Caracterización sociodemográfica, clínica y ecográfica de la enfermedad de nódulos tiroideos y su relación con la malignidad en un centro de alta complejidad colombiano / Sociodemographic, clinical and ultrasound characterization of thyroid nodule pathology and its association with malignancy in a Colombian high-complexity center

Antecedentes y objetivo Los nódulos tiroideos se encuentran entre las dolencias más frecuentes, con un 10% de riesgo de malignidad. El objetivo es describir la frecuencia de las características demográficas, clínicas y ecográficas de la enfermedad de nódulos tiroideos en adultos y explorar la relación con la malignidad del tumor. Métodos Estudio transversal analítico, retrospectivo, en adultos con nódulos tiroideos y aspiración con aguja fina nodular realizada en pacientes adultos de un centro de referencia colombiano entre 2009-2019. Los datos se obtuvieron de la historia clínica y se estimaron medidas descriptivas de las variables demográficas, clínicas y ecográficas de los pacientes y se exploró su relación con la malignidad del tumor. Resultados Se incluyeron 445 pacientes y 515 nódulos. La mediana de edad fue de 55 años (RIQ 44-64), 86,8% mujeres, 54,8% tenía lesión única. El 80,2 y el 19,8% eran nódulos benignos y malignos, con una mediana de 15,7mm (RIQ 11-25) y 12,7mm (RIQ 8,5-18,3), respectivamente (p<0,001). El hipotiroidismo y el consumo de levotiroxina fueron mayores en quienes tenían nódulos malignos, (p<0,001). Las características ecográficas fueron diferentes estadísticamente entre los nódulos: en los malignos hubo mayor frecuencia de composición sólida, hipoecogenicidad y margen irregular, mientras que en los benignos se destacó la ausencia de foco ecogénico (p<0,001). Conclusión Las características ecográficas son fundamentales para definir el riesgo de malignidad de un nódulo tiroideo, por lo cual, considerar las más frecuentes puede ayudar en el abordaje más adecuado desde la atención primaria (AU)

Background and objective Thyroid nodules are among the most frequent conditions, with a 10% risk of malignancy. The objective is to describe the frequency of demographic, clinical, and ultrasonographic characteristics of thyroid nodule pathology in adults and to explore the relationship with tumor malignancy. Methods An analytical, retrospective cross-sectional study in adults with thyroid nodules and nodular fine-needle aspiration performed in adult patients from a Colombian reference center between 2009-2019. Data were obtained from the clinical history, descriptive measures of the patient's demographic, clinical, and ultrasound variables were estimated, and their relationship with the malignancy of the tumor was explored. Results A total of 445 patients and 515 nodules were included. The median age was 55 years (IQR 44-64), 86.8% of women, and 54.8% had a single lesion. Percentages of 80.2 and 19.8 were benign and malignant nodules, with a median of 15.7mm (IQR 11-25) and 12.7mm (IQR 8.5-18.3), respectively (p<0.001). Hypothyroidism and levothyroxine consumption were higher in those with malignant nodules (p<0.001). The echographic characteristics were statistically different between the nodules. In the malignant ones, there was a higher frequency of solid composition, hypoechogenicity, and irregular margins. In contrast, in the benign ones, the absence of echogenic focus stood out (p<0.001). Conclusion The ultrasound characteristics are essential to define the risk of malignancy of a thyroid nodule. Therefore, considering the most frequent ones can help in the most appropriate approach to primary care (AU)

[Sociodemographic, clinical and ultrasound characterization of thyroid nodule pathology and its association with malignancy in a Colombian high-complexity center]. / Caracterización sociodemográfica, clínica y ecográfica de la enfermedad de nódulos tiroideos y su relación con la malignidad en un centro de alta complejidad colombiano.

BACKGROUND AND OBJECTIVE: Thyroid nodules are among the most frequent conditions, with a 10% risk of malignancy. The objective is to describe the frequency of demographic, clinical, and ultrasonographic characteristics of thyroid nodule pathology in adults and to explore the relationship with tumor malignancy. METHODS: An analytical, retrospective cross-sectional study in adults with thyroid nodules and nodular fine-needle aspiration performed in adult patients from a Colombian reference center between 2009-2019. Data were obtained from the clinical history, descriptive measures of the patient's demographic, clinical, and ultrasound variables were estimated, and their relationship with the malignancy of the tumor was explored. RESULTS: A total of 445 patients and 515 nodules were included. The median age was 55 years (IQR 44-64), 86.8% of women, and 54.8% had a single lesion. Percentages of 80.2 and 19.8 were benign and malignant nodules, with a median of 15.7mm (IQR 11-25) and 12.7mm (IQR 8.5-18.3), respectively (p<0.001). Hypothyroidism and levothyroxine consumption were higher in those with malignant nodules (p<0.001). The echographic characteristics were statistically different between the nodules. In the malignant ones, there was a higher frequency of solid composition, hypoechogenicity, and irregular margins. In contrast, in the benign ones, the absence of echogenic focus stood out (p<0.001). CONCLUSION: The ultrasound characteristics are essential to define the risk of malignancy of a thyroid nodule. Therefore, considering the most frequent ones can help in the most appropriate approach to primary care.

Diphtheria outbreak with high mortality in northeastern Nigeria.

SUMMARY A diphtheria outbreak occurred from February to November 2011 in the village of Kimba and its surrounding settlements, in Borno State, northeastern Nigeria. We conducted a retrospective outbreak investigation in Kimba village and the surrounding settlements to better describe the extent and clinical characteristics of this outbreak. Ninety-eight cases met the criteria of the case definition of diphtheria, 63 (64.3%) of whom were children aged <10 years; 98% of cases had never been immunized against diphtheria. None of the 98 cases received diphtheria antitoxin, penicillin, or erythromycin during their illness. The overall case-fatality ratio was 21.4%, and was highest in children aged 0-4 years (42.9%). Low rates of immunization, delayed clinical recognition of diphtheria and absence of treatment with antitoxin and appropriate antibiotics contributed to this epidemic and its severity.

Rendimiento de cerdos alimentados con raciones conteniendo subproductos de arroz, durante la fase de crecimiento / Performance of growing swines fed with a diet containing rice subproducts

Objetivo. Evaluar el rendimiento de cerdos alimentados con raciones conteniendo subproductos de arroz durante la fase de crecimiento. Materiales y métodos. Fueron utilizados 40 lechones mestizos de 31.26 ± 4.62 kg, distribuidos en un diseño experimental de bloques al azar, con los siguientes tratamientos 1. Control, ración basal; 2. Ración con 100% de sustitución de maíz por arroz partido; 3. Ración con 50% de sustitución de maíz por arroz partido; 4. 100% de substitución de maíz por harina de arroz integral y 5. Ración con 50% de substitución de maíz por harina de arroz integral. Resultados. En todas las fases evaluadas (I, II y fase total) fue observado un pobre desempeño de los cerdos alimentados con las raciones conteniendo harina de arroz integral, con efectos negativos más evidentes cuando el maíz fue totalmente sustituido por este subproducto (1.467 kg de consumo diario de ración y 0.512 kg de ganancia diaria de peso). La sustitución total o parcial de maíz por arroz partido no afectó el desempeño de los cerdos en crecimiento (1.681 y 1.733 kg de consumo diario de ración y 0.703 y 0.708 kg de ganancia de peso respectivamente). La peor conversión alimenticia (2.87) fue obtenida con la sustitución total del maíz por harina de arroz integral. Conclusiones. El maíz puede ser substituido en 100% en raciones para cerdos en crecimiento por arroz partido y en 50% por harina de arroz integral sin perjudicar La ganancia de peso, el consumo de ración y La conversión alimenticia.

[Frey's syndrome: report of three cases with two distinct etiopathogeneses]. / Síndrome de Frey: tres observaciones clínicas con dos etiopatogenias diferentes.

Frey's syndrome is characterized by recurrent episodes of facial gustatory flushing and sweating (most frequent in adults) limited to the cutaneous distribution of the auriculotemporal nerve which, when injured, shows abnormal regeneration. The condition is relatively common in adults following nerve injury in parotid surgery but has rarely been reported in children as a sequel of perinatal birth trauma resulting from forceps assisted delivery. We report three patients with the same syndrome and two different causes. Two children had a history of forceps assisted delivery and one adolescent had undergone preauricular lymphadenectomy. This syndrome, which has more often been described by allergists and maxillofacial surgeons than by pediatricians, may pose problems of differential diagnosis with food allergy, leading to unnecessary exclusion diets. In the pediatric age group, Frey's syndrome is self limiting and does not require therapy if the diagnosis is correct.

Síndrome de Frey: tres observaciones clínicas con dos etiopatogenias diferentes / Frey’s syndrome: report of three cases with two distinct etiopathogeneses

El síndrome de Frey se caracteriza por episodios recurrentes de enrojecimiento y sudoración facial (más frecuente en adultos) causados por estímulos gustatorios y limitados al territorio de inervación del nervio auriculotemporal que, lesionado, se regenera de forma aberrante. Relativamente común en adultos como complicación de cirugía parotídea, se ha descrito menos en la infancia temprana como secuela de traumatismo facial perinatal por parto asistido con fórceps. Se presentan 3 casos clínicos del mismo síndrome con dos etiopatogenias diferentes, en 2 niños secundario a parto con fórceps y en un adolescente que apareció tras ser intervenido de linfadenectomía preauricular. Este síndrome más descrito por alergólogos y cirujanos maxilofaciales que por pediatras puede plantear estudios de alergia alimentaria o imponer dietas de exclusión innecesarias. No precisa tratamiento en la edad pediátrica excepto un correcto diagnóstico

Frey's syndrome is characterized by recurrent episodes of facial gustatory flushing and sweating (most frequent in adults) limited to the cutaneous distribution of the auriculotemporal nerve which, when injured, shows abnormal regeneration. The condition is relatively common in adults following nerve injury in parotid surgery but has rarely been reported in children as a sequel of perinatal birth trauma resulting from forceps assisted delivery. We report three patients with the same syndrome and two different causes. Two children had a history of forceps assisted delivery and one adolescent had undergone preauricular lymphadenectomy. This syndrome, which has more often been described by allergists and maxillofacial surgeons than by pediatricians, may pose problems of differential diagnosis with food allergy, leading to unnecessary exclusion diets. In the pediatric age group, Frey's syndrome is self limiting and does not require therapy if the diagnosis is correct

Surface spreading of synaptonemal complexes in the clam Dosinia exoleta (Mollusca, Bivalvia).

There are only a few reports on the chromosomal location of DNA sequences in bivalve species, none of them using meiotic chromosomes. Mitotic chromosomes of the clam Dosinia exoleta were analysed by means of Giemsa, silver and fluorochrome staining and fluorescent in situ hybridization (FISH) with 18S + 28S rDNA and telomeric probes. A technique for surface spreading of synaptonemal complexes (SCs) of Dosinia exoleta was developed for the first time in a bivalve species. Silver and DAPI/PI staining and SC-FISH were also applied to the study of the meiotic chromosomes of this clam. The diploid chromosome number in this species is 38 and the karyotype is composed of 11 pairs of metacentric and eight pairs of submetacentric chromosomes. 18S + 28S rDNA clusters map to the subtelomeric region of the short arm of one metacentric chromosome pair whereas telomeric signals appear at both ends of every chromosome.

Phase I/II trial of low dose cyclosporin A with EP for advanced non-small cell lung cancer.

We and others have shown that cyclosporin A (CsA) reverses resistance to etoposide (E) and cis-platinum (P) in vitro and in vivo. To assess the clinical relevance of combined therapy, we studied CsA with EP in patients with advanced non-small cell lung cancer in a phase I/II clinical trial in a University setting. Patients were treated between July 1989 and June 1994 and included 10 females and 34 males with a median age of 61 years and a mean Karnofsky performance status of 80. CsA was given at escalating doses of 1-6 mg/kg per day on days 1-4 of each 21 day cycle with cis-platinum 25 mg/m2 per day and etoposide 100 mg/m2 per days on days 1-3. Response was assessed after each 2 cycles by measuring index lesions. A total of 44 patients received 133 cycles, 22.7% of patients had a partial response and 36.4% had stable disease with 8% 2-year survival. Patients receiving 1-2 mg/kg CsA had a PR rate of 37.5 and 50% SD compared to 19.4 and 33.3% for doses of 3 mg/kg or more. Although no conclusions should be drawn from this small study, the Kaplan-Meier survival curves were statistically significant different for these two groups by the log-rank test (P = 0.047). The 2-year survival of the former group was 25% compared to 4% for the latter. In light of the potential importance of immunomodulation in cancer control, it seems prudent to balance the effects of CsA on P-glycoprotein and other drug resistance pumps against its dose-dependent immunosuppressive activity. Further studies are needed to validate the activity of low dose CsA in combination with standard chemotherapy for lung cancer.

Dopaminergic influence on cardiovascular responses to exercise stress in hypertensive subjects.

Ten hypertensive subjects were studied at the Vargas Medical School in Caracas, Venezuela. They were submitted to submaximal treadmill exercises according to Bruce's protocol under treatment with dopaminergic drugs (metoclopramide, bromocriptine). Before and during submaximal exercises, metoclopramide caused a hypotensive effect accompanied by an increased heart rate, which was blocked by the administration of bromocriptine. We conclude that a probable dopaminergic modulatory influence takes place during exercise.

The effect of intravenous metoclopramide on blood pressure in normotensive and hypertensive subjects.

In the present study we evaluated the effect of intravenous metoclopramide on blood pressure in normotensive (untrained, football players, runners) and hypertensive subjects. There was a decrease in blood pressure only observed in untrained female subjects and this was greater in hypertensive subjects. In football players and runners the decrease in blood pressure was not statistically significant. There was no significant effect on heart rate. The probable mechanism of this new pharmacological effect of metoclopramide is unknown, however, research is now in progress to define its mechanism of action.