Lithraea caustic (Litre) Extract Promotes an Antitumor Response Against B16 Melanoma.

Melanoma immunotherapy, specifically the autotransplant of dendritic cells charged with tumors antigens, has shown promising results in clinical trials. The positive clinical effects of this therapy have been associated to increased Th17 response and delayed-type hypersensitivity (DTH) against to tumor antigens. Some synthetic compounds, such as diphenylcyclopropenone (DPCP), are capable of triggering a DTH response in cutaneous malignancies and also to induce clinically relevant effects against melanoma. In this work, we evaluated Litre extract (LExT), a standardized extract of a Chilean stinging plant, Lithraea caustic (Litre). As Litre plant is known to induce DTH, we used a murine B16 melanoma model to compare the topical and intratumor efficacy of LExT with synthetic DTH inducers (DPCP and 2,4-dinitrochlorobenzene [DNCB]). LExt contained mainly long chain catechols and sesquiterpenes. The intratumor injection of LExT induced a significant delay in tumor growth, similarly topical treatment of an established tumor with 0.1% LExT ointment induced a growth delay and even tumor regression in 15% of treated animals. No significant changes were observed on the T-cell populations associated to LExT treatment, and neither DNCB nor DPCP were capable to induce none of the LExT-induced antitumoral effects. Interestingly, our results indicate that LExT induces an antitumor response against melanoma in a mouse model and could bring a new -and affordable- treatment for melanoma in humans.

Poincaré analysis of an overnight arterial oxygen saturation signal applied to the diagnosis of sleep apnea hypopnea syndrome.

The analysis of oxygen desaturations is a basic variable in polysomnographic studies for the diagnosis of sleep apnea. Several algorithms operating in the time domain already exist for sleep apnea detection via pulse oximetry, but in a disadvantageous way--they achieve either a high sensitivity or a high specificity. The aim of this study was to assess whether an alternative analysis of arterial oxygen saturation (SaO2) signals from overnight pulse oximetry could yield essential information on the diagnosis of sleep apnea hypopnea syndrome (SAHS). SaO2 signals from 117 subjects were analyzed. The population was divided into a learning dataset (70 patients) and a test set (47 patients). The learning set was used for tuning thresholds among the applied Poincaré quantitative descriptors. Results showed that the presence of apnea events in SAHS patients caused an increase in the SD1 Poincaré parameter. This conclusion was assessed prospectively using the test dataset. 90.9% sensitivity and 84.0% specificity were obtained in the test group. We conclude that Poincaré analysis could be useful in the study of SAHS, contributing to reduce the demand for polysomnographic studies in SAHS screening.

Functional hyperprolactinemia and hypophyseal microadenoma in systemic sclerosis.

OBJECTIVE: Hyperprolactinemia (HPRL) has been identified in more than half of patients with systemic sclerosis (SSc). However, the association with pituitary adenoma and the status of hypothalamic dopaminergic tone using metoclopramide (MTC) test has not been studied. We investigated the prevalence of prolactin (PRL)-secreting pituitary adenoma and evaluated production of PRL by dynamic testing with MTC in SSc. METHODS: We studied 30 patients with SSc (mean age 38 +/- 10 yrs) and 20 healthy controls (mean age 37 +/- 11 yrs). Serum PRL concentrations were determined by radioimmunoassay in all subjects, and PRL response was measured 30, 60, 90, and 120 min after injection of 10 mg of MTC. Computed tomography (CT) of the sella turcica was performed. RESULTS: The mean basal serum PRL levels before and after stimulation with MTC in SSc patients versus controls were: basal 18.2 +/- 5.4 versus 8.7 +/- 1.6 ng/ml, p = NS; 30 min: 175.0 +/- 5.4 versus 61.0 +/- 42 ng/ml, p < 0.001; 60 min: 160 +/- 64 versus 52 +/- 30 ng/ml, p < 0.001; 90 min: 125 +/- 57 versus 42 +/- 21.0 ng/ml, p < 0.05; 120 min: 108.0 +/- 57 versus 30.0 +/- 10 ng/ml, p < 0.005. CT scan showed microadenomas in 24/30 SSc patients and 1/20 controls (p = 0.001). CONCLUSION: Our study suggests that a group of patients with SSc have a high prevalence of HPRL with increased central dopaminergic tone, and microadenomas. PRL may have a role in the pathogenesis of SSc. Further studies are necessary to confirm our results.

[Leptospirosis: report of a fulminant fatal case and review]. / Leptospirosis: presentación de una infección fulminante y revisión de la literatura.

In relation to the explosive increase of new and reemerging infectious diseases that threaten the humanity, and as a result of this clinical case, a literature review is done on Leptospirosis stressing out the necessity of having in mind the leptospirosis in the differential diagnostic for fever and jaundice syndrome.

Tuberculous esophagobronchial fistulae: review

Tuberculose esofagica e incomum, enquanto fistula esofago-bronquica ou esofago-traqueal e ainda mais rara. Reporta-se um desses casos, tratado com realizacao de esofagostomia terminal, gastrotomia e administracao de estreptomicina, rifampicina, isoniazada e pirazinamida. Um ano depois, apos fechamento completo da fistula, foi restabelecido o transito esofagiano. A apresentacao do caso clinico e enriquecida com informacoes da literatura concernentes a tuberculose esofagica e fistulas esofago-traqueo-bronquicas de origem tuberculosa