Inhaled Litsea glaucescens K. (Lauraceae) leaves' essential oil has anxiolytic and antidepressant-like activity in mice by BDNF pathway activation.

ETHNOPHARMACOLOGICAL RELEVANCE: Litsea glaucescens K. (Lauraceae) is a small tree from the Mexican and Central American temperate forests, named as "Laurel". Its aromatic leaves are ordinarily consumed as condiments, but also are important in Mexican Traditional Medicine, and among the most important non wood forest products in this area. The leaves are currently used in a decoction for the relief of sadness by the Mazahua ethnic group. Interestingly, "Laurel" has a long history. It was named as "Ehecapahtli" (wind medicine) in pre-Columbian times and applied to heal maladies correlated to the Central Nervous System, among them depression, according to botanical texts written in the American Continent almost five centuries ago. AIM OF THE STUDY: Depression is the first cause of incapacity in the world, and society demands alternative treatments, including aromatherapy. We have previously demonstrated the antidepressant-like activity of L. glaucescens leaves' essential oil (LEO), as well as their monoterpenes linalool, and beta-pinene by intraperitoneal route in a mice behavioral model. Here we now examined if LEO and linalool exhibit this property and anxiolytic activity when administered to mice by inhalation. We also investigated if these effects occur by BDNF pathway activation in the brain. MATERIALS AND METHODS: The LEO was prepared by distillation with water steam and analyzed by gas chromatography-mass spectrometry (GC-MS). The monoterpenes linalool, eucalyptol and ß-pinene were identified and quantified. Antidepressant type properties were determined with the Forced Swim Test (FST) on mice previously exposed to LEO or linalool in an inhalation chamber. The spontaneous locomotor activity and the sedative effect were assessed with the Open Field Test (OFT), and the Exploratory Cylinder (EC), respectively. The anxiolytic properties were investigated with the Elevated Plus Maze Apparatus (EPM) and the Hole Board Test (HBT). All experiments were video documented. The mice were subjected to euthanasia, and the brain hippocampus and prefrontal cortex were dissected. RESULTS: The L. glaucescens essential oil (LEO) contains 31 compounds according to GC/MS, including eucalyptol, linalool and beta-pinene. The LEO has anxiolytic effect by inhalation in mice, as well as linalool, and ß-pinene, as indicated by OFT and EC tests. The LEO and imipramine have antidepressant like activity in mice as revealed by the FST; however, linalool and ketamine treatments didn't modify the time of immobility. The BDNF was increased in FST in mice treated with LEO in both areas of the brain as revealed by Western blot; but did not decrease the level of corticosterone in plasma. The OFT indicated that LEO and imipramine didn't reduce the spontaneous motor activity, while linalool and ketamine caused a significant decrease. CONCLUSION: Here we report by the first time that L. glaucescens leaves essential oil has anxiolytic effect by inhalation in mice, as well as linalool, and ß-pinene. This oil also maintains its antidepressant-like activity by this administration way, similarly to the previously determined intraperitoneally. Since inhalation is a common administration route for humans, our results suggest L. glaucescens essential oil deserve future investigation due to its potential application in aromatherapy.

Synthetic biology as driver for the biologization of materials sciences.

Materials in nature have fascinating properties that serve as a continuous source of inspiration for materials scientists. Accordingly, bio-mimetic and bio-inspired approaches have yielded remarkable structural and functional materials for a plethora of applications. Despite these advances, many properties of natural materials remain challenging or yet impossible to incorporate into synthetic materials. Natural materials are produced by living cells, which sense and process environmental cues and conditions by means of signaling and genetic programs, thereby controlling the biosynthesis, remodeling, functionalization, or degradation of the natural material. In this context, synthetic biology offers unique opportunities in materials sciences by providing direct access to the rational engineering of how a cell senses and processes environmental information and translates them into the properties and functions of materials. Here, we identify and review two main directions by which synthetic biology can be harnessed to provide new impulses for the biologization of the materials sciences: first, the engineering of cells to produce precursors for the subsequent synthesis of materials. This includes materials that are otherwise produced from petrochemical resources, but also materials where the bio-produced substances contribute unique properties and functions not existing in traditional materials. Second, engineered living materials that are formed or assembled by cells or in which cells contribute specific functions while remaining an integral part of the living composite material. We finally provide a perspective of future scientific directions of this promising area of research and discuss science policy that would be required to support research and development in this field.

Enfermedad de Mondor y mamoplastías / Mondor's disease and mammoplasty

Resumen Objetivo: Revisar la incidencia de esta enfermedad en pacientes sometidos a mamoplastías en una clínicaprivada en el período de 11 años, con el fin de describir sus síntomas y signos, diagnóstico, tratamiento y evolución. Materiales y Método: Se estudiaron 355 mujeres que se sometieron a mamoplastías estéticas. Se excluyó aquellas cirugías reconstructivas secundarias a cáncer de mama y aquellas con otros antecedentes oncológicos previos. La información fue recolectada de las fichas clínicas. Resultado: Se analizan 710 mamas operadas en el período 2008-2018, de las cuales seis mamas (6/710) evolucionaron con enfermedad de Mondor (0,8%). El diagnóstico se realizó clínicamente. Todos los casos recibieron terapia antiinflamatoria oral y local, respondiendo favorablemente. Discusión: Existe poca literatura publicada al respecto. Casos bilaterales son menos reportados. Pareciera asociarse con cirugías del surco submamario y no está claro que requiera curación terapéutica. Conclusiones: La enfermedad de Mondor es infrecuente, puede presentarse secundario a mamoplastías, es de diagnóstico clínico y sólo tratamiento sintomático con evolución satisfactoria sin secuelas.

Aim: Review the disease incidence in patients who had mammoplasties in a private clinic on a 11 year-period. The purpose is to describe their symptoms and signs, diagnosis, treatment and evolution. Materials and Method: 355 women who underwent cosmetic mammoplasties were studied. Those reconstructive surgeries secondary to breast cancer and those with other previous oncological history were excluded. The information was collected from clinical files. Results: 710 breasts operated between 2008-2018 are analyzed, six of them (6/710) evolved Mondor disease (0.8%). The diagnosis was made clinically. All cases received oral and local antiinflammatory therapy, responding favorably. Discussion: There is a few published literature about it. Bilateral cases are less reported. It appears to be associated with surgeries of the submammary sulcus and it is not clear that it requires therapeutic cure. Conclusions: Mondor's disease is infrequent, can occur secondary to mammoplasty, diagnosis is clinical, treatment is symptomatic, all cases had satisfactory evolution without sequelae.

The involvement of marine tourism companies in CSR: the case of the island of Tenerife.

Corporate Social Responsibility is a voluntary strategy by companies, which integrates a set of actions that contribute to sustainable development. This study analyzes the degree of involvement of marine tourism companies in human resource management, adaptation to change, environmental management, local community development and collaboration with public and private agents. These areas configure companies' Corporate Social Responsibility strategies. Information was collected from marine tourism companies on the island of Tenerife using quantitative and qualitative methodologies. A binary logistic regression analysis was applied. The results indicate that, in general, marine tourism companies are socio-environmentally responsible. Environmental aspects and adaptation to change through innovation have the greatest weight in these companies' Corporate Social Responsibility strategies. Actions for local community development and collaboration with private agents are also important. However, human resource management influences negatively since marine tourism is a highly regulated sector in this regard. Thus, actions are mandatory and not voluntary, affecting all companies equally whether they have high levels of Corporate Social Responsibility implementation or not. Regarding relations with public authorities, the results indicate that improvement is urgently required, given the low participation of marine tourism companies in policy making.

Caracterización de los pacientes con tinnitus y hallazgos audiométricos

Resumen Introducción: El tinnitus se define como la percepción consciente de un sonido, en ausencia de un estímulo acústico externo correspondiente. Se ha relacionado a múltiples comorbilidades como hipertensión arterial (HTA), diabetes mellitus (DM) e hipoacusia, sin evidencia sólida en la actualidad. Hay diversas formas de experimentar el tinnitus, ya sea de comienzo unilateral o bilateral, intermitente o persistente, con deterioro de la calidad de vida, leve hasta formas invalidantes. El conocer las diversas patologías presentes en el tinnitus, en especial la hipoacusia, toma relevancia al momento de enfrentar a pacientes con dicha patología. Objetivo: Caracterizar el tinnitus y sus principales hallazgos audiométricos en pacientes atendidos en el Servicio de Otorrinolaringología del Hospital Clínico Herminda Martín de Chillán, Chile. Material y Método: Estudio retrospectivo. Se incluyeron pacientes mayores de 18 años con diagnóstico de tinnitus entre los años 2015-2017. Se obtuvo información epidemiológica, comorbilidades, presentación clínica del tinnitus en función de lateralidad y frecuencia, hipoacusia asociada y hallazgos audiométricos. Resultados: Se incluyeron en el estudio a 249 pacientes, la mayoría mujeres (70%) con una edad promedio de inicio de su tinnitus entre 60-79 años (52%). Entre las principales comorbilidades se encuentran la hipertensión arterial, diabetes mellitus y patologías autoinmunes; los síntomas otorrinolaringológicos acompañantes estuvieron en menos del 10% de los casos. En relación a la caracterización del tinnitus, el 52% fue de inicio unilateral y el 66% de forma continua. La hipoacusia objetivada en el audiograma estuvo presente en el 43% de los pacientes con tinnitus. Conclusión: El tinnitus es una patología compleja y multifactorial, en este sentido, la presencia de hipoacusia objetiva en la audiometría estuvo presente en un 43% de los pacientes, siendo una de las principales causas a descartar por el médico en el primer enfrentamiento del paciente.

Abstract Introduction: tinnitus is defined as the conscious perception of a sound, in the absence of a corresponding external acoustic stimulus. It has been related to multiple comorbidities such as high blood pressure, diabetes mellitus, hearing loss, with no solid evidence at present. There are various ways to experience tinnitus, whether it is unilateral or bilateral, intermittent or persistent onset, from mild quality of life deterioration to disabling forms. Knowing the various pathologies present in tinnitus, especially hearing loss, becomes relevant when confronting patients with this pathology. Aim: To characterize tinnitus and its main audiometric findings in patients treated at the Otorhinolaryngology Service of the Herminda Martin of Chillán Clinical Hospital in Chile. Material and Method: Retrospective study. Patients older than 18 years with a diagnosis of tinnitus between the years 2015-2017 were included. Epidemiological information, comorbidities, clinical presentation of tinnitus according to laterality and frequency, associated hearing loss and audiometric findings were obtained. Results: 249 patients were included. Most were women (70%), with an onset average age of tinnitus between 60 to 79 years (52%). The accompanying otorhinolaryngological symptoms were in less than 10% of the cases. The main comorbidities were high blood pressure, diabetes mellitus and autoimmune pathologies. 52% of tinnitus was unilateral presentation and in 66% it was continuous. 43% had hypoacusis objectified on the audiogram, regardless of whether they had the sensation of hearing loss. Conclusion: Tinnitus is a complex and multifactorial pathology, in this sense, the presence of objective hearing loss in audiometry was present in 43% of patients, being one of the main causes to be ruled out by the doctor in the patient's first confrontation.

Experiencia del uso de la toxina botulínica tipo A para el tratamiento sintomático del epiblefaron en pacientes menores de 2 años / Treatment of symptomatic epiblepharon with Botulinum toxin type A in patients under 2 years of age

INTRODUCCIÓN: El epiblefaron es una malposición palpebral congénita ocasionada por un pliegue redundante de piel y músculo orbicular que invierte las pestañas hacia el globo ocular. OBJETIVO: Reportamos nuestra experiencia en la corrección no quirúrgica del epiblefaron sintomático usando una inyección en el músculo orbicular pretarsal de 5 unidades de toxina botulínica tipo A (TbA). MATERIAL Y MÉTODOS: Revisamos los expedientes de los pacientes menores de 2 años con epiblefaron tratados con TbA. Evaluamos los síntomas y los signos del epiblefaron, previo y posterior al tratamiento. RESULTADOS: Se incluyó a un total de 40 pacientes (28 niñas [70%]). La edad media de presentación fue 11 meses (rango 4-24). Se trataron 76 párpados con TbA. Obtuvimos una mejoría estadísticamente significativa de los síntomas, del contacto cilio corneal y de la afectación corneal tras la aplicación de 5 unidades de TbA. El periodo medio de seguimiento fue de 25,55 semanas (rango 4-92). CONCLUSIONES: Con este estudio demostramos que la aplicación de TbA es un tratamiento efectivo y seguro para la corrección del epiblefaron sintomático en niños menores de 2 años

INTRODUCTION: Epiblepharon is a congenital eyelid malposition due to a horizontal skin fold and a redundant orbicular muscle, resulting in the inward positioning of the eyelashes. OBJECTIVE: Personal experience is presented of the non-surgical correction of symptomatic epiblepharon using a pretarsal injection of 5 IU of botulinum toxin type A (BoNT-A) into the orbicular muscle. MATERIAL AND METHODS: Patients with epiblepharon younger than 2 year were included in the study. A review was made of their clinical charts and the symptoms and signs of epiblepharon were evaluated before and after treatment with BoNT-A. RESULTS: A total of 40 patients were included (28 girls [70%]). The mean age at treatment was 11 months (range, 4-24 months). A total of 76 eyelids were treated with BoNT-A. A statistically significant improvement in symptoms, lash-corneal touch, and punctate corneal epitheliopathy were reported after the treatment with 5IU BoNT-A. The mean final follow-up was 25.5 weeks (range, 4-92 months). CONCLUSIONS: The present study provides evidence that a pretarsal BoNT-A injection is an effective and safe treatment for the correction of symptomatic epiblepharon in patients younger than 2 years of age

Treatment of symptomatic epiblepharon with Botulinum toxin type A in patients under 2years of age. / Experiencia del uso de la toxina botulínica tipo A para el tratamiento sintomático del epiblefaron en pacientes menores de 2 años.

INTRODUCTION: Epiblepharon is a congenital eyelid malposition due to a horizontal skin fold and a redundant orbicular muscle, resulting in the inward positioning of the eyelashes. OBJECTIVE: Personal experience is presented of the non-surgical correction of symptomatic epiblepharon using a pretarsal injection of 5 IU of botulinum toxin type A (BoNT-A) into the orbicular muscle. MATERIAL AND METHODS: Patients with epiblepharon younger than 2 year were included in the study. A review was made of their clinical charts and the symptoms and signs of epiblepharon were evaluated before and after treatment with BoNT-A. RESULTS: A total of 40 patients were included (28 girls [70%]). The mean age at treatment was 11 months (range, 4-24 months). A total of 76 eyelids were treated with BoNT-A. A statistically significant improvement in symptoms, lash-corneal touch, and punctate corneal epitheliopathy were reported after the treatment with 5IU BoNT-A. The mean final follow-up was 25.5 weeks (range, 4-92 months). CONCLUSIONS: The present study provides evidence that a pretarsal BoNT-A injection is an effective and safe treatment for the correction of symptomatic epiblepharon in patients younger than 2 years of age.

Evaluación del programa de computación educativo para la aplicación de escalas ISS y AIS en el servicio de urgencias para residentes de ortopedia de la Secretaría de Salud de la Ciudad de México / Evaluation of educational computer program for applying ISS and AIS scales in the emergency room for Orthopedic Residents of the Secretary of Health from Mexico City

Resumen: Introducción: Se creó el programa HAISS (Herramienta de Aprendizaje ISS) para mejorar la factibilidad y aprendizaje de las escalas de gravedad en trauma AIS (Abbreviated Injury Score) e ISS (Injury Severity Score). Objetivo: Obtener una herramienta de computación que promueva el aprendizaje y facilite el uso adecuado de las escalas AIS e ISS. Material y métodos: Se toma una muestra de 40 residentes de primero a cuarto grado de ortopedia de cuatro hospitales de la Secretaría de Salud. Se realizó un estudio longitudinal prospectivo con estadística analítica. Se entregaron 10 casos clínicos para obtención de ISS mediante la escala AIS, se utilizó el manual AIS 2005 actualización 2008, se plantearon dos preguntas para evaluar facilidad de uso y factibilidad, se midió el tiempo de realización. Se repitió el proceso al mes con el programa HAISS. Resultados: Con ayuda del programa HAISS se redujo el tiempo para resolver los 10 casos en más de 50%, la aceptación por parte del usuario de la escala AIS también mejoró. La fiabilidad de obtener la codificación de las lesiones con AIS no mejoró, pero no se ve afectada la obtención del ISS. Conclusiones: El programa HAISS mostró aceptación en un grupo de residentes de ortopedia, mejoró en forma subjetiva su uso y además ocupa poco tiempo.

Abstract: Introduction: The HAISS (Herramienta de Aprendizaje ISS) program was created to enhance the feasibility and learning of trauma severity scores AIS (Abbreviated Injury Score) and ISS (Injury Severity Score). Objective: Get a computer tool that promotes learning and facilitate proper use of AIS and ISS. Material and methods: A sample of 40 orthopedic residents from 1st to 4th grade from 4 hospitals of the Ministry of Health was taken. A prospective longitudinal study was conducted with analytical statistics. 10 clinical cases for obtaining ISS by AIS score were delivered, this was done with the AIS Manual 2005 update 2008, two questions were conducted to evaluate the feasibility and ease of use, the time to perform was measured. The process was repeated a month later with the HAISS program. Results: Using the HAISS program reduced the time to resolve the 10 cases by more than 50%, acceptance by the user of the AIS scale also improved. Reliability to obtain the codification of lesions with AIS did not improve, but it did not affected ISS. Conclusions: The HAISS computer program is useful for orthopedic residents to accept the AIS score and ISS score mainly because it improved the ease of use and makes it more user-friendly, it also takes less time to use it.

Early high levels of regulatory T cells and T helper 1 may predict the progression of recurrent hepatitis C after liver transplantation.

BACKGROUND: Immune response failure against hepatitis C virus (HCV) has been associated with an increased regulatory T cell (Treg) activity. After liver transplantation (LT), 80% of patients experience an accelerated progression of hepatitis C recurrence. The aim of this work was to assess the involvement of Tregs, T helper (Th) 1, 2 and 17 cells in recurrent hepatitis C. METHODS: Peripheral blood cells obtained before and one month after LT from 22 recipients were analysed. Forty-four key molecules related to Treg, Th1, 2 and 17 responses, were evaluated using qRT-PCR. Liver recipients were classified in two groups according to graft fibrosis evaluated by the METAVIR score on the biopsy performed one year after LT (mild: F ≤ 1, n = 13; severe: F > 1, n = 9). Patients developing a severe recurrence were compared with patients with a mild recurrence. RESULTS: mRNA levels of Treg markers obtained one month after LT were significantly increased in patients with a severe disease course when compared to patients with a mild recurrence. Markers of the Th1 response were elevated in the same group. No differences in the markers determined before LT were observed. CONCLUSION: These findings suggest that Treg, induced by a multifactorial process, which could include a strong Th1 response itself, may play a role in suppressing the early antiviral response, leading to a severe recurrence of hepatitis C.

[Evaluation of educational computer program for applying ISS and AIS scales in the emergency room for Orthopedic Residents of the Secretary of Health from Mexico City]. / Evaluación del programa de computación educativo para la aplicación de escalas ISS y AIS en el servicio de urgencias para residentes de ortopedia de la Secretaría de Salud de la Ciudad de México.

INTRODUCTION: The HAISS (Herramienta de Aprendizaje ISS) program was created to enhance the feasibility and learning of trauma severity scores AIS (Abbreviated Injury Score) and ISS (Injury Severity Score). OBJECTIVE: Get a computer tool that promotes learning and facilitate proper use of AIS and ISS. MATERIAL AND METHODS: A sample of 40 orthopedic residents from 1st to 4th grade from 4 hospitals of the Ministry of Health was taken. A prospective longitudinal study was conducted with analytical statistics. 10 clinical cases for obtaining ISS by AIS score were delivered, this was done with the AIS Manual 2005 update 2008, two questions were conducted to evaluate the feasibility and ease of use, the time to perform was measured. The process was repeated a month later with the HAISS program. RESULTS: Using the HAISS program reduced the time to resolve the 10 cases by more than 50%, acceptance by the user of the AIS scale also improved. Reliability to obtain the codification of lesions with AIS did not improve, but it did not affected ISS. CONCLUSIONS: The HAISS computer program is useful for orthopedic residents to accept the AIS score and ISS score mainly because it improved the ease of use and makes it more user-friendly, it also takes less time to use it.

INTRODUCCIÓN: Se creó el programa HAISS (Herramienta de Aprendizaje ISS) para mejorar la factibilidad y aprendizaje de las escalas de gravedad en trauma AIS (Abbreviated Injury Score) e ISS (Injury Severity Score). OBJETIVO: Obtener una herramienta de computación que promueva el aprendizaje y facilite el uso adecuado de las escalas AIS e ISS. MATERIAL Y MÉTODOS: Se toma una muestra de 40 residentes de primero a cuarto grado de ortopedia de cuatro hospitales de la Secretaría de Salud. Se realizó un estudio longitudinal prospectivo con estadística analítica. Se entregaron 10 casos clínicos para obtención de ISS mediante la escala AIS, se utilizó el manual AIS 2005 actualización 2008, se plantearon dos preguntas para evaluar facilidad de uso y factibilidad, se midió el tiempo de realización. Se repitió el proceso al mes con el programa HAISS. RESULTADOS: Con ayuda del programa HAISS se redujo el tiempo para resolver los 10 casos en más de 50%, la aceptación por parte del usuario de la escala AIS también mejoró. La fiabilidad de obtener la codificación de las lesiones con AIS no mejoró, pero no se ve afectada la obtención del ISS. CONCLUSIONES: El programa HAISS mostró aceptación en un grupo de residentes de ortopedia, mejoró en forma subjetiva su uso y además ocupa poco tiempo.

Prolactin prevents the kainic acid-induced neuronal loss in the rat hippocampus by inducing prolactin receptor and putatively increasing the VGLUT1 overexpression.

Neuroprotective effects of short prolactin (PRL) pre-treatment against kainic acid (KA)-induced damage include neuron loss avoidance in all hippocampal regions and attenuation of seizures. Recent evidence points PRL receptor (PRL-R) as mediator of such neuroprotective effects and seizures as regulators of neuronal marker transcript expression in the hippocampus. Here, we investigated if a daily PRL dose of 100 µg or vehicle for 14 days in ovariectomized rats (OVX) prevents neuron loss induced by KA administered on the third day of PRL treatment in a systemic single dose of 7.5 mg/kg or vehicle, and promotes PRL-R, vesicular glutamate transporter 1 (VGLUT1) and glutamic acid decarboxylase 65 (GAD65) expression changes in the hippocampus of sacrificed rats 27 days after the KA administration. Immunostaining for Neu-N and PRL-R revealed significant neuron number and PRL-R expression reduction induced by KA that was prevented and turned into overexpression respectively in all hippocampal regions when PRL was added; while VGLUT1,and GAD65 immunostaining displayed expression decrease in the CA1 of injured rats, prevented in the last case and turned into VGLUT1, overexpression when administered PRL. These data indicate that chronic PRL administration before damage induces hippocampal neuroprotection associated with PRL-R and VGLUT1 overexpression, the latter in a regiondependent way.

Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso / Granulomatosis with polyangiitis confined to lacrimal gland, a case report

Caso clínico: Mujer de 43 años, consulta por aumento de volumen orbitario superolateral izquierdo, doloroso, eritematoso de 2 meses de evolución. Se realiza biopsia escisional revelando vasculitis con poliangeítis de glándula lagrimal. El estudio sistémico no reveló compromiso de otros órganos. Discusión: El compromiso orbitario ocurre hasta en el 60% de los pacientes con granulomatosis con poliangeítis. La afección de la glándula lagrimal es rara, y frecuentemente unilateral. Las pruebas serológicas generalmente son negativas, tanto en etapas iniciales, como en las formas localizadas de la enfermedad (AU)

Clinical case: A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. Discussion: Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease (AU)

Relación entre linfocitos T reguladores (T regs) y anticuerpos anti-receptores de TSH (TRab) y el riesgo de cáncer de tiroides en enfermedad de Graves / Relationship between T regulatory lymphocytes (Tregs) and TSH receptor antibodies (TRab) on risk of thyroid cancer in Graves disease

Durante los últimos años se ha estudiado la relación entre enfermedad de Graves (EG), TSH, TRAb y cáncer de tiroides, existiendo estudios que demuestran mayor prevalencia y agresividad del cáncer de tiroides en pacientes con EG, mientras otros refutan estos hallazgos sugiriendo que serían producto del sesgo de selección. Aquellos estudios que plantean una relación causal entre EG y el desarrollo de cáncer de tiroides, la atribuyen a la presencia de autoanticuerpos TSI, que estimularían el foco de malignidad. Se cree que las citoquinas producidas localmente en pacientes con EG trabajarían en conjunto con los TRAb para determinar la agresividad del cáncer papilar de tiroides en estos pacientes. Dentro de las células reclutadas por el tumor para evadir la respuesta inmune se encuentran los linfocitos Treg, que estarían elevados en paciente con EG, llevando a la disminución de la respuesta inmune y creando un ambiente permisivo para la proliferación celular. Por tratarse de una línea de investigación reciente, no existe consenso sobre el tema y sus implicancias en el tratamiento de los pacientes con EG. La finalidad de este artículo es realizar una revisión de la literatura que exponga y contraste la información disponible a la fecha.

In recent years the relationship between Graves’ disease (GD), TSH, TRAb and thyroid carcinoma has been studied. Research studies show a higher prevalence and aggressiveness of thyroid carcinoma in patients with GD, however other researchers refute these findings suggesting it’s due to selection bias. Increasing evidence suggests a causal relationship between GD and the development of thyroid carcinoma, mainly because of the existence of TSI autoantibodies that could stimulate the focus of malignancy. It is believed that cytokines produced locally in patients with GD work alongside with TRAb regulating the aggressiveness of papillary thyroid carcinoma in these patients. Within the cells recruited by the tumor to elude the immune system we find Treg lymphocytes, which have been found to be increased in patients with GD, leading to a diminished immune response, creating a permissive environment for cell proliferation. Since this is a relatively new line of research, there is no consensus on the subject and its relevance for the treatment of patients with GD. The aim of this article is to show recent literature available on the subject.

Cirugía de evisceración ocular en un centro de alta especialidad en México: estudio retrospectivo de 7 años de experiencia / Evisceration surgery in a highly specialized center in Mexico: A retrospective study of 7 years of experience

INTRODUCCIÓN: En la actualidad la evisceración se está convirtiendo en la técnica de elección en el tratamiento de ciertas enfermedades oculares, como un ojo ciego doloroso, endoftalmitis, entre otras. Para la rehabilitación de la cavidad anoftálmica los implantes más utilizados actualmente son los de hidroxiapatita y polietileno poroso. OBJETIVO: Describir las indicaciones, tipo de material del implante utilizado y complicaciones en la cirugía de evisceración. MÉTODOS: Estudio retrospectivo, observacional, descriptivo, basado en expedientes clínicos de pacientes sometidos a evisceración entre 2008 y 2015 en el Instituto Fundación Conde de Valenciana. RESULTADOS: Se realizaron 186 cirugías de evisceración. El 52,7% de los pacientes eran hombres. El promedio de edad fue 54 años. El ojo derecho fue eviscerado en el 53% de los casos, el 79,2% presentaba una visión de no percepción de luz. La mayoría presentaba dolor preoperatorio.El diagnóstico más frecuente por el cual se realizó la evisceración fue endoftalmitis. Se reportaron 20 ojos en phthisis bulbi. En el 86,81% de los casos se colocó un implante primario. El 34,81% fue de polietileno poroso. Cuatro casos presentaron extrusión del implante, en 2 casos de polietileno poroso. La prótesis ocular fue tolerada en el 91% de los casos. No hubo casos de oftalmía simpática. CONCLUSIÓN: La evisceración se muestra como una alternativa a la enucleación en casos donde la esclerótica pueda preservarse, mostrando baja incidencia de oftalmía simpática

INTRODUCTION: Evisceration is currently becoming the technique of choice in the treatment of certain eye diseases, including, among others, painful blind eye and endophthalmitis. The most widely used implants are currently the hydroxyapatite and porous polyethylene for the rehabilitation of the anophthalmic socket. OBJECTIVE: To describe the indications, type of implant material used, and complications in evisceration surgery. METHODS: A retrospective, observational, descriptive study based on clinical records of patients that underwent evisceration between 2008 and 2015 in the Instituto Fundación Conde de Valenciana, Mexico. RESULTS: A total of 186 evisceration surgeries were performed, of which 52.7% of the patients were men. The mean age was 54 years. The right eye was eviscerated in 53% of cases, and 79.2% had a vision of no light perception. Most patients had preoperative pain. The most common diagnosis for which evisceration was performed was endophthalmitis. Phthisis bulbi was reported in 20 eyes. A primary implant was inserted in 86.81% of the cases, with 34.81% of the implants being made of porous polyethylene. Four cases showed extrusion of the implant, with 2 cases of porous polyethylene. The ocular prosthesis was tolerated in 91% of cases. There were no cases of sympathetic ophthalmia. CONCLUSION: Evisceration is shown to be a good alternative to enucleation in cases where the sclera can be preserved, showing a low incidence of sympathetic ophthalmia

Granulomatosis with polyangiitis confined to lacrimal gland, a case report. / Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso.

CLINICAL CASE: A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. DISCUSSION: Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease.

Evisceration surgery in a highly specialized center in Mexico: A retrospective study of 7 years of experience. / Cirugía de evisceración ocular en un centro de alta especialidad en México: estudio retrospectivo de 7 años de experiencia.

INTRODUCTION: Evisceration is currently becoming the technique of choice in the treatment of certain eye diseases, including, among others, painful blind eye and endophthalmitis. The most widely used implants are currently the hydroxyapatite and porous polyethylene for the rehabilitation of the anophthalmic socket. OBJECTIVE: To describe the indications, type of implant material used, and complications in evisceration surgery. METHODS: A retrospective, observational, descriptive study based on clinical records of patients that underwent evisceration between 2008 and 2015 in the Instituto Fundación Conde de Valenciana, Mexico. RESULTS: A total of 186 evisceration surgeries were performed, of which 52.7% of the patients were men. The mean age was 54 years. The right eye was eviscerated in 53% of cases, and 79.2% had a vision of no light perception. Most patients had preoperative pain. The most common diagnosis for which evisceration was performed was endophthalmitis. Phthisis bulbi was reported in 20 eyes. A primary implant was inserted in 86.81% of the cases, with 34.81% of the implants being made of porous polyethylene. Four cases showed extrusion of the implant, with 2 cases of porous polyethylene. The ocular prosthesis was tolerated in 91% of cases. There were no cases of sympathetic ophthalmia. CONCLUSION: Evisceration is shown to be a good alternative to enucleation in cases where the sclera can be preserved, showing a low incidence of sympathetic ophthalmia.

Antidepressant-like activity of Tagetes lucida Cav. is mediated by 5-HT(1A) and 5-HT(2A) receptors.

It has been demonstrated that the aqueous extract of Tagetes lucida Cav. shows an antidepressant-like effect on the forced swimming test (FST) in rats. The aim of this study was to analyze the participation of the serotoninergic system in the antidepressant-like effect of the aqueous extract of T. lucida. Different doses of the extract of T. lucida were administered at 72, 48, 24, 18 and 1 h before FST. The animals were pretreated with a 5-HT1A receptor antagonist (WAY-100635, 0.5 mg/kg), a 5-HT2A receptor antagonist (ketanserin, 5 mg/kg), a ß-noradrenergic receptor antagonist (propranolol, 200 mg/kg), and with a α2-noradrenergic receptor antagonist (yohimbine, 1 mg/kg) alone or combined with the extract and pretreated with a serotonin synthesis inhibitor (PCPA) before treatment with 8-OH-DPAT + the extract of T. lucida. In addition, suboptimal doses of the 5-HT1A agonist (8-OH-DPAT) + non-effective dose of extract was analyzed in the FST. To determine the presence of flavonoids, the aqueous extract of T. lucida (20 µl, 4 mg/ml) was injected in HPLC; however, a quercetin concentration of 7.72 mg/g of extract weight was detected. A suboptimal dose of 8-OH-DPAT + extract of T. lucida decreased immobility and increased swimming and climbing. An antidepressant-like effect with the aqueous extract of T. lucida at doses of 100 and 200 mg/kg was observed on the FST with decreased immobility behavior and increased swimming; however, this effect was blocked by WAY-100635, ketanserin and PCPA but not by yohimbine and propranolol, suggesting that the extract of T. lucida could be modulating the release/reuptake of serotonin.

Carcinoma papilar de tiroides en quiste del conducto tirogloso / Thyroglossal duct cyst with papillary carcinoma

Introduction: In about 1-2 percent of cases of thyroglossal cyst may be neoplastic changes, mostly correspond to papillary thyroid carcinoma (75-85 percent). The aim of this paper is to present 9 cases of papillary thyroid carcinoma in thyroglossal duct cyst. Materials and Methods: Data were recorded retrospectively from patients diagnosed with papillary thyroid carcinoma in thyroglossal duct cyst treated at Hospital Clínico Universidad de Chile between 1999 2014. Results: From 142 cases operated for thyroglossal duct cyst, 9 cases of papillary cancer (6.34 percent) were recorded. The average age was 32 years. The average diameter of the lesion was 4.4 cm (SD 2.2 cm). 8 patients underwent total thyroidectomy; a simultaneous thyroid cancer was diagnosed in 3 of them. In 6 cases was added iodine therapy. In only one patient a lymph nodal dissection was performed. We do not observe any surgical complication. A solid component in preoperative ultrasonographic study is suspicious of malignancy. The average follow-up time was 85 months. There is no recurrence or mortality in this group of patients. Conclusions: Although the safest long term management is Sistrunk surgery associated with thyroidectomy and radioiodine in selected cases, these patients must be evaluated by a multidisciplinary group and thyroidectomy should be considered in high surgical volume center, in order to minimize complications.

Introducción: En alrededor de 1-2 por ciento de los casos de quiste tirogloso pueden existir cambios neoplásicos, en su mayoría corresponden a carcinoma papilar de tiroides (75-85 por ciento). El objetivo de este trabajo es presentar 9 casos de carcinoma papilar de tiroides en quiste del conducto tirogloso, en cuanto a su forma de presentación y manejo. Material y Método: Se registraron en forma retrospectiva datos de pacientes condiagnóstico de carcinoma papilar de tiroides en quiste del conducto tirogloso atendidos en el Hospital Clínico de la Universidad de Chile entre 1999 2014. Resultados: De 142 casos de pacientes operados por quiste del conducto tirogloso, se registraron 9 casos de cáncer papilar (6,34 por ciento). El promedio de edad de los pacientes fue de 32 años. El diámetro promedio de la lesión fue de 4,4 cm (DS 2,2 cm). Del total, 8 pacientes fueron sometidos a tiroidectomía total, se diagnosticó cáncer de tiroides en 3 de ellos, en 6 se asoció tratamiento con radioyodo. En sólo 1 paciente se realizó una disección linfonodal. El tiempo promedio de seguimiento fue de 85 meses; a la fecha la serie no ha presentado recurrencia ni mortalidad. Conclusiones: Si bien el manejo más seguro a largo plazo es la cirugía de Sistrunk, asociado a una tiroidectomía y eventual radioyodo, la resolución quirúrgica con tiroidectomía asociada debe ser considerada cuando la morbilidad no sea mayor que el beneficio teórico.

Manejo de pacientes con fístulas enterocutáneas / Management of enterocutaneous fistulas

Introducción: A pesar de los avances en el manejo, las Fistulas Enterocutáneas (FE) son responsables de un morbi-mortalidad elevada en los serviciosde cirugía. El objetvo de esta investgación es determinar las característcas clínicas y los resultados de los pacientes con FE en nuestra insttución.Métodos: Se realizó un análisis retrospectvo, descriptvo, en el Insttuto de Seguro Social en los años 2009 a 2011. Se incluyeron variables demográ-fcas y clínicas: estado nutricional, característcas de la FE, terapias adyuvantes insttuidas, terapia y resultado fnal: cierre espontaneo o intervenciónquirúrgica y morbi-mortalidad.Resultados: Se presentaron un total de 13 casos, 77% masculinos, la albumina se encontró baja en el momento de diagnostcar la FE en el 77% de loscasos, el 62% fueron fstulas de gasto alto, el cierre espontaneo se dio en el 30%. Durante el tratamiento 67% de los pacientes presentó morbilidad,principalmente neumonía nosocomial. La mortalidad del estudio es de 46%.Conclusión: La FE es una patología de difcil manejo. En nuestro estudio, el 77% de los pacientes presentan hipoalbuminemia, la morbilidad es del 67%y la mortalidad del 46%.

Background: Despite advances in management, enterocutaneous fstula (EF) is responsible for signifcant morbidity and mortality. The aim of this studywas to determine clinical characteristcs and outcomes of patents with EF in our insttuton.Methods: A retrospectve analysis, from 2009 to 2011 of patents with EF at the Social Security Insttute. Demographic and clinical variables were included:nutritonal status, fstula characteristcs, therapy, adjuvant therapies, and outcome: spontaneous or surgical closure; morbidity and mortality.Results: Thirteen patents were evaluated, 77% were male; albumin levels were below normal in 77% of the patents at the tme of EF diagnosis, 62%were high output fstulas and 30% remited with spontaneous closure. Associated morbidity occurred in 67%, especially nosocomial pneumonia. Mortalityrate was 46%.Conclusions: Treatment of EF contnues to be a difcult task; in our study 77% of the patents had albumin levels below normal at the tme of EF diagnosis,morbidity was 67% and mortality was 46%.

Guía de manejo para las fístulas enterocutáneas / Enterocutaneous fístula management guideline

La fístula enterocutánea (FE) es una patología de difícil manejo que requiere la intervención de un equipo multidisciplinario . El objetivo del estudio es recopilar y revisar la mejor y más reciente información sobre la presentación clínica, el diagnóstico y el tratamiento de la FE y dar recomendaciones para su manejo basadas en la mejor evidencia disponible.

Enterocutaneous Fistula (EF) is a challenging pathology that requires a multdisciplinary approach. The aim of this study was to gather and review thebest available evidence about clinical features, diagnosis and treatment of EF in order to provide evidence-based recommendatons.