Paracoccidioidomycosis (South American blastomycosis) successfully treated with terbinafine: first case report

We describe a 63-year-old man who presented with painful malodorous lesions in the perianal, perineal and scrotal regions. Following definitive diagnosis of paracoccidioidomycosis, he was treated initially with trimethoprim/sulphamethoxazole, but there was no clinical improvement. He then received terbinafine (Lamisil) 250 mg twice daily for 6 months. There was rapid resolution of all lesions and complete relief of symptoms, without any associated side-effects. The patient remains clinically well and without any evidence of infection 2 years after discontinuation of terbinafine treatment.     

Overexpression of human cystatin C in transgenic mice does not affect levels of endogenous brain amyloid β peptide

Cystatin C, an inhibitor of cysteine proteases, colocalizes with amyloid β (Aβ) in parenchymal and vascular amyloid deposits in brains of Alzheimer’s disease (AD) patients, suggesting that cystatin C has a role in AD. Cystatin C also colocalizes with β amyloid precursor protein (βAPP) in transfected cultured cells. In vitro analysis of the association between the two proteins revealed that binding of cystatin C to full-length βAPP does not affect the level of Aβ secretion. Here we studied the effect of in vivo overexpression of cystatin C on the levels of endogenous brain Aβ. We have generated lines of transgenic mice expressing either wild-type human cystatin C or the Leu68Gln variant that forms amyloid deposits in the cerebral vessels of Icelandic patients with hereditary cerebral hemorrhage, under control sequences of the human cystatin C gene. Western blot analysis of brain homogenates was used to select lines of mice expressing various levels of the transgene. Analysis of Aβ40 and Aβ42 concentrations in the brain showed no difference between transgenic mice and their nontransgenic littermates. Thus, in vivo overexpression of human cystatin C does not affect Aβ levels in mice that do not deposit Aβ.     

Laryngeal fibroendoscopic surgery. Our experience

Since 1992, when our department acquired a flexible fiberscope with a working channel, we have used it in surgery on the upper respiratory and digestive tract. We call our technique laryngeal fiberscopic surgery. We report the results of four years of experience in this field. A total of 368 surgical interventions were performed, almost half to remove benign lesions of the vocal cords (polyps, nodules, etc). This technique is a major advance in our field of study. Its main advantages are avoidance of general anesthesia and hospitalization, reduction of surgical risk, and savings of time and money. We consider it to be a useful alternative to traditional direct laryngoscopy (Kleinsasser technique) for many applications.     

Single Agent Epirubicin in Squamous Cell Cervical Cancer: A phase II trial

Thirty consecutive patients with FIGO stage III-IV, squamous cell uterine cervix cancer were entered in a phase II trial evaluating activity and safety of epirubicin when given at a dose of 80 mg/m² i.v., every 3 weeks. Two complete responses (including a pathological complete remission) plus 3 partial responses were observed among 27 evaluable patients with a response rate of 18.5% (95% confidence limits = 7.6%-36.4%). the median time to progression and median survival for all treated patients were 3 and 8 months respectively. Treatment was well tolerated. Haematological toxicity was mild. WHO grade 4 toxicity was not observed. the median total cumulative dose of epirubicin was 360 mg/m² (80-840 mg/m²). Congestive heart failure was not noted. Further studies in cervical cancer with higher doses of epirubicin as single agent or in combination with other non-myelotoxic drugs are indicated.     

A novel mutation in the tyrosine kinase domain of ERBB2 in hepatocellular carcinoma

Background  

Several studies showed that gain-of-function somatic mutations affecting the catalytic domain of EGFR in non-small cell lung carcinomas were associated with response to gefitinib and erlotinib, both EGFR -tyrosine kinase inhibitors. In addition, 4% of non-small cell lung carcinomas were shown to have ERBB2 mutations in the kinase domain. In our study, we sought to determine if similar respective gain-of-function EGFR and ERBB2 mutations were present in hepatoma and/or biliary cancers.     

Factores predictivos de infección de herida en cirugía colorrectal. Estudio observacional multicéntrico de casos y controles

Introduction

The aim of this study is to evaluate the usefulness of Vicryl Plus^® suture in reducing the rate of postoperative wound infection in elective colorectal surgery.

Methods

A prospective case-control multicenter study with 480 patients undergoing elective colorectal surgery was performed between 2006 and 2007. Patients were divided in 2 groups of equal sample size: group 1, closure of the abdominal wall using Vicryl Plus^® and group 2 where PDS II^® was used. The study involved 5 hospitals in the Spanish State. Wound infection was classified into superficial and deep. All patients diagnosed of wound infection during the hospital stay and up to 30 days after discharge were studied. For the statistical analysis Chi-square test and Fisher exact were used for bivariate analysis and logistic regression model for multivariate analysis.

Results

Wound infection rates were significantly lower in group 1: 14.6 vs. 29.2. Multivariate analysis showed that risk of wound infection was higher in patients with cancer, lung disease, anemia, operative time greater than 2 h, lack of second dose intra-operative prophylactic antibiotic and laparotomy closure with PDS suture II^®.

Conclusions

The use of suture coated with triclosan can be an effective prophylactic tool in reducing wound infection rate in patients undergoing elective colorectal surgery.