Hipofisitis linfoplasmocitaria y fibrosis retroperitoneal asociadas a un síndrome poliglandular autoinmune: enfermedades relacionadas con IgG4. Caso clínico / Hypophysitis and retroperitoneal fibrosis associated with autoimmune polyglandular syndrome and IgG4-related disease: report of one case

We report a 23 year old woman presenting with a nephrotic syndrome due to minimal change disease, central diabetes insipidus, primary hypothyroidism, vitiligo and universal alopecia. Eleven years later, she presented secondary amenorrhea due to hypogonadotropic hypogonadism, with mild hyperprolactinemia and central adrenal insufficiency. A magnetic resonance imaging of the sella turcica showed a pituitary mass with suprasellar extension that was resected using a transsphenoidal approach. Pathology confirmed the presence of a lymphoplasmacytic hypophysitis. She needed a second surgical resection due to mass growth and neuro-ophthalmologic impairment. One year later, systemic lupus erythematosus, arterial hypertension and type 2 diabetes mellitus were diagnosed. Two years later, due to back pain, constipation and renal failure, retroperitoneal fibrosis was found, satisfactorily treated with glucocorticoids and colchicine. Hence, this clinical vignette shows the coexistence of autoimmune polyglandular syndrome with retroperitoneal fibrosis and lymphoplasmacytic hypophysitis. Tissue analysis showed the presence of IgG4 producing plasma cells in the pituitary and retroperitoneum, which constitute a basis for the diagnosis of IgG4 related disease.

El Consejo Mexicano de Medicina Interna, AC. Gestión 2015-2018. Rendición de cuentas y transparencia. Informe y análisis / The Mexican Council of Internal Medicine, AC. 2015-2018. Management accountability and transparency. Report and analysis

Resumen En febrero de 2015 inició una nueva gestión en el Consejo Mexicano de Medicina Interna (CMMI), con la firme convicción de facilitar la continuidad, consolidar y perfeccionar los logros alcanzados por las consejos directivos previos, bajo la política de ser un Consejo incluyente e integrador, flexible y con criterio, con presencia en los estados del país con la finalidad de promocionarlo e informar de las funciones del Consejo y diferencias con el Colegio de Medicina Interna de México (CMIM), pero sobre todo cumplir con nuestra misión y visión. Se comunica una relación de las acciones y mejoras realizadas en función de los cambios de la Ley General de Salud que genera obligaciones a los profesionales de la salud y, como consecuencia, al Comité Normativo Nacional de Consejos de Especialidades Médicas, consolidando al CMMI como un Consejo renovado, fortalecido y enriquecido.

Abstract In February 2015, began a new administration in the Mexican Board of Internal Medicine (CMMI) with the firm conviction of facilitating continuity, consolidating and improving the achievements of the previous board of directors, under the policy of being an inclusive Council, flexible and with discretion, with presence in the interior of the country in order to promote it and report on the functions of the Council and differences with the Internal Medicine College of Mexico (CMIM), but above all to fulfill our mission and vision. Below is a list of the actions and improvements made in accordance with the changes of the General Health Law that generates obligations to health professionals and as a consequence to the National Regulations Committee of Medical Specialty Councils, consolidating CMMI as a Board of Directors renovated, strengthened and enriched.

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Cnidarian venoms and extracts have shown a broad variety of biological activities including cytotoxic, antibacterial and antitumoral effects. Most of these studied extracts were obtained from sea anemones or jellyfish. The present study aimed to determine the toxic activity and assess the antitumor and antiparasitic potential of Palythoa caribaeorum venom by evaluating its in vitro toxicity on several models including human tumor cell lines and against the parasite Giardia intestinalis. Methods: The presence of cytolysins and vasoconstrictor activity of P. caribaeorum venom were determined by hemolysis, PLA2 and isolated rat aortic ring assays, respectively. The cytotoxic effect was tested on HCT-15 (human colorectal adenocarcinoma), MCF-7 (human mammary adenocarcinoma), K562 (human chronic myelogenous leukemia), U251 (human glyoblastoma), PC-3 (human prostatic adenocarcinoma) and SKLU-1 (human lung adenocarcinoma). An in vivo toxicity assay was performed with crickets and the antiparasitic assay was performed against G. intestinalis at 24 h of incubation. Results: P. caribaeorum venom produced hemolytic and PLA2 activity and showed specific cytotoxicity against U251 and SKLU-1 cell lines, with approximately 50% growing inhibition. The venom was toxic to insects and showed activity against G. intestinalis in a dose-dependent manner by possibly altering its membrane osmotic equilibrium. Conclusion: These results suggest that P. caribaeorum venom contains compounds with potential therapeutic value against microorganisms and cancer.(AU)

Hemolytic, anticancer and antigiardial activity of Palythoa caribaeorum venom

Background Cnidarian venoms and extracts have shown a broad variety of biological activities including cytotoxic, antibacterial and antitumoral effects. Most of these studied extracts were obtained from sea anemones or jellyfish. The present study aimed to determine the toxic activity and assess the antitumor and antiparasitic potential of Palythoa caribaeorum venom by evaluating its in vitro toxicity on several models including human tumor cell lines and against the parasite Giardia intestinalis. Methods The presence of cytolysins and vasoconstrictor activity of P. caribaeorum venom were determined by hemolysis, PLA2 and isolated rat aortic ring assays, respectively. The cytotoxic effect was tested on HCT-15 (human colorectal adenocarcinoma), MCF-7 (human mammary adenocarcinoma), K562 (human chronic myelogenous leukemia), U251 (human glyoblastoma), PC-3 (human prostatic adenocarcinoma) and SKLU-1 (human lung adenocarcinoma). An in vivo toxicity assay was performed with crickets and the antiparasitic assay was performed against G. intestinalis at 24 h of incubation. Results P. caribaeorum venom produced hemolytic and PLA2 activity and showed specific cytotoxicity against U251 and SKLU-1 cell lines, with approximately 50% growing inhibition. The venom was toxic to insects and showed activity against G. intestinalis in a dose-dependent manner by possibly altering its membrane osmotic equilibrium. Conclusion These results suggest that P. caribaeorum venom contains compounds with potential therapeutic value against microorganisms and cancer.

Enfermedad por inclusión microvellositaria como causa de diarrea congénita severa: caso clínico / Microvillous inclusion disease as a cause of severe congenital diarrhea: case report

Las diarreas congénitas son patologías graves de baja frecuencia y alta mortalidad. Se manifiestan durante los primeros días o meses de vida con severa diarrea, generando insuficiencia intestinal y dependencia de nutrición parenteral. Se debe sospechar ante un recién nacido o lactante con pérdidas masivas hidroelectrolíticas, y se diagnostican utilizando parámetros clínicos, endoscópicos, histológicos y eventualmente genéticos. El tratamiento es de soporte, con reposición hidroelectrolítica intensa y nutricional. OBJETIVO: Presentar un caso de diarrea congénita, identificada como Enfermedad por Inclusión Microvellositaria, de presentación neonatal. CASO CLÍNICO: Paciente varón edad actual 3 años, hijo de padres consanguíneos, quien debutó a los 10 días de vida con diarrea secretora severa, requiriendo ingreso a unidad de paciente crítico y nutrición parenteral permanente. Inicialmente además con síndrome de Fanconi, que luego se recupera. Se confirmó la sospecha de Enfermedad de Inclusión Microvellositaria utilizando microscopia óptica, electrónica e inmunohistoquímica. Se obtuvo una favorable evolución utilizando nutrición parenteral total (NPT) a domicilio. CONCLUSIONES: Se presenta el primer caso conocido en Chile de un paciente con diarrea congénita por inclusión microvellositaria manejado y su evolución.

Congenital diarrheas correspond to a severe and low frequency digestive disease, with a high mortality. They start a few days or months after birth, leading to intestinal insufficiency and dependence on parenteral nutrition. It must be highly suspected in newborns or infants with diarrhea and severe electrolyte disorders. The diagnosis is based on clinical, endoscopic, histologic and eventually genetic findings. Treatment is supportive with intensive correction of electrolyte imbalances as well as parenteral nutrition. OBJECTIVE: To present a case report of congenital diarrhea identified as microvillous inclusion disease presenting in the neonatal period. CASE REPORT: Male patient currently 3 years of age, son of consanguineous parents. At 10 days of age presents a severe secretory diarrhea, requiring treatment in a critical care unit and parenteral nutrition. Initially he also presented with Fanconi syndrome, which improved afterwards. The suspicion of congenital microvillous inclusion was confirmed later by optic and electronic microscopy, and inmunohistochemistry. A succesful evolution was later achieved maintaining home parenteral nutrition after discharge. CONCLUSION: We present the first known case in Chile of congenital diarrhea due to microvillous inclusión disease and his evolution.

Composition and biological activities of the aqueous extracts of three scleractinian corals from the Mexican Caribbean: Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea

Background: Scleractinian corals (stony corals) are the most abundant reef-forming cnidarians found in coral reefs throughout the world. Despite their abundance and ecological importance, information about the diversity of their toxins and their biological activities is very scarce. In this study, the chemical composition and the biological activities of the aqueous extracts of Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea, three scleractinian corals from the Mexican Caribbean, have been assessed for the first time. Methods: Toxicity of the extracts was assessed in crickets; the presence of cytolysins was detected by the hemolysis assay; the vasoconstrictor activity was determined by the isolated rat aortic ring assay; the nociceptive activity was evaluated by the formalin test. The presence of phospholipases A2 (PLA2), serine proteases, and hyaluronidases was determined by enzymatic methods. Low-molecular-weight fractions were obtained by gel filtration chromatography and ultrafiltration. Results: Extracts from the three species were toxic to crickets, induced hemolysis in human and rat erythrocytes, produced vasoconstriction on isolated rat aortic rings, and presented phospholipase A2 and serine-protease activity. Despite the fact that these corals are not considered to be harmless to humans, the extracts generated significant nociceptive responses. The matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry analysis of the low-molecular-weight fractions revealed the presence of peptides within a mass range of 3000 to 6000 Da. These fractions were toxic to crickets and two of them induced a transitory vasoconstrictor effect on isolated rat aortic rings. Conclusion: This study suggests that scleractinian corals produce low-molecular-weight peptides that are lethal to crickets and induce vasoconstriction.(AU)

Composition and biological activities of the aqueous extracts of three scleractinian corals from the Mexican Caribbean: Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea

Scleractinian corals (stony corals) are the most abundant reef-forming cnidarians found in coral reefs throughout the world. Despite their abundance and ecological importance, information about the diversity of their toxins and their biological activities is very scarce. In this study, the chemical composition and the biological activities of the aqueous extracts of Pseudodiploria strigosa, Porites astreoides and Siderastrea siderea, three scleractinian corals from the Mexican Caribbean, have been assessed for the first time. Methods: Toxicity of the extracts was assessed in crickets; the presence of cytolysins was detected by the hemolysis assay; the vasoconstrictor activity was determined by the isolated rat aortic ring assay; the nociceptive activity was evaluated by the formalin test. The presence of phospholipases A2 (PLA2), serine proteases, and hyaluronidases was determined by enzymatic methods. Low-molecular-weight fractions were obtained by gel filtration chromatography and ultrafiltration. Results: Extracts from the three species were toxic to crickets, induced hemolysis in human and rat erythrocytes, produced vasoconstriction on isolated rat aortic rings, and presented phospholipase A2 and serine-protease activity. Despite the fact that these corals are not considered to be harmless to humans, the extracts generated significant nociceptive responses. The matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry analysis of the low-molecular-weight fractions revealed the presence of peptides within a mass range of 3000 to 6000 Da. These fractions were toxic to crickets and two of them induced a transitory vasoconstrictor effect on isolated rat aortic rings. Conclusion: This study suggests that scleractinian corals produce low-molecular-weight peptides that are lethal to crickets and induce vasoconstriction.

Micro identificación taxonómica y nuevos caracteres diagnósticos del erizo marino Astropyga pulvinata (Diadematoida: Diadematidae) / Taxonomic microidentification and new diagnostic characters of the sea urchin Astropyga pulvinata (Diadematoida: Diadematidae)

Resumen Astropyga pulvinata es un diademátido que posee cinco pares de series de puntos iridiscentes presentes en los interambulacros. A partir de la observación 20 individuos in vivo a través de un estereoscopio y el análisis con un Microscopio Electrónico de Barrido se identificaron los pedicelarios, las espículas y las rosetas calcáreas de los pies ambulacrales. Los pedicelarios presentes en A. pulvinata son trivalvados y de tres tipos: claviformes (oficéfalos) presentes en ambulacro; tridentados distribuidos en el peristoma; y trifoliados presentes en toda la testa excepto en los interambulacros. Los pedicelarios claviformes son los únicos que no están unidos por un pedúnculo calcáreo de tipo diadematoide. Se obtuvieron diez tipos de espículas de diversos tejidos blandos: uno del intestino; tres de la membrana anal y seis del peristoma, dos de las cuales no han sido descritas hasta el momento. Uno de estos nuevos tipos de espículas reportados posee forma de basto y otro de media luna. De las observaciones in vivo se encontraron puntos iridiscentes más pequeños presentes en el ambitus constituidos por aproximadamente ocho células.

Abstract Astropyga pulvinata is a sea urchin of the family Diadematidae that have five pairs of series of blue iridescent spots on interambulacral zones, from in vivo observation of 20 individuals under stereo-microscope and Scanning Electron Microscope analysis identification, the pedicellariae, spicules, and calcareous rosettes. The pedicellariae of A. pulvinata have three valves and are of three types: claviform, present on ambulacres; tridentates present on peristome and triphyllous present all over the test except in interambulacral areas. So ophicephalous pedicellariae are not bounded with a calcareous stalk. Ten types of spicules were observed from different soft tissues: one type from the intestine; three from the anal membrane; and six from the peristome, two of them constitute new diagnostic characters. One of them having a bat-shaped form and the other one with a waning crescent shape. In vivo observations showed that the blue iridescent spots were present on interambulacral areas as group of 35 cells bounded, and that other smaller spots were present on the ambitus, composed by eight cells. Rev. Biol. Trop. 63 (Suppl. 2): 49-58. Epub 2015 June 01.

Purification and characterization of structural and functional properties of two lectins from a marine sponge Spheciospongia vesparia.

The purification, structural and functional characterization of two different lectins (named Svl-1 and Svl-2) has been reported from the marine sponge Spheciospongia vesparia. Purification procedure includes ammonium sulfate precipitation, combined with chromatography including Octyl-Sepharose-(NH4)SO4 hydrophobic column and DEAE-Toyopearl anion-exchange column using a high performance liquid chromatography. The similarities in function, specificity for saccharides, molecular weight, amino acid content and the N-terminal sequence of two lectins suggest that these proteins are isolectins. Amino acid composition and fluorescence analyses reveal that they contain an intrachain disulfide bridge, which might contribute to their high thermal stability. Furthermore, the purified lectins exhibit antibacterial activity against the gram-negative bacteria Pseudomonas aeruginosa and E. coli, indicating that they may be involved in a recognition strategy and may play a role in the defense response function of the sponge. This is the first report on the isolation of lectins from the S. vesparia. The purified lectins represent a potential possible candidate for future application in the recognition or treatment of cancer cells.

Enfermedad de Erdheim-Chester. Una causa rara de derrame pericárdico: Caso clínico / Erdhei-Chester disease: Report of one case

We report a 76-year-old male who was admitted due to progressive congestive heart failure lasting several months. An echocardiogram showed a large pericardial effusion with early signs of pericardial tamponade and an irregular surface suggestive of cancer infiltration. The patient was operated, creating a pericardial window and draining 1,200 ml of a brownish yellow fluid with abundant cellularity. Pericardial biopsy showed infiltration by CD68 (+), CD1a (-) and S100 (-) cells. Twenty-eight months earlier, due to fatigue, dyspnea, and a non-specific inflammatory process, an enhanced-contrast-scan showed that aorta was coated with a hypodense tissue that began near the aortic valve and extended until the inferior mesenteric artery, with stenosis of the left subclavian, celiac axis, renal and upper mesenteric arteries. An angioplasty and stent placing was carried out in the last two arteries. Both kidneys had the appearance of "hairy kidneys". A bone scan showed increased uptake in femurs and tibiae and X-ray examination showed osteosclerosis in metaphysis and diaphysis. The diagnosis of Erdheim-Chester disease (non-Langerhans-cell histiocytosis) was made and the patient was treated with steroids and methotrexate.

Inducción de supresividad a fitopatógenos del suelo: un enfoque holístico al control biológico / Induction of soil-borne disease suppressiveness: a holistic approach to biological control

La supresividad del suelo a fitopatógenos es un concepto holístico que se ha pretendido explicar y manejar infructuosamente bajo el enfoque reduccionista, en la búsqueda del control biológico mediante el aislamiento de antagonistas específicos contra ciertos fitopatógenos y su reintroducción al suelo en cantidades aumentadas. Bajo el enfoque holístico, se revalora el concepto de supresividad como una propiedad emergente del sistema, que resulta de su propia complejidad y que no puede explicarse, y menos manejarse, desintegrando al sistema en sus componentes elementales. Su guía filosófica es la teoría general de sistemas y de la complejidad. La complejidad es precursora de la estabilidad y, en ecología del suelo, la propiedad de autoorganización de los sistemas complejos puede conducir al surgimiento de la supresividad. En la presente revisión se analizan trabajos relacionados con la supresividad de suelos, que en general parecen indicar que bajo el enfoque reduccionista aquella no ha sido manejada de forma exitosa. Con el enfoque holístico existen mayores posibilidades de manejarla mediante cambios profundos en la estructura del sistema y así mejorar el control biológico. Finalmente, se analizan las perspectivas del estudio de la supresividad de suelos.

Herpes gestacional: presentación de un caso y revisión de la literatura / Herpes gestationis. A case presentation and literature review

El herpes gestacional (HG) es una enfermedad autoinmune de la piel de tipo ampuloso que se relaciona exclusivamente con la gestación, es de etilogía desconocida y se presenta un caso de 300 a 50000 embarazos. El diagnóstico se establece clínicamente pero debe confirmarse por medio de inmunohistopatología. El tratamiento consiste en medidas locales y corticoesteroides sistémicos. Aunque el pronóstico materno es excelente existen controversias en cuando al resultado perinatal. Se presenta un caso de HG y se hace revisión de la literatura

Autotransfusión en pacientes oncológicos quirúrgicos / Autotranfusion in oncologic surgical patients

Se analiza la aplicación de autotransfusión a 45 pacientes intervenidos quirúrgicamente por patología neoplásica. Se realizan consideraciones sobre las modalidades de autotransfusión, los resultados obtenidos y las ventajas del método que mejora la relación costo beneficio y constituye un factor importante de seguridad en el quirófano, lo que hace recomendable su utilización. El promedio de sangre extraída fue de 1500cc; no hubo complicaciones inherentes al método. Si la cantidad extraída fue mayor a 500cc se indicó seroterapia