28 research outputs found
Carcinoma mioepitelial ex adenoma pleomorfo de parótida: Reporte de un caso y revisión de la literatura
Los Poyos del Molinillo (Frigiliana): new site of the Bronze Age in the East Axarquía (Málaga, Andalucía)
En este trabajo damos a conocer un nuevo yacimiento descubierto recientemente en el municipio de Frigiliana. La delimitación del área denominada Los Poyos del Molinillo permitió definir la existencia de un poblado y una covacha con restos de una inhumación. El estudio de los materiales arqueológicos, que incluye cerámica, piezas metálicas o elementos de molturación, o la datación AMS obtenida, permiten adscribir el yacimiento a la Edad del Bronce y ampliar el conocimiento de esta etapa en la Axarquía oriental (Málaga, Andalucía).In this work we present a new site recently discovered in the Frigiliana municipality (Málaga). The spatial delimitation of the so called Los Poyos del Molinillo area let us define a Bronze age settlement and an inhumation burial cave. The archaeological record includes ceramic, metallic items or grinding elements, all of them belonging to the Bronze Age, as well as an AMS Radiocarbon data. This site extends the knowledge about this period in the Eastern Axarquía (Málaga, Andalucía)
Aportaciones hidrogeológicas al estudio arqueológico de los orígenes de la Edad del Bronce de La Mancha: la cueva monumentalizada de Castillejo del Bonete (Terrinches, Ciudad Real-España)
Estudios recientes indican que las motillas, asentamientos de la Edad del Bronce de La Mancha, pudieron ser las más antiguas captaciones de agua subterránea en la Península Ibérica. Pero ¿por qué no existen motivas en el Campo de Montiel, territorio ubicado tradicionalmente en esta área cultural? En Castillejo del Bonete, sitio arqueológico situado en esa comarca, existe una cueva que fue utilizada y sellada durante la Prehistoria Reciente. Se presenta ahora la primera investigación paleohidrogeológica interdisciplinar en La Mancha, que ha analizado manantiales y niveles de agua subterránea del acuífero de Campo de Montiel, así como el interior de la sima de Castillejo del Bonete. Las conclusiones avanzan una relación entre el sustrato hidrogeomorfológico y la distribución espacial de las motillas. Además permiten descartar que la sima de Castillejo del Bonete fuera utilizada como mina o como acceso al acuífero, dos de las hipótesis de trabajo planteadas. De ese modo cobra fuerza que Castillejo del Bonete fuera un excepcional monumento funerario y simbólico durante el Calcolítico y la Edad del Bronce, perteneciente a una nueva clase de asentamientos desconocidos hasta ahora en el grupo cultural de la Edad del Bronce de La Mancha
Cosmological evolution, future singularities, Little Rip and Pseudo-Rip in viable f(R) theories and their scalar-tensor counterpart
Modified f(R) gravity is one of the most promising candidates for dark
energy, and even for the unification of the whole cosmological evolution,
including the inflationary phase. Within this class of theories, the so-called
viable modified gravities represent realistic theories that are capable of
reproducing late-time acceleration, and satisfy strong constraints at local
scales, where General Relativity is recovered. The present manuscript deals
with the analysis of the cosmological evolution for some of these models, which
indicates that the evolution may enter into a phantom phase, but the behavior
may be asymptotically stable. Furthermore, the scalar-tensor equivalence of
f(R) gravity is considered, which provides useful information about the
possibility of the occurrence of a future singularity. The so-called Little Rip
and Pseudo-Rip are also studied in the framework of this class of modified
gravities.Comment: 20 pages. Extended version, new figures and additional analysis.
Version to be published in Class. Quant. Gra
Multi-parametric MR Imaging Biomarkers Associated to Clinical Outcomes in Gliomas: A Systematic Review
[EN] Purpose: To systematically review evidence regarding the association of multi-parametric biomarkers with clinical outcomes and their capacity to explain relevant subcompartments of gliomas.
Materials and Methods: Scopus database was searched for original journal papers from January 1st, 2007 to February 20th , 2017 according to PRISMA. Four hundred forty-nine abstracts of papers were reviewed and scored independently by two out of six authors. Based on those papers we analyzed associations between biomarkers, subcompartments within the tumor lesion, and clinical outcomes. From all the articles analyzed, the twenty-seven papers with the highest scores were highlighted to represent the evidence about MR imaging biomarkers associated with clinical outcomes. Similarly, eighteen studies defining subcompartments within the tumor region were also highlighted to represent the evidence of MR imaging biomarkers. Their reports were critically appraised according to the QUADAS-2 criteria.
Results: It has been demonstrated that multi-parametric biomarkers are prepared for surrogating diagnosis, grading, segmentation, overall survival, progression-free survival, recurrence, molecular profiling and response to treatment in gliomas. Quantifications and radiomics features obtained from morphological exams (T1, T2, FLAIR, T1c), PWI (including DSC and DCE), diffusion (DWI, DTI) and chemical shift imaging (CSI) are the preferred MR biomarkers associated to clinical outcomes. Subcompartments relative to the peritumoral region, invasion, infiltration, proliferation, mass effect and pseudo flush, relapse compartments, gross tumor volumes, and high-risk regions have been defined to characterize the heterogeneity. For the majority of pairwise cooccurrences, we found no evidence to assert that observed co-occurrences were significantly different from their expected co-occurrences (Binomial test with False Discovery Rate correction, alpha=0.05). The co-occurrence among terms in the studied papers was found to be driven by their individual prevalence and trends in the literature.
Conclusion: Combinations of MR imaging biomarkers from morphological, PWI, DWI and CSI exams have demonstrated their capability to predict clinical outcomes in different management moments of gliomas. Whereas morphologic-derived compartments have been mostly studied during the last ten years, new multi-parametric MRI approaches have also been proposed to discover specific subcompartments of the tumors. MR biomarkers from those subcompartments show the local behavior within the heterogeneous tumor and may quantify the prognosis and response to treatment of gliomas.This work was supported by the Spanish Ministry for Investigation, Development and Innovation project with identification number DPI2016-80054-R.Oltra-Sastre, M.; Fuster García, E.; Juan -Albarracín, J.; Sáez Silvestre, C.; Perez-Girbes, A.; Sanz-Requena, R.; Revert-Ventura, A.... (2019). Multi-parametric MR Imaging Biomarkers Associated to Clinical Outcomes in Gliomas: A Systematic Review. 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A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?
BACKGROUND: Oral ivermectin is a safe broad spectrum anthelminthic used for treating several neglected tropical diseases (NTDs). Currently, ivermectin use is contraindicated in children weighing less than 15 kg, restricting access to this drug for the treatment of NTDs. Here we provide an updated systematic review of the literature and we conducted an individual-level patient data (IPD) meta-analysis describing the safety of ivermectin in children weighing less than 15 kg. METHODOLOGY/PRINCIPAL FINDINGS: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for IPD guidelines by searching MEDLINE via PubMed, Web of Science, Ovid Embase, LILACS, Cochrane Database of Systematic Reviews, TOXLINE for all clinical trials, case series, case reports, and database entries for reports on the use of ivermectin in children weighing less than 15 kg that were published between 1 January 1980 to 25 October 2019. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017056515. A total of 3,730 publications were identified, 97 were selected for potential inclusion, but only 17 sources describing 15 studies met the minimum criteria which consisted of known weights of children less than 15 kg linked to possible adverse events, and provided comprehensive IPD. A total of 1,088 children weighing less than 15 kg were administered oral ivermectin for one of the following indications: scabies, mass drug administration for scabies control, crusted scabies, cutaneous larva migrans, myiasis, pthiriasis, strongyloidiasis, trichuriasis, and parasitic disease of unknown origin. Overall a total of 1.4% (15/1,088) of children experienced 18 adverse events all of which were mild and self-limiting. No serious adverse events were reported. CONCLUSIONS/SIGNIFICANCE: Existing limited data suggest that oral ivermectin in children weighing less than 15 kilograms is safe. Data from well-designed clinical trials are needed to provide further assurance
SINDROME ANTIFOSFOLIPIDOS Y EMBARAZO
El SAF es una enfermedad del sistema inmune (Trombofilia), en la cual existen anticuerpos con aparente especificidad por fosfolípidos con carga eléctrica negativa. Se define como la ocurrencia de trombosis, aborto recurrente o ambos junto con la presencia de anticuerpos antifosfolípidos circulantes (Anticoagulante lúpico, anticardiolipinas y ß2-glicoproteina I). Su incidencia de todas las Trombofílias es de un 3,5% a 6%. Existen hipótesis actuales que explicarían su patogenia basados en la activación de células endoteliales; el daño oxidativo del endotelio vascular y en la modulación de la coagulación. La forma de presentación esta dada por criterios clínicos mayores y menores, donde el sustrato son los sucesos trombóticos y una mala historia obstétrica. Estos fenómenos son la base para indicar su estudio. El diagnostico se confirma con exámenes de laboratorio, con medición de anticuerpos, (serología). El tratamiento durante el embarazo, los resultados perinatales mejoran con el uso (ideal) de Heparina de bajo peso molecular, (Alternativa: Heparina Estándar sc + Neosyntron, vo.), Ácido Acetilsalicílico y calcio diario, durante todo el embarazo y en el puerperio. El control debe ser frecuente, por un equipo médico multidisciplinario, con apoyo de Laboratorio y de evaluación Ecográfica - Doppler seriados. Se presentan dos casos clínicos de embarazo y SAF, manejo, tratamiento y resultado neonata
ISOINMUNIZACION Rh: EVALUACION DE LA UTILIDAD DEL DOPPLER DE ARTERIA CEREBRAL MEDIA EN LA PREDICCION Y MANEJO DE ANEMIA FETAL
Se presenta la experiencia en el manejo de pacientes altamente sensibilizadas por incompatibilidad Rh, analizando la utilidad de la evaluación de la velocidad circulatoria fetal, por Doppler-color, a través de la medición de la velocidad máxima sistólica (VMS) de la arteria cerebral media (ACM). Se realizan 19 transfusiones intravasculares en 3 casos afectados por esta enfermedad. En 14 de ellas se encontró anemia fetal moderada o leve, la que fue diagnosticada correctamente en 13 oportunidades, (92,8%) por la medición anteriormente señalada. Se encuentra una adecuada correlación entre la velocidad máxima sistólica de la arteria cerebral media y el grado de anemia fetal moderada o severa, con un índice correlacional (r= (_) 0,78). Se destaca el beneficio de un método no invasivo en el manejo de la anemia fetal de causa inmunológica o asociada a otras condiciones mórbidas y se abre un campo para futuras investigacione
TRATAMIENTO MEDICO DEL EMBARAZO ECTOPICO
Se presenta el resultado de 21 casos de embarazo ectópico (EE) no complicados que fueron tratados con Metotrexato y manejo expectante, desde enero de 2000 a marzo de 2001. Objetivos: Conocer la incidencia del EE en nuestro servicio, evaluar la efectividad del tratamiento médico, y efectuar estudio de costos comparando tratamiento médico versus quirúrgico. Material y Métodos: Estudio prospectivo de 21 casos de EE no complicados hospitalizados en la Unidad de alto riesgo, trece casos manejados con Metotrexato parenteral y ocho casos con manejo expectante. Resultados: En 3 casos se requirió resolución quirúrgica secundaria, determinando una tasa de éxito de tratamiento médico de 85,7%. No hubo correlación entre el nivel inicial de ß-HCG con el tamaño de masa anexial, tiempo de negativización de ß-HCG, necesidad de segunda dosis de MTX ni aparición de complicaciones del EE durante el tratamiento. Costo total, un 22,7% inferior para el tratamiento médico con respecto a cirugía. Conclusión: Las dos alternativas de tratamiento médico analizadas, son válidas en pacientes con EE no complicado
Changes in regional cerebral blood flow are associated with endothelial dysfunction markers in cocaine-dependent patients under recent abstinence
© 2015 American Society of Addiction Medicine. Objectives: Cocaine is a known risk factor for several vascular ischemic events. The underlying mechanisms leading to the complications are not fully understood, although thrombus formation and accelerated atherosclerosis are prominent findings. Evidence of endothelial dysfunction (ED), a key phenomenon in the pathogenesis of atherogenesis, has been demonstrated in cocaine-dependent individuals. Abnormal regional cerebral blood flow (rCBF) is a common finding among chronic cocaine users. The aim of this study was to evaluate whether brain perfusion changes were associated with ED markers in cocaine-dependent individuals. Methods: Circulating endothelial cells (CECs), soluble intercellular cell adhesion molecule, and the chemokine regulated on activation normal T cells expressed and secreted were measured in 27 DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) cocaine-dependents patients. Regional cerebral bloo