Prognostic stratification improvement by integrating ID1/ID3/IGJ gene expression signature and immunophenotypic profile in adult patients with B-ALL

Characteristics of pronostic groups according to EuroFlow immunophenotype. (TIFF 1364 kb

Multi-body-site colonization screening cultures for predicting multi-drug resistant Gram-negative and Gram-positive bacteremia in hematological patients

Background To investigate the multi-drug resistant bacteria (MDRB) colonization rate in hematological patients hospitalized for any cause using a multi-body-site surveillance approach, and determine the extent to which this screening strategy helped anticipate MDRB bloodstream infections (BSI). Methods Single-center retrospective observational study including 361 admissions documented in 250 adult patients. Surveillance cultures of nasal, pharyngeal, axillary and rectal specimens (the latter two combined) were performed at admission and subsequently on a weekly basis. Blood culture samples were incubated in an automated continuous monitoring blood culturing instrument (BACTEC FX). Results In total, 3463 surveillance cultures were performed (pharyngeal, n = 1201; axillary-rectal, n = 1200; nasal, n = 1062). MDRB colonization was documented in 122 out of 361 (33.7%) admissions corresponding to 86 patients (34.4%). A total of 149 MDRB were isolated from one or more body sites, of which most were Gram-negative bacteria, most frequently non-fermenting (n = 83) followed by Enterobacterales (n = 51). BSI were documented in 102 admissions (28%) involving 87 patients. Overall, the rate of BSI caused by MDRB was significantly higher (p = 0.04) in the presence of colonizing MDRB (16 out of 47 admissions in 14 patients) than in its absence (9 out of 55 admissions in 9 patients). Colonization by any MDRB was independently associated with increased risk of MDRB-BSI (HR, 3.70; 95% CI, 1.38-9.90; p = 0.009). Conclusion MDRB colonization is a frequent event in hematological patients hospitalized for any reason and is associated with an increased risk of MDRB BSI. The data lend support to the use of MDRB colonization surveillance cultures for predicting the occurrence of MDRB BSI in this cohort

High expression of ID family and IGJ genes signature as predictor of low induction treatment response and worst survival in adult Hispanic patients with B-acute lymphoblastic leukemia

Table S4. Complete list of signaling pathways dysregulated in patients who achieved complete remission therapy. Signaling pathway analysis was done using MetaCore KPA using the set of 442 genes differentially expressed between good and poor response group. (XLSX 10 kb

Ramsay Hunt Syndrome in a Young Adult Patient, Review of the Literature and Description of an Atypical Clinical Case in this Age Group

El síndrome de Ramsay Hunt es un tipo de herpes zoster agudo, que ocurre por la reactivación del virus varicela-zoster en el ganglio geniculado. La presentación clínica del síndrome de Ramsay Hunt incluye una erupción vesicular en el oído )herpes zóster ótico) o en la mucosa oral acompañada de parálisis aguda del nervio facial periférico. Otros nervios craneales como el V, IX, XI y XII a menudo están involucrados. La variabilidad adicional del cuadro clínico del síndrome de Ramsay Hunt se produce por patrones variables de compromiso de la piel explicados por anastomosis individuales entre los nervios craneales y cervicales. Presentamos a continuación el caso de una paciente de genero femenino adulto joven con presencia de los elementos claves del diagnostico cuya exploración semiológica y clínica corresponden con el cuadro siendo atípico en pacientes jóvenes. Se recomienda un tratamiento combinado que contenga agentes antivirales y esteroides para el tratamiento del síndrome de Ramsay Hunt. Además, el diagnóstico temprano del síndrome de Ramsay Hunt es un factor crucial para mejorar los nervios dañados en el síndrome de Ramsay Hunt.Ramsay Hunt syndrome is a type of acute herpes zoster, which occurs due to reactivation of the varicella-zoster virus in the geniculate ganglion. The clinical presentation of Ramsay Hunt syndrome includes a vesicular eruption in the ear (herpes zoster oticus) or on the oral mucosa accompanied by acute paralysis of the peripheral facial nerve. Other cranial nerves such as V, IX, XI, and XII are often involved. Additional variability in the clinical picture of Ramsay Hunt syndrome results from variable patterns of skin involvement explained by individual anastomoses between the cranial and cervical nerves. We present below the case of a young adult female patient with the presence of the key elements of the diagnosis whose semiological and clinical examination correspond to the picture being atypical in young patients. Combination therapy containing antiviral agents and steroids is recommended for the treatment of Ramsay Hunt syndrome. Also, early diagnosis of Ramsay Hunt syndrome is a crucial factor in improving the damaged nerves in Ramsay Hunt syndrome

Persistência hiperglicêmica no pós parto / Postpartum hyperglycemic persistence

Introdução: analisar a persistência de hiperglicemia no pós parto em pacientes com histórico de diabetes mellitus gestacional. Metodologia:  Revisão sistemática no Pubmed e Scopus, usando ensaios clínicos randomizados, dos últimos 10 anos (Pubmed), 20 anos (Scopus) em inglês. Com descritores: Post partum period AND Diabetes mellitus, gestational AND Hyperglicemia e Diabetes AND Mellitus AND Gestation AND Puerperium AND Hyperglicemia. Resultados: Os estudos demonstraram a importância de se utilizar mais de um método diagnóstico para DMG. As medidas não farmacológicas de mudanças de estilo de vida se mostram suficientes na maioria das pacientes. Discussão: Outros estudos levantaram questões como a necessidade de utilização de mais de um teste para diagnosticar tais condições patológicas, níveis elevados de proteína C reativa, hiperglicemia gestacional, níveis elevados de triglicerídeos, fatores étnicos, histórico familiar, tratamento e ganho excessivo de peso, sendo alguns consoantes e outros dissonantes em relação aos resultados dos estudos selecionados pelo presente artigo. Conclusão: Faz-se necessário uma padronização de um diagnóstico eficaz e propostas de intervenção com melhor evolução para a paciente, além de realizar avaliação individual, nos quesitos ambientais étnicos, história pregressa do paciente e histórico familiar da doença, a fim de predizer as suas chances de cursar com doença gestacional. 

Baseline immunophenotypic profile of bone marrow leukemia cells in acute myeloid leukemia with nucleophosmin-1 gene mutation: a EuroFlow study

Molecular techniques are the gold standard method for the diagnosis of AML with mutated nucleophosmin gene (NPM1mut). However, their worldwide availability is limited and they provide limited insight into disease heterogeneity. Hence, surrogate markers of NPM1mut are used for fast diagnostic screening of the disease [1], including, among others, immunohistochemical detection of cytoplasmic NPM1 (NPM1c) [2], cup-like nuclear morphology [3], normal karyotype, and/or recurrent flow cytometry profiles -e.g., CD34 negativity, and/or a phenotype resembling acute promyelocytic leukemia (APL)- [4]. Nevertheless, some of these methods are also not widely available, they show limited sensitivity (e.g., low or absent NPM1c expression, particularly among monoblastic/monocytic AML-NPM1mut) [5], frequently lack standardized procedures [1], and they might also bring limited information about disease heterogeneity.This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI21/01115 and co-funded by the European Union and the grant of CIBERONC of the Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain, and FONDOS FEDER (no. CB16/12/00400); MR was supported by the Ministry of Health of the Czech Republic, grant number NU20J-07-00028.Peer reviewe

Narrativas de experiencia en educación y pedagogía de la memoria

¿De qué manera las trayectorias de la vida contemporánea, caracterizadas por la pluralidad de las experiencias sociales, profesionales, laborales, formativas, se singularizan en las historias individuales que relatamos y nos contamos? ¿Cuáles son los sentidos, las comprensiones, las interpretaciones sociales, profesionales, pedagógicas, que producen y ponen a jugar los sujetos y grupos del campo pedagógico cuando viven esas experiencias y las recrean mediante relatos autobiográficos? ¿Cómo imaginar y experienciar estrategias de investigación, formación y acción pedagógica que nombren, piensen y estudien el mundo de la experiencia educativa de otro modo, a través de otros criterios, mediante otras epistemologías? ¿Resulta viable en términos epistemológicos, metodológicos y políticos, la reformulación y revitalización del lenguaje teórico de la pedagogía y las ciencias de la educación desde esas experiencias de investigación-formación- acción que se centran en la reconstrucción narrativa y (auto)biográfica del mundo de la vida educativa y escolar? La investigación narrativa y (auto)biográfica nos ayuda a recorrer y repensar estas preguntas e intenta responderlas, siempre provisoriamente, mediante sus desarrollos y experiencias

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks