Resumen Uno de los principales objetivos de los productores pecuarios es mantener la calidad del forraje a niveles adecuados que permitan obtener una buena ganancia en producción de leche. Una estrategia de suplementación pueden ser los ensilados con fuentes de grasa y carbohidratos solubles que mejoren la calidad del forraje. El objetivo del presente estudio fue evaluar la calidad de fermentación y nutritiva del ensilado de avena con maíz molido y grano de girasol (SG), mediante tres combinaciones de forraje de avena y maíz molido (100-0, 95-5, 90-10) y tres niveles de grano de girasol (0, 5 y 10 %). Se determinó el pH, N-NH3, ácido láctico, así como materia seca (MS), proteína cruda (PC), grasa cruda (GC), carbohidratos no estructurales (CNE), digestibilidad in vitro de la materia seca (DIVMS), fibra detergente neutra (FDN), fibra detergente ácida (FDA) y lignina en los tratamientos por triplicado, empleando 27 microsilos. No se observó interacción significativa combinación × nivel de grano (P > 0.05). El contenido de MS fue mayor en T2 y la concentración de PC fue menor en T6 (95-5-10) (P ≤ 0.05). La interacción combinación × nivel de SG fue significativo para el contenido de GC, FDA, lignina y DIVMS (P ≤ 0.05); sin embargo, la interacción no fue significativa para ph y la concentración de FDN, N-NH3 y ácido láctico (P > 0.05). La inclusión de grano de girasol cuando se combina con forraje de avena y maíz molido aumenta el valor nutritivo del ensilaje de avena pero no mejora la calidad fermentativa del forraje.

Summary One of the primary goals of livestock producers is to maintain forage quality at adequate levels that allow obtaining a good profit in milk production. A supplementation strategy could be silage with sources of fat and soluble carbohydrates that improve forage quality. The objective of this study was to evaluate the fermentative and nutritional quality of oat silage with ground corn and sunflower grain (SG) using three combinations of oat forage and ground corn (100-0, 95-5, 90-10) with three levels of sunflower grain (0, 5 and 10 %). The pH, N-NH3, lactic acid, dry matter (DM), crude protein (CP), crude fat (CF), non-structural carbohydrates (NSC), In vitro digestibility of drey matter (IVDDM), neutral detergent fiber (NDF), acid detergent fiber (ADF) and lignin were evaluated in triplicate using 27 micro-silos. No significant Combination × SG level interaction was observed (P > 0.05). DM content was higher in T2 whereas CP concentration was lower in T6 (P ≤ 0.05) (95-5-10). The Combination × SG level interaction was significant for CF, ADF, lignin and IVDMD (P ≤ 0.05); however, such interaction was non-significant for NDF, pH, N-NH3 and lactic acid (P > 0.05). The inclusion of SG when combined with oat forage and ground corn increases the nutritional value of the oat silage but does not improve the fermentative quality of the forage.

Resumo A fístula colecistocólica é uma complicação rara da litíase biliar. A apresentação clínica é variável e inespecífica. Os autores descrevem um caso clínico de uma paciente com obstrução mecânica baixa provocada pela impactação no cólon sigmoide de um cálculo biliar procedente de uma fístula colecistocólica. Perante a tentativa infrutífera de remoção do cálculo através da colonoscopia, procedeu-se a laparotomia, com enterotomia após mobilização do cálculo e remoção do mesmo e colostomia lateral, sem intercorrências intraoperatórias. A eleição da técnica cirúrgica e o prognóstico são inevitavelmente condicionados pelo estado geral e comorbilidades associadas.

Abstract Cholecystocolic fistula is a rare complication of biliary lithiasis. Clinical presentation is variable and nonspecific. The authors describe a clinical case of a patient with low mechanical obstruction caused by impaction in the sigmoid colon of a gallstone from a cholecystolic fistula. In view of the unsuccessful attempt to remove the calculus through colonoscopy, a laparotomy, with enterotomy was performed after mobilization of the calculus and removal of the calculation and lateral colostomy, without intraoperative complications. The choice of the surgical technique and the prognosis are inevitably conditioned by the general state and associated co-morbidities.

RESUMEN Existe un déficit de forraje en Durango, México durante la época de estiaje; por tal motivo, se hace necesario estudiar nuevas especies y variedades forrajeras prometedoras en términos de rendimiento y calidad del forraje. El objetivo del estudio fue determinar el rendimiento de materia verde, materia seca, composición morfológica y valor nutricional del pasto maralfalfa (Pennisetum sp.) a cuatro edades de rebrote (60, 90, 120 y 150d). El estudio se desarrolló en la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Juárez del Estado de Durango. Se aplicó fertilizante en dos ocasiones con dosis de 60-00-00 por aplicación. Se utilizó un diseño completamente al azar con seis repeticiones, la unidad experimental consistió de un transecto de 1.0 m lineales. Se evaluó la composición química en muestras de planta completa y sus componentes (vainas, láminas, nudos y entrenudos). Se determinó materia seca (MS), proteína cruda (PC), cenizas (C), extracto etéreo (EE), fibra cruda (FC) y extracto libre de nitrógeno (ELN), las fracciones de fibra detergente neutro (FDN), fibra detergente acida (FDA) y lignina ácido detergente (LAD), así como la digestibilidad in vitro de la materia seca (DIVMS) y el valor relativo del forraje (VRF). Los resultados mostraron que la edad de la planta tuvo efecto (P ≤ 0.05) sobre el rendimiento, la composición morfológica y la composición química. El contenido de PC, C, EE, VRF y la DIVMS disminuyeron conforme aumentó la edad de la planta; por el contrario, el contenido de FDN y FDA incrementaron. El pasto maralfalfa representa una opción viable para producir forraje en cantidad y calidad aceptables durante todo el año en Durango, México.

SUMMARY There is a forage deficit in the state of Durango, Mexico during the dry season; for this reason, it is necessary to study new promising species and varieties for forage production in terms of yield and quality. The study aimed to determine yield, green and dry matter, morphological composition and nutritional value of maralfalfa grass (Pennisetum sp.) at four regrowth ages (60, 90, 120 y 150 d)The study was carried out at the Faculty of Veterinary Medicine of the Juarez University of the State of Durango. Fertilizer was applied twice with a dose of 60-00-00 per application. A completely randomized design with six replication was used, the experimental unit consisted of a 1.0 linear m transect. Chemical composition was evaluated in samples of the whole plant and its components (sheets, leaf surface, nodes and internodes). Dry matter (DM), crude protein (CP), ash (A), ethereal extract (EE), crude fiber (CF), nitrogen-free extract (NFE), fractions of neutral detergent fiber (NDF), acid detergent fiber (ADF) and acid detergent lignin (ADL), as well as in vitro dry matter digestibility (IVDMD) and the relative value of the forage (RVF) were determined. Results show that the age of the plant had an effect (P ≤ 0.05) on yield, morphological composition and chemical composition. The content of CP, A, EE, as well as the RVF and IVDMD decreased as the age of the plant increased; on the contrary, the content of NDF and ADF increased. Maralfalfa grass represents a viable option for forage production in acceptable quantity and quality throughout the year in Durango, Mexico.

ABSTRACT Background: Bone marrow evaluation (BME) is crucial for establishing an accurate staging and prognosis in lymphoma patients. Objective: The objective of the study was to study the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) against bone marrow biopsy (BMB) for BME. Methods: Five hundred patient files of newly diagnosed lymphoma patients treated at an academic medical center were reviewed for BME at diagnosis by BMB and FDG PET-CT. Diagnostic performance of FDG PET-CT for detecting bone marrow infiltration (BMI) was assessed, as well as clinical predictors for positive BMB and positive FDG PET-CT. Results: BMB was positive in 16.3% of all patients, and 28.7% had a positive FDG PET-CT for BMI. Overall, the sensitivity of FDG PET-CT was 74.1% and specificity 80.1%. As for predictors for BMB and FDG PET-CT positivity, B symptoms and thrombocytopenia were independent factors for BMI. Seventy-four patients had discordant results between BMB and FDG PET-CT, non-Hodgkin lymphoma (NHL) having the most significant discordance. This discrepancy did not affect treatment. Conclusions: FDG PET-CT shows excellent performance for the detection of BMI in Hodgkin lymphoma. For diffuse large B-cell lymphoma, we recommend performing BMB and FDG PET-CT as complementary tests. In all other NHL, a unilateral BMB is mandatory at diagnosis.

Extracranial meningiomas are rare and comprise < 2% of all meningiomas. Only 11.5% of them are found in the nasal cavity. A case study of a 57-year-old woman is presented with a tumor with extension data through the lamina cribosa, compromising the right nasal cavity and the anterior cranial fossa. Biopsy of the lesion was performed and sent to histopathology, which showed histopathological elements suggestive of meningothelial meningioma. The biopsy was conducted together with neurosurgery, by means of bilateral frontal craniotomy and right lateral rhinotomy, for total resection of the lesion.

Abstract Cardiac hypertrophy and dysfunction are a significant complication of chronic Chagas disease, with heart failure, stroke, and sudden death related to disease progression. Thus, understanding the signaling pathways involved in the chagasic cardiac hypertrophy may provide potential targets for pharmacological therapy. Herein, we investigated the implication of focal adhesion kinase (FAK) signaling pathway in triggering hypertrophic phenotype during acute and chronic T. cruzi infection. C57BL/6 mice infected with T. cruzi (Brazil strain) were evaluated for electrocardiographic (ECG) changes, plasma levels of endothelin-1 (ET-1) and activation of signaling pathways involved in cardiac hypertrophy, including FAK and ERK1/2, as well as expression of hypertrophy marker and components of the extracellular matrix in the different stages of T. cruzi infection (60–210 dpi). Heart dysfunction, evidenced by prolonged PR interval and decrease in heart rates in ECG tracing, was associated with high plasma ET-1 level, extracellular matrix remodeling and FAK signaling activation. Upregulation of both FAK tyrosine 397 (FAK-Y397) and serine 910 (FAK-S910) residues phosphorylation as well as ERK1/2 activation, lead to an enhancement of atrial natriuretic peptide gene expression in chronic infection. Our findings highlight FAK-ERK1/2 signaling as a regulator of cardiac hypertrophy in Trypanosoma cruzi infection. Both mechanical stress, induced by cardiac extracellular matrix (ECM) augment and cardiac overload, and ET-1 stimuli orchestrated FAK signaling activation with subsequent activation of the fetal cardiac gene program in the chronic phase of infection, highlighting FAK as an attractive target for Chagas disease therapy.

Resumo Com base num paciente com elevação acentuada dos níveis de CA 19.9 sérico, portador de coledocolitíase, são feitas algumas considerações sobre a utilidade dos marcadores tumorais na prática clínica. Um nível elevado deste antigénio nem sempre corresponde a patologia maligna, não sendo específico da mesma, retirando importância diagnóstica ao mesmo, muitas vezes, confundindo situações. Estudos retrospetivos demonstram que o uso indevido dos marcadores tumorais encarece os sistemas de saúde, deturpam e atrasam diagnósticos. No entanto, os autores reforçam o seu papel no acompanhamento de pacientes oncológicos, com diagnóstico comprovado de neoplasias, podendo ser benéficos para decisões terapêuticas futuras e vigilância clínica.

Abstract Based on a patient with a marked increase in serum CA 19.9, with choledocholithiasis, some considerations are made about the usefulness of tumor markers in clinical practice. A high level of this antigen does not always correspond to malignant pathology, it is not specific for it, withdrawing its diagnostic importance, often confusing situations. Retrospective studies show that the improper use of tumor markers makes health systems more expensive, it may confound and delay diagnosis. However, the authors reinforce their role in monitoring cancer patients, with a proven diagnosis of neoplasms, which may be beneficial for future therapeutic decisions and clinical surveillance.

The compounds nitrosyl cis-[Ru(bpy)(phen)TU(NO)](PF6)3 (compound 1) and cis-[Ru(bpy)(phen)(4-N-Imd)(NO)](PF6)3 (compound 2) (bpy = 2,2’-bipyridine, phen = 1,10’-phenanthroline, TU = thiourea and 4-N-Imd = 4-nitroimidazole) were synthesized and characterized by UV-visible, infrared spectroscopies and electrochemical techniques. In the study of the reactivity it was possible to verify the nitric oxide labilization by square wave voltammetry and a photochemical upon blue light irradiation. This feature is very important for a potential application in phototherapy. Additionally, the antibacterial activity of the nitrosyl complexes was tested against gram-negative bacteria Pseudomonas aeruginosa. Thus, it has been observed that the complexes are capable of inhibiting the growth of such microorganisms.

RESUMO A anemiafalciforme (AF) é uma doença genética que causa importantes manifestações clínicas devido à hemólise crônica e à oclusão vascular. O objetivo deste estudo foi relatar um caso raro de gêmeas univitelinas com diagnóstico de AF, apresentando uma característica clínica diferente. Uma entrevista com as pacientes foi realizada, e os prontuários foram consultados. Uma paciente tem história de úlcera maleolar na região esquerda, enquanto a outra não. Ambas as pacientes faziam tratamento com hidroxiureia na mesma dosagem. Este estudo mostra que a AF apresenta, além de fatores genéticos, fatores não genéticos envolvidos na gravidade da doença e suas manifestações clínicas, sendo necessários estudos quepossam contribuir para o entendimento da heterogeneidade clínica da AF.

ABSTRACT Sickle cell anemia (SCA) is a genetic disease that causes important clinical manifestations due to chronic hemolysis and vascular occlusion. The aim of this study was to report a rare case of monozygotic twins diagnosed with SCA, presenting a different clinical characteristic. An interview with the patients was carried out and the medical records were consulted. One patient has a history of malleolar ulcer in the left back, while the other does not. Both patients used hydroxyurea at the same dosage. This study shows that SCA presents, in addition to genetic factors, non-genetic factors involved in the severity of the disease and its clinical manifestations. Studies are needed that may contribute to the understanding of the clinical heterogeneity of SCA.

RESUMEN La anemia de células falciformes (ACF) es una enfermedadgenética que causa importantes manifestaciones clínicas debido a la anemia hemolítica crónica y a la oclusión vascular. El objetivo de este estudio fue reportar un caso raro de gemelas monocigóticas con diagnóstico de ACF, presentando una característica clínica diferente. Se realizó una entrevista con las pacientes, consultándose sus fichas médicas. Una paciente tiene historia de úlcera maleolar en la región izquierda, mientras la otra no. Ambas hacían tratamiento con hidroxiurea en la misma dosis. Este estudio demuestra que la ACF presenta, además de factores genéticos, factores no genéticos involucrados en la severidadde la enfermedad y sus manifestaciones clínicas. Son necesarios estudios que contribuyan para la comprensión de la heterogeneidad clínica de la ACF.

RESUMO A monilétrix é uma condição genética que acomete a haste capilar. Descrevemos uma família com essa doença, enfocando seus aspectos clínicos e as características microscópicas do cabelo. A paciente era do sexo feminino, 10 anos de idade, e apresentava história de hipotricose. Além da alopecia difusa, notava-se um cabelo quebradiço, com rupturas na haste capilar em diferentes níveis. Os cabelos possuíam um aspecto nodular a olho nu. Outros membros da família apresentavam os mesmos sintomas, o que indica um padrão de herança autossômica dominante. A análise microscópica revelou fibras capilares com áreas de aparência nodular elíptica, intercaladas por regiões de constrição distrófica.

ABSTRACT Monilethrix is a genetic condition that affects the hair shaft. We describe a family with this disease, focusing on its clinical aspects and microscopic hair characteristics. The patient was a 10-year-old female with history of hypotrichosis. In addition to diffuse alopecia, there was brittle hair, with ruptures in the hair shaft at different levels. The hair had a nodular appearance at naked eye. Other family members had the same symptoms, what indicates an autosomal dominant pattern of inheritance. Microscopic analysis revealed capillary fibers with areas of elliptical nodular appearance interspersed with regions of dystrophic constriction.

Abstract In Durango, Mexico, high forage productivity and quality grasses are required to feed cattle. The objective of this study was to determine the forage productivity and quality of grasses cultivated during the dry season in Durango. The hypothesis was that the evaluated grasses would show equal forage productivity and quality values. The study was carried out during two periods: Cycle 1 (autumn-winter 2013-2014) and Cycle 2 (autumn winter 2014-2015). The varieties sown were Hercules and Maximus annual ryegrass (Lolium multiflorum), a perennial ryegrass mix (L. perenne Green Perennial), and prairie grass (Bromus willdenowii cv. Matua), using a random design and four to eight replicates. The variables were dry and green forage yield; crude protein (CP); neutral detergent fiber (NDF); acid detergent fiber (ADF); lignin; and in vitro dry matter degradation (IVDMD). Productivity was higher in Cycle 1, with a maximum cumulative yield value of 249 t ha-1 green forage (Maximus) and 40 t ha-1 dry forage (Matua). PC and IVDMD diminished between harvests in both cycles and NDF, ADF, and lignin increased during warm months. Crude protein was higher during the first harvest of Cycle 1 (21.8 %) (Matua) and in Cycle 2 (33.2 %) (Green Perenne). In the last harvest of Cycle 1, NDF was 60.7 % and reached 64.0 % in Cycle 2; FDA ranged from 34.3 % (Cycle 1) to 36.9 % (Cycle 2). Lignin ranged from 5.5 % to 6.3 % between cycles and IVDMD showed 69.2 % to 74.2 % during the first harvest and 51.8 % to 62.8 % in the final stage. There were differences in forage productivity and quality between types of grasses. The evaluated grasses are recommended and, during the warm months, reducing the period between harvests is necessary to keep the forage quality.

Resumen En Durango, México, se requieren pastos de productividad y calidad de forraje altas para alimentar el ganado bovino. El objetivo de este estudio fue determinar la productividad y calidad de forraje de pastos cultivados durante la época seca del año en Durango. La hipótesis fue que los pastos evaluados mostrarían valores iguales de productividad y calidad de forraje. El estudio se realizó en otoño-invierno 2013-2014 (Ciclo 1) y 2014-2015 (Ciclo 2). Las variedades sembradas fueron Hércules y Maximus (Lolium multiflorum), mezcla de pastos perennes (L. perenne Green Perenne) y pasto bromo (Bromus willdenowii cv. Matua) en un diseño completamente aleatorio y cuatro a ocho repeticiones. Las variables fueron rendimiento de forraje verde y seco, proteína cruda (PC), fibra detergente neutro (FDN), fibra detergente ácido (FDA), lignina y degradación in vitro de la materia seca (DIVMS). La productividad fue mayor en el Ciclo 1, con valores máximos en rendimiento acumulado de forraje verde de 242 t ha-1 (Maximus) y forraje seco de 39 t ha-1 (Matua). En ambos ciclos PC y DIVMS disminuyeron entre cortes y FDN, FDA y lignina aumentaron en los meses cálidos. PC fue mayor en el primer corte del Ciclo 1 (21.8 %) (Matua) y en el Ciclo 2 (33.2 %) (Green Perenne). La fibra detergente neutro en el último corte del Ciclo 1 fue 60.7 % y llegó a 64.0 % en el Ciclo 2; FDA fluctuó de 34.3 % (Ciclo 1) a 36.9 % (Ciclo 2). La lignina varió de 5.5 a 6.3 % entre ciclos y DIVMS fue 69.2 a 74.2 % en el primer corte y 51.8 a 62.8 % al final. Los pastos mostraron diferencias en productividad y calidad. Los pastos evaluados son recomendables y la reducción del periodo entre cortes, en los meses cálidos, es necesaria para mantener la calidad de forraje.

Abstract The demand for low-calorie products has increased. One of them is a natural product extracted from stevia (Stevia rebaudiana Bert.) whose diterpene glucosides generate outstanding sweetening power. The organic cultivation of this species is increasing in the southern region of Chiapas, México, but its asexual establishment through cuttings presents agronomic limitations. This can be improved with the incorporation of biofertilizers. It is the case of the efficiency in N fixation by Azospirillum brasilense and the endomycorrhizae Rhizophagus intraradices, which improve the transport of nutrients and water to the host plant. These microorganisms have been used in biofertilizer induction programs in annual and perennial crops in México. The objective of this study was to evaluate the effect of R. intraradices (Schenck & Sm.) Walker & Schüßler and A. brasilense Tarrand, Krieg & Döbereiner in interaction with brassinosteroids in S. rebaudiana Bert. plants through morphological, physiological and biochemical changes. The cv Morita 2 was established in a greenhouse, in plastic bags with 6 kg of fluvisol-euthric soil plus washed river sand (1:1) and 4 g of each inoculant at the moment of transplant. The concentration of A. brasilense was 9X106 bacteria g-1 and that of R. intraradices 40 spores g-1 of soil with 95 % colonization of the root system. The brassinosteroid (CIDEF-4, Natura del Desierto, S. A. de C.V., steroid content 80 % with 10 % i.a.) (2 mg L-1 of water) was sprayed on the foliage after 28 d of sowing, plus three later applications with frequency of 14 d. The experimental design was completely random with seven repetitions; the treatments were the microorganisms and the brassinosteroid applied individually and combined, and the control without application or with inoculum. The experimental unit was one pot. The variables recorded were yield, percentage of mycorrhizae root colonization, content of sweetener in leaves, and of N and P in shoots 90 d after sowing. The inoculated plants and treated with brassinosteroid in different modality increased the leaf area (1728 cm2 per plant), content of stevioside (35.8 mg g-1), rebaudioside (29.5 mg g-1) and steviol (5 mg g-1) compared to the control (p≤0.05). The content of N and P increased with the application of R. intraradices alone and combined with brassinoesteroid.

Resumen La demanda de productos bajos en calorías ha aumentado. Uno de ellos es un producto natural extraído de la stevia (Stevia rebaudiana Bert.) cuyos glucósidos diterpénicos generan poder edulcorante sobresaliente. El cultivo orgánico de esta especie tiende a incrementarse en la región sur de Chiapas, México, pero su establecimiento asexual mediante esquejes presenta limitantes agronómicas. Esto puede mejorarse con la incorporación de biofertilizantes. Es el caso de la eficiencia en la fijación de N por Azospirillum brasilense y el hongo endomicorrízico Rhizophagus intraradices que mejoran el transporte de nutrimentos y agua a la planta hospedante. Estos microorganismos se han utilizados en programas de inducción de los biofertilizantes en cultivos anuales y perennes en México. El objetivo de este estudio fue evaluar el efecto de R. intraradices (Schenck & Sm.) Walker & Schüßler y A. brasilense Tarrand, Krieg & Döbereiner en interacción con brasinoesteroide en plantas de S. rebaudiana Bert. mediante cambios morfológicos, fisiológicos y bioquímicos. El cv Morita 2 se estableció en un vivero, en bolsas de plástico con 6 kg de suelo fluvisol-eútrico más arena de río lavada (1:1) y 4 g de cada inoculante al momento del trasplante. La concentración de A. brasilense fue 9X106 bacterias g-1 y la de R. intraradices 40 esporas g-1 de suelo con 95 % de colonización al sistema radical. El brasinoesteroide (CIDEF-4, Natura del Desierto, S. A. de C.V., contenido esteroidal 80 % con 10 % i.a.) (2 mg L-1 de agua) se asperjó al follaje a los 28 d de la siembra, más tres aplicaciones posteriores con frecuencia de 14 d. El diseño experimental fue completamente al azar con siete repeticiones; los tratamientos fueron los microorganismos y el brasinoesteroide aplicados individualmente y combinados, y el testigo sin aplicación o con inoculo. La unidad experimental fue una maceta. Las variables registradas fueron rendimiento, porcentaje de colonización radical micorrízica, contenido de edulcorantes en hojas y de N y P en vástago 90 d después de la siembra. Las plantas inoculadas y tratadas con brasinoesteroide en diferente modalidad incrementaron el área foliar (1728 cm2 por planta), contenido de esteviósido (35.8 mg g-1), rebaudiósido (29.5 mg g-1) y esteviol (5 mg g-1) con respecto al testigo (p≤0.05). El contenido de N y P aumentó con la aplicación de R. intraradices solo y combinado con brasinoesteroide.

One experimental strategy to prepare a nitrosyl metal complex is based on the acid-base conversion of NO2- into NO+. Here, we employed UV-vis absorption and FTIR spectroscopies to investigate the reaction of cis-[Ru(NO2)(bpy)2(imN)]PF6 with H3O+, which produced cis-[Ru(NO)(bpy)2(imN)](PF6)3 complex. Chromatographic studies were carried out and showed that immediately after nitrite complex was dissolved only one species was present with retention time(tR) of 6.81 minutes. Addition of H3O+ to nitrite complex led to the formation of one major peak with tR of 3.92 min supporting nitrosyl complex formation. The reaction of nitrosyl complex with cysteine was also monitored by HPLC and it showed clearly the formation and followed decrease of a peak at 3.38 minute with maximum absorption at 380 nm, consistent with an intermediate complex. Later, it was observed the appearance of a peak at 4.15 minute with absorption band at 470 nm. In contrast to the reaction with cysteine, methionine did not show the formation of any intermediate. The use of HPLC was an important tool to support mechanistic assumptions for nitrosyl reactions.

RESUMO Descrevemos o caso de um paciente do sexo masculino com síndrome de Alagille (SA), o qual manifestou aumento do nível da enzima quitotriosidase (ChT). Avaliamos os fatores que pudessem justificar a relação entre AS e ChT. O paciente apresentou icterícia colestática, tinha dismorfias faciais, cardiopatia congênita e manifestou um breve quadro de septicemia. Foi submetido à biópsia de fígado e análises para erros inatos do metabolismo que mostraram, respectivamente, ductopenia e aumento dos níveis de ChT. Esse aumento poderia ser potencialmente explicado por processos infecciosos e inflamatórios, ou mesmo pela própria SA.

ABSTRACT We describe a case of a patient with Alagille syndrome (AS) presenting an increased level of the enzyme chitotriosidase (ChT), evaluating factors that could justify the relationship between AS and ChT. He was a male patient with cholestatic jaundice, facial dysmorphia and congenital heart disease who presented a brief septicemia. He underwent liver biopsy and analyses for inborn errors of metabolism that respectively showed ductopenia and increased levels of ChT. This increase could be potentially explained by inflammatory and infectious processes, or even by AS itself.

Abstract Background: Imaging studies, particularly simple and contrast-enhanced tomography, constitute the first diagnostic approach to detect recurrence of musculoskeletal tumors. The aim of the present retrospective study was to demonstrate the usefulness of scintigraphy plus SPECT/CT (single photon emission computed tomography) with thallium-201 (201Tl) in the evaluation of malignant musculoskeletal tumors with suspicion of recurrence or metastatic disease. Methods: Eight weeks after the last therapy, 72 scintigraphy and SPECT/CT studies were performed to assess regional recurrence and metastatic disease in 42 patients with different types of malignant musculoskeletal tumors, such as osteosarcoma, Ewing’s sarcoma, rhabdomyosarcoma, retinoblastoma, synovial sarcoma, and Wilms tumor at the Hospital Infantil de México Federico Gómez. The positive predictive value (PPV) and the confidence interval of the scintigraphy and SPECT/CT were calculated when compared with the results of the histopathological analysis and the clinical and radiological follow-up for the identification of recurrence. Results: Scintigraphy was abnormal in 30 (71.4%) of the 42 patients; 33 lesions (30 patients) were detected by scintigraphy and 25 lesions (21 patients) by chest X-ray and tomography of two regions. The SPECT/CT was performed on 30 patients, where 12 lesions were detected in addition to the planar scintigraphy. Scintigraphy showed a PPV of 82%; SPECT/CT, 100%. Conclusion: 201Tl-scintigraphy can be considered as an adequate study to identify the sites of tumor viability with a high degree of diagnostic certainty combined with the SPECT/CT technique.

Resumen Introducción: Los estudios de imagen, como la tomografía simple y contrastada, son la primera aproximación diagnóstica para detectar la recurrencia de tumores musculoesqueléticos. El objetivo de este estudio retrospectivo fue demostrar la utilidad de la gammagrafía acoplada a tomografía computarizada por emisión de fotón único (SPECT/CT) con talio-201(201Tl) en la valoración de tumores musculoesqueléticos malignos con sospecha de recurrencia o enfermedad metastásica. Métodos: Se realizaron 72 estudios gammagráficos y de SPECT/CT para la valoración de la recurrencia locorregional y a distancia, al menos 8 semanas tras la última terapia, en 42 pacientes con diferentes tipos de tumores musculoesqueléticos malignos, como osteosarcoma, sarcoma de Ewing, rabdomiosarcoma, retinoblastoma, sarcoma sinovial y tumor de Wilms en el Hospital Infantil de México. Se calcularon el valor predictivo positivo (VPP) y el intervalo de confianza del gammagrama y de la SPECT/CT en comparación con el resultado del análisis histopatológico y el seguimiento clínico y radiológico para identificar la recurrencia. Resultados: La gammagrafía fue anormal en 30 (71.4%) de los 42 pacientes. Se detectaron 33 lesiones (30 pacientes) por gammagrafía y 25 (21 pacientes) por telerradiografía de tórax y tomografía de dos regiones. La SPECT/CT se realizó en 30 pacientes y se detectaron 12 lesiones adicionales al rastreo planar. El VPP con la gammagrafía fue del 82%, y con la SPECT/CT, del 100%. Conclusión: La gammagrafía con 201Tl puede considerarse un estudio adecuado para identificar los sitios de viabilidad tumoral, con alto grado de certeza diagnóstica al complementar con SPECT/CT.