Tumor urotelial de vejiga en la infancia: reporte de un nuevo caso

Introduction: bladder tumors are rare in childhood, only 0.38% of cases belong to people younger than 20 years prevailing the mesodermic origin. Considering those of epithelial origin, more than 100 cases have been diagnosed since 1950, mostly with superficial lesions, benign behavior, more common in males (ratio male / female 5/1 to 7/1), and its etiology has not yet been clarified. Case presentation: it is reported the case of a 15-year-old black teenager who came to our hospital with a total painless haematuria with no other associated symptoms. After some studies like transabdominal ultrasound and cystoscopy with biopsy it was found that he had a malignant tumor of the vesical urothelium. Discussion: papillomatous vesical tumor in the right lateral side of the bladder, away from the urethral meatus with approximately 2 cm of diameter and narrow base similar to bladder mucosa coloration. Partial cystectomy was performed evolving without complications. Conclusions: urothelial tumors in the pediatric population are extremely rare, its biological behavior is less aggressive than the one in the adult population, and the election treatment is the Trans urethral resection.Introducción: los tumores vesicales son infrecuentes en la infancia, solo un 0,38% de los casos corresponden a menores de 20 años, prevaleciendo los de origen mesodérmico. Considerando aquellos de estirpe epitelial, algo más de 100 casos han sido diagnosticados desde 1950, tratándose, en su gran mayoría, de lesiones superficiales, de comportamiento benigno, más frecuentes en varones (cociente hombre/mujer de 5/1 a 7/1), su etiología aún no ha sido aclarada.Presentación de caso: se reporta el caso de un adolescente de 15 años de edad raza negra que acude a nuestro hospital por hematuria total indolora, sin otros síntomas asociados. Después de los estudios realizados como Ecografía transabdominal y Cistoscopia con biopsia se comprueba que presentaba una tumoración maligna del urotelio vesical.Discusión:tumoración vesical de aspecto papilomatoso, en la cara lateral derecha de la vejiga alejada del meato ureteral, de aproximadamente 2 cm de diámetro, de base estrecha y de coloración similar a la mucosa de vejiga. Se le realizo Cistectomía parcial evolucionando sin complicaciones.Conclusiones: los tumores uroteliales en la población pediátrica, son extremadamente raros, su comportamiento biológico es menos agresivo que el que tienen en la población adulta, el tratamiento de elección es la Resección Tran­suretral

Risk Factors in Patients with Kidney Cancer

Introducción: el adenocarcinoma renal descrito por Koing y conocido como tumor de Grawitz representa aproximadamente el 3 % de todas las neoplasias malignas en el ser humano y la proporción masculina femenina  de 2.1 resulta más frecuente en la zona urbana y la mayoría de los pacientes afectados se encuentran entre los 50 y 70 años a nivel internacional.Objetivo: identificar la influencia de determinados factores de riesgo en la aparición de esta enfermedad.Método: se realizó un estudio descriptivo y retroprospectivo donde se analizó el tratamiento quirúrgico del cáncer de riñón en el Hospital Provincial Universitario “Carlos Manuel de Céspedes”, desde Enero de 2008 a Enero 2013, distribuyendo los pacientes por edad y sexo, síntomas encontrados, tratamiento realizado, metástasis y tiempo de sobrevida. Resultados: se determinó que dicho cáncer fue más frecuente en el sexo femenino  entre 50 y 59 años. El síntoma predomínate fue el dolor lumbar y hematuria. Las metástasis más frecuentes fueron en Hígado y partes blandas. Los fallecidos fueron de 4 pacientes, 3 mujeres y un hombre.Conclusiones: el proceder terapéutico utilizado con mayor frecuencia fue la nefrectomía radical; la infección urinaria predomino como complicación. Resultó el carcinoma de células claras el tipo histológico que prevaleció. La supervivencia  fue mayor en el sexo masculino. El tumor renal derecho predomino sobre el izquierdo.Introduction: renal adenocarcinoma described by Koing and known as Grawitz tumor represents approximately 3% of all malignant neoplasias in human beings and the female – male ratio of 2.1 is more frequent in the urban area and the most affected patients are between 50 and 70 years internationally. Objective: to identify the influence of certain risk factors in the onset of the disease. Method: it was performed a retro descriptive and prospective study where it was analyzed the surgical treatment of kidney cancer in the University Province Hospital "Carlos Manuel de Céspedes", since January 2008 to January 2013, distributing the patients according to age and sex, symptoms, treatment, metastasis and survival time. Results: it was found that the cancer was more frequent in women between 50 and 59 years. The prevailing symptoms were lumbar pain and hematuria. The most frequent metastases were in the liver and in soft parts. The deceased were 4 patients: 3 women and a man. Conclusions: the mostly used therapeutic procedure was the radical nephrectomy; the urinary infection prevailed as a complication. The clear cell carcinoma was the histological type that prevailed. Survival was greater in males. The right renal tumor prevailed on the left tumor

Granzyme A inhibition reduces inflammation and increases survival during abdominal sepsis

Aims: Peritonitis is one of the most common causes of sepsis, a serious syndrome characterized by a dysregulated systemic inflammatory response. Recent evidence suggests that Granzyme A (GzmA), a serine protease mainly expressed by NK and T cells, could act as a proinflammatory mediator and could play an important role in the pathogenesis of sepsis. This work aims to analyze the role and the therapeutic potential of GzmA in the pathogenesis of peritoneal sepsis. Methods: The level of extracellular GzmA as well as GzmA activity were analyzed in serum from healthy volunteers and patients with confirmed peritonitis and were correlated with the Sequential Organ Failure Assessment (SOFA) score. Peritonitis was induced in C57Bl/6 (WT) and GzmA-/- mice by cecal ligation and puncture (CLP). Mice were treated intraperitoneally with antibiotics alone or in combination serpinb6b, a specific GzmA inhibitor, for 5 days. Mouse survival was monitored during 14 days, levels of some proinflammatory cytokines were measured in serum and bacterial load and diversity was analyzed in blood and spleen at different times. Results: Clinically, elevated GzmA was observed in serum from patients with abdominal sepsis suggesting that GzmA plays an important role in this pathology. In the CLP model GzmA deficient mice, or WT mice treated with an extracellular GzmA inhibitor, showed increased survival, which correlated with a reduction in proinflammatory markers in both serum and peritoneal lavage fluid. GzmA deficiency did not influence bacterial load in blood and spleen and GzmA did not affect bacterial replication in macrophages in vitro, indicating that GzmA has no role in bacterial control. Analysis of GzmA in lymphoid cells following CLP showed that it was mainly expressed by NK cells. Mechanistically, we found that extracellular active GzmA acts as a proinflammatory mediator in macrophages by inducing the TLR4-dependent expression of IL-6 and TNFa. Conclusions: Our findings implicate GzmA as a key regulator of the inflammatory response during abdominal sepsis and provide solid evidences about its therapeutic potential for the treatment of this severe pathology

Mitochondrial Bioenergetic Alterations in Mouse Neuroblastoma Cells Infected with Sindbis Virus: Implications to Viral Replication and Neuronal Death

The metabolic resources crucial for viral replication are provided by the host. Details of the mechanisms by which viruses interact with host metabolism, altering and recruiting high free-energy molecules for their own replication, remain unknown. Sindbis virus, the prototype of and most widespread alphavirus, causes outbreaks of arthritis in humans and serves as a model for the study of the pathogenesis of neurological diseases induced by alphaviruses in mice. In this work, respirometric analysis was used to evaluate the effects of Sindbis virus infection on mitochondrial bioenergetics of a mouse neuroblastoma cell lineage, Neuro 2a. The modulation of mitochondrial functions affected cellular ATP content and this was synchronous with Sindbis virus replication cycle and cell death. At 15 h, irrespective of effects on cell viability, viral replication induced a decrease in oxygen consumption uncoupled to ATP synthesis and a 36% decrease in maximum uncoupled respiration, which led to an increase of 30% in the fraction of oxygen consumption used for ATP synthesis. Decreased proton leak associated to complex I respiration contributed to the apparent improvement of mitochondrial function. Cellular ATP content was not affected by infection. After 24 h, mitochondria dysfunction was clearly observed as maximum uncoupled respiration reduced 65%, along with a decrease in the fraction of oxygen consumption used for ATP synthesis. Suppressed respiration driven by complexes I- and II-related substrates seemed to play a role in mitochondrial dysfunction. Despite the increase in glucose uptake and glycolytic flux, these changes were followed by a 30% decrease in ATP content and neuronal death. Taken together, mitochondrial bioenergetics is modulated during Sindbis virus infection in such a way as to favor ATP synthesis required to support active viral replication. These early changes in metabolism of Neuro 2a cells may form the molecular basis of neuronal dysfunction and Sindbis virus-induced encephalitis

Morbilidad en Consulta externa de urología

Se realizó un estudio prospectivo, longitudinal y descriptivo para conocer el comportamiento de la morbilidad de las principales afecciones urológicas en la consulta externa del Servicio de Urología del Hospital Provincial General Docente «Carlos Manuel de Céspedes». Se estudiaron 120 pacientes en el período comprendido entre el 1ro. de enero y el 31 de diciembre de 1998. El adenoma prostático predominó en la serie (37,1 %). La edad media de los pacientes fue de 51,25 años (±19,52), y predominó el grupo de 30 a 44 años (30,9 %). El sexo masculino dominó en la serie (90,8 %). Predominó la concordancia diagnóstica negativa entre los diferentes grupos de remitentes (55,8 %). El examen físico fue el método diagnóstico principal (54,7 %). Las afecciones urológicas halladas en la investigación son fácilmente diagnosticables por examen físico, lo cual puede ser realizado por un médico general con entrenamiento mínimoA prospective, longitudinal and descriptive study was conducted to know the behavior of morbidity of the main urologic affections at the Outpatient Department of the Urology Service of "Carlos Manuel de Céspedes" Provincial General Teaching Hospital. 120 patients were studied from January 1st to December 31st, 1998. The prostatic adenoma predominated in the series (37.1 %). The average age of the patients was 51.25 % ( ± 19.52). The age group 30-44 (30.9 %) prevailed. Most of the patients were males (90.8 %). The negative diagnostic concordance predominated among the different groups of referred patients (55.8 %). The physical examination was the main diagnostic method (54.7 %). The urologic affections found in our investigation may be easily diagnosed by physical examination, which can be made by a general physician with a minimum trainin

Natural and human disturbance in a rookery of the California sea lion (Zalophus californianus californianus) in the Gulf of California, Mexico

Los Islotes is the southernmost breeding site of the California sea lion (Zalophus californianus californianus) in the Northern Hemisphere and represents one of the principal tourist attractions for the city of La Paz, Mexico. The tourism has been growing without control and could be the cause of perturbation in the reproductive and haul-out patterns of the sea lion. The aim of the present study was to determine the effect of tourism activities on the behavior of sea lions, in order to help design regulations to assure better use and conservation of the site. The nature and intensity of tourism activity and sea lion behavior were determined based upon monthly sampling over a one-year period (May 2000 - April 2001). Tourist activity was higher during autumn and winter, with visits by 'panga' boats being the most numerous. A total of 112 disturbances were recorded, the majority of which being non-anthropogenic causes. A quarter of disturbances were triggered by human activity within 20m of the rookery and with harassment reaction (animals going into the water) in 32% of the anthropogenic disturbances. Principal component analysis (PCA) described the conditions under which disturbance was generated (74% of the variation explained). Using three factors (47% of the total variation) the major contributing variables were month, tidal level, relative humidity, Beaufort number, total number of boats and number of powerboats and sailboats. In Los Islotes, the perturbation occurs mostly in autumn and winter coinciding with the highest frequency of tourism, large number of adult and subadult males and unfavorable environmental conditions for haul-out, such as high tide level and strong winds. The lowest number of disturbances occurred in summer, during the breeding season of the sea lion. Most of these, however, were caused by human activity