Vasculopatía Livedoide, la punta del témpano: a propósito de un caso / Livedoid vasculopathy, the tip of the iceberg: a case report

Resumen La vasculopatía livedoide (VL), es una enfermedad vascular oclusiva que afecta la microvasculatura, se caracteriza por ser recurrente y no inflamatoria. Su incidencia es de 1/100.000 casos por habitantes, afectando en su mayoría a mujeres de edad media. Su patogenia se desconoce, pero se destaca el componente trombótico de la misma, causado por un estado de hipercoagulabilidad, que conduce a la oclusión vascular, debiendo distinguirse una forma primaria y una secundaria.Clínicamente se observan úlceras dolorosas a nivel maleolar que evolucionan progresivamente a una cicatrización atrófica, blanquecina nacarada y estrellada característica.Presentamos un caso clínico en un varón con múltiples comorbilidades y difícil tratamiento, el cual requirió un trabajo multidisciplinario.

Abstract Livedoid vascular disease (VL), is an occlusive vascular disease that affects the microvasculature, is characterized by being recurrent and non-inflammatory. Its incidence is 1 / 100,000 cases per inhabitant, affecting mostly middle-aged women. Its pathogenesis is unknown, but its thrombotic component stands out, caused by a state of hypercoagulability, which leads to vascular occlusion, and a primary and secondary form must be distinguished. Clinically, painful ulcers are observed at the malleolar level, progressing progressively to characteristic atrophic, pearly whitish and starry healing. We present a clinical case in a male with multiple comorbidities and difficult management, which required multidisciplinary work.

Anisakis spp. larvae in different kinds of ready to eat products made of anchovies (Engraulis encrasicolus) sold in Italian supermarkets.

In this study the occurrence of visible anisakid larvae in semi-preserved anchovy products sold on the Italian market was investigated. Totally, 107 ready to eat products (33 salted-ripened, 49 in oil and 25 marinated) were sampled. Each sample was digested, then the digested material was observed under natural and UV light. Parasites were counted, collected and microscopically identified to genus level. A representative subset was molecularly identified using the cox2 gene. At least one visible Anisakis sp. larva was found in 54.2% of the total 107 products analysed and totally 1283 dead larvae were collected. Anisakis sp. larvae were found in all the 33 salted products and 1139 (88.8%) larvae were collected, with a range of 1-105 parasites per product. Larval density per gram was 0.13. Anisakis sp. larvae were found in 49.0% of the products in oil and 143 (11.1%) larvae were isolated, with a range of 0-28 and a density of 0.03. Only 1 larva was found in the 25 marinated products (4.0%, density 0.00). A highly significant difference between all the product categories in respect of number of larvae per product, frequency of products contaminated by at least one larva and larval density per gram was found. Within the subset of larvae molecularly analysed (n=122), 92 (75.4%) were identified as A. pegreffii and 30 (24.6%) as A. simplex. This study showed that semi-preserved anchovy products heavily contaminated with Anisakis spp. larvae reach the market. Beyond the negligible risk for anisakidosis, the presence of dead visible parasites may cause immediate rejection in consumers. In addition, the potential risk related to allergic reactions in sensitized individuals needs to be further assessed. In order to avoid commercialization of obviously contaminated products, fresh anchovies' batches intended for the production of such products should be accurately selected by the processing industry applying inspection methods.

Visceral larvae as a predictive index of the overall level of fish batch infection in European anchovies (Engraulis encrasicolus): A rapid procedure for Food Business Operators to assess marketability.

The European anchovy (Engraulis encrasicolus), one of the most important pelagic fish resources in the Mediterranean Sea, is frequently infected by anisakid larvae. Food Business Operators (FBOs) should use appropriate sampling plans and analytical methods to avoid commercialization of massively infected batches and reduce the risk of transmission of viable zoonotic larvae. In this study, performed at FishLab (Department of Veterinary Sciences of the University of Pisa) during 2016, an official sampling plan was associated with a digestion protocol for the inspection of anchovies. Considering that anisakid larvae are usually located in the fish visceral cavity and in the adjacent muscles (VM), this part was analyzed. In particular, we assessed the reliability of the digestion of a subsample of 150g (±30g) of VM, randomly collected from 29 specimens, in estimating the marketability of the anchovies' batch. Fifty-seven samples of 29 anchovies were collected. Each anchovy was sectioned to separate VM. All the subsamples were digested, and visible larvae counted. A high correlation between the number of larvae in VM regions and in the total batch was observed, indicating a very significant contribution of the VM region on total number of parasites. The Mean Abundance (MA) was used to assess the batch marketability according to a threshold calculated on the basis of the maximum number of nematodes tolerated per sample. Considering that the MA can be calculated only when the number of examined specimens is known, the number of visible Larvae per gram of tissue (LpG) was calculated on 150g (±30g) of VM subsamples. A LpG marketability threshold was calculated dividing the maximum number of tolerated nematodes by the average weight of a sample of 29 anchovies calculated considering data available in literature. To evaluate the diagnostic performance of the LpG threshold, the marketability of 57 batches assessed on the basis of the MA threshold was assumed as the gold standard. The proposed LpG showed very high Specificity and Sensitivity. These findings suggest that the analysis of VM is representative of the overall infestation of the batch, both when considering the absolute number of parasites and the LpG, and may represent a valid alternative to the whole anchovy digestion. In particular, the use of an automated digestive method, coupled with the aforesaid sampling plan, could allow the procedure to be used by FBOs in operational conditions.

Farmacodermia: la otra "gran simuladora" / Pharmacodermia: the other "great simulator"

Dentro de las reacciones adversas a fármacos (RAM), se destacan las farmacodermias por su frecuencia de presentación y por sus variantes clínicas que abarcan manifestaciones agudas graves y crónicas leves, que pueden simular gran variedad de patologías cutáneas. Presentamos el caso de una paciente de sexo femenino de 37 años de edad, con una farmacodermia leve y crónica secundaria a hidroxicloroquina. (AU)

Among adverse drug reactions (ADRs), pharmacodermatics are noteworthy because of their frequency of presentation and their clinical variants that include mild acute and chronic manifestations, which can mimic a wide variety of skin pathologies. We present the case of a female patient of 37 years of age, with a mild and chronic pharmacodermia secondary to hydroxychloroquine. (AU)

[Paraneoplastic dermatomyositis related to breast cancer: rare clinical association in two patients]. / Dermatomiositis paraneoplásica relacionada a cáncer de mama: asociación clínica en dos pacientes.

Paraneoplastic dermatomyositis is an inflammatory disease of the connective tissue that is caused by inmmunologic events in the presence of malignant tumors. It is more likely to happen in middle aged women and is related to ovarian, pancreatic, stomach and colon cancer and non Hogdkin lymphoma. We present two cases of dermatomyositis, with amyopathic origin associated to breast cancer. The first case occurs as the neoplasia evolves and the second one as an initial manifestation that leads to the search and subsequent diagnosis of cancer.

[Subacute diseminated histoplasmosis in HIV patients]. / Histoplasmosis diseminada subaguda en pacientes VIH.

Histoplasmosis is a cosmopolitan mycosis caused by Histoplasma capsulatum. It is endemic of Río de la Plata's riverbed and in immunocompromised patients may be deadly. We present two patients with Human Immunodeficiency Virus diagnosed with subacute disseminated histoplasmosis, which is a marker of Acquired Human Immunodeficiency Syndrome. This situation increases the morbimortality, thus forcing clinicians to diagnose and treat rapidly in order to avoid fatal outcomes.

La histoplasmosis es una micosis cosmopolita causada por el Histoplasmacapsulatum. Es un hongo endémico de la cuenca del Río de La Plata que si afecta a inmunosuprimidos puede ser mortal. Presentamos dos pacientes con Virus de Inmunodeficiencia Humana con diagnóstico de histoplasmosis diseminada subaguda. Esta situación los cataloga en estadío de Síndrome de Inmunodeficiencia Adquirida y requiere pronta acción médica para evitar complicaciones.

Labeling of ethnic food in the Prato Chinese community.

Ethnic food consumption is a quickly growing reality within Chinese communities, which have a well-organized "internal" food market for both Asian and ethnic foods produced in the European Union. The main problems associated with these markets are related to hygienic conditions, certifications of accomplishment, and personnel management. Moreover, controls and identification of the products are difficult because of cultural and linguistic barriers. In this study, five markets managed by the Chinese were visited, and the conformity of the reported label information found on different kinds of food (prepackaged or loose) was assessed by a collaboration between the Local Authorities of Control of the Prato territory, which hosts the largest Chinese community in Italy, and of native speakers of Chinese. All visited markets presented products (n = 75) with non-conformities: lack of translation (6%) and incomplete/mistaken translation of the commercial name (72%) and place of production (12%). In addition to the legal implications of the observed non-compliances, certain sanitary issues were taken into consideration. In fact, a number of the products that belong to risk categories could be misclassified in a non-risk category. Lastly, missing ingredients or complete alteration of their commercial names may represent health threats in cases of allergen ingestion by allergic or intolerant consumers.

Effects of growth hormone treatment on the expression of somatotropic axis genes in the skeletal muscle of lactating Holstein cows.

This study focused on the expression of somatotropic axis genes in the skeletal muscle of dairy cattle. A slow-release recombinant bovine growth hormone (GH) (rbGH) formulation was administered to 5 cows, and saline solution (control) was administered to another 5 cows every 2 wk for a total of 10 wk, starting from the peak of lactation. Tissue and blood samples were collected on days 2 and 14 after each rbGH injection. As target genes insulin-like growth factor (IGF)-1, IGF-2, IGFBPs (1, 2, 3, 4, 5, 6), acute labile subunit (ALS), IGF-1 receptor (IGF-1R), GH receptor (GHR), and the known GHR 5'-UTR variants were selected as target genes, and their relative expression was measured using real-time polymerase chain reaction. In GH-treated cows, an increase in expression was observed for GHR 5'-UTR variant 1I on day 14 (P < 0.05), whereas a significant down-regulation of GHR (P < 0.05) was found after comparing values of treated cows between day 2 and day 14. However, only IGF binding proteins (BP)-5 was found to be appreciably up-regulated in GH-treated cows (P < 0.001), which may indicate the importance of this gene in the overall molecular response to GH administration. Our study indicated that GH treatment did not affect the expression of most somatotropic axis genes, despite the marked increase in GH and IGF-1 in blood (P < 0.001). Nor did it have a large impact on the proportion of GHR 5'-UTR variants in the skeletal muscle of lactating cows. Finally, although we observed a significant variation in the expression of some genes, it would appear that the differences between GH-treated cows and controls were not great enough to be considered as reliable indirect indicators of GH treatment in dairy cattle.

Praziquantel efficacy and long-term appraisal of schistosomiasis control in Pemba Island.

OBJECTIVE: To determine whether praziquantel (PZQ) has retained its efficacy against Schistosoma haematobium on Pemba Island after 20 years of mass administration--albeit discontinuous--and to analyse retrospectively the performance of schistosomiasis control programmes. METHODS: A sample of Pemba schoolchildren was examined before and after PZQ treatment by urine filtration, macro- and micro-haematuria and viability of excreted eggs. RESULTS: Although 5% of treated children continued to pass some eggs in the urine up to the seventh week after PZQ administration, none of these eggs was viable, indicating an effective schistosomicidal activity followed by a slow release of dead eggs from host tissues. CONCLUSION: No signs of PZQ resistance could be detected in the population under study. An overall retrospective analysis of schistosomiasis control activities in Pemba Island revealed that mass drug administration is clearly effective in reducing infection prevalence, but soon after interruption of drug distribution prevalence returns rapidly to pre-intervention levels.

On the alterations in serum concentration of somatotropin and insuline-like growth factor 1 in lactating cows after the treatment with a little studied recombinant bovine somatotropin.

A study was performed to delineate bST and IGF-1 variation, over a whole lactation, in cows treated with a nowadays widely commercialised but little studied sustained release formulation of recombinant bST. Total bST levels were found to be exceptionally high in the first days after administration, but decreased rapidly in the second week after injection. The increase in the IGF-1 serum concentration was significant for almost the entire biweekly cycle. Based on this study, the peaks of ST (often above 100 ng/ml) are considered particularly unlikely to be found in non-treated bovines, even under pathological conditions, especially when detected in a number of animals within a herd. Notwithstanding the great heterogeneity of results on this topic, these data suggest that tests against fraud involving the use of rbST in dairy products may be regarded as a feasible possibility.

Tricyclic structures in medicinal chemistry: an overview of their recent uses in non-CNS pathologies.

Tricyclic compounds are sometimes considered as synonima of drugs healing central nervous system pathologies, although there are some well known examples of tricyclic derivatives marketed for different indications, such as antihistamines, antivirals and antiulceratives. Following the insertion of tricyclic structures in the "privileged structures" pool, several compounds bearing a central 7-membered ring and two aryl rings at its sides have been reported, and some of them have been progressed to advanced clinical trials. An overview of tricyclic derivatives reported in the literature since 1995, that are investigated for indications not directly related to central nervous system affections, shows the potential of these structures in a broad range of therapeutical indications, going from antiviral and anticancer compounds to the therapy of cardiovascular diseases. Very recent examples confirm the usefulness of tricyclic structures for the modern medicinal chemists.

What kind of formation in the multiethnic culture of the European Union of the third millennium?

Even though occidental food production and control systems guarantee a reasonable level of safety for consumers, western countries are facing a growing phenomenon of immigration from all over the world. With this enrichment and the shuffling of cultures and customs in the same places, even alimentary habits undergo an unavoidable evolution, also influencing the commercial trends of society. The growing demand for ethnic products, often of uncertain provenance, composition and manufacturing, has motivated the appearance of illegal trade and markets or improper local productions besides the legal ones, implying a rise in hygienic risks for the consumers. These underground realities, together with the unfilled gap that still exists between different cultures and customs cause significant difficulties in carrying out efficient controls to guarantee sanitary safety for consumers. For this reason, the risks associated with this increasing globalization must be faced with proper information and a decisive formative strategy must be divided, in order to allow the operator of the whole system and control employees to be acquainted about different raw materials, manufacturing systems, alimentary habits, languages for communication and commercial dynamics which stand beyond the new alimentary trends.

Biochemical survey on episodic localized darkening in turkey deboned thigh meat packaged in modified atmosphere.

The color of food, especially meat and meat products, is a parameter that strongly influences consumer choice. In Italy, repeated cases of darkening in deboned thigh meat of male turkeys packaged in modified atmosphere (MAP; 80% 02, 20% CO2) have been reported. The pH, lipid oxidation (TBARS), heme proteins, and iron content were investigated in MAP samples of turkey males, females, and in oxygen-permeable film-packaged males. Furthermore, the absorbance spectrum (400 to 700 nm) of the meat extracts was analyzed to better delineate the evolution and characteristics of the darkening process. Results showed that darkening occurred only in males with higher content of total iron, independently of the content of heme proteins, which differs only between males and females. Furthermore, pH was higher in muscles taken as controls, with respect to muscles involved in the darkening, as well as in females. Finally, TBARS values were found to be higher in darkened regions than in not darkened ones, as well as in MAP samples with respect to oxygen-permeable film-packaged samples. These findings suggest that darkening occurrence might depend on kind of muscle, sex, and individual characteristics of the animals raised under the same breeding conditions.

[Perceptive and semantic selection difficulties and cognitive aging]. / Difficulté de sélection perceptive et sémantique liée au vieillissement cognitif.

This work took place within tipper's negative priming paradigm. In a study with two age groups (young and older adults), Connelly and Hasher have measured the identity negative priming, the location negative priming and the "identity and location" negative priming. They used a simple material (letters). For these authors, the young people showed the negative priming effect in all the conditions, but the older people showed this effect only in location and in "identity and location" conditions, but there was no effect in identity condition. Hence, there is a dissociation between identity and location in the older adults group. Our work replicated the procedure of Connelly and Hasher using material presenting semantic (words) and perceptive selection difficulties. Our results were not consistent with the results of the authors. For the two age groups, the "location" and "identity and location" conditions were computed statistically faster than the "identity" condition, and there was no difference in the reaction times between the "location" and "identity and location" conditions. In the young adults group, even if an identity negative priming was obtained, there was no effect in the "location" and "identity and location" conditions (in comparison with a control condition). This led us to conclude is the existence of a dissociation between identity and location for the young adults. In the older adults group, we obtained positive priming in the "identity and location" condition, and no effect in the other conditions. Moreover, the reaction times in the "location" and "identity and location" conditions were faster than in the identity condition. We think about a dissociation between identity and location in the older group. Our data led us to conclude in the existence of a dissociation between identity and location, not only for the older adults, but also for the young adults. Our conclusion agrees with the explanations given by the authors regarding the neurological system; with the existence of two neuronal pathways, one for the identity and the other for the location. We explain the negative priming effect obtained in the young adults group through controlled inhibition processes, and we explain the positive priming obtained in the older adults group through automatic recuperation processes.