Leukemia in children and youths of the Azuay province, Ecuador: 2000-2010.

We mapped leukemia risk among children and youths in the Azuay province, Rio Paute river basin, Ecuador, in 2000-2010, using a Bayesian disease mapping model. We assessed the comprehensiveness of the list of leukemia cases from the Sociedad de Lucha contra el Càncer en el Ecuador (SOLCA) Hospital in Cuenca, the only referral center for oncology in the whole Rio Paute area, by comparison to the Quito cancer registry. Risk of leukemia did not vary significantly by canton within the Azuay province. However, a moderate increase in risk of borderline statistical significance was observed in the city of Cuenca and particularly among males in a heavily industrialized parish, who had an almost eight-fold excess (95% CI 3.03, 20.39, p = 0.01) of AML. Analytical studies are warranted to properly address specific etiological factor of leukemia among children and youths of the Azuay province of Ecuador.

Combinations of apoptosis and cell-cycle control biomarkers predict the outcome of human melanoma.

The deregulation of apoptosis is characteristic of human carcinogenesis. Survivin, an inhibitor of apoptosis, p53 and p16, two tumour suppressor proteins involved in cell cycle control, play a central role in apoptosis. The aim of this study was to investigate, in primary cutaneous melanoma from 68 patients, the expression of survivin with respect to p53 or p16; the association of these proteins, alone or in combination with clinicopathological features; and, most importantly, to elucidate the role of these markers in predicting survival. The level of survivin expression was significantly higher in the p53 positive group of melanomas compared with the p53 negative one, suggesting a cooperative effect in favouring the progression of melanoma, while no correlation was found between survivin and p16. Moreover, the altered expression of nuclear survivin, p53 and p16 were all associated with poor survival, as demonstrated by univariate analysis. However, these biomarkers have been shown to have superior predictive value when studied in combination (P<0.0001) rather than alone, while the risk of mortality grew progressively with increasing the number of altered biomarkers. These data suggest that the assessment of the combined marker status and number of altered markers in patients with melanoma provides important additional prognostic information that may help in patient selection for adjuvant therapies.

Nuclear factor-κB expression is predictive of overall survival in patients with cutaneous melanoma.

Nuclear factor (NF)- κB is one of the most important transcription factors that plays a crucial role in the regulation of a wide spectrum of genes involved in modulating the cell cycle, apoptosis, cell growth, angiogenesis, inflammation and the tissue invasiveness of highly malignant cells. NF-κB activity has been found to be constitutively elevated in a number of human tumors from either a haematological or solid origin, such as melanomas. In several studies, NF-κB activation was shown to be an adverse prognostic factor, and in melanoma it was proposed as an event that promotes tumor progression. This study aimed to evaluate whether NF-κB activation in tumor tissues, assessed by the expression of the NF-κB p65 subunit, has an effect on the survival of melanoma patients. The expression of NF-κB was immunohistochemically investigated, and the correlation with survival was analyzed. Furthermore, the immunostaining for p53 and survivin was evaluated, and the relationship of these apoptotic and anti-apoptotic factors with NF-κB expression was analyzed. Kaplan-Meier analysis showed that patients with low levels of NF-κB in the nuclei of tumor cells had a significantly longer survival compared to those with high levels. Multivariate analysis confirmed the predictive value of nuclear NF-κB, showing that its expression maintains significance after the model was adjusted using clinicopathological factors. The results demonstrate the correlation of NF-κB p65 nuclear staining with the disease-specific 5-year survival of melanoma patients and suggest that nuclear NF-κB p65 may be promising as an early independent prognostic factor in patients with primary cutaneous melanoma.

Nuclear 8-hydroxy-2'-deoxyguanosine as survival biomarker in patients with cutaneous melanoma.

8-hydroxy-2'-deoxyguanosine (8-OHdG) is one of the main mutagenic modifications induced in DNA by oxidative stress. Elevated levels of 8-OHdG have been regarded as an independent prognostic factor in different types of cancer. Various enzymes, such as human 8-oxoguanine DNA-glycosylase 1 (hOGG1) and glucose-6-phosphate dehydrogenase (G6PD), act as protection against oxidative stress. The low activity of such enzymes has been consistently associated with increased risk of progression in several tumor types. The aim of this study was to investigate whether 8-OHdG, hOGG1 and G6PD expression in tumor tissues might be a predictor of survival in melanoma patients. The expression of 8-OHdG, hOGG1 and G6PD was immunohistochemically investigated in primary cutaneous melanoma and the effect on survival was analyzed. Furthermore, the immunostaining for p53 and survivin was evaluated and the relationship among 8-OHdG, hOGG1, G6PD, p53 and survivin expression was analyzed. Kaplan-Meier analysis demonstrated that patients with low expression of nuclear 8-OHdG had significantly longer survival time compared with those with a high expression (P=0.032), whereas cancer-specific survival of patients was not associated with hOGG1 or G6PD expression. These results suggest an involvement of oxidative DNA damage in the process of melanoma pathogenesis and demonstrate that 8-OHdG expression in nuclei of tumor cells could be useful as an early independent prognostic marker in patients with primary cutaneous melanoma.

The stem cell marker nestin predicts poor prognosis in human melanoma.

The cancer stem cell hypothesis suggests that mutated melanocyte stem cells are present in skin as precursors of melanoma cells. Nestin and CD133 have been described as markers of melanocytic stem cells. The aim of this study was to establish if melanocytic stem cells could have a prognostic significance in melanoma progression. An immunohistochemical study for nestin and CD133 was performed in 130 primary tumors and 32 nodal metastasis biopsy specimens to evaluate possible differences, and to compare the results with survival data and clinicopathological variables. Nestin was expressed in cytoplasm of non-pigmented tumor cells and in endothelial cells, especially at the invading tumor front. Nestin staining in stage I and II (according to the American Joint Committee on Cancer Staging system) melanoma patients significantly predicted poor survival (log-rank test, P=0.037), with lower survival rates in cases with nestin positivity in both tumoral and endothelial cells. CD133 staining was not associated with survival. There were no significant differences in nestin or CD133 expression between primary tumors and metastases. These results suggest that nestin expression in both tumoral and endothelial cells may be considered an important early prognostic marker in melanoma.

Enfermedad de Chagas aguda, en un adulto tratado con benznidazol (Rochagan®) en Costa Rica

Se da a conocer un caso agudo de la enfermedad de Chagas en un adulto de 48 años con signo de Romaña, infectado al recibir un chorro de orina de una chinche (T dimidiata), cuando trataba de destriparla con un palo de café. Es el primer adulto con enfermedad de Chagas aguda tratado en Costa Rica con benznidazol. Se citan los síntomas encontrados, así como los aspectos epidemiológicos relacionados con su presentación. Se enfatizan el tratamiento y la evolución del caso. Se hace un llamado de atención a los clínicos, ya que este caso no fue diagnosticado apropiadamente desde un inicio, lo que evidencia el desconocimiento que existe de la enfermedad de Chagas como motivo de consulta.

Enfermedad de Chagas aguda, en un adulto tratado con benznidazol (Rochagan) en Costa Rica / Disease acute Chagas, in a adult dealt with benznidazol (Rochagan) en Costa Rica

Se da a conocer un caso agudo de la enfermedad de Chagas en un adulto de 48 años con signo de Romaña, infectado a recibir un chorro de orina de una chince (T dimidiata), cuando trataba de destriparla con un palo de café. Es el primer adulto con enfermedad de Chagas aguda tratado en Costa Rica con Benznidazol. Se citan los síntomas encontrados, así como los aspectos epidemiológicos relacionados con su presentación. Se enfatizan el tratamiento y la evolución del caso. Se hace un llamado de atención a los clínicos, ya que este caso no fue diagnosticado apropiadamente desde un inicio, lo que evidencia el desconocimiento que existe de la enfermedad de Chagas como motivo de consulta. Descriptores: Chagas, agudo, benznidazol.

Ectoparasitosis por acaros macronísidos (Gamasida: Macronyssidae) / Ectoparasites with macronyssid mites (Gamasida: Macronyssidae)

Se describe el caso de una dermatitis asociada a ácaros macronísidos en una paciente femenina de Tuetal Norte (Provincia de Alajuela), Costa Rica. El cuadro clínico mostró un brote generalizado con prurito constante. Los demás miembros del grupo familiar presentaron manifestaciones similares. La paciente comentó que "diminutos animales" caminaban por su cuerpo y por las paredes de la casa. Una muestra de estos organismos fue aclarada y montada entre porta y cubreobjetos para su examen microscópico. Mostró la presencia de ácaros macronisidos. El tratamiento fue realizado con jabón de Tetmosol, Eurax en loción y Atarax. Diez días luego de iniciado el tratamiento se documentó la cura del cuadro. Palabras clave: Macronyssidae, Ornithonyssus, dermatitis, ectoparásitosis