Feocromocitoma: Cirugía urgente vs Cirugía programada

Pheochromocytoma is a chromaffin cell tumor preferentially located in the abdominal cavity and in particular in the adrenal gland. Clinically it can be asymptomatic or present with a wide variety of symptoms, given its ability to secrete catecholamines, such as high blood pressure as well as the classic triad of headache, hyperhidrosis and tachycardia. Moreover, we present a clinical case of a male patient, 24 years old, who debuts with loss of strength in right limbs after hypertensive crisis and hematoma in basal ganglion, which must be intervened desperately under the suspicion of pheochromocytoma tumor, with subsequent diagnosis, presurgical preparation and scheduled surgery.  El feocromocitoma es un tumor de células cromafines localizado preferentemente en la cavidad abdominal y en particular en la glándula suprarrenal. Clínicamente puede ser asintomático o presentarse con una amplia variedad de síntomas, dada su capacidad de secretar catecolaminas, tales como hipertensión arterial junto con la triada clásica de cefalea, hiperhidrosis y taquicardia. A continuación, presentamos un caso  clínico de un paciente de sexo masculino, de 24 años, que debuta con pérdida de fuerza en extremidades derechas tras crisis hipertensiva y hematoma en ganglios basales, al cual se tiene que intervenir de urgencia bajo la sospecha de tumor feocromocitoma, con posterior diagnóstico, preparación prequirúrgica meticulosa y cirugía programada del mismo.    

Association of High Serum Levels of Growth Factors with Good Outcome in Ischemic Stroke : a Multicenter Study

Altres ajuts: This project was partially supported by grants from Xunta de Galicia (Consellería Educación: GRC2014/027 and IN607A2018/3), Spanish Research Network on Cerebrovascular Diseases RETICS-INVICTUS PLUS (RD16/0019), and by the European Union FEDER program.The main objective of this research work was to study the association of serum levels of growth factors (GF) and SDF-1α with the functional outcome and reduction of lesion volume in ischemic stroke patients. In this multicenter study, 552 patients with non-lacunar stroke (male, 62.1%; mean age, 68.2 ± 11.4) were included within 24 h from symptom onset. The main outcome variable was good functional outcome (modified Rankin Scale [mRS] ≤ 2) at 12 months. Secondary outcome variable was infarct volume (in mL) after 6 ± 3 months. Serum levels of VEGF, Ang-1, G-CSF, BDNF, and SDF-1α were measured by ELISA at admission, 7 ± 1 days, at 3 ± 1 months, and 12 ± 3 months. Except for BDNF, all GF and SDF-1α serum levels showed a peak value at day 7 and remained elevated during the first 3 months (all p < 0.01). High serum levels at day 7 of VEGF (OR, 19.3), Ang-1 (OR, 14.7), G-CSF (OR, 9.6), and SDF-1α (OR, 28.5) were independently associated with good outcome at 12 months (all p < 0.0001). On the other hand, serum levels of VEGF (B, − 21.4), G-CSF (B, − 14.0), Ang-1 (B, − 13.3), and SDF-1α (B, − 44.6) measured at day 7 were independently associated with lesion volume at 6 months (p < 0.01). In summary, high serum levels of VEGF, Ang-1, G-CSF, and SDF-1α at day 7 and 3 months after ischemic stroke are associated with good functional outcome and smaller residual lesion at 1 year of follow-up

Noninvasive early detection of colorectal cancer by hypermethylation of the LINC00473 promoter in plasma cell-free DNA

Background Current noninvasive assays have limitations in the early detection of colorectal cancer. We evaluated the clinical utility of promoter methylation of the long noncoding RNA LINC00473 as a noninvasive biomarker to detect colorectal cancer and associated precancerous lesions. Methods We evaluated the epigenetic regulation of LINC00473 through promoter hypermethylation in colorectal cancer cell lines using bisulfite genomic sequencing and expression analyses. DNA methylation of LINC00473 was analyzed in primary colorectal tumors using 450K arrays and RNA-seq from The Cancer Genome Atlas (TCGA). Tissue-based findings were validated in several independent cohorts of colorectal cancer and advanced colorectal polyp patients by pyrosequencing. We explored the clinical utility of LINC00473 methylation for the early detection of colorectal cancer in plasma cell-free DNA by quantitative methylation-specific PCR and droplet digital PCR. Results LINC00473 showed transcriptionally silencing due to promoter hypermethylation in colorectal cancer cell lines and primary tumors. Methylation of the LINC00473 promoter accurately detected primary colorectal tumors in two independent clinical cohorts, with areas under the receiver operating characteristic curves (AUCs) of 0.94 and 0.89. This biomarker also identified advanced colorectal polyps from two other tissue-based clinical cohorts with high diagnostic accuracy (AUCs of 0.99 and 0.78). Finally, methylation analysis of the LINC00473 promoter in plasma cell-free DNA accurately identified patients with colorectal cancer and advanced colorectal polyps (AUCs of 0.88 and 0.84, respectively), which was confirmed in an independent cohort of patients. Conclusions Hypermethylation of the LINC00473 promoter is a new promising biomarker for noninvasive early detection of colorectal cancer and related precancerous lesions

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Multiple Scenario Generation of Subsurface Models:Consistent Integration of Information from Geophysical and Geological Data throuh Combination of Probabilistic Inverse Problem Theory and Geostatistics

Neutrinos with energies above 1017 eV are detectable with the Surface Detector Array of the Pierre Auger Observatory. The identification is efficiently performed for neutrinos of all flavors interacting in the atmosphere at large zenith angles, as well as for Earth-skimming \u3c4 neutrinos with nearly tangential trajectories relative to the Earth. No neutrino candidates were found in 3c 14.7 years of data taken up to 31 August 2018. This leads to restrictive upper bounds on their flux. The 90% C.L. single-flavor limit to the diffuse flux of ultra-high-energy neutrinos with an E\u3bd-2 spectrum in the energy range 1.0 7 1017 eV -2.5 7 1019 eV is E2 dN\u3bd/dE\u3bd &lt; 4.4 7 10-9 GeV cm-2 s-1 sr-1, placing strong constraints on several models of neutrino production at EeV energies and on the properties of the sources of ultra-high-energy cosmic rays

Feocromocitoma: Cirugía urgente vs Cirugía programada

Pheochromocytoma is a chromaffin cell tumor preferentially located in the abdominal cavity and in particular in the adrenal gland. Clinically it can be asymptomatic or present with a wide variety of symptoms, given its ability to secrete catecholamines, such as high blood pressure as well as the classic triad of headache, hyperhidrosis and tachycardia. Moreover, we present a clinical case of a male patient, 24 years old, who debuts with loss of strength in right limbs after hypertensive crisis and hematoma in basal ganglion, which must be intervened desperately under the suspicion of pheochromocytoma tumor, with subsequent diagnosis, presurgical preparation and scheduled surgery.  El feocromocitoma es un tumor de células cromafines localizado preferentemente en la cavidad abdominal y en particular en la glándula suprarrenal. Clínicamente puede ser asintomático o presentarse con una amplia variedad de síntomas, dada su capacidad de secretar catecolaminas, tales como hipertensión arterial junto con la triada clásica de cefalea, hiperhidrosis y taquicardia. A continuación, presentamos un caso  clínico de un paciente de sexo masculino, de 24 años, que debuta con pérdida de fuerza en extremidades derechas tras crisis hipertensiva y hematoma en ganglios basales, al cual se tiene que intervenir de urgencia bajo la sospecha de tumor feocromocitoma, con posterior diagnóstico, preparación prequirúrgica meticulosa y cirugía programada del mismo.