Neuroimagen del linfoma primario del sistema nervioso central en pacientes inmunodeprimidos

ResumenObjetivosEl linfoma primario del sistema nervioso central (LPSNC) es una entidad rara con un pronóstico fatal. Dado el aumento en el número de casos con inmunosupresión adquirida, nuestros objetivos son estudiar las características epidemiológicas y neurorradiológicas de aquellos pacientes inmunodeprimidos con diagnóstico de LPSNC con afectación cerebral e investigar si existen diferencias entre los pacientes con el virus de la inmunodeficiencia humana (VIH) positivo y negativo.Materiales y métodosSe realizó un estudio descriptivo y retrospectivo de los pacientes inmunodeprimidos con afectación cerebral por LPSNC, diagnosticados durante los últimos 13 años en 2 hospitales de referencia. Se evaluaron múltiples variables. El nivel de significación estadística utilizado fue p<0,05.ResultadosEl grupo VIH-positivo tenía una media de edad de 36,82±5,4 años, frente a los 55,60 ± 21,43 años de los pacientes VIH-negativo (p<0,022). Los pacientes VIH-positivo tuvieron una media de 1,27 ± 0,65 lesiones por paciente, mientras que en el grupo VIH-negativo fue de 2,60 ± 1,78 (p<0,039). El 18,2% (n=2) del grupo VIH-positivo y el 80% (n=8) del grupo VIH-negativo presentaron lesiones homogéneas (p<0,005). Ningún paciente VIH-positivo tuvo afectación del cuerpo calloso, pero el grupo VIH-negativo presentó un 50% (n=5) de afectación (p<0,012).ConclusionesEl LPSNC en pacientes inmunodeprimidos puede presentar múltiples características en las imágenes. Existen diferencias entre los pacientes VIH positivo y negativo, por lo que es importante reconocerlas para establecer un manejo y tratamiento diferente entre ambos grupos.AbstractPurposesPrimary central nervous system lymphoma (PCNSL) is a rare tumour with poor prognosis. Due to the increased number of patients with acquired immunodeficiency, our purposes are to describe epidemiological and imaging findings in immunodeficient patients with PCNSL of the brain and to study the differences between HIV-positive and HIV-negative patients with PCNSL.Materials and methodsA retrospective, descriptive study was performed with immunodeficient patients diagnosed of PCNSL of the brain during the last 13 years in two reference hospitals. Twenty-one patients fulfilled the inclusion criteria. Multiple variables were evaluated. Significance was defined as p<0.05.ResultsHIV-positive group was a mean age of 36,82±5,4 years and the mean age in HIV-negative group was 55,60±21,43 years (p<0,022). The mean number of lesions was 1,27±0,65 in HIV-positive group and 2,60±1,78 in HIV-negative group (p<0,039). The lesions were homogeneous in 18,2% (n=2) HIV-positive group and 80% (n=8) in HIV-negative group (p<0,005). No HIV-positive patient and 50% (n=5) of HIV-negative patients showed corpus callosum involvement (p<0,012).ConclusionsPCNSL in immunodeficient patients is associated with a large spectrum of radiological findings. There were differences between HIV-positive and HIV-negative patients, is important recognize these differences as the therapeutic management of these two groups vary

Climatic variability and decline of Atlantic Iberian Nephrops fisheries

PresentationNephrops landings and landings per unit effort from the mixed bottom trawl fishery in the northwest Spain have a marked downward trend since the earliest 90s. Since 2006, a recovery plan has been developed but improvement signs have not been detected up to now, and the fishery shows currently a depleted state. Multiple environmental-related causal mechanisms may interact in this decline other than fishing pressure. Climatic variability of the region was characterized using series (1950-2010) of teleconnection patterns (North Atlantic Oscillation index, Eastern Atlantic index, Scandinavian index and Poleward index). Fishery Nephrops data and climatic series were jointly analyzed. The aim was to indentify relationships between the Nephrops dynamics and the environmental system, and the mechanisms that could have an influence on the biological fluctuation

Factors affecting diabetic patient’s long-term quality of life after simultaneous pancreas-kidney transplantation: a single-center analysis

[Purpose]: Pancreas transplantation (PT) is one of the few ways to restore euglycemia within diabetic patients; however, the high morbidity caused by surgical complications and the need for immunosuppressive therapy has raised controversy about PT improving the health-related quality-of-life (HRQoL). The aim of this study is to assess the long-term (≥ 5 years after PT) HRQoL and to identify the factors affecting it.[Methods]: A single-center, cross-sectional study of 49 sequential PT was performed. All patients conducted a telephone interview to fulfill the modification of Medical Outcome Health Survey Short Form questionnaire (SF-36v2) and were compared to similar post-PT studies from the literature.[Results]: Patients with a history of replacement renal therapy (RRT) or neuropathy undergoing a PT were associated to a worse bodily pain (P = 0.03) and physical function (P = 0.04), respectively, whereas those with retinopathy showed an improved Role Emotional (P = 0.04). Multivariate analysis revealed the presence of RRT as the only independent prognostic factor for a worse bodily pain [relative risk = 3.9; 95% confidence interval (1.1–14.6)], (P = 0.04). Furthermore, nearly all PT recipients (91.8%) claimed an overall better health than prior to PT.[Conclusion]: Our study confirms that PT recipients’ HRQoL improves after PT, showing similar HRQoL scores across different populations and suggests that patients in predialysis could benefit from an improved HRQoL if transplanted on the early stages of the disease

The poor accuracy of D-dimer for the diagnosis of prosthetic joint infection but its potential usefulness in early postoperative infections following revision arthroplasty for aseptic loosening

Background: D-dimer was introduced in 2018 as an alternative biomarker for C-reactive protein (CRP) in the diagnostic of prosthetic joint infection (PJI) criteria of the Musculoskeletal Infection Society. We assessed the accuracy of plasma D-dimer for the diagnosis of early, delayed, and late PJI according to Infectious Diseases Society of America (IDSA) criteria, and whether persistently high levels of D-dimer in cases of aseptic loosening (AL) may be predictive of subsequent implant-related infection. Methods: A prospective study of a consecutive series of 187 revision arthroplasties was performed at a single institution.Septic (n = 39) and aseptic revisions (n = 141) were classified based on IDSA criteria. Preoperative assessment of CRP, erythrocyte sedimentation rate (ESR) and D-dimer was performed. Receiver operating curves were used to determine maximum sensitivity and specificity of the biomarkers. The natural progress of D-dimer for AL cases was followed up either until the date of implant-related infection at any time during the first year or 1 year after revision in patients without failure. Clinical outcomes for those AL cases included infection-related failure that required a new surgery or need for antibiotic suppression. Results: Preoperative D-dimer level was significantly higher in PJI cases than in AL cases (p = 0.000). The optimal threshold of D-dimer for the diagnosis of PJI was 1167 ng/mL. For overall diagnosis of PJI, C-reactive protein (CRP) achieved the highest sensitivity (84.6%), followed by erythrocyte sedimentation rate (ESR) and D-dimer (82% and 71.8%, respectively). Plasma D-dimer sensitivity was lower for all PJI types. When combinations of 2 tests were studied, the combined use of ESR and CRP achieved the best accuracy for all types of PJI (76.9%). 4.25% of AL cases had implant failure due to implant-related infection during the first year after the index revision arthroplasty, only the cases with early failure maintained high D-dimer levels

Quantitative analysis of Tr1 lymphocytes in patients with type 2 diabetes mellitus

Background: Type 2 diabetes mellitus (T2DM) is usually accompanied by a low-grade inflammatory phenomenon, which participates in the pathogenesis of different complications of this condition. The inflammatory response is under the regulation of different mechanisms, including T regulatory (Treg) lymphocytes. However, the possible role of type 1 T regulatory (Tr1) cells in T2DM has not been explored so far. Aim: To carry out a quantitative analysis of Tr1 lymphocytes and other immune cell subsets in patients with T2DM and correlate these results with clinical findings and treatments. Materials and methods: Sixty patients with T2DM and twenty-three healthy controls were included in the study. Biochemical and anthropometric variables were evaluated, and Tr1 lymphocytes (CD4+CD49+LAG-3+IL-10+) and other cell subsets (Th17, Th22 and Foxp3 + Treg cells) were analyzed in peripheral blood samples by multiparametric flow cytometry. Results: Significant increased levels of Tr1 cells were detected in patients with severe and mild disease, compared to healthy controls. In addition, CD4+IL-10+ lymphocytes were also increased in patients with T2DM. In contrast, similar levels of Foxp3+ Treg cells, Th17 and Th22 lymphocytes were observed in patients and controls. Likewise, no significant associations were detected between Tr1 cell levels and different clinical and laboratory parameters. However, those patients receiving glucagon-like peptide-1 receptor agonists (GLP-1-RA) showed similar levels of Tr1 cells than healthy controls, and significant lower numbers than untreated patients. Conclusion: We observed an increase in Tr1 and CD4+IL10+ lymphocyte levels in T2DM. Moreover, GLP1-RA treatment was significantly associated with normalization of the Tr1 levels. This highlights another potential immune dysfunction in patients with T2DM, which could participate in the pathogenesis of this conditionProyectos de Investigacion en Salud (FIS) PI19-00584 and PI22/01404, ACROMICS project PMP22/00021 (funded by Instituto de Salud Carlos III), iTIRONET (P2022/BMD7379 funded by Comunidad de Madrid

Fibrous Hamartoma of Infancy: A Series of 21 Cases and Review of the Literature

Introducción: El hamartoma fibroso de la infancia (HFI) es tumor poco frecuente de tejidos blandos en lactantes y niños, caracterizado histopatólogicamente por su morfología trifásica y curso benigno. Métodos: Presentamos las características histopatológicas e inmunohistoquímicas de una serie de 21 casos de HFI y revisamos sus principales diagnósticos diferenciales. Resultados: Las lesiones predominaron en varones con una edad media de 3,7 años (5 meses24 años) en localizaciones previamente descritas. Histopatológicamente, se caracterizaron por proporciones variables de tejido fibroblástico, mesenquimal y adiposo maduro. Tres casos (21%) mostraron zonas hialinizadas con artefactos en grietas, que imitaban al fibroblastoma de células gigantes. Presentaron tinción positiva para actina de músculo liso 8/13 (61%) en el componente fibroblástico, CD34 en 6/8 (75%) en el mesenquimal inmaduro y fibroblástico; y S100 en el tejido adiposo en 7/7 (100%). Conclusión: Nuestros hallazgos histopatológicos son superponibles a los descritos en series amplias. No obstante, la heterogeneidad clínica obliga a conocer las variantes de esta entidad dentro de su típica histomorfología trifásica, para lograr un correcto diagnóstico y manejo terapéutico.Background: Fibrous hamartoma of infancy (FHI) is a rare soft-tissue tumor usually seen in infants and young children. Histologically, the tumor is characterized by a triphasic morphology, and the clinical course is benign. Methods: We described the histopathologic and immunohistochemical features in a series of 21 cases of FHI and reviewed the main entities to consider in differential diagnosis. Results: Most patients in the series were male. The mean age was 3.7 years (range, 5 months---24 years), and lesions were found in locations that have been previously reported. Histopathologically, the tumors were composed of variable proportions of fibroblastic, mesenchymal, and mature adipose tissue. Three of the 13 immunohistochemically stained biopsies (14%) contained hyalinized zones with cracking artifacts, mimicking giant cell fibroblastoma. Eight of the 13 stained with smooth-muscle actin (61%) were positive in the fibroblastic component, 6 of the 8 stained with CD34 (75%) were positive in the immature mesenchymal and fibroblastic components, and all 7 stained with S100 were positive (100%) in adipose tissue. Conclusions: Our histopathologic findings are consistent with those described in larger series. However, in order to reach a precise diagnosis and plan treatment, clinical heterogeneity obliges us to become familiar with variations in the characteristic triphasic histology of FHI

Estudio y caracterización de algunas 5-E-aldoximino-4-glucosilaminopirimidinas

La reacción de 1,6-dihidro-5-formil-4-β-D-(2 ', 3 ' 4 ', 6 '-tetra-O-acetil)-glucopiranosilamino-1-metil-2-metoxi-6-oxopirimidina con exceso de ClH.H2NOH permite aislar 5-E-aldoximino derivado como único producto. La estructura del mismo ha sido establecida en base a pruebas químicas y espectroscópicas.The reaction between 1,6-dihydro-S-formil-4- β -D-(tetra-O-acetyl}glucopyranosylamino-l-methyl-2-methoxy-6-oxo-pyrimidine and an excess of ClH.H2 NOH yields S-E-aldoximine derivative as the only producto On the basis of its chemical behaviour and espectroscopic data we propose its structure

Cross‐sectional study about impact of parental smoking on rhinitis symptoms in children

[Abstract] Objective. Assess the prevalence of rhinitis and exposure to environmental tobacco smoke (ETS) of children in our community and its relationship with symptoms of rhinitis Methods (design, setting, participants, main outcome measures). Cross‐sectional study using questionnaire on rhinitis of the International Study of Asthma and Allergies in Childhood, in children (6‐7 years) and adolescents (13‐14 years). Categories: “rhinitis ever”, “recent rhinitis”, “recent rhinoconjunctivitis”, “severe rhinoconjunctivitis”. Parental smoking: (i) neither parent smokes; (ii) only the mother smokes; (iii) only the father smokes; and (iv) both parents smoke. Odds ratio of the prevalence of symptoms of rhinitis according to ETS exposure was calculated using logistic regression. Results. 10 690 children and 10 730 adolescents. The prevalence of “rhinitis ever” in children: 29.4%, “recent rhinitis” 24%, “recent rhinoconjunctivitis” 11.5% and “severe rhinoconjunctivitis” 0.1%. In adolescents: 46.2%, 34.5%, 16.2% and 0.2%, respectively. Environmental tobacco smoke exposure in the home occurred in 51% of cases. Parental smoking was associated with a higher prevalence of forms of rhinitis in adolescents when only the mother was a smoker. In children when both parents were smokers. Conclusion. Rhinitis is highly prevalent in our community. Environmental tobacco smoke exposure is still very common. The relationship between ETS and rhinitis symptoms in children of this community is not as robust as that found for asthma

Estudio y caracterización de algunas 5-E-aldoximino-4-glucosilaminopirimidinas

The reaction between 1,6-dihydro-5-formil-4-β-D-(tetra-O-acetyl)glucopyranosylamino-1-methyl-2-methoxy-6-oxo-pyrimidine and an excess of ClH.H2NOH yields 5-E-aldoximine derivative as the only product. On the basis of its chemical behaviour and espectroscopic data we propose its structure.La reacción de 1,6-dihidro-5-formil-4-β-D-(2 ', 3 ' 4 ', 6 '-tetra-O-acetil)-glucopiranosilamino-1-metil-2-metoxi-6-oxopirimidina con exceso de ClH.H2NOH permite aislar 5-E-aldoximino derivado como único producto. La estructura del mismo ha sido establecida en base a pruebas químicas y espectroscópicas

A review of NAFO 3LMN roughhead grenadier (Macrourus berglax Lacepède, 1801) reproductive biology including the evaluation of maturity ogive estimates.

A collection of 4770 histological slides collected in NAFO divisions 3LMN in a depth range from 200 to 1500 m and covering a time period between 2001 and 2015, has been reviewed to obtain information on reproductive biology of Macrourus berglax. Especial attention has been paid in atresia because its potential impact on stock productivity. Spatial and temporal variability of size and age at maturity of female roughhead grenadier was analyzed in NAFO divisions 3LMN based on microscopic maturity staging and individual age readings. Spawning capable females are homogeneously distributed nearly year-round, but in scarce numbers what prevent to define a spawning season. This statement united to the high levels of atresia could indicate a reproductive migration. We observed a clear decrease in length at first maturity (L50) of females from 27.8 cm in the period 2005-2011 to 25.6 cm in the last four years. The age at first maturity, A50, varied between 13.1 and 15 years, and there is not an evident trend of change over the years.Postprint0,000