Mexican consensus on Hodgkin's lymphoma Álvarez-Vera, José L; Aguilar-Luevano, Jocelyn; Alcívar-Cedeño, Luisa M ...
Gaceta médica de México,
2021, Letnik:
157, Številka:
Suppl 2
Journal Article
Recenzirano
El linfoma de Hodgkin (LH) se debe a la transformación clonal de células originadas en los linfocitos B, lo que genera las células binucleadas patognomónicas de Reed-Sternberg. El LH es una ...enfermedad de células B con una distribución bimodal, con mayor incidencia en la adolescencia y la tercera década de la vida y un segundo pico en personas mayores de 55 años. Las células del LH clásico habitualmente sufren una reprogramación de la expresión génica, ya que pierden la expresión de la mayoría de los genes típicos de las células B y han adquirido la expresión de múltiples genes que son típicos de otros tipos de células del sistema inmunitario. El algoritmo de tratamiento dependerá si se trata de LH clásico o de predominio linfocítico, si es un estadio temprano con marcadores de pronóstico desfavorables o no, el esquema inicial de manejo y si existe enfermedad voluminosa, entre las variables más relevantes.
Hodgkin’s lymphoma (HL) is due to the clonal transformation of cells originating from B lymphocytes, generating the pathognomonic binucleate Reed-Sternberg cells. HL is a B cell disease with a bimodal distribution, with higher incidence in adolescence and the third decade of life, showing a second peak in people over 55 years of age. Classic Hodgkin lymphoma cells routinely undergo gene expression reprogramming, as they lose the expression of most of the typical B-cell genes and acquire the expression of multiple genes that are typical of other types of cells in the immune system. The treatment algorithm will depend on whether it is classic or predominantly lymphocytic HL, if it is early stage with unfavorable prognostic markers or not, the initial management regimen, and whether there is bulky disease, among the most relevant variables.
Objectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors ...(ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006–May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST. Risk factors associated with 30-day mortality were investigated in both groups. Results: Of 1217 episodes of PA BSI, 917 occurred in patients with HM and 300 in patients with ST. Hematological patients had more commonly profound neutropenia (0.1 × 10sup.9 cells/mm) (67% vs. 44.6%; p < 0.001), and a high risk Multinational Association for Supportive Care in Cancer (MASCC) index score (32.2% vs. 26.7%; p = 0.05). Catheter-infection (10.7% vs. 4.7%; p = 0.001), mucositis (2.4% vs. 0.7%; p = 0.042), and perianal infection (3.6% vs. 0.3%; p = 0.001) predominated as BSI sources in the hematological patients, whereas pneumonia (22.9% vs. 33.7%; p < 0.001) and other abdominal sites (2.8% vs. 6.3%; p = 0.006) were more common in patients with ST. Hematological patients had more frequent BSI due to multidrug-resistant P. aeruginosa (MDRPA) (23.2% vs. 7.7%; p < 0.001), and were more likely to receive inadequate initial antibiotic therapy (IEAT) (20.1% vs. 12%; p < 0.001). Patients with ST presented more frequently with septic shock (45.8% vs. 30%; p < 0.001), and presented worse outcomes, with increased 7-day (38% vs. 24.2%; p < 0.001) and 30-day (49% vs. 37.3%; p < 0.001) case-fatality rates. Risk factors for 30-day mortality in hematologic patients were high risk MASCC index score, IEAT, pneumonia, infection due to MDRPA, and septic shock. Risk factors for 30-day mortality in patients with ST were high risk MASCC index score, IEAT, persistent BSI, and septic shock. Therapy with granulocyte colony-stimulating factor was associated with survival in both groups. Conclusions: The clinical features and outcomes of PA BSI in neutropenic cancer patients showed some differences depending on the underlying malignancy. Considering these differences and the risk factors for mortality may be useful to optimize their therapeutic management. Among the risk factors associated with overall mortality, IEAT and the administration of granulocyte colony-stimulating factor were the only modifiable variables.
We present a checklist of ferns and lycophytes from Parque Estadual Mata das Flores, a state park located in Castelo, Espírito Santo, Brazil. The park has an area of 800 ha, and its main vegetation ...is composed of dry forest (at 150–500 m elev.), and a small portion of wet forest (500–700 m), within the Brazilian Atlantic Rainforest biome. We found 83 taxa, including 75 species, 3 varieties, 4 putative hybrids, and 1 cultivar. Among these, 17 are newly recorded from the Espírito Santo. Twentyfive taxa are endemic to the Atlantic Forest biome, and 5 are endemic to southeastern Brazil, and 2 are narrow endemics to the states of Rio de Janeiro and Espírito Santo. Anemia blechnoides is the only vulnerable species found, according to the national red list. We found 4 naturalized species. Among the hybrids, 3 are reported for the first time in literature (Blechnum asplenioides × B. glandulosum, Campyloneurum decurrens × C. repens, and Doryopteris collina × D. lorentzii) and 1 for the first time in Brazil (B. glandulosum × B. polypodioides).
In this study, transparent conducting nanocrystalline ZnO:Ga (GZO) films were deposited by dc magnetron sputtering at room temperature on polymers (and glass for comparison). Electrical resistivities ...of 8.8 × 10
-4
and 2.2 × 10
-3
Ω cm were obtained for films deposited on glass and polymers, respectively. The crack onset strain (COS) and the cohesive strength of the coatings were investigated by means of tensile testing. The COS is similar for different GZO coatings and occurs for nominal strains approx. 1%. The cohesive strength of coatings, which was evaluated from the initial part of the crack density evolution, was found to be between 1.3 and 1.4 GPa. For these calculations, a Young's modulus of 112 GPa was used, evaluated by nanoindentation.
Al2O3‐ZrO2 eutectics containing 0 to 12.2 mol% Y2O3 (with respect to zirconia) were produced by directional solidification using the laser floating zone (LFZ) method. Processing variables were chosen ...to obtain homogeneous, colony‐free, interpenetrating microstructure for all of the compositional range, optimum from the viewpoint of mechanical properties. The amount of cubic, tetragonal, or monoclinic zirconia phases was determined using a combination of Raman and X‐ray diffraction techniques. Monoclinic zirconia was present up to concentrations of 3 mol% Y2O3, while the amount of tetragonal zirconia gradually increased with yttria content up to 3 mol%. Cubic zirconia was the only phase detected when the yttria content reached 12 mol%. The residual stresses in alumina were measured using the shift of the ruby R lines. Compressive stresses were isotropic when measured in the samples containing tetragonal and cubic zirconia, while higher tensile, anisotropic stresses were found when monoclinic zirconia was present. They were partially relieved in the eutectic sample without yttria. These results were compared with a thermoelastic analysis based on the self‐consistent model.
The effect of Y2O3 content on the flexure strength of melt‐grown Al2O3–ZrO2 eutectics was studied in a temperature range of 25°–1427°C. The processing conditions were carefully controlled to obtain a ...constant microstructure independent of Y2O3 content. The rod microstructure was made up of alternating bands of fine and coarse dispersions of irregular ZrO2 platelets oriented along the growth axis and embedded in the continuous Al2O3 matrix. The highest flexure strength at ambient temperature was found in the material with 3 mol% Y2O3 in relation to ZrO2(Y2O3). Higher Y2O3 content did not substantially modify the mechanical response; however, materials with 0.5 mol% presented a significant degradation in the flexure strength because of the presence of large defects. They were nucleated at the Al2O3–ZrO2 interface during the martensitic transformation of ZrO2 on cooling and propagated into the Al2O3 matrix driven by the tensile residual stresses generated by the transformation. The material with 3 mol% Y2O3 retained 80% of the flexure strength at 1427°C, whereas the mechanical properties of the eutectic with 0.5 mol% Y2O3 dropped rapidly with temperature as a result of extensive microcracking.
BACKGROUNDLeishmania RNA virus 1 (LRV1) is commonly found in South American Leishmania parasites belonging to the subgenus Viannia, whereas Leishmania RNA virus 2 (LRV2) was previously thought to be ...restricted to the Old-World pathogens of the subgenus Leishmania. OBJECTIVESIn this study, we investigated the presence of LRV2 in strains of Leishmania (L.) infantum, the causative agent of visceral leishmaniasis (VL), originating from different hosts, clinical forms, and geographical regions. METHODSA total of seventy-one isolates were screened for LRV2 using semi-nested reverse transcription-polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. FINDINGSWe detected LRV2 in two L. infantum isolates (CUR268 and HP-EMO) from canine and human cases, respectively. MAIN CONCLUSIONSTo the best of our knowledge, this is the first detection of LRV2 in the New World.
This study documents the variation in the amino acid neurotransmitter contents during mouse parietal cortex development, from embryonic day 13 (E13) until young adulthood, between postnatal day 21 ...(P21) and P30. Taurine, an inhibitory neurotransmitter and neuromodulator, is the most abundant neurotransmitter in the developing neocortex, whereas, at the adult stage, glutamate is the more prominent neurotransmitter playing an excitatory role, and GABA is the major inhibitory neurotransmitter. During the proliferative stage of neurogenesis in the mouse cerebral cortex, between E13 and E17, relatively high levels of glutamate, aspartate, taurine and glycine were detected, consistent with a possible trophic influence of these neurotransmitters during cortical development prior to synaptogenesis. Between E17 and E19, a significant decline in the contents of these neurotransmitters was observed, consistent with earlier reports of cell death in the ventricular and subventricular zones during this stage of development. During the perinatal period, a progressive increment in glutamate level was seen between E21 and P5, and then the values remained constant until the second postnatal week. Glutamate also decreased by about 25% between P11 and P15, on the other hand, aspartate diminished by about 20% between P7 and P9. These results were consistent with previous reports of histogenetic cell death during the first 2 postnatal weeks in mouse neocortex. GABA increased from the embryonic period until young adulthood, in contrast, the glycine content decreased; thus, in the adult parietal cortex, the GABA content was about 2.6-fold higher than that of glycine. During the first postnatal week, the concentrations of glutamate and GABA showed significant increments between P0 and P5, while those of aspartate and glycine remained constant. During this period, amino acids are predominantly excitatory and the cerebral cortex is vulnerable to epileptiform activity; the significant increment in taurine content between P0 and P3 suggests a neuroprotective action of taurine against excitotoxicity. At P15, coinciding with the period of maximum cortical synaptogenesis, significant increments in GABA and glycine contents were observed which could be related to the maturation of inhibitory synaptic transmission. At the young adult stage, there was a rise in the levels of both excitatory neurotransmitters, glutamate and aspartate, and a significant reduction in the contents of all three inhibitory neurotransmitters, GABA, glycine and taurine.
PDF
