Angiosarcoma gastrointestinal multifocal, con compromiso extenso de estómago, intestino delgado y colon. Reporte de un caso / Multifocal gastrointestinal angiosarcoma, with extensive gastric, small intestine and colon involvement. A case report

Introducción. El angiosarcoma es una neoplasia vascular originada a nivel del endotelio, de baja frecuencia, conocido por su agresividad y crecimiento acelerado. Alcanza solo el 1 al 2 % del total de los sarcomas. La presentación gastrointestinal es infrecuente y su incidencia es poco conocida debido al escaso reporte de casos en la literatura. Suele identificarse en etapas avanzadas debido a la dificultad del diagnóstico histopatológico por sus características morfológicas, siendo necesario aplicar tinciones especiales o estudio inmunohistoquímico. Caso clínico. Por su interés y singularidad, presentamos el caso de un paciente masculino de 54 años, quien consultó con hemorragia digestiva profusa, anemización y requerimiento de terapia transfusional. Resultados. Durante el proceso diagnóstico, en la endoscopia encontraron diversas lesiones multifocales que se extendían por gran parte del tracto gastrointestinal. El estudio histopatológico mostró angiosarcoma gastrointestinal. Discusión. El angiosarcoma del tracto gastrointestinal es extremadamente infrecuente, de difícil diagnóstico y bajas posibilidades de manejo curativo, con opciones terapéuticas limitadas, lo que configura un mal pronóstico a corto plazo

Introduction. Angiosarcoma is a vascular neoplasm originating from endothelial cells, known for its aggressiveness, accelerated growth and reduced frequency. Reach only 1 to 2% of total sarcomas. Gastrointestinal presentation is extremely rare, the true incidence is poorly known, due to the limited reports of this entity in the literature. It is usually identified in advanced stages in view of the difficulty of the histopathological diagnosis, attributable to its morphological characteristics, being necessary to apply special stains or immunohistochemical study. Case report. Due to their interest and uniqueness, we present the case of a 54-year-old male patient, who presented with a profuse gastrointestinal bleeding, anemia, and requirement for transfusion therapy. Results. The endoscopy detected several multifocal lesions that extended most of the gastrointestinal tract. The histopathological study showed gastrointestinal angiosarcoma. Discussion. Angiosarcoma of the gastrointestinal tract is extremely uncommon, difficult to diagnose and has low possibilities of curative management, with limited therapeutic options, which configures a poor prognosis in the short term

Patrones de detección de Helicobacter pylori y lesiones relacionadas mediante protocolo Sydney en una población de Antioquia, Colombia

Objetivos: Se buscó determinar si las endoscopias que cumplieron el protocolo Sydney en una población de Antioquia tuvieron una detección mayor de H. pylori y sus lesiones asociadas que las endoscopias que sólo tomaron muestras de antro. Materiales y métodos: Realizamos un estudio retrospectivo, trasversal y descriptivo. Se incluyeron pacientes adultos sometidos a endoscopia superior. Se dividieron los pacientes en dos grupos según si se siguió o no el protocolo Sydney y se midió la frecuencia de detección de H. pylori, y lesiones premalignas. Resultados: Se incluyeron 261 participantes, a 88 se les tomó el protocolo de Sydney y a 173 se les tomaron muestras exclusivamente de antro gástrico. La indicación principal de endoscopia fue dispepsia (35,6%). La detección de H. pylori, gastritis atrófica y metaplasia intestinal fue del 36,4%, 19,3% y 20,5% respectivamente en el grupo Sydney, y 30,1%, 11,6% y 9,8% en el grupo control. En el grupo Sydney, la detección de H. pylori fue mayor en antro y cuerpo (26,1%) que en antro (6,8%) o cuerpo (3,4%) por separado. La detección de gastritis atrófica y metaplasia intestinal fue mayor en antro solamente (10,2% y 11,4% respectivamente) que en antro y cuerpo o cuerpo por separado. Conclusiones: La omisión del protocolo Sydney reduce la detección de H. pylori, gastritis atrófica y metaplasia intestinal en un 9,4%, 29,4% y 27,7% respectivamente. Se debe implementar el protocolo sistemáticamente en todo centro de endoscopia digestiva.

Objectives: We sought to determine whether the endoscopies that met the Sydney protocol in a population of Antioquia had a greater detection of H. pylori and their associated lesions than the endoscopies that only took antrum samples. Materials and methods: We carried out a retrospective, cross-sectional and descriptive study. Adult patients undergoing upper endoscopy were included. Patients were divided into two groups depending on Sydney protocol compliance. The detection frequency was measured for H. pylori and premalignant lesions. Results: 261 participants were included, 88 from which biopsies were taken with the Sydney protocol and 173 with biopsies taken exclusively from the gastric antrum. The main endoscopy indication was dyspepsia (35.6%). The detection of H. pylori, atrophic gastritis and intestinal metaplasia was 36.4%, 19.3% and 20.5% respectively in the Sydney group, and 30.1%, 11.6% and 9.8% in the control group. In the Sydney group, the detection of H. pylori was higher in the antrum and body (26.1%) than in antrum (6.8%) or body (3.4%) separately. The detection of atrophic gastritis and intestinal metaplasia was higher in antrum only (10.2% and 11.4% respectively) than in antrum and body or body separately. Conclusions: The omission of the Sydney protocol reduces the detection of H. pylori, atrophic gastritis and intestinal metaplasia by 9.4%, 29.4% and 27.7% respectively. The protocol must be implemented systematically in every gastrointestinal endoscopy center.

Genotypic variation in morphology and freezing resistance of Eucalyptus globulus seedlings subjected to drought hardening in nursery / Variación genotípica en la morfología y resistencia a la congelación del Eucalyptus globulus a la sequía sometido al endurecimiento en vivero

Eucalyptus globulus Labill is one of the most planted species in Chile, because of its fast growth and superior pulp qualities. Nevertheless, the incidence of drought and frost damage immediately after planting is frequent. The purpose of this work was to study the effect of drought hardening on frost resistance and on variations in morphological traits that may increase drought resistance at nursery phase in four genotypes of E. globulus Labill. Drought hardening treatments consisted in induced water stress by watering restriction, until pre-dawn stem xylem water potentials (Psi pd) reached -0.2, -1.8 and -2.6 MPa. Two water stress-rewatering cycles were applied during 54 days of hardening. Plant and root biomasses were affected by the interaction of drought hardening and genotypes. The rest of morphological and alometrical traits were affected independently by drought or genotype. Plant height, leaf area, specific leaf area (SLA), stem, and leaf biomasses decreased with drought hardening, while collar diameter was not affected. Genotypes responded differentially to drought hardening in plant height, leaf area, SLA, and stem, and leaf biomasses. Ice nucleation temperature (INT), and freezing temperatures (FRT), and 50 percent freezing damage index of leaves (LT50) were affected by the interaction between drought hardening and genotypes. EG-13, EG-23 and EG-22 genotypes became freezing tolerant with drought hardening (-2.6 MPa). Additionally, EG-14 genotype increased its freezing resistance at -1.8 MPa. Therefore, freezing resistance levels and mechanism depend on genotype and drought hardening treatment. The success in tree breeding by genetic selection should be facilitated by improved understanding of the physiology of stress resistance development and survival during water supply limitations. The knowledge of morphological and freezing resistance dependency on the interaction between genotype and drought hardening may be useful...

Niveles séricos de procalcitonina y sepsis en el posoperatorio inmediato de diversos tipos de cirugía / Serum procalcitonin levels and sepsis during the immediate postoperative period in several types of surgery

Introducción: la procalcitonina (PCT) es un marcador que ha demostrado ser útil en el diagnóstico de infecciones bacterianas. Considerando que algunas cirugías como la cardiaca inducen liberación de PCT, se necesitan múltiples estudios que demuestren su utilidad en estas circunstancias.Objetivo: evaluar la capacidad discriminatoria de la PCT ntre el síndrome de respuesta inflamatoria sistémica (SRIS) con sepsis y sin sepsis, en el periodo posoperatorio temprano para un valor de PCT mayor a 2 ng/ml.Material y métodos: evaluamos 119 pacientes con SRIS en las primeras 72 horas de posoperatorio. Se midió los niveles séricos de PCT semicuantitativa y se realizo seguimiento a los pacientes para clasificarlos en SRIS con sepsis y SRIS sin sepsis basados en el protocolo de sepsis de la Fundación Cardio-Infantil de Bogotá.Resultados: la sensibilidad para el diagnóstico de sepsis con procalcitonina de > 2 ng/ml fue de 28 por ciento y especificidad de 68 por ciento. La mortalidad global de la población fue 11,7 por ciento encontrándose asociación con los niveles de procalcitonina dado por un OR 5.20 (IC 95 por ciento limites 1.42 – 19.86).Discusión: las características demográficas de la población son reflejo de las características y estadísticas institucionales. Los resultados difieren de la literatura probablemente por el uso de procalcitonina semicuantitativa y no LUMI-test®, además de los tipos de cirugía incluidos. Estas observaciones deben ser confirmadas por otros estudios.Conclusión: la medición de procalcitonina semicuantitativa no es una herramienta útil en discriminar pacientes sépticos de los no sépticos en posoperatorio temprano.

Changes in morpho-physiological attributes of Eucalyptus globulus plants in response to different drought hardening treatments

Morpho-physiological attributes exhibited in response to drought hardening at the end of the growing season of Eucalyptus globulus Labill under nursery conditions were studied to evaluate the effect of three drought hardening treatments in morpho-physiological traits used as suitable indicators of drought hardiness, such as, plant growth, root growth potential, plant water relationships and survival. Freezing resistance of drought hardened plants was also studied in order to evaluate cross hardening effects in cuttings of Eucalyptus globulus Labill. Drought hardening consisted in induced water stress by watering restriction, until plant stem xylem water potentials (psipd) reached to-0.2, -1.3 and -2.4 MPa. Two water stress-rewatering cycles were applied during 54 days of treatment. The hardening treatments caused a significant reduction in plant height, leaf area, specific leaf area, plant, leaf, stem and root biomass. However, stem diameter was not affected. Root growth potential increased with the exposure to moderate water stress (-1.3 MPa). Drought hardening treatments have not effect on water relationship parameters such as saturation osmotic potential (psipisat), volumetric module of elasticity (e), relative water content (RWCtlp) and osmotic potential (psitlp) at the turgor loss point. Only 1.7 percent and 6 percent of dehydrated dead plants were observed on treatments at -1.3 and -2.4 MPa respectively. Finally, the freezing damage index of leaves (LT50) was not significantly affected by drought hardening treatments. Furthermore, a reduction of 1.1ºC of supercooling capacity was observed at -2.4 MPa. As a conclusion, drought hardening is an important step of plants production programs during the final phase of nursery, because changes in morphological attributes caused by exposure to moderate drought, enable the plants to maintain the balance between transpiration and absorption areas and increase the capacity of plants to generate n...

Resistance to freezing in three Eucalyptus globulus Labill subspecies

The resistance to low temperatures was assessed in seedlings of three subspecies of E. globulus (ssp globulus, ssp bicostata and ssp maidenii) of two different provenances. Lethal temperature 50 (LT50) was obtained by measuring the electrolytic conductivity, nucleation and freezing temperatures were obtained by thermal analysis and the total soluble carbohydrates concentration was determined through the phenol-sulphuric method. Results showed that the most resistant provenance corresponded to Bolaro Mountain of ssp maidenii with a LT50 lower than -9ºC. The provenance Moogora of ssp globulus, had a LT50 of -8.47ºC, which situates it, as the second most resistant to low temperatures. According to the nucleation and freezing temperatures, the results indicate that all the provenances analyzed evaded the formation of ice, except for Bolaro Mountain of ssp maidenii which was tolerant to freezing. Finally, an inverse correlation (r = -0.89) between the content of total soluble carbohydrates and the LT50 was found, indicating the cryoprotection effect of these in the resistance to low temperatures.