Eumicetoma como tumoración en la pierna

A 40-year-old male patient of the black race came to the Doctor’s office due to an increase in volume in the right lower limb. Surgical treatment was performed and eumycetoma was diagnosed. The causative agents of mycetomas are of exogenous origin, and can be fungi (eumycetoma) or actinomycetals (actinomycetoma). They are more frequent in men, although they occur with a very low frequency. Several stages of the disease are observed in endemic areas: plaques in early lesions, advanced lesions, nodules with drainage to the bony sinuses and, very rarely, the formation of a cyst of varying size. Histology consists of a mixture of granulomatous and suppurative reaction, in the dermis and the subcutis.Paciente masculino, de la raza negra, de 40 años que acudió a consulta por presentar aumento de volumen en el miembro inferior derecho. Se realizó tratamiento quirúrgico y se diagnosticó eumicetoma. Los agentes causales de los micetomas son de origen exógeno y pueden ser hongos (eumicetoma) o actinomicetales (actinomicetoma). Son más frecuentes en hombres, a pesar de que se presentan con una frecuencia muy baja. Varios estadios de la enfermedad se observan en áreas endémicas: placas en lesiones tempranas, lesiones avanzadas, nódulos con drenaje a los senos óseos y, muy raramente, formación de quiste de variada talla. La histología consiste en una mezcla de reacción granulomatosa y supurativa, en la dermis y el subcutis

Iron deficiency: impact on functional capacity and quality of life in heart failure with preserved ejection fraction

The effects of iron deficiency (ID) have been widely studied in heart failure (HF) with reduced ejection fraction. On the other hand, studies in HF with preserved ejection fraction (HFpEF) are few and have included small numbers of participants. The aim of this study was to assess the role that ID plays in functional capacity and quality of life (QoL) in HFpEF while comparing several iron-related biomarkers to be used as potential predictors. ID was defined as ferritin <100 ng/mL or transferrin saturation <20%. Submaximal exercise capacity, measured by the 6-min walking test (6MWT), and QoL, assessed by the Minnesotta Living with Heart Failure Questionnaire (MLHFQ), were compared between iron deficient patients and patients with normal iron status. A total of 447 HFpEF patients were included in the present cross-sectional study, and ID prevalence was 73%. Patients with ID performed worse in the 6MWT compared to patients with normal iron status (ID 271 ± 94 m vs. non-ID 310 ± 108 m, p < 0.01). They also scored higher in the MLHFQ, denoting worse QoL (ID 49 ± 22 vs. non-ID 43 ± 23, p = 0.01). Regarding iron metabolism biomarkers, serum soluble transferrin receptor (sTfR) was the strongest independent predictor of functional capacity (β = −63, p < 0.0001, R2 0.39) and QoL (β = 7.95, p < 0.0001, R2 0.14) in multivariate models. This study postulates that ID is associated with worse functional capacity and QoL in HFpEF as well, and that sTfR is the best iron-related biomarker to predict both. Our study also suggests that the effects of ID could differ among HFpEF patients by left ventricular ejection fractio

Neurohormonal activation induces intracellular iron deficiency and mitochondrial dysfunction in cardiac cells

Background: Iron deficiency (ID) is common in patients with heart failure (HF) and is associated with poor outcomes, yet its role in the pathophysiology of HF is not well-defined. We sought to determine the consequences of HF neurohormonal activation in iron homeostasis and mitochondrial function in cardiac cells. Methods: HF was induced in C57BL/6 mice by using isoproterenol osmotic pumps and embryonic rat heart-derived H9c2 cells were subsequently challenged with Angiotensin II and/or Norepinephrine. The expression of several genes and proteins related to intracellular iron metabolism were assessed by Real time-PCR and immunoblotting, respectively. The intracellular iron levels were also determined. Mitochondrial function was analyzed by studying the mitochondrial membrane potential, the accumulation of radical oxygen species (ROS) and the adenosine triphosphate (ATP) production. Results: Hearts from isoproterenol-stimulated mice showed a decreased in both mRNA and protein levels of iron regulatory proteins, transferrin receptor 1, ferroportin 1 and hepcidin compared to control mice. Furthermore, mitoferrin 2 and mitochondrial ferritin were also downregulated in the hearts from HF mice. Similar data regarding these key iron regulatory molecules were found in the H9c2 cells challenged with neurohormonal stimuli. Accordingly, a depletion of intracellular iron levels was found in the stimulated cells compared to non-stimulated cells, as well as in the hearts from the isoproterenol-induced HF mice. Finally, neurohormonal activation impaired mitochondrial function as indicated by the accumulation of ROS, the impaired mitochondrial membrane potential and the decrease in the ATP levels in the cardiac cells. Conclusions: HF characteristic neurohormonal activation induced changes in the regulation of key molecules involved in iron homeostasis, reduced intracellular iron levels and impaired mitochondrial function. The current results suggest that iron could be involved in the pathophysiology of HF

Púrpura de Schönlein-Henoch fulminante

A female patient of 51 years old with personal pathological precedent of bronchial asthma, hypertension and ulcerative colitis and infection by chikungunya virus for a month. She incomes with dark pasty diarrhea with mucus and blood, she evolved unfavorably with flaccid paraplegia and recticularis livedo, which became extensive purple; then phlyctena and generalized edema. She remained hypotensive with electrolyte imbalance and impairment of consciousness, complementaries were performed, she was transfused and underwent to hemodialysis; she evolved to coma and death. The pathological findings showed an adult, fulminant and deadly form of anaphylactoid purpura or Henoch-Schönlein. Mesangial proliferation with fushinofílicos mesangial deposits werefound corresponding to immunoglobulin A with immunofluorescence, leukocytoclastic vasculitis and necrotizing vasculitis of small vessels. Purple of Schönlein-Henoch is a peculiar form of vasculitis that tends to spontaneous healing and occasionally may have a fatal course or proceed to a chronic nephritis.Se trata de paciente femenina de 51 años, con antecedentes patológicos personales de asma bronquial, hipertensión arterial y colitis ulcerativa e infección por el virus de la chikungunya desde hacía un mes. Ingresó con diarreas pastosas oscuras con moco y sangre, evolucionó desfavorablemente con paraplejia flácida y livedo reticularis, que se transformó en púrpura extensa; posteriormente flictenas y edema generalizado. Se mantuvo hipotensa con desequilibrio hidroelectrolítico y deterioro del estado de conciencia, se le realizaron complementarios, fue transfundida y se le realizó hemodiálisis; evolucionó al coma y a la muerte. Los hallazgos anatomopatológicos mostraron una forma adulta, fulminante y mortal de púrpura anafilactoide o de Schönlein-Henoch. Se encontró proliferación mesangial con depósitos mesangiales fushinofílicos correspondientes a inmunoglobulina A con inmunofluorescencia, vasculitis leucocitoclástica y vasculitis necrotizante de pequeños vasos. La púrpura de Schönlein-Henoch es una forma peculiar de vasculitis que tiende a la curación espontánea y, ocasionalmente, puede tener un curso mortal o proseguir hacia una nefritis crónica

Izaña Atmospheric Research Center. Activity Report 2019-2020

Editors: Emilio Cuevas, Celia Milford and Oksana Tarasova.[EN]The Izaña Atmospheric Research Center (IARC), which is part of the State Meteorological Agency of Spain (AEMET), is a site of excellence in atmospheric science. It manages four observatories in Tenerife including the high altitude Izaña Atmospheric Observatory. The Izaña Atmospheric Observatory was inaugurated in 1916 and since that date has carried out uninterrupted meteorological and climatological observations, contributing towards a unique 100-year record in 2016. This reports are a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues.[ES]El Centro de Investigación Atmosférica de Izaña (CIAI), que forma parte de la Agencia Estatal de Meteorología de España (AEMET), representa un centro de excelencia en ciencias atmosféricas. Gestiona cuatro observatorios en Tenerife, incluido el Observatorio de Izaña de gran altitud, inaugurado en 1916 y que desde entonces ha realizado observaciones meteorológicas y climatológicas ininterrumpidas y se ha convertido en una estación centenaria de la OMM. Estos informes resumen las múltiples actividades llevadas a cabo por el Centro de Investigación Atmosférica de Izaña. El liderazgo del Centro en materia de investigación y desarrollo con respecto a las técnicas de medición, calibración y validación de última generación, así como la cooperación internacional, le han otorgado una reputación sobresaliente en lo que se refiere al tiempo, el clima, la hidrología y otros temas ambientales afines

Izaña Atmospheric Research Center. Activity Report 2015-2016

This report is a summary of the many activities at the Izaña Atmospheric Research Center to the broader community. The combination of operational activities, research and development in state-of-the-art measurement techniques, calibration and validation and international cooperation encompass the vision of WMO to provide world leadership in expertise and international cooperation in weather, climate, hydrology and related environmental issues

La erupción volcánica de La Palma y el papel de la Agencia Estatal de Meteorología

Durante la erupción del volcán de Cumbre Vieja, en la isla de La Palma en 2021, la Agencia Estatal de Meteorología (AEMET), en calidad de Servicio Nacional y Autoridad Meteorológica del Estado, prestó diferentes servicios de apoyo al Comité Científico y al Comité Asesor del Plan de Emergencias Volcánicas de Canarias (PEVOLCA). Parte de sus actividades abarcaron la vigilancia y predicción meteorológica, la monitorización y predicción del transporte del penacho volcánico, y la valoración del impacto de las emisiones de gases y cenizas de la erupción volcánica en la calidad del aire en la isla de La Palma y en la región de Canarias.Peer reviewe