Hexyltrimethylammonium ion enhances potential copper-chelating properties of ammonium thiomolybdate in an in vivo zebrafish model.

Ammonium and hexyltrimethylammonium thiomolybdates (ATM and ATM-C6) and thiotungstates (ATT and ATT-C6) were synthesized. Their toxicity was evaluated using both in vitro and in vivo approaches via the zebrafish embryo acute toxicity assay (ZFET), while the copper-thiometallate interaction was studied using cyclic voltammetry, as well as in an in vivo assay. Cyclic voltammetry suggests that all thiometallates form complexes with copper in a 2:1 Cu:thiometallate ratio. Both in vitro and in vivo assays demonstrated low toxicity in BALB/3T3 cells and in zebrafish embryos, with high IC50 and LC50 values. Furthermore, the hexyltrimethylammonium ion played a crucial role in enhancing viability and reducing toxicity during prolonged treatments for ATM and ATT. In particular, the ZEFT assay uncovered the accumulation of ATM in zebrafish yolk, averted by the incorporation of the hexyltrimethylammonium ion. Notably, the copper-thiometallate interaction assay highlighted the improved viability of embryos when cultured in CuCl2 and ATM-C6, even at high CuCl2 concentrations. The hatching assay further confirmed that copper-ATM-C6 interaction mitigates inhibitory effects induced by thiomolybdates and CuCl2 when administered individually. These results suggest that the incorporation of the hexyltrimethylammonium ion in ATM increase its ability to interact with copper and its potential application as a copper chelator.

Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital.

BACKGROUND: Life-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it. OBJECTIVE: To determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU. DESIGN: Retrospective longitudinal study. AMBIT: Intensive care unit of a tertiary hospital. PATIENTS: People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019. INTERVENTIONS: None. This is an observational study. VARIABLES OF INTEREST: Age, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays. RESULTS: Of 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients. CONCLUSIONS: Our results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.

Concordance between freehand SPECT and conventional scintigraphy for sentinel lymph node detection in breast cancer.

INTRODUCTION: Freehand SPECT can be a useful imaging technique for preoperative planning of sentinel lymph node biopsy (SLNB) as it allows localization of the sentinel node by 3D and real-time tomographic imaging and determines its depth after a few minutes of scanning. The aim of the study was to evaluate the correlation between the number of detected SNs between freehand SPECT images and lymphoscintigraphy (LS). MATERIALS AND METHODS: 100 patients with a diagnosis of invasive breast cancer and no clinical evidence of lymph node involvement prospectively underwent SLNB. The preoperative study included freehand SPECT imaging at 15min after injection and LS imaging at 25 and 60-90min after injection (early and late). The observed agreement was analyzed and a concordance study was performed between the number of SNs detected with freehand SPECT and LS. RESULTS: The observed agreement in the detection of SNs between freehand SPECT and early LS was 72%; between freehand SPECT and late LS was 85%; and between early and late LS was 87%. In the concordance study, there was moderate concordance between freehand SPECT and early LS (kappa coefficient: 0.42); moderate-high concordance between freehand SPECT and late LS (kappa coefficient: 0.60); and moderate-high concordance between early and late LS (kappa coefficient: 0.70), with no significant differences between them (p-value=0.16). CONCLUSION: Freehand SPECT showed a moderate-high concordance with conventional imaging studies and could be a valid alternative for the presurgical study of SLNB in breast cancer.

Effectiveness and safety of the radiofrequency ablation of single hyperfunctioning parathyroid lesions suggestive of adenomas in primary hyperparathyroidism.

INTRODUCTION: Radiofrequency ablation (RFA) has emerged as a minimally invasive approach to single parathyroid adenoma in primary hyperparathyroidism; however, there is limited evidence on its effectiveness. OBJECTIVE: To evaluate the effectiveness and safety of RFA to treat hyper-functioning parathyroid lesions suggestive of adenomas. MATERIAL AND METHODS: A prospective study was conducted in consecutive patients with primary hyperparathyroidism treated with RFA for single parathyroid lesions in our reference center between November 2017 and June 2021. Pre-treatment (baseline) and follow-up analytical data were gathered on total protein-adjusted calcium, parathyroid hormone [PTH], phosphorus, and 24-h urine calcium. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 15.0 was used for statistical analysis. RESULTS: Four of thirty-three enrolled patients were lost to the follow-up. The final sample comprised 29 patients (22 females) with mean age of 60.93 ± 13.28 years followed up for a mean of 16.29 ± 7.23 months. Complete response was observed in 48.27%, partial response in 37.93%, and hyperparathyroidism persistence in 13.79%. Serum calcium and PTH levels were significantly lower at 1 and 2 years of post-treatment than at baseline. Adverse effects were mild, with two cases of dysphonia (self-limited in one patient) and no cases of hypocalcaemia or hypoparathyroidism. CONCLUSION: RFA may be a safe and effective technique to treat hyper-functioning parathyroid lesions in selected patients.

Exploring the opinion of Spanish medical specialists about the usefulness of radiomics in oncology.

AIM: To describe the knowledge and opinion of health professionals regarding the usefulness of radiomics in oncology. METHODS: A 12-question questionnaire (multiple-choice responses, Likert-type scale, and open response) was developed and sent to professionals related to diagnosis/treatment of oncological diseases (Oncology, Radiodiagnosis, Nuclear Medicine, Radiation Oncology, Hematology-Oncology, Radiophysics and Pathology). Participants were classified into two groups according to their level of training: attending physicians and residents. RESULTS: 114 professionals completed the survey (54% residents, mostly from Nuclear Medicine and Radiodiagnostic specialties). Attending physicians obtained a better performance in the area pf knowledge compared to residents. Both groups of respondents agreed regarding the usefulness of radiomics to help make more accurate diagnoses and promoting the work of medical teams and the most frequent disadvantages were related to the lack of systematization in the acquisition of images and extraction of parameters, the need for the training of professionals and concern about the replacement of human work by technological tools. CONCLUSIONS: Radiomics is a novel field and the most general aspects are known by health professionals. The professionals surveyed were optimistic about the benefits provided by radiomics and other types of tools. The main problem detected was the lack of systematization in its implementation. The replacement of professionals and job loss is a concern, albeit less prevalent, and may respond to a generational phenomenon.

Progress and current utility of radiomics in PET/CT study of non-metastatic breast cancer: A systematic review.

AIM: To synthesize the current evidence of the usefulness of radiomics in PET/CT image analysis in local and locally advanced breast cancer. Also, to evaluate the methodological quality of the radiomic studies published. METHODS: Systematic review of articles in different databases until 2021 using the terms "PET", "radiomics", "texture", "breast". Only articles with human data and that included a PET image were included. Studies with simulated data and with less than 20 patients were excluded. Were extracted sample size, radiotracer used, imaging technique, and radiomics characteristics from each article. The methodological quality of the studies was determined using the QUADAS-2 tool. RESULTS: 18 articles were selected. The retrospective design was the most used. The most studied radiomic characteristic was SUVmax. Several radiomic parameters were correlated with tumor characterization, and tumor heterogeneity proved useful for predicting disease course and response to treatment. Most articles showed a high risk of bias, mainly from the patient selection. CONCLUSIONS: A high probability of bias was observed in most of the published articles. Radiomics is a developing field and more studies are needed to demonstrate its usefulness in routine clinical practice. The QUADAS-2 tool allows critical assessment of the methodological quality of the available evidence. Despite its limitations, radiomics is shown to be an instrument that can help to achieve personalized oncologic management of breast cancer.

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours: results from the COPPADIS cohort.

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose.

Hydrogeochemical, isotopic and geophysical characterization of saline lake systems in semiarid regions: The Salada de Chiprana Lake, Northeastern Spain.

Most of the athalassic saline and hypersaline lakes are located in arid and semiarid regions where water availability drives the hydrological dynamics of the lake itself and the associated ecosystems. This is the case of the Salada de Chiprana Lake, in the Ebro River basin (Spain). It is the only athalassic permanent hypersaline lake in Western Europe, and where rare and endangered bacterial mats exist. This work presents a robust hydrogeological conceptual model for the lake system. The model evaluates the contribution of groundwater discharge to the whole water budget and explains the hydrological behaviour of the lake system. The lake behaves as a flow-through system rather than a closed basin. About 40% of total water outflow from the lake occurs as groundwater, whereas evaporation accounts for the remaining 60%. The surface water inflows are variable, but the groundwater contribution seems almost constant, amounting to 13% of the average total water inflow and contributing 1.9% of salt income. The high water salinity of the lake is controlled by evaporation, by saline water inflows from irrigation return flows, and the by groundwater outflows. The role of groundwater should be taken into account when drafting the water and land planning, once the conditions for the conservation of the algal mats are defined. A major contribution of this study is the water balance in the Salada de Chiprana Lake, which is consistent with a robust hydrogeological conceptual model defined upon scarce hydrogeological, hydrochemical and isotopic data in the local context as conditioned by the regional behaviour. The water balance is a key tool to help to correctly manage this unique athalassic saline lake, and the approach used here can be extrapolated to other similar ecosystems around the world.

Influencia del tiempo extendido por la Ley 20. 545 en el mantenimiento de la lactancia materna al retorno laboral, en funcionarias de un hospital público en Curanilahue, Región del Bío Bío, Chile. / Influence of the leave time extended by law 20. 545 in the maintenance of breastfeeding upon return to work, in female employees of a public hospital in Curanilahue, Bío Bío Region, Chile.

RESUMEN Con el fin de fomentar una adecuada calidad de vida se han establecido diversas políticas públicas a nivel internacional y nacional, para lo cual Chile generó en el año 2011 la Ley 20.545 de Postnatal parental, que amplía el periodo de descanso materno con lo que se pretende, entre otras cosas, extender el tiempo de lactancia materna. Objetivo: Interpretar el impacto de la Ley 20.545, en el mantenimiento de la lactancia materna en funcionarias del Hospital Dr. Rafael Avaria Valenzuela, Curanilahue, en 2017. Material y métodos: Se utilizó metodología cualitativa con diseño fenomenológico. Como instrumento de recolección de datos se utilizó una entrevista semi-estructurada aplicada a 15 mujeres de acuerdo a los criterios de selección. Resultados: El tiempo de extensión otorgado por el postnatal parental permite efectivamente mantener la lactancia materna una vez se ha retornado al trabajo, siendo relevante para lo anterior contar con un espacio físico que permita el cuidado de los hijos en un lugar cercano al trabajo donde se desempeñan las madres. Conclusión: La influencia del tiempo extendido por de la Ley 20.545 genera que el amamantamiento sea posible de mantener al retorno a las actividades laborales principalmente, por el acceso a sala cuna.

ABSTRACT In order to promote an adequate quality of life, several public policies have been established at the international and national levels. In 2011, Chile passed law 20,545 for Parental Postnatal Leave that extended the maternal leave period in order to, among other things, extend the duration of breastfeeding. Objective: To interpret the impact of law 20,545 in the maintenance of breastfeeding among female employees of the Dr. Rafael Avaria Valenzuela Hospital, Curanilahue, in 2017. Material and methods: We used a qualitative methodology with phenomenological design. A semi-structured interview was conducted with 15 women, chosen according to selection criteria. Results: The extended time given by the law regarding parental postnatal leave allowed for effectively maintaining breastfeeding when it was time to return to work. It was important that women have a place that allowed for the care of children, near their work space. Conclusion: The influence of extended time provided by law 20,545 makes maintaining breastfeeding possible when women return to work primarily because of access to nursery facilities.

[Acute traumatic pectoralis major tendon ruptures. Case series with a new approach]. / Desinserción distal del pectoral mayor traumática aguda. Reporte de 19 casos con nuevo abordaje.

INTRODUCTION: Described for the first time in 1822, being the treatment in acute the method of choice since the chronic injuries results in more complex procedures by the presence of fibrosis and muscular retraction. MATERIAL AND METHODS: Report of 19 cases with injury after physical activity, averaging age 30 years and range 20-48 years. Average follow-up of 41 months, carrying out functional evaluations pre and post-operatively of CONSTANT, UCLA, SST and ASES, immobilization in internal rotation for five weeks. RESULTS: They showed improvement in the scales SST, CONSTANT, UCLA and ASES, being made with the U of Mann-Whitney for related samples, stablishing the value of p in 0.05 in all tests. CONSTANT preoperative values range from 32 to 93, UCLA ranges from 10 to 34, aces from 11.6 to 80 and SST from 0 to 9; CONSTANT postoperative values ranging from 73 to 96, UCLA with a range of 15 to 35, ASES with a range of 55 to 100 and SST ranging from 6 to 12. DISCUSSION: The use of this technique presented functional results, we consider has low level of difficulty, low risk of neurovascular injury, cosmetic and present functional recovery.

INTRODUCCIÓN: Descrita por primera vez en 1822, siendo el tratamiento en agudo el de preferencia, ya que el tardío resulta en procedimientos más complejos por la presencia de fibrosis y retracción muscular. MATERIAL Y MÉTODOS: Reporte de 19 casos con lesión posterior a actividad física, con un promedio de edad de 30 años y rango de 20-48 años de edad, con un seguimiento promedio de 41 meses, se realizaron evaluaciones funcionales pre- y postoperatoriamente de CONSTANT, UCLA, SST y ASES, inmovilización en rotación interna por cinco semanas. RESULTADOS: Presentaron mejoría evaluada con las escalas SST, CONSTANT, UCLA y ASES, se realizaron comparaciones con U de Mann-Whitney para muestras relacionadas, fijándose el valor de p en 0.05 en todas las pruebas. Valores preoperatorios CONSTANT rango de 32 a 93, UCLA rango de 10 a 34, ASES de 11.6 a 80 y SST de 0 a 9; valores postoperatorios CONSTANT con rango de 73 a 96, UCLA con rango de 15 a 35, ASES con rango de 55 a 100 y SST con rango de 6 a 12. DISCUSIÓN: El uso de esta técnica arrojó resultados funcionales, consideramos que tiene bajo nivel de dificultad, bajo riesgo de lesión neurovascular, cosmético y presenta recuperación funcional.

The BDNF-Val66Met polymorphism modulates parental rearing effects on adult psychiatric symptoms: a community twin-based study.

PURPOSE: To test whether firstly, different parental rearing components were associated with different dimensions of psychiatric symptoms in adulthood, secondly BDNF-Val66Met polymorphism moderated this association and thirdly, this association was due to genetic confounding. METHOD: Perceived parental rearing according to Parental Bonding Instrument (PBI), psychiatric symptoms evaluated with the Brief Symptom Inventory (BSI) and the BDNF-Val66Met polymorphism were analyzed in a sample of 232 adult twins from the general population. RESULTS: In the whole sample, paternal care was negatively associated with depression. Maternal overprotection was positively associated with paranoid ideation, obsession-compulsion and somatization. Gene-environment interaction effects were detected between the BDNF-Val66Met polymorphism and maternal care on phobic anxiety, paternal care on hostility, maternal overprotection on somatization and paternal overprotection also in somatization. In the subsample of MZ twins, intrapair differences in maternal care were associated with anxiety, paranoid ideation and somatization. CONCLUSIONS: Met carriers were, in general, more sensitive to the effects of parental rearing compared to Val/Val carriers in relation to anxiety and somatization. Contra-intuitively, our findings suggest that high rates of maternal care might be of risk for Met carriers regarding anxiety. Results from analyses controlling for genetic confounding were in line with this finding.

Modified release terbutaline (SKP1052) for hypoglycaemia prevention: a proof-of-concept study in people with type 1 diabetes mellitus.

AIMS: In this randomized, single blind, cross-over study 2.5 mg and 5 mg of the modified-release terbutaline formulation (SKP-1052) were compared with conventional immediate-release terbutaline (IRT, 5 mg) and placebo on overnight blood glucose (BG) and hypoglycaemia in 30 subjects with type 1 diabetes mellitus. METHODS: Subjects received subcutaneous injections of insulin glargine (individualized doses) before dinner. SKP-1052, IRT or placebo was administered around 21:00 hours. BG and terbutaline concentrations were monitored overnight for 10 h post-dosing. Endpoints comprised of the nadir BG (BGn 0-10 h, primary endpoint), mean overnight BG (BGmean), morning BG (BGmorning) and hypoglycaemia rates as well as pharmacokinetic (PK) endpoints. RESULTS: SKP-1052 delayed release of terbutaline by 2 h [PK-tmax (mean ± SD) 5.0 ± 2.1 h (2.5 mg) and 4.7 ± 1.7 h (5 mg) vs. 2.6 ± 1.3 h with IRT, p < 0.01, respectively]. Compared with placebo, no significant differences were observed for BGn 0-10 h across treatments, but both 5 mg formulations showed less hypoglycaemic events [10 (IRT), 16 (SKP-1052) vs. 33], higher BGmean (120, 114 and 95 mg/dl) and BGmorning (126, 126 and 101 mg/dl, all comparisons p < 0.05 vs. placebo). Numerically higher BG-levels between 3 and 8 h post-dosing were observed with 2.5 mg SKP-1052 vs. placebo. CONCLUSIONS: Compared with IRT SKP-1052 delays release of terbutaline. 2.5 mg SKP-1052 led to numerically higher BG 3 to 8 h post-dose without fasting hyperglycaemia while 5 mg SKP-1052 resulted in fasting hyperglycaemia vs. placebo. Future studies will investigate optimized doses of SKP-1052 for nocturnal hypoglycaemia prevention.

Mal nutrición por exceso en escolares / Malnutrition by excess among school-age children

Objectives: To implement an educational intervention that contributes to the prevention of malnutrition by excess among adolescents. Patients and Method: This descriptive study included a sample of 939 individuals attending school at Colegio Manuel D'Alzon, in Lota (small town), between 2007-2009. Studies included anthropometric evaluations, nutritional intake and training workshops. Parents and teachers were included in the workshops. Healthy nutrition was incorporated in the curriculum, and a site for distribution of healthy foods was implemented. Results: A 3 percent decrease in prevalence of malnutrition by excess was seen (28 percent to 25 percent), most marked among males. This decrease was attributed to reduction in obesity and increase of lower weights. This decrease appears during a period of time when boys show a growth spurt, which occurs earlier among girls. Conclusion: Collaborative interventions between health and education show positive results in this population.

Objetivo: Implementar una intervención educativa que contribuya a prevenir la malnutrición por exceso en adolescentes. Pacientes y Método: Estudio descriptivo observacional que incluyó una muestra de 939 personas pertenecientes a la comunidad educativa del Colegio Manuel D'Alzon de la Comuna de Lota, período 2007-2009. Se incluyo estudiantes a quienes se les realizó evaluaciones antropométricas, de ingesta alimentaria, y talleres educativos, se incluyó igualmente a docentes y apoderados con quienes se efectuaron talleres educativos. Se logró la incorporación de temas de alimentación saludable en las actividades curriculares, y la implementación de un kiosco saludable (tipo b). Resultados: Se observó una disminución en la prevalencia de malnutrición por exceso en 3 puntos porcentuales de un 28 por ciento inicial a un 25 por ciento final, siendo en el género masculino en donde se hace más evidente esta reducción. Atribuyéndose esto al aumento del estado de bajo peso y reducción de la obesidad, ello se sustentaría en el peak que alcanza el estirón puberal en los varones en este período de vida, lo que en las niñas ocurre a lo menos dos a tres años antes. Conclusiones: Estas intervenciones colaborativas entre el sector salud y educación logran resultados positivos en disminuir la mal nutrición por exceso en la población escolar.

Percepciones, actitudes y conductas de médicos gineco-obstetras, respecto al uso actual de terapia de reemlazo hormonal / Perceptions, attitudes, and behavior of obstetrician-gynecologists for the use of hormonal replacement therapy

Resultados de una encuesta con preguntas específicas contestadas por el 97,6 por ciento de los gineco-obstetras del Departamento de Obstetricia y Ginecología de Clínica Alemana de Santiago, para establecer un diagnóstico de situación sobre el uso de terapia de reemplazo hormonal (TRH). Se enfatizan preguntas sobre la aceptabilidad de las futuras usuarias tanto de TRH como de terapias alternativas; sobre la percepción de los eventuales beneficios desde un punto de vista general, o específicamente cardiovascular; así como las preferencias de hormonas a usar y predilecciones por las vías de administración; las asociaciones del uso y cáncer mamario; las variaciones sobre el uso de TRH pos publicación del Women Health Iniciative Study; los factores que inciden en la discontinuación del tratamiento; la importancia de edad para el uso, factores relacionados con los costos de las terapias y la preferencia o no de productos originales de investigación. Conclusión: Es necesaria una mayor capacitación sobre el uso de TRH en la actualidad tanto de los ginecólogos especialistas en climaterio y menopausia, como de los que no lo son. A falta de información concluyente sobre esta temática en el momento actual se sugiere que el manejo de este tipo de pacientes sea efectuado por los equipos médicos especializados.

In order to set a diagnosis about the use of hormonal replacement therapy (HRT) in peri and postmenopausal women by the obstetricians and gynecologists members of our staff, we did a survey that was answered by 97.6 percent of them. Questions about the future patients desire related to use of HRT or use of natural or alternative medicines were included. There were also questions related to the "risk-benefit" relationship on the use of HRT from an overall point of view as well as from a cardiovascular point of view. The preference of medical doctors (MD) on choice of hormone type in HRT use, in respect to the administration, were also asked. Among others, questions were asked in order to know MD opinions on the relationship with breast cancer, the changes on acceptability use after the WHI study, reasons for the treatment discontinuation, the importance of women's age and the cost of pharmaceuticals produces on HRT use. Conclusions: Are focused on a need of a solid educational program on use of HRT addressed to gynecologists, as well as to general practitioners, cardiologists, oncologists and others related. Educational programs are also quite beneficial to future users as well as women that are currently under treatment. In the absence of conclusive information available at the present moment, we advise that patients considering HRT should seek the counsel of medical teams whose specialties include menopause.

Correlación entre distintos tipos histológicos de cáncer de mama y receptores estrogénicos / Correlation between different histological types of breast cancer and estrogen receptors

Se presentan los resultados de 140 muestras histológicas tomadas en pacientes con cáncer de mama para determinar su concentración de receptores de estrógenos. Destaca la importancia, frecuencia de positividad para receptores de estrógenos en todos los tipos histológicos.

We've analized the resuls from 140 histologic samples taken to patients with breast cancer in order to find its concentration of estrogen receptors. We notice a high frecuency of positive indexes for estrogen receptors in all histologic types.

Bone mineral density at time of clinical diagnosis of adult-onset type 1 diabetes mellitus.

OBJECTIVE: To study bone mineral density (BMD) and bone remodeling factors at the time of diagnosis of adult-onset type 1 diabetes mellitus (DM). METHODS: In 22 men and 10 women, who ranged in age from 20 to 39 years, a study was undertaken promptly after diagnosis of type 1 DM (on the basis of criteria established by the World Health Organization). Before any treatment, the clinical history, glycemia, ketonuria, basal and glucagon-stimulated C-peptide levels, islet cell antibodies (ICA), glutamic acid decarboxylase autoantibodies (GADA), and bone remodeling variables were recorded for all the study subjects. Dual-energy x-ray absorptiometry (Hologic QDR1000) was performed to measure BMD in the lumbar spine (LS), femoral neck (FN), and Ward's triangle. RESULTS: Of the 32 patients, 24 (75%) showed positive levels of ICA or GADA (or both), whereas 8 (25%) tested negative. The BMD values-Z-scores (standard deviation [SD] adjusted for age and sex)-were lower among the patients with DM than in a matched healthy population in both the LS (-0.61 +/- 1.23 SD; P = 0.008) and the FN (-0.38 +/- 1.00 SD; P = 0.003). Twelve patients had a T-score between -2.5 SD and -1 SD in the LS, and 14 had the same scores in the FN and were classified as having osteopenia. A correlation was found between BMD values and C-peptide levels in the LS (r = 0.231; P = 0.02) and the FN (r = 0.27; P = 0.01). The BMD values did not correlate with bone remodeling markers, hemoglobin A1c, or immunologic variables. CONCLUSION: We found reduced bone mass in patients with type 1 DM at the time of the clinical diagnosis. A high percentage of patients with DM have osteopenia, which may not, therefore, be a late complication of type 1 DM. These findings need to be confirmed in larger studies.

Intensive insulin therapy and bone mineral density in type 1 diabetes mellitus: a prospective study.

To determine the effect of metabolic control on bone mineral density (BMD) in type 1 diabetes mellitus (type 1 DM), we studied BMD (by dual-energy X-ray energy absorptiometry) and bone remodeling parameters in 62 patients with type 1 DM both before and 7 years after commencement of intensive insulin therapy. Overall outcomes after the 7-year treatment included the stabilization of BMD at all sites, as well as a significant decrease in tartrate-resistant acid phosphatase (TRAP) (4.302 +/- 2.62 vs 2.65 +/- 0.97 IU/I; p=0.0001) and increase in intact parathyroid hormone (PTHi) (28.05 +/- 15.7 vs 39.78 +/- 22.41 ng/l; p=0.005). Presence of diabetic retinopathy (RTP) versus its absence (non-RTP) was associated with lower BMD in femoral neck (FN) (0.831 +/- 0.142 vs 0.756 +/- 0.153 mg/ cm2; p = 0.03) and Ward's triangle (WT) (0.736 +/- 0.165 vs 0.632 +/- 0.172 mg/cm2; p=0.03), and with a lower T-score in FN (-0.93 +/- 1.34 vs -1.70 +/- 1.46; p = 0.04) and WT (-0.72 +/- 1.42 vs -1.540 +/- 1.55; p = 0.04) and Z-score in FN (-0.591 +/- 1.23 vs -1.132 +/- 1.46; p=0.01). The percentage of patients with osteopenia or osteoporosis in the RTP group was significantly higher than in the non-RTP group (72% vs 53%, p=0.05; RR= 3.2) and the glycosylated hemoglobin (HbA1c) levels of the RTP group were also higher (8.53 +/- 1.6% vs 7.1+/- 1.1%; p=0.05). The improvement in metabolic control, increase in body mass index and decrease in resorption parameters could contribute to the stabilization of bone mass in type I DM but the presence of retinopathy is a critical factor in the progression of diabetic osteopenia.

Carcinoma verrucoso cérvico uterino en una mujer jóven / Verrucous carcinoma of the cervix in a young woman

Se describe el hallazgo de un carcinoma verrucoso en el cuello uterino, de una mujer joven (21 años). Se discute los aspectos clínicos y anátomo-patológicos, además se analiza la conducta terapéutica realizada

Relaxation training and opioid inhibition of blood pressure response to stress.

The present study was designed to determine the role of endogenous opioid mechanisms in the circulatory effects of relaxation training. Opioid mechanisms were assessed by examination of the effects of opioid receptor blockade with naltrexone on acute cardiovascular reactivity to laboratory stress before and after relaxation training. Thirty-two young men with mildly elevated casual arterial pressure were recruited for placebo-controlled naltrexone stress tests and relaxation training. The results indicated that relaxation training significantly reduced the diastolic pressure response to mental arithmetic stress. Opioid receptor blockade with naltrexone antagonized the effects of relaxation training. These findings suggest that some of the physiological effects of relaxation training are mediated by augmentation of inhibitory opioid mechanisms.