Impaired intratumoral dendritic cell function and potential predictive value of dendritic cell markers for metastasis in malignant salivary gland tumors.

BACKGROUND: The differentiation between primary and metastatic salivary gland neoplasms (SGNs) helps in determining appropriate management strategies, including the need for additional diagnostic tests, surveillance, or aggressive treatment. The purpose of this study was to identify and quantify the immature and mature dendritic cells (DCs) in metastatic and no metastatic SGNs and determine its association with clinicopathological findings. MATERIAL AND METHODS: Cross-sectional, observational, and descriptive study that includes 33 malignant salivary gland neoplasms [MSGN (6, 18.1% metastatic)], and 22 pleomorphic adenomas (PA), as a control group. Clinical and histopathological characteristics were obtained. Immunohistochemistry for human leukocyte antigen D-related (HLA-DR), CD1a, CD83, and Ki-67 proteins was done. Positive intra- and peritumoral DCs were counted. RESULTS: Individuals with MSGN had a lower density of intratumoral HLA-DR+ cells than those with PA (p=0.001), Ki-67 immunostaining was significantly higher in MSGN than in PA (6% vs. 1.4%, p<0.001). Metastatic MSGN showed less intratumoral CD1a+ than non-metastatic (3.2 vs. 165.1, p=0.001). No differences in intra- and peritumoral CD83+ cells were found between benign and malignant SGN. CONCLUSIONS: These results suggest that the immune-protective function of intratumoral DCs is compromised in MSGNs. DCs markers may represent useful prediction tools for metastases in salivary gland malignancies, with crucial implications in the implementation of appropriate disease management strategies.

Primary oral and sinonasal mucosal melanomas in Latin America: a systematic review.

Primary oral and sinonasal mucosal melanomas (POSNMMs) are aggressive neoplasms with limited therapeutic alternatives. The aim of this review was to characterize the demographic, clinical, immunohistochemical, and molecular information regarding these tumors in the Latin American population. Articles published in English, Spanish, or Portuguese (1990-2022) retrieved from the PubMed/MEDLINE, Scopus, CAS, Web of Science, EBSCO, and Google Academic databases were included. Thirty-three studies, with a total of 1212 cases, were identified. Clinicopathological data were available for 870 cases and immunohistochemical and/or molecular information for 342. Nineteen studies (57.6%) reported cases of oral melanoma, three (9.1%) sinonasal melanoma, and 11 (33.3%) oral and sinonasal melanoma. Fifteen studies (45.5%) provided only clinicopathological data, 12 (36.4%) reported only immunohistochemical data, two (6.1%) shared clinicopathological and immunohistochemical data, one (3.0%) offered clinicopathological, immunohistochemical, and molecular data, one (3.0%) provided immunohistochemical and molecular data, one (3.0%) clinicopathological and molecular data, and one (3.0%) only molecular data. The mean age of individuals with POSNMMs was 58 years, and slightly more were male (male 51.3%, female 48.7%). In Latin America, POSNMMs are a rare but aggressive malignancy with a poor prognosis and limited treatment options. Although molecular data and targeted therapy are still being researched, data from Latin America indicate the need for multicenter collaborative clinical trials to unite individual and isolated efforts.

Human papillomavirus load in benign HPV-associated oral lesions from HIV/AIDS individuals.

BACKGROUND: Although HPV emerged as a crucial carcinogenic and prognostic biomarker in head and neck cancer, and considering the increase in HPV-associated oral lesions (HPV-OLs) in HIV individuals, molecular information about HPV-OLs is scarce; thus, our aim was to determine viral loads in HPV-OLs from HIV/AIDS individuals. METHODS: HIV/AIDS subjects with HPV-OL were included in this cross-sectional study. Following informed consent, biopsies were obtained. HPV detection and typing were carried out by PCR and sequencing (MY09/11, GP5+/6+). HPV-13 and HPV-32 loads were determined by a high-resolution melting assay. For statistical analysis, X2 , Fisher's exact, and Mann-Whitney U tests were applied, using SPSS software (v.23). RESULTS: Twenty-nine HIV subjects (median age 38 years, 93% males) were included. Most were AIDS individuals (72.4%) under HAART (89.7%). Twenty-two (75.9%) participants had more than one HPV-OL (four with florid presentations), mostly multifocal epithelial hyperplasia (62%), being HPV-13 (26%) and HPV-32 (31%) the most frequent types. HPV load was higher in individuals with multiple HPV-OLs than in solitary lesions (4.9 vs. 3.2 Log10 copies/ml, p = .090) and in HPV-32+ than in HPV-13+ (8.3 vs. 6.4 Log10 copies/ml, p = .014). CONCLUSIONS: Multiple HPV-OLs showed high HPV loads, possibly indicating transcriptional activity of the virus; however, in the HIV setting, the individual and local immunological response could be the key process.

Double-blind placebo-controlled randomized clinical trial evaluating doxycycline effects on chemotherapy-induced oral mucositis.

WHAT IS KNOWN AND OBJECTIVE: Chemotherapy (CT)-associated oral mucositis (OM) is one of the most debilitating and painful side effects in oncology patients, with limited effective management options. During CT, matrix metalloproteinases (MMPs) are upregulated, causing damage in mucosal and submucosal tissues, and playing a key role in OM; therefore, the use of subantimicrobial doxycycline as a MMP inhibitor may represent a potential approach for OM management. The aim of this clinical trial was to evaluate the efficacy and safety of low doses of doxycycline in OM development in individuals with acute leukaemia (AL) during CT. METHODS: Randomized controlled clinical trial (Registration No. NCT01087476) performed in adult AL patients scheduled to receive CT (September 2010-October 2014). Individuals were stratified by leukaemia type and assigned randomly to receive doxycycline hyclate (50 mg/d) (doxycycline group: DG) or placebo (placebo group: PG) before and during CT. Included subjects had a baseline oral examination and thereafter 3 times a week during 21 days. The primary outcome was OM development. RESULTS AND DISCUSSION: One hundred and forty-seven AL subjects were enrolled: 74 in DG and 73 in PG; baseline characteristics between groups were comparable. During follow-up, 15 (10.2%) individuals developed OM; no differences between treatment groups were found (DG:8.1%, PG:12.3%; P = .59). The mean OM Assessment Scale score was 2.51, without differences between groups (DG:2.7, PG:2.4; P = .65). Low baseline blood albumin levels in the OM-affected individuals were identified, revealing the effect of systemic deterioration as a predisposing factor for OM development. No adverse effects were observed. WHAT IS NEW AND CONCLUSION: Subantimicrobial doses of doxycycline did not reduce the incidence, onset, duration or severity of OM.

Diversidad haplotípica del exón xii del gen dopamina p-hidroxilasa en tres razas bovinas / Haplothic diversity of exon xii of the dopamine p-hydroxylase gene in three cattle breeds

Los polimorfismos en el gen dopamina p-hidroxilasa (DBH) se asocian con el temperamento en los bovinos. En 16 animales de la raza criolla colombiana Blanco Orejinegro (BON), 20 Brahman (BRA) y 16 de Ganado de lidia (GLI), se evaluaron los polimorfismos del exón xii del gen DBH mediante secuenciación. Se encontraron 13 haplotipos, 6 en BON, 9 en BRA y 2 en GLI. El haplotipo H2 fue el más frecuente (0,615) y se encontró en las tres razas, mientras los haplotipos H6 y H9 fueron compartidos entre BON-BRA y BRA-GLI, respectivamente. La mayor diversidad genética (DG: 0,915 ± 0,04) y nucleotídica (DN: 0,011 ± 0,006) se encontró en la raza BRA, seguida por BON (DG: 0,700 ± 0,12; DN: 0,008 ± 0,004) y GLI (DG: 0,350 ± 0,14; DN: 0,0011 ± 0,001). Si bien el test de D-Tajima fue mayor que cero, no fue significativo (P > 0,05) en BON y BRA, pero en la raza GLI presentó un valor de -1,92 (P < 0,05). El análisis de varianza molecular mostró una variación entre las razas de 23,9% y una estructura poblacional (F^) de 0,23 (P < 0,001). Los mayores valores del coeficiente de coancestría se presentaron entre GLI y BRA (0,52) y entre GLI y BON (0,22). Se concluye que la raza GLI tiene baja diversidad en el gen DBH en comparación con las razas BON y BRA, que hay efectos de la selección natural en BON y BRA mientras que en la raza GLI se evidencia un barrido selectivo reciente y no a favor del temperamento.

Polymorphisms in the dopamine p-hydroxylase gene (DBH) have been associated with temperament in cattle. In 16 animals of Colombian creole breed Blanco Orejinegro (BON), 20 Brahman (BRA) and 16 fighting bulls (GLI), polymorphisms of exon xii of the DBH gene were evaluated by sequencing. 13 haplotypes were found, 6 in BON, 9 and 2 in BRA and GLI respectively. Haplotype H2 was the most frequent in the whole population (0,615) and it was found in all breeds. Haplotypes H6 and H9 were shared between BON-BRA and BRA-GLI, respectively. The greatest value of genetic (DG: 0.915 ± 0.04) and nucleotide (DN: 0.011 ± 0.006) diversity, was found in BRA, followed by BON (DG: 0.700 ± 0.12; DN: 0.008 ± 0.004) and GLI (DG: 0.350 ± 0.14; DN: 0.0011 ± 0.001). The D-Tajima test was greater than zero, but not significant (P > 0.05) in BON and BRA, GLI presented a value of -1.92 (P < 0.05). The analysis of molecular variance showed a variation between the breeds of 23.9% and a poblacional structure (F$t) of 0.23 (P < 0.001). The highest values of the coancestry coefficient were presented between GLI and BRA (0.52) and between GLI and BON (0.22). It is concluded that the GLI race has low diversity in the DBH gene compared to BON and BRA, that there are effects of neutral selection in BON and BRA breeds, whereas, in the GLI and not in favor of temperament.

Clinicopathological characterization of primary oral and sinonasal melanoma in a referral centre in Mexico City: 2000-2012.

In Mexico, there have been few studies on primary oral and sinonasal melanoma, an aggressive neoplasm with a low survival rate and few therapeutic alternatives. Further, there is limited information about its clinical and histopathological characteristics. The aim of this retrospective study was to describe the clinicopathological profile of these tumours in patients attending a major oncology reference centre in Mexico City over a 12-year period. Demographic and clinical data were obtained from the clinical charts, and histopathological features were evaluated. χ(2), Fisher's exact, and Mann-Whitney U-tests were used for analysis; significance was set at P<0.05. Thirty-three cases were studied (73% sinonasal melanoma (SNM) and 27% oral melanoma (OM)); 58% were female and the median age was 66 (Q1-Q3 55.5-75) years. Compared with OM patients, SNM patients had a shorter time to diagnosis (16.7 vs. 11.7 months, P=0.022), were identified at earlier stages (33.3% vs. 58.3%, P=0.010), and all presented symptoms (66.7% vs. 100%, P=0.015). All samples showed vertical growth and 96.9% exhibited pleomorphism. A higher proportion of cases with pleomorphism developed metastases at follow-up than those without (60% vs. 12.5%, P=0.026). The present study provides valuable information that could form the basis of future studies in the search for advanced therapy modalities.

Tromboprofilaxis en pacientes médicos hospitalizados. ¿A todos por igual? / Thromboprophylaxis in hospitalized medical patients. Do all alike?

Venous thromboembolic disease is the leading preventable cause of hospital mortality. Up to 75 percent of these are in non - surgical patients. This is a large, heterogeneous group of patients; so to know the risk factors for deep venous thrombosis crucial to provide a correct prevention. This article reviewed the indications, contraindications and complications of thromboprophylaxis. Difficult cases in elderly, obese, chronic kidney disease, critical care and cirrhotic patients were reviewed. The purpose of this article is to support decision – making on dvt prevention in hospitalized medical patients...

hMLH1 promoter methylation is an early event in oral cancer.

Promoter methylation is believed to inactivate the expression of hMLH1. This process has been implicated in the tumorigenesis of oral squamous cell carcinoma (OSCC). Thus, the aim of this study was to determine the profile of hMLH1 methylation and protein expression in OSCC. The matched case-control study included 50 OSCC cases and 200 controls, with a median of age 64 (Q1-Q3 54-71) years. Protein expression was determined by immunohistochemical staining, and hMLH1 gene promoter methylation was analyzed by methylation-specific polymerase chain reaction (MSP). A conditional logistic regression model for risk factors was built for OSCC cases and matched controls. Promoter methylation of hMLH1 was detected in 38 (76%) OSCC cases, but in none of the control samples. Of the 38 OSCC samples with promoter methylation, 12 (32%) were negative for hMLH1 protein, and corresponded to early clinical stages (10 in stage II and 2 in stage I). All 12 unmethylated samples showed positive stain for hMLH1. Multiple logistic regression analysis showed an OR of 16.54 (IC 95%: 1.69-161.68, p=0.016) for methylation of the hMLH1 gene and early stages of OSCC, adjusting by gender and tobacco use. This study showed a high frequency of hMLH1 promoter methylation that occurred in most of the early stage cases and in about half of the late stage cases. It is proposed that hMLH1 promoter methylation is an early event that is maintained during tumor progression.

Curvas manométricas rectales en niños: estudio promano fase I / Rectal mamometric curves in children: phase I study

Aim of this study: To evaluate the role of anorectal manometry (ARM) and determine normal ARM's parameters in a group of children referred for evaluation of defecation disorders. Patients and Methods: A retrospective review of pediatric ARMs performed over an 8-year period. Results: Records from 789 children (52.6 percent male) were reviewed. Patients were classified in four groups according to the main ARM's findings in: "Control group" (CL), "Probable megarectum group" (PMG), "Abnormalities of intrinsic innervation group" (All) and "Abnormalities of extrinsic innervation group" (AET). 79 percent of them had been referred for evaluation of chronic constipation and 10 percent because of suspicion of abnormalities of intrinsic innervation. In 94 and 83 percent of them respectively, the ARM ruled out organic causes. ARM's findings distribution was: CL (48.0 percent), PMG (42.6 percent), All (7.5 percent) and AEI (1.5 percent). CL and PMG showed age-dependent differences in manometric parameters. Differences in manometric parameters between CL, PMG, API and AEI were found. Conclusions: Four distinctive patterns were described in 789 patients referred for evaluation of their presumed defecation disorder. The main indication of ARM was study of chronic constipation, where organic problems were confirmed only in a few of them.

Propósito del estudio: Evaluar el rol de la manometría rectoanal (MRA) y establecer valores de normalidad en un grupo de niños referidos por desórdenes de defecación. Pacientes y Métodos: Revisión retrospectiva de MRA efectuadas durante un período de 8 años. Resultados: Se analizaron los resultados obtenidos de 789 niños (52,6 por ciento hombres). Éstos se clasificaron en cuatro grupos según resultado de la MRA como "Grupo control" (CL), "Grupo con probable megarrecto" (PMG), "Grupo con anormalidades de la inervación intrínseca" (All) y "Grupo con anormalidades de la inervación extrínseca" (ALE). Setenta y nueve por ciento de los pacientes fueron referidos para evaluación de constipación crónica y 10 por ciento por sospecha de anormalidades de inervación intrínseca; en 94 por ciento y 83 por ciento de ellos respectivamente, la MRA descartó causas orgánicas. Los niños se distribuyeron en: CL (48,0 por ciento), PMG (42,6 por ciento), All (7,5 por ciento) y AIE (1,5 por ciento). El grupo CL y PMG mostraron diferencias edad-dependiente en algunos parámetros manométricos. Además se encontró diferencias en parámetros manométricos entre CL, PMG, All y AIE. Conclusiones: La principal indicación de MRA fue para estudio de constipación crónica, siendo las alteraciones orgánicas confirmadas sólo en un bajo porcentaje. Se describió cuatro patrones diferentes en 789 pacientes referidos para evaluación de dificultades en la defecación.

Clonal dissemination of Enterococcus faecalis ST201 and Enterococcus faecium CC17-ST64 containing Tn5382-vanB2 among 16 hospitals in Chile.

We report the clonal dissemination of ST201 Enterococcus faecalis carrying Tn5382-vanB2 and of CC17-ST64 Enterococcus faecium carrying Tn5382-vanB2-ISEnfa110 among 16 hospitals in four geographically distant regions in Chile. This is the first epidemiological characterization of vancomycin resistance in Chile, and also the first report of interhospital dissemination of enterococcal vanB2 in South America.

Clinical, histological and immunohistochemical findings in oral Kaposi's sarcoma in a series of Mexican AIDS patients. Comparative study.

BACKGROUND: The origin of spindle cells (SC) in oral Kaposi's sarcoma (OKS) is still an intriguing aspect. Thus the aim of the present study was to compare the clinical, histological and immunohistochemical characteristics of OKS and oral pyogenic granuloma (OPG), in order to contribute to the knowledge of the cells involved in Kaposi's sarcoma pathogenesis. METHODS: In this retrospective, observational and comparative study, 39 OKS and 30 OPG cases were included. Immunohistochemical studies were performed for vimentin, alpha SMA, desmin, C-kit, CD34, D2-40 and LANA-1 [human herpesvirus-8(HHV-8)]. Statistical comparisons were done using the chi-square and Wilcoxon-Mann-Whitney rank sum tests. RESULTS: Fourteen (35.9%) OKS cases also affected the skin, and 83.8% involved the palate. All OKS and OPG were positive for vimentin and CD34. OKS samples were positive for alpha SMA, and 25.6% expressed C-kit. All OKS cases were positive for HHV-8, and the number of positive cells increased significantly from early / intermediate to late histological stage. D2-40 was expressed in the cellular component and vascular walls of all OKS cases, but it was negative in OPG. HHV-8 expression was increased in late histological stages of OKS lesions. CONCLUSIONS: The expression of D2-40 marker in the vascular walls and SC supports the view of a lymphatic differentiation in neoplastic cells of OKS. Desmin, alpha SMA, D2-40, C-kit and HHV-8 were the main markers differently expressed in OKS and OPG.

Evaluación de los índices de monitoreo de pH esofágico y su relación con indicaciones clínicas: MePeache Fase I / Evaluation of the esophageal pH monitoring and its relation with clinical indications: MePeache Phase I

Objectives: Establish mean values and normality range for pH metric parameters, different to reflux index (RI), in esophageal pH monitoring (EpHm) according to new RI cut- off values; besides, correlate them with clinical diagnosis. Method: Retrospective study of EpHm parameters including RI, number and average length of episodes (DPE), number of episodes > 5 minutes and duration of the longest episode. 153 patients were classified according to age (Group I < 1 year and Group II > 1 year) and RI cut-off values: Normal group (NL) with physiological range (RI < 12 percent GI and < 6 percent GII) and Pathological group (PT) when RI was higher. Results: The most frequent EpHm indications were gastroesophageal reflux (GER) study (41.7 percent), airway diseases (19.9 percent) and otolaryngologic diseases (17.2 percent). There was no correlation between EpHm parameters in GI (n = 53) when analyzed by gender, referring physician or EpHm indication. In GII (n = 100), the RI for children referred by pediatricians was higher than the one for those referred by gastroenterologists in Group NL (p = 0.002). There were differences in all pH metric parameters according to NL and PT groups, except DPE. 84.9 percent and 77 percent of the EpHms in GI and GII respectively were normal. Conclusions: The EpHm parameters allow the division in NL and PT groups according to new RI cut-off values. There is a weak correlation between clinical suspicion and pHmetric diagnosis, sugesting the necessity to reevaluate EpHm indications.

Objetivos: Establecer valores promedio y rangos de normalidad de parámetros pHmétricos diferentes al índice de Reflujo (IR) en monitoreos de pH esofágico (MpHe), según nuevos valores de IR y correlacionarlos con el diagnóstico clínico. Pacientes y Método: Estudio retrospectivo de parámetros de MpHe incluyendo IR, n° y duración de episodios (DPE), n° episodios > 5 min y duración episodio mayor. Se reagrupó a los 153 pacientes según edad (Grupo I < 1 año y Grupo II > 1 año) y según IR como: Grupo Normal (NL) a aquéllos con IR en rango fisiológico (IR < 12 por ciento GI y < 6 por ciento GII) y Grupo Patológico (PT), cuando el IR superaba estos valores. Resultados: Las indicaciones más frecuentes fueron estudio de RGE (41,7 por ciento), patología de vías aéreas (19,9 por ciento) y otorrinolaringológicas (17,2 por ciento). Al comparar MpHes en GI (n = 53) no se encontraron diferencias significativas según género, médico referente o indicación. En el Grupo NL de GII (n = 100) se encontró un IR en niños referidos por pediatras mayor al de aquellos referidos por gastroenterólogos (p = 0,002). Según grupos NL y PT, todos los parámetros pHmétricos resultaron significativos (p < 0,005), excepto la DPE. 84,9 por ciento y 77 por ciento de los MpHes en GI y GII, respectivamente fueron normales. Conclusión: Los índices de MpHe permiten separar los grupos NL y PT bajo los nuevos puntos de corte del IR. Existe escaso correlato entre sospecha clínica y diagnóstico pHmétrico lo que sugiere la necesidad de reevaluar sus indicaciones clínicas.

Utilización de vacuum extractor de copa blanda en la atención de partos vaginales / Vacuum extractor with a soft cup is used in vaginal birth deliveries

En Chile, el parto vaginal instrumentalizado está reducido al uso de fórceps y espátulas de Thierry. La tendencia mundial está dirigida al uso de vacuum extractor de copa blanda. El vacuum extractor presenta múltiples ventajas en comparación con el fórceps, tales como requerimientos analgésicos menores, técnica de fácil aprendizaje y menor incidencia de traumatismo neonatal. Presentamos nuestra experiencia con el uso de vacuum extractor de copa blanda, en casos de expulsivo detenido y sufrimiento fetal, como alternativa al fórceps. Se utilizó el vacuum en 3 pacientes, sin traumatismo materno y neonatal.

Antioxidant activity of Paraguayan plant extracts.

The antioxidant properties of six medical herbs used in the traditional Paraguayan medicine were studied using free radical-generating systems. The methanol extracts from Aristolochia giberti, Cecropia pachystachya, Eugenia uniflora, Piper fulvescens, Schinus weinmannifolia and Schinus terebinthifolia protected against enzymatic and non-enzymatic lipid peroxidation in microsomal membranes of rat. C. pachystachya, E. uniflora, S. weinmannifolia and S. terebinthifolia showed the highest scavenging activity on the superoxide and DPPH radicals.

Efectos del valerato de estradiol ciproterona sobre el síndrome climaterio y parámetros bioquímicos en mujeres chilenas / Effects of estradiol valerate and ciproterone acetate on climateric syndrome and biochemical parameters in Chilean women

La menopausia se asocia a un demostrado aumento del riesgo de enfermedad cardiovascular y de osteoporosis, lo que justifica el uso de terapia hormonal de reemplazo. Como ésta se plantea por tiempo prolongado, debe ser efectiva en prevenir las complicaciones y en suprimir el síndrome climatérico. Se estudió la eficacia de la asociación de valerato de estradiol (VE) y acetato de ciproterona (CPA) en la reducción de los síntomas asociados a menopausia. Se analizaron, prospectivamente, 342 mujeres durante 6 meses, consignando la intensidad de sus síntomas y los cambios en peso, presión arterial y parámetros bioquímicos. Las oleadas de calor, así como otros síntomas y signos, disminuyeron en intensidad. No hubo diferencia significativa en la evolución del peso ni de la presión arterial, aunque sí en algunos parámetros del perfil lipídico y hepático. Se concluye que la asociación VE y CPA reduce la intensidad de los síntomas climatéricos en el grupo estudiado

Rol del tejido adiposo / Adipose tissue role

Currently the research on adipose tissue has yielded same insights of itïs function. On the embrionary state the differentiation between white adipose tissue and brown adipose tissue and brown adipose tissue signals different functions. The presence of multiple receptors and actions define itïs autocrine, paracline and endocrine roles

Buena praxis en obesidad / Good praxis in obesity

This is a brief summary of the general guidelines for and adequate assessment, diagnosis and treatment of abesity, based on the criteria published by the National Heart Lung and Blood Institutes (NHLBI), the World health Organization (WHO), Latin America Federation of Obesity Societies (FLASO) and Chilean Society of Obesity (SOCHOB))

¿Es el embarazo una limitante para hacer deportes o viajes en avión? / Is pregnancy a limiting factor for sport practice or airplane traveling?

Se presenta un resumen de distintas investigaciones que avalan la posibilidad de seguir realizando algunos deportes para las gestantes, como a su vez la posibilidad de realizar viajes vía aérea con seguridad para la madre y su(s) fetos