Disfagia progresiva en un adulto mayor por hiperostosis esquelética idiopática difusa. Caso clínico y revisión bibliográfica

[ES] Introducción y objetivo: La hiperostosis esquelética idiopática difusa o enfermedad de Forestier Rotes Querol en una enfermedad no inflamatoria producida por la calcificación y osificación del ligamento vertebral común anterior generalmente a nivel torácico, siendo su aparición a nivel cervical extremadamente rara. Presentamos un caso de disfagia progresiva producida por esta enfermdad a nivel cervical. Descripción del caso: Varón de 70 años con parestesias hipofaríngeas, disfagia progresiva y tos de larga evolución. La laringoscopia indirecta objetiva una neoformación submucosa en línea media de pared faríngea posterior a nivel de supraglotis que ocupa el 50% de la luz de la hipofaringe. El estudio de imagen revela osificación del ligamento vertebral común anterior. Discusión: La hiperostosis esquelética idiopática difusa, descrita por primera vez en 1950 por Forestier et al, es una enfermedad no inflamatoria producida por la calcificación del ligamento vertebral común anterior. Aunque es idiopática, se han descrito como predisponentes factores mecánicos, metabólico- dietéticos y la herencia. Típicamente afecta a la región dorsal baja, siendo la afectación cervical, como en este caso, excepcional. Suele diagnosticarse como un hallazgo casual. En el área ORL se ha descrito su presentación como disfagia progresiva en la mayoría de los casos, aunque existen otras formas de presentación como la disnea, apnea obstructiva del sueño o neumonías aspirativas. El tratamiento es en principio conservador, reservando el tratamiento quirúrgico en el área ORL para los casos de disfagia extrema. Conclusión: La enfermedad de Forestier debe considerarse dentro del diagnóstico diferencial ante un paciente de edad avanzada con una tumoración submucosa. [EN] Introduction and objective: Diffuse idiopathic skeletal hyperostosis or Forestier Rotes Querol disease is a non inflammatory disease caused by ossification and calcification of cervical anterior longitudinal ligament. It usually affects thoracic region, being cervical affectation extremely rare. It is presented the case of progressive dysphagia due to cervical affection by this entity. Case description: 70 years male with hypopharyngeal paresthesias, progressive dysphagia and cough of long duration. Indirect laryngoscopy shown a submucosal neoformation in posterior pharyngeal wall at supraglottic level that occupies 50% of the lumen. The imaging study revealed ossification of common anterior vertebral ligament. Discussion: Diffuse idiopathic skeletal hiperostosis, first described in 1950 by Forestier et al, is a non inflammatory disease caused by cervical anterior longitudinal ligament calcification. Although idiopathic, it has been described as predisposing mechanical, metabolic, dietetic and heredity factors. Typically affects the lower dorsal region, being cervical involvement, as in this case, outstanding. It is usually diagnosed as an incidental finding. In the ENT area it is typically presented as progressive dysphagia, although there are other symptoms such as dyspnea, obstructive sleep apnea or aspiration pneumonia. Treatment is conservative, leaving surgery for extreme dysphagia cases. Conclusion: Forestier 's disease should be considered in the differential diagnosis in a patient of advanced age with a submucosal tumor of firm consistency that mark on the posterior pharyngeal wall

Molecular characterization of imported and autochthonous dengue in northeastern spain

Dengue is the most significant arbovirus worldwide and a public health threat to nonendemic areas in which Aedes vectors are present. Autochthonous dengue transmission has been reported in several European countries in the last decade. Infected travelers from endemic regions arriving to areas colonized by Aedes albopictus in Europe need to be monitored in surveillance and control programs. We aimed to perform molecular characterization of RT-PCR-positive dengue cases detected in Catalonia, northeastern Spain, from 2013 to 2018. The basic demographic information and the geographical regions of importation were also analyzed. One-hundred four dengue cases were studied (103 imported infections and the first autochthonous case in our region). The dengue virus strains detected were serotyped and genotyped using molecular methods, and phylogenetic analyses were conducted. All four dengue serotypes were detected in travelers, including up to 10 different genotypes, reflecting the global circulation of dengue in endemic areas. The primary travel-related case of the 2018 autochthonous transmission was not identified, but the molecular analysis revealed dengue serotype 1, genotype I of Asian origin. Our results highlight the diversity of imported dengue virus strains and the role of molecular epidemiology in supporting arbovirus surveillance programs

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery

ABSTRACT INTRODUCTION: Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. OBJECTIVE: To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. METHODS: This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. RESULTS: In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. CONCLUSIONS: Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs

Molecular Differences between Squamous Cell Carcinoma and Adenocarcinoma Cervical Cancer Subtypes: Potential Prognostic Biomarkers

The most frequently diagnosed histological types of cervical cancer (CC) are squamous cell carcinoma (SCC) and adenocarcinoma (ADC). Clinically, the prognosis of both types is controversial. A molecular profile that distinguishes each histological subtype and predicts the prognosis would be of great benefit to CC patients. Methods: The transcriptome of CC patients from The Cancer Genome Atlas (TCGA) was analyzed using the DESeq2 package to obtain the differentially expressed genes (DEGs) between ADC and SCC. The DEGs were validated on a publicly available Mexican-Mestizo patient transcriptome dataset (GSE56303). The global biological pathways involving the DEGs were obtained using the Webgestalt platform. The associations of the DEGs with Overall Survival (OS) were assessed. Finally, three DEGs were validated by RT-qPCR in an independent cohort of Mexican patients. Results. The molecular profiles of ADC and SCC of the CC patients of the TCGA database and the Mexican-Mestizo cohort (GSE56303) were determined obtaining 1768 and 88 DEGs, respectively. Strikingly, 70 genes were concordant—with similar Log2FoldChange values—in both cohorts. The 70 DEGs were involved in IL-17, JAK/STAT, and Ras signaling. Kaplan-Meier OS analysis from the Mexican-Mestizo cohort showed that higher GABRB2 and TSPAN8 and lower TMEM40 expression were associated with better OS. Similar results were found in an independent Mexican cohort. Conclusions: Molecular differences were detected between the ADC and SCC subtypes; however, further studies are required to define the appropriate prognostic biomarker for each histological type

A microRNA Profile Regulates Inflammation-Related Signaling Pathways in Young Women with Locally Advanced Cervical Cancer

Cervical cancer (CC) remains among the most frequent cancers worldwide despite advances in screening and the development of vaccines against human papillomavirus (HPV), involved in virtually all cases of CC. In mid-income countries, a substantial proportion of the cases are diagnosed in advanced stages, and around 40% of them are diagnosed in women under 49 years, just below the global median age. This suggests that members of this age group share common risk factors, such as chronic inflammation. In this work, we studied samples from 46 patients below 45 years old, searching for a miRNA profile regulating cancer pathways. We found 615 differentially expressed miRNAs between tumor samples and healthy tissues. Through bioinformatic analysis, we found that several of them targeted elements of the JAK/STAT pathway and other inflammation-related pathways. We validated the interactions of miR-30a and miR-34c with JAK1 and STAT3, respectively, through dual-luciferase and expression assays in cervical carcinoma-derived cell lines. Finally, through knockdown experiments, we observed that these miRNAs decreased viability and promoted proliferation in HeLa cells. This work contributes to understanding the mechanisms through which HPV regulates inflammation, in addition to its canonical oncogenic function, and brings attention to the JAK/STAT signaling pathway as a possible diagnostic marker for CC patients younger than 45 years. To our knowledge to date, there has been no previous description of a panel of miRNAs or even ncRNAs in young women with locally advanced cervical cancer

Un paso hacia el bilingüismo en las áreas de Conocimiento del Medio y Educación Artística

El objetivo principal del proyecto es el aprendizaje de una segunda lengua a través de las áreas de Conocimiento del Medio y de Educación Artística mediante la utilización de las nuevas tecnologías de información y comunicación. Otros objetivos son adquirir y utilizar correctamente y con precisión de forma oral y escrita, el vocabulario específico de las áreas de Conocimiento del Medio y Educación Artística; desarrollar la sensibilidad estética, visual y sonora; aplicar las técnicas de estudio básicas para la comprensión y asimilación de los contenidos de dichas áreas; y recoger y utilizar información a partir de fuentes diversas para elaborar materiales de trabajo en el aula. En cuanto a la metodología, se utiliza el aprendizaje de la lengua inglesa apoyándose en la Teoría de Stephen Krashen 'The Monitor Model'. Los programas basados en temas proponen utilizar los contenidos curriculares para el aprendizaje de una segunda lengua y ésta pasa a ser un medio de aprendizaje. El área de Conocimiento del Medio se imparte tanto en inglés como en español, mientras que el área Artística se enseña en inglés. Las actividades son de introducción y motivación, desarrollo, síntesis y resumen, evaluación, refuerzo y ampliación así como de vocabulario antes de cada unidad. El área de Informática se trabaja como apoyo al proyecto. En anexos, se incluyen materiales con pruebas de evaluación, fichas de refuerzo y unidades didácticas para 5õ y 6õ de Primaria.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Identification of miRNA Master Regulators in Breast Cancer

Breast cancer is the neoplasm with the highest number of deaths in women. Although the molecular mechanisms associated with the development of this tumor have been widely described, metastatic disease has a high mortality rate. In recent years, several studies show that microRNAs or miRNAs regulate complex processes in different biological systems including cancer. In the present work, we describe a group of 61 miRNAs consistently over-expressed in breast cancer (BC) samples that regulate the breast cancer transcriptome. By means of data mining from TCGA, miRNA and mRNA sequencing data corresponding to 1091 BC patients and 110 normal adjacent tissues were downloaded and a miRNA&ndash;mRNA network was inferred. Calculations of their oncogenic activity demonstrated that they were involved in the regulation of classical cancer pathways such as cell cycle, PI3K&ndash;AKT, DNA repair, and k-Ras signaling. Using univariate and multivariate analysis, we found that five of these miRNAs could be used as biomarkers for the prognosis of overall survival. Furthermore, we confirmed the over-expression of two of them in 56 locally advanced BC samples obtained from the histopathological archive of the National Cancer Institute of Mexico, showing concordance with our previous bioinformatic analysis