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Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver characterized by parenchymal destruction, hypergammaglobulinemia, specific autoantibody production, and hepatic fibrosis and necrosis. Murine models of AIH have been described; however, little is known about the immunologic mechanisms of tissue destruction. In this study, a new murine model of type 2 AIH was developed using recombinant human cytochrome P450 (CYP) 2D6 emulsified with complete Freund's adjuvant (CFA). BALB/c mice were immunized with 2 μg/mL i.p. of CYP2D6 in CFA. The control group received CFA or phosphate-buffered saline alone. Alanine aminotransferase activity, autoantibody production, IgG concentrations, histologic damage, and specific T-cell response were evaluated. Persistent AIH, characterized by cellular infiltration, hepatic fibrosis, elevated alanine aminotransferase, and the production of anti-liver kidney microsomal antibody type 1 developed in CFA/CYP2D6-immunized mice. This group presented high levels of IgG and its subclasses IgG1, IgG2a, and IgG2b against liver self-proteins. Interestingly, IL-2+ and interferon γ-positive Cyp2d6-specific T cells were present in greater concentrations in mice immunized with CFA/CYP2D6 compared with controls. Immunization with CFA, in combination with a natural human autoantigen like CYP2D6, was demonstrated to break tolerance, resulting in a chronic form of autoimmune-related liver damage. This murine model of type 2 AIH is expected to be instrumental in understanding the immunologic mechanisms of the pathogenesis of this autoimmune liver disease.

Background: Betulinic Acid (BA) is a lipophilic compound with proven beneficial results in topical inflammation. Nanogels (NG) are carriers of bioactive compounds with properties that make them good candidates to treat skin diseases. Objective: The objective of this study was to evaluate the anti-inflammatory activity of BA carried in NG. Methods: NG were composed of a nanoemulsion and a crosslinking agent (Carbopol 940®) applied at three concentrations (0.5, 1, and 1.5 %) and three activation times (6, 12 and 24 h). In order to select the optimal formulation, the NG were characterized mechanically and micro-structurally followed by evaluation of the BA anti-inflammatory activity in an in vivo model of auricular edema. We determined the edema inhibition activity as percent weight. Additionally, the anti-inflammatory activity of NG was validated through histological analysis. Results: The formulation with the best viscoelastic properties was the one prepared with 0.5% carbopol and 6 h of activation. Microstructural examination of this formulation showed mostly spherical structures with a mean diameter of 65 nm. From the evaluation of edema and the histological analyses, we established that the NG of BA produced 52% inhibition. In contrast, a conventional gel and free BA produced 28% and 19% inhibition, respectively. Conclusion: The NG of BA were found to be good vehicles to treat skin inflammation.

Introduction: Malignant tumors of the digestive system are a public health problem with epidemiologic variations attributed to factors resulting from the aging of the population and lifestyle changes. Therefore, estimating the future magnitude of the problem is prudent. Aim: To determine the epidemiologic projection up to 2025 of malignant tumors of the digestive system in Veracruz. Materials and methods: A predictive, analytic, observational study was conducted on patients belonging to the Public health sector of Veracruz that presented with digestive system cancer, within the time frame of 2000-2016, carrying out a disease projection up to 2025. The IBM SPSS 22.0 program was utilized for the statistical analysis, employing simple linear regression. A comparative analysis of the data was carried out and results are shown in scatter graphs. Results: A total of 2,540 cases were included in the study. Mean patient age was 63.25 ± 13.43, with a predominance of men at 56.65%. The most frequent tumor locations were in the colon and rectum (25.04%), liver (23.66%), and stomach (21.93%). Less frequent sites were the esophagus (4.88%) and small bowel (5.08%). A general 7.63% increase in the disease was predicted for 2025, with increases to 11.51% for esophageal cancer, 7.22% for gastric cancer, 9.09% for colorectal cancer, 5.98% for liver cancer, 7.88% for pancreatic cancer, and 6.46% for cancer of the gallbladder and bile ducts. Only cancer of the small bowel showed a predicted decrease to 3.33%. Discussion and conclusions: The results of the present study predict that digestive system cancers in Veracruz will increase importantly by 2025, with colorectal cancer, hepatocellular carcinoma, and gastric cancer as the most frequent tumors, in descending order. The other cancers are estimated to maintain a discrete line of growth. In addition to predicting the behavior of those cancers, the results of the present study are useful for estimating the resources that will be needed for their care by 2025. Resumen: Introducción y objetivo: Las neoplasias malignas del aparato digestivo representan un problema de salud pública con variaciones epidemiológicas atribuidas a factores resultantes del envejecimiento poblacional y cambios del estilo de vida por lo que es conveniente estimar la magnitud del problema a futuro. Objetivo: Determinar la proyección epidemiológica a 2025 de las neoplasias malignas de aparato digestivo en Veracruz. Material y métodos: Estudio predictivo, analítico, observacional de pacientes con cáncer de aparato digestivo del Sector Salud de Veracruz durante 2000-2016 y su proyección al 2025. Análisis estadístico: Se utilizó el programa IBM SPSS 22.0, regresión lineal simple. Los datos se analizaron de forma comparativa y representados mediante gráficos de dispersión. Resultados: Se incluyeron 2,540 casos, con promedio de edad 66.93 ± 14.94, predominando el género masculino 56.65%, la localización más frecuente fue colorrectal 25.04%, hígado 23.66% y gástrico 21.93%; siendo los de menor frecuencia esofágico (4.88%) y de intestino delgado 85.07%. Para 2025 se aprecia un incremento de 7.63% en general, el cáncer de esófago de 11.51%, estómago 7.22%, colorrectal 9.09%, hígado 5.98%, páncreas 7.88% y vesícula y vías biliares 6.46%, solamente el cáncer de intestino delgado mostró decremento de 3.32%. Discusión y conclusiones: Las neoplasias del aparato digestivo en Veracruz sufrirán un incremento importante para el 2025 siendo los más frecuentes el colorrectal y el carcinoma hepatocelular con descenso a tercer lugar del gástrico, el resto mantendrá una línea de crecimiento discreta. Los resultados además de predecir su comportamiento son de utilidad para estimar los recursos necesarios para su atención en el 2025.

Curcumin is a bioactive compound with proven antioxidant and anti-inflammatory activities, but has low water solubility and dermal absorption. The inflammatory process is considered as the biological response to damage induced by various stimuli. If this process fails to self-regulate, it becomes a potential risk of cancer. The objective of this work was to evaluate the anti-inflammatory activity of curcumin administered to mice with induced atrial edema using two topical vehicles: organogels and O/W-type nanogels at pH 7, Organogels and O/W-type nanogels at pH 7 were prepared, characterized and the anti-inflammatory activity was assessed. A histopathological analysis of mouse ears was performed and two gel formulations were selected. Thermograms of organogels indicated that increasing the gelling agent improved the stability of the system. Deformation sweeps confirmed a viscoelastic behavior characteristic of gels in both systems. During the anti-inflammatory activity evaluations, the nanogels demonstrated greater activity (61.8 %) than organogels; Diclofenac® (2-(2,6-dichloranilino) phenylacetic acid), used as a control medication achieved the highest inhibition (85.4%); however, the drug produced the death of 2 (40%) of the study subjects caused by secondary adverse events. Histopathological analysis confirmed the data.

Background Colorectal cancer (CRC) is one of the main five causes of morbidity and mortality by oncologic diseases in our country and worldwide. Recently, fecal immunochemical test (FIT) has proven to be a noninvasive screening test that allows to select patients most likely to have a pre-malign lesion in order to perform a colonoscopy. Objective To report the findings of a CRC screening program using FIT in our country population. Method A multicentric study was performed, by inviting open population older than 50 years to participate in a CRC screening. Quantitative FIT specific for human hemoglobin was used, with a cut point of 100 ng/ml or higher to consider as positive. Those patients with positive results were asked to undergo a colonoscopy. In the cases where polypoid lesions were found, biopsies were performed. Results In total, 751 FIT were processed, and 51 (6.8) of those were positive, with a rate of 15.9 premalign lesions for 1,000 individuals, and 1.3 patients with CRC for every 1,000. Conclusions The present study matches worldwide reports, supporting the initiative of establishing a formal and standardized CRC screening program in the public health sector.

Background: Cancer is one of the main causes of death by disease; several alternative treatments have been developed to counteract this condition. Curcumin (diferuloylmethane), extracted from the rhizome of Curcuma longa, has antioxidant, anti-inflammatory, and anti-cancer properties; however, it has low water solubility and poor intestinal absorption. Carrier systems, such as nanoemulsions, can increase the bioavailability of lipophilic bioactive compounds. Objective: To evaluate the effect of curcumin nanoemulsions prepared with lecithin modified with medium-chain fatty acids as an emulsifier, on the expression of the Cdk4, Ccne2, Casp8 and Cldn4 genes involved in the carcinogenesis process in K14E6 transgenic mice. Methods: The emulsifier was prepared by interesterification of medium-chain fatty acids, pure lecithin, and immobilized phospholipase-1 on Duolite A568. An Ultraturrax homogenizer and a Branson Ultrasonic processor were used for the preparation of nano-emulsions, and a Zetasizer evaluated the particle size. qRT-PCR analysis was performed to quantify the cancer-related genes expressed in the K14E6 mice. The development and evolution of skin carcinogenesis were assessed through histological analysis to compare cell morphology. Results: Ca 59% of the MCFA were incorporated via esterification into the PC within 12 hours of the reaction. An emulsifier yield used to formulate the NE of 86% was achieved. Nanoemulsions with a particle size of 44 nm were obtained. The curcumin nano-emulsion group had a 91.81% decrease in the tumorigenesis index and a reduction in tumor area of 89.95% compared to the sick group. Histological analysis showed that the group administered with free curcumin developed a microinvasive squamous cell carcinoma, as opposed to the group with nanoemulsion which presented only a slight inflammation. In gene expression, only a significant difference in Cdk4 was observed in the nanoemulsion group.

Background Mullerian adenosarcoma is a rare gynecological malignancy with a low malignant potential, with biphasic growth, consisting of a benign epithelial element and a malignant mesenchymal element. It occurs in all ages predominating in postmenopausal women. Cervical localization of Mullerian adenosarcomas is rare; however, it is associated with a presentation in young women. The diagnosis is made by anatomopathological study of the lesion and immunohistochemistry. The prognosis is generally good although the recurrence rate is high. Clinical case We present the case of a 27-year-old patient who attended a gynecological consultation with bleeding and transvaginal flow. During the gynecological examination, a polypoid lesion originating in the cervix was identified, which was removed by torsion and was diagnosed as Mullerian cervical adenosarcoma. Subsequently, a cervical cone was performed because the patient refused hysterectomy. Conclusions Mullerian cervical adenosarcoma is a rare neoplasm with a recurrence rate that can reach up to 50% of cases, so close follow-up is necessary. A local excision can be considered in patients without poor prognosis factors and who wish to preserve their fertility.

Current changes in diet, characterized by an increase in the intake of sweetened beverages, are heavily related to metabolic disorders such as non-alcoholic fatty liver. This condition can produce simple steatosis and, in worse cases, potentially result in steatohepatitis, fibrosis, and cirrhosis, comparable to the damage caused by the consumption of more or less 20–30 g of alcohol per day. The main objective of this research was to evaluate the effect of curcumin (Curcuma longa) nanoemulsions, using mono- and diacylglycerides medium chain fatty acids as stabilizers in an in vivo hepatic steatosis rat model. Pathology was induced by providing 30% fructose intake in the drinking water. Globule sizes under 200 nm that were stable for 4 weeks were obtained, curcumin encapsulated in the nanoemulsion was &gt, 70%. The results revealed an improvement regarding body and liver weight in the animals treated with curcumin nanoemulsions. A decrease in total cholesterol, LDL, AST/ALT, and HDL in serum was observed, however, no apparent improvement regarding serum glucose or triacylglycerides values was noted. Histological analysis showed a significant decrease in the extent of steatosis, inflammation, and brown adipose tissue in the treated animals.

Pemphigus is a rare autoimmune disease that causes blistering of the skin and oral mucosa. In bullous pemphigoid (BP), skin involvement is predominant, whereas oesophageal involvement is rare, compared with other blistering diseases. We present, herein, the case of a 67-year-old man with a history of successfully treated BP that 2 years later developed progressive dysphagia, unintentional weight loss and iron deficiency anaemia. An endoscopy with biopsies was performed, and its findings were consistent with ‘sloughing esophagitis’ (esophagitis dissecans superficialis) associated with BP. Oesophageal involvement was present during the first weeks, making our case unusual due to the isolated oesophageal symptoms that developed 24 months later.

Gluten-related disorders (GRDs) are common chronic enteropathies and increasing evidence suggests an involvement of the gut microbiota. We examined the gut microbiota in Mexican people afflicted with GRDs. Ultra-high-throughput 16S marker sequencing was used to deeply describe the duodenal and fecal microbiota of patients with celiac disease (CD, n = 6), non-celiac gluten sensitivity (NCGS, n = 12), and healthy subjects (n = 12) from our local area. Additionally, we also investigated the changes in gut microbiota after four weeks on a gluten-free diet (GFD) in a subset of patients from whom paired samples were available. Despite a high inter-individual variability, significant differences in various microbial populations were identified. The linear discriminant analysis (LDA) effect size (LEfSe) method revealed that the genus Actinobacillus and the family Ruminococcaceae were higher in the duodenal and fecal microbiota of NCGS patients, respectively, while Novispirillum was higher in the duodenum of CD patients (p &lt, 0.05, LDA score &gt, 3.5). Interestingly, paired samples from NCGS patients showed a significant difference in duodenal Pseudomonas between the baseline period (median: 1.3%, min/max: 0.47&ndash, 6.8%) and the period after four weeks on GFD (14.8%, 2.3&ndash, 38.5%, p &lt, 0.01, Wilcoxon signed-rank test). These results encourage more research on GRDs in M&eacute, xico.

Aim: To evaluate the mRNA expression levels of Cd36 in adipose and hepatic tissues, in rats with NAFLD after the consumption of sucrose for 10 and 20 weeks. Methods: Twenty Wistar rats, all nearly 21 days old were divided into two experimental groups (NAFLD-10 and NAFLD-20), that received a standard diet (2014 Teklad Global) plus 30% sucrose in their drinking water for 10 and 20 weeks and the control groups (C Groups). Variables such as body weight, food intakes, and serum parameters were measured. Adipose and hepatic tissues were extirpated; some tissue was preserved in formalin and some at -70 °C until analysis. Histological analysis was carried out, and the Cd36 mRNA expression levels were determined. Results: The rats in the NAFLD-10 and NAFLD-20 groups showed a significative increase in abdominal fat, triglycerides, free fatty acids, insulin, AST, ALT, uric acid and HOMA index; as well as changes in the cellular dynamics in adipose tissue, (adipocytes hypertrophic: >1500 µm2) with respect to the control groups (P

Gastric polypoid lesions are found in ∼1-4% of patients who undergo esophagogastroduodenoscopy. The hyperplastic lesions are considered non-neoplastic polyps that are distributed randomly in the stomach and they are usually related to chronic gastritis as a result of the exaggerated mucosal healing response. Although several conditions have been associated with celiac disease (CD), such as thyroiditis, Addison's disease, type 1 diabetes mellitus, and autoimmune hepatitis, the association with gastric polyps is rare. In this case series, we present seven newly diagnosed patients (six women) with CD and hyperplastic gastric polyps. Helicobacter pylori infection was ruled out through histology in all the patients and two out of seven had a history of occasional proton pump inhibitor use. An unusual association was found between CD and hyperplastic polyps in this case series.

Sebaceous glands typically are located in the pilosebaceous unit located in the superficial layers of the skin. Thus, ectopic sebaceous glands in the esophagus are a very unusual condition. Since 1962 when De la Pava and Pickren described that sebaceous glands could be ectopically located in the esophagus, no more than 30 cases have been reported in the literature. Macroscopically, single or multiple nodular yellowish lesions are found, and most of the times are overlooked. In this paper, we describe 3 cases (2 female and one male) of ectopic sebaceous glands in the esophagus incidentally detected during routine upper gastrointestinal tract endoscopic examination. Histopathology diagnoses were supported using immunohistochemestry for AE1/AE3 citokeratins and epithelial membrane antigen.

Background The cost-effectiveness for screening for celiac disease (CD) in patients with irritable bowel syndrome (IBS), specifically in the diarrhea (IBS-D) subtype, is beneficial if the prevalence is >1%. However, recent studies have shown controversial results. In this large case–control study, our aim was to determine the prevalence of CD and a panel of related antibodies in patients diagnosed with IBS. Materials and methods Four hundred IBS patients (Rome III) and 400 asymptomatic healthy controls were prospectively evaluated using antihuman tissue transglutaminase (h-tTG IgA) and deamidated gliadin peptide antibodies (DGP II IgA and DGP II IgG). Duodenal biopsy was performed on the patients that were positive for the h-tTG IgA and/or DGP II IgG antibodies. Results The mean age of the population was 44.47 ± 18.01 years and 335 (82%) of the subjects were women. Twenty-one patients and six controls had at least one positive test for CD (5.25% VS 1.5%, p = 0.003, OR 3.63 [95% CI 1.4–9.11]). Eighteen patients were positive for h-tTG and/or DGP-II IgG. Histologic confirmation of CD was 2.5% in the IBS patients vs 0.5% in the controls (p = 0.04, OR 5.21). The IBS-D subtype had the highest prevalence for serological positivity (12.7%). Conclusions Up to 5.2% of the patients with IBS according to the Rome III criteria were positive for at least one of the CD-related antibodies and 2.5% had biopsy-confirmed CD. Therefore, in our population, screening for CD in subjects with IBS appears to be a reasonable strategy, especially in the IBS-D subgroup.

Resumen El tumor miofibroblastico inflamatorio (seudotumor inflamatorio) es una lesion idiopatica, poco frecuente en cabeza y cuello, de etiologia desconocida, que se presenta mas comunmente en tejidos blandos, pulmon y orbita. En la literatura mundial solo se tiene conocimiento previo de 2 casos con afeccion amigdalar. Informamos del caso de una nina de 10 anos, que ingreso en nuestro hospital con cuadro clinico de dolor en la region cervical, tos con vomito, disnea y dislexia, la exploracion fisica mostro halitosis y una neoformacion dependiente de la amigdala izquierda, se le realizo amigdalectomia bilateral.

Inflammatory myofibroblastic tumour (inflammatory pseudotumor) is an idiopathic lesion, rare in the head and neck, of unknown aetiology. It is primarily a soft tissue, lung and orbital condition. In the world literature, only two cases with tonsillar disease have been found. We report a case of a 10-year-old girl admitted to our hospital with clinical complaints of pain in the neck region, cough with vomiting, dyspnoea and dyslexia. Clinical examination revealed halitosis and a neoformation dependent on the left tonsil. Bilateral tonsillectomy was performed.

Background: Recent research has described that obesity and high carbohydrates intake increases fat content of the gallbladder, decreases its motility and mucosal absorption, leading to a condition known as steatocholecystitis. Gallstone disease (GD) and the metabolic syndrome (MS) share common risk factors. Objective: To identify if MS contributes to the development of functional disorders and wall changes of the gallbladder. Methods: A Prospective study was conducted from August 2010 to July 2011 on patients with symptomatic gallbladder disease undergoing laparoscopic cholecystectomy. Forty two patients were included and divided into two groups; 22 patients with MS and 20 patients without MS. Family history, risk factors, anthropometric, clinical and laboratory variables were evaluated before surgery. Gallbladder specimens were analyzed, measured and graded by two pathologists at 3 standardized areas (cystic duct, liver bed, free margin and fundus). Results: Thirty three patients who underwent cholecystectomy were female. A family history of GD and MS were present in 90% of patients. Chronic cholecystitis was the most frequent diagnostic (93%). Median weight was 75.5kg±14.3 and 67.1kg±9.2 for MS and No-MS groups respectively. Gallbladder wall thickness was significantly increased (P=0.012) in the MS group. This thickness was secondary mainly observed in the cystic duct area of patient with MS. The percentage of fatty infiltration of the gallbladder wall, muscle degeneration and cholesterolosis did not show significant differences between groups. Conclusions: MS is associated with an increased gallbladder wall thickness. Muscle fibrosis in the cystic duct was the most important wall modification in these patients. In our series, MS was not associated to fat infiltration of the gallbladder wall or cholesterolosis.

Glomus tumours are a rare type of subepithelial mesenchymal tumours that present in deep visceral organs such as the stomach, which are difficult to diagnose. We report a case of a 44-year-old woman with diabetes who presented with anaemia, abdominal pain and melena diagnosed preoperatively with a gastric glomus tumour initially misdiagnosed as a gastric ulcer located at the lesser curvature. Upon referral to our centre a repeat endoscopy and biopsy were performed. A partial gastrectomy was performed with no complications. Histopathological analysis of the tumour reported clear margins and immunostaining was positive for smooth muscle actin and collagen IV. The patient remains asymptomatic at 3-month follow-up.