Treating chronic diarrhea: A systematic review on Immunoproliferative Small Intestinal Disease (IPSID).

Immunoproliferative Small Intestinal Disease (IPSID) is a disease characterized by extra-nodal marginal zone B-cell lymphoma with villous atrophy in the small intestine, causing chronic intermittent non-bloody diarrhea. Although originally associated with the Mediterranean region, this disease is present in many countries worldwide and may have been underreported due to its complicated diagnosis and scarce scientific literature, especially in regards to treatment. This study aims to review IPSID clinical features, therapeutic options, and treatment outcomes to help physicians identify and treat IPSID. Using PRISMA guidelines, a systematic review of articles was conducted on PubMed database with search terms including IPSID, therapy, treatment, and outcomes. Inclusion and exclusion criteria were used to select 33 English language articles published from the year 2000-2020 that included relevant clinical information about IPSID treatment. Data were extracted independently by at least two authors to reduce the introduction of potential bias. There were 22 case reports, 7 reviews, 1 research article, 1 prospective study, 1 letter to the editor and 1 memoriam in which 76 patients were identified. Epidemiological analysis showed a mean patient age of 32 years old, 2.4:1 mal to female ratio and heterogeneous ethnicities, with 16 Europeans (43.2%) and 12 Asians (32.4%). Chief symptoms included chronic diarrhea (53/76, 69.7%), weight loss (49/76, 64.4%), malabsorption (38/76, 50%), abdominal pain (32/76, 42.1%), and finger clubbing (24/76, 31.6%). Patients stratified into the early disease stage (Galian A) were treated with tetracycline antibiotics, corticosteroids, and non-pharmacological supplements with mostly with complete or partial remission. Late stages (Galian B or C), were treated mostly with anthracycline-based chemotherapy, and occasionally surgery, radiotherapy, or rituximab. This work offers a targeted approach to diagnosing and treating IPSID to aid physicians and serve as a treatment guideline recommendation for future public policies and clinical studies.

Regioselective Functionalization of Ester-, Amide-, Carbonate-, and Carbamate-Substituted 2-Phenyl-2-oxazolines with Mixed Lithium-Magnesium Amides.

We have prepared novel highly functionalized benzene derivatives by regioselective metalation of ester-, amide-, carbamate-, and carbonate-substituted 2-phenyl-2-oxazolines with mixed lithium-magnesium amides followed by reaction with different electrophiles. While a complementary metalation site can be accessed by using different bases, steric and electronic effects promoted by the aromatic ring substituents also play an important role in reaction regioselectivity. Computational calculations of the aromatic hydrogen pKa values have helped us to rationalize the metalation preference by the complex-induced proximity effect concept.

Biodiesel Processing Using Sodium and Potassium Geopolymer Powders as Heterogeneous Catalysts.

This work investigates the catalytic activity of geopolymers produced using two different alkali components (sodium or potassium) and four treatment temperatures (110 to 700 °C) for the methyl transesterification of soybean oil. The geopolymers were prepared with metakaolin as an aluminosilicate source and alkaline activating solutions containing either sodium or potassium in the same molar oxide proportions. The potassium-based formulation displayed a higher specific surface area and lower average pore size (28.64-62.54 m²/g; 9 nm) than the sodium formulation (6.34-32.62 m²/g; 17 nm). The reduction in specific surface area (SSA) after the heat treatment was more severe for the sodium formulation due to the higher thermal shrinkage. The catalytic activity of the geopolymer powders was compared under the same reactional conditions (70-75 °C, 150% methanol excess, 4 h reaction) and same weight amounts (3% to oil). The differences in performance were attributed to the influences of sodium and potassium on the geopolymerization process and to the accessibility of the reactants to the catalytic sites. The Na-based geopolymers performed better, with FAME contents in the biodiesel phase of 85.1% and 89.9% for samples treated at 500 and 300 °C, respectively. These results are competitive in comparison with most heterogeneous base catalysts reported in the literature, considering the very mild conditions of temperature, excess methanol and catalyst amount and the short time spent in reactions.

Mal de Pott: uma revisão bibliográfica dos últimos 5anos / Pott’s Disease: a bibliographic review from the last 5 years

Na revisão de literatura, o mal de Pott (MP) é um tipo de tuberculoseextrapulmonar que afeta a coluna vertebral. É uma doença negligenciada,subdiagnosticada e muitas vezes abordada tardiamente.Os malefícios desta moléstia podem ser para toda a vida. Sua tríadeclínica inclui gibosidade, abscesso e paraplegia, sendo-lhe a dor crônicanas costas altamente sugestiva. O padrão-ouro do diagnósticoé a ressonância nuclear magnética com biopsia guiada por tomografiacomputadorizada, seguida de cultura das amostras. Existemdiversos diagnósticos diferenciais, o que corrobora com o seu subdiagnóstico.Há muitas controvérsias quanto à sua terapêutica, emespecial quanto à sua duração e à inclusão de tratamento cirúrgico.Concluímos que ainda são necessários mais trabalhos sobre o tema,pois essa doença continua a ser negligenciada...

Pott’s Disease (PD) is a type of extra-pulmonary tuberculosis thataffects the vertebral spine. It’s a neglected, under-diagnosed andfrequently lately approached disease. The sequels of this illnessmay become a lifelong condition. It has three main symptoms thatinclude gibbosity, abscess and paraplegia. The chronic backacheis highly suggestive of PD. The diagnostic gold-standard exam ismagnetic resonance images (MRI) including a biopsy guided by acomputed tomography (CT) exam, followed by culture. The differentialdiagnosis of PD is vast, which contributes to its under-diagnosis.There are many controversies regarding the treatment, speciallyabout its duration and the addition of surgical debridement.We concluded that more studies are needed about PD because it isstill a neglected disease...

Study of the histological profile of papillary thyroid carcinomas associated with Hashimoto's thyroiditis.

OBJECTIVE: To investigate the association between the histological parameters of papillary thyroid cancer (PTC) and the presence of Hashimoto's thyroiditis (HT). MATERIALS AND METHODS: Histological samples from patients with PTC were reviewed by an endocrine pathologist. The following parameters were analyzed: presence of concomitant HT, multifocality, presence of nodal metastasis, tumor size, vascular invasion, perineural infiltration, histological variant, and pathological staging. Clinical data included gender and age at the time of the diagnosis. RESULTS: A total of 94 cases of PTC were reviewed. There was a predominance of women (85.1% vs. 14.9%) and median age at presentation was 45.13 years. The presence of HT was significantly associated with greater occurrence of multifocal tumors (p = 0.004), early pathological stage (p = 0.02), and smaller tumor size (p = 0.025). CONCLUSIONS: Patients with PTC associated with HT had significantly smaller tumors, more often multifocal and in an earlier stage than their counterparts without HT. A better understanding of the immune response involved in these tumors may be useful for future strategies on the prevention and for the development of new therapeutic approaches for this group of neoplasms.

Study of the histological profile of papillary thyroid carcinomas associated with Hashimoto's thyroiditis / Estudo do perfil histológico de carcinomas papilíferos de tireoide associados à tireoidite de Hashimoto

OBJECTIVE: To investigate the association between the histological parameters of papillary thyroid cancer (PTC) and the presence of Hashimoto's thyroiditis (HT). MATERIALS AND METHODS: Histological samples from patients with PTC were reviewed by an endocrine pathologist. The following parameters were analyzed: presence of concomitant HT, multifocality, presence of nodal metastasis, tumor size, vascular invasion, perineural infiltration, histological variant, and pathological staging. Clinical data included gender and age at the time of the diagnosis. RESULTS: A total of 94 cases of PTC were reviewed. There was a predominance of women (85.1% vs. 14.9%) and median age at presentation was 45.13 years. The presence of HT was significantly associated with greater occurrence of multifocal tumors (p = 0.004), early pathological stage (p = 0.02), and smaller tumor size (p = 0.025). CONCLUSIONS: Patients with PTC associated with HT had significantly smaller tumors, more often multifocal and in an earlier stage than their counterparts without HT. A better understanding of the immune response involved in these tumors may be useful for future strategies on the prevention and for the development of new therapeutic approaches for this group of neoplasms.

OBJETIVO: Investigar a associação entre parâmetros histológicos do carcinoma papilífero da tireoide (CPT) e a presença de tireoidite de Hashimoto (TH). MATERIAIS E MÉTODOS: Amostra de tecidos de CPT foi revista por um médico patologista. Os seguintes parâmetros foram avaliados: presença de TH concomitante, multicentricidade, metástase linfonodal, tamanho tumoral, invasão vascular, infiltração perineural, variante histológica e estadiamento patológico. Os dados clínicos incluíam gênero e idade ao diagnóstico. RESULTADOS: Um total de 94 casos de CPT foi revisto. Houve predomínio do sexo feminino (85,1% vs. 14,9%) e a idade média de apresentação foi de 45,13 anos. A presença de TH foi associada a maior ocorrência de tumores multifocais (p = 0,004), estágios iniciais de estadiamento (p = 0,02) e tumores menores (p = 0,025). CONCLUSÃO: O CPT associado a TH apresentou-se com menor dimensão, maior ocorrência de multifocalidade e em estadiamentos mais iniciais do que os casos de CPT sem TH associada. Um melhor entendimento da resposta imune envolvida nesses tumores pode ser útil para estratégias futuras de prevenção e para o desenvolvimento de novas abordagens terapêuticas para esse tipo de neoplasia.