Earliest hominin cancer: 1.7-million-year- old osteosarcoma from Swartkrans Cave, South Africa

The reported incidence of neoplasia in the extinct human lineage is rare, with only a few confirmed cases of Middle or Later Pleistocene dates reported. It has generally been assumed that premodern incidence of neoplastic disease of any kind is rare and limited to benign conditions, but new fossil evidence suggests otherwise. We here present the earliest identifiable case of malignant neoplastic disease from an early human ancestor dated to 1.8–1.6 million years old. The diagnosis has been made possible only by advances in 3D imaging methods as diagnostic aids. We present a case report based on re-analysis of a hominin metatarsal specimen (SK 7923) from the cave site of Swartkrans in the Cradle of Humankind, South Africa. The expression of malignant osteosarcoma in the Swartkrans specimen indicates that whilst the upsurge in malignancy incidence is correlated with modern lifestyles, there is no reason to suspect that primary bone tumours would have been any less frequent in ancient specimens. Such tumours are not related to lifestyle and often occur in younger individuals. As such, malignancy has a considerable antiquity in the fossil record, as evidenced by this specimen.NCS201

Why don't we treat chronic hepatitis C in HIV patients? Results from a cohort of HIV-HCV coinfected patients from the southeast of Spain

Purpose of the study: To know the different reasons why we decide not to treat or to delay the antiviral treatment against HCV in HIV coinfected patients. Methods: Prospective cohort of HIV and HCV coinfected patients, followed in the Infectious Diseases Department of the Santa Lucia Universitary Hospital (Cartagena, Spain) between 1/12/2011 and 28/02/2012 in which we made transitory elastography. We evaluated the main reasons that moved us to decide not to treat or to delay the antiviral treatment against HCV: social-familiar-laboral reasons; neuro-psychiatric severe diseases; patient decision; low grade hepatic fibrosis; previous failure to pegylated interferon (IFN) and ribavirin (RBV) in no-1 genotype patients; delay in the approval of the triple therapy with INF-RBV and a protease inhibitor (boceprevir or telaprevir) by the Regional Sanitary Authority; active alcohol abuse; active diseases that contraindicate the antiviral treatment, incomplete study of HCV (VL of HCV, genotype, ILB28, abdominal ecography); previous intolerance against IFN-RBV and severe thrombocytopenia (<50×109/L). Summary of results: The cohort included 109 patients, being 27 of them females (25%) and 82 males (75%), with a median of age of 45.8 years (SD: 6.2). In 98 patients (90%) we decided not to treat or to delay the antiviral treatment against HCV for one or more of the following reasons: 37 (34%) presented low grade hepatic fibrosis (<9.5 kpascal or F0-F2); 19 (17%) had neuro-psychiatric diseases; 18 (16.5%) were waiting for the approval of triple therapy by the Regional Sanitary Authority; 10 (9.2%) did not want to be treated; 10 (9.2%) had failure to IFN-RBV in no-1 genotype; 6 (5.5%) had social-familiar-laboral reasons; 6 (5.5%) presented active severe diseases; 4 (3.7%) were waiting to complete HCV study; 3 (2.8%) presented active alcohol abuse; 3 (2.8%) had previous intolerance against IFN-RBV treatment and 2 (2%) had severe thrombocytopenia. Conclusions: In our cohort of HIV-HCV coinfected patients it was decided to delay or not to treat chronic hepatitis C in a significant proportion of subjects. The low grade of hepatic fibrosis measured with transitory elastography was the main reason for delaying the HCV antiviral treatment. The neuro-psychiatric disease was the main clinical reason to not treat HCV. The delay of the approval of triple therapy treatment by the Regional Sanitary Authority was the most relevant non- clinical reason in our prospective study

El príncipe de Eboli como señor de vasallos

Actas de la V Reunión Científica de la Asociación Española de Historia Moderna. Cádiz 1998Peer reviewe