Linfoma angiocéntrico centrofacial

El linfoma angiocéntrico centrofacial es una neoplasia linfoide rara, con un diagnóstico a menudo difícil, debido al cuadro clínico inespecífico y a que muchas veces son necesarias varias biopsias para llegar a un diagnóstico correcto. Se trata de un linfoma no Hodgkin(LNH) agresivo, de localización preferente en el tracto respiratorio superior (sobre todo en cavidad nasal), y con un pronóstico ominoso, ya que la supervivencia media es de 12-18 meses aproximadamente(1). Predomina en orientales y sudamericanos, entre los 50-60 años de edad, y con ligera preferencia por el sexo masculino (2:1). Se presenta el caso de una paciente ecuatoriana que acude a nuestro servicio con edema hemifacial, rinorrea achocolatada y obstrucción respiratoria nasal de 1 mes de evolución, sin respuesta al tratamiento antibiótico y antiinflamatorio, que tras realizar varias pruebas diagnósticas se evidenció histológicamente la presencia de un linfoma T extranodal de tipo nasal (también llamado linfoma de células T angiocéntrico).The centrofacial angiocentric lymphoma is a rare lymphoid neoplasm, with an often-difficult diagnosis due to the non-specific clinical picture. On many occasions it is necessary to perform various biopsies to reach the correct diagnosis. This lymphoma is an aggressive Non-Hodgkin's (NHL) type, which is normally found in the upper respiratory tract (predominantly in the nasal cavity), and has an ominous prognosis, as the average survival rate is between 12 and 18 months (1). It is predominantly found in subjects of oriental and South American extraction, who are between the ages of 50 and 60 years and with a slight tendency towards males (2:1). This is the case study of a female Ecuadorian patient who was referred to our department with a hemifacial edema, chocolate- like rhinorrhea and nasal respiratory obstruction, which had been treated with antibiotics and anti-inflammatories for a month without success. After performing a number of diagnostic tests, it was found histologically that the patient had an extranodal T-cell lymphoma of the nasal type (also known as T-cell angiocentric lymphoma)

Certificação de produtos orgânicos: obstáculos à implantação de um sistema participativo de garantia na Andaluzia, Espanha.

O trabalho analisa o processo de organização de produtores orgânicos da Andaluzia que estiveram envolvidos em uma tentativa de implantação de um sistema participativo de garantia. Esta iniciativa foi liderada pela administração dessa comunidade autônoma espanhola entre 2006 e 2008. O estudo baseia-se em entrevistas realizadas com atores sociais que estiveram implicados nesse processo, identificando os obstáculos políticos e organizativos que impediram que essa proposta pudesse avançar

Vientos de cambio, reflexión y conocimiento

After a historic and resounding electoral triumph on June 2 of this year, we saw the maturity of Mexican democracy; for the first time in 200 years of independent life in Mexico, the first woman president will arrive, Claudia Sheimbaum Pardo, who won the federal elections with 35.9 million votes representing 59.75 % of the total votes cast by Mexicans. Likewise, in the past elections, a citizen participation that favored a greater number of women governors in the history of the country stood out.Después de un triunfo electoral histórico y contundente del 2 de junio de este año, vimos la madurez de la democracia mexicana; por primera vez en 200 años de vida independiente en México, llegará la primera mujer presidenta, Claudia Sheimbaum Pardo, quien ganó las elecciones federales con 35.9 millones de votos que representan un 59.75 % del total de los votos emitidos por los mexicanos. De igual manera, en las pasadas elecciones se destacó una participación ciudadana que favoreció a un mayor número de mujeres gobernadoras en la historia del país

Reparative giant cell granuloma in a pediatric patient

Reparative giant cell granulomas are benign, infrequent tumors, of non-odontogenic origin, that develop at central or peripheral level. Peripherally located lesions are frequently denominated ?giant cell epulis?, and never correspond to true neoplasia, but rather to inflammatory reactions secondary to another lesion (hemorrhage, etc.). It should be taken into account, that in general, head and neck tumors of infancy usually demonstrate an atypical biological behaviour. Furthermore, the anatomicopathologic diagnosis is often compromised in this type of lesion. We present the case of a 6-year-old boy, who, three weeks after suffering a slight facial trauma, developed a painless, exophytic swelling of approximately 4 cm, with bleeding on palpation, in the ipsilateral hemimaxilla. The lesion demonstrated rapid, progressive and continuous growth. The facial CT and incisional biopsy confirmed the suspected diagnosis of reparative giant cell granuloma. The patient was surgically treated, carrying out a left marginal maxillectomy associated with the extirpation of the soft-tissue lesion. The resultant defect was reconstructed with a Bichat fat-pad providing the patient with optimal esthetic and functional results. The definitive anatomicopathologic report of the surgical piece is compatible with reparative giant cell granuloma

The disruption of proteostasis in neurodegenerative diseases

Cells count on surveillance systems to monitor and protect the cellular proteome which, besides being highly heterogeneous, is constantly being challenged by intrinsic and environmental factors. In this context, the proteostasis network (PN) is essential to achieve a stable and functional proteome. Disruption of the PN is associated with aging and can lead to and/or potentiate the occurrence of many neurodegenerative diseases (ND). This not only emphasizes the importance of the PN in health span and aging but also how its modulation can be a potential target for intervention and treatment of human diseases.info:eu-repo/semantics/publishedVersio

Frontal sinus mucocele with intracranial and intraorbital extension

ABSTRACT Introduction: Frontal sinus mucoceles can present with a multitude of different symptoms including ophthalmic disturbances. Even benign, they have a tendency to expand by eroding the surrounding bony walls that displaces and destroys structures by pressure and bony resorption. Case report: A 32-year-old man with diplopia, proptosis of the right eye and headache was presented. The diagnosis was frontal sinus mucocele with intracranial and intraorbital extension. Possible clinical manifestations of mucoceles, diagnostic imaging techniques and treatment used are discussed. Conclusion: Frontal mucoceles are benign and curable, early recognition and management of them is of paramount importance, because they can cause local, orbital or intracranial complications

Frontal sinus mucocele with intracranial and intraorbital extension

ABSTRACT Introduction: Frontal sinus mucoceles can present with a multitude of different symptoms including ophthalmic disturbances. Even benign, they have a tendency to expand by eroding the surrounding bony walls that displaces and destroys structures by pressure and bony resorption. Case report: A 32-year-old man with diplopia, proptosis of the right eye and headache was presented. The diagnosis was frontal sinus mucocele with intracranial and intraorbital extension. Possible clinical manifestations of mucoceles, diagnostic imaging techniques and treatment used are discussed. Conclusion: Frontal mucoceles are benign and curable, early recognition and management of them is of paramount importance, because they can cause local, orbital or intracranial complications

United States Acculturation and Cancer Patients' End-of-Life Care

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients' end-of-life treatment preferences and medical care. Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19-item scale developed to assess the degree of "Americanization" in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers' USAS scores predicted patients' communication, treatment preferences, and end-of-life medical care in multivariable models that corrected for significant confounding influences (e.g. education, country of origin, English proficiency). The USAS measure was internally consistent (Cronbach α = 0.98); and significantly associated with US birthplace (r = 0.66, P<0.0001). USAS scores were predictive of patients' preferences for prognostic information (AOR = 1.31, 95% CI:1.00-1.72), but not comfort asking physicians' questions about care (AOR 1.23, 95% CI:0.87-1.73). They predicted patients' preferences for feeding tubes (AOR = 0.68, 95% CI:0.49-0.99) and wish to avoid dying in an intensive care unit (AOR = 1.36, 95% CI:1.05-1.76). Scores indicating greater acculturation were also associated with increased odds of patient participation in clinical trials (AOR = 2.20, 95% CI:1.28-3.78), compared with lower USAS scores, and greater odds of patients receiving chemotherapy (AOR = 1.59, 95% CI:1.20-2.12). Conclusion: The USAS is a reliable and valid measure of "Americanization" associated with advanced cancer patients' end-of-life preferences and care. USAS scores indicating greater caregiver acculturation were associated with increased odds of patient participation in cancer treatment (chemotherapy, clinical trials) compared with lower scores. Future studies should examine the effects of acculturation on end-of-life care to identify patient and provider factors that explain these effects and targets for future interventions to improve care (e.g., by designing more culturally-competent health education materials). © 2013 Wright et al

The digital revolution in the tourist industry. An opportunity for tourism in Spain

La industria turística más tradicional está experimentando una penúltima revolución industrial que requiere no solo de un proceso de adaptación continua por parte de los agentes implicados, sino también de un análisis de sus consecuencias. El sector turístico en España supone un pilar fundamental en su economía y empleo, sin embargo, nos encontramos ante un sector que no crea su propia innovación, haciendo que la especialización turística española sea vulnerable y dependiente. Este trabajo tiene por objetivo analizar el estado actual del turismo español y el reto tecnológico al que se enfrentan sus ventajas comparativas cuando se ven amenazadas por los nuevos competidores disruptivos que basan su modelo de negocio en las nuevas tecnologías de inteligencia artificial y en la economía de plataforma, siendo estos agentes disruptivos los que tienen la capacidad de cambiar la oferta y la demanda del sector.The traditional tourist industry is experiencing a penultimate industrial revolution that requires not only a process of continuous adaptation by the agents involved, but also an analysis of its consequences. The tourism sector in Spain is a fundamental pillar in its economy and employment. However, we are facing a sector that does not create its own innovation, making Spanish tourism specialization vulnerable and dependent. This work aims to analyse the current state of Spanish tourism and the technological challenge faced by its comparative advantages when threatened by the new disruptive competitors that base their business model on new artificial intelligence technologies and on the platform economy, having these agents the ability to change the supply and demand of the sector