Tumor testicular de saco vitelino con metástasis a pleura: primer caso reportado en la literatura

ResumenEl cáncer testicular es el tumor urológico maligno más común en hombres jóvenes. Más del 90% corresponden a tumores de células germinales. El objetivo del estudio es el reporte del primer caso de cáncer testicular de tumores de células germinales con metástasis a pleura.Paciente masculino de 21 años, inicia su padecimiento con dolor en hemitórax derecho; la radiografía de tórax presenta una radioopacidad en lóbulo medio de pulmón derecho y la tomografía de tórax detecta una masa intratorácica y extrapulmonar. La biopsia torácica guiada por ultrasonido muestra una masa sólida adosada a la pared torácica, con efecto de desplazamiento sobre la pleura, conocido como «efecto en cola de cometa». La biopsia fue positiva para lesión neoplásica maligna poco diferenciada de la pleura. A la exploración encontramos testículo derecho con tumoración en polo inferior el cual se corrobora por ultrasonido. Los marcadores tumorales solo con elevación de alfa-fetoproteína 295.87ng/dL y deshidrogenasa láctica en 2,380UI/L. En la tomografía de abdomen se identificó actividad ganglionar interaortocava. Realizamos orquiectomía radical derecha. Reporte patológico: tumor testicular de saco vitelino, pT1N2M1S2.En este caso se pudo comprobar que las metástasis fueron a nivel pleural, que lo ubica como una forma de diseminación excepcional.AbstractTesticular cancer is the most common malignant urologic tumor in young men. More than 90% are germ cell tumors. The aim of this study was to report the first case of germ cell tumor testicular cancer with metastasis to the pleura.A 21-year-old man had disease onset with pain in the right hemithorax. The chest x-ray showed radio-opacity in the middle lobe of the right lung. A chest tomography scan detected an intrathoracic and extrapulmonary mass. Ultrasound-guided thoracic biopsy revealed a solid mass attached to the thoracic wall, displaced over the pleura, known as the “comet tail effect”. The biopsy was positive for a poorly differentiated malignant neoplastic lesion of the pleura. Upon physical examination we encountered a right testis with a tumor at the lower pole; this was corroborated through ultrasound. In relation to tumor markers, only alpha-fetoprotein was elevated at 295.87ng/dl and lactate dehydrogenase at 2,380 IU/l. An abdominal tomography scan identified interaortocaval lymph node activity. We performed a right radical orchiectomy and the pathology report was testicular yolk sac tumor, pT1N2M1S2.In our patient, metastasis at the level of the pleura was confirmed, making this a case with an exceptional form of spread

3D‐Architected Alkaline‐Earth Perovskites

3D ceramic architectures are captivating geometrical features with an immense demand in optics. In this work, an additive manufacturing (AM) approach for printing alkaline-earth perovskite 3D microarchitectures is developed. The approach enables custom-made photoresists suited for two-photon lithography, permitting the production of alkaline-earth perovskite (BaZrO 3, CaZrO 3, and SrZrO 3) 3D structures shaped in the form of octet-truss lattices, gyroids, or inspired architectures like sodalite zeolite, and C 60 buckyballs with micrometric and nanometric feature sizes. Alkaline-earth perovskite morphological, structural, and chemical characteristics are studied. The optical properties of such perovskite architectures are investigated using cathodoluminescence and wide-field photoluminescence emission to estimate the lifetime rate and defects in BaZrO 3, CaZrO 3, and SrZrO 3. From a broad perspective, this AM methodology facilitates the production of 3D-structured mixed oxides. These findings are the first steps toward dimensionally refined high-refractive-index ceramics for micro-optics and other terrains like (photo/electro)catalysis.</p

Mollicutes antibiotic resistance profile and presence of genital abnormalities in couples attending an infertility clinic.

OBJECTIVE: The present study aimed to identify Mollicutes infection in the reproductive system. We also examined the microbiological, biochemical, and antimicrobial profiles of Mollicutes infection, which are potentially associated with clinical reproductive abnormalities causing infertility in couples. METHODS: Thirty-seven couples who were attending an infertility clinic were enrolled. Detection of genital mycoplasmas was performed in cervicovaginal samples or male urethral swabs. Microbiological culture and biochemical and antimicrobial profiles were characterized using a Mycoplasma kit. The results were associated with reproductive abnormalities, as assessed by medical specialists from the infertility clinic. RESULTS: Up to 28.3% of all biological samples (n = 74) showed positive cultures. Bacterial isolates were Ureaplasma urealyticum (71.4%), Mycoplasma hominis (9.5%), or coinfections (19%). Most Mollicutes showed significant resistance to fluoroquinolones, macrolides, and tetracycline; and showed susceptibility to doxycycline, josamycin, and pristinamycin. The presence of resistant strains to any antibiotic was significantly associated with genital abnormalities (χ2 test, relative risk = 11.38 [95% confidence interval: 5.8-22.9]), particularly in women. The highest statistical association was found for macrolide-resistant strains. CONCLUSION: The microbiological antibiotic resistance profile is epidemiologically associated with abnormalities of the reproductive system in couples attending an infertility clinic

Temporal relationship of serum markers and tissue damage during acute intestinal ischemia/reperfusion

OBJECTIVE: It is essential to identify a serological marker of injury in order to study the pathophysiology of intestinal ischemia reperfusion. In this work, we studied the evolution of several serological markers after intestinal ischemia reperfusion injury in rats. The markers of non-specific cell damage were aspartate aminotransferase, alanine aminotransaminase, and lactic dehydrogenase, the markers of inflammation were tumor necrosis factor alpha, interleukin-6, and interleukin-1 beta, and the markers of intestinal mucosal damage were intestinal fatty acid binding protein and D-lactate. We used Chius classification to grade the histopathological damage. METHODS: We studied 35 Wistar rats divided into groups according to reperfusion time. The superior mesenteric artery was clamped for 30 minutes, and blood and biopsies were collected at 1, 3, 6, 12, 24, and 48 hours after reperfusion. We plotted the mean ¡ standard deviation and compared the baseline and maximum values for each marker using Student’s t-test. RESULTS: The maximum values of interleukin-1 beta and lactic dehydrogenase were present before the maximal histopathological damage. The maximum tumor necrosis factor alpha and D-lactate expressions coincided with histopathological damage. Alanine aminotransaminase and aspartate aminotransferase had a maximum expression level that increased following the histopathological damage. The maximum expressions of interluken-6 and intestinal fatty acid binding protein were not significantly different from the Sham treated group. CONCLUSION: For the evaluation of injury secondary to acute intestinal ischemia reperfusion with a 30 minute ischemia period, we recommend performing histopathological grading, quantification of D-lactate, which is synthesized by intestinal bacteria and is considered an indicator of mucosal injury, and quantification of tumor necrosis factor alpha as indicators of acute inflammation three hours after reperfusion

Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry

Objective: To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes. Methods: Patients from the EAHFE Registry (a multicenter, observational, multipurpose, cohort-designed database including consecutive AHF patients in 41 Spanish EDs) were grouped based on NIV treatment (NIV+ and NIV–groups). Using propensity score (PS) methodology, we identified two subgroups of patients matched by 38 covariates and compared regarding 30-day survival (primary outcome). Interaction was investigated for age, sex, ischemic cardiomyopathy, chronic obstructive pulmonary disease, AHF precipitated by an acute coronary syndrome (ACS), AHF classified as hypertensive or acute pulmonary edema (APE), and systolic blood pressure (SBP). Secondary outcomes were intensive care unit (ICU) admission; mechanical ventilation; in-hospital, 3-day and 7-day mortality; and prolonged hospitalization (>7 days). Results: Of 11, 152 patients from the EAHFE (age (SD): 80 (10) years; 55.5% women), 718 (6.4%) were NIV+ and had a higher 30-day mortality (HR = 2.229; 95%CI = 1.861–2.670) (p 85 years, p < 0.001), AHF associated with ACS (p = 0.045), and SBP < 100 mmHg (p < 0.001). No significant differences were found in the secondary endpoints except for more prolonged hospitalizations in NIV+ patients (OR = 1.445; 95%CI = 1.122–1.862) (p = 0.004). Conclusion: The use of NIV to treat AHF in ED is not associated with improved mortality outcomes and should be cautious in old patients and those with ACS and hypotension

Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study

Objective: To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. Methods: Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH <6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. Results: We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4–11): 2934 (34.3%) had a LOH 15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0–64.9) when LOH was 11–15 days, and by 72.0% (95%CI = 42.6–107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4–36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. Conclusions: Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e. a controlling message) compared to no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly-internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared to the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly-internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing: Controlled motivation was associated with more defiance and less long-term behavioral intentions to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges