Endometrial blood flow mapping using transvaginal power Doppler sonography in women with postmenopausal bleeding and thickened endometrium

Objective To evaluate the role of transvaginal power Doppler sonography to discriminate between benign and malignant endometrial conditions in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography. Methods Ninety-one postmenopausal women (median age, 58 years; range, 47–83 years) presenting with uterine bleeding and a thickened endometrium (≥5-mm doublelayer endometrial thickness) on transvaginal sonography were included in this prospective study. Endometrial blood flow distribution was assessed in all patients by power Doppler immediately after B-mode transvaginal sonography. Three different vascular patterns were defined: Pattern A: multiple-vessel pattern, Pattern B: single-vessel pattern and Pattern C: scattered-vessel pattern. Histological diagnoses were obtained in all cases. No patient taking tamoxifen citrate or receiving hormone replacement therapy was included. Results Histological diagnoses were as follows: endometrial cancer: 33 (36%), endometrial polyp: 37 (41%), endometrial hyperplasia: 14 (15%), endometrial cystic atrophy: 7 (8%). Blood flow was found in 97%, 92%, 79% and 85% of cases of carcinoma, polyp, hyperplasia and endometrial cystic atrophy, respectively. A total of 81.3% of vascularized endometrial cancers showed Pattern A, 97.1% of vascularized polyps exhibited Pattern B and 72.7% of vascularized hyperplasias showed Pattern C. Sensitivity and specificity for endometrial cancer were 78.8% and 100%. For endometrial polyp these respective values were 89.2% and 87% and for hyperplasia they were 57.1% and 88.3%. Conclusions Transvaginal power Doppler blood flow mapping is useful to differentiate benign from malignant endometrial pathology in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography

Characterization of plasmid-mediated beta-lactamases in fecal colonizing patients in the hospital and community setting in Spain

Aim: Active surveillance of plasmid-mediated ß-lactamase-producing Enterobacteriaceae (PMBL-E) in fecal carriers in the hospital and in the community setting in a non-outbreak period of time. Methods: Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins and PMBL-E were characterized (extended-spectrum-ß-lactamase [ESBL], plasmid-mediated AmpC ß-lactamase [pAmpC], and carbapenemases) by PCR and sequencing. Results: The prevalence of ESBL and pAmpC carriers was 5.06% and 0.59%, respectively. Overall, CTX-M-like enzymes were the ESBL dominate enzymes (96.15%). The group CTX-M-9 was the most prevalent (81, 54%) [CTX-M-14 (74, 91.35%), CTX-M-9 (5, 6.17%), CTX-M-24 (1, 1.23%), and CTX-M-27 (1, 1.23%)] followed by the group CTX-M-1 (64, 42.67%) [CTX-M-15 (42, 65.63%), CTX-M-1 (13, 20.31%), CTX-M-32 (8, 12.5%), and CTX-M-3 (1, 1.56%)]. One CTX-M-10, one CTX-M-59, and three CTX-M-8 were also found. A very small representation of SHV or TEM ESBL enzymes was found (3.2% and 0.64%, respectively). pAmpC characterization revealed a predominance of CMY-2 (81.25%), followed by DHA-1 (18.75%). We did not detect the presence of carbapenemase producers. Conclusions: The prevalence of ESBL-producers from fecal carriers is stable in our area, but colonization by pAmpC producers has emerged recently as we have confirmed. Periodic active surveillance is useful to identify these human reservoirs and control the evolution of PMBL carriage in a community over time

Local flap reconstruction of large scalp defects

Scalp defects can have a number of origins, and their repair is dependent upon their location, size and depth. In the case of the scalp, the repair of even small defects is complicated. Local flaps are the reference for the reconstruction of such defects. Knowledge of scalp anatomy is essential for preparing these flaps, which must be based on one or two vascular pedicles to afford a large rotation angle ? thereby facilitating closure of the defect. The parietal zone is the location offering the greatest flap mobilization possibilities. We present a case involving the repair of a major pericranial frontoparietal scalp defect. A local transverse posterior transpositioning scalp flap was raised with the posterior auricular and occipital arteries as vascular pedicle. Following repositioning of the flap, a free partial-thickness skin graft from the thigh was used to cover the donor zone. A review is provided of the different techniques for the reconstruction of large scalp defects

Objectives, organization and limiting factors of selection programs for indigenous breeds in Spain

Ponencia publicada en ITEA, vol.104En esta ponencia invitada se resumen las principales características de los programas de selección de las razas autóctonas que se están llevando a cabo en España. Se describen para cada una de ellas la población controlada, los caracteres registrados, los objetivos y criterios de selección, la valoración genética de los reproductores, los aspectos organizativos, la utilización de la información por parte de los ganaderos y los factores limitantes del progreso genético. Los más antiguos de estos programa comenzaron al principio de la década de los 80 del pasado siglo, la mayoría lo hicieron al final de dicha década o en la siguiente y unos pocos en la década actual. Debido a esta disparidad de fechas de iniciación y a otros factores estructurales y organizativos, sus niveles de desarrollo y efectividad son muy variables. Entre los factores limitantes de dicho desarrollo y efectividad más frecuentemente citados se encuentran los reducidos tamaños de los núcleos de selección, la reducida implantación de la I.A. y, consecuentemente, el bajo número de sementales en prueba de descendencia y las bajas fiabilidades de las valoraciones genéticas, la escasa utilización por parte algunos de los ganaderos de las valoraciones genéticas de sus animales para elegir la reposición en los rebaños y, en un cierto número de casos, la escasa participación e interés de los mismos.This invited contribution summarizes the most important characteristics of selection programs being applied to Spanish indigenous breeds. Population and traits being recorded, selection objectives and criteria, breeding values estimation, managing aspects, diffusion to and use of genetic information by breeders and constraints to genetic progress are synthetically described for each breed. The oldest programs started at the beginning of the eighties of the last century. Most of them began at the end of the eighties or in the nineties and a few were initiated within present decade. Due to these age differences, and to other structural and managing factors, their developmental and effectiveness levels are very variable. Small number of animals being registered and, therefore, selected, low number of dams inseminated an its consequence on the capacity to sire testing and on the reliability of estimated breeding values, the scanty use that some of the breeders make of the genetic evaluations and the low participation of farmers in the programs, are among the most important factors limiting their development and their effectiveness in terms of genetic progress obtained

Análisis de la participación de mujeres y jóvenes en la cadena de Valor de miel de apis mellifera en somoto

The study was carried out in the municipality of Somoto, Madriz department, 217 km from Managua, Nicaragua. The objectives were: determine roles, access to resources, decision making, identify social, economic and cultural factors that influence participation, as well as identify elements for the construction of lines of action for the strengthening of the participation of young people (18-30 years old) and women over 30 years old in the honey value chain of Bee. The instrument used was the survey and the interview, the methodological design being ''non-experimental'', with a descriptive-explanatory study of the area, with a mixed qualitative-quantitative method, considering that the sample selected is the total of 33 beekeepers that make up the universe. It was found that 69% of young beekeepers dedicated to the roles and 67% who decide on the activities, and there is no active participation of women in the link of production, however, the average 5% are dedicated to the value chain; young people have the highest percentage of participation in all the study variables. The social factors that do not affect or limit them in the participation of young people is marital status with 75%, young people believe that the best economic factor that does not limit them is policies and programs of government with a percentage of 70% null. In cultural factors, young people do not take religion as a limitation with 95% null. The support organizations are INPRHU.El estudio se realizó en el municipio de Somoto, departamento Madriz a 217 km de Managua, Nicaragua.. Los objetivos fueron: determinar roles, acceso a recursos, toma de decisiones, identificar factores sociales, económicos y culturales que influyen en la participación, así como también e identificar elementos para la construcción de líneas de acción para el fortalecimiento de la participación de jóvenes (18 – 30 años) y mujeres mayores de 30 años en la cadena de valor de miel de abeja. El instrumento utilizado fue la encuesta y la entrevista siendo el diseño metodológico ‘‘no experimental’’, con un estudio descriptivo- explicativo de la zona, con un método mixto cualitativo–cuantitativo, considerando que la muestra seleccionada es el total de 33 apicultores que conforman el universo. Se encontró que el 69% de los jóvenes apicultores se dedican a los roles y el 67 % quienes deciden de las actividades, y no hay intervención activa de mujeres en el eslabón de producción, sin embargo, el 5% promedio se dedican en la cadena de valor; son los jóvenes los que tienen mayor porcentaje de participación en todas las variables de estudio. Los factores sociales que no los afecta o limita en la participación de jóvenes es el estado civil con 75%, los jóvenes opinan que el mejor factor económico que no los limita es políticas y programas de gobierno con un porcentaje del 70% nulo. En los factores culturales los jóvenes no toman como limitante la religión con 95% nulo. Los organismos de apoyo son INPRHU

Análisis didáctico de una lección sobre proporcionalidad en un libro de texto de primaria con herramientas del enfoque ontosemiótico

El libro de texto es un recurso ampliamente usado en la práctica de la enseñanza y, en consecuencia, es objeto de investigación educativa, aplicando diversas perspectivas teóricas. En este trabajo se ejemplifica el uso de las herramientas teóricas del Enfoque Ontosemiótico del conocimiento y la instrucción matemáticos para realizar el análisis didáctico de una lección sobre proporcionalidad de sexto curso de primaria (11-12 años de edad). Se considera que una lección refleja el proceso de instrucción planificado por el autor como medio para lograr el aprendizaje del contenido por parte de los estudiantes potenciales del mismo. En consecuencia, se plantean las siguientes cuestiones que guían el análisis: 1) ¿Cuál es el grado de idoneidad didáctica del proceso de instrucción planificado? 2) ¿Cómo gestionar el uso del texto para incrementar la idoneidad del proceso? El método de análisis implementado permite obtener conocimientos didáctico-matemáticos que pueden ayudar al profesor a tomar decisiones sobre las posibilidades y limitaciones de los libros de texto cuando se asumen los postulados socioculturales sobre el aprendizaje matemático

Amphiregulin contributes to the transformed phenotype of human hepatocellular carcinoma cells

Hepatocellular carcinoma is a major cause of cancer-related deaths. Current treatments are not effective, and the identification of relevant pathways and novel therapeutic targets are much needed. Increasing evidences point to the activation of the epidermal growth factor receptor (EGFR) as an important mechanism in the development of hepatocarcinoma. We previously described that amphiregulin (AR), a ligand of the EGFR, is not expressed in healthy liver but is up-regulated during chronic liver injury, the background on which most liver tumors develop. Now, we have studied the expression and role of AR in human hepatocarcinoma. AR expression and function was studied in human liver tumors and cell lines. AR is expressed in human hepatocellular carcinoma tissues and cell lines and behaves as a mitogenic and antiapoptotic growth factor for hepatocarcinoma cells. We provide several lines of evidence, including AR silencing by small interfering RNAs and inhibition of amphiregulin by neutralizing antibodies, showing the existence of an AR-mediated autocrine loop that contributes to the transformed phenotype. Indeed, interference with endogenous AR production resulted in reduced constitutive EGFR signaling, inhibition of cell proliferation, anchorage-independent growth, and enhanced apoptosis. Moreover, knockdown of AR potentiated transforming growth factor-beta and doxorubicin-induced apoptosis. Conversely, overexpression of AR in SK-Hep1 cells enhanced their proliferation rate, anchorage-independent growth, drug resistance, and in vivo tumorigenic potential. These observations suggest that AR is involved in the acquisition of neoplastic traits in the liver and thus constitutes a novel therapeutic target in human hepatocarcinoma

RBFOX1, encoding a splicing regulator, is a candidate gene for aggressive behavior

The RBFOX1 gene (or A2BP1) encodes a splicing factor important for neuronal development that has been related to autism spectrum disorder and other neurodevelopmental phenotypes. Evidence from complementary sources suggests that this gene contributes to aggressive behavior. Suggestive associations with RBFOX1 have been identified in genome-wide association studies (GWAS) of anger, conduct disorder, and aggressive behavior. Nominal association signals in RBFOX1 were also found in an epigenome-wide association study (EWAS) of aggressive behavior. Also, variants in this gene affect temporal lobe volume, a brain area that is altered in several aggression-related phenotypes. In animals, this gene has been shown to modulate aggressive behavior in Drosophila. RBFOX1 has also been associated with canine aggression and is upregulated in mice that show increased aggression after frustration of an expected reward. Associated common genetic variants as well as rare duplications and deletions affecting RBFOX1 have been identified in several psychiatric and neurodevelopmental disorders that are often comorbid with aggressive behaviors. In this paper, we comprehensively review the cumulative evidence linking RBFOX1 to aggression behavior and provide new results implicating RBFOX1 in this phenotype. Most of these studies (genetic and epigenetic analyses in humans, neuroimaging genetics, gene expression and animal models) are hypothesis-free, which strengthens the validity of the findings, although all the evidence is nominal and should therefore be taken with caution. Further studies are required to clarify in detail the role of this gene in this complex phenotype

Information and community for mothers on the Internet: An analysis of the principal Spanish baby websites

The four baby websites with most users in Spain (www.mibebeyyo.com, www.bebesymas.com, www.parabebes.com and www.elbebe.com) are at the centre of the present study. The sites have been analysed from the perspective of the social web, or Web 2.0, focusing on their structure and content throughout one year (from October 2010 to October 2011), as well as on their presence on Facebook and Twitter. Also, user preferences and the levels of user activity and participation were studied. The purpose was to determine how the potential of Web 2.0 is materialised in the very concrete segment of the population that is the target of the websites, mothers and mothers-to-be.---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------El análisis de las cuatro webs de bebés con mayor audiencia en España (www.mibebeyyo.com, www.bebesymas.com, www.parabebes.com y www.elbebe.com) centra la presente investigación. Se han estudiado, desde la perspectiva de la web social o web 2.0, su estructura y su contenido a lo largo de un año (de octubre de 2010 a octubre de 2011), así como su presencia en dos de las principales redes sociales: Facebook y Twitter. Se han comprobado cuáles son las preferencias, los consumos y el grado de participación y de actividad de sus usuarias. Con ello, se ha pretendido conocer de qué modo se materializan las posibilidades de la web 2.0 en un sector muy concreto de la población, el de las madres o futuras madres, público objetivo de las páginas estudiadas