Novel Endometrial Cancer Models Using Sensitive Metastasis Tracing for CXCR4-Targeted Therapy in Advanced Disease

Advanced endometrial cancer (EC) lacks therapy, thus, there is a need for novel treatment targets. CXCR4 overexpression is associated with a poor prognosis in several cancers, whereas its inhibition prevents metastases. We assessed CXCR4 expression in EC in women by using IHC. Orthotopic models were generated with transendometrial implantation of CXCR4-transduced EC cells. After in vitro evaluation of the CXCR4-targeted T22-GFP-H6 nanocarrier, subcutaneous EC models were used to study its uptake in tumor and normal organs. Of the women, 91% overexpressed CXCR4, making them candidates for CXCR4-targeted therapies. Thus, we developed CXCR4(+) EC mouse models to improve metastagenesis compared to current models and to use them to develop novel CXCR4-targeted therapies for unresponsive EC. It showed enhanced dissemination, especially in the lungs and liver, and displayed 100% metastasis penetrance at all clinically relevant sites with anti-hVimentin IHC, improving detection sensitivity. Regarding the CXCR4-targeted nanocarrier, 60% accumulated in the SC tumor; therefore, selectively targeting CXCR4(+) cancer cells, without toxicity in non-tumor organs. Our CXCR4(+) EC models will allow testing of novel CXCR4-targeted drugs and development of nanomedicines derived from T22-GFP-H6 to deliver drugs to CXCR4(+) cells in advanced EC. This novel approach provides a therapeutic option for women with metastatic, high risk or recurrent EC that have a dismal prognosis and lack effective therapies

Diagnóstico y Propuesta de Evaluación de las Clases en Línea en Educación Superior para Nicaragua y Honduras

En este texto se presenta como resultado de un estudio que tuvo como objetivo proponer alternativas o estrategias de evaluación en entornos virtuales en la educación superior para Honduras y Nicaragua, haciendo énfasis en cómo se evaluaba a través de entornos virtuales antes de la emergencia del -19, cómo se encuentra el proceso, y hacia dónde va la evaluación en la educación del futuro. El estudio se realizó a través de una técnica de recolección de datos utilizando como instrumento la encuesta, la que fue aplicada a 74 docentes, obteniendo como resultado aportes significativos para la elaboración de la propuesta mediante la que se identificó que el 61% de los docentes considera que debe haber una combinación de evaluación sumativa (finalista con exámenes) y acumulativa por proceso. Con base en estos resultados se concluye que la educación que se brinde a los futuros profesionales debe estimular la creatividad e imaginación, fomentando la comunicación entre estudiantes y docentes, desarrollo y crecimiento de este importante programa educativo

Inflammatory pseudotumour secondary to spilled intra-abdominal gallstones

AbstractINTRODUCTIONSpillage of calculi in the abdomen is frequent during Laparoscopic Cholecystectomy (LC). Though uncommon, these stones may lead to early or late complications. We describe a rare case of spilled gallstone presenting four years after the index procedure, with a mass in the parietal wall mimicking a neoplastic lesion.PRESENTATION OF CASEA 50 year old male presented with a mass in the right upper quadrant for the past 2 years. His past surgical history included a LC done four years ago. Intraoperative procedural details of the surgery were not available. A Computed Tomography (CT) scan showed an extrahepatic mass in the subdiaphragmatic space extending onto the soft tissues of the parietal wall. He underwent laparoscopic piecemeal excision of this organized mass. His post operative period was uneventful and he was pain-free on follow up.DISCUSSIONGallbladder perforation can occur due to excessive traction during retraction or during dissection from the liver bed. It can also occur during extraction from the abdomen. Infected bile, pigment gallstones, male gender, advanced age, perihepatic location of spilled gallstones, more than 15 gallstones and an average size greater than 1.5cm have been identified as risk factors for complications. Definitive treatment is surgery with excision of the organized inflammatory mass and extraction of gallstones to avoid future recurrence.CONCLUSIONSpilled gallstones can be a diagnostic challenge and can cause significant morbidity to the patient. Clear documentation of spillage and explanation to the patient is of utmost importance, as this will enable prompt recognition and treatment of any complications. Prevention of spillage is the best policy

Conservative management of splenic abscess septic emboli after tooth extractions

Splenic abscesses are rare but may be associated with high mortality. Usually they occur in patients with systemic infection related to some immunocompromised state. The symptoms are nonspecific and the diagnosis is often late, but the development of better imaging techniques has enabled better diagnosis of splenic abscess and percutaneous drainage is a valid and safe complementary treatment option. We report a case of a patient with splenic abscess secondary to septic emboli after tooth extractions, managed conservatively with antibiotics and percutaneous drainage