Angina bullosa hemorrhagica an enigmatic oral disease

Angina bullosa hemorrhagica (ABH) is an enigmatic oral disorder described for the first time by Badham in 1967 to define blisters with a hematic content in the oral cavity and oropharynx unrelated to any hematological, dermatological or systemic disease. The ABH is an uncommon disease of the oral cavity distinctively affecting adults, with the highest incidence over the 5th decade of life. This process is considered nowadays to have a multifactorial etiopathogenesis, where mild oral traumatisms can trigger the blisters in susceptible individuals. Certain association on the onset of the lesion with the chronic use of inhaled steroids and, more controversially, with triggering systemic disorders, such as, diabetes or hypertension has been described. Characteristically, the ABH blisters are acute and are located on the lining mucosa, more frequently on the soft palate. Usually, the lesions are solitary and rupture easily, resulting in a superficial ulceration that heals quickly without scarring. The histopathological analysis shows a subepithelial blister containing blood and direct immunofluorescence on the epithelium is negative. The differential diagnosis should consider all oral vesiculobullous disorders with hematic content, including mucocutaneos, hematological or cystic pathology. The diagnosis of ABH is clearly clinical, although the biopsy might be helpful on atypical or abnormally recurrent cases. The general prognosis of ABH is good and the treatment is symptomatic. Although it is an uncommon disease, the angina bullosa hemorrhagica should be considered in the differential diagnosis of oral vesiculo-bullous processes. Acknowledging this entity will help in differentiating it from important mucocutaneous and hematological diseases such as pemphigus vulgaris, mucous membrane pemphigoid or coagulation disorders. In this review we analyze the main etiopathogenic, clinicopathological, diagnostic and therapeutic aspects of this enigmatic oral condition.peer-reviewe

Artificial Neural Network Based Reinforcement Learning for Wind Turbine Yaw Control

This paper introduces a novel data driven yaw control algorithm synthesis method based on Reinforcement Learning (RL) for a variable pitch variable speed wind turbine. Yaw control has not been extendedly studied in the literature; in fact, most of the currently considered developments in the scope of the wind energy are oriented to the pitch and speed control. The most important drawbacks of the yaw control are the very large time constants and the strict yaw angle change rate constraints due to the high mechanical loads when the wind turbine angle is changed in order to adequate it to the wind speed orientation. An optimal yaw control algorithm needs to be designed in order to adapt the rotor orientation depending on the wind turbine dynamics and the local wind speed regime. Consequently, the biggest challenge of the yaw control algorithm is to decide the moment and the quantity of the wind turbine orientation variation to achieve the highest quantity of power at each instant, taking into account the constraints derived from the mechanical limitations of the yawing system and the mechanical loads. In this paper, a novel based algorithm based on the RL Q-Learning algorithm is introduced. The first step is to obtain a model of the power generated by the wind turbine (a real onshore wind turbine in this paper) through a power curve, that in conjunction with a conventional proportional regulator will be used to obtain a dataset that explains the actual behaviour of the real wind turbine when a variety of different yaw control commands are imposed. That knowledge is then used to learn the best control action for each different state of the wind turbine with respect to the wind direction represented by the yaw angle, storing that knowledge in a matrix Q(s,a). The last step is to model that matrix through a MultiLayer Perceptron with BackPropagation (MLP-BP) Artificial Neural Network (ANN) to avoid large matrix management and quantification problems. Once that the optimal yaw controller has been synthetized, its performance has been assessed using a number of wind speed realizations obtained using the software application TurbSim, in order to analyze how the introduced novel algorithm deals with different wind speed scenarios

Efecto neuroprotector de IGF-II en situaciones de estrés neuronal inducido por corticosterona

Presentado en el 15º Congreso Nacional de la SENC 2013El daño por estrés en tejido neuronal mediado por la presencia de elevados niveles de corticosterona, se relaciona con la producción de alteraciones en funciones cognitivas. Así, el estrés agudo induce un aumento importante en los niveles plasmáticos de corticosterona que se asocia con alteraciones de plasticidad neuronal. Datos previos de nuestro grupo demuestran un efecto neuroprotector a dosis bajas del factor de crecimiento similar a insulina (IGF-II) en ratas de edad avanzada, donde el estrés de tipo oxidativo se encuentra involucrado en el propio proceso senil y en el desarrollo de diferentes enfermedades neurodegenerativas. Objetivos: En el presente trabajo se pretenden estudiar las propiedades antioxidantes de dosis bajas de IGF-II en cultivos primarios de corteza neuronal de ratas adultas, sometidos a elevadas concentraciones transitorias de corticosterona. Métodos: Los parámetros de estrés oxidativo se determinaron mediante citometria de flujo y espectrofotometría. Resultados: Las neuronas corticales incubadas con corticosterona mostraron un aumento de especies reactivas de oxígeno (ROS), del consumo de reserva antioxidante celular (etax), y de la peroxidación lipídica (LOOH) todo ello corno consecuencia de un desequilibrio entre factores pro-oxidantes (ej. daño mitocondrial, NOS) y factores antioxidantes (ej. GSH, SOD). La co-incubación de corticosterona y dosis bajas de IGF-II reequilibra estos factores. Este efecto neuroprotector podría estar mediado al menos en parte por la interacción de IGF-II con sus receptores específicos, ya que su bloqueo origina de nuevo un desequilibro entre los factores antioxidantes/pro-oxidantes. Conclusión: Las dosis bajas de IGF-II ejercen un efecto neuroprotector en situaciones de estrés oxidativo inducido por altos niveles de corticosterona.Laboratorios Lilly (Madrid) por cesion del IGF-II y Ayuda de la Universidad de Malaga. Campus de Excelencia Andalucia Tec

Lymph Node Tumor Burden Correlates With Tumor Budding and Poorly Differentiated Clusters: A New Prognostic Factor in Colorectal Carcinoma?

Factor pronòstic; Carcinoma colorectal; Càrrega tumoralFactor pronóstico; Carcinoma colorrectal; Carga tumoralPrognostic factor; Colorectal Carcinoma; Tumor BurdenINTRODUCTION: Molecular lymph node (LN) staging in early colorectal cancer (CRC) has demonstrated to be more precise than conventional histopathology pN staging. Tumor budding (TB) and poorly differentiated clusters (PDCs) are associated with LN metastases, recurrences, and lower survival in CRC. We evaluated the correlation between the total tumor load (TTL) in LNs from CRC surgical specimens with patient outcome, TB, and PDC. METHODS: In this retrospective multicentre study, 5,931 LNs from 342 stage I–III CRC were analyzed by both hematoxylin and eosin and molecular detection of tumor cytokeratin 19 mRNA by one-step nucleic acid amplification. TB and PDC were evaluated by hematoxylin and eosin and cytokeratin 19 immunohistochemistry. Results: One-step nucleic acid was positive in 38.3% patients (n = 131). Tumor Budding was low in 45% cases, intermediate in 25%, and high in 30%. Poorly Differentiated Clusters were low-grade G1 in 53%, G2 in 32%, and G3 in 15%. TB and PDC correlated with TTL, high-grade, lymphovascular and perineural invasion, pT, pN and stage (P < 0.001). TB, PDC, and TTL ≥ 6,000 copies/µL were associated with worse overall survival (P = 0.002, P = 0.013, and P = 0.046) and disease-free survival (P < 0.001). Discussion: The implementation of more sensitive molecular methods to assess LN status is a promising alternative approach to pN staging, which could be integrated to other factors to help risk stratification and management of patients with early-stage CRC. This study demonstrates the correlation of the amount of LN tumor burden with TB and PDCs. TTL is related to the outcome and could be used as a new prognostic factor in CRC (see Visual Abstract, Supplementary Digital Content 2, https://links.lww.com/CTG/A512).This work was supported by the Instituto de Salud Carlos III (grants PI17/01304 to J.C and M.C; grant PI16/00766 to F.B., and a Miguel Servet grant to J.C, cofunded by the European Regional Development Fund (ERDF) (CPII18/00026), through the Plan Estatal de Investigación Científica y Técnica y de Innovación, and Agència de Gestió d’Ajuts Universitaris i de Recerca (2017SGR653 and 2017SGR1035). CIBERehd is funded by the Instituto de Salud Carlos III. We also acknowledge the support of the CERCA Programme/Generalitat de Catalunya, and the Xarxa de Bancs de Tumors de Catalunya (XBTC)

Evaluación de impacto en la suplementación dietaría con grasas sobrepasantes en porcinos de la raza híbrida PIC en etapas de gestantes 100 días, lactantes y precebos. Caso: granja san Joaquín del municipio de Pauna, Boyacá.

Fotografias Granja Porcicola, tabla de datos, registros de produccion y tablas estadisticasLa contracción económica del sector agropecuario en Colombia ha impulsado a las firmas a optimizar sus recursos de manera que puedan reducir los costos sin afectar la calidad de la producción. El presente documento ilustra el impacto presentado en cerdos de la raza hibrida PIC al suministrar grasas sobre-pasantes como alternativa nutricional, el método de evaluación de emparejamiento revela evidencia empírica suficiente para orientar a los productores sobre el uso de este suplemento energético para la ganancia de peso en explotaciones porcícolas, empleando etapas de hembras gestantes de cien días, lactantes y pre-cebos. Para el experimento se utilizó la granja San Joaquín del municipio de Pauna, Boyacá.The economic contraction of farming sector in Colombia motivate to the different firms to optimize your resources of mode that these can to reduce the costs without affect the quality of the production. The present paper explain the impact obtained in pigs of PIC hybrid breed to provide on-interns fat like nutritional alternative, the evaluation by pair bonding method expose enough empirical evidence for guide to the producers about the use of this energetic supplement for the weight gain in hog holdings, using one hundred Days pregnant females, lactantings and pre-bait stages. The experiment was develops in the “San Joaquin’s” farm from Pauna, Boyacá town

Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm

We reviewed all the available data regarding the current management of non-complex rhegmatogenous retinal detachment and aimed to propose a new decision-making algorithm aimed to improve the single surgery success rate for mid-severity rhegmatogenous retinal detachment. An online review of the Pubmed database was performed. We searched for all available manuscripts about the anatomical and functional outcomes after the surgical management, by either scleral buckle or primary pars plana vitrectomy, of retinal detachment. The search was limited to articles published from January 1995 to December 2015. All articles obtained from the search were carefully screened and their references were manually reviewed for additional relevant data. Our search specifically focused on preoperative clinical data that were associated with the surgical outcomes. After categorizing the available data according to their level of evidence, with randomized-controlled clinical trials as the highest possible level of evidence, followed by retrospective studies, and retrospective case series as the lowest level of evidence, we proceeded to design a logical decision-making algorithm, enhanced by our experiences as retinal surgeons. A total of 7 randomized-controlled clinical trials, 19 retrospective studies, and 9 case series were considered. Additional articles were also included in order to support the observations further. Rhegmatogenous retinal detachment is a potentially blinding disorder. Its surgical management seems to depend more on a surgeon´s preference than solid scientific data or is based on a good clinical history and examination. The algorithms proposed herein strive to offer a more rational approach to improve both anatomical and functional outcomes after the first surgery

Non-infectious granulomatous disorders of the upper lip: clinicopathological analysis of 11 patients

Background Non-infectious granulomatous disorders of the upper lip represent a special chapter of oral and maxillofacial pathology. In this work we report a case-series of this process, to analyse its main clinicopathological features and find differential data that allow us improve its diagnosis and understand its pathogenesis. Methods We present 11 cases of non-infectious granulomatous disorders of the upper lip, 8 women and 3 men with an age range of 29-84 years, who have been attended at the Oral Medicine Department of the IUCT (France) and the Oral Medicine Unit of the UPV/EHU (Spain). All clinicopathological data were collected in a specific protocol. Results We recognized 4 different subtypes of non-infectious granulomatous disorders of the upper lip: (1) associated with Crohn's disease (1 case), (2) associated with foreign body (2 cases), (3) associated with gingivitis lichenoid-like (4 cases), (4) idiopathic (4 cases). Conclusions Clinicopathological differences were identified between these subtypes. A good differential diagnosis is necessary in all cases to rule out the presence of local or systemic etiopathogenic factors

Comportamiento mecánico en función de la temperatura de aleaciones wolframio-vanadio.

En esta investigación se evalúa el comportamiento mecánico del wolframio puro y de dos de sus aleaciones con contenidos de 2% y 4% de vanadio, fabricadas mediante prensado isostático en caliente (HIP). La caracterización mecánica se ha realizado mediante ensayos de flexión en tres puntos en atmósfera oxidante a distintas temperaturas comprendidas entre temperatura ambiente y 1000 ºC. Adicionalmente, se han realizado ensayos en inmersión en nitrógeno líquido para los de -197 ºC. Estos últimos valores pueden servir para una determinación más precisa de la temperatura la transición dúctil-frágil en éstos materiales, y de su posible comportamiento plástico o frágil a temperatura ambiente. Mediante estos ensayos ha sido posible obtener la tenacidad de fractura, la resistencia mecánica, el límite elástico y el módulo de elasticidad en función de la temperatura. Así mismo, se ha determinado la densidad y la dureza Vickers para dos cargas distintas, lo que permitido determinar la influencia de este parámetro en la medida realizada. Adicionalmente, se han examinado mediante microscopia electrónica de barrido las superficies de fractura. De esta forma ha sido posible determinar el modo de rotura y analizar la relación de las propiedades mecánicas macroscópicas con los micromecanismos de fallo involucrados

Detection of EGFR mutations with mutation-specific antibodies in stage IV non-small-cell lung cancer

<p>Abstract</p> <p>Background</p> <p>Immunohistochemistry (IHC) with mutation-specific antibodies may be an ancillary method of detecting EGFR mutations in lung cancer patients.</p> <p>Methods</p> <p>EGFR mutation status was analyzed by DNA assays, and compared with IHC results in five non-small-cell lung cancer (NSCLC) cell lines and tumor samples from 78 stage IV NSCLC patients.</p> <p>Results</p> <p>IHC correctly identified del 19 in the H1650 and PC9 cell lines, L858R in H1975, and wild-type EGFR in H460 and A549, as well as wild-type EGFR in tumor samples from 22 patients. IHC with the mAb against EGFR with del 19 was highly positive for the protein in all 17 patients with a 15-bp (ELREA) deletion in exon 19, whereas in patients with other deletions, IHC was weakly positive in 3 cases and negative in 9 cases. IHC with the mAb against the L858R mutation showed high positivity for the protein in 25/27 (93%) patients with exon 21 EGFR mutations (all with L858R) but did not identify the L861Q mutation in the remaining two patients.</p> <p>Conclusions</p> <p>IHC with mutation-specific mAbs against EGFR is a promising method for detecting EGFR mutations in NSCLC patients. However these mAbs should be validated with additional studies to clarify their possible role in routine clinical practice for screening EGFR mutations in NSCLC patients.</p

A genome-wide association study follow-up suggests a possible role for PPARG in systemic sclerosis susceptibility

Introduction: A recent genome-wide association study (GWAS) comprising a French cohort of systemic sclerosis (SSc) reported several non-HLA single-nucleotide polymorphisms (SNPs) showing a nominal association in the discovery phase. We aimed to identify previously overlooked susceptibility variants by using a follow-up strategy.&lt;p&gt;&lt;/p&gt; Methods: Sixty-six non-HLA SNPs showing a P value &#60;10-4 in the discovery phase of the French SSc GWAS were analyzed in the first step of this study, performing a meta-analysis that combined data from the two published SSc GWASs. A total of 2,921 SSc patients and 6,963 healthy controls were included in this first phase. Two SNPs, PPARG rs310746 and CHRNA9 rs6832151, were selected for genotyping in the replication cohort (1,068 SSc patients and 6,762 healthy controls) based on the results of the first step. Genotyping was performed by using TaqMan SNP genotyping assays. Results: We observed nominal associations for both PPARG rs310746 (PMH = 1.90 × 10-6, OR, 1.28) and CHRNA9 rs6832151 (PMH = 4.30 × 10-6, OR, 1.17) genetic variants with SSc in the first step of our study. In the replication phase, we observed a trend of association for PPARG rs310746 (P value = 0.066; OR, 1.17). The combined overall Mantel-Haenszel meta-analysis of all the cohorts included in the present study revealed that PPARG rs310746 remained associated with SSc with a nominal non-genome-wide significant P value (PMH = 5.00 × 10-7; OR, 1.25). No evidence of association was observed for CHRNA9 rs6832151 either in the replication phase or in the overall pooled analysis.&lt;p&gt;&lt;/p&gt; Conclusion: Our results suggest a role of PPARG gene in the development of SSc