Navigating Argentina's BRICS Entry: between domestic dynamics and geopolitical Implications

The XV BRICS Summit is where Argentina finally received its official invitation to join BRICS. It was the culmination of a process that began in August 2022, when the country first officially expressed a desire to join the influential group. The matter of enlarging BRICS, which had stirred internal disagreements, particularly between China and the rest, has swept-in nations as diverse as Egypt, Ethiopia, Iran, Saudi Arabia, and the United Arab Emirates. Argentine President Alberto Fernández enthusiastically welcomed his country's membership, which is slated to take effect on January 1st, 2024. He believes Argentina will gain enhanced access to external financing and become an integral part of a Global South reformist coalition that advocates a new and better international financial architecture. Yet his political opposition openly denounced membership of BRICS in the midst of an unanticipated electoral process. Notwithstanding that President Fernández (now in the twilight of his tenure) has been the main advocate of BRICS membership, Argentina’s future with that organization is still uncertain. The nation has commenced its electoral process, and a new President is expected to be elected by October (or November if a second round is required). Consequently, an important question looms: What position will the new government take regarding BRICS

Neoadjuvant intralesional methotrexate for juvenile xanthogranuloma in an adult

Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis usually occurring in infants and typically located in the head or neck.1 Clinically, solitary skin lesions are found in 60%–82% of patients and the most common variant is characterized by one yellowish nodule. Adult onset is rare, and although JXG is usually self-limiting in children, spontaneous resolution is uncommon at older ages. In addition, up to 50% of patients with spontaneous regression develop an atrophy or anetodermal area.2 Thus, complete excision is frequently performed in this population subgroup to achieve better cosmetic results. In disseminated forms, different chemotherapy regimens, corticosteroids and other systemic therapies are used. Herein, we report a case of adult JXG treated with intralesional methotrexate (MTX) resulting in a rapid reduction in size

Alpelisib decreases nevocytes of congenital melanocytic nevi

Background: Multiple, large or giant congenital melanocytic nevi (CMN) are uncommon and affected patients can show progressive growth and thickening, associate neurocutaneous melanocytosis or develop melanoma. Current treatment modalities are mostly complex surgeries that frequently do not solve the disease and its risks completely. Thus, investigation on new treatment options for CMN and its complications must continue. MAPK pathway inhibitors are being investigated, also targeting PI3K-AKT. Omipalisib (PI3K inhibitor, with no indications approved yet) has been studied for CMN in vitro and in mice with promising results. However, alpelisib, a PI3K inhibitor approved with an adequate safety profile for patients with severe manifestations of PROS (PIK3CA-Related Overgrowth Spectrum), had not yet been tested for CMN. Objective: To evaluate the effect of alpelisib in nevocytes of congenital melanocytic nevi. Methods: Nevomelanocytic tissue samples of 10 patients were collected prospectively and, following a previously reported preclinical ex vivo model, explants were placed in organotypic culture for 5 days, with or without alpelisib. Consecutively, tissue sections were stained and using scanned images with Qupath and ImageJ softwares, representative regions from the dermis were analysed (using Wilcoxon test and Spearman's correlation). Results: When comparing alpelisib-treated explants with respect to control explants, we found a decrease in cell density (p = 0.0273), in density of SOX10+ -cells (p = 0.0391) and also in the % of S-100+ area (p = 0.0078), in alpelisib samples. The three markers showed a positive correlation (p < 0.05). Conclusions: This study provides first-time evidence that alpelisib induces nevocyte reduction in CMN from patient-derived explants, probably inducted by autophagy. Alpelisib is an approved drug with an adequate safety profile used in another mosaicism affecting PI3K (PROS). Further studies are needed to evaluate its efficacy in treating CMN and potentially, their complications, either with local or systemic administration, alone or in combination

Neoadjuvant intralesional methotrexate for juvenile xanthogranuloma in an adult

Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis usually occurring in infants and typically located in the head or neck.1 Clinically, solitary skin lesions are found in 60%–82% of patients and the most common variant is characterized by one yellowish nodule. Adult onset is rare, and although JXG is usually self-limiting in children, spontaneous resolution is uncommon at older ages. In addition, up to 50% of patients with spontaneous regression develop an atrophy or anetodermal area.2 Thus, complete excision is frequently performed in this population subgroup to achieve better cosmetic results. In disseminated forms, different chemotherapy regimens, corticosteroids and other systemic therapies are used. Herein, we report a case of adult JXG treated with intralesional methotrexate (MTX) resulting in a rapid reduction in size