Compromiso pseudotumoral colónico como expresión de déficit grave de plasminogéno / Colonic pseudotumoral involvement as an expression of severe plasminogen deficiency

Resumen La deficiencia de plasminógeno es una entidad multisistémica, muy infrecuente, que afecta diferentes tejidos de la economía mediante el depósito de pseu do membranas ricas en fibrina y que determina una presentación clínica heterogénea y diversa. Se trans mite en forma autosómica recesiva por mutaciones del gen PLG del cromosoma 6 y se puede dividir en hipoplasminogenemia o tipo I y displasminogenemia o tipo II, esta última no relacionada con patología clínica. El déficit grave de plasminógeno tiene una prevalencia de 1.6 individuos por millón de habitan tes y si bien puede diagnosticarse en edad adulta, los síntomas más graves se observan en lactantes y ni ños. La forma de inicio más común es la denominada conjuntivitis leñosa, caracterizada por membranas de fibrina que se depositan en los parpados desde la infancia, provocando lesiones exofíticas que afectan la visión. También puede afectar otras mucosas como la gingival, respiratoria, orofaríngea, digestiva y genital entre otros. Presentamos un raro caso de deficiencia grave de plasminógeno con conjuntivitis y cervicitis leñosa que ingresó con un cuadro de abdomen agudo clínico, asociado a una masa tumoral por depósito de pseudomembranas en el colon ascendente que simu ló una enfermedad inflamatoria intestinal y que se resolvió espontáneamente.

Abstract Plasminogen deficiency is a very rare multisystem entity that affects different tissues of the economy through the de position of fibrin-rich pseudomembrane and determines a heterogeneous and diverse clinical presentation. It is trans mitted in an autosomal recessive manner by mutations of the PLG gene on chromosome 6 and can be divided into hypoplasminogenemia or type I and dysplasminogenemia or type II, the latter not related to clinical pathology. Severe plasminogen deficiency has a prevalence of 1.6 individuals per million inhabitants and although it can be diagnosed in adulthood, the most severe symptoms are observed in infants and children. The most common form of onset is the so-called woody conjunctivitis, characterized by fibrin membranes that are deposited on the eyelids since child hood, causing exophytic lesions that affect vision. It can also affect other mucous membranes such as the gingival, respiratory, oropharyngeal, digestive and genital mucosa, among others. We present a rare case of severe plasminogen deficiency with conjunctivitis and woody cervicitis who was admitted with clinical acute abdominal symptoms, associated with a tumor mass due to pseudomembranous deposition in the ascending colon that simulated inflam matory bowel disease and resolved spontaneously.

[Colonic pseudotumoral involvement as an expression of severe plasminogen deficiency]. / Compromiso pseudotumoral colónico como expresión de déficit grave de plasminogéno.

Plasminogen deficiency is a very rare multisystem entity that affects different tissues of the economy through the deposition of fibrin-rich pseudomembrane and determines a heterogeneous and diverse clinical presentation. It is transmitted in an autosomal recessive manner by mutations of the PLG gene on chromosome 6 and can be divided into hypoplasminogenemia or type I and dysplasminogenemia or type II, the latter not related to clinical pathology. Severe plasminogen deficiency has a prevalence of 1.6 individuals per million inhabitants and although it can be diagnosed in adulthood, the most severe symptoms are observed in infants and children. The most common form of onset is the so-called woody conjunctivitis, characterized by fibrin membranes that are deposited on the eyelids since childhood, causing exophytic lesions that affect vision. It can also affect other mucous membranes such as the gingival, respiratory, oropharyngeal, digestive and genital mucosa, among others. We present a rare case of severe plasminogen deficiency with conjunctivitis and woody cervicitis who was admitted with clinical acute abdominal symptoms, associated with a tumor mass due to pseudomembranous deposition in the ascending colon that simulated inflammatory bowel disease and resolved spontaneously.

La deficiencia de plasminógeno es una entidad multisistémica, muy infrecuente, que afecta diferentes tejidos de la economía mediante el depósito de pseudo membranas ricas en fibrina y que determina una presentación clínica heterogénea y diversa. Se transmite en forma autosómica recesiva por mutaciones del gen PLG del cromosoma 6 y se puede dividir en hipoplasminogenemia o tipo I y displasminogenemia o tipo II, esta última no relacionada con patología clínica. El déficit grave de plasminógeno tiene una prevalencia de 1.6 individuos por millón de habitantes y si bien puede diagnosticarse en edad adulta, los síntomas más graves se observan en lactantes y niños. La forma de inicio más común es la denominada conjuntivitis leñosa, caracterizada por membranas de fibrina que se depositan en los parpados desde la infancia, provocando lesiones exofíticas que afectan la visión. También puede afectar otras mucosas como la gingival, respiratoria, orofaríngea, digestiva y genital entre otros. Presentamos un raro caso de deficiencia grave de plasminógeno con conjuntivitis y cervicitis leñosa que ingresó con un cuadro de abdomen agudo clínico, asociado a una masa tumoral por depósito de pseudomembranas en el colon ascendente que simuló una enfermedad inflamatoria intestinal y que se resolvió espontáneamente.

ElectroPredictor: An Application to Predict Mayr's Electrophilicity E through Implementation of an Ensemble Model Based on Machine Learning Algorithms.

Electrophilicity (E) is one of the most important parameters to understand the reactivity of an organic molecule. Although the theoretical electrophilicity index (ω) has been associated with E in a small homologous series, the use of w to predict E in a structurally heterogeneous set of compounds is not a trivial task. In this study, a robust ensemble model is created using Mayr's database of reactivity parameters. A combination of topological and quantum mechanical descriptors and different machine learning algorithms are employed for the model's development. The predictability of the model is assessed using different statistical parameters, and its validation is examined, including a training/test partition, an applicability domain, and a y-scrambling test. The global ensemble model presents a Q5-fold2 of 0.909 and a Qext2 of 0.912, demonstrating an excellent predictability performance of E values and showing that w is not a good descriptor for the prediction of E, especially for the case of neutral compounds. ElectroPredictor, a noncommercial Python application (https://github.com/mmoreno1/ElectroPredictor), is developed to predict E. QM9, a well-known large dataset containing 133885 neutral molecules, is used to perform a virtual screening (94.0% coverage). Finally, the 10 most electrophilic molecules are analyzed as possible new Mayr's electrophiles, which have not yet been experimentally tested. This study confirms the necessity to build an ensemble model using nonlinear machine learning algorithms, topographic descriptors, and separating molecules into charged and neutral compounds to predict E with precision.

Green and simple extraction of free seleno-amino acids from powdered and lyophilized milk samples with natural deep eutectic solvents.

Natural deep eutectic solvents (NADES) were introduced for the extraction of free seleno-amino acids from lyophilized and powdered milk samples. Different NADES were evaluated, and lactic acid:glucose (LGH) showed the highest selenium recoveries. Selenium analysis was performed by inductively coupled plasma mass spectrometry (ICP MS). Se-NADES analysis in ICP MS was optimized according to the radio frequency power and nebulization gas flow rate. Se-NADES extraction was optimized by an experimental design. LGH dilution, LGH volume, sample quantity, and ultrasound time were factors influencing the extraction. Seleno-amino acids were determined by liquid chromatography-ICP MS. After optimization, the limits of detection obtained were 7.37, 8.63, and 9.64 µg kg-1 for selenocysteine, selenomethionine, and seleno-methyl-selenocysteine, respectively. The NADES-extraction is a green procedure with 2 penalty points in the EcoScale. The method was applied to the analysis of powdered milk, lyophilized Se-fortified sheep milk, and ERM-BD151 skimmed milk powder.

Complicaciones postoperatorias y supervivencia del cáncer de esófago: análisis de dos periodos distintos / Postoperative complications and survival rate of esophageal cancer: Two-period analysis

INTRODUCCIÓN: Actualmente el tratamiento del cáncer de esófago requiere un enfoque multidisciplinar en el que la esofaguectomía sigue siendo su pilar básico. El objetivo del estudio es analizar si el tratamiento multimodal y la introducción de nuevas técnicas quirúrgicas menos invasivas ha supuesto una disminución de las complicaciones de la esofaguectomía y una mayor supervivencia del cáncer de esófago. MÉTODOS: Estudio retrospectivo de 318 pacientes con cáncer de esófago que incluyen 81 esofaguectomías. Se comparan los periodos 2000-2007 y 2008-2015 y se analizan los factores pronósticos que pueden influir en las complicaciones y supervivencia. RESULTADOS: Las complicaciones postoperatorias mayores según la clasificación de Clavien-Dindo fueron globalmente 35%, mostrando una disminución entre el 1.° y 2.° periodo: 41% de morbilidad vs. 30%, 27% de mortalidad vs. 9% (p < 0,001) y 13,5% de fístulas vs. 7%. La incorporación de la esofaguectomía toracoscópica con 19% de complicaciones y 5% de mortalidad y la anastomosis mecánica triangularizada con 5% de fístulas y 9% de estenosis contribuyeron a estos resultados. La supervivencia global a los 5 años fue del 19%, con una mejoría significativa entre el 1.° y 2.° periodo: 11 vs. 28% (p < 0,001). CONCLUSIONES: La valoración multidisciplinar de los pacientes, con una mejor selección e indicación del tratamiento multimodal, y la introducción de nuevas técnicas quirúrgicas menos invasivas y más depuradas, como la toracoscopia y la anastomosis mecánica triangularizada, se ha traducido en una disminución de la morbimortalidad de las esofaguectomías y en un aumento significativo de la supervivencia de los pacientes con CE

INTRODUCTION: Nowadays, treatment of esophageal cancer requires a multidisciplinary approach, in which esophagectomy remains the mainstay. The aim of this report is to assess whether multimodal treatment and minimally invasive surgery have led to a lower morbidity rate and an improvement in survival rates. METHODS: Retrospective evaluation of 318 patients diagnosed with esophageal cancer including 81 esophagectomies. The periods of 2000-2007 and 2008-2015 were compared, analyzing the prognostic factors that may have an impact in morbidity and survival rate. RESULTS: Major postoperative complications according to the Clavien-Dindo classification accounted for 35%, showing a decrease between the 1.st and 2.nd period: 41% morbidity vs. 30%, 27% mortality vs. 9% (p < .001) and 13.5% fistulas vs. 7%. The implementation of thoracoscopic esophagectomy contributed to the outcome improvement, as shown by 19% morbidity and 5% mortality rates, with triangularized mechanical anastomosis showing 9% fistula and 5% stenosis. The overall 5-year survival rate was 19%, with a significant increase from 11% in the 1.st period to 28% in the 2.nd (p < .001). CONCLUSIONS: Multidisciplinary assessment of patients with esophageal cancer, as well as better selection and indication of treatment and the introduction of new minimally invasive techniques (thoracoscopy and triangularized mechanical anastomosis), have improved the morbidity and mortality rates of esophagectomies, resulting in increased survival rates of these patients

Postoperative complications and survival rate of esophageal cancer: Two-period analysis. / Complicaciones postoperatorias y supervivencia del cáncer de esófago: análisis de dos periodos distintos.

INTRODUCTION: Nowadays, treatment of esophageal cancer requires a multidisciplinary approach, in which esophagectomy remains the mainstay. The aim of this report is to assess whether multimodal treatment and minimally invasive surgery have led to a lower morbidity rate and an improvement in survival rates. METHODS: Retrospective evaluation of 318 patients diagnosed with esophageal cancer including 81 esophagectomies. The periods of 2000-2007 and 2008-2015 were compared, analyzing the prognostic factors that may have an impact in morbidity and survival rate. RESULTS: Major postoperative complications according to the Clavien-Dindo classification accounted for 35%, showing a decrease between the 1.st and 2.nd period: 41% morbidity vs. 30%, 27% mortality vs. 9% (p < .001) and 13.5% fistulas vs. 7%. The implementation of thoracoscopic esophagectomy contributed to the outcome improvement, as shown by 19% morbidity and 5% mortality rates, with triangularized mechanical anastomosis showing 9% fistula and 5% stenosis. The overall 5-year survival rate was 19%, with a significant increase from 11% in the 1.st period to 28% in the 2.nd (p < .001). CONCLUSIONS: Multidisciplinary assessment of patients with esophageal cancer, as well as better selection and indication of treatment and the introduction of new minimally invasive techniques (thoracoscopy and triangularized mechanical anastomosis), have improved the morbidity and mortality rates of esophagectomies, resulting in increased survival rates of these patients.

Traditional use and perception of snakes by the Nahuas from Cuetzalan del Progreso, Puebla, Mexico.

BACKGROUND: Indigenous cultures are the result of their adaptation to the natural surroundings, in such a way that, amongst their main features is a set of knowledge, technologies and strategies for the appropriation of nature. In Cuetzalan del Progreso, Puebla, Mexico snakes represent 71.1% of the total local herpetofauna; and in addition to this, different groups of Nahuas have shown to have information of their use of various snake species in many ways. This study was conducted to investigate the traditional uses of snakes in this cultural group. METHODS: Formal and informal interviews were conducted with the inhabitants of the communities. During these interviews, 30 images of the different species of snakes present in the area were presented to the subjects, so that they would recognize them and reveal information about the knowledge they possess on them. A usage analysis was applied to each species considering the following categories: food purposes, medicinal, artisanal and magical-religious. Likewise, the frequency, the diversity and the value of use was estimated for these snakes. RESULTS: A total of 51 interviews were carried out. The individuals recognized 18 out of 30 images of snakes that were presented. The total of usage categories was five; we found that the magic-religious use was the most mentioned by 32 personas. Boa imperator and Antropoides nummifer were the species with the highest value of use. More than half of the interviewees mentioned killing snakes because they're poisonous and aggressive. In the magic-religious aspect the "Danza de los Negritos" is highlighted; this is a local festival, brought by Africans, and alludes to snakes. CONCLUSIONS: This study revealed that snakes are still very important for the culture in Cuetzalan del Progreso, finding that the magical-religious and the medicinal use stand out. On the other hand, the fear and misperception on the toxicity of snakes might represent a potential threat for their conservation. Therefore, it is necessary to carry out a long-term monitoring of the ethno-zoological activities, and develop a sustainable management plan compatible with the cultural characteristics of the natives of the region.