Neurocysticercosis mimicking craniopharyngioma: A case report.

Key Clinical Message: In patients with appropriate epidemiological risk factors, neurocysticecosis should be considered as part of the differential diagnosis of suprasellar or parasellar mass lesions. As neuroimaging findings can be nonspecific, serology may be helpful, but when still in doubt, brain biopsy, and histopathology may be necessary to make the correct diagnosis. Abstract: Neurocysticercosis (NCC) is a well-documented central nervous system helminth infection that is, frequently observed in developing countries. Known sites of NCC infection include the highly vascular gray-white matter junction, basal cistern, brain parenchyma, subarachnoid space, ventricular system, and spinal cord. This case highlights an uncommon yet intriguing site of NCC infection within the suprasellar area, which presented with similar clinical and imaging characteristics as suprasellar masses or lesions. The 44-year-old female initially complained of headaches and nausea that persisted for 5 years and progressed to vision problems and short-term memory loss. A craniopharyngioma was initially suspected, based on imaging findings of a partially calcified suprasellar tumor. However, cysticercosis was confirmed by histopathology and serological testing positive for Cysticercus IgG antibodies. The patient was successfully treated with albendazole and tapering doses of steroids, which improved her presenting symptoms and resolved prior imaging findings. This case serves as a reminder to consider NCC in the differential diagnosis of sellar and suprasellar masses or lesions, particularly when an epidemiologic risk factor is present.

Comparative proteomic profiling of uric acid, ammonium acid urate, and calcium-based kidney stones.

INTRODUCTION: Kidney stone matrix proteins may help explain cellular mechanisms of stone genesis. However, most existing proteomic studies have focused on calcium oxalate stones. Here, we present a comparative proteomic analysis of different kidney stone types. METHODS: Proteins were extracted from the stones of patients undergoing percutaneous nephrolithotomy (PCNL). Approximately 20 µg of protein was digested into tryptic peptides using filter aided sample preparation, followed by liquid chromatography tandem-mass-spectrometry using an EASY-nLC 1200 and Orbitrap Fusion Lumos mass spectrometer. A standard false discovery rate cutoff of 1% was used for protein identification. Stone analysis was used to organize stone samples into similar groups. We selected the top 5% of proteins based on total ion intensities and used DAVID and Ingenuity Pathway Analysis to identify and compare significantly enriched gene ontologies and pathways between groups. RESULTS: Six specimens were included and organized into the following four groups: 1) mixed uric acid (UA) and calcium-based, 2) pure UA, 3) pure ammonium acid urate (AAU), and 4) pure calcium-based. We identified 2,426 unique proteins (1,310-1,699 per sample), with 11-16 significantly enriched KEGG pathways identified per group and compared via heatmap. Based on number of unique proteins identified, this is the deepest proteomic study of kidney stones to date and the first such study of an AAU stone. CONCLUSIONS: The results indicate that mixed UA and calcium-based kidney stones are more similar to pure UA stones than pure calcium-based stones. AAU stones appear more similar to pure calcium-based stones than UA containing stones and may be related to parasitic infections. Further research with larger cohorts and histopathologic correlation is warranted.

Receptor-interacting protein kinase 2 (RIPK2) stabilizes c-Myc and is a therapeutic target in prostate cancer metastasis.

Despite progress in prostate cancer (PC) therapeutics, distant metastasis remains a major cause of morbidity and mortality from PC. Thus, there is growing recognition that preventing or delaying PC metastasis holds great potential for substantially improving patient outcomes. Here we show receptor-interacting protein kinase 2 (RIPK2) is a clinically actionable target for inhibiting PC metastasis. RIPK2 is amplified/gained in ~65% of lethal metastatic castration-resistant PC. Its overexpression is associated with disease progression and poor prognosis, and its genetic knockout substantially reduces PC metastasis. Multi-level proteomics analyses reveal that RIPK2 strongly regulates the stability and activity of c-Myc (a driver of metastasis), largely via binding to and activating mitogen-activated protein kinase kinase 7 (MKK7), which we identify as a direct c-Myc-S62 kinase. RIPK2 inhibition by preclinical and clinical drugs inactivates the noncanonical RIPK2/MKK7/c-Myc pathway and effectively impairs PC metastatic outgrowth. These results support targeting RIPK2 signaling to extend metastasis-free and overall survival.

Concerns About The Integrity of The Scientific Research Process-Focus On Recent Negative Publications Regarding Nutrition, Multivitamins, Fish Oil And Cardiovascular Disease.

The next step in reestablishing credibility seams to us honesty and recognizing we all share a common goal of the health and wellness of the human community and the planet. Everyone agrees that the current healthcare system, despite its many incredible successes, is also showing its limitations and is no longer sustainable. We believe the solution starts with us the researchers and editors. A good first step might be formally recognizing the errors and showing how we can and intend to get better.

Biological plausibility of the gut-brain axis in autism.

Organic abnormalities with neuroinflammatory and psychiatric consequences involving abnormal kynurenine and purine metabolism, neurotransmitter and cytokine imbalances, and altered levels of nutrients and metabolites are noted in autism, and many of these abnormalities-specifically including increased intestinal permeability, microbial metabolites, and heightened serum levels of endotoxin-originate from the gut.

Treatment of hypovitaminosis D in infants and toddlers.

CONTEXT: Hypovitaminosis D appears to be on the rise in young children, with implications for skeletal and overall health. OBJECTIVE: The objective of the study was to compare the safety and efficacy of vitamin D2 daily, vitamin D2 weekly, and vitamin D3 daily, combined with supplemental calcium, in raising serum 25-hydroxyvitamin D [25(OH)D] and lowering PTH concentrations. DESIGN: This was a 6-wk randomized controlled trial. SETTING: The study was conducted at an urban pediatric clinic in Boston. SUBJECTS: Forty otherwise healthy infants and toddlers with hypovitaminosis D [25(OH)D < 20 ng/ml] participated in the study. INTERVENTIONS: Participants were assigned to one of three regimens: 2,000 IU oral vitamin D2 daily, 50,000 IU vitamin D2 weekly, or 2,000 IU vitamin D3 daily. Each was also prescribed elemental calcium (50 mg/kg.d). Infants received treatment for 6 wk. MAIN OUTCOME MEASURES: Before and after treatment, serum measurements of 25(OH)D, PTH, calcium, and alkaline phosphatase were taken. RESULTS: All treatments approximately tripled the 25(OH)D concentration. Preplanned comparisons were nonsignificant: daily vitamin D2 vs. weekly vitamin D2 (12% difference in effect, P = 0.66) and daily D2 vs. daily D3 (7%, P = 0.82). The mean serum calcium change was small and similar in the three groups. There was no significant difference in PTH suppression. CONCLUSIONS: Short-term vitamin D2 2,000 IU daily, vitamin D2 50,000 IU weekly, or vitamin D3 2,000 IU daily yield equivalent outcomes in the treatment of hypovitaminosis D among young children. Therefore, pediatric providers can individualize the treatment regimen for a given patient to ensure compliance, given that no difference in efficacy or safety was noted among these three common treatment regimens.

Vaginitis en mujeres sexualmente activas. Centro de Salud Urubamba enero - abril 2001 / Vaginitis in sexually active women. Center of Health Urubamba January - April 2001

El flujo vaginal es una de las molestias principales de la vaginitis, siendo motivo frecuente de consulta ginecológica en mujeres sexualmente activas. El objetivo del presente estudio fué determinar los gérmenes más frecuentes que causan esta patología. Se aplicó un cuestionario a 80 pacientes que cumplieron con los criterios de inclusión. La edad osciló entre 18 y 45 años con una media de 30 años. El estado civil de conviviente se presentó en 50 por ciento, grado de instrucción secundaria 60 por ciento y la ocupación ama de casa fué la más frecuente, un 80 por ciento no tuvo tratamiento previo, siendo el síntoma más frecuente el prurito vaginal (48 por ciento) y el tiempo de enfermedad promedio 6 meses. Se concluye que el gérmen causal más frecuente de infección vaginal fué la gadnerella (55 por ciento) seguido por la cándida (22 por ciento) y trichomona (12 por ciento), existiendo un 12 por ciento de pacientes con infección mixta.

Depresión en pacientes adultos con diabetes / Depression in adults patients whith diabetes

El objetivo de este trabajo fue el de determinar la prevalencia en pacientes diabéticos en la consulta externa del Hospital Loayza y relacionar la depresión con factores psicosociales tanto en varones como en mujeres y si estas se asociaban manifestaciones tardías de la diabetes, también se determinó la prevalencia según el tratamiento recibido. METODOLOGIA mediante una encuesta sencilla se comprobó que el médico diabetólogo o el internista está en la capacidad de diagnosticar y asesorar a pacientes con transtornos depresivos. MATERIAL Y METODOS de agosto 1994 a marzo de 1995 se estudiaron a 50 pacientes que tuvieron el diagnóstico de Diabetes mellitus y a un grupo de 50 pacientes con enfermedades crónicas y 50 pacientes de la población general; que constutuyeron el grupo control. A todos estos pacientes incluídos en el estudio se les practicó el test de Beck. RESULTADOS los pacientes crónicos y diabéticos reportaron niveles más altos de sintomatología depresiva que la población en general (p<0.05), en cuanto al sexo se vió que no había mayor prevalencia de depresión en mujeres que en hombres (p>0.05). En cuanto a la depresión según grado de instrucción se vió que no había diferencia estadística entre los grupos en estudio. En relación al tratamiento que recibían los pacientes diabéticos se observó que en los pacientes que recibían tratamiento farmacológico la depresión no era más prevalente que en los pacientes, que sólo usaban dieta como tratamiento (p>0.05). Los pacientes que presentaban complicaciones crónicas de la diabetes la sintomatología depresiva no era más frecuente. Debido a que el intervalo de depresión de Beck toma como componentes somáticos de depresión sólo se estudió la sintomatología depresiva pero no la depresión clínica (p>0.05). CONCLUSIONES la depresión es más prevalente en la diabetes y enfermedades crónicas que en la población en general