Prevalence of Lynch Syndrome among Patients with Newly Diagnosed Endometrial Cancers

Background: Lynch syndrome (LS) is a hereditary condition that increases the risk for endometrial and other cancers. The identification of endometrial cancer (EC) patients with LS has the potential to influence life-saving interventions. We aimed to study the prevalence of LS among EC patients in our population. Methods: Universal screening for LS was applied for a consecutive series EC. Tumor testing using microsatellite instability (MSI), immunohistochemistry (IHC) for mismatch-repair (MMR) protein expression and MLH1-methylation analysis, when required, was used to select LS-suspicious cases. Sequencing of corresponding MMR genes was performed. Results: One hundred and seventy-three EC (average age, 63 years) were screened. Sixty-one patients (35%) had abnormal IHC or MSI results. After MLH1 methylation analysis, 27 cases were considered suspicious of LS. From these, 22 were contacted and referred for genetic counseling. Nineteen pursued genetic testing and eight were diagnosed of LS. Mutations were more frequent in younger patients (<50 yrs). Three cases had either intact IHC or MSS and reinforce the need of implement the EC screening with both techniques. Conclusion: The prevalence of LS among EC patients was 4.6% (8/173); with a predictive frequency of 6.6% in the Spanish population. Universal screening of EC for LS is recommended.This study was supported by Conselleria Sanidad Comunidad Valenciana, Spain (AP/177/10) (http://www.san.gva.es/); Biomedical Research Foundations of the Alicante University Hospital (PI14/2006 and NI02/2011) (http://www.dep19.san.gva.es/); and the Elche University Hospital, Spain (FIBElx-CO11/03) (http://www.dep20.san.gva.es/)

Interdependence between training and magnetization reversal in granular Co-CoO exchange bias systems

The interdependence between training and magnetization reversal in granular Co-CoO exchange bias (EB) systems prepared byOion implantation inCo thin films is demonstrated by polarized neutron reflectometry. While high-fluence O-implanted thin films show reduced relative training values and no asymmetry in magnetization reversal (all reversals take place by domain wall nucleation and motion), low-fluence O ion implantation results in an increased relative training and a magnetization reversal asymmetry between the first descending and the first ascending branches. Whereas the untrained decreasing field reversal occurs mainly by domain wall nucleation and motion, traces of a domain rotation contribution are evidenced in the increasing field reversal. This is explained by the evolution of the CoO structure and the contribution of the out-of-plane magnetization with ion implantation. The amount of incorporated O, which determines the threshold between both behaviors, is around 20 at.%. This reveals that the interdependence between training and magnetization reversal is insensitive to the morphology of the constituents (i.e., granular or layered), indicating that this is an intrinsic EB effect, which can be conveniently tailored by the interplay between the intrinsic properties of the investigated materials and ion implantation

A new reversal mode in exchange coupled antiferromagnetic/ferromagnetic disks: distorted viscous vortex

Magnetic vortices have generated intense interest in recent years due to their unique reversal mecha-nisms, fascinating topological properties, and exciting potential applications. In addition, the exchangecoupling of magnetic vortices to antiferromagnets has also been shown to lead to a range of novelphenomena and functionalities. Here we report a new magnetization reversal mode of magnetic vorticesin exchange coupled Ir20Mn80/Fe20Ni80microdots: distorted viscous vortex reversal. In contrast to thepreviously known or proposed reversal modes, the vortex is distorted close to the interface and viscouslydragged due to the uncompensated spins of a thin antiferromagnet, which leads to unexpected asymme-tries in the annihilation and nucleationfields. These results provide a deeper understanding of the physicsof exchange coupled vortices and may also have important implications for applications involvingexchange coupled nanostructure

Spontaneous formation of spiral-like patterns with distinct periodic physical properties by confined electrodeposition of Co-In disks

Spatio-temporal patterns are ubiquitous in different areas of materials science and biological systems. However, typically the motifs in these types of systems present a random distribution with many possible different structures. Herein, we demonstrate that controlled spatio-temporal patterns, with reproducible spiral-like shapes, can be obtained by electrodeposition of Co-In alloys inside a confined circular geometry (i.e., in disks commensurate with the typical size of the spatio-temporal features). These patterns are mainly of compositional nature, i.e., with virtually no topographic features. Interestingly, the local changes in composition lead to a periodic modulation of the physical (electric, magnetic and mechanical) properties. Namely, the Co-rich areas show higher saturation magnetization and electrical conductivity and are mechanically harder than the In-rich ones. Thus, this work reveals that confined electrodeposition of this binary system constitutes an effective procedure to attain template-free magnetic, electric and mechanical surface patterning with specific and reproducible shapes

Actuaciones de Sanidad Ambiental frente al mosquito tigre en la Comunitat Valenciana (2014-2017)

El mosquito tigre, Aedes albopictus, se ha expandido por el arco mediterráneo español, incluyendo la Comunitat Valenciana. Tiene capacidad para transmitir al menos 22 arbovirosis, como dengue, enfermedad por virus de chikunguña y zika. Desde la Direcció General de Salut Pública, de la Conselleria de Sanitat Universal i Salut Pública, se han puesto en marcha actuaciones de vigilancia y control de la especie y de las enfermedades derivadas. Para abordar la lucha contra este vector se creó, desde Sanidad Ambiental, un grupo de trabajo multidisciplinar que incluye a técnicos de la administración autonómica y local así como a entomólogos universitarios. Posteriormente, se constituyó la Comisión Institucional, de ámbito directivo, donde se adquirieron compromisos clave y se impulsaron programas con actuaciones concretas. La Direcció General de Salut Pública, trabaja conjuntamente con el Laboratorio de Entomología y Control de Plagas de la Universitat de València, para dar cumplimiento a los objetivos fijados

Atuações de Saúde Ambiental perante o mosquito tigre na Comunidade Valenciana (2014-2017)

The Asian tiger mosquito, Aedes albopictus, has spread across the Spanish Mediterranean area, including the Autonomous Region of Valencia. This mosquito is capable of transmitting at least 22 arboviruses such as Dengue, Chikungunya and Zika.The Regional Public Health and Universal Healthcare Ministry’s Directorate General of Public Health has launched several initiatives to monitor and control this species as well as any diseases caused by it. The Environmental Health Area set up a multidisciplinary work group, which includes technicians from both the regional and local administrations and university entomologists, to lead the fight against this vector.An Institutional Commission –with a managerial scope— was subsequently established that has reached key commitments and launched programs with specific actions.The Directorate General of Public Health is working together with the University of Valencia’s Entomology and Pest Control Laboratory to accomplish the goals that have been set.El mosquito tigre, Aedes albopictus, se ha expandido por el arco mediterráneo español, incluyendo la Comunitat Valenciana. Tiene capacidad para transmitir al menos 22 arbovirosis, como dengue, enfermedad por virus de chikunguña y zika. Desde la Direcció General de Salut Pública, de la Conselleria de Sanitat Universal i Salut Pública, se han puesto en marcha actuaciones de vigilancia y control de la especie y de las enfermedades derivadas. Para abordar la lucha contra este vector se creó, desde Sanidad Ambiental, un grupo de trabajo multidisciplinar que incluye a técnicos de la administración autonómica y local así como a entomólogos universitarios. Posteriormente, se constituyó la Comisión Institucional, de ámbito directivo, donde se adquirieron compromisos clave y se impulsaron programas con actuaciones concretas. La Direcció General de Salut Pública, trabaja conjuntamente con el Laboratorio de Entomología y Control de Plagas de la Universitat de València, para dar cumplimiento a los objetivos fijados.O mosquito tigre, Aedes albopictus, expandiu-se pelo arco mediterrâneo espanhol, onde se inclui a Comunidade Valenciana. Tem capacidade de transmitir pelo menos 22 arbovírus, como dengue, doenças pelosvírus de Chikungunya e Zika. A Direção Geral de Saúde Pública, do Departamento de Sanidade Universal e Saúde Pública, desencadeou ações de vigilância e controle das espécies e doenças derivadas. Para enfrentar a luta contra este vetor, foi criado, um grupo de Saúde Ambiental, de trabalho multidisciplinar, que inclui técnicos da administração regional e local, bem como entomologistas universitários. Posteriormente, constituiu-se uma Comissão Institucional, a nível diretivo, onde se definiram compromissos-chave e impulsionaram programas com atuações concretas. A Direção Geral de Saúde Pública, do Departamento de Sanidade Universal e Saúde Pública, trabalha em conjunto com o Laboratório de Entomologia e Controlo de Pragas da Universidade de Valência, para o cumprimento dos objetivos definidos

Socio-cultural, historical, political and economic dimensions of health and medicine

Health is one of the most important areas of human development and, along with quality of life, occupies a prominent place in the academic world, being studied from various theoretical perspectives and from different scientific disciplines. These studies try to explain, from the micro to the macro, what it means and what elements are involved in the health of individuals in particular and of society in general. However, given the diversity of perspectives, there is no consensus on the definition of health. At the beginning, the study of health focused on biomedical research into disease. This approach has shown its limits in understanding health in its most complete dimension, as defined by the World Health Organization as early as 1946 : “ health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity ” ( preamble to the WHO Constitution, 1946 ). This “ positive ” orientation of health is later taken up as a universal human right ( Declaration of Human Rights, art. 25 ), being considered today not only a right, but also a value in itself, an aspiration and a social demand....Peer reviewe

Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 +/- 20.6% vs 93.6 +/- 20.6%, P < 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 +/- 5.2 mm vs 19.9 +/- 6.7 mm, P < 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P < 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P < 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

Impact of interstitial lung disease on the survival of systemic sclerosis with pulmonary arterial hypertension

To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included. PAH-SSc patients had worse NYHA-functional class (NYHA-FC), worse forced vital capacity (FVC) (81.2 ± 20.6% vs 93.6 ± 20.6%, P &lt; 0.001), worse tricuspid annular plane systolic excursion (TAPSE) (17.4 ± 5.2 mm vs 19.9 ± 6.7 mm, P &lt; 0.001), higher incidence of pericardial effusion (30% vs 5.2%, P &lt; 0.001) and similar prevalence of ILD (41.8% vs. 44.9%). In individuals with PAH-SSc, ILD was associated with worse hemodynamics and pulmonary function tests (PFT). Up-front combination therapy was used in 59.8% and 61.7% of patients with and without ILD, respectively. Five-year transplant-free survival rate was 41.1% in PAH-SSc patients and 93.9% in non-PAH-SSc patients (P &lt; 0.001). Global survival of PAH-SSc patients was not affected by ILD regardless its severity. The multivariate survival analysis in PAH-SSc patients confirmed age at diagnosis, worse NYHA-FC, increased PVR, reduced DLCO, and lower management with up-front combination therapy as major risk factors. In conclusion, in PAH-SSc cohort risk of death was greatly increased by clinical, PFT, and hemodynamic factors, whereas it was decreased by up-front combination therapy. Concomitant ILD worsened hemodynamics and PFT in PAH-SSc but not survival regardless of FVC impairment

Staging Parkinson’s Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life

COPPADIS Study Group.[Introduction] In a degenerative disorder such as Parkinson’s disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr’s motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient’s quality of life (QoL) with regard to a defined clinical stage.[Materials and Methods] Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0–20; B: NMSS = 21–40; C: NMSS = 41–70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale.[Results] A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB (). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively (; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; ).[Conclusion] The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden.Peer reviewe