Prognostic value of specific KRAS mutations in patients with colorectal peritoneal metastases.

BACKGROUND: There is little evidence on KRAS mutational profiles in colorectal cancer (CRC) peritoneal metastases (PM). This study aims to determine the prevalence of specific KRAS mutations and their prognostic value in a homogeneous cohort of patients with isolated CRC PM treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. MATERIALS AND METHODS: Data were collected from 13 Italian centers, gathered in a collaborative group of the Italian Society of Surgical Oncology. KRAS mutation subtypes have been correlated with clinical and pathological characteristics and survival [overall survival (OS), local (peritoneal) disease-free survival (LDFS) and disease-free survival (DFS)]. RESULTS: KRAS mutations occurred in 172 patients (47.5%) out of the 362 analyzed. Two different prognostic groups of KRAS mutation subtypes were identified: KRASMUT1 (G12R, G13A, G13C, G13V, Q61H, K117N, A146V), median OS > 120 months and KRASMUT2 (G12A, G12C, G12D, G12S, G12V, G13D, A59E, A59V, A146T), OS: 31.2 months. KRASMUT2 mutations mainly occurred in the P-loop region (P < 0.001) with decreased guanosine triphosphate (GTP) hydrolysis activity (P < 0.001) and were more frequently related to size (P < 0.001) and polarity change (P < 0.001) of the substituted amino acid (AA). When KRASMUT1 and KRASMUT2 were combined with other known prognostic factors (peritoneal cancer index, completeness of cytoreduction score, grading, signet ring cell, N status) in multivariate analysis, KRASMUT1 showed a similar survival rate to KRASWT patients, whereas KRASMUT2 was independently associated with poorer prognosis (hazard ratios: OS 2.1, P < 0.001; DFS 1.9, P < 0.001; LDFS 2.5, P < 0.0001). CONCLUSIONS: In patients with CRC PM, different KRAS mutation subgroups can be determined according to specific codon substitution, with some mutations (KRASMUT1) that could have a similar prognosis to wild-type patients. These findings should be further investigated in larger series.

Emphysematous osteomyelitis: a rare and aggressive disease.

Emphysematous osteomyelitis is an extremely rare entity consisting of the presence of intraosseous gas that can extend to the joints and adjacent soft tissues. It is an aggressive infectious process associated with high mortality, especially in patients with risk factors such as tumors or diabetes mellitus. Because early diagnosis and immediate treatment are crucial to prevent the potentially devastating consequences of this condition, imaging tests such as computed tomography play a fundamental role in its diagnosis and management. Therefore, radiologists must be aware that intraosseous gas is a rare but alarming sign that is pathognomonic of emphysematous osteomyelitis, especially in the axial skeleton.

Ion dynamic characterization using phase-resolved laser-induced fluorescence spectroscopy in a Hall effect thruster.

Significant information on the dynamics of the plasma constituents in Hall effect thrusters can be obtained using minimally intrusive techniques, such as laser-induced fluorescence (LIF) diagnostics. Indeed, LIF provides an excellent tool to determine the ion velocity distribution function with high spatial resolution. Even in a steady-state operation, recording time-resolved maps of the velocity distribution is relevant due to persisting time-dependent features of the thruster discharge. One of the preeminent phenomena that render the ion velocity distribution to be time dependent is commonly attributed to the breathing mode, characterized by pronounced oscillations in the discharge current. The goal of this work is to propose a new technique for plasma dynamic studies based on LIF spectroscopy with phase-resolution during the breathing period. For this purpose, the Hilbert transform is used to define the instantaneous phase of oscillation of the thruster current. Ion velocity distribution modification over assigned phases of oscillation is measured simultaneously and in real-time thanks to a fully numerical analysis of the data.

Manejo del trauma pre-hospitalario. ¿Qué hacer?

El manejo pre-hospitalario del trauma corresponde a la fase cero del control de daños, tiene por objetivo evitar y prevenir el desarrollo del rombo mortal. A pesar de que la mortalidad causada por una hemorragia aguda traumática es prevenible, solo el 50% de los pacientes son manejados a tiempo. En la actualidad, existen múltiples métodos mecánicos y químicos para el control hemorrágico en un ambiente austero. La campaña Stop the Bleed de la American College of Surgeons (ACS), ha promovido el uso de los dispositivos mecánicos por la población general a través de la capacitación. En el enfrentamiento prehospitalario del trauma, se utiliza el clásico A-B-C-D-E, agregando la letra X al inicio, para indicar que el primer manejo debe ser el control de las hemorragias externas compresibles. En conclusión: El manejo prehospitalario rápido y ordenado, determina mejores resultados en la evolución clínica y sobrevida del paciente politraumatizado.

The pre-hospital management of trauma is zero phase of damage control, its objective is to avoid and prevent the development of the fatal rhombus. Although mortality caused by acute traumatic hemorrhage is preventable, only 50% of patients are managed on time. Currently there are multiple mechanical and chemical methods for hemorrhagic control in an austere environment. The Stop the Bleed program of the American College of Surgeons (ACS) has promoted the use of mechanical devices by the general population through training. In prehospital trauma, the classic A-B-C-D-E is used, adding the letter X at the beginning to indicate that the first management should be of compressible external hemorrhages. The rapid and orderly prehospital management determines better results in the clinical evolution and survival of the polytraumatized patient.

Nanostructured Conducting Polymers and Their Applications in Energy Storage Devices.

Due to the energy requirements for various human activities, and the need for a substantial change in the energy matrix, it is important to research and design new materials that allow the availability of appropriate technologies. In this sense, together with proposals that advocate a reduction in the conversion, storage, and feeding of clean energies, such as fuel cells and electrochemical capacitors energy consumption, there is an approach that is based on the development of better applications for and batteries. An alternative to commonly used inorganic materials is conducting polymers (CP). Strategies based on the formation of composite materials and nanostructures allow outstanding performances in electrochemical energy storage devices such as those mentioned. Particularly, the nanostructuring of CP stands out because, in the last two decades, there has been an important evolution in the design of various types of nanostructures, with a strong focus on their synergistic combination with other types of materials. This bibliographic compilation reviews state of the art in this area, with a special focus on how nanostructured CP would contribute to the search for new materials for the development of energy storage devices, based mainly on the morphology they present and on their versatility to be combined with other materials, which allows notable improvements in aspects such as reduction in ionic diffusion trajectories and electronic transport, optimization of spaces for ion penetration, a greater number of electrochemically active sites and better stability in charge/discharge cycles.

Intraventricular hemorrhage induces inflammatory brain damage with blood-brain barrier dysfunction in immature rats.

BACKGROUND: We aimed to characterize a preclinical model of intraventricular hemorrhage-induced brain damage (IVH-BD) in extremely low birth weight newborns (ELBWN), to identify potential therapeutic targets based on its pathophysiology. METHODS: IVH was induced in 1-day-old (P1) Wistar rats by left periventricular injection of clostridium collagenase (PVCC). At P6, P14, and P45 IVH-BD (area of damage, motor and cognitive deficits, Lactate/N-acetylaspartate ratio), white matter injury (WMI: ipsilateral hemisphere and corpus callosum atrophy, oligodendroglial population and myelin basic protein signal reduction), blood-brain barrier (BBB) dysfunction (occludin and Mfsd2a expression, Gadolinium leakage) and inflammation (TNFα, TLR4, NFkB, and MMP9 expression; immune cell infiltration), excitotoxicity (Glutamate/N-acetylaspartate), and oxidative stress (protein nitrosylation) were assessed. Sham animals were similarly studied. RESULTS: IVH-BD leads to long-term WMI, resulting in motor and cognitive impairment, thus reproducing IVH-BD features in ELBWN. BBB dysfunction with increased permeability was observed at P6 and P14, coincident with an increased inflammatory response with TLR4 overexpression, increased TNFα production, and increased immune cell infiltration, as well as increased excitotoxicity and oxidative stress. CONCLUSIONS: This model reproduced some key hallmarks of IVH-BD in ELBWN. Inflammation associated with BBB dysfunction appears as relevant therapeutic target to prevent IVH-BD-induced WMI. IMPACT: Paraventricular injection of clostridium collagenase (PVCC) to 1-day-old Wistar rats uniquely reproduced the neuroimaging, histologic and functional characteristics of intraventricular hemorrhage-induced brain damage (IVH-BD) in extremely low birth weight newborns (ELBWN). PVCC-induced IVH triggered a prolonged inflammatory response associated with blood-brain barrier increased permeability, which in turn facilitates the infiltration of inflammatory cells. Thus, PVCC led to white matter injury (WMI) resulting in long-term motor and cognitive impairment. This model offers a valuable tool to obtain further insight into the mechanisms of IVH-BD in ELBWN and proposes some key therapeutic targets.

Capacitors Based on Polypyrrole Nanowire Electrodeposits.

The electrochemical polymerization of polypyrrole nanowires is carried out using potentiodynamic and galvanostatic methods in order to enhance the performance of the modified electrodes as capacitor devices. The electrochemical, spectroscopic, and morphological properties are determined through cyclic voltammetry, Raman spectroscopy and scanning electron microscopy, respectively, corroborating the presence of PPy-nw in dimensions of 30 nm in diameter. Characterization as a capacitor revealed that the nanowire structure enhances key parameters such as specific capacitance with 60 times greater value than bulk polymer modification, in addition to a significant increase in stability. In this way, it is verified that electrodes modified with polypyrrole nanowires obtained in situ by electrochemical methods constitute an excellent candidate for the development of capacitors.

Polystyrene nanoplastics affect the human ubiquitin structure and ubiquitination in cells: a high-resolution study.

Humans are estimated to consume several grams per week of nanoplastics (NPs) through exposure to a variety of contamination sources. Nonetheless, the effects of these polymeric particles on living systems are still mostly unknown. Here, by means of CD, NMR and TEM analyses, we describe at an atomic resolution the interaction of ubiquitin with polystyrene NPs (PS-NPs), showing how a hard protein corona is formed. Moreover, we report that in human HeLa cells exposure to PS-NPs leads to a sensible reduction of ubiquitination. Our study overall indicates that PS-NPs cause significant structural effects on ubiquitin, thereby influencing one of the key metabolic processes at the base of cell viability.

Analgesia perioperatoria mediante bloqueo del plano erector espinal en implante de asistencia ventricular izquierda / Perioperative analgesia by erector spinae plane block in left ventricular assist implant

Los dispositivos de asistencia ventricular izquierda se han convertido en los últimos años en un elemento importante para el manejo del fallo ventricular izquierdo refractario a tratamiento farmacológico. Su implantación (realizada mediante toracotomía izquierda o esternotomía) genera un importante dolor perioperatorio, que puede ser manejado con técnicas de anestesia locorregional. Sin embargo, existe gran controversia sobre su realización en cirugía cardíaca debido a la interferencia con la terapia anticoagulante necesaria en estos pacientes.El bloqueo del plano erector espinal constituye una alternativa a las técnicas locorregionales clásicas, al no producir alteraciones hemodinámicas y no interferir con la terapia antiagregante y anticoagulante, siendo una alternativa a tener en cuenta en cirugía cardíaca. Presentamos un caso de implantación de asistencia ventricular izquierda con realización de dicho bloqueo previo al procedimiento quirúrgico e infusión postoperatoria a través de catéter, obteniéndose resultados satisfactorios en el manejo del dolor perioperatorio.(AU)

In recent years, left ventricular assist devices have become an important element in the management of left ventricular failure refractory to pharmacological treatment. Their implantation (performed by left thoracotomy or sternotomy) generates significant perioperative pain, which can be managed with locoregional anesthesia techniques. However, opinions vary on their use in cardiac surgery due to interference with the anticoagulant therapy required in these patients.The erector spinae plane block is an alternative to classic locoregional techniques. It does not produce hemodynamic alterations and does not interfere with antiplatelet and anticoagulant therapy, and is therefore an alternative to be considered in cardiac surgery. We present a case of left ventricular assist device implantation under this block prior to the surgical procedure and postoperative infusion through a catheter, obtaining satisfactory results in the management of perioperative pain.(AU)

Perioperative analgesia by erector spinae plane block in left ventricular assist implant.

In recent years, left ventricular assist devices have become an important element in the management of left ventricular failure refractory to pharmacological treatment. Their implantation (performed by left thoracotomy or sternotomy) generates significant perioperative pain, which can be managed with locoregional anaesthesia techniques. However, opinions vary on their use in cardiac surgery due to interference with the anticoagulant therapy required in these patients. The erector spinae plane block is an alternative to classic locoregional techniques. It does not produce hemodynamic alterations and does not interfere with antiplatelet and anticoagulant therapy, and is therefore an alternative to be considered in cardiac surgery. We present a case of left ventricular assist device implantation under this block prior to the surgical procedure and postoperative infusion through a catheter, obtaining satisfactory results in the management of perioperative pain.

Fístula de gerbode adquirida após cirurgia de correção valvar / Gerbod fistula acquired after valve repair surgery

INTRODUÇÃO: Fístula de Gerbode é uma comunicação entre o ventrículo esquerdo e o átrio direito (VE-AD). O defeito é raro, pode ser congênito ou adquirido. A forma adquirida é mais frequentemente observada após cirurgia valvar, endocardite ou infarto. Relataremos 2 casos de pacientes com fístula de Gerbode adquirida pós-intervenção valvar. Caso 1: Mulher, 56 anos, com diagnóstico pré-operatório de insuficiência mitral (IM) importante, fibrilação atrial, hipertensão pulmonar (HP) e insuficiência tricúspide (IT) discreta. Foi submetida à plastia mitral, tricúspide e exclusão de ambas as auriculetas. Um ano após a cirurgia, paciente assintomática, sem sinais de insuficiência cardíaca (IC), porém foi auscultado um sopro sistólico rude em borda esternal esquerda (BEE). O ecocardiograma transesofágico (ETE) demonstrou presença da fístula com 3,5mm do VE para o AD com gradiente de VE-AD de 95 mmHg, redução da HP (de 50 para 36 mmHg) e função do VD normal. A paciente foi mantido em observação. Caso 2: Homem, 61 anos, diagnóstico pré-operatório de IM importante primária, HP importante (PSAP 116mmHg) e IT moderada. Foi submetido a implante de bioprótese mitral e plastia tricúspide. Evoluiu com melhora sintomática e redução da HP. Foi observado sopro sistólico rude em BEE. O ETE demonstrou uma fístula VE-AD, com gradiente de 92 mmHg. Paciente assintomático, sem repercussão hemodinâmica, mantido em tratamento conservador. DISCUSSÃO: Na literatura, a evolução de casos com a fístula varia desde assintomáticos até desfechos desfavoráveis como insuficiência cardíaca, endocardite e necessidade de oclusão da fístula. Apesar de ser relatado como defeito raro, a incidência está aumentando devido ao maior número de intervenção cirúrgica. O diagnóstico é difícil e muitas vezes necessário complementação com ETE para melhor definição do tamanho e localização do defeito e para melhor programação da correção quando houver indicação. A intervenção pode ser cirúrgica ou percutânea. Em paciente assintomáticos, defeitos pequenos e sem sobrecarga de VD podem ser mantidos em conduta conservadora desde que com acompanhamento frequente. CONCLUSÃO: Foram relatados dois casos de fístula de Gerbode (comunicação entre o VE e o AD) adquiridas após cirurgia de correção valvar. Ambos os pacientes relatados foram tratados clinicamente, estão em CF I, sem alterações das câmaras cardíacas.

Collegiate male athletes exhibit conditions of the Male Athlete Triad.

The primary purpose of this study was to determine prevalence of the Male Athlete Triad (MAT) conditions: low energy availability (EA), low bone mineral density (BMD), and low testosterone in male collegiate athletes from different sports. Participants included 44 collegiate male athletes (age, 20.4 ± 0.2 years; body mass index, 25.3 ± 1.3 kg/m2) from 7 sports (cross country, soccer, basketball, wrestling, track, golf, and baseball). Resting metabolic rate, 3-day food intake, 7-day exercise energy expenditure, body composition, and reproductive and metabolic hormones were assessed. Of the total participants, 15% had low EA, 0% had low BMD, 28% had low total testosterone (TT), and 80% had low calculated free testosterone (cFT). There were no significant correlations between EA, BMD, TT, and cFT. Insulin and sex hormone binding globulin (SHBG) were below and on the upper end of the reference range for healthy male adults, respectively. Insulin was negatively correlated with total (r = -0.330, p = 0.043) and lumbar spine BMD z-scores (r = -0.413, p = 0.010). Low TT and low cFT were the most prevalent MAT conditions among all athletes. Further research should investigate the relationship between insulin and SHBG and the role of these hormones in the MAT. Novelty: Assessment of energy availability alone is not sufficient to identify physiological disturbances in collegiate male athletes. Low total and/or free testosterone may be present in some collegiate male athletes, regardless of BMD status. Low insulin and high SHBG concentration may portray the presence of conditions of the MAT in male collegiate athletes.

[Effectiveness, adherence and usability of a teleneurorehabilitation programme to ensure continuity of care for patients with acquired brain injury during the COVID-19 pandemic]. / Efectividad, adhesión y usabilidad de un programa de teleneurorrehabilitación para garantizar la continuidad de cuidados en pacientes con daño cerebral adquirido durante la pandemia originada por la COVID-19.

INTRODUCTION: The health pandemic brought about by SARS-CoV-2 (COVID-19) has limited access to neurorehabilitation programmes for many patients who have suffered stroke, traumatic brain injury or acquired brain damage due to some other cause. As telerehabilitation allows for the provision of care in situations of social distancing, it may mitigate the negative effects of confinement. The aim of this study was to determine the efficacy, adherence and usability of a teleneurorehabilitation intervention for patients with acquired brain injury. PATIENTS AND METHODS: All patients included in a face-to-face neurorehabilitation programme at the time of the declaration of the state of alarm in Spain due to COVID-19 and who agreed to participate in the study were included in a teleneurorehabilitation programme. The effectiveness of the programme, understood as an improvement in independence, was quantified with the Barthel index. Adherence to the programme and usability of the tool were explored through questionnaires. RESULTS: Altogether, 46 patients, accounting for 70.6% of the total, participated in the study. Participants significantly improved their independence and showed an improvement in the Barthel index between the start (77.3 ± 28.6) and the end of the programme (82.3 ± 26). Adherence to the intervention was very high (8.1 ± 2.2 out of 10) and the online sessions were the most highly rated content. The tool used showed a high usability (50.1 ± 9.9 out of 60) and could be used without assistance by more than half the participants. CONCLUSION: The teleneurorehabilitation intervention was found to be effective in improving patients' independence, and promoted a high degree of adherence and usability.

TITLE: Efectividad, adhesión y usabilidad de un programa de teleneurorrehabilitación para garantizar la continuidad de cuidados en pacientes con daño cerebral adquirido durante la pandemia originada por la COVID-19.Introducción. La pandemia sanitaria originada por el SARS-CoV-2 (COVID-19) ha limitado el acceso a programas de neurorrehabilitación de muchos pacientes que han sufrido ictus, traumatismos craneoencefálicos o un daño cerebral adquirido por otra causa. Dado que la telerrehabilitación permite la provisión de cuidados en situaciones de distanciamiento social, podría atenuar los efectos negativos del confinamiento. El objetivo de este estudio fue determinar la eficacia, la adhesión y la usabilidad de una intervención de teleneurorrehabilitación dirigida a pacientes con daño cerebral adquirido. Pacientes y métodos. Todos los pacientes incluidos en un programa de neurorrehabilitación presencial en el momento de la declaración del estado de alarma en España con motivo de la COVID-19 y que aceptaron participar en el estudio fueron incluidos en un programa de teleneurorrehabilitación. La eficacia del programa, entendida como una mejora en la independencia, se cuantificó con el índice de Barthel. La adhesión al programa y la usabilidad de la herramienta se investigaron mediante cuestionarios. Resultados. Un total de 146 pacientes, el 70,6% del total, participó en el estudio. Los participantes mejoraron significativamente su independencia y mostraron una mejoría en el índice de Barthel entre el inicio (77,3 ± 28,6) y el fin del programa (82,3 ± 26). La intervención tuvo una gran adhesión (8,1 ± 2,2 sobre 10) y las sesiones en línea fueron el contenido mejor valorado. La herramienta utilizada mostró una elevada usabilidad (50,1 ± 9,9 sobre 60) y pudo ser utilizada sin ayuda por más de la mitad de los participantes. Conclusión. La intervención de teleneurorrehabilitación resultó ser eficaz para mejorar la independencia de los pacientes, y promovió una elevada adhesión y usabilidad.

Hyptis mociniana: phytochemical fingerprint and photochemoprotective effect against UV-B radiation-induced erythema and skin carcinogenesis.

Skin cancer is a public health problem due to its high incidence. Ultraviolet radiation (UVR) is the main etiological agent of this disease. Photochemoprotection involves the use of substances to avoid damage caused by UV exposure. The aim of this work was to determine the phytochemical fingerprint and photochemoprotective effect against UVB radiation-induced skin damage such as erythema and carcinogenesis of H. mociniana methanolic extract (MEHm). The chemical composition of the MEHm was analysed by LC/ESI-MS/MS. Three quercetin derivatives, two pectinolides, and two caffeic acid derivatives were identified in the methanolic extract. MEHm has antioxidant effect and it is not cytotoxic in HaCaT cells. Phytochemicals from H. mociniana have a photochemopreventive effect because they absorb UV light and protect HaCaT cells from UVR-induced cell death. Also, in SKH-1 mice -acute exposure-, it decreased erythema formation, modulating the inflammatory response, reduced the skin damage according to histological analysis and diminished p53 expression. Finally, MEHm protects from photocarcinogenesis by reducing the incidence and multiplicity of skin carcinomas in SKH-1 mice exposed chronically to UVB radiation.

Medical education from the point of view of medical students: Results from four participatory Delphi panels in Quito, Ecuador.

BACKGROUND: Medical curricula have historically been designed in a top-down approach, usually excluding students. While Delphi panels have been used as a tool for medical education curricula design, none have been conducted in Ecuador. In addition, no such approach has ever included students both as panelists and researchers. MATERIAL AND METHODS: Four Delphi panels were developed and conducted using a participatory approach that allowed medical students to take part both as expert panelists and researchers: specifically, students developed the questionnaire and conducted a qualitative synthesis. Questionnaire responses were anonymized and dispatched online to panelists. The information was organized and collected to develop the qualitative syntheses and prepare the final statements. RESULTS: Thirty-two medical students participated between February and May 2018. A total of 32 questions were developed, corresponding to five different categories. For some questions, consensus was reached; for other questions, general statements were obtained.Discussion and conclusion: Developing the questionnaire, responding to it and analyzing the answers allowed students to raise significant concerns regarding medical education topics proposing relevant policy and curricula change. Participatory Delphi panels can be an efficient tool to obtain organized feedback, improve student class involvement, and promote research skills.

The influence of hospital antimicrobial use on carbapenem-non-susceptible Enterobacterales incidence rates according to their mechanism of resistance: a time-series analysis.

BACKGROUND: Carbapenem non-susceptible Enterobacterales (CNSE) can be broadly divided into those that produce carbapenemases (carbapenemase-producing Enterobacterales (CPE)), and those that harbour other mechanisms of resistance (non-carbapenemase-producing CNSE (NCP-CNSE)). AIM: To determine the predictors of CNSE nosocomial incidence rates according to their mechanism of resistance. METHODS: A time-series analysis was conducted (July 2013 to December 2018) to evaluate the relationship in time between hospital antibiotic use and the percentage of adherence to hand hygiene with the CNSE rates. FINDINGS: In all, 20,641 non-duplicated Enterobacterales isolates were identified; 2.2% were CNSE. Of these, 48.1% and 51.9% were CPE and NCP-CNSE, respectively. Of the CPE, 78.3% possessed a blaOXA-232 gene. A transfer function model was identified for CNSE, CPE, and OXA-232 CPE that explained 20.8%, 19.3%, and 24.2% of their variation, respectively. According to the CNSE and CPE models, an increase in piperacillin-tazobactam (TZP) use of 1 defined daily dose (DDD) per 100 hospital patient-days (HPD) would lead to an increase of 0.69 and 0.49 CNSE and CPE cases per 10,000 HPD, respectively. The OXA-232 CPE model estimates that an increase of 1 DDD per 100 HPD of TZP use would lead to an increase of 0.43 OXA-232 CPE cases per 10,000 HPD. A transfer function model was not identified for NCP-CNSE, nor was there an association between the adherence to handhygiene and the CNSE rates. CONCLUSION: The use of TZP is related in time with the CPE nosocomial rates, mostly explained by its effect on OXA-232 CPE.

Disintegrins extracted from totonacan rattlesnake (Crotalus totonacus) venom and their anti-adhesive and anti-migration effects on MDA-MB-231 and HMEC-1 cells.

Disintegrins are low molecular weight cysteine-rich proteins (4-14 kDa) that are isolated mainly from viperid snake venom. Due to their potential as lead compounds for binding and blocking integrin receptors, snake venom disintegrins have become one of the most studied venom protein families. The aim of this study was to obtain disintegrins from C. totonacus venom and evaluate their capability to bind and block integrin receptors. The C. totonacus disintegrin fraction (totonacin) represents two disintegrin isoforms obtained from C. totonacus venom. These disintegrins showed extracellular-matrix (ECM) protein adhesion and migration inhibitory effects on MDA-MB-231 and HMEC-1 cells. Totonacin (3 µM) inhibited MDA-MB-231 cell adhesion to the ECM proteins, fibronectin, vitronectin, and laminin by 31.2, 44.0, and 32.1, respectively. Adhesion inhibition to fibronectin, vitronectin, and laminin observed on HMEC-1 cells was 42.8, 60.8, and 51%, respectively. In addition, totonacin (3 µM) significantly inhibited MDA-MB-231 and HMEC-1 cell migration (41.4 and 48.3%, respectively). Totonacin showed more potent cell adhesion inhibitory activity toward vitronectin in both cell lines. These results suggest a major affinity of totonacin toward αVß3, α8ß1, αVß5, αVß1, and αIIbß3 integrins. In addition, the inhibitory effect observed on MDA-MB-231 and HMEC-1 cell migration reinforces the evidence of an interaction between these disintegrins and αVß3 integrin, which plays a key role in migration and angiogenesis.