Carcinoma gengival: um relatório de caso

Squamous-cell carcinoma is a malignant epithelial neoplasm characterized by various clinical manifestations. Present study aimed to report a case of gingival squamous-cell carcinoma in a who patient did not present risk factors associated with the referred neoplasm. A 95-year-old female, attended dental services exposing a rapidly growing, painful proliferative lesion of 6 months of evolution, located in vestibular marginal gingiva, which affected teeth # 33-32-31-43-42-41. According to clinical symptoms and differential diagnosis (central giant cell granuloma and malignant neoplasm), an excisional biopsy was obtained. Diagnosis of referred carcinoma was obtained after three days of patient decease consequent to a severe dyspnea case. Gingival squamous-cell carcinoma is a condition that usually has a good prognostic when diagnostic and treatment are established on time. This study reports a clinical case of a patient who died before having an opportunity to access treatment.El carcinoma de células escamosas o escamocelular es una neoplasia epitelial maligna que se caracteriza por que sus manifestaciones clínicas son variadas. El objetivo de este artículo es presentar el caso clínico de un paciente con carcinoma gingival de células escamosas, sin antecedentes de factores de riesgo comunes para el desarrollo de esta neoplasia. Mujer de 95 años con un historial de 6 meses de una lesión proliferativa dolorosa y de rápido crecimiento en la encía marginal vestibular de los dientes # 33-32-31-43-42-41. De acuerdo con los signos y síntomas clínicos, se da una impresión clínica de carcinoma gingival y un diagnóstico diferencial de granuloma central de células gigantes, se tomó una biopsia por escisión de la lesión. El diagnóstico fue de carcinoma de células escamosas. Después de tres días, la paciente falleció en el hospital por un cuadro de disnea severa que le produjo un paro cardiorrespiratorio. El carcinoma gingival de células escamosas es una afección con un buen pronóstico cuando se diagnostica y trata a tiempo, este articulo informó un caso de un paciente que falleció antes de realizar un tratamiento a lesión tumoral.O carcinoma de células escamosas é uma neoplasia epitelial maligna caracterizada por manifestações clínicas variáveis. O objetivo deste estudo foi relatar um caso de carcinoma espinocelular, no qual o paciente não apresentava fatores de risco para o desenvolvimento dessa neoplasia. Uma mulher de 95 anos de idade foi observada com 6 meses de história de uma lesão proliferativa dolorosa de crescimento rápido na gengiva marginal vestibular na zona dos dentes # 33-32-31-43-42-41. Assim, diante dos sintomas clínicos e do diagnóstico diferencial de granuloma central de células gigantes e neoplasia maligna, foi obtida uma biópsia excisional da lesão.Foi feito o diagnóstico de carcinoma espinocelular. Após três dias, o paciente falecido no hospital apresentou dispnéia grave. O carcinoma de células escamosas gengival é uma condição com bom prognóstico quando diagnosticado e tratado precocemente. Este estudo relatou um caso de paciente que morreu antes de realizar um tratamento tumoral

High risk serotypes of the human papillomavirus (hpv) in patients With exofitic lesions in the oral cavity

Introduction: Oral squamous cell carcinoma has been associated with risk factors such as: tobacco consumption, alcohol and human papillomavirus, the authors determined the prevalence of high-risk serotypes of human papillomavirus infection in exofitic lesions of the oral cavity in a Cartagena hospital during the year 2014-2015. Material and Methods: an observational, descriptive, prospective and cross-sectional study was performed on 73 patients with verrucous lesions in the oral cavity, in which socio- demographic characteristics and the clinical and histopathological diagnosis were determined, and high-risk HPV was identified. The study complied with legal and ethical standards. The results were analyzed using descriptive statistics with the Stata v13.2 program. Results: The prevalence of HPV in the study population during the period 2014-2015 was 9.59% (n: 7). in none of the positive HPV cases in the histopathological study, any high-risk genotype was identified by the real-time multiplex PCR assay. HPV infection was more prevalent in patients in the third decade of life (29.5 years, DS ± 10.60), mean age was 62.8 years SD ± 17.74. The population came mainly from the rural area. The most common site was the labial mucosa. There was a relationship between smoking and the presence of HPV. Discussions: In the present study, no relationship of high risk HPV genotypes was found in the evaluated samples

Solar Reflector Materials Degradation Due to the Sand Deposited on the Backside Protective Paints

Concentrating solar power (CSP) Technologies are foreseen to be a crucial actor in the future renewable energy mix. Soil accumulation on the optical surfaces of CSP plants involves significant expenses of the operation and maintenance activities because a high cleanliness level is required to achieve proper plant revenues. Normally, only the front side of the solar reflectors is cleaned to reflect the maximum possilbe amount of direct solar radiation towards the receiver. However, soil depoisted on the backside of the reflector could provoke degradation and might need to be considered in the cleaning strategyAs this possible degradation has never been studied, this work is dedicated to assess if the backside of refelctros should be regularly cleaned. The influence of the sand in the possible paint degradation depends on its chemical composition and the weather conditions. Therefore, several climatic conditions of artificially soiled reflector samples with different types of sand were simulated in accelerated aging tests. Concerning the results obtained, the ambient conditions simulated by the damp heat and thermal cycling tests were the only ones that produced a significant degradation of the backside paints. Also, the sand from Ouarzazate was responsible for higher Deterioration

Incorporation of Eye-Tracking and Gaze Feedback to Characterize and Improve Radiologist Search Patterns of Chest X-rays: A Randomized Controlled Clinical Trial

Diagnostic errors in radiology often occur due to incomplete visual assessments by radiologists, despite their knowledge of predicting disease classes. This insufficiency is possibly linked to the absence of required training in search patterns. Additionally, radiologists lack consistent feedback on their visual search patterns, relying on ad-hoc strategies and peer input to minimize errors and enhance efficiency, leading to suboptimal patterns and potential false negatives. This study aimed to use eye-tracking technology to analyze radiologist search patterns, quantify performance using established metrics, and assess the impact of an automated feedback-driven educational framework on detection accuracy. Ten residents participated in a controlled trial focused on detecting suspicious pulmonary nodules. They were divided into an intervention group (received automated feedback) and a control group. Results showed that the intervention group exhibited a 38.89% absolute improvement in detecting suspicious-for-cancer nodules, surpassing the control group's improvement (5.56%, p-value=0.006). Improvement was more rapid over the four training sessions (p-value=0.0001). However, other metrics such as speed, search pattern heterogeneity, distractions, and coverage did not show significant changes. In conclusion, implementing an automated feedback-driven educational framework improved radiologist accuracy in detecting suspicious nodules. The study underscores the potential of such systems in enhancing diagnostic performance and reducing errors. Further research and broader implementation are needed to consolidate these promising results and develop effective training strategies for radiologists, ultimately benefiting patient outcomes.Comment: Submitted for Review in the Journal of the American College of Radiology (JACR

Risk related to pre–diabetes mellitus and diabetes mellitus in heart failure with reduced ejection fraction: insights from prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial

Background—The prevalence of pre–diabetes mellitus and its consequences in patients with heart failure and reduced ejection fraction are not known. We investigated these in the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial. Methods and Results—We examined clinical outcomes in 8399 patients with heart failure and reduced ejection fraction according to history of diabetes mellitus and glycemic status (baseline hemoglobin A1c [HbA1c]: <6.0% [<42 mmol/mol], 6.0%–6.4% [42–47 mmol/mol; pre–diabetes mellitus], and ≥6.5% [≥48 mmol/mol; diabetes mellitus]), in Cox regression models adjusted for known predictors of poor outcome. Patients with a history of diabetes mellitus (n=2907 [35%]) had a higher risk of the primary composite outcome of heart failure hospitalization or cardiovascular mortality compared with those without a history of diabetes mellitus: adjusted hazard ratio, 1.38; 95% confidence interval, 1.25 to 1.52;P<0.001. HbA1c measurement showed that an additional 1106 (13% of total) patients had undiagnosed diabetes mellitus and 2103 (25%) had pre–diabetes mellitus. The hazard ratio for patients with undiagnosed diabetes mellitus (HbA1c, >6.5%) and known diabetes mellitus compared with those with HbA1c<6.0% was 1.39 (1.17–1.64); P<0.001 and 1.64 (1.43–1.87); P<0.001, respectively. Patients with pre–diabetes mellitus were also at higher risk (hazard ratio, 1.27 [1.10–1.47];P<0.001) compared with those with HbA1c<6.0%. The benefit of LCZ696 (sacubitril/valsartan) compared with enalapril was consistent across the range of HbA1c in the trial. Conclusions—In patients with heart failure and reduced ejection fraction, dysglycemia is common and pre–diabetes mellitus is associated with a higher risk of adverse cardiovascular outcomes (compared with patients with no diabetes mellitus and HbA1c <6.0%). LCZ696 was beneficial compared with enalapril, irrespective of glycemic status

Comparing the microstructure and photovoltaic performance of 3 perylene imide acceptors with similar energy levels but different packing tendencies

[Abstract] While it is widely recognized that microstructure plays an important role in the performance of organic photovoltaics (OPV), systematic studies are often challenging, as varying the molecular packing through typical chemical means (such as sidechain tuning) often affects the molecular energy levels, thus preventing a clear correlation. In this work we present the synthesis of three perylene imide (PI) based electron acceptors with almost identical energy levels, but distinct packing tendencies. We confirm our initial hypothesis by measuring solution and solid-state absorption, and cyclic voltammetry as well as characterizing the films by grazing incidence wide angle X-ray scattering (GIWAXS). In a second step, we repeat the characterization of the three materials in blends with two polymer donors, namely PCDTBT or PBDBT, whose energy levels are well aligned with those of the PI acceptors, and which, additionally, exhibit different degrees of structural order. We show how the initial strong difference between acceptors is partially blurred in blends, but still critical. Finally, we correlate our structural data with OPV devices made with the corresponding six blends. Our data suggest that a good donor acceptor marriage should ensure good energy alignment but also exhibit complementary crystallization tendencies of the two components.Ministerio de Ciencia e Innovación; CEX2019-000917-SMinisterio de Ciencia e Innovación; PGC2018-095411-B-I00Ministerio de Ciencia e Innovación; PID2019-106268GB-C33MInisterio de Ciencia e Innovación; PID2019-110305GB-I00Universidad Complutense de Madrid; INV.GR.00.1819.10759Universidad Complutense de Madrid; CT20/19-CT21/19/PEJD-2018-POST/IND-8661PAIJunta de Andalucía; UMA18-FEDERJA-08

Jeux péritextuels : "Quel petit vélo à guidon chromé au fond de la cour?" de Georges Perec

Chez Perec, style, techniques narratives, règles génériques deviennent prétexte au ludique. Toutefois, se jouer des conventions littéraires suppose qu'elles sont familières au lecteur. Or, s'il sait reconnaître les conventions du récit fictif traditionnel, sait-il toujours identifier les entorses qui y sont faites? Il faut que les jeux proposés se présentent ouvertement. Dans Quel petit vélo , le jeu commence par la remise en cause des fonctions et des conventions du péritexte (défini par Genette comme les éléments « situés autour du texte mais dans l'espace du même volume ») et jette une nouvelle lumière sur les possibilités du livre en tant que production et objet de consommation.In Perec's writing, style, narrative techniques, generic rules are always conducing to the ludic purpose of the author. Yet, playing with literary conventions assumes familiarity with these on the part of the reader. Now, if he can recognize the conventions of traditional narrative fiction, does it follow that he will also identify the dislocations done to them? It is necessary that the games proposed by the text should be overtly presented. In Quel petit vélo the game begins by questioning the functioning and conventions of what Genette defines as the "peritext" (those elements "situated around the text but within the book") and sheds new light on the possibilities of the book as both production and article of consumption

Comparing the microstructure and photovoltaic performance of 3 perylene imide acceptors with similar energy levels but different packing tendencies

While it is widely recognized that microstructure plays an important role in the performance of organic photovoltaics (OPV), systematic studies are often challenging, as varying the molecular packing through typical chemical means (such as sidechain tuning) often affects the molecular energy levels, thus preventing a clear correlation. In this work we present the synthesis of three perylene imide (PI) based electron acceptors with almost identical energy levels, but distinct packing tendencies. We confirm our initial hypothesis by measuring solution and solid-state absorption, cyclic voltammetry as well as characterizing the films by grazing incident wide angle X-ray scattering (GIWAXS). In a second step, we repeat the characterization of the three materials in blends with two polymer donors, namely PCDTBT or PBDBT, whose energy levels are well aligned with those of the PI acceptors, and which, additionally, exhibit different degrees of structural order. We show how the initial strong difference between acceptors is partially blurred in blends, but still critical. Finally, we correlate our structural data with OPV devices made with the corresponding six blends. Our data suggest that a good donor acceptor marriage should ensure good energy alignment but also exhibit complementary crystallization tendencies of the two components.The authors acknowledge financial support from the Spanish Ministry of Science and Innovation through the Severo Ochoa” Program for Centers of Excellence in R&D (No. CEX2019-000917-S), and projects PGC2018-095411-B-I00, PID2019-106268GB-C33 and PID2019-110305GB-I00, as well as the European Commission through the Horizon 2020 Marie Sklodowska-Curie ITN Programme, SEPOMO, Grant Number: 722651, and the UCM (INV.GR.00.1819.10759). E.G. specially acknowledges Comunidad de Madrid and Universidad Complutense de Madrid for a post-doctoral contract (CT20/19- CT21/19/PEJD-2018-POST/IND-8661PAI). M.J.A.N. acknowledges URJC for a post-doctoral contract. R.P.O and A.H. also acknowledge support from Junta de Andalucía (projects UMA18-FEDERJA-080). We acknowledge support of the publication fee by the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI).Peer reviewe

Geographic variations in the PARADIGM-HF heart failure trial

Aims: The globalization of clinical trials has highlighted geographic variations in patient characteristics, event rates, and treatment effects. We investigated these further in PARADIGM-HF, the largest and most globally representative trial in heart failure (HF) to date. Methods and results: We looked at five regions: North America (NA) 622 (8%), Western Europe (WE) 1680 (20%), Central/Eastern Europe/Russia (CEER) 2762 (33%), Latin America (LA) 1413 (17%), and Asia-Pacific (AP) 1487 (18%). Notable differences included: WE patients (mean age 68 years) and NA (65 years) were older than AP (58 years) and LA (63 years) and had more coronary disease; NA and CEER patients had the worst signs, symptoms, and functional status. North American patients were the most likely to have a defibrillating-device (53 vs. 2% AP) and least likely prescribed a mineralocorticoid receptor antagonist (36 vs. 61% LA). Other evidence-based therapies were used most frequently in NA and WE. Rates of the primary composite outcome of cardiovascular (CV) death or HF hospitalization (per 100 patient-years) varied among regions: NA 13.5 (95% CI 11.7–15.6), WE 9.6 (8.6–10.6), CEER 12.3 (11.4–13.2), LA 11.2 (10.0–12.5), and AP 12.5 (11.3–13.8). After adjustment for prognostic variables, relative to NA, the risk of CV death was higher in LA and AP and the risk of HF hospitalization lower in WE. The benefit of sacubitril/valsartan was consistent across regions. Conclusion: There were many regional differences in PARADIGM-HF, including in age, symptoms, comorbidity, background therapy, and event-rates, although these did not modify the benefit of sacubitril/valsartan