Utilidad de la ecografía intraparto: manejo en las distocias de rotación

La posición occipito posterior supone la malrotación de la cabeza fetal más frecuente en nuestro medio. Su importancia radica en las complicaciones tanto obstétricas como fetales que se derivan de su aparición. La realización de una ecografía vía abdominal en la segunda fase de parto en aquellas gestantes en las que se sospecha esta variante, evaluando la posición de la cabeza y el dorso fetal puede ser un predictor del éxito del parto vaginal. Para establecer si existe alguna asociación se diseña un estudio prospectivo y analítico que nos permita determinar si existen diferencias entre una posición posterior con un dorso fetal anterior vs un dorso fetal posterior. Se valora la repercusión de esta situación sobre la finalización de la gestación. Se recogen además características epidemiológicas tanto maternas como fetales de los casos incluidos en el estudio

Síndrome Genitourinario de la Menopausia. Impacto en la calidad de vida relacionada con la salud en las mujeres con cáncer de mama

Se ha realizado un estudio observacional prospectivo de cohortes analítico, en el que se incluyen 122 pacientes postmenopáusicas clasificadas en dos grupos en función de haber padecido cáncer de mama o no. El objetivo es valorar el impacto del SGM en relación a la calidad de vida en pacientes supervivientes a cáncer de mama, comparar su afectación subjetiva con las mujeres postmenopaúsicas sin cáncer de mama y estudiar los factores clínico-demográficos en ambos grupos.<br /

Mutaciones patogénicas en pacientes de alto riesgo para Cáncer de Mama y Ovario del área sanitaria II de Aragón: Prevalencia y características clínico-patológicas.

Introducción: La evidencia actual ha demostrado que en el cáncer de mama y ovario existe un componente hereditario de tipo poligénico en el que influyen diversas variantes patogénicas. Las mutaciones en los genes implicados confieren un riesgo mayor de padecer dicha enfermedad, que varía en función de la susceptibilidad del gen. Así, a esta entidad se le conoce como Síndrome de cáncer de mama y ovario hereditario. Objetivos: Determinar la prevalencia de mutaciones patogénicas en pacientes de alto riesgo para cáncer de mama y ovario en el área sanitaria II de Aragón y describir las características clínico-patológicas de estas neoplasias. Material y métodos: Se ha realizado un estudio transversal descriptivo retrospectivo en el que se evaluaron 210 pacientes desde enero de 2016 a diciembre de 2020. El estudio genético se ha hecho mediante muestras obtenidas en sangre periférica. En pacientes sin familiares con mutación conocida se realizó una secuenciación masiva de un panel de 21 genes mientras que las mutaciones conocidas en familiares se analizaron mediante la técnica de amplificación de sondas dependiente de ligandos múltiples (MLPA). Paralelamente, se ha realizado una revisión bibliográfica en las siguientes bases de datos: PUBMED, Web of Science, Dialnet, Scopus, SEOM.Resultados: Se han registrado 210 mutaciones de las cuales 93 se han producido en el gen BRCA1, 82 en BRCA2 y 35 en otros genes. Las mutaciones en genes no BRCA más frecuentes se han registrado en BRIP1 con 14 casos (6.7%) seguido del gen ATM con 9 casos (4.3%). Entre las familias con miembros portadores la mayoría han presentado el mismo tipo de mutación. Discusión y conclusiones: El perfil de pacientes observado con este síndrome hereditario se corresponde con mujeres jóvenes con fuerte agregación familiar, en las que se ha evidenciado un alto riesgo de cáncer de mama triple negativo. El análisis de las variantes patogénicas de alto riesgo, a pesar de que incluya a un pequeño porcentaje de las mujeres afectas por estas neoplasias, es una importante medida preventiva con un gran impacto en su supervivencia <br /

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Prenatal diagnosis of umbilical cord cyst: Clinical significance and prognosis

Objective: Clarify the prognosis of the prenatal ultrasound diagnosis of umbilical cord cysts at any gestation trimester and to assess the ultrasound findings and chromosomal alterations associated to this entity. Materials and methods: Between 2003 and 2015 a multicenter study was carried out, collecting, in five centers in Spain, the associated findings and perinatal outcomes of 27 cases of umbilical cord cysts, regardless of gestational age of diagnosis. A bibliographic review was conducted to identify previous studies in order to compare them with our data. Results: In our sample, the prognosis of this finding and the neonatal outcome, when isolated, is favorable, regardless of gestational age at diagnosis, multiple or unique presentation or vanishing or persistent cysts. Conclusions: It is important to properly assess the umbilical cord cyst and when is diagnosed, it is recommended to conduct a meticulous ultrasound examination searching for other associated malformations. In our study the prognosis of this finding seems to be favorable when isolated. Also, there is no relation between prognosis and gestation weeks at diagnosis. On the other hand, when we find this entity with associated anomalies, it is recommended to assess the need to carry out a karyotype

Immobilization of Polyoxometalates on Tailored Polymeric Surfaces

Herein we describe the preparation of hybrid polymer–inorganic interfaces by the immobilization of polyoxometalate nanoclusters on functionalized polymer surfaces. The polymeric surfaces were made of polystyrene-b-poly(acrylic acid)/polystyrene (PS-b-PAA/PS) blends by spin coating on a silicon wafer. The functionalization of the polymer film was obtained by interfacial migration of the amphiphilic block copolymer toward the interface upon water vapor annealing. The carboxylic acid functional groups contained in the PAA block were then employed to anchor the [LnIII(α-SiW11O39)]5− polyoxometalates (Ln: Ce, Er). This purpose was achieved by immersing the films in aqueous solutions of the in situ-formed inorganic nanoclusters. X-ray photoelectron and confocal Raman spectroscopies, together with atomic force microscopy, confirmed the immobilization of the inorganic species at the interface

Immobilization of Polyoxometalates on Tailored Polymeric Surfaces

Herein we describe the preparation of hybrid polymer–inorganic interfaces by the immobilization of polyoxometalate nanoclusters on functionalized polymer surfaces. The polymeric surfaces were made of polystyrene-b-poly(acrylic acid)/polystyrene (PS-b-PAA/PS) blends by spin coating on a silicon wafer. The functionalization of the polymer film was obtained by interfacial migration of the amphiphilic block copolymer toward the interface upon water vapor annealing. The carboxylic acid functional groups contained in the PAA block were then employed to anchor the [LnIII(α-SiW11O39)]5− polyoxometalates (Ln: Ce, Er). This purpose was achieved by immersing the films in aqueous solutions of the in situ-formed inorganic nanoclusters. X-ray photoelectron and confocal Raman spectroscopies, together with atomic force microscopy, confirmed the immobilization of the inorganic species at the interface.This work has been financially supported by MINECO (grants MAT2010-17016 and MAT2010-21088-C03-01) and EJ/GV (IT477-10 and IT718-13; and ELKARTEK program (ACTIMAT)). The authors thank UPV/EHU for financial support (UFI11/53). S.A.-U. is indebted to UPV/EHU for her pre-doctoral fellowship. Technical and human support provided by SGIker (UPV/EHU) is gratefully acknowledged

Analysis of the role of intratecal liposomal cytarabine in the prophylaxis and treatment of central nervous system lymphomatosis: The Balearic Lymphoma Group experience

<div><p>Central nervous system (CNS) lymphomatosis is a fatal complication of aggressive non-Hodgkin lymphoma (NHL). In lymphoblastic or Burkitt lymphoma, without specific CNS prophylaxis the risk of CNS relapse is 20–30%. DLBCL has a lower risk of relapse (around 5%) but several factors increase its incidence. There is no consensus or trials to conclude which is the best CNS prophylaxis. Best results seem to be associated with the use of intravenous (iv) high-dose methotrexate (HDMTX) but with a significant toxicity. Other options are the administration of intrathecal (IT) MTX, cytarabine or liposomal cytarabine (ITLC). Our aim is to analyze the experience of the centers of the Balearic Lymphoma Group (BLG) about the toxicity and efficacy of ITLC in the prophylaxis and therapy of CNS lymphomatosis. We retrospectively reviewed cases from 2005 to 2015 (n = 58) treated with ITLC. Our toxicity results were: 33% headache, 20% neurological deficits, 11% nausea, 9% dizziness, 4% vomiting, 4% fever, 2% transient blindness and 2% photophobia. In the prophylactic cohort (n = 26) with a median follow-up of 55 months (17–81) only 3 CNS relapses (11%) were observed (testicular DLBCL, Burkitt and plasmablastic lymphoma, with a cumulative incidence of 8%, 14% and 20% respectively). In the treatment cohort (n = 32), CSF complete clearance was obtained in 77% cases. Median OS was 6 months (0–16). Death causes were lymphoma progression (19 patients, 79%), treatment toxicity (2 patients) and non-related (3 patients, 12%). Toxicity profile was good especially when concomitant dexamethasone was administered. In the prophylactic cohort the incidence of CNS relapse in DLBCL group was similar to previously reported for HDMTX and much better than IT MTX. A high number of ITLC injections was associated with better rates of CSF clearance, clinical responses, PFS and lower relapses. Survival is still poor in CNS lymphomatosis and new therapeutic approaches are still needed.</p></div