AND METHODS: All patients implanted with the Recap-M2a-Magnum cup between 2008 and 2011 were included. They were prospectively reviewed recording Harris Hip Score, clinical symptoms of chromium or cobalt intoxication. Serum levels of these ions were requested as well as X-Rays and ultrasonography. An MRI was performed in the cases of positive ultrasonography. RESULTS: Twenty-six males with a mean age of 48.54 years [32-62, SD: 7.18] were included. An anterolateral approach and Bi-Metric (7) and F-40 (19) stems were used. Cephalic diameters ranged 42-52 (mode: 46) and the mean cup inclination was 39.35° [21-59°, SD: 9.78]. During follow-up (7.3 years [5.9-9.4; SD: .78]), 3 patients (11.5%) underwent revision (2 cases aseptic loosening, 1 pseudotumour). Mean time until revision was 5.4 years [3.1-8.0; SD: 2.48]. The accumulated survival probability was 88.5% (95% CI 76.3-100%). Harris Hip Score was 94.47 [66.5-100; SD: 8.94] and the patients showed no metallic intoxication symptoms. The levels of chromium were 1.88 mcg/dl [0.6-3.9] and cobalt 1,74 mcg/dl [0.5-5,6]. One pseudotumour was found in an asymptomatic patient, and small amounts of periarticular liquid were found in 5 patients (19.2%) DISCUSSION AND CONCLUSIONS: High revision rates are still found when follow up is extended due to aseptic loosening and pseudotumour formation. MRI might not be the most adequate test to study the complications of these prostheses.

Magnetic resonance imaging in dementia. / Resonancia magnética en las demencias.

OBJECTIVE: To describe and illustrate the key findings on structural magnetic resonance imaging (MRI) in the most common dementias of neurodegenerative origin: Alzheimer's disease, vascular dementia, dementia with Lewy bodies, variants of frontotemporal dementia, progressive supranuclear palsy, variants of multiple system atrophy, Parkinson dementia, and corticobasal degeneration. CONCLUSION: Today the role of MRI is no longer limited to ruling out underlying causes of cognitive deterioration. MRI can show patterns of atrophy with a predictive value for certain dementias which, although not specific or unique to each disease, can help to confirm diagnostic suspicion or to identify certain processes. For this reason, it is important for radiologists to know the characteristic findings of the most common dementias.

Unapparent hypoxanthine-guanine phosphoribosyltransferase deficiency.

Complete deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT) activity causes Lesch Nyhan disease (LND), characterized by hyperuricemia, severe action dystonia, choreoathetosis, ballismus, cognitive and attention deficit and self-injurious behavior. Partial HPRT deficiency is present in patients with Lesch-Nyhan variant (LNV), who present with HPRT-related gout and a variable degree of neurological involvement. The diagnosis of HPRT deficiency relies on clinical, biochemical, enzymatic and molecular data. Patients with HPRT deficiency present low or undetectable HPRT activity in hemolysates, with increased adenine phosphoribosyltransferase (APRT) activity. We present a 9-year-old boy who experienced an episode of macroscopic hematuria with dysuria and left flank pain. He presented hyperuricemia and hyperuricosuria. HPRT and APRT activities were both normal in hemolysate; however, HPRT activity assayed in intact erythrocytes was 50% of control levels. A new missense point mutation c.424 A>G (T142A) was found in the HPRT1 gene. The apparent Michaelis constant (Km) for 5-phosphoribosyl-pyrophosphate assayed in patient hemolysate was 20-fold of control levels. In conclusion, we report a patient with HPRT deficiency who presented with both normal HPRT and APRT activity in hemolysate, in which the enzyme activity determined in intact erythrocytes was of diagnostic utility.

Potassium starvation induces oxidative stress in Solanum lycopersicum L. roots.

The relationship between potassium deficiency and the antioxidative defense system has received little study. The aim of this work was to study the induction of oxidative stress in response to K(+) deficiency and the putative role of antioxidants. The tomato plants were grown in hydroponic systems to determine the role of reactive oxygen species (ROS) in the root response to potassium deprivation. Parameters of oxidative stress (malondialdehyde and hydrogen peroxide (H(2)O(2)) concentration), activities of antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), dehydroascorbate reductase (DHAR) and glutathione reductase (GR)) and antioxidant molecules (ascorbate (ASC) and glutathione) were investigated. H(2)O(2) was subcellularly located by laser confocal microscopy after potassium starvation in roots. During the first 24h, H(2)O(2) induced the cascade of the cellular response to low potassium, and ROS accumulation was located mainly in epidermal cells in the elongation zone and meristematic cells of the root tip and the epidermal cells of the mature zones of potassium starved roots. The activity of the antioxidative enzymes SOD, peroxidase and APX in potassium deprivation significantly increased, whereas CAT and DHAR activity was significantly depressed in the potassium starvation treatment compared to controls. GR did not show significant differences between control and potassium starvation treatments. Based on these results, we put forward the hypothesis that antioxidant molecule accumulations probably scavenge H(2)O(2) and might be regenerated by the ASC-glutathione cycle enzymes, such as DHAR and GR.

Changes to the proteome and targeted metabolites of xylem sap in Brassica oleracea in response to salt stress.

Root-to-shoot signalling via xylem sap is an important mechanism by which plants respond to stress. This signalling could be mediated by alteration in the concentrations of inorganic and/or organic molecules. The effect of salt stress on the contents of xylem sap in Brassica olarecea has been analysed by mass spectrometry in order to quantify these changes. Subcellular location of arabinogalactan proteins (AGPs) by immunogold labelling and peroxidase isozymes was also analysed by isoelectrofocusing. The xylem sap metabolome analysis demonstrated the presence of many organic compounds such as sugars, organic acids and amino acids. Of these, amino acid concentrations, particularly that of glutamine, the major amino acid in the sap, were substantially reduced by salt stress. The xylem sap proteome analysis demonstrated the accumulation of enzymes involved in xylem differentiation and lignification, such as cystein proteinases, acid peroxidases, and a putative hydroxycinnamoyl-CoA:shikimate hydroxycinnamoyl transferase under salt stress. The peroxidase isozyme pattern showed that salt stress induced a high accumulation of an acid isoform. These results suggest that xylem differentiation and lignification is induced by salt stress. The combination of different methods to analyse the xylem sap composition provides new insights into mechanisms in plant development and signalling under salt stress.

Consultas dermatológicas en pediatría de atención primaria / Dermatology consultations in primary care pediatrics

Las consultas por problemas dermatológicos son muy frecuentes en pediatría.Material y métodos: mediante un estudio descriptivo observacional realizado durantetodo el año 2008, que analiza las consultas pediátricas por causas dermatológicas, se obtuvieronlos motivos principales de las consultas, se cuantificó la tasa de resolución de éstas enel ámbito de la Atención Primaria y se elaboró un listado de procesos dermatológicos comoguía para futuras actividades formativas en dermatología pediátrica.Resultados: de un total de 21.748 consultas, 1.323 se debieron a procesos dermatológicos(6,1%). La categoría con mayor número de diagnósticos correspondió al grupo dermatitis/eczema con 438 consultas (33%), seguida de las infecciones víricas con 352 (26%), lasinfecciones bacterianas con 128 (10%) y las zoonosis con 118 (9%). Fueron derivados 75 niños(5,7% de las consultas) al servicio de dermatología.Conclusiones: concluimos que la mayoría de procesos dermatológicos de la infancia puedenser manejados en Atención Primaria, manteniendo una estrecha colaboración con los especialistasen dermatología para aquellas situaciones precisadas por el escenario clínico (AU)

Consultations for dermatological problems are very common in pediatrics.Material and methods: descriptive observational study along 2008, that analyzes dermatologicalcauses of visits in Primary Care pediatrics; the main reasons for consultations wereobtained, the rate of resolution in Primary Care was quantified and a list of dermatologicalprocesses was obtained as a guide oriented to pediatric dermatological formation.Results: of 21,748 visits, 1,323 were due to dermatological conditions (6.1%). The diagnosticgroups were: skin infections, dermatitis-eczema, urticaria, zoonosis, hair and nail disorders,pigmentation disorders and miscellaneous. The main causes of consultation were:dermatitis/eczema (33%), viral skin infections (26%), bacterial skin infections (10%) andzoonosis (9%); 75 children (5.7%) were referred to dermatologists Conclusions: most of pediatric dermatological conditions can be assessed in Primary Careas far as close collaboration with the dermatologist is provided for those situations that theclinical scenario demands (AU)

Characterisation and changes in the antioxidant system of chloroplasts and chromoplasts isolated from green and mature pepper fruits.

Purification and characterisation of pepper (Capsicum annuum L) chloroplasts and chromoplasts isolated from commercial green, red and yellow mature fruits were undertaken. Induction of the synthesis of several antioxidants in organelles isolated from mature fruits was found. The ultrastructure of organelles and the presence and activity of SOD isozymes and enzymes involved in the ASC-GSH cycle, together with the non-enzymatic antioxidant content and some oxidative parameters, were analysed. It was found that lipids, rather than proteins, seem to be a target for oxidation in the chromoplasts. The ascorbate and glutathione contents were elicited during differentiation of chloroplasts into chromoplasts in both red and yellow fruits. The activity of SOD and of components of the ASC-GSH cycle was up-regulated, suggesting that these enzymes may play a role in the protection of plastids and could act as modulators of signal molecules such as O(2) ( -) and H(2)O(2) during fruit maturation. The presence of an Mn-SOD in chromoplasts isolated from yellow pepper fruits was also investigated in terms of structural and antioxidant differences between the two cultivars.

Role of phi cells and the endodermis under salt stress in Brassica oleracea.

Phi cell layers were discovered in the 19th century in a small number of species, including members of the Brassicaceae family. A mechanical role was first suggested for this structure; however, this has never been demonstrated. The main objective of the present work was to analyse the ultrastructure of phi cells, their influence on ion movement from the cortex to the stele, and their contribution to salt stress tolerance in Brassica oleracea. Transmission electron microscopy and X-ray microanalysis studies were used to analyse the subcellular structure and distribution of ions in phi cells and the endodermis under salt stress. Ion movement was analysed using lanthanum as an apoplastic tracer. The ultrastructural results confirm that phi cells are specialized cells showing cell wall ingrowths in the inner tangential cell walls. X-ray microanalysis confirmed a build-up of sodium. Phi thickenings were lignified and lanthanum moved periplasmically at this level. To the best of our knowledge, this is the first study reporting the possible role of the phi cells as a barrier controlling the movement of ions from the cortex to the stele. Therefore, the phi cell layer and endodermis seem to be regulating ion transport in Brassica oleracea under salt stress.

Síndrome auriculotemporal (síndrome de Frey) en dos lactantes con presentación bilateral / Auriculotemporal nerve syndrome (Frey syndrome) in two infants with bilateral presentation

El síndrome auriculotemporal (síndrome de Frey) se caracteriza por episodios de enrojecimiento facial, sudoración o ambos, localizados en el territorio de distribución del nervio auriculotemporal, y que ocurren como respuesta a estímulos gustativos. Cuando se manifiesta en la infancia y coincide con la introducción de nuevos alimentos en lactantes, se puede llegar al diagnóstico erróneo de alergia alimentaria. Presentamos dos lactantes (de 5 y 6 meses) con enrojecimiento facial bilateral en el área temporal, extendiéndose hasta el borde oral; ambos manifestaron los síntomas inmediatamente a la toma de fruta (y posteriormente tras un tipo de golosina en uno de los niños) con desaparición de cuadro instantes después del cese de la toma. Los dos niños eran fruto de un parto eutócico. En uno de ellos, los síntomas desaparecieron antes del año, mientras que el segundo aún tiene 7 meses y presenta episodios de intensidad variable. Es conveniente reconocer este síndrome para evitar exploraciones innecesarias y restricciones dietéticas improcedentes (AU)

Patients with auriculotemporal nerve syndrome (Frey syndrome) have facial flushing, sweating, or both located along the distribution of the auriculotemporal nerve, and that occurs in response to gustatory stimuli. As the condition usually manifests during infancy with the introduction of solid food, it can lead to the misdiagnosis of food allergy by physicians unfamiliar with this syndrome. Two boys (5 and 6 months old) presented with a history of bilateral facial flushing extending from the corner of the mouth to the temporal area. Symptoms began at the moment of fruit introduction (orange, pear, apple and banana) and also with some type of candy in the first. Symptoms appeared immediate to fruit mastication and cutaneous erythema spontaneously disappeared in a few minutes after finishing fruit. Both cases had been born without instrumental delivery. In one case the symptoms disappeared before the end of the first year of age, and the second (he?s now 7 months old) has symptoms discontinuously. The recognition of this entity might avoid unnecessary referral and laboratory evaluation (AU)

Pigment epithelium-derived factor as a multifunctional antitumor factor.

The design of new therapeutic strategies for cancer treatment is based on the combination of drugs directed against different tumor compartments, including the tumor cells themselves and components of the stroma, such as the tumor vasculature. Indeed, several antiangiogenic compounds have entered clinical trials for use alone or in combination with conventional cytotoxic drugs. Pigment epithelium-derived factor (PEDF) is a multifunctional natural peptide with complex neurotrophic, neuroprotective, antiangiogenic, and proapoptotic biological activities, any of which could potentially be exploited for therapeutic purposes. This review summarizes recent studies that reveal the antitumor potential of PEDF based on its antiangiogenic properties and its newly discovered direct antitumor effects, which involve the induction of differentiation or apoptosis in tumor cells. We also discuss possible therapeutic applications of PEDF, based on these mechanistic insights and on the identification of functional domains that retain specific biological activities.

Detección de la presencia de Macroprolactina como parte integrante del diagnostico diferencial de la Hiperprolactinemia. Evaluación de la introducción de un protocolo para detectar la presencia de Macroprolactinemia / Macroprolactin detection in the differential diagnosis of Hyperprolactinemia. Evaluation of a screening protocol for Macroprolactin detection

La presencia de macroprolactina debe tenerse en cuenta en eldiagnóstico diferencial de la hiperprolactinemia. La macroprolactinaestá constituida por una molécula de inmunoglobulina G unidaa la prolactina monomérica. En esta forma es relativamenteresistente a la degradación y eleva la concentración sérica deprolactina. Casi todos, si no todos, los inmunoensayos detectanla presencia de macroprolactina pero en diferente grado.En nuestro hospital hemos implantado un protocolo de precipitacióncon polietilengicol para detectar la presencia de macroprolactina,en todos los pacientes con valores de prolactina basalsuperiores a 40 ng/mL. Se ha detectado la presencia de macroprolactinemiaen el 15,94% de los casos analizados(IC 95% 10,4 – 23,3).No diagnosticar esta situación clínica puede llevar a las pacientesa ser sometidas a pruebas y tratamientos innecesarios

The presence of macroprolactin should be considered in thedifferential diagnosis of hyperprolactinemia. Macroprolactinconsists of an G immunoglobulin molecule bound to a prolactinmolecule. In this form it is relatively resistant to degradationand rises to high levels serum prolactin. Almost, if not all, ofthe immunoassays detect macroprolactin but to varyingdegrees.In our hosptal we have used a polyethylene glycol precipitationprotocol to detect the presence of macroprolactinemiaamong patients with basal prolactin higher than 40 ng/mL. Wehave confirmed the presence of macroprolactinemia in the15,94% of them (IC95% 10,4 – 23,3).Misdiagnosis in these patients may lead to inappropiateinvestigations and treatments

Anemias en la infancia. Anemia ferropénica / Anemias in childhood. Iron anemia

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Determinantes que influyen en la concentración plasmática de la homocisteina / Parameters influencing plasma homocysteine concentration

No disponible