Hemangioma intramuscular de la infancia simulando rabdomiosarcoma

Se presenta un caso de hemangioma intramuscular de la infancia en una paciente de 14 meses de edad en quien la historia, examen clínico y técnicas de imagen sugerían un rabdomiosarcoma. El tratamiento plateado fue la escisión en bloque, y la anatomía patológica reveló la verdadera naturaleza de la lesión. Se revisan las características de este raro tumor y los elementos que lo hacen semejante a lesiones malignas.We report a case of intramuscular haemangioma occurring in a 14-month-old girl. Medical history, physical findings and imaging techniques suggested rhabdomyosarcoma. Complete excision was the treatment applied. The histological analysis gave the diagnosis. We review the characteristics of such unusual tumor and the aspects which make it similar to malignant tumors

Conocimientos sobre anticoncepción en mujeres menores de 20 años

Many teenagers start having sex without having received accurate information about sexuality and reproductive health. This lack of information is responsible for the high incidence of unplanned pregnancies and sexually transmitted diseases that are currently reported. There are many medical risks associated with early pregnancy, so it is important to conduct studies on the knowledge that teens have about contraception, and the consequences of a pregnancy at this stage of life. Sex education is to prepare the new generations for love, marriage and family, so it must be part of the education of the whole personality, with participation of the community.Muchos adolescentes comienzan a tener relaciones sexuales sin haber recibido información exacta sobre la sexualidad y la salud reproductiva; esta falta de información es responsable de la alta incidencia de embarazos no planificados y de enfermedades de transmisión sexual que se informan en la actualidad. Son numerosos los riesgos médicos asociados con el embarazo precoz, por lo que es importante realizar estudios sobre el conocimiento que los adolescentes tienen sobre métodos anticonceptivos y las consecuencias de un embarazo en esta etapa de la vida. La educación sexual consiste en preparar a las nuevas generaciones para el amor, el matrimonio y la familia, por lo que debe formar parte de la educación integral de la personalidad, con participación de la comunidad

Regulación menstrual en mujeres menores de 20 años

The practice of abortion has accompanied mankind since time immemorial. It is the oldest method known to man to end an unwanted pregnancy. An abortion is the termination of pregnancy in the first 20 weeks or the expulsion of the product of conception that weighs less than 500g. Menstrual regulation has been used for birth control. Among the factors influencing pregnancy in women under 20 years of age it is the non-use of contraception or its failure. Menstrual regulation is more frequent between 14-16 years of age and in those that have no steady partner. The most common causes that motivate pregnancy termination are: continue studying, contraceptive failure, work, marital instability and family problems. It is important to give a warning to the Ministries of Education and Health to promote sexual education in the curriculum at all levels of education to avoid this procedure.La práctica del aborto acompaña a la humanidad desde épocas inmemoriales; el aborto es el método más antiguo conocido por el hombre para terminar un embarazo no deseado y es la interrupción de la gestación en las primeras 20 semanas o la expulsión del producto de la concepción con un peso menor de 500g. La regulación menstrual ha sido utilizada para el control de la natalidad. Entre los factores que influyen en el embarazo en menores de 20 años se encuentra la no utilización de métodos anticonceptivos o su fallo; la regulación menstrual es más frecuente en jóvenes entre 14-16 años que no tienen pareja estable y las causas más frecuentes que motivan la interrupción del embarazo son la continuación de los estudios, el fallo del anticonceptivo, trabajar, la inestabilidad matrimonial y los problemas familiares. Es importante dar un alerta a los Ministerios de Educación y Salud para fomentar la educación sexual como programa de estudio en todos los niveles de enseñanza para evitar este procedimiento

A DNA damage repair gene-associated signature predicts responses of patients with advanced soft-tissue sarcoma to treatment with trabectedin

Signatura genètica; Biomarcadors predictius; TrabectedinaFirma genética; Biomarcadores predictivos; TrabectedinaGene signature; Predictive biomarkers; TrabectedinPredictive biomarkers of trabectedin represent an unmet need in advanced soft-tissue sarcomas (STS). DNA damage repair (DDR) genes, involved in homologous recombination or nucleotide excision repair, had been previously described as biomarkers of trabectedin resistance or sensitivity, respectively. The majority of these studies only focused on specific factors (ERCC1, ERCC5, and BRCA1) and did not evaluate several other DDR-related genes that could have a relevant role for trabectedin efficacy. In this retrospective translational study, 118 genes involved in DDR were evaluated to determine, by transcriptomics, a predictive gene signature of trabectedin efficacy. A six-gene predictive signature of trabectedin efficacy was built in a series of 139 tumor samples from patients with advanced STS. Patients in the high-risk gene signature group showed a significantly worse progression-free survival compared with patients in the low-risk group (2.1 vs 6.0 months, respectively). Differential gene expression analysis defined new potential predictive biomarkers of trabectedin sensitivity (PARP3 and CCNH) or resistance (DNAJB11 and PARP1). Our study identified a new gene signature that significantly predicts patients with higher probability to respond to treatment with trabectedin. Targeting some genes of this signature emerges as a potential strategy to enhance trabectedin efficacy.This study was funded by the Spanish Group for Research on Sarcoma (GEIS) and partially by PharmaMar. The authors would like to thank the GEIS data center for data management. The authors also thank the donors and the Hospital Universitario Virgen del Rocío—Instituto de Biomedicina de Sevilla Biobank (Andalusian Public Health System Biobank and ISCIII-Red de Biobancos PT17/0015/0041) for part of the human specimens used in this study. David S. Moura is recipient of a Sara Borrell postdoctoral fellowship funded by the National Institute of Health Carlos III (ISCIII) (CD20/00155)

Intraosseous Rosai-Dorfman disease diagnosed by touch imprint cytology evaluation: A case series

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease (RDD) is a rare benign disorder that primarily affects the lymph nodes. Localized lymphadenopathy is the most common clinical manifestation of this disorder. However, RDD has been described in several extra-nodal sites including the head and neck region, soft tissue, skin, upper respiratory tract, gastro-intestinal tract and central nervous system (CNS). Involvement of the bone is considered very rare, occurring in less than 10% patients. RDD is one of the histiocytoses and the differential diagnosis includes entities such as Langerhans cell histiocytosis and Erdheim-Chester disease. In the rare intraosseous variant, the clinical and radiologic differential diagnosis is broader and includes neoplasms such as osteosarcoma and Ewing sarcoma. In this report, we describe three cases of extra-nodal, intraosseous RDD where touch imprint cytology played a crucial role in diagnosis. Two of the cases initially presented with involvement of the head and neck region and later developed intraosseous disease; while the third patient presented with primary bone involvement. The diagnosis was established by core biopsy with touch imprints of the bone lesions. The cytologic samples showed numerous histiocytes, often with neutrophils within their cytoplasm (emperipolesis) in addition to lymphocytes and plasma cells. The diagnosis of RDD was confirmed with appropriate immunohistochemical stains. Our account of these three cases of intraosseous Rosai-Dorfman disease highlights the role of cytology in the diagnosis of this rare entity

Statins Inhibit HIV-1 Infection by Down-regulating Rho Activity

Human immunodeficiency virus (HIV)-1 infectivity requires actin-dependent clustering of host lipid raft–associated receptors, a process that might be linked to Rho guanosine triphosphatase (GTPase) activation. Rho GTPase activity can be negatively regulated by statins, a family of drugs used to treat hypercholesterolemia in man. Statins mediate inhibition of Rho GTPases by impeding prenylation of small G proteins through blockade of 3-hydroxy-3-methylglutaryl coenzyme A reductase. We show that statins decreased viral load and increased CD4+ cell counts in acute infection models and in chronically HIV-1–infected patients. Viral entry and exit was reduced in statin-treated cells, and inhibition was blocked by the addition of l-mevalonate or of geranylgeranylpyrophosphate, but not by cholesterol. Cell treatment with a geranylgeranyl transferase inhibitor, but not a farnesyl transferase inhibitor, specifically inhibited entry of HIV-1–pseudotyped viruses. Statins blocked Rho-A activation induced by HIV-1 binding to target cells, and expression of the dominant negative mutant RhoN19 inhibited HIV-1 envelope fusion with target cell membranes, reducing cell infection rates. We suggest that statins have direct anti–HIV-1 effects by targeting Rho

Gene expression analyses determine two different subpopulations in KIT-negative GIST-like (KNGL) patients

Introduction: There are limited findings available on KIT-negative GIST-like (KNGL) population. Also, KIT expression may be post-transcriptionally regulated by miRNA221 and miRNA222. Hence, the aim of this study is to characterize KNGL population, by differential gene expression, and to analyze miRNA221/222 expression and their prognostic value in KNGL patients. Methods: KIT, PDGFRA, DOG1, IGF1R, MIR221 and MIR222 expression levels were determined by qRT-PCR. We also analyzed KIT and PDGFRA mutations, DOG1 expression, by immunohistochemistry, along with clinical and pathological data. Disease-free survival (DFS) and overall survival (OS) differences were calculated using Log-rank test. Results: Hierarchical cluster analyses from gene expression data identified two groups: group I had KIT, DOG1 and PDGFRA overexpression and IGF1R underexpression and group II had overexpression of IGF1R and low expression of KIT, DOG1 and PDGFRA. Group II had a significant worse OS (p = 0.013) in all the series, and showed a tendency for worse OS (p = 0.11), when analyzed only the localized cases. MiRNA222 expression was significantly lower in a control subset of KIT-positive GIST (p < 0.001). OS was significantly worse in KNGL cases with higher expression of MIR221 (p = 0.028) or MIR222 (p = 0.014). Conclusions: We identified two distinct KNGL subsets, with a different prognostic value. Increased levels of miRNA221/222, which are associated with worse OS, could explain the absence of KIT protein expression of most KNGL tumors

Gene expression analyses determine two different subpopulations in KIT-negative GIST-like (KNGL) patients

Introduction: there are limited findings available on KIT-negative GIST-like (KNGL) population. Also, KIT expression may be post-transcriptionally regulated by miRNA221 and miRNA222. Hence, the aim of this study is to characterize KNGL population, by differential gene expression, and to analyze miRNA221/222 expression and their prognostic value in KNGL patients. Methods: KIT, PDGFRA, DOG1, IGF1R, MIR221 and MIR222 expression levels were determined by qRT-PCR. We also analyzed KIT and PDGFRA mutations, DOG1 expression, by immunohistochemistry, along with clinical and pathological data. Disease-free survival (DFS) and overall survival (OS) differences were calculated using Log-rank test. Results: hierarchical cluster analyses from gene expression data identified two groups: group I had KIT, DOG1 and PDGFRA overexpression and IGF1R underexpression and group II had overexpression of IGF1R and low expression of KIT, DOG1 and PDGFRA. Group II had a significant worse OS (p = 0.013) in all the series, and showed a tendency for worse OS (p = 0.11), when analyzed only the localized cases. MiRNA222 expression was significantly lower in a control subset of KIT-positive GIST (p < 0.001). OS was significantly worse in KNGL cases with higher expression of MIR221 (p = 0.028) or MIR222 (p = 0.014). Conclusions: we identified two distinct KNGL subsets, with a different prognostic value. Increased levels of miRNA221/222, which are associated with worse OS, could explain the absence of KIT protein expression of most KNGL tumors

Opcions disponibles en la cirurgia de la malaltia de Parkinson i la tremolor essencial

Parkinson; Tremolor; CirurgiaParkinson; Temblor; CirugíaParkinson's; Shaking; SurgeryAquest document conté una revisió de revisions i d’informes de síntesi, en què s’han seleccionat els informes d’avaluació de tecnologies sanitàries i les guies de pràctica clínica, s’han descrit de forma narrativa els resultats i, mitjançant la tècnica qualitativa de grup nominal, s’ha elaborat una taula comparativa amb recomanacions sobre les indicacions per a cada tipus de tècnica quirúrgica.Este documento contiene una revisión de revisiones y de informes de síntesis, en que se han seleccionado los informes de evaluación de tecnologías sanitarias y las guías de práctica clínica. Se han descrito de forma narrativa los resultados y, mediante la técnica cualitativa de grupo nominal, se ha elaborado una mesa comparativa con recomendaciones sobre las indicaciones para cada tipo de técnica quirúrgica.This document contains review of reviews and synthesis reports has been prepared, in which health technology assessment reports and clinical practice guidelines were selected. The results have been described narratively, and, through a qualitative nominal group technique, a comparative table has been drawn up with recommendations on indications for each type surgical intervention

Global warming and ocean stratification : a potential result of large extraterrestrial impacts

We acknowledge the support of resources provided by UK National Centre for Atmospheric Science (NCAS), the High Performance Computing Cluster supported by the Research and Specialist Computing Support service at the University of East Anglia, UK Natural Environment Research Council (NERC), grants "CPE" (NE/K014757/1), and "Paleopolar" (NE/I005722/1). Data can be obtained from MJ on request. ACM acknowledges support from an AXA Postdoctoral Fellowship and the ERC ACCI grant Project No 267760, and NERC grant NE/M018199/1.The prevailing paradigm for the climatic effects of large asteroid or comet impacts is a reduction in sunlight and significant short-term cooling caused by atmospheric aerosol loading. Here we show, using global climate model experiments, that the large increases in stratospheric water vapor that can occur upon impact with the ocean cause radiative forcings of over +20 W m−2 in the case of 10 km sized bolides. The result of such a positive forcing is rapid climatic warming, increased upper ocean stratification, and potentially disruption of upper ocean ecosystems. Since two thirds of the world's surface is ocean, we suggest that some bolide impacts may actually warm climate overall. For impacts producing both stratospheric water vapor and aerosol loading, radiative forcing by water vapor can reduce or even cancel out aerosol-induced cooling, potentially causing 1–2 decades of increased temperatures in both the upper ocean and on the land surface. Such a response, which depends on the ratio of aerosol to water vapor radiative forcing, is distinct from many previous scenarios for the climatic effects of large bolide impacts, which mostly account for cooling from aerosol loading. Finally, we discuss how water vapor forcing from bolide impacts may have contributed to two well-known phenomena: extinction across the Cretaceous/Paleogene boundary and the deglaciation of the Neoproterozoic snowball Earth.Publisher PDFPeer reviewe