Search for histopathological characteristics of inflammatory juvenile conjunctival nevus in conjunctival nevi related to age: Analysis of 33 cases.

PURPOSE: Conjunctival nevi in young individuals can correspond to the entity named Inflammatory Juvenile Conjunctival Nevus (IJCN), presenting clinically as a rapid growth lesion, and showing at the histopathological study an inflammatory infiltrate surrounding the lesion. All these findings can suggest a diagnosis of malignancy. Due to a case of IJCN diagnosed in our Pathology department, we realized that this entity is rarely reported in the literature and histopathological diagnostic criteria are not well defined. The aim of our study is to compare the histopathological characteristics of conjunctival nevi in patients aged thirty years or less to those in patients above 30 years, looking for the findings described in IJCN. METHODS: All the excisional specimens of resected conjunctival nevus in a tertiary hospital from 2000 to 2018 were retrieved from the Pathology department archives. Demographic data were recorded, and histopathological variables (histological type of nevus, lymphocytic infiltration, eosinophilic infiltration, presence of lymphoid follicles, stromal nevomelanocytic component, intraepithelial nevomelanocytic component, epithelial inclusions, quantity of goblet cells in epithelial inclusions, cellular atypia, mitoses and maturation of the lesion) were evaluated by three independent observers. Statistical analysis was performed comparing the two age groups. RESULTS: The study determined a significant predominance of the lymphocytic and eosinophilic infiltration in the group of patients aged thirty years or less respect to the elderly group. The percentage of stromal component of the lesion is larger in patients over thirty years compared to the younger group. There was no correlation between epithelial inclusions, maturation or cytological atypia and age groups. CONCLUSION: We found some histopathological differences in conjunctival nevi related to young age, some of them coincident with the ones described in IJCN, which histopathologically could lead to a misleading diagnosis. However, we did not find significant differences related to age in many of the described histopathological findings described in IJCN. Larger series with a greater number of cases would be of interest to characterize more precisely this lesion.

Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED (Non-Invasive Hepatitis-C-Related Cirrhosis Early Detection) index.

INTRODUCTION: liver disease resulting from chronic hepatitis C virus (HCV) infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation of fibrosis grade is liver biopsy. Our group validated a predictive index - NIHCED - based on demographic, laboratory parameters, and echographic data to determine the presence of cirrhosis. OBJECTIVE: our objective is to evaluate whether the NIHCED score predicts the presence of advanced fibrosis in patients with chronic HCV infection. MATERIAL AND METHODS: this prospective study included patients with chronic HCV infection who underwent liver biopsy and were administered the NIHCED score. Fibrosis grade correlated with the NIHCED score using the ROC curve analysis and Spearman s correlation coefficient. RESULTS: in total 321 patients were included (male/female ratio 1.27) with a mean age of 48 +/- 14 years. Liver biopsy showed that 131 (30.5%) had no fibrosis or had portal expansion while 190 (69.5%) had advanced fibrosis or cirrhosis. At a cut-off point of 6, sensitivity was 72%, specificity was 76.3%, positive predictive value (PPV) was 81%, negative predictive value (NPV) was 63.7%, and diagnostic accuracy was 72.5%, with an area under the curve (AUC) of 0.787, and a Spearman s correlation coefficient of r = 0.65. CONCLUSIONS: the NIHCED score predicts the presence of advanced fibrosis in an elevated percentage of patients with a need of liver biopsy.

Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación prospectiva del Sabadell’s NIHCED score (Sabadell’s Non Invasive, Hepatitis C Related-Cirrhosis Early Detection Score) / Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED: non-invasive hepatitis C related cirrhosis early detection) index

Introducción: la hepatitis crónica por VHC cursa de forma asintomática desarrollando cirrosis hepática y sus complicaciones en un 20-40% de los casos. En estudios previos se ha demostrado que la fibrosis avanzada es un factor pronóstico fundamental. El método gold standard para la valoración del grado de fibrosis es la biopsia hepática. Nuestro grupo ha validado un índice predictivo, el NIHCED (Sabadell's Non Invasive, Hepatitis C related-Cirrosis Early Detection Score), basado en datos demográficos, analíticos y ecográficos para determinar la presencia de cirrosis. Objetivo: nuestro objetivo es el de evaluar si el NIHCED predice la presencia de fibrosis avanzada en los pacientes con hepatitis crónica por virus C. Material y métodos: estudio prospectivo donde se incluyeron pacientes con hepatitis crónica por VHC. Se les realizó una biopsia hepática y el NIHCED. El grado de fibrosis se correlacionó con el valor del NIHCED mediante curva de ROC y el coeficiente de correlación de Spearman. Resultados: se incluyeron un total de 321 pacientes (ratio hombre/mujer 1,27) con una edad media de 48 ± 14 años. La biopsia hepática mostró que 131 (30,5%) no tenían fibrosis o era expansión portal, mientras que 190 (69,5%) tenían fibrosis avanzada o cirrosis. Para un punto de corte de 6 puntos, la sensibilidad fue del 72%, especificidad del 76,3%, VPP del 81%, VPN del 63,7% y una precisión diagnóstica del 72,5%, con un área bajo la curva fue de 0,787 y un coeficiente de correlación de Spearman de r = 0,65. Conclusiones: el NIHCED predice la presencia de fibrosis avanzada en un elevado porcentaje de pacientes sin necesidad de realizar biopsia hepática(AU)

Introduction: liver disease resulting from chronic hepatitis C virus (HCV) infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation of fibrosis grade is liver biopsy. Our group validated a predictive index - NIHCED - based on demographic, laboratory parameters, and echoghraphic data to determine the presence of cirrhosis. Objective: our objective is to evaluate whether the NIHCED score predicts the presence of advanced fibrosis in patients with chronic HCV infection. Material and methods: this prospective study included patients with chronic HCV infection who underwent liver biopsy and were administered the NIHCED score. Fibrosis grade correlated with the NIHCED score using the ROC curve analysis and Spearman's correlation coefficient. Results: in total 321 patients were included (male/female ratio 1.27) with a mean age of 48 ± 14 years. Liver biopsy showed that 131 (30.5%) had no fibrosis or had portal expansion while 190 (69.5%) had advanced fibrosis or cirrhosis. At a cut-off point of 6, sensitivity was 72%, specificity was 76.3%, positive predictive value (PPV) was 81%, negative predictive value (NPV) was 63.7%, and diagnostic accuracy was 72.5%, with an area under the curve (AUC) of 0.787, and a Spearman's correlation coefficient of r = 0.65. Conclusions: the NIHCED score predicts the presence of advanced fibrosis in an elevated percentage of patients with a need of liver biopsy(AU)

Evaluation of Helicobacter pylori diagnostic methods in patients with liver cirrhosis.

BACKGROUND: Helicobacter pylori-associated peptic ulcer is a frequent complication in cirrhotic patients and its morbidity rate is high. In spite of this, diagnostic methods for H. pylori infection have not been fully evaluated in these patients. AIM: To evaluate H. pylori diagnostic methods in patients with liver cirrhosis. METHODS: One hundred and one cirrhotic patients were included in the study. Three antral and two corpus biopsies were obtained for rapid urease test of the antral mucosa, and Giemsa stain and immunohistochemistry were performed for both the corpus and antrum. Serology, 13C-urea breath test and faecal H. pylori antigen determination were also carried out. RESULTS: Sixty-two patients were positive and 35 were negative for H. pylori infection; four were indeterminate. The sensitivity and specificity were 90.4% and 100%, respectively, for antral histology, 100% and 100% for gastric body histology, 90.4% and 100% for antral immunohistochemistry, 96.2% and 96.7% for body immunochemistry, 85.7% and 97% for rapid urease test, 83.6% and 55.9% for serology, 96.4% and 97.1% for 13C-urea breath test and 75.4% and 94.1% for faecal antigen. CONCLUSION: The most reliable tests for H. pylori infection in cirrhotic patients were the 13C-urea breath test and gastric body histology.

Study of flavonoids/beta-cyclodextrins inclusion complexes by NMR, FT-IR, DSC, X-ray investigation.

Flavonoids are natural substances with a lot of biological activities, including the antioxidant one. Their use in pharmaceutical field is, however, limited by their aqueous insolubility. As the formation of the inclusion complexes can improve their solubility in water, the flavonoids hesperetin, hesperidin, naringenin and naringin have been complexed with beta-cyclodextrin (beta-CD) by the coprecipitation method and studied in solution and in solid state by NMR, FT-IR, differential scanning calorimetry and X-ray techniques. The effects of complexation on the chemical shifts of the internal and external protons of beta-CD in the presence of each flavonoid were observed.

Serum IgD levels in children with atopic asthma. A longitudinal study.

BACKGROUND: Serum IgD and IgE levels were measured in children with atopic asthma and in control Group in order to determine their relationship with clinical status. METHODS: Samples of venous blood (of 5 cc) were drawn from 25 asthmatic children (Group A) and 25 healthy children (Group B) at the moment of first diagnosis (T0), after 6 months (T180) and after 18 months (T540). To measure IgD, an ELISA assay based on the sandwich principle was used. RESULTS: At T0, IgD were significantly higher in Group A (182.7 5+/-88.18 IU/ml) in comparison with Group B (69.58+/-4.93 IU/ml, p<0.0001); IgD levels decreased in Group A at T540. CONCLUSIONS: In conclusion, a significant increase of IgD levels observed in children at first signs of asthma and the following normalization of these same levels after 18 months, may represent a non specific response or an attempt of the organism to block asthma, favouring therefore immunologic tolerance.

Study of beta-blockers/beta-cyclodextrins inclusion complex by NMR, DSC, X-ray and SEM investigation.

The formation of inclusion complexes between beta-cyclodextrin with the two beta-blockers, atenolol and celiprolol, have been studied in the aqueous environment and in the solid state by nuclear magnetic resonance (NMR) spectroscopy, X-ray, differential scanning calorimetry (DSC) and scanning electron microscopy (SEM) techniques. The magnitude of the chemical shifts of the interior and exterior beta-cyclodextrin protons in the presence of each beta-blocker indicated that these are included within the beta-cyclodextrin cavity. In aqueous solution they form 1:1 complexes. In the solid state the formation of the beta-cyclodextrin/atenolol (celiprolol) complexes is confirmed by X-ray, DSC and SEM, also employed to characterize pure substances and their physical mixtures.

Stability study of piroxicam and cinnoxicam in solid pharmaceuticals.

The pseudo-first order rate constant for the hydrolysis of cinnoxicam as a function of temperature was obtained by variable-temperature kinetic experiments. The method used is on a generalization of non-isothermal analysis, and takes advantage of the capabilities of modern data collection and processing systems. A spectrophotometric method under non isothermal conditions was carried out. The results obtained are identical to those obtained under the same conditions by using traditional constant-temperature kinetic runs. This provides the possibility of reducing the amount of time spent and chemicals usually used in collecting kinetic data in mechanistic studies in solution by an order of magnitude.

Isolation and characterization of Guiera senegalensis J.F.Gmel. active principles.

A combination of thin-layer chromatography, high-performance liquid chromatography, UV spectroscopy and NMR spectrometry techniques for analysis of flavonoid content of Guiera senegalensis J.F.Gmel. (Combretaceae) leaves is described. Four components, catechin, myricitrin, rutin and quercetin were evidenced and determined by HPLC.

[Giant laryngeal polyps. Report of three cases and review of the literature]. / Pólipos gigantes de laringe. Presentación de tres casos y revisión de la literatura.

Laryngeal polyps are common, but they rarely cause death in head and neck sites. We report three cases of giant laryngeal polyps which produced respiratory distress, cardiorespiratory failure, and sudden death, respectively.

[Tumorous lymphedema of the penis. Report of verrucous elephantiasis. A brief case. Preliminary note]. / Linfedema tumoral del pene. A propósito de una elefantiasis verrucosa. Caso sucinto. Nota preliminar.

Exclusively penial lymphatic affections can be considered a highly infrequent occurrence. In the absence of an scrotal oedema, an "elephantiac" involvement with tumoral appearance in the penis, is indeed exceptional. A clinical case is briefly commented here. It refers to a patient with a significant sociopathy who presented a lymphedema confined to the penis in its maximum expression (elephantiasis verrucosa nostras).

Necrotizing sialometaplasia (adenometaplasia) of the trachea.

Necrotizing sialometaplasia is a benign condition first described in minor salivary glands of the soft palate with morphological changes which can be misinterpreted as squamous-cell carcinoma. Similar lesions have been subsequently reported in other locations including major salivary glands, lip, breast and skin (the term syringometaplasia has been applied for the latter). We report three cases of such a process involving submucosal glands in the trachea following prolonged translaryngeal intubation.

[Pericardial tamponade as a complication of T-cell cutaneous lymphoma]. / Taponamiento pericárdico como complicación de un linfoma cutáneo de células T.

Mycosis fungoides is a T cell lymphoma characterized by the initial skin involvement. Organ infiltration generally occurs many years after the cutaneous presentation. The organ disease is accompanied of peripheral blood involvement (more than 20% lymphocytes have atypical convolute nucleus and there are palpable adenopathies. Pericardic involvement is a rare complication as the initial manifestation of the visceral disease, in patients with mycosis fungoides of long evolution. We present a patient suffering mycosis fungoide who presented a pericardic tamponade. The visceral disease in our patient was not accompanied by blood anomalies or palpable adenopathies.

[Myxoglobulosis of the cecal appendix]. / Mixoglobulosis del apéndice cecal.

We report a case of mucinous cystadenoma of the appendix with myxoglobulosis associated to cecal adenocarcinoma. Appendiceal myxoglobulosis present typical gross and microscopical findings. The clinical diagnosis of myxoglobulosis should be followed by a careful evaluation of the patient in order to detect an appendicular neoplasm and/or an assoiciated occult intestinal carcinoma.