Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015.

In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.

Ferropenia sin anemia, más que un hallazgo de laboratorio / Ferropenia without anemia, more than a laboratory finding

El déficit de hierro sin anemia se encuentra presente en diversas patologías de la práctica clínica; sin embargo, se conoce poco sobre la importancia, las complicaciones y los beneficios de su tratamiento. Este artículo describe la evidencia actual sobre distintas vías fisiopatológicas, abordaje y tratamiento de las principales patologías relacionadas con la ferropenia sin anemia. Para ello se realizó una búsqueda completa y actualizada de la literatura científica en Medline, OVID, Lilacs, SciELO y EMBASE utilizando una estrategia definida con términos MeSH y no MeSH, limitado a español e inglés.

The deficit of iron without anemia is present in frequent pathologies of clinical practice, however, little is known about the importance, complications and benefits of the treatment. In this article, we describe an uptodate of the physiopathological pathways, the approach and treatment of the main pathologies related to iron deficiency without anemia. Methods; A complete and updated search of the scientific literature was made, in Medline, OVID, Lilacs, SciELO, EMBASE using a strategy defined with MeSH terms and not MeSH, limited to Spanish and English.

Miofibroblastoma de seno: tumor de abrikossoff, un tumor infrecuente / Myofibroblastoma of the breast: the infrequent Abrikosoff's tumor

Introducción. La incidencia de enfermedades neoplásicas de seno se ha incrementado en los últimos años; por tal razón, existe un acentuado aumento de casos de neoplasias que anteriormente eran de baja frecuencia o inclusive inexistentes. Con la notable mejoría y mayor disposición de técnicas de tamización, de estudios de anatomía patológica y de mejor acceso a la atención clínica oportuna y adecuada, hemos sido testigos del aumento en el diagnóstico de tumores de células granulares, o tumor de Abrikossoff, que se refleja en los reportes disponibles en la literatura científica que sirven para aclarar y obtener una mejor perspectiva en cuanto a su diagnóstico, estudio y manejo. Materiales y métodos. Se hizo una búsqueda sistemática de la literatura científica disponible en la base de datos de Pubmed, sin limitaciones de año de publicación, idioma, sexo, especialidad médica o características del tipo de reporte, comparando los diferentes resultados tanto de técnicas diagnósticas como de tratamientos y seguimiento aplicados. Discusión. Existen múltiples reportes de casos clínicos de tumores de células granulares, aunque hay, hoy en día, algunas discrepancias sobre el tratamiento de estas neoplasias, especialmente cuando se encuentran localizados en la mama, ya que por sus características de comportamiento benigno pueden ser menospreciados y resultar en futuras complicaciones propias de la historia natural de este tipo de trastornos. Por tal razón, se deben enfatizar los nuevos enfoques diagnósticos y en los tratamientos contundentes para disminuir la morbimortalidad de los pacientes, y buscar estandarizar su origen y los criterios clínicos y de laboratorio para su diagnóstico.

Introduction: There is an increasing incidence of neoplastic diseases of the breast being recorded in recent years, with the consequent increase in the number of cases of neoplastic lesions that previously had been infrequent or nonexistent. With the marked improvement and availability of screening techniques, more sophisticated pathological studies, and better access to opportune and adequate medical treatment, we are witnessing an increase in the number of cases of the granular cell tumors of the breast, or Abrikossoff´s tumors. Materials and methods. A systematic search of the literature available in PubMed was conducted, without limitations on the year of publication, language, gender, medical specialty or type of report, comparing the results from diagnostic techniques, management, and follow-up. Discussion. There are multiple clinical reports of cases of granular cell tumors, but currently there are discrepancies regarding their treatment, especially when they are located in the breast, and that because of their benign clinical behavior they can be underestimated with the consequent complications proper of the natural history of these tumors. For this reason the newer diagnostic techniques and treatment modalities should be emphasized so as to diminish morbidity and mortality in these patients, and seek to standardize their origin and the clinical and laboratory criteria for their diagnosis.

Cáncer de seno y hormonoterapia. Estado actual / Breast cancer and hormone therapy. Current state of knowledge

El manejo del cáncer de seno es multidisciplinario e involucra la cirugía, la quimioterapia, la radioterapia y la hormonoterapia. La hormonoterapia es un tratamiento muy antiguo para el manejo efectivo del cáncer de seno hormono-sensible. Cerca de 75 porciento de las pacientes expresan receptores hormonales en el tumor y el estándar de manejo ha sido con antiestrógenos como el tamoxifeno, que se viene usando desde hace más de 25 años en ensayos clínicos con buena respuesta, mejorando la supervivencia libre de enfermedad (SLE) y la supervivencia total (ST) de las pacientes, tanto en mujeres premenopáusicas como postmenopáusicas; por los efectos secundarios sobre endometrio y coagulación, se han venido desarrollando nuevas drogas llamadas inhibidores de aromatasa, que han sido comparados con el tamoxifeno en el estado metastásico y en adyuvancia, con mejores resultados de supervivencia libre de enfermedad con menos efectos secundarios sobre endometrio y menos eventos trombóticos, aunque aumentan el riesgo de osteoporosis y fracturas con su uso prolongado.

Behavioral and morphological effects of minocycline in the 6-hydroxydopamine rat model of Parkinson's disease.

The neuropathology in many neurodegenerative diseases is mediated by inflammatory cascades that influence neuronal dysfunction and death. Minocycline reduces the neurodegeneration observed in various models of Parkinson's. We exploited the unilateral 6-hydroxydopamine (6-OHDA) lesion model to assess the effect of minocycline on related neurodegeneration. Thirty Fisher 344 rats were divided into three daily treatment groups: (1) after: 45 mg/kg of minocycline beginning 24 h after lesioning; (2) before: 45 mg/kg of minocycline beginning 3 days before 6-OHDA lesioning; (3) control: corresponding saline-treated controls. Animals were assessed for apomorphine-induced rotations for 4 weeks. A longitudinal model for repeated measures showed that both after and before groups had significantly lower rotations than controls (P < 0.001 for both comparisons). Pair-wise group comparisons showed that the before animals rotated less compared to controls (mean rotations: 164 +/- 38 versus 386 +/- 49, respectively, P = 0.001). After animals also rotated significantly less then controls (mean rotations: 125 +/- 41 versus 386 +/- 49, respectively, P < 0.001). Animals receiving minocycline displayed reduced tyrosine hydroxylase-positive cell loss in the lesioned nigra versus contralateral nonlesioned nigra, compared to controls (mean differences: 5065 for after, 3550 for before, and 6483 for controls; P = 0.158 for after versus controls, P = 0.019 for before versus controls). The remaining lesioned nigral cells of both minocycline-treated groups were larger than controls, with the most robust cell size and fiber density observed in the after group. These data suggest that the therapeutic potential of minocycline may depend on the time of drug administration relative to neuropathogenic event.