Histiocitosis sinusal con linfadenopatía masiva en el hueso cuneiforme medial: reporte de un caso / Sinus histiocytosis with massive lymphadenopathy in the medial cuneiform bone: A case report

Introducción: la histiocitosis sinusal con linfadenopatía masiva (HSLM) es un trastorno histiocítico benigno que afecta con mayor frecuencia a adultos jóvenes. La afectación ósea es poco frecuente y se suele presentar en huesos largos. Presentación del caso: hombre de 38 años con diagnóstico de HSLM según biopsia de nódulo cutáneo. Seis meses después del diagnóstico, presentó dolor mecánico en el pie derecho, por lo que asistió a una nueva consulta. Se realizó exploración física y radiografía simple, encontrando una lesión lítica en el hueso cuneiforme medial que posteriormente fue confirmada con tomografía computarizada y resonancia magnética nuclear. Por lo anterior, se realizó la resección de la lesión lítica, curetaje y relleno con cemento de fosfato de calcio HydraSet (Stryker®). Se realizaron pruebas inmunohistoquímicas y estudio anatomopatológico en el tejido resecado, evidenciando tinción de proteínas CD68 y S100 positivas, y tinción de proteina CD1a negativa, así como proliferación histiocitaria. Un año después de la cirugía, el paciente se encontraba asintomático y realizaba actividades sin ninguna restricción.Conclusiones: esta enfermedad es poco frecuente; no obstante, debe considerarse en el diagnóstico diferencial de lesiones líticas en huesos, especialmente cuando hay lesiones en otras partes del cuerpo

Introduction: Sinus histiocytosis with massive lymphadenopathy (SHML), also known as Rosai-Dorfman disease, is a benign histiocytic disorder most commonly found in young adults. Bone involvement is rare and usually occurs in long bones.Case presentation: 38-year-old man diagnosed with SHML based on skin lesion biopsy. Six months after diagnosis, he presented with mechanical pain in the right foot, so he attended a new medical appointment. Physical examination and a non-enhanced X-ray were performed, finding a lytic lesion in the medial cuneiform bone, which was later confirmed with computed tomography and nuclear magnetic resonance imaging. The lytic lesion was excised, curetted and filled with calcium phosphate cement HydraSet (Stryker®). Immunohistochemical tests and anatomopathological study were performed on the excised tissue, evidencing positive CD68 and S100 protein staining and negative CD1a protein staining, as well as histiocyte proliferation. One year after surgery, the patient was asymptomatic and performed activities without any restriction.Conclusions: Even though HSLM is a rare disease, it should be considered in the differential diagnosis of lytic lesions in the bones, especially when there are lesions in other parts of the body

Tumour growth activation by the central nervous system-An integrative theory of cancer.

The currently recognized mechanisms of the biology of cancer are not yet enough to explain the high incidence of the disease in industrialized countries. Survival and proliferation of cancer cells demand a well-orchestrated combination of functional capabilities, or hallmarks, which requires complex signalling networks that often exceed the tumour boundaries. Based on latest research on environmental health and aiming to provide cancer with a coherent set of organizing principles, we propose an integrative model of carcinogenesis founded on tumour growth activation by the central nervous system as an adaptive, allostatic response to both environmental and emotional challenges. In this way, chronicity of physical as well as psychological stressors may be directly involved in cancer genesis and progression, after an early inflammatory stage. The model also contemplates accidental activation of the tumour growth programme following direct DNA damage, but as a rare event that does not account for most cancers in humans. Bodily and cellular mechanisms designed to facilitate tumorigenesis may include exacerbation of the sympathetic activity, overexpression of membrane ion channels, promotion of selected mutations and methylations, degradation of the mitochondria and reprogramming of adult stem cells.

System dynamics for predicting the impact of traffic noise on cardiovascular mortality in Madrid.

The impact of road traffic noise on health is an important issue worldwide. In Madrid (Spain), the existing high daily noise levels all year round have been associated with short-term cardiovascular mortality. A system dynamics model is constructed to estimate the evolution of the traffic noise impact on the population older than 65 in Madrid over the upcoming years. This strategy allows to make predictions based on yearly variations in traffic intensity, population at risk, motor vehicle-related technological advances and lifestyles, and urban planning policies. Madrid harbours a persisting noise epidemic since 1980, which would be eradicated in 2040 at the earliest if significant action for noise abatement were taken.

Emergency multiple sclerosis hospital admissions attributable to chemical and acoustic pollution: Madrid (Spain), 2001-2009.

INTRODUCTION: Multiple sclerosis (MS) is the most prevalent neurological disease among young adults in Spain. A number of recent studies have linked traffic-related pollution, both chemical and acoustic, to the aetiology and exacerbation of neurodegenerative diseases. OBJECTIVE: To analyse the existence of a significant short-term association between daily emergency MS hospital admissions and chemical and acoustic pollution caused by traffic in Madrid. METHODOLOGY: We conducted a longitudinal ecological time series study, in which the dependent variable was the number of daily emergency MS hospital admissions (ICD-9: 340) registered in Madrid from 1 January 2001 to 31 December 2009. The independent variables were daily mean concentrations (µg/m3) of PM2.5, PM10, O3 and NO2. Equivalent diurnal (Leqd), nocturnal (Leqn) and daily equivalent noise levels (Leq24) were also considered. In addition, we controlled for linear trends, seasonality and the autoregressive nature of the series itself. Day of the week was also added as a covariate. Significant environmental variables were determined using Poisson GLM models. Relative risk (RR) and attributable risk (AR) values were calculated for increases of 10µg/m3 in the case of chemical pollutants and 1dB(A) in noise levels. RESULTS: While there was no association between chemical pollutants caused by traffic and MS admissions, such an association was in evidence for Leqd at lag zero. This association is linear without a threshold, with there being a level above 67dB(A) from which this effect is more pronounced. The RRs were as follows: for all Leqd values, 1.21 (95% CI: 1.16, 1.26); and for Leqd >67dB(A), 1.62 (95% CI: 1.24, 2.13). CONCLUSION: The above results indicate that traffic noise can exacerbate MS symptoms, leading to hospital admissions due to this cause.

Impact of road traffic noise on cause-specific mortality in Madrid (Spain).

Latest time-series research conducted in Madrid has reported associations of road traffic noise with cause-specific daily mortality. Based on the results from that research, this study presents the health impact of urban noise for the period 2003-2009 as the number of avoidable deaths from various cardiovascular, respiratory, and metabolic diseases. The impact of noise on cardiovascular mortality exceeds that of fine particles (PM2.5) in the two population groups considered: <65 and >65years of age.

The short-term association of road traffic noise with cardiovascular, respiratory, and diabetes-related mortality.

BACKGROUND: Road traffic noise has well-documented effects on cardiovascular, respiratory, and metabolic health. Numerous studies have reported long-term associations of urban noise with some diseases and outcomes, including death. However, to date there are no studies on the short-term association between this pollutant and a set of various specific causes of death. OBJECTIVES: To investigate the short-term association of road traffic noise with daily cause-specific mortality. METHODS: We used a time-stratified case-crossover design with Poisson regression. Predictor variables were daytime, nighttime, and 24-h equivalent noise levels, and maximum daytime and nighttime noise levels. Outcome variables were daily death counts for various specific causes, stratifying by age. We adjusted for primary air pollutants (PM2.5 and NO2) and weather conditions (mean temperature and relative humidity). RESULTS: In the ≥65 age group, increased mortality rates per 1 dBA increase in maximum nocturnal noise levels at lag 0 or 1 day were 2.9% (95% CI 1.0, 4.8%), 3.5% (95% CI 1.1, 6.1%), 2.4% (95% CI 0.1, 4.8%), 3.0% (95% CI 0.2, 5.8%), and 4.0% (95% CI 1.0, 7.0%), for ischemic heart disease, myocardial infarction, cerebrovascular disease, pneumonia, and COPD, respectively. For diabetes, 1 dBA increase in equivalent nocturnal noise levels at lag 1 was associated with an increased mortality rate of 11% (95% CI 4.0, 19%). In the <65 age group, increased mortality rates per 1 dBA increase in equivalent nocturnal noise levels at lag 0 were 11% (95% CI 4.2, 18%) and 11% (95% CI 4.2, 19%) for ischemic heart disease and myocardial infarction, respectively. CONCLUSION: Road traffic noise increases the short-term risk of death from specific diseases of the cardiovascular, respiratory, and metabolic systems.

Road traffic noise effects on cardiovascular, respiratory, and metabolic health: An integrative model of biological mechanisms.

BACKGROUND: Road traffic noise is a major public health issue, given the documented association with several diseases and the growing number of exposed persons all over the world. The effects widely investigated pertain to cardiovascular health, and to a lesser extent to respiratory and metabolic health. The epidemiological design of most studies has made it possible to ascertain long-term associations of urban noise with a number of cardiovascular, respiratory, and metabolic disorders and diseases; additionally, time series studies have reported short-term associations. OBJECTIVES: To review the various biological mechanisms that may account for all long-term as well as short-term associations between road traffic noise and cardiovascular, respiratory, and metabolic health. We also aimed to review the neuroendocrine processes triggered by noise as a stressor and the role of the central nervous system in noise-induced autonomic responses. METHODS: Review of the literature on road traffic noise, environmental noise in general, psychosomatics, and diseases of the cardiovascular, respiratory, and metabolic systems. The search was done using PubMed databases. DISCUSSION: We present a comprehensive, integrative stress model with all known connections between the body systems, states, and processes at both the physiological and psychological levels, which allows to establish a variety of biological pathways linking environmental noise exposure with health outcomes. CONCLUSIONS: The long- and short-term associations between road traffic noise and health outcomes found in latest noise research may be understood in the light of the integrative model proposed here.

Health impact assessment of traffic noise in Madrid (Spain).

The relationship between environmental noise and health has been examined in depth. In view of the sheer number of persons exposed, attention should be focused on road traffic noise. The city of Madrid (Spain) is a densely populated metropolitan area in which 80% of all environmental noise exposure is attributed to traffic. The aim of this study was to quantify avoidable deaths resulting from reducing the impact of equivalent diurnal noise levels (LeqD) on daily cardiovascular and respiratory mortality among people aged ≥65 years in Madrid. A health impact assessment of (average 24h) LeqD and PM2.5 levels was conducted by using previously reported risk estimates of mortality rates for the period 2003-2005: For cardiovascular causes: LeqD 1.048 (1.005, 1.092) and PM2.5 1.041(1.020, 1.062) and for respiratory causes: LeqD 1.060 (1.000, 1.123) and PM2.5 1.030 (1.000, 1.062). The association found between LeqD exposure and mortality for both causes suggests an important health effect. A reduction of 1dB(A) in LeqD implies an avoidable annual mortality of 284 (31, 523) cardiovascular- and 184 (0, 190) respiratory-related deaths in the study population. The magnitude of the health impact is similar to reducing average PM2.5 levels by 10µg/m(3). Regardless of air pollution, exposure to traffic noise should be considered an important environmental factor having a significant impact on health.

Responses to cochlear normalized speech stimuli in the auditory nerve of cat.

Previous studies of auditory-nerve fiber (ANF) representation of vowels in cats and rodents (chinchillas and guinea pigs) have shown that, at amplitudes typical for conversational speech (60-70 dB), neuronal firing rate as a function of characteristic frequency alone provides a poor representation of spectral prominences (e.g., formants) of speech sounds. However, ANF rate representations may not be as inadequate as they appear. Here, it is investigated whether some of this apparent inadequacy owes to the mismatch between animal and human cochlear characteristics. For all animal models tested in earlier studies, the basilar membrane is shorter and encompasses a broader range of frequencies than that of humans. In this study, a customized speech synthesizer was used to create a rendition of the vowel [E] with formant spacing and bandwidths that fit the cat cochlea in proportion to the human cochlea. In these vowels, the spectral envelope is matched to cochlear distance rather than to frequency. Recordings of responses to this cochlear normalized [E] in auditory-nerve fibers of cats demonstrate that rate-based encoding of vowel sounds is capable of distinguishing spectral prominences even at 70-80-dB SPL. When cochlear dimensions are taken into account, rate encoding in ANF appears more informative than was previously believed.