[Infantile hypertrofic pyloric stenosis or gastric adenomyoma? Differential diagnosis of gastric outlet obstruction in children]. / ¿Estenosis hipertrófica de píloro o adenomioma pilórico? Diagnóstico diferencial de obstrucción gástrica en niños.

PURPOSE: Gastrointestinal adenomyoma is a rare benign tumor most frequently located in the stomach. The differential diagnosis is wide because of its large clinical spectrum and unspecific radiological findings. Surgical excision is both diagnostic and therapeutic. CASE REPORT: A 49-days old girl presented with nonbilious vomiting of 48 hours of evolution. Infantile hypertrofic pyloric stenosis was suspected. Ultrasound showed a nonobstructive nodular lesion in the anterior pyloric wall. MRI suggested a myofibroblastic tumor. We proceeded to laparotomy and complete resection of the pyloric tumor. Histologic diagnosis was gastric adenomyoma. CONCLUSIONS: Pyloric adenomyoma causes obstructive symptoms similar to other common entities such as hypertrophic pyloric stenosis or cystic duplication. We have to consider this condition in children with digestive symptoms and radiological images of intussusceptions or duplication. Surgical excision is recommended to reach a definitive diagnosis and to avoid a possible malignant degeneration.

INTRODUCCION: El adenomioma gastrointestinal es una tumoración benigna rara cuya localización más frecuente es gástrica. Su diagnóstico diferencial es amplio debido a su gran espectro clínico y baja especificidad radiológica. La escisión quirúrgica es diagnóstico-terapeútica. CASO CLINICO: Niña de 49 días que presenta vómitos no biliosos de 48 horas de evolución. Ante sospecha de estenosis hipertrófica de píloro se solicita ecografía que muestra lesión nodular no obstructiva en pared anterior del píloro. Se realiza RM sugestiva de tumor miofibroblástico. Se procede a laparotomía y resección completa de tumoración pilórica, informada histológicamente como adenomioma gástrico. COMENTARIOS: El adenomioma pilórico produce clínica obstructiva y se confunde con entidades comunes como la estenosis hipertrófica de píloro o la duplicación quística. En un niño con síntomas digestivos e imagen radiológica de invaginación o duplicación, debemos tener en cuenta esta patología. La resección quirúrgica es de elección para un diagnóstico certero y para evitar una posible degeneración maligna.

[Influence of clinical and biographical factors on the quality of life of women with breast cancer receiving adjuvant chemotherapy]. / Influencia de los factores clínicos y biográficos en la calidad de vida de las mujeres durante la quimioterapia adyuvante por cáncer de mama.

OBJECTIVE: Adjuvant chemotherapy affects the life of women with breast cancer in different ways. The aim of this work is to study the effect of adjuvant chemotherapy on the quality of their lives and the impact of their clinical and biographical characteristics. PATIENTS AND METHOD: Women with breast cancer, candidates for adjuvant chemotherapy, participating in a randomised trial with non-pharmacological intervention (ClinicalTrials.gov Identifier: NCT00964522), completed the EORTC QOL-C30 and QOL-BR23 quality of life questionnaires before, in the middle, and at the end of the treatment. RESULTS: Fifty women completed the questionnaires. Overall health got worse over time (p=0.01). Physical functioning (p=0.0001) and body image (p=0.002) were the scales that deteriorated most, and asthenia (p=0.004), nausea/vomiting (p=0.05), and anorexia (p=0.025), were the symptoms with the largest temporary impact of the chemotherapy. Unemployed women had worse physical functioning (p=0.046) and role functioning (p=0.005). Older women had more diarrhoea (p=0.013). The most qualified women had a worse score in financial difficulties scale (p=0.034). Women with advanced stage (III) underwent more deterioration in the body image (p=0.001) and were more concerned about the future (p=0.006). Women treated with anthracycline and taxane also had a worse perspective of the future (p=0.02). CONCLUSIONS: Adjuvant chemotherapy deteriorates the quality of life of patients with breast cancer, basically in physical functioning and body image areas. Asthenia and gastrointestinal toxicity are the side effects that affect patients most. Women need support if they are older, unemployed, more educated, and have stage III breast cancer treated with anthracycline and taxane based chemotherapy.

GintMT1 encodes a functional metallothionein in Glomus intraradices that responds to oxidative stress.

A full-length metallothionein (MT) gene (GintMT1) was isolated from Glomus intraradices extraradical mycelium. This is the first MT gene reported in the genus Glomus, third in the Glomeromycota. Functional analysis of GintMT1 in a MT-defective Saccharomyces cerevisiae strain indicates that it encodes a functional MT. Gene expression analyses revealed that the transcript levels of GintMT1 were elevated in mycelia treated with 5 mM Cu or paraquat but inhibited in mycelia treated with 50 microM Cu or 450 microM Cd. The elevated expression of GintMT1 in the 5 mM Cu-treated mycelia together with the ability of GintMT1 to provide tolerance to a Cu-sensitive yeast suggests that GintMT1 might afford protection against Cu. Induction of GintMT1 expression by paraquat and 5 mM Cu, treatments that also produced an oxidative damage to the fungal membranes, suggests that GintMT1 may play a role in the regulation of the redox status of the extraradical mycelium of G. intraradices.