Pediatric thyroid cancer

Thyroid cancer is a rare disease in pediatric age; however it is increasing in the last few years, mainly in adolescent women. Although children and adult thyroid cancer are similar, they have some particular differences. The aim of this report is to analyze those differences, emphasizing the particularities of thyroid cáncer in pediatric age./nThe development of molecular genetic testing has allowed a deeper understanding of genetic predisposition síndromes, such as MEN2A, which has led to a significant increase in prophylactic thyroidectomies. The most frequent histological group is differentiated cáncer, specifically papilar type. At the time of diagnosis in children thyroid cancer presents a greater size and extensión, and more probabilities of multifocality and metastasis than in adults. The short-term prognosis is excellent; however in the long-term there are a significant number of recurrences and second tumors. It is important to carry out a personalized medicine, and to create diagnostic protocols. A Deep tumor characterization and the prognosis stratification will be essential to choose the correct treatment for each case, also to achieve maximum effectiveness, survival and to minimize side effects.Introducción y objetivo: El cáncer de tiroides es una enfermedad rara en la edad pediátrica que está aumentando en los últimos años, principalmente en mujeres adolescentes. Aunque guarda similitudes con el cáncer tiroideo del adulto tiene una serie de peculiaridades que lo diferencian. Nuestro objetivo es mostrar estas diferencias, resaltando las particularidades de esta enfermedad en la edad pediátrica frente a la del adulto./nLos avances en las técnicas diagnósticas de genética molecular han permitido nuevos descubrimientos acerca de la génesis de tumores tiroideos en edades tempranas. También han supuesto un incremento de los diagnósticos de síndromes de predisposición genética, principalmente MEN2A, que ha producido un aumento significativo de tiroidectomías profilácticas. Los tipos histológicos más frecuentes son los cánceres diferenciados, principalmente el papilar. Al diagnóstico en edad pediátrica, suelen presentar un mayor tamaño, extensión, y probabilidades de multifocalidad y metástasis que en el adulto. A corto plazo el pronóstico es excelente; sin embargo, a largo plazo existe un número importante de recaídas y de aparición de segundos tumores. Para su tratamiento y seguimiento son necesarias unidades de alta especialización pediátrica que incluyan cirujanos expertos en tiroides. Se debe tender a la medicina personalizada estableciendo protocolos diagnósticos que caractericen correctamente el tumor y estratifiquen el pronóstico, adaptando la cirugía, la administración de yodo-131 y los nuevos tratamientos farmacológicos para buscar la máxima efectividad y supervivencia y minimicen los efectos secundarios

Does ADHD Symptomatology Influence Treatment Outcome and Dropout Risk in Eating Disorders? A longitudinal Study

Attention-deficit/hyperactivity disorder (ADHD) and its symptoms have been shown to be present in patients with eating disorders (EDs) and are associated with increased psychopathology and more dysfunctional personality traits. This study aimed to assess if the presence of ADHD symptoms in patients with EDs affects their short and long-term therapy outcome. A total of 136 consecutively treated ED patients were considered in this study. Baseline pre-treatment evaluation included the Adult ADHD Self-Report Scale (ASRS v1.1) for ADHD symptoms and the assessment of eating symptomatology using the Eating Disorders Inventory (EDI-2). Treatment outcome was evaluated in terms of ED symptoms after cognitive behavioral therapy (CBT) and dropout rate during treatment. Furthermore, we evaluated ED symptoms in treatment completers after a follow-up of 8 years on average. Path analyses assessed the potential mediational role of the EDI-2 total score in the relationship between ADHD and treatment outcome. Results showed that baseline symptoms of ADHD indirectly affected treatment outcome after CBT; the ASRS positive screening was related to higher eating symptomatology (standardized coefficient B = 0.41, p = 0.001, 95% CI: 0.26 to 0.55), and the presence of high ED levels contributed to the increase of dropout (B = 0.15, p = 0.041, 95% CI: 0.03 to 0.33) and a worse treatment outcome (B = 0.18, p = 0.041, 95% CI: 0.01 to 0.35). No direct effect was found between the ASRS positive screening with the risk of dropout (B = −0.08, p = 0.375) and worse treatment outcome (B = −0.07, p = 0.414). These results suggest the relevance of identifying specific treatment approaches for patients with ADHD symptoms and severe eating symptomatolog

Reemplazo del oxígeno medicinal por aire comprimido en anestesia inhalatoria en caninos: evaluación de parámetros sanguíneos

The objective of this work was to evaluate the efficiency to use atmospheric air as a substitute of oxygen in anaesthetic dogs with halothane. The work was carried out in two groups of fife animals each using either oxygen or compressed air. Physiologic parameters such as clinica signs and arterial blood analysed were done. To evaluate the breath efficiency blood arterial samples were taken at 30, 60 and 90 minutes trough measurement of the partial pressure of PCO2, PO2 and pH. Under the present condition the inhalatory anaesthesia with halothane and assisted breath using atmospheric air with quirurgic time until 90 minutes shown comparative parameter as that using medicinal oxygen.El objetivo del presente trabajo fue evaluar la eficiencia del uso de aire atmosférico como sustituto del oxígeno medicinal en caninos anestesiados con halotano. Los estudios comparativos fueron llevados a cabo en anestesias con respiración asistida, realizadas a 2 grupos de 5 animales cada uno, empleando oxígeno y aire comprimido respectivamente para alimentar el equipo de anestesia inhalatoria semicerrado. Se evaluaron parámetros fisiológicos a través de signos clínicos y análisis de sangre arterial. El plano quirúrgico fue mantenido empleando como referencia los signos clínicos de rutina. Para evaluar la eficiencia respiratoria se tomaron muestras de sangre arterial al comienzo, 30, 60 y 90 minutos midiendo la presión parcial ( PCO 2, PO2 y pH. Se concluye que en las condiciones del presente ensayo la anestesia inhalatoria con halotano y respiración asistida, utilizando aire atmosférico no ofrece inconveniente alguno para tiempos quirúrgicos de hasta 90 minutos y presenta parámetros comparativos con la anestesia utilizando O2 medicinal

Comparación de rasgos de personalidad entre pacientes con trastorno de la conducta alimentaria y sus hermanas sanas

Los objetivos del presente estudio con pacientes-hermanas fueron: 1) Analizar diferencias existentes en sintomatología alimentaria y psicopatología general entre pacientes con trastorno alimentario (TCA) y hermanas discordantes para el trastorno, 2) Identificar en qué medida pacientes y hermanas presentan vulnerabilidades de personalidad diferenciales; 3) Identificar factores predictores de aparición de un trastorno alimentario. La muestra estuvo formada por 92 participantes mujeres (46 pacientes TCA vs 46 hermanas sanas). Todos los pacientes cumplían criterios DSM-IV-TR para el TCA. Los resultados mostraron diferencias significativas en todas las escalas de sintomatología alimentaria y psicopatología general entre ambos grupos. En términos de rasgos de personalidad, las pacientes con TCA presentaban una mayor evitación del daño (p<.001) y menor autodirección (p<.001) al ser comparadas con sus hermanas discordantes para el trastorno. Finalmente, los resultados mostraron que haber tenido historia previa de obesidad o sobrepeso (p=.027) y rasgos específicos de temperamento (elevada evitación al daño; p=.025) y carácter (baja autodirección; p=.009) se asociaban al posterior desarrollo de un TCA. La combinación de factores ambientales no compartidos, tales como obesidad con vulnerabilidades específicas de personalidad, influyen en la posterior aparición de un trastorno de la conducta alimentariaThe aims of the study were threefold: 1) analyze differences in symptomatology and general psychopathology among eating disorder (ED) patients and their sisters discordant for eating disorders, 2) identify differential personality vulnerabilities between ED patients and their healthy sisters and 3) identify predictors of developing an eating disorder. The sample consisted of 92 female participants (46 ED patients fulfilling DSM-IV-TR criteria for eating disorders vs 46 healthy sisters). The results showed significant differences in eating symptomatology and general psychopathology. In terms of personality traits, ED patients had higher harm avoidance (p<.001) and lower self-directedness (p<.001) compared with their discordant sister. Finally, the results showed that having a history of obesity or overweight (p=.027), and specific traits of temperament (high scores on harm avoidance; p=.025) and character (low self-directedness; p=.009) were associated with the development of an ED. These findings allow to conclude that the combination of non-shared environmental factors such as obesity with specific vulnerabilities of personality, influence the subsequent emergence of an eating disorder

Hyperspectral imaging and robust statistics in non-melanoma skin cancer analysis

Non-Melanoma skin cancer is one of the most frequent types of cancer. Early detection is encouraged so as to ensure the best treatment, Hyperspectral imaging is a promising technique for non-invasive inspection of skin lesions, however, the optimal wavelengths for these purposes are yet to be conclusively determined. A visible-near infrared hyperspectral camera with an ad-hoc built platform was used for image acquisition in the present study. Robust statistical techniques were used to conclude an optimal range between 573.45 and 779.88 nm to distinguish between healthy and non-healthy skin. Wavelengths between 429.16 and 520.17 nm were additionally found to be optimal for the differentiation between cancer types.Gerencia Regional de Salud de Castilla y León (GRS 2139/A/20); Spanish Ministry of Science, Innovation and Universities (PRE2019-089411); Instituto de Salud Carlos III (PI18/00587); Ibderdrola Spain; Junta de Castilla y León (GRS 1837/A/18). This project was funded by the Junta de Castilla y Leon, under the title project HYPERSKINCARE (Ref. GRS 1837/A/18). Lloyd Austin Courtenay is funded by the Spanish Ministry of Science, Innovation and Universities with an FPI Predoctoral Grant (Ref. PRE2019-089411) associated to project RTI2018-099850-B-I00 and the University of Salamanca. Susana Lagüela and Susana del Pozo are both funded by the Iberdrola Spain through the initiative Cátedra Iberdrola VIII Centenario of the University of Salamanca. Javier Cañueto is partially supported by the PI18/00587(Instituto de Salud Carlos III cofinanciado con fondos FEDER) and GRS 2139/A/20 (Gerencia Regional de Salud de Castilla y León

Cognitive behaviour therapy response and dropout rate across purging and nonpurging bulimia nervosa and binge eating disorder: DSM-5 implications

BACKGROUND: With the imminent publication of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there has been a growing interest in the study of the boundaries across the three bulimic spectrum syndromes [bulimia nervosa-purging type (BN-P), bulimia nervosa-non purging type (BN-NP) and binge eating disorder (BED)]. Therefore, the aims of this study were to determine differences in treatment response and dropout rates following Cognitive Behavioural Therapy (CBT) across the three bulimic-spectrum syndromes. METHOD: The sample comprised of 454 females (87 BED, 327 BN-P and 40 BN-NP) diagnosed according to DSM-IV-TR criteria who were treated with 22 weekly outpatient sessions of group CBT therapy. Patients were assessed before and after treatment using a food and binging/purging diary and some clinical questionnaires in the field of ED. 'Full remission' was defined as total absence of binging and purging (laxatives and/or vomiting) behaviors and psychological improvement for at least 4 (consecutive). RESULTS: Full remission rate was found to be significantly higher in BED (69.5%) than in both BN-P (p < 0.005) and BN-NP (p < 0.001), which presented no significant differences between them (30.9% and 35.5%). The rate of dropout from group CBT was also higher in BED (33.7%) than in BN-P (p < 0.001) and BN-NP (p < 0.05), which were similar (15.4% and 12.8%, respectively). CONCLUSIONS: Results suggest that purging and non-purging BN have similar treatment response and dropping out rates, whereas BED appears as a separate diagnosis with better outcome for those who complete treatment. The results support the proposed new DSM-5 classification

Childhood B-Cell Preleukemia Mouse Modeling

Leukemia is the most usual childhood cancer, and B-cell acute lymphoblastic leukemia (B-ALL) is its most common presentation. It has been proposed that pediatric leukemogenesis occurs through a “multi-step” or “multi-hit” mechanism that includes both in utero and postnatal steps. Many childhood leukemia-initiating events, such as chromosomal translocations, originate in utero, and studies so far suggest that these “first-hits” occur at a far higher frequency than the incidence of childhood leukemia itself. The reason why only a small percentage of the children born with such preleukemic “hits” will develop full-blown leukemia is still a mystery. In order to better understand childhood leukemia, mouse modeling is essential, but only if the multistage process of leukemia can be recapitulated in the model. Therefore, mouse models naturally reproducing the “multi-step” process of childhood B-ALL will be essential to identify environmental or other factors that are directly linked to increased risk of disease.Research in CV-D group has been funded by Instituto de Salud Carlos III (ISCIII), through a “Miguel Servet Grant” (CPII19/00024-AES 2017–2020); co-funded by the European Union. Research in IS-G group is partially supported by FEDER and by SAF2015-64420-R MINECO/FEDER, UE, RTI2018-093314-B-I00 MCIU/AEI/FEDER, UE, by PID2021-122185OB-I00 MCIU/AEI/FEDER, UE, and by Junta de Castilla y León (UIC-017, CSI001U16, CSI234P18, and CSI144P20). IS-G have been supported by the Fundacion Unoentrecienmil (CUNINA project). CC and IS-G have been supported by the Fundación Científica de la Asociación Española contra el Cáncer (PRYCO211305SANC). Research at CC’s laboratory was partially supported by Ministerio de Ciencia e Innovación/AEI/FEDER (PID2021-122787OB-I00), FEDER MINECO (SAF2017-83061-R), the “Fundación Ramón Areces” and a Research Contract with the “Fundación Síndrome de Wolf-Hirschhorn o 4p-”. Institutional grants from the “Fundación Ramón Areces” and “Banco de Santander” to the CBMSO are also acknowledged. J.M.-C. is the recipient of a UAM FPU fellowship. AC-G (CSI067-18) and MI-H (CSI021-19) are supported by FSE-Conserjería de Educación de la Junta de Castilla y León 2019 and 2020 (ESF—European Social Fund) fellowship, respectively. SA-A is supported by an Ayuda para Contratos predoctorales para la formación de doctores (PRE2019-088887). L.S. is supported by a scholarship from University of Salamanca co-financed by Banco Santander and ESF

Hyperspectral imaging and robust statistics in non-melanoma skin cancer analysis

[EN] Non-Melanoma skin cancer is one of the most frequent types of cancer. Early detection is encouraged so as to ensure the best treatment, Hyperspectral imaging is a promising technique for non-invasive inspection of skin lesions, however, the optimal wavelengths for these purposes are yet to be conclusively determined. A visible-near infrared hyperspectral camera with an ad-hoc built platform was used for image acquisition in the present study. Robust statistical techniques were used to conclude an optimal range between 573.45 and 779.88 nm to distinguish between healthy and non-healthy skin. Wavelengths between 429.16 and 520.17 nm were additionally found to be optimal for the differentiation between cancer typesSIGerencia Regional de Salud de Castilla y LeónSpanish Ministry of Science, Innovation and UniversitiesInstituto de Salud Carlos IIIJunta de Castilla y Leó

Deep Convolutional Neural Support Vector Machines for the Classification of Basal Cell Carcinoma Hyperspectral Signatures

[EN] Non-melanoma skin cancer, and basal cell carcinoma in particular, is one of the most common types of cancer. Although this type of malignancy has lower metastatic rates than other types of skin cancer, its locally destructive nature and the advantages of its timely treatment make early detection vital. The combination of multispectral imaging and artificial intelligence has arisen as a powerful tool for the detection and classification of skin cancer in a non-invasive manner. The present study uses hyperspectral images to discern between healthy and basal cell carcinoma hyperspectral signatures. Upon the combined use of convolutional neural networks, with a final support vector machine activation layer, the present study reaches up to 90% accuracy, with an area under the receiver operating characteristic curve being calculated at 0.9 as well. While the results are promising, future research should build upon a dataset with a larger number of patients.SIJunta de Castilla y Leo

Impulsivity, emotional dysregulation and executive function deficits could be associated with alcohol and drug abuse in eating disorders

Background: Empirical data suggests a high comorbid occurrence of eating disorders (EDs) and substance use disorders (SUDs), as well as neurological and psychological shared characteristics. However, no prior study has identified the neuropsychological features of this subgroup. This study examines the prevalence of alcohol and/or drug abuse (A/DA) symptoms in ED patients. It also compares the clinical features and neuropsychological performance of ED patients with and without A/DA symptoms. Methods: 145 participants (74.5% females) with various forms of diagnosed EDs underwent a comprehensive clinical (TCI-R, SCL-90-R and EDI-2) and neuropsychological assessment (Stroop, WCST and IGT). Results: Approximately 19% of ED patients (across ED subtypes) had A/DA symptoms. Those with A/DA symptoms showed more impulsive behaviours and higher levels of interoceptive awareness (EDI-2), somatisation (SCL-90-R) and novelty seeking (TCI-R). This group also had a lower score in the Stroop-words measure, made more perseverative errors in the WCST and showed a weaker learning trajectory in the IGT. Conclusions: ED patients with A/DA symptoms display a specific phenotype characterised by greater impulsive personality, emotional dysregulation and problems with executive control. Patients with these temperamental traits may be at high risk of developing a SUD