Adenocarcinoma de la tercera porción duodenal moderadamente diferenciado

ResumenAntecedentesEl adenocarcinoma de duodeno es un tumor poco frecuente; representa el 33-45% de todos los tumores de intestino delgado. Los síntomas no son específicos, y el diagnóstico con frecuencia es accidental.Caso clínicoVarón de 35 años, que consulta por dolor abdominal posprandial. La endoscopia diagnosticó un tumor de la tercera porción duodenal (adenoma tubular con alto grado de displasia mediante la biopsia endoscópica). La tomografía computada, la resonancia magnética nuclear y la ecoendoscopia, mostraron un tumor de la tercera porción duodenal, sin metástasis linfáticas o peritoneales. Se realizó resección parcial del duodeno y el diagnóstico definitivo fue de adenocarcinoma de la tercera porción duodenal sobre adenoma tubular pT2N0M0.ConclusionesLas neoplasias de duodeno son muy raras. La duodenopancreatectomía cefálica se recomienda para los tumores de localización proximal, mientras que las resecciones segmentarias son apropiadas para localizaciones distales, con la misma supervivencia.AbstractBackgroundDuodenal carcinoma is very rare. It represents 33-45% of the all tumours of the small bowel. The symptoms are non-specific, and the diagnosis is often accidental.Clinical caseA 35-year old man was admitted to our hospital with post-prandial abdominal pain. Upper gastrointestinal examination revealed a tumour of the third duodenal portion, which was diagnosed, using endoscopic biopsy, as a tubular adenoma with high grade dysplasia. The computed axial tomography scan, the magnetic resonance imaging, and the endoscopic ultrasound showed the neoplasia of the third duodenal portion with no lymph node or peritoneal metastases. Partial resection of the duodenum was performed. The definitive histopathological diagnosis was primary adenocarcinoma of the third duodenal portion. pT2 N0M0, originated in a tubular adenoma.ConclusionsPrimitive neoplasia of the duodenum is very rare. Duodeno-cephalo-pancreatectomy is recommended in proximally located tumours, while segmental resection of the duodenum is appropriated for distal locations, with the same survival

Greater diversity than previously thought of chromaffin cell Ca2+ channels, derived from mRNA identification studies

AbstractUsing reverse transcription followed by PCR amplification (RT-PCR), we have identified multiple messenger RNAs encoding for the neuronal pore-forming Ca2+ channel subunits α1A (P/Q channel), α1B (N channel), α1D (neuronal/endocrine L channel), α1E (R channel), α1G-H (T channel) and α1S (skeletal muscle L channel) in bovine chromaffin cells. mRNAs for the auxiliary β2, β3, β4, α2/δ and γ2 subunits were also identified. In agreement with these molecular data, perforated patch-clamp recordings of whole-cell Ca2+ currents reveal the existence of functional R-type Ca2+ channels in these cells that were previously undetected with other techniques. Our results provide a molecular frame for a much wider functional diversity of Ca2+ channels in chromaffin cells than that previously established using pharmacological and electrophysiological approaches

Rituximab therapy for chonic and refractory immune thrombocytopenic purpura: a long-term follow-up analysis

The aim of this study was to evaluate the long-term response to rituximab in patients with chronic and refractory immune thrombocytopenic purpura (ITP). Adults with ITP fail to respond to conventional therapies in almost 30% of cases, developing a refractory disease. Rituximab has been successfully used in these patients. We used rituximab at 375 mg/m2, IV, weekly for a total of four doses in 18 adult patients. Complete remission (CR) was considered if the platelet count was >100 × 109/l, partial remission (PR) if platelets were >50 × 109/l, minimal response (MR) if the platelet count was >30 × 109/l and <50 × 109/l, and no response if platelet count remained unchanged. Response was classified as sustained (SR) when it was stable for a minimum of 6 months. Median age was 43.5 years (range, 17 to 70). Median platelet count at baseline was 12.5 × 109/l (range, 3.0 to 26.3). CR was achieved in five patients (28%), PR in five (28%), MR in four (22%), and two patients were classified as therapeutic failures (11%). Two additional patients were lost to follow-up. The median time between rituximab therapy and response was 14 weeks (range, 4 to 32). SR was achieved in 12 patients (67%). There were no severe adverse events during rituximab therapy. During follow-up (median, 26 months; range, 12 to 59), no other immunosuppressive drugs were used. In conclusion, rituximab therapy is effective and safe in adult patients with chronic and refractory ITP. Overall response rate achieved is high, long term, and with no risk of adverse events

Intestinal Dysbiosis and Rheumatoid Arthritis: A Link between Gut Microbiota and the Pathogenesis of Rheumatoid Arthritis

Characterization and understanding of gut microbiota has recently increased representing a wide research eld, especially in autoimmune diseases. Gut microbiota is the major source of microbes which might exert benecial as well as pathogenic effects on human health. Intestinal microbiome’s role as mediator of inammation has only recently emerged. Microbiota has been observed to differ in subjects with early rheumatoid arthritis compared to controls, and this nding has commanded this study as a possible autoimmune process. Studies with intestinal microbiota have shown that rheumatoid arthritis is characterized by an expansion and/or decrease of bacterial groups as compared to controls. In this review, we present evidence linking intestinal dysbiosis with the autoimmune mechanisms involved in the development of rheumatoid arthritis

Rol del propano en la reacción de deshidrogenación oxidativa de etano para producir etileno / Papel do propano na reação de desidrogenação oxidativa do etano para produzir etileno

En este trabajo se investiga el efecto del propano, la impureza más prominente de las corrientes de etano que se procesan industrialmente en los hornos pirolíticos, en la reacción de deshidrogenación oxidativa de etano (DHO-E), siendo este último un proceso catalítico novedoso para producir etileno. El propano se hizo reaccionar con aire en un micro-reactor de lecho fijo, empacado con un catalizador a base de MoVSbOx utilizando condiciones de reacción empleadas típicamente en la DHO-E. La conversión de propano es de moderada a alta, con una distribución a productos tal en la que las especies de oxidación total (COx) dominan a las de oxidación parcial (propileno), un comportamiento que difiere de lo observado con etano. La producción de COx es relevante debido a la alta exotermicidad de las reacciones de combustión. La importancia relativa de las reacciones de oxidación parcial y total del propano a condiciones de la ODH-E es luego valorada formalmente mediante una cinética del tipo Ley de Potencias. La descripción cinética de la conversión del propano en la ODH-E es crucial para poder especificar el contenido máximo de propano en la corriente industrial de etano, desde la perspectiva térmica del reactor y seguridad de un proceso industrial. 

Plasma levels of mitochondrial and nuclear DNA in patients with massive pulmonary embolism in the emergency department: A prospective cohort study

Introduction: Cell-free plasma mitochondrial DNA (mt-DNA) and nuclear DNA (n-DNA) are biomarkers with prognostic utility in conditions associated with a high rate of cell death. This exploratory study aimed to determine the plasma levels of both nucleic acids in patients with massive and submassive pulmonary embolism (PE) and to compare them with other biomarkers, such as heart-type fatty acid-binding protein (H-FABP) and troponin I (Tn-I) Methods: This was a prospective observational study of 37 consecutive patients with massive PE, 37 patients with submassive PE, and 37 healthy subjects. Quantifications of plasma mt-DNA and n-DNA with real-time quantitative polymerase chain reaction (PCR), and plasma H-FABP and Tn-I by commercial assays, were done on blood samples drawn within 4 hours after presentation at the emergency department. Results: Plasma mt-DNA and n-DNA concentrations were much higher in patients with massive PE (median, 2,970 GE/ml; interquartile range (IQR), 1,050 to 5,485; and 3,325 GE/ml, IQR: 1,080 to 5,790, respectively) than in patients with submassive PE (870 GE/ml and 1,245 GE/ml, respectively; P < 0.01) or controls (185 GE/ml and 520 GE/ml, respectively). Eighteen patients with massive PE died of a PE-related cause by day 15 of observation. Plasma mt- DNA and n-DNA values were 2.3-fold and 1.9-fold higher in the subgroup of nonsurviving patients than in survivors. H-FABP and Tn-I values were also higher in patients with massive PE who died (7.3 ng/ml and 0.023 ng/ml, respectively) than in those who survived (6.4 ng/ml, and 0.016 ng/ml, respectively). By receiver operating curve (ROC) analysis, the best cutoff values for predicting 15-day mortality were 3,380 GE/ml for mt-DNA, 6.8 ng/ml for H-FABP, 3,625 GE/ml for n-DNA, and 0.020 ng/ml for Tn-I, based on the calculated areas under the curve (AUCs) of 0.89 (95% confidence interval (CI), 0.78 to 0.99), 0.76 (95% CI, 0.69 to 093), 0.73 (95% CI, 0.58 to 0.91), and 0.59 (95% CI, 0.41 to 0.79), respectively. By stepwise logistic regression, a plasma mt-DNA concentration greater than 3,380 GE/ml (adjusted odds ratio (OR), 8.22; 95% CI, 1.72 to 39.18; P 6.8 ng/ml (OR, 5.36; 95% CI, 1.06 to 27.08; P < 0.01) were the only independent predictors of mortality. Conclusions: mt-DNA and H-FBAP might be promising markers for predicting 15-day mortality in massive PE, with mt-DNA having better prognostic accuracy.This work was supported partially by grants from Plan Nacional I+D+I (SAF 2008-05347 and SAF2011-23575) and from Fundación Mutua Madrileña de Investigación Biomédica (2008 and 2011) to Francisco Arnalich and Carmen Montie

Entomopathogenic Nematodes: Biological Model of Studies with Anthelmintics

Anthelmintics used in animals to combat parasitic infections are mainly excreted in manure and cause negative effects on the environment and decomposers. Nematodes are associated with the rhizosphere; some are gastrointestinal parasites of animals, and others regulate insects and other arthropods (entomopathogenic nematodes) and are considered beneficial. The habitat and the similarities that exist among them give the opportunity to use nematodes as a biological model. The availability of target organisms is not always feasible; therefore, experimental studies with models similar to those of the target organisms are a possibility. In veterinary clinics, the study of drug susceptibility is a fundamental tool to monitor the development of resistance. To conserve the biodiversity of the environment, it is necessary to make adequate use of anthelmintics, avoid resistance to these pesticides and prevent the used products from damaging populations of beneficial organisms