Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. / Registro de linfomas cutáneos primarios (RELCP) de la AEDV: datos tras 5 años de funcionamiento.

BACKGROUND AND OBJECTIVE: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.

A singular value decomposition entropy approach to assess the impact of Covid-19 on the informational efficiency of the WTI crude oil market.

This work investigates the impact of the Covid-19 outbreak on crude oil market efficiency. The approach is based on the singular value decomposition (SVD) entropy. Iso-distributional surrogate data test was used to contrast the results against random patterns, and phase randomization based on Fourier transform was used to assess nonlinearities. The analysis considered the WTI market and focused on the Covid-19 pandemic period January 2020-November 2021 and contrasted with the long preceding period from January 2000 to date. It was found that the crude oil market was informationally efficient most of the time with small sporadic deviations from efficiency in the pre-Covid-19 years. The Covid-19 period exhibited the largest deviations from efficiency, mainly in the first months of the outbreak, accompanied by a marked reduction of nonlinear components. The analysis was conducted for different scales, and the results showed that the deviations from efficiency were more pronounced for quarterly scales. For the sake of comparison, the analysis was also carried out on the trading volume dynamics and the results showed that the market activity is not fully random. The dynamics of the trading volume exhibited significant deviations from the randomness behavior when the crude oil market was efficient, and a behavior that was consistent with nonlinear patterns. The opposite behavior was noted for stages when the crude oil market showed strong deviations from efficiency. Overall, the findings of this study suggest an increasing opportunity for crude oil price predictions and abnormal returns during the Covid-19 pandemic.

Acute generalized exanthematous pustulosis due to dextromethorphan.

Acute generalized exanthematous pustulosis (AGEP) is a rare, severe, pustular, cutaneous reaction. We report a case in which a patient developed AGEP after the intake of 3 different antitussive agents containing dextromethorphan as the only ingredient in common.

Diffusion in one-dimensional channels with zero-mean time-periodic tilting forces.

We investigate the motion of overdamped Brownian particles in a one-dimensional channel under a zero-mean time-periodic tilting force F(t). By introducing a simple harmonic signal, strong enhancement of diffusion is possible for relatively large values of the Peclet number. Direct numerical simulations over the corresponding Fokker-Planck equation show that the diffusion enhancement is induced by a type of nonlinear resonance effect involving the tilting force and the density gradient.

Study of the properties of ZnO:Zn thin films obtained from ZnO/Zn/ZnO structure deposited by DC sputtering.

A method to manage the resistivity of n-type ZnO films is presented. It involves the controlled diffusion of Zn at low temperature in N2 atmosphere into the ZnO/Zn/ZnO structure. The structures were made by DC sputtering technique. The diffusion periods were varied from 5 to 30 min. This process allow us to obtain ZnO films with excess of Zn (ZnO:Zn). The electrical characterization showed that the resistivity of the films can be varied from 0.01 to 100 omega-cm, the electron concentration from 10(19) to 10(17) cm(-3) and the carrier mobility from 10 to 40 cm2N-s. The films are nanocrystalline with preferred (002) orientation and crystal size that varies from 13 to 20 nm depending on the diffusion period. The films have a band gap of 3.18 eV and 70% of transmittance in the visible region, these properties were obtained from the transmittance measurements of low-resistivity films. Films have good structural, optical and electrical properties, and could be used in the manufacture of light emitting diodes.

Glucose biosensor based on disposable electrochemical paper-based transducers fully fabricated by screen-printing.

This paper describes a new approach for the massive production of electrochemical paper-based analytical devices (ePADs). These devices are fully fabricated by screen-printing technology and consist of a lineal microfluidic channel delimited by hydrophobic walls (patterned with diluted ultraviolet screen-printing ink in chromatographic paper grade 4) and a three-electrode system (printed with carbon and/or Ag/AgCl conductive inks). The printing process was characterised and optimized for pattern each layer with only one squeeze sweep. These ePADs were used as transducers to develop a glucose biosensor. Ionic strength/pH buffering salts, electrochemical mediator (ferricyanide) and enzyme (glucose dehydrogenase FAD-dependent) were separately stored along the microfluidic channel in order to be successively dissolved and mixed after the sample dropping at the entrance. The analyses required only 10 µl and the biosensors showed good reproducibility (RSD = 6.2%, n = 10) and sensitivity (0.426 C/M cm2), wide linear range (0.5-50 mM; r2 = 0.999) and low limit of detection (0.33 mM). Furthermore, the new biosensor was applied for glucose determination in five commercial soft-drinks without any sample treatment before the analysis. These samples were also analysed with a commercial enzymatic-kit assay. The results indicated that both methods provide accurate results.

Percepción y prioridades respecto al proceso de consentimiento informado quirúrgico; un análisis mediante métodos mixtos

Objetivo: Identificar las principales preocupaciones antes y después de realizarse un procedimiento quirúrgico, e identificar diferencias basadas en género, edad y nivel de escolaridad. Material y Método: Mediante un muestreo no probabilístico incidental se aplicaron 201 encuestas semiestructuradas a personas en la sala de espera del HSJD. Las respuestas fueron procesadas mediante un análisis mixto donde se organizaron categorías por unidades de significancia y se ordenaron de forma decreciente para luego comparar según edad, género y escolaridad. Resultados: Respecto a los aspectos que las personas consideran relevante conocer previo a la cirugía, 4 categorías concentran el 71 % del total: 1. Riesgos, complicaciones y secuelas, 2. Explicación del procedimiento, 3. Beneficios y pronóstico, 4. Cuidados y evaluaciones previas. En relación con lo que le gustaría que le explicaran después, se prioriza: 1. Conocer los resultados del procedimiento (19,3%), 2. Control, derivaciones y cuidados paliativos (15%), 3. Tiempo de recuperación (13,7%). Diferencias significativas: una mayor necesidad de acompañamiento y explicación de la patología expresada por hombres, el interés por conocer y los aspectos relacionados con funcionalidad postoperatoria en personas entre 18-65 años, el interés de conocer los cuidados y evaluaciones previas, conocer los resultados del procedimiento, los cuidados de la herida y la funcionalidad posoperatoria según nivel educacional. Discusión y conclusión: Existen variaciones significativas en contenido prioritario según edad, género y nivel educacional. Finalmente, el presente artículo proporciona evidencia en cuanto a las principales prioridades de pacientes en el sistema público chileno para el consentimiento informado.

Aim: To identify the main concerns before and after undergoing a surgical procedure, and to identify differences based on gender, age and level of education. Material and Method: 201 semi-structured surveys were administered to people in the waiting room of the HSJD by means of incidental non-probabilistic sampling. The responses were processed by means of a mixed analysis in which categories were organized by units of significance and ordered in decreasing order to then compare according to age, gender and schooling. Results: Regarding the aspects that people considered relevant to know before surgery, 4 categories accounted for 71% of the total: 1. Risks, complications and sequels, 2. Explanation of the procedure, 3. Benefits and prognosis, 4. Prior care and evaluations. In relation to what you would like to have explained to you afterwards, priority is given to: 1. knowing the results of the procedure (19.3%), 2. Monitoring, referrals and palliative care (15%), 3. Recovery time (13.7%). Significant differences: a greater need for accompaniment and explanation of the pathology expressed by men, interest in knowing and aspects related to postoperative functionality in persons between 18-65 years of age, interest in knowing the previous care and evaluations, knowing the results of the procedure, wound care and postoperative functionality according to educational level. Discussion and conclusion: There are significant variations in priority content according to age, gender and educational level. Finally, the present article provides evidence regarding the main priorities of patients in the chilean public system for informed consent.

Rendimiento diagnóstico y morbimortalidad de las biopsias pulmonares quirúrgicas en enfermedad pulmonar intersticial difusa

Introducción: Se denomina Enfermedad Pulmonar Intersticial Difusa (EPID) a un conjunto heterogéneo de patologías caracterizadas por inflamación y fibrosis pulmonar. El diagnóstico basado en patrones clínicos o radiológicos puede, ocasionalmente, ser insuficiente para iniciar un tratamiento. La biopsia pulmonar quirúrgica es una alternativa cuando se requiere aumentar la precisión diagnóstica luego de discusión multidisciplinaria. Objetivo: Describir el rendimiento diagnóstico, morbilidad y mortalidad de las biopsias quirúrgicas pulmonares en un hospital público chileno. Pacientes y Método: Cohorte retrospectiva de todos los pacientes a quienes se realizó biopsia quirúrgica por diagnóstico de EPID entre los años 2010 y 2020, indicada por un comité multidisciplinario. Se excluyen procedimientos similares o biopsias con diagnóstico de EPID como hallazgo incidental. Resultados: 38 pacientes intervenidos, mediana de edad de 63 años, 47% femenino. Solo 1 (2,6%) paciente operado de urgencia, y 34 (89,5%) por videotoracoscopía. 5 (13,1%) pacientes presentaron morbilidad, en 4 de ellos fuga aérea, ninguno requiriendo intervención adicional. No hubo rehospitalización, reoperación ni mortalidad a 90 días. En el 95% de los casos se alcanzó un diagnóstico preciso de la EPID tras discusión multidisciplinaria. Discusión: Se observa un alto rendimiento diagnóstico y una baja morbimortalidad en los pacientes estudiados. La baja frecuencia de procedimientos de urgencia y la adecuada indicación en comité multidisciplinario puede haber contribuido a la baja morbilidad. Conclusión: La biopsia pulmonar quirúrgica en un hospital general tiene un alto rendimiento diagnóstico cuando se discute en comité multidisciplinario para precisar el diagnostico en EPID, con una baja morbimortalidad si se seleccionan adecuadamente los pacientes.

Background: Interstitial Lung Disease (ILD) is a heterogeneous group of diseases characterized by inflammation and fibrosis of the lung. Diagnosis based exclusively on clinical or radiologic patterns may be inaccurate, and if a reliable diagnosis cannot be made, surgical lung biopsy can be strongly considered to increase the diagnostic yield after multidisciplinary committee. Objective: To review the diagnostic results, morbidity, and mortality of surgical biopsies in a chilean public health institution. Patients and Method: Retrospective cohort of patients operated for diagnostic purposes for ILD between 2010 - 2020. Surgical biopsies done for other diagnoses were excluded. Results: 38 patients were included, with a median age of 63 years, 47% were female. Only 1 patient (2.6%) underwent emergency surgery and 89.5% underwent minimally invasive surgery techniques. 5 patients had some morbidity (13.1%), 4 of them being air leak. All complications were successfully managed conservatively. We had no readmission, reoperations, or 90-day mortality in this cohort. In 95% of the cases an accurate diagnosis of ILD was reached after multidisciplinary discussion. Discussion: In our experience surgical lung biopsy has a high diagnostic yield and a low morbidity and mortality. A low number of emergency procedures and accurate surgical indication by an expert committee could explain the low morbidity. Conclusion: Surgical lung biopsy in a general hospital reach a high diagnostic performance when discussed in a multidisciplinary committee to specify the diagnosis in ILD, with low morbidity and mortality if patients are properly selected.

[The antiphospholipid syndrome, an update]. / Síndrome antifosfolípido, estado actual.

The antiphospholipid syndrome is an antibody mediated hypercoagulable state characterized by recurrent venous and arterial thromboembolic events. Several studies have determined that the frequency of antiphospholipid syndrome in patients presenting with a venous thromboembolic event is between 4% and 14%. Classical criteria include the presence of anticardiolipin antibody or lupus anticoagulant with typical complications of thrombosis or pregnancy loss. Other common associated manifestations include livedo reticularis, thrombocytopenia, valvular heart disease, and nephropathy with renal insufficiency, hypertension and proteinuria. Because of the high risk for recurrent thromboembolism in these patients, current recommendations suggest a longer, potentially lifelong, course of antithrombotic therapy following an initial event. For an initial venous thromboembolic event, a target INR of 2.0 to 3.0 is supported by two prospective, randomized clinical trials. In contrast, relatively limited data exist for an initial arterial thromboembolic event in patients who have the antiphospholipid syndrome, and therapeutic recommendations range from aspirin to warfarin with a high target INR. Recurrent thromboembolic events can be extremely difficult to treat, and some patients may benefit from the addition of immunosuppressive therapies. It is very important to evaluate in this setting additional, coincident prothrombotic risk factors.

Reseña: El laberinto de la choledad: páginas para entender la desigualdad

Nugent, Guillermo

Taurus. Lima, 2021, 254 pp

Seroprevalence and parasite load of Toxoplasma gondii in Mexican hairless pig (Sus scrofa) tissues from the Southeast of Mexico.

This study aimed to estimate the seroprevalence and determine the parasite load of Toxoplasma gondii (T. gondii) in the heart and tongue tissues and the semimembranosus/gracilis muscles in a population of Mexican hairless pig (MHP). A cross-sectional study was conducted in 81 MHP, 9-12 weeks of age, from 10 municipalities in Yucatan, Mexico. The prevalence was estimated by the detection of T. gondii IgG antibodies via an indirect ELISA assay. The parasite burden was also determined by testing genomic DNA from sampled tissues using quantitative real-time PCR (qPCR), which amplified a 62bp product from the B1 gene of T. gondii. The seroprevalence was 53% (43/81), ranging from 0 to 100% seropositivity rate depending on the municipalitie of origin. The qPCR allowed detection of T. gondii in 5.3% (9/168) of the tissue samples, with an average of 2.5±2.71 parasites per gram (0.17±0.18 parasite equivalent) for the leg muscle tissue, 0.26±0.39 (0.01±0.02 parasite equivalent) for the heart tissue and 0.31±0.37 (0.021±0.025 parasite equivalent) for the tongue tissue. No significant difference (p>0.05) was observed in the proportion and parasite burden among the different types of tissues evaluated. As shown by the ELISA, a high seroprevalence of T. gondii exists in MHP from the Yucatán Peninsula. The parasite burden found in the tissues showed similar tropism; therefore, the consumption of these tissues involves the same risk of acquiring infection if not properly cooked.

Effect of ionotropic glutamate receptors antagonists on the modifications in extracellular glutamate and aspartate levels during picrotoxin seizures: a microdialysis study in freely moving rats.

Our previous studies have shown a local decrease in glutamate and aspartate levels during seizures, induced by picrotoxin microdialysis in the hippocampus of chronic freely moving rats. In this paper, we study the effect of continuous hippocampal microperfusion of the NMDA, AMPA and kainate glutamate receptor inhibitors 5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5, 10-imine (MK-801); 6,7-dinitroquinoxaline-2,3-dione (DNQX), and 1-(4-aminophenyl)-4-methyl-7,8-methylenedioxy-5H-2,3-benzodiazepine hydrochloride (GYKI 52466). We also examine the action of L(-)-threo-3-hydroxyaspartic acid (THA), a glutamate and aspartate reuptake blocker, on the modification of extracellular glutamate and aspartate levels induced by picrotoxin, using the microdialysis method in freely moving rats. We found that changes in extracellular hippocampal concentrations in both amino acids are prevented by NMDA, AMPA and kainate receptor inhibitors. Seizures elicited under DNQX also induce a transient increase in aspartate extracellular levels coincident with seizure time. L(-)-threo-3-hydroxyaspartic acid increased the basal extracellular concentrations of both amino acids, but did not prevent the seizure-related decrease. Our results suggest that glutamate, the major neurotransmitter at the synaptic level, may also play an important role in non-synaptic transmission during seizures.

Microperfusion of picrotoxin in the hippocampus of chronic freely moving rats through microdialysis probes: a new method of induce partial and secondary generalized seizures.

In this study we investigated the threshold and latency of seizures in a new model of chemically induced partial seizures, with or without secondary generalization. We performed repeated experiments with a maximum of 20 between day seizures on each individual rat over a period up to 6 months, with resting intervals ranging from 3 to 15 days depending on the severity of seizures. Seizures were induced by microperfusion of variable doses of picrotoxin starting at 100 microM in each animal and increasing in steps of 25 microM through microdialysis probes introduced in the hippocampus of freely moving rats. The seizures were registered in a Holter-EEG and videotaped. Only one picrotoxin dose was perfused during each experimental session. Threshold was defined as the minimum dose of picrotoxin which induced a type of seizure after a 5 min period of perfusion. Latency was defined as the period from the end of the microperfusion period to the onset of electro-behavioral seizures. Patterns of seizures induced in different experimental sessions showed a dose-dependent variation ranging from arrest behavior (absence-like) to rapidly recurring seizures. A permanent seizure threshold for each type of seizure was observed in repeated experiments within individual rats, but when compared with different animals, significant variations in threshold were observed. A long latency period (14-41 min) was observed, unrelated to threshold or seizure type. Since the method can induce separate seizures with constant seizure threshold in experiment rats over a testing period as long as 6 months, the described method offers a new way to test a large number of antiepileptic drugs on the same animals.

Effect of extracellular long-time microperfusion of high concentrations of glutamate and glycine on picrotoxin seizure thresholds in the hippocampus of freely moving rats.

The effect of high concentrations of glutamate and glycine on picrotoxin seizure thresholds was investigated by perfusion through microdialysis probes in the hippocampus of freely moving rats. Microperfusion of glutamate at concentrations up to 1 mM, produced no changes in behavior or basal EEG recordings, but microperfusion of 200 microM glutamate was sufficient to lower the picrotoxin seizure threshold down to 50% in 60% of the animals studied and produced an increase of 180+/-23% in seizure duration. Microperfusion of 1 mM glutamate reduced seizure threshold in all animals, and markedly prolonged seizure duration (230+/-30%). Microperfusion of 200 microM or 1 mM glycine lowered picrotoxin seizure thresholds down to 50% in 70% of the animals and lengthened seizure duration up to 176+/-43%. Continuous microperfusion of the antagonist for the glycine binding site in NMDA receptors 5,7-dichlorokynurenic acid (100 microM) reversed the effect of both glutamate (1 mM) and glycine (1 mM) and suppressed seizures completely in 90% of the animals. These results indicate that although neurotoxicity is not achieved by perfusing glutamate and glycine at concentrations as high as 1 mM, neuronal excitability is modified by altering extracellular glutamate and glycine concentrations, and they suggest that glutamate-induced neuronal hyperexcitability is induced through mechanisms different from excitotoxicity.

Effects of NMDA antagonists on seizure thresholds induced by intrahippocampal microdialysis of picrotoxin in freely moving rats.

The role of N-methyl-D-aspartate (NMDA) receptors on individual variations in animal seizure threshold induced by picrotoxin microperfusion in the hippocampus of freely moving rats was analyzed by testing the effects of NMDA receptor antagonists 2-amino 5-phosphonovalerate (AP-5) and dizocilpine (MK-801) on individual seizure thresholds. We found a correlation between the increased threshold levels induced by AP-5 and control seizure levels of each individual animal. However, no correlation was found with the increased threshold level induced by MK-801. These data suggest that the individual variations in seizure threshold in different animals reflect dynamic processes of NMDA mediated activity and emphasizes the value of whole-animal models to analyze NMDA receptor functions.

Calpain inhibitor I retards seizure offset in the hippocampus of freely moving rats.

The implications of increased calpain-mediated proteolysis during epileptic seizures are still unclear, and in this study we investigate the effect of the continuous perfusion of calpain inhibitor I on picrotoxin-induced seizures in chronic freely moving rats. Continuous intrahippocampal microperfusion of 500 microM calpain inhibitor I had no effect on basal EEG, but doubled (P < 0.05) average seizure duration, and increased more than five-fold (P < 0.01) the total seizure time and three-fold (P < 0.01) the seizure offset time compared to picrotoxin alone, in each individual rat. However, seizure type and onset time were not modified by calpain inhibitor I. These results indicate that a calpain-mediated mechanism may be responsible for seizure offset, probably through AMPA glutamate receptors internalization and further degradation.