Effect of Paclitaxel-based Hyperthermic Intraperitoneal Chemotherapy (HIPEC) on colonic anastomosis in a rat model

BACKGROUND

Paclitaxel has been used frequently for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for ovarian carcinomatosis. Cytoreductive surgery and HIPEC are associated with high rates of morbidity being anastomotic dehiscence one of the most frequent. The objective of this study is to quantify the effect of Paclitaxel-based HIPEC on colonic anastomosis in an experimental rat model.

METHODS

After left colon resection and anastomosis, animals were randomized into four groups: Controls (C); Hyperthermia (H); Normothermic Intraperitoneal Paclitaxel (CP) and Paclitaxel-based HIPEC (HP). On postoperative day four, animals' peritoneal cavities were examined macroscopically, colon anastomosis burst pressures measured and specimens analyzed histologically.

RESULTS

Thirty-nine animals were randomized and 36 were included in the analysis. H group presented the highest burst pressure 105.11 ± 22.9 mmHg, which was 27% higher than C (77.89 ± 27.6 mmHg). On the other hand, HP presented the lowest burst pressure 64 ± 26 mmHg, 16% lower than C group and 39% lower than H, being this latter difference statistically significant (p = 0.004). There were no significant differences regarding weight loss, adhesion scores, perianastomotic abscesses and histological findings (inflammation, fibroblasts, neoangiogenesis, and collagen among groups).

CONCLUSION

Strength of colonic anastomosis was improved by isolated hyperthermia and negatively affected by Paclitaxel-based HIPEC.

Sarna sarcóptica en cerdos criados en cama profunda. Reporte de caso clínico

La sarna sarcóptica en los cerdos es causada por Sarcoptes scabiei var. suis el cual se distribuye ampliamente en los cinco continentes. Los productores porcícolas en general están preocupados por las infecciones parasitarias internas e ignoran las infestaciones parasitarias externas; estas últimas, causadas por S. scabiei tienen gran importancia económica ya que causa morbilidad, mortalidad, disminución de la fertilidad y de la tasa de conversión alimenticia. Este trabajo permitió determinar la presencia de sarna sarcóptica en cerdos criados bajo sistema de producción con cama profunda de una granja en el estado Guárico (Venezuela), utilizando las técnicas parasitológicas directas de flotación-concentración y microscopía directa. Los resultados demostraron que dos de siete muestras evaluadas fueron positivas con S. scabiei var. suis. El 100% de los animales presentaron lesiones de piel compatibles con la presencia del ácaro, pero el mismo solo pudo ser detectado en el 28,6% de ellos. La técnica de flotación-concentración fue más efectiva que la de microscopía directa. En este estudio describimos la primera detección de S. scabiei var. suis en cerdos domésticos en Venezuela criados en cama profunda.

Basal cell carcinoma treated with Mohs micrographic surgery in young Ibero-American patients

BACKGROUND

The incidence of basal cell carcinoma (BCC) in younger individuals has increased in recent decades. However, the characteristics of BCCs in this population, especially in Ibero-Latin American countries, have not been completely defined.

OBJECTIVE

To describe the demographic, clinical, and histopathological characteristics of BCCs in patients younger than 40 treated with Mohs Micrographic Surgery (MMS).

MATERIALS AND METHODS

A multicenter, retrospective study conducted between January 2009 and December 2014, in five Ibero-American countries, included biopsy-proven BCCs in patients younger than 40 that were treated with MMS. Demographic, clinical, histopathological, and surgical characteristics were described.

RESULTS

The study included 301 tumors in 241 patients, of whom 61% were female. The most common Fitzpatrick phototype was III. The most common histological subtypes were nodular (37.5%) and infiltrative (18.9%). Perineural invasion was encountered in 1.7%, and tumor clearance was achieved in 87.4% within two stages of MMS.

CONCLUSIONS

This is the first Ibero-Latin American transnational study describing the characteristics of BCCs in young patients treated with MMS. Despite darker skin phototypes in this population, BCCs can occur in early ages and may present with aggressive features. Therefore, MMS may be considered an appropriate first-line treatment option in this population.

Factors associated with poor anticoagulation control with vitaminK antagonists among outpatients attended in Internal Medicine and Neurology. The ALADIN study

OBJECTIVE

To identify factors associated with poor anticoagulation control with vitaminK antagonists (VKA) among outpatients with nonvalvular atrial fibrillation (NVAF) attended in Neurology and Internal Medicine in Spain.

METHODS

Cross-sectional and multicenter study, from the ALADIN database, of outpatients with NVAF treated with VKA and attended in Internal Medicine and Neurology in Spain. Rates of anticoagulation control were determined with the direct and Rosendaal methods, considering data from the 6months before the inclusion.

RESULTS

Out of 1,337 patients included in the ALADIN study, 750 were taking VKA, and complete information about INR values in the last 6months was available in 383 patients. Mean scores of Charlson Index, CHADS₂, CHA₂DS₂-VASc and HAS-BLED were 1.94±1.54; 3.10±1.26; 4.63±1.54, and 2.20±0.90, respectively. 46.2% and 47.0% of patients had an adequate anticoagulation control according to the direct and Rosendaal methods, respectively. Inadequate anticoagulation control according to the direct method was associated with diabetes (OR: 2.511; 95%CI: 1.144-5.659), prior labile INR (OR: 35.371; 95%CI: 15.058-83.083) and the determination of >6INR controls in the last 6months (OR: 4.747; 95%CI: 2.094-10.759), and according to the Rosendaal method, with prior labile INR (P<.001) and HAS-BLED score (OR: 3.991; 95%CI: 2.520-6.319).

CONCLUSIONS

Despite the high thromboembolic risk, only a little more than a half of patients were well controlled. Factors associated with poor anticoagulation control were diabetes, labile INR, >6INR controls and HAS-BLED.

Enhancement of VP6 immunogenicity and protective efficacy against rotavirus by VP2 in a genetic immunization

VP2/VP6 virus like particles (VLPs) are very effective in inducing protection against the rotavirus infection in animal models. Individually, VP6 can also induce protection. However, there is no information about the immunogenicity of VP2. The aim of this work was to evaluate the efficacy of DNA vaccines codifying for VP2 or VP6, alone or combined, to induce protection against the rotavirus infection. Murine rotavirus VP2 and VP6 genes were cloned into the pcDNA3 vector. Adult BALB/c mice were inoculated three times by intramuscular (i.m.) injections with 100 or 200µg of pcDNA3-VP2 or pcDNA3-VP6 alone or co-administered with 100µg of pcDNA3-VP2/100µg of pcDNA3-VP6. Two weeks after the last inoculation, mice were challenged with the wild type murine rotavirus strain epizootic diarrhea of infant mice (EDIM_wt). We found that both plasmids, pcDNA3-VP2 and pcDNA3-VP6, were able to induce rotavirus-specific serum antibodies, but not intestinal rotavirus-specific IgA; only 200µg of pcDNA3-VP6 induced 35% protection against the infection. A similar level of protection was found when mice were co-administered with 100µg of pcDNA3-VP2/100µg of pcDNA3-VP6 (1:1 ratio). However, the best protection (up to 58%) occurred when mice were inoculated with 10µg of pcDNA3-VP2/100µg of pcDNA3-VP6 (1:10 ratio). These results indicate that the DNA plasmid expressing VP6 is a better vaccine candidate that the one expressing VP2. However, when co-expressed, VP2 potentiates the immunogenicity and protective efficacy of VP6.

Preoperative CEA and TAG-72 Serum Levels as Prognostic Indicators in Resectable Gastric Carcinoma

We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p<0.01) in patients with stage I tumors (2.9 ± 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 ± 6.8 ng/ml; stage HI-TV: 6.8 ± 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 ± 1.8 U/ml) and stage II and stage III-IV (30.4 ± 20.7 U/ml and 26.1 ± 9.7 U/ml, respectively) (p<0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 ± 20.1 U/ml and 23.1 ± 9.4 U/ml, respectively) than in well differentiated tumors (4.4 ± 0.9 U/ml) (p<0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p<0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.

Evaluation of Obstructed Kidneys by Discriminant Analysis of 99mTc-MAG3 Renograms

This study sought to develop a method of improving the differential diagnostic between healthy and obstructed kidneys using only parameters derived from the 99mTc-MAG3 renogram. The analysis included data from 46 healthy and 36 obstructed kidney units. The parameters calculated were: mean transit time (MTT), time at 20% of the initial height of the renal retention function (T20) and time to peak of the renogram (TP). A discriminant analysis was carried out to obtain a discriminant function in order to differentiate between the two groups. The best results were obtained using the function: (2.5629 lnT20) +(2.1280 In TP) -27.1224 which correctly classified 97.56% of the cases, giving a sensitivity of 94.44% and a specificity of 99.99%.

Parity and grazing-time effects on milk fatty acid profile in dairy cows

Milk fatty acid (FA) profiles of lactating Holstein dairy cows were determined to evaluate the effects of parity (primiparous or multiparous) and the grazing time (0, 6 and 12 h), complementary to a total mixed ration, in a 2 × 3 factorial design. The interaction of parity with grazing time did not affect milk production and protein content; however, dry matter intake of herbage, total dry matter intake and milk fat content were affected by the interaction (P < 0.05). Both factors affected the milk concentration of monounsaturated FAs. The 18 : 3 cis9 cis12, 18 : 2 cis9 trans11, and 18 : 3 cis9 cis12 cis15 concentrations in milk were higher (P < 0.05) in primiparous cows. Milk 18 : 2 cis9 trans11 concentration in primiparous cows with 12 h grazing (1.17 g/100 g FA) was 44% and 57% higher than with 6 h and 0 h grazing (0.66 and 0.50 g/100 g FA, respectively). Similar pattern was observed for 18 : 3 cis9 cis12 cis15. The milk 18 : 1 trans11 concentration was higher (P < 0.05) with 6 h and 12 h grazing than without grazing. In conclusion, the parity would appear to mainly affect the proportion of short-chain FAs, and had an important influence on the proportions of 18 : 2 cis9 trans11, and 18 : 3 cis9 cis12 cis15. These FAs and also 18 : 1 trans11 were modified by grazing time.

Metal accumulation and detoxification mechanisms in mycorrhizal Betula pubescens

Metal detoxification in plants is a complex process that involves different mechanisms, such as the retention of metals to the cell wall and their chelation and subsequent compartmentalization in plant vacuoles. In order to identify the mechanisms involved in metal accumulation and tolerance in Betula pubescens, as well as the role of mycorrhization in these processes, mycorrhizal and non-mycorrhizal plants were grown in two industrial soils with contrasting concentrations of heavy metals. Mycorrhization increased metal uptake at low metal concentrations in the soil and reduced it at high metal concentrations, which led to an enhanced growth and biomass production of the host when growing in the most polluted soil. Our results suggest that the sequestration on the cell wall is the main detoxification mechanism in white birch exposed to acute chronic metal-stress, while phytochelatins play a role mitigating metal toxicity inside the cells. Given its high Mn and Zn root-to-shoot translocation rate, Betula pubescens is a very promising species for the phytoremediation of soils polluted with these metals.

Direct and maternal additive effects are not the main determinants of Iberian piglet perinatal mortality

Data of 127,800 Iberian piglets were used to study genetic parameters of mortality at birth at the piglet level. These records proceed from three data sets: 4,987 litter of 2,156 sows of a dam line, 2,768 litter of 817 sows of a complete diallel cross between four Iberian strains and 7,153 litter of 2,113 sows of the Torbiscal composite line. Perinatal mortality was considered as a binary trait, and Bayesian threshold animal models were fitted to separately analyse the three data sets. The posterior means of direct heritability were 0.010, 0.004 and 0.003, and those of maternal heritability were 0.034, 0.011 and 0.014 for dam line, diallel cross and Torbiscal line, respectively. Important effects of litter size and parity order were inferred in the three data sets, of within-breed cross-breeding parameters in the diallel cross and of sex and sow handling in the Torbiscal line Therefore, the inclusion of perinatal mortality in the objective of selection is questionable in this breed and strategies for reducing piglet mortality successful in other breeds should be considered.

Mycorrhization protects Betula pubescens Ehr. from metal-induced oxidative stress increasing its tolerance to grow in an industrial polluted soil

In recent years, the use of woody plants in phytoremediation has gained popularity due to their high biomass production and their association with mycorrhizal fungi, which can improve their survival and development rates under stress conditions. In this study, mycorrhized and non-mycorrhized white birch plants (Betula pubescens Ehr.) were grown in control and a metal-polluted industrial soil. After 60days of culture, plant growth and metal accumulation, the content of photosynthetic pigments and oxidative-stress markers, as well as the enzymatic activities and gene expressions of antioxidant enzymes were measured. According to our results, mycorrhized birch plants grown in control soil showed an increased activity and gene expression of catalase and ascorbate peroxidase, along with hydrogen peroxide overproduction, which could support the importance of the reactive oxygen species as signaling molecules in the regulation of plant-fungus interactions. Additionally, in polluted soil mycorrhized plants had higher biomass but lower metal accumulation, probably because the symbiotic fungus acted as a barrier to the entrance of metals into the host plants. This behavior led to mitigation in the oxidative challenge, reduced hydrogen peroxide content and diminished activities of the antioxidant enzymes in comparison to non-mycorrhized plants.

Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014)

INTRODUCTION

In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends.

PATIENTS AND METHODS

CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain.

RESULTS

Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014).

CONCLUSIONS

Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups.

Mapping natural radioactivity of soils in the eastern Canary Islands

The Canary Islands archipielago (Spain) comprises seven main volcanic islands and several islets that form a chain extending for around 500 km across the eastern Atlantic, between latitudes 27°N and 30°N, with its eastern edge only 100 km from the NW African coast. The administrative province of Las Palmas comprises the three eastern Canary Islands (Lanzarote, Fuerteventura and Gran Canaria). An extensive study of terrestrial gamma dose rates in surface soils has been carried out to cover the entire territory of the province (4093 km²). The average outdoor gamma dose rate in air at 1 m above ground is 73 nGyh^-1 at Gran Canaria, 32 nGyh^-1 at Fuerteventura, and 25 nGyh^-1 at Lanzarote. To complete the radiological characterization of this volcanic area, 350 soil samples at 0-5 cm depth were collected to cover all the geologic typologies of the islands. These samples were measured using high resolution gamma spectrometry to determine the activity concentrations of ²²⁶Ra, ²³²Th and ⁴⁰K. The average values obtained were 25.2 Bq/kg, 28.9 Bq/kg, and 384.4 Bq/kg, respectively. Maps of terrestrial gamma activity, effective dose, and activity concentrations of ²²⁶Ra, ²³²Th and ⁴⁰K for the region have been developed through the use of geostatistical interpolation techniques. These maps are in accord with the geology of the islands.

Datos morfométricos de Trypanosoma evansi en carpinchos (Hydrochaeris hydrochaeris) de Chaco, Argentina

El objetivo del trabajo fue verificar la existencia de variaciones morfométricas de Trypanosoma evansi en Hydrochaeris hydrochaeris criados en cautiverio en Chaco, Argentina. Para ello se efectuaron mediciones de variables biométricas de 52 ejemplares de T. evansi provenientes de carpinchos. Se reconocieron dos variaciones morfométricas del parásito, delgadas y rechonchas. Las dimensiones de ambas formas se compararon con los resultados obtenidos en T. evansi de carpinchos del amazonas peruano. Los resultados revelaron diferencias significativas en todas las variables sometidas a estudio (p&lt;0,05). Se concluye que al parasitar a H. hydrochaeris, T. evansi presenta dimensiones morfométricas diferentes a las halladas en Perú, variando inclusive en el mismo animal.

Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus

OBJECTIVES

To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients.

METHOD

We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function.

RESULTS

All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL.

CONCLUSIONS

Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.