ABSTRACT Objective: To describe the evidence of Platelet Rich Plasma (PRP), Stem cells therapy (SCT) and Extracorporeal shockwave therapy (ESWL) for the treatment of Peyronies disease (PD), including information from the main urological society guidelines. Materials and Methods: A literature review of PubMed articles published between 2000 and 2023 was conducted, utilizing keywords such as "Peyronie's Disease", "Penile curvature", "Platelet Rich Plasma", "Stem cells", and "Extracorporeal shockwave therapy". Only full-text articles in English were included, excluding case reports and opinions. Results: A considerable number of clinical trials were conducted using PRP penile injections for therapy of PD, showing reduction of curvature, plaque size and improvement in quality of life. Preclinical studies in rats have shown the potential benefit of adipose-derived stem cells, with improvements in erectile function and fibrosis. Human studies with mesenchymal stem cells demonstrated promising results, with reduction of curvature and plaque size. ESWL effects on PD were investigated in randomized clinical trials and demonstrated no significant impact in curvature or plaque size, but reasonable effect on pain control. Conclusion: Restorative therapies has emerged as an innovative treatment option for PD and the results from current studies appear to be promising and demonstrated good safety profile. Unfortunately, due to scarce evidence, PRP and SCT are still considered experimental by American Urological Association (AUA) and European Association of Urology (EAU) guidelines. ESWT is recommended, by the same guidelines, for pain control only. More high-quality studies with long-term follow-up outcomes are needed to evaluate efficacy and reproducibility of those therapies. Objective PRP, , (PRP) (SCT (ESWL (PD) guidelines Methods 200 202 Peyronie s Disease, Disease Disease" Penile curvature" Plasma, Plasma" cells" therapy. . therapy" fulltext full text included opinions Results life adiposederived adipose derived fibrosis Conclusion profile Unfortunately AUA (AUA EAU (EAU recommended only highquality high longterm long term followup follow up (PRP (PD 20 2

Resumen: La Enfermedad de Von Willebrand adquirida (EVW adquirida) es un trastorno hemorrágico adquirido poco frecuente, con características clínicas y de laboratorio similares a la Enfermedad de Von Willebrand congénita. Asociándose con enfermedades hemato-oncológicas, autoinmunes, cardiovasculares y tumores sólidos. Las gammapatías monoclonales constituyen un grupo heterogéneo de trastornos caracterizados por la proliferación de linfocitos B en los últimos estadios madurativos o células plasmáticas que preservan la capacidad de producir una inmunoglobulina (Ig) monoclonal o alguno de sus componentes. Como consecuencia, se produce la aparición de una paraproteína o componente M (CM) en suero y/o orina que estará formado por la misma cadena pesada o ligera, y por regiones variables idénticas. Se presenta el caso de una mujer de 57 años, que se presenta con un síndrome hemorragíparo, alteración de la crasis en su vía intrínseca, donde se diagnostica EVW adq secundaria a Mieloma Múltiple (MM) con CM IgM 5,9 g/dl. El tratamiento tuvo como objetivos detener el sangrado, prevenir complicaciones y abordar precozmente la patología hemato-oncológica causante. Para su abordaje requirió la realización de recambios plasmáticos terapéuticos (RPT) que tuvieron un rol de acción terapéutica temprana y eficaz con excelente tolerancia. Ante el diagnóstico se inició rápidamente poliquimioterapia siendo ésta una paciente candidata a trasplante de progenitores hematopoyéticos. El objetivo de la presentación de este caso clínico es destacar la importancia de un correcto y oportuno diagnóstico ante la sospecha clínica de una coagulopatía secundaria a una enfermedad hemato-oncológica subyacente. Por lo que hacemos énfasis en el abordaje multidisciplinario.

Resumo: A doença de von Willebrand adquirida (EVW acq, AVWS) é um distúrbio hemorrágico adquirido raro com características clínicas e laboratoriais semelhantes à doença de von Willebrand congênita. Associado a doenças hemato-oncológicas, autoimunes, cardiovasculares e tumores sólidos. As gamopatias monoclonais constituem um grupo heterogêneo de distúrbios caracterizados pela proliferação de linfócitos B nos últimos estágios de maturação ou plasmócitos que preservam a capacidade de produzir uma imunoglobulina monoclonal (Ig) ou um de seus componentes. Como consequência, ocorre o aparecimento de uma paraproteína ou componente M (CM) no soro e/ou na urina, que serão formados pela mesma cadeia pesada ou leve, e por regiões variáveis idênticas. Apresentamos o caso de uma mulher de 57 anos, que apresentava um síndroma hemorrágico, alteração da crase na sua via intrínseca, onde é diagnosticada Doença de Von Willebrand Adquirida secundária a Mieloma Múltiplo. O tratamento visava estancar o sangramento, prevenir complicações e abordar prontamente a patologia hemato-oncológica subjacente. Para sua abordagem, exigiu a realização de plasmaférese terapêutica que teve papel de ação terapêutica precoce e efetiva com excelente tolerância. Diante do diagnóstico, rapidamente foi iniciada poliquimioterapia, sendo este paciente candidato a transplante de células-tronco hematopoiéticas. O objetivo da apresentação deste caso clínico é realçar a importância de um diagnóstico correto e atempado face à suspeita clínica de uma coagulopatia secundária a uma doença hemato-oncológica subjacente. Portanto, enfatizamos a abordagem multidisciplinar.

Abstract: Acquired von Willebrand disease (AVWS) is a rare acquired bleeding disorder with clinical and laboratory features similar to congenital von Willebrand disease. Associated with hemato-oncological, autoimmune, cardiovascular diseases and solid tumors. Monoclonal gammopathies constitute a heterogeneous group of disorders characterized by the proliferation of B lymphocytes in the last stages of maturation or plasma cells that preserve the capacity to produce a monoclonal immunoglobulin (Ig) or one of its components. As a consequence, the appearance of a paraprotein or M component (CM) occurs in serum and/or urine, which will be formed by the same heavy or light chain, and by identical variable regions. We present the case of a 57-year-old woman, who presented with a hemorrhagic parous syndrome, alteration of the crasis in its intrinsic way, where Acquired Von Willebrand Disease secondary to Multiple Myeloma is diagnosed. Treatment was aimed at stopping the bleeding, preventing complications, and promptly addressing the underlying hemato-oncological pathology. For its approach, it required the performance of therapeutic plasma exchanges that had a role of early and effective therapeutic action with excellent tolerance. Given the diagnosis, polychemotherapy was quickly started, this patient being a candidate for hematopoietic stem cell transplantation. The objective of presenting this clinical case is to highlight the importance of a correct and timely diagnosis in the face of clinical suspicion of a coagulopathy secondary to an underlying hemato-oncological disease. Therefore, we emphasize the multidisciplinary approach.

Abstract Chronic ulcers significantly affect the quality of life of patients and impose a high cost on the healthcare system. The therapeutic management should be comprehensive, taking into consideration the etiological diagnosis of the wound and the characteristics of the wound bed when deciding on a therapeutic proposal appropriate to the healing phase, correcting factors that delay healing. During the epithelialization phase, repair techniques with grafts are recommended to shorten re-epithelialization time, improve the quality of scar tissue, and achieve adequate pain management. Currently, due to the reported benefits of skin appendages, the technique of follicular unit auto-grafting obtained with a scalp punch is among the chosen strategies for wound repair. This is a minimally invasive, outpatient practice, whose technique has advantages over the donor site, patients recovery and well-being. system comprehensive phase reepithelialization re time tissue Currently appendages autografting auto grafting invasive practice site wellbeing. wellbeing well being. being well-being

ABSTRACT Erectile dysfunction is observed in about 50% of men. It has been found that diabetes mellitus increases its prevalence to 19-86.3%, necessitating attention to a therapeutic strategy. Among the available treatment methods, intracavernosal injections of mesenchymal stem cells have proven to be particularly effective. Objective The purpose of study is to assess and analyse the effectiveness of their use in the treatment of erectile dysfunction in patients with diabetes mellitus. Materials and Methods The literature search was conducted using systematic methods and analysis in databases such as Web of Science, Scopus, PubMed, Elsevier, and Springer, with 41 sources included for further review. Results The study highlights microangiopathic and neuropathic links as key factors in erectile dysfunction development in diabetic patients, stemming from endothelial dysfunction and conductivity disturbances. Mesenchymal stem cell therapy from bone marrow, adipose tissue, and umbilical cord mitigates pathogenic impact through regenerative and anti-apoptotic effects. Due to this, most studies indicate high efficacy of the treatment and rapid therapeutic action through intracavernosal administration. Some studies suggest an increase in the body’s receptor sensitivity to other drugs, such as sildenafil. Conclusion From the perspective of further research on this issue, standardising the preparation of stem cells and the treatment method using a large sample size is essential to introduce such a method as an extremely promising therapy for this delicate issue in men into practical medicine. The practical value of the study lies in the systematisation of information on different sources of mesenchymal stem cells for treating erectile dysfunction. 50 1986.3%, 19863 19 86.3%, 86 3 19-86.3% strategy effective Science Scopus PubMed Elsevier Springer 4 review disturbances marrow tissue antiapoptotic anti apoptotic effects administration bodys body s drugs sildenafil medicine 5 1986 1986.3% 1 863 86.3% 8 19-86.3 198 1986.3 86.3 19-86. 1986. 86. 19-86 19-8 19-

ABSTRACT: In order to ensure reliable inferences in scientific experiments, sampling criteria should be determined and defined during the experimental design phase. Determining plot and sample sizes without scientific criteria could result in resource and labor inefficiencies with no gain in experimental precision. In this work we estimate plot and sample sizes for biometric variable analyses in lettuce seedlings. The seedlings were sown in four expanded polystyrene foam transplant trays with 128 and 200 cells. Foliar area, stem diameter, shoot height, root length, root volume, root area, fresh and dry shoot and root masses. The methods described by Paranaiba (PARANAIBA et al., 2009) and Cochran (COCHRAN, 1977) were used for plot size and sample size estimations, respectively. Sample size varied according to the variables analysed and transplant tray cell number. Root variables required the highest number of samples. For a 10% margin of error, 12 seedlings were necessary for evaluations in a 128 cell tray, while 11 seedlings were required for analysis in 200 cell trays. ABSTRACT experiments phase precision 20 cells area diameter height length volume masses PARANAIBA al al. 2009 COCHRAN, COCHRAN (COCHRAN 1977 estimations respectively samples 10 error 1 2 197 19

RESUMO: A fim de garantir inferências confiáveis em experimentos científicos, os critérios de amostragem devem ser determinados e definidos durante a fase de planejamento experimental. Determinar tamanhos de parcelas e amostras sem critérios científicos pode resultar em ineficiências de recursos e mão de obra sem ganho de precisão experimental. Neste trabalho estimamos tamanhos de parcelas e amostras para análises de variáveis biométricas em mudas de alface. As mudas foram semeadas em quatro bandejas de transplante de espuma de poliestireno expandido com 128 e 200 células. Área foliar, diâmetro do caule, altura da parte aérea, comprimento da raiz, volume da raiz, área da raiz, parte aérea fresca e seca e massas radiculares. Os métodos descritos por Paranaíba (PARANAÍBA et al., 2009) e Cochran (COCHRAN, 1977) foram utilizados para estimativas de tamanho de parcela e tamanho de amostra, respectivamente. O tamanho da amostra variou de acordo com as variáveis analisadas e o número de células da bandeja de transplante. As variáveis de raiz exigiram o maior número de amostras. Para uma margem de erro de 10%, foram necessárias 12 mudas para avaliação em bandeja de 128 células, enquanto 11 mudas foram necessárias para análise em bandeja de 200 células. RESUMO experimental alface 20 foliar caule radiculares PARANAÍBA al al. 2009 COCHRAN, COCHRAN (COCHRAN 1977 respectivamente 10 10% 1 2 197 19

Abstract Vegetative propagation with stem cuttings requires the origination of shoots and roots to form a complete plant. Factors involved in root generation have been researched, but little work has been done on pH. The research was conducted at the College of Postgraduates, Montecillo Campus, Texcoco, Mexico in 2021. In Ficus carica cuttings, the following were evaluated: pH values (4, 7, and 11) in solution with or without auxin, dilution (alcohol or NaOH) of indole butyric acid (IBA), concentration of alcohol to dissolve IBA (10, 15, and 20%), in the percentage of rooting, number of roots, length of the longest root, percentage of sprouted buds at 21 days, date of establishment and anatomical changes at 0, 3 and 6 days after the cutting. Meristematic cells and root primordia were found up to day 6. One hundred percent rooting was obtained in all treatments. pH was not shown to have an effect on the auxin solution, but it did influence the percentage of rooting assessed individually. The way auxin was diluted influenced the number of roots due to the concentration of alcohol used, lower concentration (10%) had a positive effect.

Resumen La propagación vegetativa con estacas de tallo requiere originar brotes y raíces para formar una planta completa. Se han investigado factores que intervienen en la generación de raíces, pero poco se ha trabajado con el pH. La investigación se realizó en el Colegio de Postgraduados, Campus Montecillo, Texcoco, México en 2021. En estacas de Ficus carica se evaluaron: valores de pH (4, 7 y 11) en solución con o sin auxina, la dilución (alcohol o NaOH) del ácido indolbutírico (AIB), concentración de alcohol para disolver AIB (10, 15 y 20%), en el porcentaje de enraizamiento, número de raíces, longitud de la raíz más larga, porcentaje de yemas brotadas a los 21 días, fecha de establecimiento y cambios anatómicos en 0, 3 y 6 días de estacado. Se encontraron células meristemáticas y primordios de raíz hasta el día 6. Se obtuvo 100% de enraizamiento en todos los tratamientos. El pH no demostró tener efecto en la solución auxínica, pero si influyó en el porcentaje de enraizamiento evaluado individualmente. La forma de diluir la auxina influyó en el número de raíces por la concentración de alcohol utilizada, menor concentración (10%) tuvo efecto positivo.

RESUMEN Introducción: El procedimiento terapéutico con células mononucleares autólogas ha abierto una alternativa dentro del arsenal con que se cuenta para la reparación y regeneración de los defectos óseos máxilo-mandibulares derivados de procederes quirúrgicos, que se asocian con discapacidad y detrimento de la calidad de vida. Objetivo: Evaluar la evolución de los pacientes tratados con células mononucleares autólogas como terapia regenerativa ante defectos óseos máxilo-mandibulares. Métodos: Se realizó un estudio descriptivo transversal en los Servicios de Cirugía Máxilo-facial de la Clínica Estomatológica Provincial Docente y los Hospitales Provincial Docente Clinicoquirúrgico Saturnino Lora Torres, General Docente Juan Bruno Zayas Alfonso, Clinicoquirúrgico Docente Joaquín Castillo Duany de Santiago de Cuba, en el periodo de enero de 2017 a diciembre de 2019. Los pacientes incluidos en el estudio fueron sometidos a procedimientos quirúrgicos por enfermedades que afectaban la arquitectura ósea, implantándose células madre movilizadas con factor estimulante de colonias de granulocitos al finalizar el acto quirúrgico. Las variables investigadas fueron enfermedades quirúrgicas, complicaciones posquirúrgicas, tamaño del defecto óseo, evidencia radiográfica y evolución del tratamiento. Resultados: Entre los 6 y 12 meses posteriores a la cirugía y la terapia celular, todas las variables de respuesta al tratamiento probaron mejoras clínicas y radiológicas, observándose hueso de neoformación y aumento de la densidad ósea. Conclusiones: La regeneración de los defectos óseos, asociados a intervenciones quirúrgicas, mediante el implante de células mononucleares autólogas de sangre periférica suspendidas en plasma rico en plaquetas quedó evidenciada clínica y radiográficamente de forma satisfactoria.

ABSTRACT Introduction: The therapeutic procedure with autologous mononuclear cells has opened an alternative within the arsenal available for repair and regeneration of the maxillomandibular bone defects derived from surgical procederes which are associated with disability and detriment to life quality. Objective: To evaluate the clinical course of patients treated with autologous mononuclear cells as regenerative therapy for maxillofacial bone defects. Methods: A cross-sectional descriptive study was carried out in the Maxillo Facial Surgery Services of the Teaching Provincial Dentistry Clinic and the Provincial Teaching Clinical Surgical Hospitals Saturnino Lora Torres, Teaching General Juan Bruno Zayas, Teaching Clinical Surgical Joaquin Castillo Duany, in Santiago de Cuba, from January, 2017 to December, 2019. The patients included in the study underwent surgical procedures due to diseases that affected bone architecture, implanting mobilized stem cells with granulocyte colony stimulating factor at the end of the surgical procedure. The variables investigated were surgical diseases, post-surgical complications, size of the bone defect, radiographic evidence and treatment evolution. Results: Six to 12 months after the surgery and cell therapy, all the response variables to the treatment proved clinical and radiological improvements, being observed bone neoformation and increase of bone density. Conclusions: Regeneration of bone defects, associated with surgical interventions, implanting autologous mononuclear cells of peripheral blood suspended in plasm rich in platelets was clinic and radiographically evidenced in a satisfactory way.

Abstract Objective: To compare clinicopathological characteristics of patients with solitary subependymal giant cell astrocytoma (SEGA) at our institution, with those associated to tuberous sclerosis complex (TSC). Methods: It was a descriptive-retrospective study of surgically treated SEGA patients (2013-2022). Demographic and clinical data were obtained. An immunohistochemistry (IHC) panel was applied: GFAP, neurofilaments, hamartin, tuberin, Ki67, nestin, OCT-4, INI-1, STAT-6, CK-AE1/AE3, TTF1, and YAP-1. Descriptive statistical was used. Results: 4 patients were studied: Two women, 23 and 25 years old, diagnosed as TSC patients at 10 and 12 years of age, and two men with solitary SEGA (18 and 46 years old). Tumors were positive to GFAP, NF, nestin, and TTF1. Cytoplasmic STAT6 and CK stains was observed in all patients. 2/4 cases showed YAP-1 nuclear expression. TSC patients retained INI-1 nuclear expression, while solitary SEGAs lost it. Conclusions: SEGA is a glioneuronal tumor that expresses markers of neuroepithelial stem cells and cytokeratins. Its diagnosis must be supported with a minimal IHC panel: GFAP, neurofilaments, synaptophysin, nestin and TTF1. Morphological differences were observed between the TSC related and solitary SEGAs and in INI1 expression. Nuclear expression of YAP-1 in 2/4 tumors, opens the possibility of research for combined use of YAP and mTOR regulators in the management of SEGA.

Resumen Objetivo: Comparar las características clínico-patológicas de los pacientes con astrocitoma subependimario de células gigantes (SEGA) solitario y el asociado al complejo de esclerosis tuberosa (TSC). Métodos: Se realizó un estudio descriptivo-retrospectivo de pacientes con SEGA tratados quirúrgicamente (2013-2022). Se obtuvieron datos demográficos y clínicos. Se aplicó un panel de inmunohistoquímica (IHC): GFAP, neurofilamentos, hamartina, tuberina, Ki67, nestina, OCT-4, INI-1, STAT-6, CK-AE1/AE3, TTF1 y YAP-1. Se utilizó estadística descriptiva. Resultados: Se estudiaron 4 pacientes: dos mujeres de 23 y 25 años, diagnosticadas como pacientes con TSC a los 10 y 12 años, y dos hombres con SEGA solitario (18 y 46 años). Los tumores fueron positivos para GFAP, NF, nestina y TTF1. Se observó positividad citoplásmica de STAT6 y CK en todos los pacientes. 2/4 casos mostraron expresión nuclear YAP-1. Los pacientes con TSC conservaron la expresión nuclear de INI-1, mientras que los SEGA solitarios la perdieron. Conclusiones: SEGA es un tumor glioneuronal que expresa marcadores de células madre neuroepiteliales y citoqueratinas. Su diagnóstico debe apoyarse en un panel IHC mínimo: GFAP, neurofilamentos, sinaptofisina, nestina y TTF1. Se observaron diferencias morfológicas entre los SEGA solitarios y los relacionados con TSC y en la expresión de INI1. La expresión nuclear de YAP-1 en 2/4 tumores es un hallazgo nuevo, que abre la posibilidad del uso combinado de reguladores YAP y mTOR en el manejo de SEGA.

Abstract Osteoarthritis (OA) can incapacitate the individual to perform their activities of daily living due to pain. This is an important public health issue that worsens worldwide and in Brazil, since the population goes through an aging process, and has caused increased public spending on the monitoring and maintenance of treatments that can last for years and still not be resolutive. Thus, the search for innovative and effective therapies that can reduce costs becomes necessary. In this context, the present study reports the first application of cell therapy with adipose-derived stem cells in the treatment of cases of OA that are refractory to the conservative treatment, performed in the Brazilian Unified Health System (Sistema Único de Saúde, SUS). The evaluation was performed with the application of the Visual Analog Scale (VAS), the Short Form Health Survey (SF-36) and the Western Ontario and McMaster Universities (WOMAC), specifics for OA evaluation, and also an analysis of the synovial fluid (inflammatory cytokines). The cell therapy improved the scores on the WOMAC, SF-36 and EVA, and reduced the inflammatory process. We observed a decrease of 0.73x in the TNF, of 0,71x in IL-1b, of 0,68x in IL-8, and of 0,70x in IL-10. For IL-6, an increase of 1,48x was observed. Therefore, this cell therapy can be considered promising in aiding the management of this disease, since it improved the patient's pain, decrease inflammatory markers, and enabled the return to activities of daily living, which resulted in an improvement in their quality of life. (OA pain Brazil process resolutive Thus necessary context adiposederived adipose derived Sistema Saúde SUS. SUS . SUS) VAS, VAS , (VAS) SF36 SF 36 (SF-36 WOMAC (WOMAC) cytokines. cytokines cytokines) SF-3 EVA 073x x 0 73x TNF 071x 71x IL1b, IL1b ILb IL 1b, 1b b IL-1b 068x 68x IL8, IL8 8, 8 IL-8 070x 70x IL10. IL10 10. 10 IL-10 IL6, IL6 6, 6 IL-6 148x 1 48x Therefore disease patients patient s markers life (VAS SF3 3 (SF-3 (WOMAC SF- IL- IL1 IL-1 (SF- (SF

Resumo A osteoartrite (OA) pode deixar o indivíduo incapacitado para realizar suas atividades da vida diária devido ao quadro álgico. Essa é uma importante questão de saúde pública que se agrava no mundo inteiro e no Brasil, uma vez que a população passa pelo processo de envelhecimento, e isso causa um aumento nos gastos públicos com o acompanhamento e manutenção dos tratamentos que podem perdurar por anos e mesmo assim não serem resolutivos. Assim, torna-se necessária a busca por terapias inovadoras e eficazes que possam reduzir esses custos. Nesse contexto, o presente estudo relata a primeira aplicação de terapia celular com células-tronco mesenquimais do tecido adiposo no tratamento de OA refratária ao tratamento conservador realizada no Sistema Único de Saúde (SUS). Na avaliação, foram usados os instrumentos Escala Visual Analógica (EVA), os questionários de qualidade de vida Short Form Health Survey (SF-36) e Western Ontario and McMaster Universities (WOMAC), específicos para avaliação da OA, e fez-se uma análise do líquido sinovial (citocinas inflamatórias). A terapia celular melhorou as pontuações no WOMAC, SF-36, e EVA, e reduziu o processo inflamatório. Observou-se redução de 0,73 × do TNF, de 0,71 × da IL-1b, de 0,68 × da IL-8, e de 0,70 × da IL-10. Já para a IL-6, observou-se aumento de 1,48 ×. Portanto, considera-se este tipo de terapia celular promissora no auxílio do manejo desta doença, pois melhorou o quadro álgico do paciente, reduziu os marcadores inflamatórios, e possibilitou o retorno às atividades da vida diária, o que resultou em uma melhora de sua qualidade de vida. (OA Brasil envelhecimento resolutivos Assim tornase torna custos contexto célulastronco células tronco SUS. SUS . (SUS) EVA , (EVA) SF36 SF 36 (SF-36 WOMAC (WOMAC) fezse fez citocinas inflamatórias. inflamatórias inflamatórias) SF36, 36, SF-36 inflamatório Observouse Observou 073 0 73 0,7 TNF 071 71 IL1b, IL1b ILb IL 1b, 1b b IL-1b 068 68 0,6 IL8, IL8 8, 8 IL-8 070 70 IL10. IL10 10. 10 IL-10 IL6, IL6 6, 6 IL-6 observouse observou 148 1 48 1,4 Portanto considerase considera doença paciente inflamatórios (SUS (EVA SF3 3 (SF-3 (WOMAC SF-3 07 7 0, 06 IL- IL1 IL-1 14 4 1, (SF- SF- (SF

Thyroid cancer (TC) is the first malignant tumor in endocrine glands, and it is estimated that by 2030 it will be in the top five cancers worldwide. In Chile, TC was recently included as pathology No. 82 with Explicit Health Guarantees, which implies allocating significant public and private resources to the treatment of patients with a cancer that is on the rise. There are groups of young patients with small tumors that present a more aggressive clinical behavior, where decision-making could be advanced. Specifically, a group of patients under 55 years of age with tumors less than 2 cm in size but with regional metastases, that lack indication for radioiodine therapy and could require complementary treatment or present a worse evolution. Clinical and molecular tools to guide appropriate treatment in patients with lymph node metastases are limited and have not been updated. There are tumorigenicity and prognostic factors, such as EpithelialMesenchymal Transition (EMT) and Cancer Stem Cells (CSC) markers that have been incorporated into the study of other tumors and recently in thyroid cancer. Studies linking EMT and CSC with TC currently point to molecular and genetic description, with few reports clinically correlating these findings (particularly in subgroups with particular characteristics of aggressiveness) and proposing them as tumorigenicity and prognosis markers. The description of these biomarkers in the described population could facilitate decision-making regarding follow-up, surgical therapy, and radioiodine therapy.

Resumen El cáncer de tiroides (CT) es el primer tumor maligno en glándulas endocrinas, y se estima que al 2030 estará en el top cinco de cáncer a nivel mundial. En Chile, el CT fue incluido, recientemente, como la patología N° 82 con Garantías Explícitas de Salud, lo que implica destinar importantes recursos públicos y privados al tratamiento de pacientes con un cáncer que va en aumento en el mundo. Existen grupos de pacientes jóvenes con tumores pequeños que presentan un comportamiento clínico más agresivo desde el inicio, donde se podría adelantar la toma de decisiones. Específicamente, destaca un grupo de pacientes menores de 55 años con tumores pequeños menores de 2 cm, pero con metástasis regionales, que quedan fuera de la indicación de radioyodoterapia y podrían requerir tratamiento complementario o presentar peor evolución. Las herramientas clínicas y moleculares para guiar el tratamiento adecuado en pacientes con metástasis linfonodales son limitadas y no han sido actualizadas hasta el momento. Existen factores de tumorigenicidad y pronóstico, tales como los marcadores de Transición Epitelio-Mesenquimal (TEM) y Cáncer Stem Cells (CSC) que se han incorporado al estudio de otros tumores y recientemente en cáncer de tiroides. Actualmente estudios que relacionan TEM y CSC con CT apuntan a la descripción molecular y genética, con escasos reportes que correlacionen, clínicamente, estos hallazgos, (particularmente en subgrupos con características particulares de agresividad) y que los propongan como marcadores de tumorigenicidad y pronóstico. La descripción de estos biomarcadores en la población descrita podría facilitar la toma de decisiones en cuanto a seguimiento, terapia quirúrgica y radioyodoterapia.

Introdução: Recentes progressos feitos na bioengenharia de enxertos cardíacos oferecem nova modalidade terapêutica para a regeneração do tecido cardíaco pós-infarto do miocárdio. O CD34 é marcador que expressa todas as células precursoras hematopoiéticas e endoteliais, e funciona como fator de adesão celular. O anticorpo que correspondente a este marcador é utilizado na imunoistoquímica para avaliar a formação de novos vasos e a presença de células-tronco. Objetivo: Avaliar a eficácia da omentopexia na neovascularização e células-tronco. Métodos:  Revisão colhendo informações publicadas em plataformas virtuais selecionadas (SciELO – Scientific Electronic Library Online, Google Scholar, Pubmed e Scopus).  A busca iniciou-se por descritores relacionados ao tema, identificados por meio do DeCS/MESH nos seguintes descritores: “isquemia miocárdica; revascularização miocárdica; omentopexia; imunoistoquímica; CD34; células-tronco” e seus equivalentes em inglês: “stem cell; myocardial ischemia; myocardial revascularization; omentopexy; immunohistochemistry; CD34”. Foram lidos pelo título e resumo, com busca AND ou OR seguindo-se da leitura na íntegra daqueles com maior relação ao tema. Foram incluídos o total de 23 artigos. Resultados: O omento maior tem propriedade clínica marcante em conter sítios de danos teciduais. Ele aumenta seu volume tecidual em resposta às partículas estranhas e inflamatórias envolvendo diversas células imunomoduladoras com células progenitoras, em um processo chamado “ativação do omento”. Conclusão: A cárdio-omentopexia associada à abrasão mecânica e perfurações miocárdicas, mostra ser eficiente na indução de neovascularização. O omento maior promove células-tronco - confirmadas pelo CD34 -, demonstrando grande potencial como futura terapêutica para restaurar áreas de miocárdio isquêmico.

Introduction: Recent progress in the bioengineering of cardiac grafts offers a new therapeutic modality for the regeneration of cardiac tissue after myocardial infarction. CD34 is a marker that expresses all hematopoietic and endothelial precursor cells, and functions as a cell adhesion factor. The antibody corresponding to this marker is used in immunohistochemistry to evaluate the formation of new vessels and the presence of stem cells. Objective: To evaluate the effectiveness of omentopexy in neovascularization and stem cells. Methods: Review collecting information published on selected virtual platforms (SciELO – Scientific Electronic Library Online, Google Scholar, Pubmed and Scopus). The search began with descriptors related to the topic, identified through DeCS/MESH in the following: “myocardial ischemia; myocardial revascularization; omentopexy; immunohistochemistry; CD34; stem cells”. They were read by title and summary, with an AND or OR search followed by the full reading of those most closely related to the topic. A total of 23 articles were included. Results: The greater omentum has a remarkable clinical property in containing sites of tissue damage. It increases its tissue volume in response to foreign and inflammatory particles involving several immunomodulatory cells with progenitor cells, in a process called “omentum activation”. Conclusion: Cardio-omentopexy associated with mechanical abrasion and myocardial perforations proves to be efficient in inducing neovascularization. The greater omentum promotes stem cells - confirmed by CD34 -, demonstrating great potential as a future therapy to restore areas of ischemic myocardium.

RESUMEN El riesgo de amputaciones en pacientes con diabetes es 10 a 20 veces más frecuente en comparación con no diabéticos. El equipo biotecnológico desarrollado por ROKIT Healthcare, Inc., de procedencia surcoreana: Dr. INVIVO, es un equipo de biotecnología que ofrece una terapia eficaz para el tratamiento del pie diabético, con una plataforma de regeneración de órganos hiperpersonalizados que mediante la inteligencia artificial, escanea la lesión para así, fabricar un parche que contiene células madres autólogas, matriz extracelular y materiales específicos de tejido, para posteriormente aplicarla a la herida, y con esto, lograr la cicatrización y regeneración completa. El propósito del presente reporte apunta a demostrar la efectividad del tratamiento en úlceras en pie diabético y exponer los resultados de 3 casos clínicos con extensas lesiones posteriores a amputaciones de miembros inferiores, atendidos en el Hospital Distrital de Ñemby, Paraguay, utilizando esta tecnología.

ABSTRACT The risk of amputations in patients with diabetes is 10 to 20 times more frequent compared to non-diabetics. The biotechnological team developed by ROKIT Healthcare, Inc., of South Korean origin: Dr. INVIVO, is a biotechnology team that offers an effective therapy for the treatment of diabetic foot, with a hyper-personalized organ regeneration platform that, through artificial intelligence, scan the injury in order to manufacture a patch that contains autologous stem cells, extracellular matrix and specific tissue materials, to later apply it to the wound, and with this, achieve complete healing and regeneration. The purpose of this report aims to demonstrate the effectiveness of treatment in diabetic foot ulcers and present the results of 3 clinical cases with extensive injuries after lower limb amputations, treated at the District Hospital of Ñemby, Paraguay, using this technology.

ABSTRACT Introduction: The myth to rejuvenate or to be eternally beautiful is a dream that the humanity has always shared in many legends. Objective: To evaluate the results of lipotransference by assisted decantation with stem cells of adipose tissue for the facial rejuvenation. Methods: A descriptive, prospective and longitudinal study was carried out with 35 patients selected by simple random sampling in the Plastic Surgery Service of Hermanos Ameijeiras Hospital in Havana city, from September, 2019 to the same month in 2022. Results: In the case material, the mean age was of 46,5 ± 11,5 years with minimum values of 34 and maximum 57 years; 48.6% was in the 50-59 age group. A prevalence of the II cutaneous phototype was verified (60.0%); in healthy patients, the highest percentage with aging degree was that of type III (57.1%). There was a prevalence of fine wrinkles in rest and deeper lines with facial expression (40.0%) in those who would receive assisted lipotransference. After the treatment improvement was verified in all the patients; none presented complication. The evaluation of this procedure was good (94.3%). Conclusions: Lipotransference is a minimumly invasive procedure with advantages as for histocompatibility, durability and smaller number of complications; it has a high rate of acceptance. The favorable final result, security and effectiveness are observed in the patient's satisfaction.

RESUMEN Introducción: El mito de rejuvenecer o ser bello eternamente es un sueño que la humanidad siempre ha compartido en muchas leyendas. Objetivo: Evaluar los resultados de la lipotransferencia por decantación asistida con células madre del tejido adiposo para el rejuvenecimiento facial. Métodos: Se realizó un estudio descriptivo, prospectivo y longitudinal de 35 pacientes seleccionados por muestreo aleatorio simple, en el Servicio de Cirugía Plástica del Hospital Hermanos Ameijeiras de La Habana, desde septiembre de 2019 hasta igual periodo de 2022. Resultados: En la casuística, la edad media fue de 46,5 ± 11,5 años con valores mínimo de 34 y máximo de 57 años; 48,6 % se encontraban en el grupo etario de 50-59 años. Se constató un predominio del fototipo cutáneo II (60,0 %); en pacientes sanos, el mayor porcentaje con grado de envejecimiento fue el de tipo III (57,1 %). Prevalecieron las arrugas finas en reposo y líneas más profundas con expresión facial (40,0 %) en quienes recibirían lipotransferencia asistida. Posterior al tratamiento se constató mejoría en todos los pacientes; ninguno presentó complicación. La evaluación de este procedimiento resultó ser buena (94,3 %). Conclusiones: La lipotransferencia es un procedimiento mínimamente invasivo con ventajas en cuanto a histocompatibilidad, durabilidad y menor número de complicaciones; tiene una elevada tasa de aceptación. El resultado final favorable, la seguridad y la efectividad se observan en la satisfacción del paciente.

ABSTRACT Introduction. Autologous hematopoietic progenitor cell transplantation is an effective therapy in hematological malignancies, the number of CD34+ cells in peripheral blood is the best predictor of hematopoietic progenitor cell harvesting performance. Objective. To determine the number of CD34+ cells in peripheral blood associated with the successful collection of hematopoietic progenitors by apheresis in autologous transplantation. Methods. The data of 236 hematopoietic progenitor cell apheresis procedures for autologous transplantation at the Edgardo Rebagliati Martins Hospital (Lima, Peru) were retrospectively evaluated from July 2020 to July 2023. The ROC (receiver operating characteristics) curve was used to determine the number of CD34+ cells in peripheral blood necessary to achieve an collection by apheresis ≥ 2 x 106 CD34+ cells/kg. Results. 61% were men, with a median age of 58 years, the cut-off value was 18.38 CD34+ cells/μL (sensitivity of 94.1% and specificity of 96.9%). Conclusion. The number of peripheral blood CD34+cells for successful collection of hematopoietic progenitor cells for autologous transplantation was 18.38 CD34+ cells/μL.

RESUMEN Introducción. El trasplante autólogo de células progenitoras hematopoyéticas es una terapia eficaz en neoplasias malignas hematológicas. El número de células que CD34+ en sangre periférica es el mejor predictor del rendimiento de recolección de células progenitoras hematopoyéticas. Objetivo. Determinar el número de células CD34+ en sangre periférica asociado al éxito de recolección de progenitores hematopoyéticos por aféresis en trasplante autólogo. Métodos. Se evaluó retrospectivamente los datos de 236 procedimientos de aféresis de células progenitoras hematopoyéticas para el trasplante autólogo en el Hospital Edgardo Rebagliati Martins (Lima, Perú) de julio del 2020 a julio del 2023. Se utilizó la curva ROC (características operativas del receptor) para determinar el número de células CD34+ en sangre periférica necesario para lograr una recolección por aféresis ≥ 2 x 106 células CD34+/kg. Resultados. El 61% fueron hombres, con mediana de edad de 58 años, el valor de corte fue de 18,38 células CD34+/μL (sensibilidad de 94,1% y especificidad de 96,9%). Conclusión. El número de células CD34+ sangre periférica para una recolección exitosa de células progenitoras hematopoyéticas para el trasplante autólogo fue de 18,38 células CD34+/μL.