Xantoma tendinoso normolipémico múltiple en coexistencia con glaucoma terminal bilateral y sindactilia

Tendinous xanthomas are usually associated with hyperlipidemia, normolipemic tendinous xanthomas are uncommon. The histopathology of this condition is characterized by the presence of foam cells, cholesterol clefts, and Touton cells. We present a 22-year-old male patient with normolipemic tendon xanthomas, coexisting with bilateral terminal glaucoma and syndactyly, where histology and immunohistochemistry were very useful to reach the definitive diagnosis.Los xantomas tendinosos están habitualmente asociados con hiperlipidemia, de ahí que son infrecuentes los xantomas tendinosos normolipémicos. La histopatología de este cuadro es característica por la presencia de células espumosas, hendiduras de colesterol y células de Touton. Presentamos el caso de un paciente varón de 22 años portador de xantomas tendinosos normolipémicos, en coexistencia con glaucoma terminal bilateral y sindactilia donde la histología y la inmunohistoquímica fueron de gran utilidad para el diagnóstico definitivo

Searching for glycosylated natural products in actinomycetes and identification of novel macrolactams and angucyclines

Many bioactive natural products are glycosylated compounds in which the sugar components usually participate in interaction and molecular recognition of the cellular target. Therefore, the presence of sugar moieties is important, in some cases essential, for bioactivity. Searching for novel glycosylated bioactive compounds is an important aim in the field of the research for natural products from actinomycetes. A great majority of these sugar moieties belong to the 6-deoxyhexoses and share two common biosynthetic steps catalyzed by a NDP-D-glucose synthase (GS) and a NDP-D-glucose 4,6-dehydratase (DH). Based on this fact, seventy one Streptomyces strains isolated from the integument of ants of the Tribe Attini were screened for the presence of biosynthetic gene clusters (BGCs) for glycosylated compounds. Total DNAs were analyzed by PCR amplification using oligo primers for GSs and DHs and also for a NDP-D-glucose-2,3-dehydratases. Amplicons were used in gene disruption experiments to generate non-producing mutants in the corresponding clusters. Eleven mutants were obtained and comparative dereplication analyses between the wild type strains and the corresponding mutants allowed in some cases the identification of the compound coded by the corresponding cluster (lobophorins, vicenistatin, chromomycins and benzanthrins) and that of two novel macrolactams (sipanmycin A and B). Several strains did not show UPLC differential peaks between the wild type strain and mutant profiles. However, after genome sequencing of these strains, the activation of the expression of two clusters was achieved by using nutritional and genetic approaches leading to the identification of compounds of the cervimycins family and two novel members of the warkmycins family. Our work defines a useful strategy for the identification new glycosylated compounds by a combination of genome mining, gene inactivation experiments and the activation of silent biosynthetic clusters in Streptomyces strains

Características clínicas histológicas y epidemiológicas del cáncer de piel no melanoma Hospital Militar Central 2015-2016

El objetivo del presente estudio fue conocer las características clínicas, histológicas y epidemiológicas del cáncer de piel no melanoma en el Hospital Militar Central en los años 2015 a 2016. Se realizó un estudio observacional, descriptivo, retrospectivo de corte transversal. Se revisaron las historias clínicas de 163 pacientes atendidos en el servicio de dermatología del Hospital Militar Central en los años 2015 y 2016, con diagnóstico clínico e histopatológico de CPNM, que incluía al Carcinoma Basocelular (CBC) y al Carcinoma Espinocelular (CEC) y se analizaron variables como edad, sexo, raza, grado militar, formas clínicas e histológicas y ubicación anatómica de las lesiones. En el presente estudio se observó un aumento en el número de casos del CPNM en los años estudiados. Se encontró una relación CBC/CEC: 3,2/1. El sexo masculino (60%), la raza mestiza (87,7%) y los oficiales militares (66%) fueron los más afectados. La edad promedio de presentación fue 75,16 años. El CBC nodular fue la forma clínica más frecuente (70,97%) de los CBC y el tipo invasivo de los CEC (76,92%). Los tipos histológicos más comunes fueron CBC sólido (49,19%) y el CEC bien diferenciado (46,15%). La ubicación anatómica más frecuentemente afectada por el CPNM fue la cabeza (79,8%), seguido por el tronco (9,2%). La tendencia al aumento de la incidencia del CPNM, edad, predominancia del CBC, tipos histológicos y ubicación anatómica muestran similitudes con la literatura revisada. La cabeza como localización frecuente y la edad encontrada corroborarían el rol predominante de la radiación solar en la patogenia de la enfermedad. Hacen falta más estudios en el Hospital Militar Central y en otras Instituciones de Salud del Perú para obtener mayores registros epidemiológicos que permitan conseguir la prevalencia nacional del CPNM

Knowledge, attitudes and practices about sun exposure and photoprotection in outpatients attending dermatology clinics at four hospitals in Lima, Peru Exposição solar e conhecimento, atitudes e práticas de fotoproteção em pacientes de unidades ambulatoriais de dermatologia em quatro hospitais de Lima, Peru

BACKGROUND: To establish the knowledge, about sun exposure and photoprotection in outpatients treated at the dermatology clinics in four hospitals in Lima, Peru. MATERIAL AND METHODS: A cross-sectional study was conducted involving a sample of 364 patients selected using a systematic random sampling process in the four participating hospitals. The selected patients were interviewed to determine their knowledge, behavior and practices in relation to sun exposure and photoprotection. The chi-square test was used to identify any significant differences between knowledge and practices. RESULTS: The mean age of the patients in this sample was 45.1 ± 21.4 years. Of the 364 patients, 55.9% were women and 54.8% had skin phototype IV. The principal risks related to sun exposure were skin cancer (80.5%) and sunburn (77.8%). Knowledge regarding sun protection was more evident in individuals with university/college education (p<0.001). In addition, 78.9% of the individuals reported that they knew about photo-protectors and 52.3% stated that they used them regularly. In general, women were more knowledgeable regarding sun protection (p=0.001). Of the total number of users of photoprotection, 38.4% used these products daily, while 61.6% used them only occasionally. The use of photo-protectors differed significantly in accordance with the individual's education level (p<0.001). In the majority of cases there was a statistically significant difference between knowledge and practice with respect to solar protection. CONCLUSIONS: The level of awareness of the outpatients treated at the dermatology clinics in these four hospitals in Lima, Peru about the risks of sun exposure is acceptable; however, a large proportion fail to incorporate regular solar protection as a practice in their daily life.<br>FUNDAMENTOS: O objetivo deste estudo foi determinar o conhecimento, sobre a exposição solar e fotoproteção em pacientes ambulatoriais tratados nas unidades de dermatologia de quatro hospitais em Lima, Peru. MATERIAIS E MÉTODOS: Estudo de corte transversal. A amostra foi formada por 364 pacientes originários dos quatro hospitais participantes. Os pacientes foram selecionados através de um processo de amostragem aleatória sistemática. Uma vez selecionados, os pacientes foram entrevistados para determinação do conhecimento, atitudes e práticas em relação à exposição ao sol e à fotoproteção. O teste do qui-quadrado foi usado para determinar diferenças significativas entre conhecimento e práticas. RESULTADOS: Os pacientes tinham em média 45,1±21,4 anos de idade, 55,9% eram mulheres e 54,8% tinham pele fototipo IV. Os principais riscos relacionados à exposição solar foram câncer de pele (80,5%) e queimaduras solares (77,8%). Participantes com nível universitário apresentaram maior conhecimento sobre proteção solar (p <0,001). O conhecimento de fotoprotetores foi relatado por 78,9% dos participantes enquanto o uso periódico dos fotoprotetores foi relatado por 52,3%. As mulheres tinham conhecimento amplamente maior sobre proteção solar (p = 0,001). Do total de usuários de fotoprotetores, 38,4% usavam o produto diariamente e 61,6% usavam somente ocasionalmente. O uso de fotoprotetores variou significantemente com o nível de escolaridade (p <0,001). Na maioria dos casos se encontrou diferença estatisticamente significante entre o conhecimento sobre fotoproteção e práticas de fotoproteção. CONCLUSÕES: Os pacientes ambulatoriais tratados nas unidades de dermatologia desses quatro hospitais em Lima têm um nível aceitável de conhecimento mas um grande número deles não haviam incorporado práticas de fotoproteção nas rotinas pessoais