Impact of a lecture abour empirical bases of hypnosis on beliefs and attitudes toward hypnosis among Cuban health professionals.

The aim of this study is to examine whether a lecture on hypnosis can modify attitudes and misconceptions about hypnosis. The sample consisted of 97 health professionals from institutions of Havana City. Group 1 consisted of 46 participants who received a lecture on hypnosis. Group 2 consisted of 51 participants who received a lecture about Urology. The Valencia Scale of Attitudes and Beliefs toward HypnosisTherapist was applied before and after the lecture. Results indicated that there were significant differences between the groups in which Group 1 showed more positive attitudes toward hypnosis. However, both groups showed similar misconceptions about hypnosis and memory, which changed significantly in Group 1 after receiving the lecture about hypnosis, but not in Group 2. Therefore, the lecture about hypnosis had a significant impact in correcting participants" misconceptions about memory and hypnosis

Hipokalemia severa como manifestación de síndrome de Cushing ectópico asociado a colangiocarcinoma

Ectopic Cushing´s syndrome is a rare, but generally serious entity due to the adrenocorticotropic hormone secretion or, in exceptional cases, corticotropin-releasing hormone secretion by extra pituitary tumors. It should be considered an endocrine emergency that requires multidisciplinary and simultaneous management of hypercortisolism, associated comorbidities and etiological treatment. We present a case of ectopic Cushing´s syndrome to describe the main clinical and biochemical features associated with intense hypercortisolism and its rapid clinical evolution associated with cholangiocarcinoma.El síndrome de Cushing ectópico es una entidad poco frecuente, pero generalmente grave, debido a la secreción de hormona adrenocorticotropa o, en casos excepcionales, de hormona liberadora de corticotropina por tumores extra hipofisarios. Se ha de considerar una emergencia endocrinológica que requiere un manejo multidisciplinario y simultáneo del hipercortisolismo, comorbilidades asociadas y tratamiento etiológico. Presentamos un caso de síndrome de Cushing ectópico, donde damos a conocer las principales características clínicas y bioquímicas asociadas al hipercortisolismo intenso, y su rápida evolución clínica secundario a un colangiocarcinoma

Identification of histological threshold concepts in health sciences curricula: Students' perception

Students' metacognitive skills and perceptions are considered important variables for high-quality learning. In this study, students' perceptions were used to identify histological threshold concepts (integrative, irreversible, transformative, and trouble-some) in three health sciences curricula. A specific questionnaire was developed and validated to characterize students' perceptions of histological threshold concepts. A sample of 410 undergraduate students enrolled in the dentistry, medicine, and phar-macy degree programs participated in the study. Concepts assessed in the study were clustered to ten categories (factors) by exploratory and confirmatory factor analy-sis. Concepts linked to tissue organization and tissue functional states received the highest scores from students in all degree programs, suggesting that the process of learning histology requires the integration of both static concepts related to the constituent elements of tissues and dynamic concepts such as stem cells as a tis-sue renewal substrate, or the euplasic, proplasic and retroplasic states of tissues. The complexity of integrating static and dynamic concepts may pose a challenging bar-rier to the comprehension of histology. In addition, several differences were detected among the students in different degree programs. Dentistry students more often per-ceived morphostructural concepts as threshold concepts, whereas medical students highlighted concepts related to two-dimensional microscopic identification. Lastly, pharmacy students identified concepts related to tissue general activity as critical for the comprehension and learning of histology. The identification of threshold concepts through students' perceptions is potentially useful to improve the teaching and learn-ing process in health sciences curricula.Departamento de Histología, Universidad de GranadaPlan de Innovación y Formación Docente, Universidad de Granada (FIDO refs. 19–30 and 19–31

Granulomatous hypophysitis by Mycobacterium gordonae in a non HIV-infected patient

Lymphocytic or granulomatous hypophysitis is a rare entity with a difficult diagnosis. Our objective was to report a patient with non-tuberculous granulomatous hypophysitis. An HIV-negative 45-year old man with confusional state, subacute ophthalmoplegia, and clinical and laboratory findings of panhypopituitarism was seen in the emergency unit. A cranial MRI showed a sellar mass suggestive of hypophysitis. After an unsuccessful attempt with steroids and antituberculous drugs the patient died. Post-mortem histopathology revealed granulomatous lesions and restriction fragment length polymorphism analysis confirmed the presence of Mycobacterium gordonae’s DNA. In conclusion, we should consider granulomatous hypophysitis in the differential diagnosis of non-secreting hypophyseal tumors. The etiology of a pituitary granuloma by a non-tuberculous mycobacteria is best reached by histopathological techniques and molecular assays. The optimal therapy is yet to be established

Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Herniation of the liver through an anterior abdominal wall hernia defect is rare. To the best of our knowledge, only three cases have been described in the literature.</p> <p>Case presentation</p> <p>A 70-year-old Mexican woman presented with a one-week history of right upper quadrant abdominal pain, nausea, vomiting, and jaundice to our Department of General Surgery. Her medical history included an open cholecystectomy from 20 years earlier and excessive weight. She presented with jaundice, abdominal distension with a midline surgical scar, right upper quadrant tenderness, and a large midline abdominal wall defect with dullness upon percussion and protrusion of a large, tender, and firm mass. The results of laboratory tests were suggestive of cholestasis. Ultrasound revealed choledocholithiasis. A computed tomography scan showed a protrusion of the left hepatic lobe through the anterior abdominal wall defect and a well-defined, soft tissue density lesion in the right adrenal topography. An endoscopic common bile duct stone extraction was unsuccessful. During surgery, the right adrenal tumor was resected first. The hernia was approached through a median supraumbilical incision; the totality of the left lobe was protruding through the abdominal wall defect, and once the lobe was reduced to its normal position, a common bile duct surgical exploration with multiple stone extraction was performed. Finally, the abdominal wall was reconstructed. Histopathology revealed an adrenal myelolipoma. Six months after the operation, our patient remains in good health.</p> <p>Conclusions</p> <p>The case of liver herniation through an incisional anterior abdominal wall hernia in this report represents, to the best of our knowledge, the fourth such case reported in the literature. The rarity of this medical entity makes it almost impossible to specifically describe predisposing risk factors for liver herniation. Obesity, the right adrenal myelolipoma mass effect, and the previous abdominal surgery are likely to have contributed to incisional hernia formation.</p

Maritime-oriented foragers during the Late Pleistocene on the eastern costa del sol (Southeast Iberia): Cueva Victoria (Málaga, Spain)

The Mediterranean coast of Spain is marked by several clusters of Palaeolithic sites: to the south of the Pyrenees, in the area around the Ebro River, in the central part, and on the south coast, one of the southernmost regions in Europe. The number of sites is small compared with northern Iberia, but like that region, the Palaeolithic occupations are accompanied by several rock art ensembles. The archaeological material (both biotic and abiotic resources) and radiocarbon dates presented here were obtained during archaeological fieldwork of professor J. Fortea in the Late Pleistocene deposits in Cueva Victoria, located near the modern coastline and about 150 km north of the Strait of Gibraltar. In the three occupation phases, marine resources were acquired by shell-fishing (focusing almost exclusively on the clam Ruditapes decussatus), fishing, and the use of beached marine mammals. This contrasts with the limited data about the exploitation of terrestrial resources by hunting and gathering animals and plants. The study is completed by the study of artefacts (lithic and bone industry and objects of adornment) that help to understand the subsistence strategies of the cave occupants and enable a comparison with other groups inhabiting the Mediterranean coasts of the Iberian Peninsula during Greenland Interstadial 1, between ca. 15.1 and 13.6 cal BP.This work was supported by the University of Salamanca GIR PREHUSAL, the Ministry of Science and Innovation-Spanish Government (PaleontheMove-PID2020-114462GB-I00), the Universidad Nacional de Educación a Distancia (Madrid) and Dirección General de Universitat, Investigacio i Ciencia of the Valencian Regional Government (Project Aico/2020/97).Peer reviewe

Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome

Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported

Adult intussusception secondary to an ileum hamartoma

Intussusception is a rare condition in the adult population. However, in contrast to its presentation in children, an identifiable etiology is found in the majority of cases. Clinical manifestations of adult intussusception are non-specific and patients may present with acute, intermittent or chronic symptoms, predominantly those of intestinal obstruction. A 27-year-old male patient with recurrent abdominal pain secondary to intussusception is herein reported. The clinical presentation and ultrasonographic findings led to the diagnosis. At laparotomy, an ileal hamartoma was found as the lead point of the intussusception. Surgical management and histopathologic studies are described. A recurrent intestinal obstruction and classic ultrasound findings may lead to the diagnosis of intussusception but surgical exploration remains essential. The principle of resection without reduction is well established

Technological study of kaolinitic clays from Fms. Escucha and Utrillas to be used in dermo-pharmaceutical products

The present study aims to evaluate five clay samples from different pits in the Teruel province, Spain. While these clays are primarily utilized as raw materials in ceramics, their potential applications in pharmaceutical and cosmetic domains, notably in sun protection and thermal mud products, are under investigation. Characterization of these clays entailed X-ray diffraction, X-ray fluorescence, scanning electron microscopy, pH measurement, analysis of technological properties, rheological assessment, and thermal property evaluation. Furthermore, given the predominant composition of kaolin in most of the samples, their Sun Protection Factor (SPF) in suspensions and physical stability were assessed. The studied samples exhibited varied mineralogical compositions, primarily consisting of kaolinite (70% to 15%), quartz (75% to 5%), and illite (26% to 7%). The pH values of these dispersions closely matched the skin's pH, exhibiting anti-thixotropic behavior at 50% w/w and demonstrating suitable viscosity for skin application. Based on their composition and rheological properties, the samples exhibited potential for use as therapeutic thermal muds. Analyses of cooling kinetics were performed to validate this potential. Results showed that the dispersions systems attained temperatures between 33.89 °C and 34.62 °C within 20 min (the common application time for thermal muds) and reached 32 °C (skin temperature) in 24.3 to 26.22 min, confirming their appropriateness as therapeutic muds. The SPF values of the dispersions varied from 7.46 to 16.65, with the majority of samples showing significant stability during 45 h. Consequently, it can be inferred that most of the studied samples show advantageous characteristics for inclusion in topical formulations, especially in sun protection and thermal mud products.This work was supported by the spanish project PID2022-137603O13-100 of the Ministerio de Ciencia, Innovación y Universidades. R.d.M.B. wishes to acknowledge by EMERGIA, Junta de Andalucía, Universidad de Sevilla, Spain,Contract number USE 23922-W