Diagnóstico citológico de las recidivas tumorales de ameloblastoma: presentación de dos casos clínicos

Introducción: Los ameloblastomas son los tumores odontogénicos más frecuentes del maxilar. A pesar de su aspecto citohistológico de benignidad, se comportan como tumores invasivos, recidivantes y con posibilidad de metastatizar. La P.A.A.F. es una prueba rápida e incruenta que proporciona un diagnóstico prequirúrgico evitando, en ocasiones, tomas biópsicas destinadas al diagnóstico. Presentamos las características citológicas de dos casos de recidiva yugal de ameloblastoma de rama mandibular diagnosticados por PAAF, así como su correlación citohistológica. Casos clínicos: Dos pacientes, una mujer de 36 años y un varón de 62 años, que acuden por tumoración mandibular de escasos meses de evolución. En ambos casos, la primera aproximación diagnóstica fue junto a los estudios radiológicos el estudio histológico de la masa tumoral. Tras la extirpación terapeútica, ambos casos recidivaron. El diagnóstico de las recidivas fue establecido citológicamente mediante PAAF. Las extensiones citológicas mostraron un fondo granular con aislados macrófagos y células multinucleadas gigantes y una abundante celularidad epitelial de aspecto basaloide dispuesta en grupos cohesivos configurando imágenes de empalizada periférica, así como pequeños grupos de células de metaplasia escamosa. Discusión: La PAAF se considera como un método diagnóstico rápido, incruento y fiable en el diagnóstico del ameloblastoma. La citología de estos tumores revela los componentes de la lesión que, en general, son suficientes para llegar al diagnóstico de ameloblastoma, especialmente en casos de recidiva.Introduction: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, bloodless test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. Clinical cases: Two patients, a 36-year-old woman, and a 62- year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass, together with the radiological studies. Following therapeutic extirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. Discussion: FNAB is considered to be a rapid, bloodless and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially in cases of recurrence

Patient Profiling Based on Spectral Clustering for an Enhanced Classification of Patients with Tension-Type Headache

Profiling groups of patients in clusters can provide meaningful insights into the features of the population, thus helping to identify people at risk of chronification and the development of specific therapeutic strategies. Our aim was to determine if spectral clustering is able to distinguish subgroups (clusters) of tension-type headache (TTH) patients, identify the profile of each group, and argue about potential di erent therapeutic interventions. A total of 208 patients (n = 208) with TTH participated. Headache intensity, frequency, and duration were collected with a 4-week diary. Anxiety and depressive levels, headache-related burden, sleep quality, health-related quality of life, pressure pain thresholds (PPTs), dynamic pressure thresholds (DPT) and evoked-pain, and the number of trigger points (TrPs) were evaluated. Spectral clustering was used to identify clusters of patients without any previous assumption. A total of three clusters of patients based on a main difference on headache frequency were identified: one cluster including patients with chronic TTH (cluster 2) and two clusters including patients with episodic TTH (clusters 0-1). Patients in cluster 2 showed worse scores in all outcomes than those in clusters 0-1. A subgroup of patients with episodic TTH exhibited pressure pain hypersensitivity (cluster 0) similarly to those with chronic TTH (cluster 2). Spectral clustering was able to confirm subgrouping of patients with TTH by headache frequency and to identify a group of patients with episodic TTH with higher sensitization, which may need particular attention and specific therapeutic programs for avoiding potential chronification

A longitudinal study of gene expression in first-episode schizophrenia; exploring relapse mechanisms by co-expression analysis in peripheral blood

Little is known about the pathophysiological mechanisms of relapse in first-episode schizophrenia, which limits the study of potential biomarkers. To explore relapse mechanisms and identify potential biomarkers for relapse prediction, we analyzed gene expression in peripheral blood in a cohort of first-episode schizophrenia patients with less than 5 years of evolution who had been evaluated over a 3-year follow-up period. A total of 91 participants of the 2EPs project formed the sample for baseline gene expression analysis. Of these, 67 provided biological samples at follow-up (36 after 3 years and 31 at relapse). Gene expression was assessed using the Clariom S Human Array. Weighted gene co-expression network analysis was applied to identify modules of co-expressed genes and to analyze their preservation after 3 years of follow-up or at relapse. Among the 25 modules identified, one module was semi-conserved at relapse (DarkTurquoise) and was enriched with risk genes for schizophrenia, showing a dysregulation of the TCF4 gene network in the module. Two modules were semi-conserved both at relapse and after 3 years of follow-up (DarkRed and DarkGrey) and were found to be biologically associated with protein modification and protein location processes. Higher expression of DarkRed genes was associated with higher risk of suffering a relapse and early appearance of relapse (p = 0.045). Our findings suggest that a dysregulation of the TCF4 network could be an important step in the biological process that leads to relapse and suggest that genes related to the ubiquitin proteosome system could be potential biomarkers of relapse. © 2021, The Author(s)

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Clustering analysis reveals different profiles associating long-term post-COVID symptoms, COVID-19 symptoms at hospital admission and previous medical co-morbidities in previously hospitalized COVID-19 survivors

PURPOSE: To identify subgroups of COVID-19 survivors exhibiting long-term post-COVID symptoms according to clinical/hospitalization data by using cluster analysis in order to foresee the illness progress and facilitate subsequent prognosis. METHODS: Age, gender, height, weight, pre-existing medical comorbidities, Internal Care Unit (ICU) admission, days at hospital, and presence of COVID-19 symptoms at hospital admission were collected from hospital records in a sample of patients recovered from COVID-19 at five hospitals in Madrid (Spain). A predefined list of post-COVID symptoms was systematically assessed a mean of 8.4 months (SD 15.5) after hospital discharge. Anxiety/depressive levels and sleep quality were assessed with the Hospital Anxiety and Depression Scale and Pittsburgh Sleep Quality Index, respectively. Cluster analysis was used to identify groupings of COVID-19 patients without introducing any previous assumptions, yielding three different clusters associating post-COVID symptoms with acute COVID-19 symptoms at hospital admission. RESULTS: Cluster 2 grouped subjects with lower prevalence of medical co-morbidities, lower number of COVID-19 symptoms at hospital admission, lower number of post-COVID symptoms, and almost no limitations with daily living activities when compared to the others. In contrast, individuals in cluster 0 and 1 exhibited higher number of pre-existing medical co-morbidities, higher number of COVID-19 symptoms at hospital admission, higher number of long-term post-COVID symptoms (particularly fatigue, dyspnea and pain), more limitations on daily living activities, higher anxiety and depressive levels, and worse sleep quality than those in cluster 2. CONCLUSIONS: The identified subgrouping may reflect different mechanisms which should be considered in therapeutic interventions

An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer.

OBJECTIVE: Malnutrition is frequent in cancer. The objective of this study was to determine the prevalence, in Spain, of malnutrition in cancer patients with advanced disease and to assess the therapeutic focus. METHODS: A total of 781 patients were evaluated to determine individual nutritional status using the Scored Patient Generated-Subjective Global Assessment (Scored PG-SGA) questionnaire. Almost 60% of the patients included were receiving cancer treatment. RESULTS: Patients with the highest weight loss were those with tumours of oesophagus (57%), stomach (50%) and larynx (47%). Serious eating problems were encountered by 68% of the patients; the principal problem being anorexia (42.2%). The median number of symptoms impeding food intake was 2. According to the Scored PG-SGA, 52% of the patients were moderately or severely malnourished and 97.6% required some form of nutritional intervention/recommendation. CONCLUSIONS: (a) the majority of patients in the study needed nutritional intervention; (b) more than 50% had moderate or severe malnutrition; (c) the Scored PG-SGA is a useful and simple tool for evaluating nutritional status and contains additional information on nutritional recommendations; (d) nutritional evaluation of the cancer patients needs to be improved so as to offer better treatment of symptoms and to improve the patient's quality of life

Reply to Ayuso García et al. Health Perception among Female COVID-19 Patients. Comment on "Fernández-de-las-Peñas et al. Female Sex Is a Risk Factor Associated with Long-Term Post-COVID Related-Symptoms but Not with COVID-19 Symptoms: The LONG-COVID-EXP-CM Multicenter Study. J. Clin. Med. 2022, 11, 413"

We have read with great interest the comment by Ayuso García et al [...

Laser-driven neutrons for time-of-flight experiments?

Neutron beams, both pulsed and continuous, are a powerful tool in a wide variety of research fields and applications. Nowadays, pulsed neutron beams are produced in conventional accelerator facilities in which the time-of-fight technique is used to determine the kinetic energy of the neutrons inducing the reactions of interest. In the last decades, the development of ultra-short (femtosecond) and ultra-high power (> 1018 W/cm2) lasers has opened the door to a vast number of new applications, including the production and acceleration of pulsed ion beams. These have been recently used to produce pulsed neutron beams, reaching fluxes per pulse similar and even higher than those of conventional neutron beams, hence becoming an alternative for the pulsed neutron beam users community. Nevertheless, these laser-driven neutrons have not been exploited in nuclear physics experiments so far. Our main goal is to produce and characterize laser-driven neutrons but optimizing the analysis, diagnostic and detection techniques currently used in conventional neutron sources to implement them in this new environment. As a result, we would lay down the viability of carrying out nuclear physics experiments using this kind of sources by identifying the advantages and limitations of this production method. To achieve this purpose, we plan to perform experiments in both medium (50TW@L2A2, in Santiago de Com-postela) and high (1PW@APOLLON, in Paris) power laser facilities

Laser-driven neutrons for time-of-flight experiments?

Neutron beams, both pulsed and continuous, are a powerful tool in a wide variety of research fields and applications. Nowadays, pulsed neutron beams are produced in conventional accelerator facilities in which the time-of-fight technique is used to determine the kinetic energy of the neutrons inducing the reactions of interest. In the last decades, the development of ultra-short (femtosecond) and ultra-high power (> 1018 W/cm2) lasers has opened the door to a vast number of new applications, including the production and acceleration of pulsed ion beams. These have been recently used to produce pulsed neutron beams, reaching fluxes per pulse similar and even higher than those of conventional neutron beams, hence becoming an alternative for the pulsed neutron beam users community. Nevertheless, these laser-driven neutrons have not been exploited in nuclear physics experiments so far. Our main goal is to produce and characterize laser-driven neutrons but optimizing the analysis, diagnostic and detection techniques currently used in conventional neutron sources to implement them in this new environment. As a result, we would lay down the viability of carrying out nuclear physics experiments using this kind of sources by identifying the advantages and limitations of this production method. To achieve this purpose, we plan to perform experiments in both medium (50TW@L2A2, in Santiago de Com-postela) and high (1PW@APOLLON, in Paris) power laser facilities