Sarcoidosis-like reactions in cancer patients treated with immune checkpoint inhibitors: experience in a Spanish hospital.

BACKGROUND: Immune checkpoint inhibitors (ICI) have been associated with several immune-related adverse events, including sarcoidosis-like reactions (SLR). SLR, which has a low prevalence but an increasing incidence, is similar to sarcoidosis in terms of histology, and clinical and radiological manifestations. The most commonly affected organs are hilar and mediastinal lymph nodes and skin. SLR is an exclusion diagnosis, so a lymph node biopsy can be useful to distinguish between tumor progression and SLR, particularly in tumors in which nodal involvement is very common. PATIENTS AND METHODS: We performed a retrospective analysis of SLR in all cancer patients receiving ICIs in our institution between January 2016 and June 2020. RESULTS: Among the 1063 treated patients, seven experienced SLR, four of whom were symptomatic (cough, skin lesions, arthralgia), with time to onset ranging from 1.5 to 6.7 months after ICI initiation. All seven patients had bilateral hilar lymphadenopathy, and granulomatous reactions in five of the six patients with lymph node biopsies. SLR improved in all patients, including four patients who continued with ICI. Three patients received corticosteroids and/or stopped ICI therapy. Four of these patients had partial responses at the time SLR was identified. CONCLUSION: Management of SLR lacks a consensus recommendation, although corticosteroids and/or stopping the ICI are generally implemented. The potential consequences of stopping anticancer treatment should be taken into consideration, particularly in the absence of clear management recommendations.

On the use of ultrasonic dental scaler tips as cleaning technique of microfiltration ceramic membranes.

The use of ultrasonic dental scaler (UDS) tips has been investigated for cleaning ceramic membranes fouled when filtering cactus juice. Thin and long tips having a larger coverage exhibited the best performance for removing the cake layer deposited on the membrane surface. Such tips cleaned an area equivalent to almost one third of total area of the membrane surface. However, the cleaned area could be increased notoriously if the membrane were placed in rotatory disc holder. The resistance-in series model and atomic force microscopy (AFM) technique helped to reveal the effect of the UDS tips as cleaning process of ceramic membranes. The reversible resistances estimated for UDS tips were 58% and 17% lower than the ones obtained by chemical cleaning at transmembrane pressures of 0.3 bar and 0.5 bar, respectively. This was corroborated by microscope images, which showed the detachment of cake layer of the membrane surface. Results of this work showed that UDS tips are an innovative option as cleaning strategy for filtration membranes.

Efecto del aliskireno sobre la angiogénesis en modelo de membrana alantocoriónica (MAC) de pollo / Effect of aliskiren on angiogenesis in chick embryo chorioallantoic membrane (CAM) assay

La acción antiangiogénica de los inhibidores del receptor de angiotensina II (ARA II), ha sido documentada previamente, sin embargo, no ha sido descrita la relación entre angiogénesis e inhibidores directos de la renina (DRIs), los cuales participan regulando el sistema renina-angiotensina-aldosterona (SRAA). El objetivo fue demostrar el efecto antiangiogénico de aliskireno, un DRI, en membranas alantocoriónicas (MAC) de pollo, para lo cual fueron instilados aliskireno y enalapril sobre MAC en distintas concentraciones para realizar su comparación posterior. En secciones histológicas seriadas se registró el número de vasos sanguíneos presentes en 9000 µm2 bajo microscopio de luz a máximo aumento, y se realizó análisis estadístico utilizando ANOVA y el test de Tukey para demostrar posibles diferencias. Los receptores tratados con aliskireno, en ambas concentraciones utilizadas, presentaron menor densidad vascular, en comparación con los controles, siendo ésta estadísticamente significativa a mayor concentración. Aliskireno en concentraciones altas tiene un efecto antiangiogénico en un modelo experimental de MAC. Este hallazgo plantea la necesidad de estudios posteriores, dada la proyección que podría tener el uso inhibidores directos de la renina. A partir de estos resultados, se podría pensar en la factibilidad del uso de aliskireno para la modulación de la angiogénesis en diversas enfermedades crónicas no transmisibles.

Angiogenesis is the formation of new blood vessels from pre-existing ones. Antiangiogenic effect of angiotensin receptor blockers has been reported, however, the relationship between direct renin inhibitors and angiogenesis has not been well described. To assess the antiangiogenic effect of aliskiren, a direct renin inhibitor, on chick embryo chorioallantoic membrane (CAM) assay. Aliskiren and enalapril were instilled in different concentrations and compared. In serial histological sections, the number of blood vessels per 9000 µm2 area under observation through optical microscope using maximum zoom, was registered. Statistical analysis using Anova and Tukey test in order to show possible differences, was performed. Receptors treated with aliskiren presented lower vascular density, which was statistically significant when a higher concentration was administered. High concentrations of aliskiren have an antiangiogenic effect on CAM assay. This finding means further studies are needed, because of the usefulness direct renin inhibitors could have. These results, also, might enhance the possibility of using aliskiren for regulating angiogenesis in the context of non-transmissible chronic diseases.

Caracterización de pacientes pediátricos usuarios de fototerapia en el Servicio de Dermatología, Hospital Clínico Universidad de Chile (2007-2015) / Characterization of pediatrics patients users of phototherapy in dermatology service, Hospital Clínico Universidad Chile (2007-2015)

Phototherapy is the use of specific wavelenghts of light that have shown effectiveness in the treatment of several cutaneous diseases. Current indications for phototherapy in Dermatology include multiple pathologies and it is considered to be costeffective. Literature about its use in children is rare, there are no studies on phototherapy in Chilean children. Patients and methods: Observational, descriptive, retrospective study. Clinical records of pediatric patients treated with phototherapy at University of Chile Clinical Hospital between 2007 and 2015, were studied. For each patient, the following parameters were analyzed: age of starting treatment, sex, skin phenotype, diagnosis, prescribed phototherapy and weekly frecuency. Results: 146 patients, 85 girls and 51 boys, average age 11.7 +/- 4.0 years. Predominant skin phenotype, was Fitzpatrick type III. Vitiligo was identified as the most common indication for phototherapy (52,2 percent), followed by psoriasis (22,6 percent). By a large margin, the most used type of phototherapy was nb UVB (96.6 percent). Most of the patients were treated twice per week (69.2 percent). Discussion: The obtained results in this group are similar to those results described in the international literature. Further studies are required for a better knowledge about efficacy and possible long-term effects of phototherapy on Chilean children.

Caracterización de trabajadores sexuales del área norte de Santiago portadoras de Chlamydia trachomatis / Characterization of sex workers in the northern area of Santiago with Chlamydia trachomatis

Marco Teórico: chlamydia trachomatis, agente bacteriano de infección de transmisión sexual (ITS) más frecuente en el mundo, se asocia a patología inflamatoria y neonatal, y a infertilidad. Las trabajadoras sexuales constituyen un grupo de alto riesgo para su contagio. Objetivo: Caracterizar trabajadoras sexuales portadoras de C. trachomatis del área norte de Santiago. Pacientes y Métodos: 36 trabajadoras sexuales con inmunofluorescencia directa positiva para C. trachomatis controladas en una Unidad de ITS. Se analizó en sus fichas clínicas: nivel educacional, uso de alcohol y drogas, tendencia sexual, ITS asociadas y uso de preservativo. Esta información se comparó con fichas clínicas de trabajadoras sexuales no portadoras. Resultados: No se encontraron diferencias estadísticamente significativas entre portadoras y no portadoras, a partir de la revisión de registros clínicos. Conclusión: El diagnóstico de infección de C. trachomatis y su adecuado control requieren de procedimientos estandarizados para su implementación en grupos de alto riesgo.

Background: chlamydia trachomatis, the most frequent bacterial agent of sexually transmited infections (STI) in the world, is associated with inflammatory and neonatal diseases, as well as with infertility. Sex workers are a high risk group. Objetive: To characterize sex workers in the northern area of Santiago, who are C. trachomatis carriers. Patients and Methods: 36 sex workers, whose direct immunofluorescence assays tested positive for C. trachomatis, attending a STI Unit. The following information was analyzed from their clinical records: educational level, alcohol and drugs use, sexual tendency, associated STIs and condom use. It was compared to the information from clinical records of non C. trachomatis carrier sex workers. Results: No statistically significant difference between carriers and noncarriers was found, regarding the aforementioned features, from the clinical records review. Conclusion: The diagnosis of C. trachomatis infection and its proper control require standardized proceedings to be implemented in high risk groups.

Caracterización de trabajadores sexuales extranjeras del área norte de Santiago / Characterization of foreign sex workers from the north area of Santiago

Marco teórico: Chile está experimentando un importante fenómeno inmigratorio, con los consiguientes cambios en el perfil epidemiológico. A pesar de la llegada de numerosas trabajadoras sexuales extranjeras, no se conocen sus características epidemiológicas ni demográficas. Objetivo: Caracterizar trabajadoras sexuales extranjeras del área norte de Santiago. Pacientes y métodos: 55 trabajadoras sexuales extranjeras controladas en una Unidad de ITS. Se analizó en sus fichas clínicas: nivel educacional, uso de alcohol y drogas, tendencia sexual, ITS asociadas y uso de preservativo. Esta información se comparó con fichas clínicas de trabajadoras sexuales chilenas. Resultados: A excepción del nivel sociocultural y el consumo de drogas, no se encontraron mayores diferencias entre chilenas y extranjeras, a partir de sus registros clínicos. Conclusión: Se requieren intervenciones a cargo de equipos multidisciplinarios en trabajadoras sexuales chilenas y extranjeras, enfocadas en la pesquisa de pacientes de alto riesgo e incluyendo la atención de salud mental y reproductiva.

Background: Chile is undergoing an important immigration phenomenon, with the consequent epidemiological changes. Despite the arrival of numerous foreign sex workers, their epidemiological and demographic features remain unknown, Objective: To characterize foreign sex workers in the northern area of Santiago. Patients and Methods: 55 foreign sex workers, attending a STI Unit. The following information was analyzed from their clinical records: educational level, alcohol and drugs use, sexual tendency, associated STIs and condom use. It was compared to the information from clinical records of Chilean sex workers. Results: With the exception of the educational level and the drugs use, no major difference was found from the clinical records review. Conclusion: Health interventions by multidisciplinary teams on Chilean and foreign sex workers are required, focusing on the search for high risk patients, and including mental and reproductive health attention.

Relación entre psoriasis y salud sexual: estudio en población chilena / Association between psoriasis and sexual health in a group of Chilean patients

Marco teórico: la asociación entre psoriasis y daño orgánico y psicológico está ampliamente descrita. Existen pocos estudios que la relacionen con la salud sexual. Objetivo: Establecer la relación entre cambios en la severidad de la psoriasis y la salud sexual en un grupo de pacientes chilenos. Pacientes y métodos: 47 pacientes chilenos portadores de psoriasis vulgar. Se realizó una encuesta epidemiológica, PASI y una entrevista llamada CSFQ-14, que evalúa la respuesta sexual. A los 3 meses de tratamiento, fueron reevaluados. Resultados: El PASI promedio disminuyó al tercer mes (p < 0.01). En los promedios de CSFQ-14, no hubo variación del total de la muestra (p > 0.05), pero al comparar sexos, tanto en día 1 como en día 3 fueron mayores en hombres (p < 0.01). Conclusión: En un primer estudio en población chilena, no se encontró relación entre cambios en la psoriasis y la salud sexual.

Background: The association between psoriasis and organic and mental damage is widely described. Few studies link this condition to sexual health. Objective: To establish the relationship between changes in the severity of psoriasis and sexual health in a group of Chilean patients. Patients and Methods:47 Chilean patients, submitted to an epidemiological survey, PASI, and an interview called CSFQ-14, which evaluates sexual response. After 3 months of treatment, they were re-assessed. Results: A decrease in average PASI was found after 3 months(p < 0.01). There was no change in the average CSFQ-14 scores of the total sample in the third month (p > 0.05). However, when comparing between sexes, either on day 1 or month 3, CSFQ-14 scores were higher in men (p < 0.01). Conclusion: In a first study using Chilean population, no relationship was found between changes in psoriasis and sexual health.

Purification of egg yolk immunoglobulin (IgY) by ultrafiltration: effect of pH, ionic strength, and membrane properties.

Immunoglobulin Y (IgY) was purified from hen egg yolk water-soluble protein fraction by ultrafiltration-diafiltration with different membranes. The effect of changing solution properties (pH and ionic strength) on purification factor (P), process selectivity (Psi), and IgY recovery (RIgY) was studied. Salt presence (150 and 1500 mM) decreased the selectivity and purity factor. This effect was more evident at pH values closer to or higher than the IgY's isoelectric point. The best results were obtained in the absence of salt at pH values of 5.7 and 6.7 using poliethersulfone (PES) and modified PES (MPES), respectively. Process selectivity was doubled, and IgY's purification factors were increased in more than 1 order of magnitude when diafiltration was used. Results from this work show the potential of membrane technology for the purification of IgY from hen's egg yolk.

[Usefulness of transesophageal echocardiography during myocardial revascularization surgery without extracorporeal circulation]. / Utilidad de la ecocardiografía transesofágica intraoperatoria durante revascularización miocárdica sin circulación extracorpórea.

OBJECTIVE: Intraoperative transesophageal echocardiography can be a highly useful monitoring technique during myocardial revascularization surgery when extracorporeal circulation (ECC) is not being used. Transesophageal echocardiography provides real-time images on both volume status and segmental myocardial contractility without interfering with the surgical field. PATIENTS AND METHODS: A total of 25 patients undergoing myocardial revascularization by sternotomy without ECC were monitored by transesophageal echocardiography during surgery. RESULTS: The 18 men and 7 women studied had a mean (SD) age of 71.3 (8) years. A third of them had hypertension and diabetes, 3 had suffered a cerebrovascular accident, and 2 had renal failure. Nine patients had a history of acute myocardial infarction and 3 had undergone angioplasty. Baseline echocardiograms on all patients established that 6 had a low ejection fraction (<30%). Twelve had altered segmental contractility, which was transient in 11 cases. Six patients had improved ejection fraction at the final assessment. Transesophageal electrocardiography also monitored volume status and the effects of inotropic drugs and beta-blockers in 83% of the patients. CONCLUSION: Transesophageal electrocardiography is a minimally invasive, safe, and precise way to directly monitor the beating heart in real time during myocardial revascularization without ECC. Image quality is good.

BCR/ABL p210, p190 and p230 fusion genes in 250 Mexican patients with chronic myeloid leukaemia (CML).

There are two major forms of the BCR/ABL fusion gene, involving ABL exon 2, but including different exons of BCR gene. The transcripts b2a2 or b3a2 code for a p210 protein. Another fusion gene leads to the expression of an e1a2 transcript, which codes for a p190 protein. Another, less common fusion gene is c3a2[e19a2], which encodes a p230 protein. The incidence of one or the other rearrangement in chronic myeloid leukaemia (CML) patients varies in different reported series. This study was designed to determine the frequency of coexpresion of the p210, p190 and p230 transcripts in 250 Mexican patients with CML. We performed nested and multiplex reverse transcriptase polymerase chain reaction (RT-PCR) on bone marrow samples from adult patients and found that all cases were positive for some type of BCR/ABL rearrangement. In 226 (90.4%) patients it was p210, while the remaining 9.6% showed coexpression or one of the transcripts of p190/p210/p230. In 7% of patients with p210 expression there are both isoforms (b3a2/b2a2), presumably the result of alternative splicing. The rate of coexpression of the p190/p210 transcripts was 5%, which is much lower than in other reports. This may be due to the technical factors. These patients had high platelet counts, marked splenomegaly and chromosomal abnormalities in addition to Ph'. Other types of coexpression seen were p210/p230 and p190/p210/p230, in patients with high-risk clinical factors. Our study confirms the occurrence of coexpression of different BCR/ABL transcripts, although the rate (9.6%) was much lower than has been reported in other populations. This may reflect either the sensitivity of the detection techniques used or the possibility of genetic differences between the populations studied. Coexpression may be due to alternative splicing or to phenotypic variation, with clinical courses different from classical CML.

Estudio de eficacia y seguridad de ofloxacina en diversas infecciones bacterianas / Study of ofloxacin efficacy and safe in diversity

Se estudiarón 64 pacientes infectados con rango de edad entre 16 y 84 años, a quienes se les administró ofloxacina. Las enfermedades incluídas en el estudio fuerón: infección de partes blandas 41,93 por ciento, infección del tracto respiratorio inferior 26,8 por ciento, infecciones del tracto urinario 24,2 por ciento, y otras infecciones (sepsis, meningitis bacteriana, complicación post-parto y politraumatismo) 6,4 por ciento. De acuerdo al grado de severidad la distribución fue la siguiente: leves: 3,23 por ciento, moderadas: 51,61 por ciento y severas: 41,94 por ciento. El tratamiento con ofloxacina se administró en dosis promedio de 800 mg/día durante 3-17 días (promedio=9,75+3,37). La evolución clínica fue curación en el 83,87 por ciento, mejoría 12,90 por ciento (curación + mejoría = 96,7 por ciento), no determinada 3,22 por ciento y fracaso 0 por ciento. La evaluación de la eficacia bacteriológica mostró erradicación 70 por ciento, erradicación/superinfección 12 por ciento, persistencia 2 por ciento, resistencia 0 por ciento y no determinado 16 por ciento. La evaluación global del tratamiento fue clasificada como excelente en el 67,24 por ciento de los pacientes, buena 27,59 por ciento (excelente +buena =94,8 por ciento), regular 5,17 por ciento. Ningún paciente fue considerado con evolución inadecuada. En cuanto a la toxicidad de la droga, se registraron reacciones adversas: ardor local, nauseas, mareos, sudoración, acidez, insomnio y rash. Estas fueron clasificadas según su severidad en leve (2) moderada (2) y severa (1) este último caso ameritó la suspensión de la droga. En conclusión, ofloxacina puede considerarse eficaz y segura para el tratamiento de infecciones bacterinas

Bioadhesives: a biotechnological opportunity.

Marine mussels secrete the byssus in order to attach to solid surfaces and to survive under the turbulent effects of waves. The adhesive responsible for this attachment is the polyphenolic protein secreted by the phenol gland in the foot of the animal. To purify this adhesive protein from the chilean mussel Mylilus chilensis, a modification of previous procedures has been developed. Accordingly, the protein is differentially precipitated with acetone in the presence of 0.25 N HCl. The purified protein is rich in the amino acids lysine, 3,4-dihydroxyphenylalanine, serine, threonine, proline and hydroxyproline. The protein exhibited strong adhesion to glass and other solid supports. Moreover, it has been found that the adhesive protein can mediate the immobilization of beta-galactosidase to glass. About 75% of the enzyme activity was immobilized under the experimental conditions described. This is the first study reporting the use of the polyphenolic protein to immobilize enzymes.