Efficacy of an aloe vera, chamomile, and thyme cosmetic cream for the prophylaxis and treatment of mild dermatitis induced by radiation therapy in breast cancer patients (the Alantel study).

Objectives: Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design: We conducted a controlled, randomized, double-blind clinical trial. Setting: Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions: Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures: The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results: Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions: The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.

First report of Stegomyia aegypti (= Aedes aegypti) in Mexico City, Mexico.

Stegomyia aegypti (= Aedes aegypti) (Diptera: Culicidae) is a species of mosquito that is currently widespread in Mexico. Historically, the mosquito has been distributed across most tropical and subtropical areas lower than 1700 m a.s.l. Currently, populations that are found at higher altitudes in regions with cold and dry climates suggest that these conditions do not limit the colonization and population growth of S. aegypti. During a survey of mosquitoes in September 2015, larvae of S. aegypti mosquitoes were found in two different localities in Mexico City, which is located at about 2250 m a.s.l. Mexico City is the most populous city in Mexico and has inefficient drainage and water supply systems. These factors may result in the provision of numerous larval breeding sites. Mosquito monitoring and surveillance are now priorities for the city.

[Evaluation of topical vasoconstrictors in pterygium surgery and their role in reducing intraoperative bleeding]. / Evaluación de vasoconstrictores tópicos en la cirugía del pterigión y su papel en la disminución del sangrado intraoperatorio.

OBJECTIVE: To reduce vascularisation before surgery through the application of topical vasoconstrictors, decreases the rate of intraoperative bleeding, improves the dynamics of the surgery and reduces the difficulty in surgical performance. METHODS: Only patients with primary pterygium were included in the study. A prospective randomized clinical trial was designed to compare intraoperative bleeding, need for cauterization and surgical time a group that was administered phenylephrine. preoperatively and one which did not receive it. The sample was divided into two groups: 1st (n=27) received topical phenylephrine (F) 0.1 ml (10%), twice in 5 minutes before surgery. 2nd (n=30) did not receive phenylephrine (NoF). The technique was similar in both groups using conjunctival autograft suturing. In both groups, the subconjunctival aneasthesia was performed with 0.5% bupivacaine hydrochloride with epinephrine 1:200,000. RESULTS: A total of 57 patients were included in the study. The mean operation time for group F was 15.57 minutes (SD: 1.8 min) and the NoF group 16.51 min (SD to 1.82 min, P=.057). In the group F, it was necessary to use diathermy in 2 patients (7.4%) and in the NoF group cauterisation was used in 14 patients (46.7%, Chi-Square=10.848, P=.001. There is a relative risk 6.3 (95% CI 1.57 - 25.27) times greater than having to cauterise without phenylephrine when used phenylephrine. CONCLUSIONS: The use of topical vasconstrictors prior to pterygium surgery reduces the rate of bleeding and the time of surgery.

Evaluación de vasoconstrictores tópicos en la cirugía del pterigión y su papel en la disminución del sangrado intraoperatorio / Evaluation of topical vasoconstrictors in pterygium surgery and their role in reducing intraoperative bleeding

Objetivo: Reducir la vascularización previa a la cirugía mediante la aplicación de vasoconstrictorestópicos disminuye la tasa de sangrado intraoperatorio, mejora la dinámica de lacirugía y reduce la dificultad de la actuación quirúrgicaMétodos: Sólo los pacientes con pterigión primario se incluyeron en el estudio. Un ensayoclínico aleatorizado prospectivo fue diseñado para comparar el sangrado intraoperatorio,necesidad de cauterización y tiempo de cirugía entre los grupos a los que se les administró ono fenilefrina preoperatoriamente. Lamuestra se dividió en dos grupos: 1◦ (n = 27) recibieronfenilefrina tópica (F) 0,1 ml (10%) por dos veces 5 minutos antes de la cirugía; 2◦ (n = 30) no seadministró fenilefrina (NoF). La técnica fue similar en ambos grupos, mediante autoinjertoconjuntival y sutura. En ambos, la anestesia subconjuntival se realiza con 0,5% de clorhidratode bupivacaína con epinefrina 1:200.000.Resultados: Un total de 57 pacientes se incluyeron en el estudio. Lamedia del tiempo quirúrgicopara el grupo F fue de 15,57 minutos (SD: 1,8 min) y para el grupo de NoF de 16,51 min(SD; 1,82 min; p = 0,057). En el grupo F, fue necesario usar la diatermia en 2 pacientes (7,4%),en el NoF se usó la cauterización en 14 pacientes (46,7%; Chi-cuadrado = 10,848; p = 0,001.Existe un riesgo relativo 6,3 (IC 95%: 1,57 a 25,27) veces mayor de tener que cauterizar sinfenilefrina que cuando se usa fenilefrina.Conclusiones: El uso de vasconstrictores tópicos previos a la cirugía de pterigión disminuyela tasa de sangrado y reduce el tiempo de cirugía(AU)

Objective: To reduce vascularisation before surgery through the application of topical vasoconstrictors,decreases the rate of intraoperative bleeding, improves the dynamics of thesurgery and reduces the difficulty in surgical performance.Methods: Only patients with primary pterygium were included in the study. A prospectiverandomized clinical trial was designed to compare intraoperative bleeding, need for cauterizationand surgical time a group thatwas administered phenylephrine. preoperatively andone which did not receive it. The sample was divided into two groups: 1st (n = 27) receivedtopical phenylephrine (F) 0.1 ml (10%), twice in 5 minutes before surgery. 2nd (n = 30) did notreceive phenylephrine (NoF). The technique was similar in both groups using conjunctivalautograft suturing. In both groups, the subconjunctival aneasthesia was performed with0.5% bupivacaine hydrochloride with epinephrine 1:200,000.Results: A total of 57 patients were included in the study. The mean operation time for groupF was 15.57 minutes (SD: 1.8 min) and the NoF group 16.51 min (SD to 1.82 min, P = .057). Inthe group F, it was necessary to use diathermy in 2 patients (7.4%) and in the NoF groupcauterisation was used in 14 patients (46.7%, Chi-Square = 10.848, P = .001. There is a relativerisk 6.3 (95% CI 1.57 - 25.27) times greater than having to cauterise without phenylephrinewhen used phenylephrine.Conclusions: The use of topical vasconstrictors prior to pterygium surgery reduces the rateof bleeding and the time of surgery(AU)

[IGF-I, VEGF and bFGF as predictive factors for the onset of retinopathy of prematurity (ROP)]. / IGF-I, VEGF y bFGF, como factores pronósticos de la aparición de la retinopatía de la prematuridad.

OBJECTIVE: To determine if IGF-I, VEGF and bFGF, present in the serum of premature infants, are independent risk factors of the development of ROP. It was also our objective to design a multivariate model that included these three cytokines as indicator parameters in the ROP screening, in addition to the other parameters already in existence. METHODS: 74 patients were recruited with a birth weight below 1500g or gestational age below 32 weeks. These were classified into those who developed ROP (N = 37) and those without ROP (N = 37). We obtained serum from each infant at the time of the first examination at 4-6 postnatal weeks. These samples were frozen until the time of analysis. The roles of gestational age and birth weight were also evaluated. RESULTS: There were significant differences in the amount of the cytokines IGF-I and VEGF between the groups with or without ROP, but there were no significant differences for bFGF. The differences enabled us to establish a multivariate model including IGF-I and VEGF for the prediction of risk of ROP. CONCLUSIONS: Cytokine serum levels in premature infants can be useful as an indicator in ROP screening, as well as being used to predict the probability of suffering the illness.

IGF-I, VEGF y b-FGF, como factores pronósticos de la aparición de la retinopatía de la prematuridad / IGF-I, VEGF and b-FGF as predictive factors for the onset of retinopathy of prematurity (ROP)

Objetivo: Identificar en suero de prematuros a IGF, VEGF y bFGF, como factores de riesgo independientes en el desarrollo de la ROP. Es también nuestro objetivo el diseño de un modelo multivariante que englobe a las tres citokinas y que este pueda ser usado como parámetro indicador del examen de la ROP, además de los ya existentes. Métodos: 74 pacientes prematuros fueron reclutados con un peso al nacer menor de 1500 grs o edad gestacional menor de 32 semanas, y fueron divididos en pacientes enfermos de ROP (N=37) y pacientes no enfermos de ROP (N=37). Se tomaron muestras de sangre de cada paciente, coincidiendo con el primer examen, entre la 4 a 6 primeras semanas de vida y estas fueron congeladas en espera de su determinación. La edad gestacional y el peso al nacer fueron evaluados. Resultados: Encontramos diferencias significativas entre grupos en función de los valores de IGF-I y VEGF, pero no encontramos diferencias en función de la bFGF. Establecimos un modelo multivariante incluyendo a la IGF-I y VEGF, para la predicción del riesgo de padecer ROP en función de estas dos citokinas. Conclusiones: Los niveles en sangre de prematuros de estas citokinas pueden ser usados como factores indicadores del examen de la ROP, así como para predecir la probabilidad de sufrir la enfermedad

Objective: To determine if IGF-I, VEGF and bFGF, present in the serum of premature infants, are independent risk factors of the development of ROP. It was also our objective to design a multivariate model that included these three cytokines as indicator parameters in the ROP screening, in addition to the other parameters already in existence. Methods: 74 patients were recruited with a birth weight below 1500g or gestational age below 32 weeks. These were classified into those who developed ROP (N = 37) and those without ROP (N = 37). We obtained serum from each infant at the time of the first examination at 4-6 postnatal weeks. These samples were frozen until the time of analysis. The roles of gestational age and birth weight were also evaluated. Results: There were significant differences in the amount of the cytokines IGF-I and VEGF between the groups with or without ROP, but there were no significant differences for bFGF. The differences enabled us to establish a multivariate model including IGF-I and VEGF for the prediction of risk of ROP. Conclusions: Cytokine serum levels in premature infants can be useful as an indicator in ROP screening, as well as being used to predict the probability of suffering the illness

The local immune response in ulcerative lesions of Buruli disease.

Buruli disease (BU) is a progressive necrotic and ulcerative disease of the skin and subcutaneous tissue caused by Mycobacterium ulcerans. BU is considered the third most common mycobacterial disease after tuberculosis and leprosy. Three clinical stages of the cutaneous lesions have been described in BU: pre-ulcerative, ulcerative and healed lesions. In this study we used immunohistochemistry and automated morphometry to determine the percentage of macrophages and of CD4/CD8 lymphocytes and their expression of interferon (IFN)-gamma, interleukin (IL)-10, tumour necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta. Expression of these cytokines was correlated with the inflammatory response evaluated by histopathology. All the studied BU ulcerative cases showed extensive necrosis and chronic inflammation. The most important feature was the presence or absence of granulomas co-existing with a mixed pro-inflammatory/anti-inflammatory cytokine balance. When granulomas were present significantly higher expression of IFN-gamma was seen, whereas in ulcerative lesions without granulomas there was increased expression of IL-10 and significantly higher bacillary counts. These features correlated with the chronicity of the lesions; longer-lasting lesions showed granulomas. Thus, granulomas were absent from relatively early ulcerative lesions, which contained more bacilli and little IFN-gamma, suggesting that at this stage of the disease strong suppression of the protective cellular immune response facilitates proliferation of bacilli.

[Serum IGF-I levels in retinopathy of prematurity. New indications for ROP screening]. / Valores de IGF-I séricos en la ROP. Buscando nuevas indicaciones para su screening.

OBJECTIVE: To determine the IGF-I serum levels in premature infants with the objective of being able to use these levels as an indicator of the need for exploration in a screening program for retinopathy of prematurity (ROP). METHODS: This was a comparative study in which IGF-I levels were measured in every infants' serum during the first exploration in the 4 to 6 postnatal weeks. The degree of ROP and a variety of morbidity factors were evaluated, including the presence of intraventricular haemorrhage, sepsis, need for blood transfusion and the number of days of mechanical ventilation. RESULTS: The average IGF-I values during the first 4 to 6 postnatal weeks were lowest in the ROP cases (10.75 microg/L SD 16.053) while the NO-ROP cases yielded higher values (29.75 microg/L, SD 13.022). The Mann-Whitney U test showed a value of P for the IGF-I values of 0.004, indicating significant differences between the groups with or without ROP. CONCLUSIONS: The low IGF-I serum levels in ROP infants in comparison with the NO-ROP cases, suggest that this marker could be used as an indicator in the screening for ROP.

Valores de IGF-I séricos en la ROP. Buscando nuevas indicaciones para su screening / Serum IGF-I levels in retinopathy of prematurity. New indications for ROP screening

Objetivo: Determinar los niveles séricos IGF-I en niños prematuros con el objetivo de que éstos, pueden ser usados como indicadores de la exploración en el despistaje de la ROP.Método: Nuestro estudio se diseña como transversal comparativo, midiendo los valores de IGF-I en suero de cada niño en la primera exploración entre las primeras 4-6 semanas postnatales. Se evaluaron el grado de ROP y otros factores de morbilidad: hemorragia intraventricular, sepsis, transfusiones y días de ventilación mecánica.Resultados: Los valores medios de la IGF-I entre las 4-6 primeras semanas postnatales fue más baja en los casos de ROP, 10,75 µg/L D.E. 16,053, siendo los casos de No ROP de 29,75 µg/L D.E. 13,022. El test de la U de Mann-Whitney reflejó un valor de la P para los valores de IGF-I de .004, indicando así diferencias significativas entre los dos grupos.Conclusión: Los bajos niveles de IGF-I séricos en niños con ROP en comparación con los casos de no ROP, sugieren que este marcador podría servir como indicador del screening de la ROP

Objective: To determine the IGF-I serum levels in premature infants with the objective of being able to use these levels as an indicator of the need for exploration in a screening program for retinopathy of prematurity (ROP).Methods: This was a comparative study in which IGF-I levels were measured in every infants’ serum during the first exploration in the 4 to 6 postnatal weeks. The degree of ROP and a variety of morbidity factors were evaluated, including the presence of intraventricular haemorrhage, sepsis, need for blood transfusion and the number of days of mechanical ventilation.Results: The average IGF-I values during the first 4 to 6 postnatal weeks were lowest in the ROP cases (10.75 µg/L SD 16.053) while the NO-ROP cases yielded higher values (29.75 µg/L, SD 13.022). The Mann-Whitney U test showed a value of P for the IGF-I values of 0.004, indicating significant differences between the groups with or without ROP.Conclusions: The low IGF-I serum levels in ROP infants in comparison with the NO-ROP cases, suggest that this marker could be used as an indicator in the screening for ROP

Expression of cyclooxygenase type 2 in lepromatous and tuberculoid leprosy lesions.

BACKGROUND: Leprosy is an infectious disease with two polar forms, tuberculoid leprosy (TL) and lepromatous leprosy (LL), which are dominated by T-helper (Th) 1 and Th2 cells, respectively. High concentrations of prostaglandin E2 produced by the inducible enzyme cyclooxygenase type 2 (COX-2) in LL could inhibit Th1 cytokine production, contributing to T-cell anergy. OBJECTIVES: To compare the COX-2 expression in LL and TL. METHODS: Skin biopsies from 40 leprosy patients (LL, n = 20; TL, n = 20) were used to determine by immunohistochemistry and automated morphometry the percentage of COX-2 immunostained cells. RESULTS: Most COX-2-positive cells were macrophages; their percentages in the inflammatory infiltrate located in the papillary dermis, reticular dermis and periadnexally were significantly higher in LL than TL (P < 0.001 by Student's t-test). CONCLUSIONS: The high expression of COX-2 in LL may be related to high prostaglandin production contributing to T-cell anergy.

Expression of transforming growth factor-beta isoforms and their receptors in lepromatous and tuberculoid leprosy.

Leprosy is an infectious disease with two polar forms, tuberculoid leprosy (TT) and lepromatous leprosy (LL), that are characterized by strong cell-mediated immunity (CMI) and CMI anergy, respectively. Transforming growth factor-beta (TGF-beta) belongs to a family of pleiotropic cytokines (TGF-beta1, TGF-beta2 and TGF-beta3) that participate in the control of cell differentiation and proliferation, as well as tissue repair. This cytokine family is unique because it suppresses CMI. In this study, we compared the expression of the three TGF-beta isoforms and their receptors in skin biopsies from LL and TT patients (LL = 20; TT = 20) using immunohistochemistry and automated morphometry. The percentage of cells immunostained for the three TGF-beta isoforms and cells positive for the three TGF-beta receptors in the inflammatory infiltrate located in the papillary dermis, reticular dermis and periadnexal tissue were significantly higher in LL than that in TT, with macrophages being the most common and strongest immunoreactive cells. Some lymphocytes, fibroblasts, keratinocytes and epithelial cells from sweat glands and hair roots were also positive. In situ reverse-transcription polymerase chain reaction corroborated the capacity of these cells to synthesize TGF-beta1 and TGF-beta receptor 2. This high expression of TGF-beta isoforms and their receptors could contribute to CMI anergy and other clinical characteristic features of leprosy, like skin atrophy.

Expression of transforming growth factor-beta isoforms and their receptors in lepromatous and tuberculoid leprosy

Leprosy is an infectious disease with two polar forms, tuberculoid leprosy (TT) and lepromatous leprosy (LL), that are characterized by strong cell-mediated immunity (CMI) and CMI anergy, respectively. Transforming growth factor-beta (TGF-beta) belongs to a family of pleiotropic cytokines (TGF-beta1, TGF-beta2 and TGF-beta3) that participate in the control of cell differentiation and proliferation, as well as tissue repair. This cytokine family is unique because it suppresses CMI. In this study, we compared the expression of the three TGF-beta isoforms and their receptors in skin biopsies from LL and TT patients (LL = 20; TT = 20) using immunohistochemistry and automated morphometry. The percentage of cells immunostained for the three TGF-beta isoforms and cells positive for the three TGF-beta receptors in the inflammatory infiltrate located in the papillary dermis, reticular dermis and periadnexal tissue were significantly higher in LL than that in TT, with macrophages being the most common and strongest immunoreactive cells. Some lymphocytes, fibroblasts, keratinocytes and epithelial cells from sweat glands and hair roots were also positive. In situ reverse-transcription polymerase chain reaction corroborated the capacity of these cells to synthesize TGF-beta1 and TGF-beta receptor 2. This high expression of TGF-beta isoforms and their receptors could contribute to CMI anergy and other clinical characteristic features of leprosy, like skin atrophy.

Localization and expression of BCAT during pregnancy and lactation in the rat mammary gland.

During lactation, branched-chain aminotransferase (BCAT) gene expression increases in the mammary gland. To determine the cell type and whether this induction is present only during lactation, female rats were randomly assigned to one of three experimental groups: pregnancy, lactation, or postweaning. Mammary gland BCAT activity during the first days of pregnancy was similar to that of virgin rats, increasing significantly from day 16 to the last day of pregnancy. Maximal BCAT activity occurred on day 12 of lactation. During postweaning, BCAT activity decreased rapidly to values close to those observed in virgin rats. Analyses by Western and Northern blot revealed that changes in enzyme activity were accompanied by parallel changes in the amount of enzyme and its mRNA. Immunohistochemical studies of the mammary gland showed a progressive increase in mitochondrial BCAT (mBCAT)-specific staining of the epithelial acinar cells during lactation, reaching high levels by day 12. Immunoreactivity decreased rapidly after weaning. There was a significant correlation between total BCAT activity and milk production. These results indicate that the pattern of mBCAT gene expression follows lactogenesis stages I and II and is restricted to the milk-producing epithelial acinar cells. Furthermore, BCAT activity is associated with milk production in the mammary gland during lactation.