Liver damage in bleomycin-induced pulmonary fibrosis in mice.

Pulmonary fibrosis is an emerging disease with a poor prognosis and high mortality rate that is even surpassing some types of cancer. This disease has been linked to the concomitant appearance of liver cirrhosis. Bleomycin-induced pulmonary fibrosis is a widely used mouse model that mimics the histopathological and biochemical features of human systemic sclerosis, an autoimmune disease that is associated with inflammation and expressed in several corporal systems as fibrosis or other alterations. To determine the effects on proliferation, redox and inflammation protein expression markers were analyzed by immunohistochemistry. Analyses showed a significant increase in protein oxidation levels by lipoperoxidation bio-products and in proliferation and inflammation processes. These phenomena were associated with the induction of the redox status in mice subjected to 100 U/kg bleomycin. These findings clearly show that the bleomycin model induces histopathological alterations in the liver and partially reproduces the complexity of systemic sclerosis. Our results using the bleomycin-induced pulmonary fibrosis model provide a protocol to investigate the mechanism underlying the molecular alteration found in the liver linked to systemic sclerosis.

Screening for biosurfactant production by 2,4,6-trinitrotoluene-transforming bacteria.

AIMS: To isolate and identify TNT-transforming cultures from explosive-contaminated soils with the ability to produce biosurfactants. METHODS AND RESULTS: Bacteria (pure and mixed cultures) were selected based on their ability to transform TNT in minimum media with TNT as the sole nitrogen source and an additional carbon source. TNT-transforming bacteria were identified by 16S rRNA gene sequencing. TNT transformation rates were significantly lower when no additional carbon or nitrogen sources were added. Surfactant production was enabled by the presence of TNT. Fourteen cultures were able to transform the explosive (>50%); of these, five showed a high transformation capacity (>90%), and six produced surfactants. CONCLUSIONS: All explosive-transforming cultures contained Proteobacteria of the genera Achromobacter, Stenotrophomonas, Pseudomonas, Sphingobium, Raoultella, Rhizobium and Methylopila. These cultures transformed TNT when an additional carbon source was added. Remarkably, Achromobacter spanius S17 and Pseudomonas veronii S94 have high TNT transformation rates and are surfactant producers. SIGNIFICANCE AND IMPACT OF THE STUDY: TNT is a highly toxic, mutagenic and carcinogenic nitroaromatic explosive; therefore, bioremediation to eliminate or mitigate its presence in the environment is essential. TNT-transforming cultures that produce surfactants are a promising method for remediation. To the best of our knowledge, this is the first report that links surfactant production and TNT transformation by bacteria.

Dolor irruptivo oncológico inducido por radioterapia: ¿es posible optimizar su tratamiento? / Radiotherapy-induced breakthrough cancer pain: is it possible to optimize its treatment?

Introducción: en el contexto de la radioterapia, el control del dolor irruptivo oncológico (DIO) supone un reto especial. El DIO ha sido definido por la Sociedad Española del Dolor (SED), la Sociedad Española de Oncología Médica (SEOM) y la Sociedad Española de Cuidados Paliativos (SECPAL) como una exacerbación del dolor súbita y transitoria, de gran intensidad (EVA > 7) y de corta duración (inferior a 20-30 minutos), que aparece sobre la base de un dolor persistente estable cuando este se encuentra reducido a un nivel tolerable (EVA < 5) mediante el uso de opioides mayores. Objetivos: el objetivo principal de este estudio fue evaluar la intensidad del DIO inducido por tratamientos oncológicos que incluyeran radioterapia (RT), tanto exclusiva como asociada a quimioterapia (RT/QT). Secundariamente, se evaluó la eficacia del tratamiento con fentanilo sublingual pautado para el control del DIO. Material y métodos: estudio observacional retrospectivo realizado en 110 pacientes reclutados en 19 Servicios de Radioterapia españoles. Los pacientes debían presentar DIO inducido por RT o RT/QT, con o sin medicación pautada y cuya intensidad fuera de una EVA > 6 en las últimas 24-48 h. Se establecieron controles en el momento basal, y a los 3, 7, 15 y 30 días. Resultados: se apreció un descenso en la media de los valores en la escala EVA según avanzó el estudio (EVA = 6 en el control 0 a EVA = 3 en el control 3), y las diferencias fueron significativas (p < 0,0001). La satisfacción con el tratamiento fue calificada como buena o excelente por el 85,3% de los pacientes y por el 92,7% de los investigadores. Conclusiones: los resultados de este estudio demuestran la eficacia del tratamiento del DIO con fentanilo sublingual en el contexto del tratamiento oncológico radioterápico, con un descenso significativo en los valores EVA frente al valor basal. La elevada satisfacción de los médicos y pacientes con este tratamiento refleja la eficacia y la comodidad del fentanilo sublingual en el control del DIO (AU)

Introduction: In the context of radiotherapy, control of breakthrough cancer pain (BTPc) is particularly challenging. BTPc has been defined by the Spanish Society of Pain (SED), the Spanish Society of Medical Oncology (SEOM) and the Spanish Society for Palliative Care (SECPAL) as a sudden and transient exacerbation of pain of great intensity (VAS > 7) and short (less than 20-30 minutes), which appears on the basis of a stable persistent pain when it is reduced to a tolerable level (VAS < 5) by using major opioids. Objectives: The main objective of this study was to assess the intensity of BTPc induced by cancer treatments that included radiotherapy (RT), both exclusive and associated with chemotherapy (RT/CT). Secondly, the efficacy of treatment was evaluated with fentanyl sublingual scheduled for BTPc control. Material and methods: Retrospective, observational study in 110 patients recruited in 19 Spanish Radiotherapy Services. Patients must have BTPc induced by RT or RT/CT, with or without medication prescribed and with an intensity outside a VAS > 6 in the last 24-48 h. Controls were established at baseline and at 3, 7, 15 and 30 days. Results: There was a decrease in mean values on the VAS scale as the study progressed (VAS = 6 in the control 0 to VAS = 3 in the control 3) and the differences were significant (p < 0.0001). Treatment satisfaction was rated as good or excellent by 85.3% of patients and 92.7% of researches. Conclusions: The results of this study demonstrate the efficacy of BTPc treatment with sublingual fentanyl in the context of the radiotherapy cancer treatment, with a significant decrease in VAS from baseline values . The high satisfaction among physicians and patients with this treatment reflects the efficacy and convenience of sublingual fentanyl in controlling BTPc (AU)

Nivel de conocimientos sobre salud bucal de padres que asisten a una institución pública / Level of knowledge on oral health of parents that attend a public institution

INTRODUCCIÓN La salud bucal de la población de Córdoba se caracteriza por una alta incidencia y prevalencia de enfermedades orales. Por otro lado, la falta de conocimiento específico por parte de la sociedad constituye una barrera en el acceso a la salud como derecho universal. OBJETIVOS Indagar acerca del nivel de conocimiento sobre salud bucal en padres de niños que asisten al Servicio de Odontopediatría del Instituto Provincial de Odontología y determinar cuál es su relación con el estado de salud bucal de los niños. MÉTODOS Se realizó un estudio observacional descriptivo de corte transversal. RESULTADOS La variable conocimientos sobre salud bucal y medidas preventivas arrojó un 34% (n=102) con escasos conocimientos (0 a 3 respuestas correctas sobre un total de 10), un 62% (n=186) con nivel regular (4 a 7 respuestas correctas) y apenas un 4% (n=12) que respondió bien (8 a 10 respuestas correctas). Por otro lado, el índice de necesidad de tratamiento de caries (INTC) de los niños examinados reflejó que un 11% poseía necesidad de tratamiento preventivo (0 a 2), mientras que hubo un 31% con INTC de 3 a 6 (inactivación de caries), un 16% con necesidad de tratamiento pulpar o extracción y un 42% con INTC de 11 a 14, que indica pérdida de piezas dentarias con rehabilitación protésica y control de espacio. DISCUSIÓN A pesar de que el 62% de los padres encuestados posee un nivel de conocimiento regular sobre salud bucal, esto no se ve reflejado en el estado de los niños. Se presume que los conocimientos no son aplicados en forma adecuada, por lo cual es necesario reforzar los programas de prevención y promoción con el objeto de lograr hábitos saludables destinados al cuidado de la salud bucal desde una temprana edad.

[Haemorrhage in arteriovenous malformations of the brain following radiosurgery: the importance of the latency period]. / Hemorragia de las malformaciones arteriovenosas cerebrales tras la radiocirugía: importancia del período de latencia.

INTRODUCTION: Arteriovenous malformations are abnormal communications between arteries and veins. Treatment can consist in surgery, embolisation and/or radiosurgery. AIM: To assess the influence of radiosurgery on the risk of bleeding and related factors. PATIENTS AND METHODS: Retrospective study of 79 patients who were treated with a 6 MV linear accelerator. Clinical, morphological and dosimetric parameters were collected and a statistical analysis was performed to investigate their relationship with bleeding during the latency period. RESULTS: The mean age was 33.7 years, and 56% of patients were females. The mean volume was 6.16 cm(3). Bleeding occurred before treatment in 52.6% of cases. Altogether 25% had been embolised and 7.6% had been treated earlier using radiosurgery. Six patients suffered a haemorrhage after treatment. Bleeding occurred in 21% of those who had undergone embolisation versus 3.6% in non-embolised individuals (p < 0.02). Bleeding occurred in 33.3% of those who had been treated radiosurgically on more than one occasion, and only 5.7% if they were treated just once (p = 0.02). Bleeding took place in 28.6% of lesions above 10 cm(3) and in 3.2% when they were smaller (p < 0.01). Bleeding occurred in 16.1% of patients if they received less than 17 Gy, and in 2.22% if they received 17 or more (p < 0.01). All haemorrhages took place in treatments with more than one isocentre (p < 0.01) and with a higher homogeneity index (p < 0.01). CONCLUSIONS: Radiosurgery does not modify the risk of bleeding. The factors associated to higher percentages of bleeding are also related to poorer closure outcomes and longer latency periods.

Hemorragia de las malformaciones arteriovenosas cerebrales tras la radiocirugía: importancia del período de latencia / Haemorrhage in arteriovenous malformations of the brain following radiosurgery: The importance of the latency period

Introducción. Las malformaciones arteriovenosas son comunicaciones anómalas entre arterias y venas. El tratamiento puede realizarse mediante cirugía, embolización y/o radiocirugía. Objetivo. Evaluar la influencia de la radiocirugíasobre el riesgo de sangrado y los factores relacionados con éste. Pacientes y métodos. Estudio retrospectivo de 79 pacientes tratados con acelerador lineal de 6 MV. Se recogieron parámetros clínicos, morfológicos y dosimétricos, analizando estadísticamentesu relación con el sangrado durante el período de latencia. Resultados. La edad media fue de 33,7 años, y el 56%fueron mujeres. El volumen medio fue de 6,16 cm3. El 52,6% sangró antes del tratamiento. El 25% había sido embolizado y el 7,6% había recibido radiocirugía previamente. Seis pacientes sufrieron hemorragia tras el tratamiento. Sangró el 21% de los embolizados, frente al 3,6% de los no embolizados (p = 0,02). Entre los tratados con más de una radiocirugía sangró el33,3%, y sólo el 5,7% si se trataron una sola vez (p = 0,02). Sangró el 28,6% de las lesiones mayores de 10 cm3 y el 3,2% de las menores (p < 0,01). Sangró el 16,1% si recibieron menos de 17 Gy, y el 2,22% si recibieron 17 o más (p < 0,01). Todas las hemorragias se produjeron en tratamientos con más de un isocentro (p < 0,01) y con índice de homogeneidad más alto (p < 0,01). Conclusiones. La radiocirugía no modifica el riesgo de sangrado. Los factores asociados con mayores porcentajes de hemorragia se relacionan también con peores resultados de cierre y períodos de latencia más prolongados

Introduction. Arteriovenous malformations are abnormal communications between arteries and veins. Treatmentcan consist in surgery, embolisation and/or radiosurgery. Aim. To assess the influence of radiosurgery on the risk of bleeding and related factors. Patients and methods. Retrospective study of 79 patients who were treated with a 6 MV linear accelerator. Clinical, morphological and dosimetric parameters were collected and a statistical analysis was performed to investigate their relationship with bleeding during the latency period. Results. The mean age was 33.7 years, and 56% of patients were females. The mean volume was 6.16 cm3. Bleeding occurred before treatment in 52.6% of cases. Altogether 25% had been embolised and 7.6% had been treated earlier using radiosurgery. Six patients suffered a haemorrhage after treatment. Bleeding occurred in 21% of those who had undergone embolisation versus 3.6% in non-embolised individuals (p < 0.02).Bleeding occurred in 33.3% of those who had been treated radiosurgically on more than one occasion, and only 5.7% if they were treated just once (p = 0.02). Bleeding took place in 28.6% of lesions above 10 cm3 and in 3.2% when they were smaller (p < 0.01). Bleeding occurred in 16.1% of patients if they received less than 17 Gy, and in 2.22% if they received 17 or more (p < 0.01). All haemorrhages took place in treatments with more than one isocentre (p < 0.01) and with a higher homogeneityindex (p < 0.01). Conclusions. Radiosurgery does not modify the risk of bleeding. The factors associated to higher percentagesof bleeding are also related to poorer closure outcomes and longer latency periods

Carcinoma epidermoide de mama (descripción de un caso y revisión de la literatura) / Breast epidermoid carcinoma: report of a case and review of the literature

El carcinoma epidermoide primario de mama esuna entidad muy poco frecuente. Típicamente sepresenta como un tumor cístico en la mama de grantamaño y evolución rápida. (También se caracterizapor diseminación a distancia y escasa afectaciónmetastásica en ganglios). En la mayoría de los casos,los receptores hormonales son negativos y loshallazgos radiológicos son inespecíficos. Los tratamientosdescritos en la literatura consisten en lacombinación de cirugía, quimioterapia y radioterapia

Breast primary squamous carcinoma is an infrequententity. It appears typically as a voluminousbreast cystic tumour of rapid evolution. It is characteristicthe development of a systemic disseminationgenerally in the absence of regional lymph nodemetastases. In most cases hormone receptors arelacking, and radiological findings are not specific.The treatments described in the medical literatureconsist of a combination of surgery, chemotherapyand radiotherapy

Recidiva del cáncer de próstata después de la prostatectomía radical y radioterapia de rescate / Prostate cancer recurrence after radical prostatectomy and salvage radiotherapy

OBJETIVO: Evaluar la eficacia de la radioterapia en el lecho prostático en pacientes con cáncer de próstata y fracaso bioquímico después de la prostatectomía radical. MATERIAL Y MÉTODOS: Analizamos los resultados de 292 pacientes a los que se le practicó prostatectomía radical por cáncer de próstata localizado T1-T2, entre enero de 1992 y junio de 2003, con un seguimiento medio de 36 meses (rango 6 meses a 12 años). Se detecta fracaso bioquímico (PSA > 0,20 ng/ml) en 75 (26%) pacientes. De los 75 pacientes con fracaso bioquímico, 9 (12%) se diagnosticó de recidiva local siguiendo los siguientes criterios: a) Primer PSA obtenido a las 6 semanas de la intervención 6 meses. c) Tiempo de duplicación del PSA > 6 meses. d) Velocidad de PSA después de la prostatectomía radical <0,75/ng/ml/año. e) Nivel de PSA después de la prostatectomía radical <2,5 ng/ml. Los 9 pacientes diagnosticados de recidiva local reciben una dosis media de 56,42 Gy en el lecho prostático. RESULTADOS: De los 9 pacientes diagnosticados de recidiva local, en 7 (77,7%) se obtuvo una respuesta completa durante un tiempo medio de seguimiento de 25 meses (6-30 meses). El tiempo entre la radioterapia y la respuesta, en los pacientes con respuesta completa, siempre fue inferior a los 3 meses. No se observaron efectos adversos importantes secundarios a la radioterapia. CONCLUSIONES: La radioterapia de rescate puede ser beneficiosa en un seleccionado grupo de pacientes con recidiva local. La cinética del PSA después de la prostatectomía radical es útil para distinguir las recidivas locales de las metástasis a distancia

OBJETIVE: To evaluate the efficacy of the radiotherapy to prostatic bed in patients with biochemical recurrence for prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the results of 292 patients underwent radical prostatectomy for localized prostate cancer T1-T2 between January 1992 and June 2003, with an average folow-up of 36 months (range 6 months to 12 years). We detect biochemical recurrence (PSA >0.20 ng/ml) in 75 (26%) patients. Of 75 patients with biochemical recurrence, 9 (12 %) was diagnosed of local recurrence by the following criteria: a) The first PSA obtained 6 weeks after radical prostatectomy 6 months. c) The prostate specific antigen doubling time >6 months. d) The prostate specific antigen velocity after radical prostatectomy <0.75 ng/ml/year. e) The prostate specific antigen level after radical prostatectomy <2.5 ng/ml. The 9 patients diagnosed of local recurrence received an average dose of 56.42 Gy in the prostate bed. RESULTS: Of all 9 patients with local recurrence, 7 (77.7%) has complete response with an average time of followup of 25 months (6-30 months). The time between the radiotherapy and the response, in patients with complete response, was lower than 3 months. Were not observed significant adverse effects associated to radiotherapy. CONCLUSIONS: The salvage radiotherapy may be beneficial in select patients with local recurrence. The characteristics of prostate specific antigen elevation are useful in distinguishing men with local recurrence from those with distant metastases

[Prostate cancer recurrence after radical prostatectomy and salvage radiotherapy]. / Recidiva del cáncer de próstata después de la prostatectomía radical y radioterapia de rescate.

OBJECTIVE: To evaluate the efficacy of the radiotherapy to prostatic bed in patients with biochemical recurrence for prostate cancer after radical prostatectomy. MATERIAL AND METHODS: We analyse the results of 292 patients underwent radical prostatectomy for localized prostate cancer T1-T2 between January 1992 and June 2003, with an average folow-up of 36 months (range 6 months to 12 years). We detect biochemical recurrence (PSA >0.20 ng/ml) in 75 (26%) patients. Of 75 patients with biochemical recurrence, 9 (12%) was diagnosed of local recurrence by the following criteria: a) The first PSA obtained 6 weeks after radical prostatectomy <0.20 ng/ml. b) The time to biochemical recurrence >6 months. c) The prostate specific antigen doubling time >6 months. d) The prostate specific antigen velocity after radical prostatectomy <0.75 ng/ml/year. e) The prostate specific antigen level after radical prostatectomy <2.5 ng/ml. The 9 patients diagnosed of local recurrence received an average dose of 56.42 Gy in the prostate bed. RESULTS: Of all 9 patients with local recurrence, 7 (77.7%) has complete response with an average time of follow-up of 25 months (6-30 months). The time between the radiotherapy and the response, in patients with complete response, was lower than 3 months. Were not observed significant adverse effects associated to radiotherapy. CONCLUSIONS: The salvage radiotherapy may be beneficial in select patients with local recurrence. The characteristics of prostate specific antigen elevation are useful in distinguishing men with local recurrence from those with distant metastases.

Pioderma gangrenoso / gangrenous Pioderma

El Pioderma Gangrenoso es una enfermedad inflamatoria, destructiva de la piel, en la que un nódulo o pústula dolorosa evoluciona a una ulceración que crece progresivamente con un borde socavado, violáceo, doloroso; y frecuentemente está asociado a una enfermedad sistémica en especial del tracto digestivo (Enf. de Crohn, Colitis ulcerosa), hematopatías y neoplasias del sistema reticuloendotelial. Presenta cuatro variantes clínicas, las cuales, tienen diferencias semiológicas, histopatológicas, y lo más important, diversas asociaciones sistémicas, por lo que es de capital importancia su reconimiento: Estas variantes son: Pioderma gangrenoso ulcerativo, pustuloso, ampolloso y vegetante.