AIP and MEN1 mutations and AIP immunohistochemistry in pituitary adenomas in a tertiary referral center.

Background: Pituitary adenomas have a high disease burden due to tumor growth/ invasion and disordered hormonal secretion. Germline mutations in genes such as MEN1 and AIP are associated with early onset of aggressive pituitary adenomas that can be resistant to medical therapy. Aims: We performed a retrospective screening study using published risk criteria to assess the frequency of AIP and MEN1 mutations in pituitary adenoma patients in a tertiary referral center. Methods: Pituitary adenoma patients with pediatric/adolescent onset, macroadenomas occurring ≤30 years of age, familial isolated pituitary adenoma (FIPA) kindreds and acromegaly or prolactinoma cases that were uncontrolled by medical therapy were studied genetically. We also assessed whether immunohistochemical staining for AIP (AIP-IHC) in somatotropinomas was associated with somatostatin analogs (SSA) response. Results: Fifty-five patients met the study criteria and underwent genetic screening for AIP/MEN1 mutations. No mutations were identified and large deletions/duplications were ruled out using MLPA. In a cohort of sporadic somatotropinomas, low AIP-IHC tumors were significantly larger (P = 0.002) and were more frequently sparsely granulated (P = 0.046) than high AIP-IHC tumors. No significant relationship between AIP-IHC and SSA responses was seen. Conclusions: Germline mutations in AIP/MEN1 in pituitary adenoma patients are rare and the use of general risk criteria did not identify cases in a large tertiary-referral setting. In acromegaly, low AIP-IHC was related to larger tumor size and more frequent sparsely granulated subtype but no relationship with SSA responsiveness was seen. The genetics of pituitary adenomas remains largely unexplained and AIP screening criteria could be significantly refined to focus on large, aggressive tumors in young patients

Clinicopathological And Immunohistochemical Evaluation Of Oral And Oropharyngeal Squamous Cell Carcinoma In Chilean Population.

In oral and oropharyngeal squamous cell carcinoma (OCSCC and OPSCC) exist an association between clinical and histopathological parameters with cell proliferation, basal lamina, connective tissue degradation and surrounding stroma markers. We evaluated these associations in Chilean patients. A convenience sample of 37 cases of OCSCC (n=16) and OPSCC (n=21) was analyzed clinically (TNM, clinical stage) and histologically (WHO grade of differentiation, pattern of tumor invasion). We assessed the expression of p53, Ki67, HOXA1, HOXB7, type IV collagen (ColIV) and carcinoma-associated fibroblast (α-SMA-positive cells). Additionally we conducted a univariate/bivariate analysis to assess the relationship of these variables with survival rates. Males were mostly affected (56.2% OCSCC, 76.2% OPSCC). Patients were mainly diagnosed at III/IV clinical stages (68.8% OCSCC, 90.5% OPSCC) with a predominantly infiltrative pattern invasion (62.9% OCSCC, 57.1% OPSCC). Significant association between regional lymph nodes (N) and clinical stage with OCSCC-HOXB7 expression (Chi-Square test P < 0.05) was observed. In OPSCC a statistically significant association exists between p53, Ki67 with gender (Chi-Square test P < 0.05). In OCSCC and OPSCC was statistically significant association between ki67 with HOXA1, HOXB7, and between these last two antigens (Pearson's Correlation test P < 0.05). Furthermore OPSCC-p53 showed significant correlation when it was compared with α-SMA (Kendall's Tau-c test P < 0.05). Only OCSCC-pattern invasion and OPSCC-primary tumor (T) pattern resulted associated with survival at the end of the follow up period (Chi-Square Likelihood Ratio, P < 0.05). Clinical, histological and immunohistochemical features are similar to seen in other countries. Cancer proliferation markers were associated strongly from each other. Our sample highlights prognostic value of T and pattern of invasion, but the conclusions may be limited and should be considered with caution (small sample). Many cases were diagnosed in the advanced stages of the disease, which suggests that the diagnosis of OCSCC and OPSCC is made late.75968-7

Recent consequences of climate change have affected tree growth in distinct Nothofagus macrocarpa (DC.) FM Vaz & Rodr age classes in Central Chile

Forests play an important role in water and carbon cycles in semiarid regions such as the Mediterranean ecosystems. Previous research in the Chilean Mediterranean forests revealed a break point in 1980 in regional tree-ring chronologies linked to climate change. However, it is still unclear which populations and age classes are more affected by recent increases in drought conditions. In this study, we investigated the influence of recent variations in precipitation, temperature, and CO2 concentrations on tree growth of various populations and age classes of Nothofagus macrocarpa trees in Central Chile. We sampled 10 populations from five sites of N. macrocarpa through its whole geographic distribution in both Coastal and Andes ranges. We used standard dendrochronological methods to (i) group populations using principal component analysis, (ii) separate age classes (young, mature, and old trees), (iii) evaluate linear growth trends based on the basal area increment (BAI), and (iv) analyze the link between BAI and atmospheric changes using linear mixed-effects models. Results showed that young trees are more sensitive to climate variability. Regarding population grouping, we observed that all population clusters were sensitive to winter-spring precipitation, but only the Andes and Coastal populations were negatively correlated with temperature. The results of CO2 fertilization analyses were controversial and unclear. Since young trees from all population clusters reacted positively in the phase with an increase of atmospheric CO2 between 1980 and 2014, this behavior was not translated into growth for the last 15 years (2000-2014). However, it should be noted that the young trees of the highest elevation populations did not have a negative growth trend, so it seems that CO2 counteracted the negative effect of recent regional climate change (increase in temperature and precipitation decrease) in these population trees. Further studies are needed to assess the effects of climate variability over other ecological and physiological processes.Fil: Venegas González, Alejandro. Universidad Mayor.; ChileFil: Roig Junent, Fidel Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Peña Rojas, Karen. Universidad de Chile; ChileFil: Hadad, Martín Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Centro de Investigaciones de la Geosfera y Biosfera. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Aguilera Betti, Isabella. Pontificia Universidad Católica de Valparaíso; Chile. Universidad Austral de Chile; ChileFil: Muñoz, Ariel A.. Pontificia Universidad Católica de Valparaíso; Chil

Estudio de caso. Estrategia de Andrews para buscar el liderazgo en la industria Capstone

Este Trabajo de obtención de Grado presenta el estudio de caso de la empresa Andrews en el simulador Capstone con la finalidad de obtener el grado de Maestría en Administración de Negocios del ITESO. El capítulo uno describe el marco teórico relacionado con estrategia, metodología y procesos que la conforman. Además, se estudian casos empresariales que han implementado dichos conceptos para salir adelante en su entorno económico. Dentro del capítulo dos se describe cómo funciona el simulador Capstone, desde los reportes que genera, las áreas que lo componen y las estrategias sugeridas para producir las cinco gamas de sensores que se ofrecen al mercado. también el equipo directivo de Andrews determina la estrategia a seguir en un período de ocho años, así como, los objetivos anuales, de corto plazo y de largo plazo. En los capítulos tres al seis, se muestran los resultados de Andrews tras la toma de decisiones en cada uno de los bienios dentro de cada una de las áreas: investigación y desarrollo, mercadotecnia, producción, calidad TQM, recursos humanos y finanzas. Se revisan los indicadores del Balanced Scorecard y se comparan contra las demás empresas, analizando así si es necesario hacer modificaciones a las tácticasITESO, A.C

Neurocognitive Function in Acromegaly after Surgical Resection of GH-Secreting Adenoma versus Naïve Acromegaly

Patients with active untreated acromegaly show mild to moderate neurocognitive disorders that are associated to chronic exposure to growth hormone (GH) and insulin-like growth factor (IGF-I) hypersecretion. However, it is unknown whether these disorders improve after controlling GH/IGF-I hypersecretion. The aim of this study was to compare neurocognitive functions of patients who successfully underwent GH-secreting adenoma transsphenoidal surgery (cured patients) with patients with naive acromegaly. In addition, we wanted to determine the impact of different clinical and biochemical variables on neurocognitive status in patients with active disease and after long-term cure. A battery of six standardized neuropsychological tests assessed attention, memory and executive functioning. In addition, a quantitative electroencephalography with Low-Resolution Electromagnetic Tomography (LORETA) solution was performed to obtain information about the neurophysiological state of the patients. Neurocognitive data was compared to that of a healthy control group. Multiple linear regression analysis was also conducted using clinical and hormonal parameters to obtain a set of independent predictors of neurocognitive state before and after cure. Both groups of patients scored significantly poorer than the healthy controls on memory tests, especially those assessing visual and verbal recall. Patients with cured acromegaly did not obtain better cognitive measures than naïve patients. Furthermore memory deficits were associated with decreased beta activity in left medial temporal cortex in both groups of patients. Regression analysis showed longer duration of untreated acromegaly was associated with more severe neurocognitive complications, regardless of the diagnostic group, whereas GH levels at the time of assessment was related to neurocognitive outcome only in naïve patients. Longer duration of post-operative biochemical remission of acromegaly was associated with better neurocognitive state. Overall, this data suggests that the effects of chronic exposure to GH/IGF-I hypersecretion could have long-term effects on brain functions. © 2013 Martín-Rodríguez et al.Funding for this project was provided by an R&D grant from Novartis Oncology and the Plan Andaluz de Investigación (CTS-444). DAC was supported by the “Ramón y Cajal” program (RYC-2006-001071) of the Spanish Ministry of Science and Innovation.Peer Reviewe

Sex Hormone Receptor Expression in Craniopharyngiomas and Association with Tumor Aggressiveness Characteristics

Craniopharyngiomas (CPs) are rare tumors of the sellar and suprasellar regions of embryonic origin. The primary treatment for CPs is surgery but it is often unsuccessful. Although CPs are considered benign tumors, they display a relatively high recurrence rate that might compromise quality of life. Previous studies have reported that CPs express sex hormone receptors, including estrogen and progesterone receptors. Here, we systematically analyzed estrogen receptor α (ERα) and progesterone receptor (PR) expression by immunohistochemistry in a well-characterized series of patients with CP (n = 41) and analyzed their potential association with tumor aggressiveness features. A substantial proportion of CPs displayed a marked expression of PR. However, most CPs expressed low levels of ERα. No major association between PR and ERα expression and clinical aggressiveness features was observed in CPs. Additionally, in our series, β-catenin accumulation was not related to tumor recurrence. View Full-TextThis work was supported by grants from the ISCIII-Subdirección General de Evaluación y Fomento de la Investigación co-funded with Fondos FEDER (PI16/00175 to A.S-M. and D.A.C.) and the Sistema Andaluz de Salud (A-0006-2017 and A-0055-2018 to A.S-M, RC-0006-2018 to D.A.C.)

A Silent Corticotroph Pituitary Carcinoma: Lessons From an Exceptional Case Report

Nowadays, neither imaging nor pathology evaluation can accurately predict the aggressiveness or treatment resistance of pituitary tumors at diagnosis. However, histological examination can provide useful information that might alert clinicians about the nature of pituitary tumors. Here, we describe our experience with a silent corticothoph tumor with unusual pathology, aggressive local invasion and metastatic dissemination during follow-up. We present a 61-year-old man with third cranial nerve palsy at presentation due to invasive pituitary tumor. Subtotal surgical approach was performed with a diagnosis of silent corticotroph tumor but with unusual histological features (nuclear atypia, frequent multinucleation and mitotic figures, and Ki-67 labeling index up to 70%). After a rapid regrowth, a second surgical intervention achieved successful debulking. Temozolomide treatment followed by stereotactic fractionated radiotherapy associated with temozolomide successfully managed the primary tumor. However, sacral metastasis showed up 6 months after radiotherapy treatment. Due to aggressive distant behavior, a carboplatine-etoposide scheme was decided but the patient died of urinary sepsis 31 months after the first symptoms. Our case report shows how the presentation of a pituitary tumor with aggressive features should raise a suspicion of malignancy and the need of follow up by multidisciplinary team with experience in its management. Metastases may occur even if the primary tumor is well controlled.This work was supported by grants from the ISCIII-Subdirección General de Evaluación y Fomento de la Investigación co-funded with Fondos FEDER (PI16/00175 to AS-M and DC) and the Sistema Andaluz de Salud (A-0003-2016 and A-0006-2017 to AS-M, C-0015-2014 and RC-0006-2018 to DC)

Rutas del Valle, rodadas para el desarrollo del turismo

Un equipo multidisciplinario de distintas carreras del ITESO comenzaron el semestre con la intención de crear un proyecto con el fin de mejorar el turismo en el Valle de Mazatepec. Una vez que los estudiantes tuvieron una idea clara del proyecto, se realizaron encuestas en la comunidad de ahuisculco con el fin de saber si la gente estaba de acuerdo con la idea proporcionada por los alumnos y a su vez, saber cuáles eran las preferencias de la gente. Con la información recabada, el equipo decidió darle forma a dos rodadas que consistirán de aproximadamente 15 kilómetros cada una, saliendo de la plaza de san Isidro Mazatepec con el fin de llegar a la presa de San Pedro de Valencia y regresar al punto inicial. A continuación en el reporte se explica la forma en la que se realizó el proyecto, desde los antecedentes, análisis y conclusiones por parte del equipo sobre el proyecto realizado.ITESO, A.C

Rutas del Valle rodadas para el desarrollo del turismo

Un equipo multidisciplinario ideó un proyecto con el fin de mejorar el turismo en el Valle de Mazatepec. Una vez que los estudiantes tuvieron una idea clara del proyecto, se realizaron encuestas en la comunidad de ahuisculco con el fin de saber si la gente estaba de acuerdo con la idea proporcionada por los alumnos y a su vez, saber cuáles eran las preferencias de la gente Con la información recabada, el equipo decidió darle forma a dos rodadas que consistirán de aproximadamente 15 kilómetros cada una, saliendo de la plaza de san Isidro Mazatepec con el fin de llegar a la presa de San Pedro de Valencia y regresar al punto inicial. A continuación en el reporte se explica la forma en la que se realizó el proyecto, desde los antecedentes, análisis y conclusiones por parte del equipo sobre el proyecto realizado.ITESO, A.C

Proyecto para el desarrollo de turismo rural sustentable en el Valle de Mazatepec y diseño de actividad para el Festival Cultural Mazatepec

Al ver la importancia que tienen algunas de las comunidades localizadas entre los municipios de Acatlán de Juárez y en su mayoría en el municipio de Tala, un equipo conformado por estudiantes del ITESO de diferentes áreas profesionales, tales como arquitectura, ingeniería, comercio y negocios, gestión cultural y los integrantes del Colectivo Cultural de Mazatepec, se dieron a la tarea de realizar visitas turísticas con la finalidad de encontrar lugares con potencial turístico para que las personas que asistieron al Festival Cultural de Mazatepec, pudieran acceder de manera más fácil, las comunidades visitadas fueron las siguientes: San Isidro Mazatepec, Las Navajas, Cuxpala, Ahuisculco. Para la elaboración del proyecto en curso, se realizaron visitas en cada comunidad mencionada a los lugares que pudieran ser de hospedaje y de alimentación principalmente, los cuales fueron encontrados por miembros del equipo al caminar por las comunidades, como continuación de lo que ya se ha estado trabajando en la zona del Valle los semestres anteriores, en los cuales se ha trabajado la implementación del turismo. 3 Se contó con la participación de los integrantes del equipo en el Festival Cultural de Mazatepec de manera que pudiéramos dar a conocer no solo este proyecto, sino también los demás proyectos mediante un pabellón y posteriormente por un festival de cine. La estrategia del proyecto se llevó a cabo mediante mapeo y registro, así como un formato de protección a algunas zonas del Valle, el cual será enviado a la Secretaría de Cultura para su posterior protección. Se pretende que las comunidades del Valle en conjunto con el Colectivo Cultural de Mazatepec mejoren sus condiciones y trabajen juntos para que sean más reconocidas y valoradas.ITESO, A.C