Country-report pattern corrections of new cases allow accurate 2-week predictions of COVID-19 evolution with the Gompertz model.

Accurate short-term predictions of COVID-19 cases with empirical models allow Health Officials to prepare for hospital contingencies in a two-three week window given the delay between case reporting and the admission of patients in a hospital. We investigate the ability of Gompertz-type empiric models to provide accurate prediction up to two and three weeks to give a large window of preparation in case of a surge in virus transmission. We investigate the stability of the prediction and its accuracy using bi-weekly predictions during the last trimester of 2020 and 2021. Using data from 2020, we show that understanding and correcting for the daily reporting structure of cases in the different countries is key to accomplish accurate predictions. Furthermore, we found that filtering out predictions that are highly unstable to changes in the parameters of the model, which are roughly 20%, reduces strongly the number of predictions that are way-off. The method is then tested for robustness with data from 2021. We found that, for this data, only 1-2% of the one-week predictions were off by more than 50%. This increased to 3% for two-week predictions, and only for three-week predictions it reached 10%.

[Postural control and gait changes in subacute stroke patients after receiving interdisciplinary rehabilitation and related factors: a retrospective study]. / Cambios en el control postural y la marcha en pacientes con ictus en fase subaguda tras recibir rehabilitación interdisciplinar y factores relacionados: estudio retrospectivo.

INTRODUCTION: Although early post-stroke rehabilitation is essential to optimize recovery, its effects and prognostic factors are yet under discussion. OBJECTIVE: To assess postural control and gait changes in post-stroke patients who underwent interdisciplinary rehabilitation in subacute phase and evaluate potential associated factors. PATIENTS AND METHODS: An observational retrospective study that analyzed sociodemographic and clinical data, including Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulatory Categories (FAC) and Tinetti scale, at admission and two months after rehabilitation. RESULTS: Data were collected from 63 patients with stroke in subacute phase. Interdisciplinary rehabilitation had a moderate and relevant clinical impact (p < 0,01; d mayor de 0,5) in postural control and gait. Ambulatory rehabilitation, psychotropic medication absence and dislipemia absence were moderate associated factors (p < 0,05; d mayor de 0,5) with a greater evolution in postural control measured with TIS and PASS. TIS at admission showed significant association with all scales' results at two months after rehabilitation, except with PASS changing posture subscale. CONCLUSIONS: Interdisciplinary rehabilitation promotes moderate and clinically relevant changes in postural control and gait recovery in subacute stroke patients, after two-month rehabilitation period. Ambulatory rehabilitation, dyslipidemia absence and psychotropic medication absence were associated with patients' evolution, but further research is required to confirm their actual influence in larger samples.

TITLE: Cambios en el control postural y la marcha en pacientes con ictus en fase subaguda tras recibir rehabilitación interdisciplinar y factores relacionados: estudio retrospectivo.Introducción. La rehabilitación precoz tras el ictus resulta fundamental para optimizar la recuperación, pero sus efectos y los factores pronósticos están aún en discusión. Objetivo. Evaluar los cambios en el control postural y la marcha en los pacientes con ictus que reciben rehabilitación interdisciplinar en fase subaguda y valorar los posibles factores relacionados. Pacientes y métodos. Estudio observacional retrospectivo que analizó datos sociodemográficos y clínicos, incluyendo el control postural y la capacidad de marcha, mediante las escalas Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulation Categories (FAC) y de Tinetti, tanto en el inicio como a los dos meses de rehabilitación. Resultados. Se recogieron datos de 63 pacientes con ictus en fase subaguda. La rehabilitación interdisciplinar tuvo un impacto clínico moderado (p menor de 0,01; d mayor de 0,5) y relevante sobre el control postural y la marcha. Los factores asociados moderadamente (p menor de 0,05; d > 0,5) a una mayor evolución en el control postural evaluado con la TIS y la PASS fueron la rehabilitación ambulatoria, la ausencia de medicación psicótropa y la ausencia de dislipidemia. La TIS en el inicio se asoció significativamente (p menor de 0,05) con los valores de todas las escalas tras dos meses de rehabilitación, excepto con la PASS movilidad. Conclusiones. La rehabilitación interdisciplinar favorece cambios moderados y clínicamente relevantes en la recuperación del control postural y la marcha de pacientes con ictus subagudo tras dos meses de tratamiento. La rehabilitación ambulatoria y la ausencia de dislipidemia y de medicación psicótropa se asocian con la evolución, pero son necesarios más estudios para confirmar su influencia en muestras mayores.

[Effectiveness of motor imagery in patients with multiple sclerosis: a systematic review]. / Eficacia de la imagen motora en la esclerosis múltiple: revisión sistemática.

INTRODUCTION: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Motor imagery (MI) has been proposed as a treatment to improve gait, fatigue and quality of life in these dysfunctions. AIM: To assess the effectiveness of MI, action observation therapy or mirror therapy approaches compared to other rehabilitation modality or no intervention, in MS. DEVELOPMENT: A systematic review of randomized controlled trials was conducted. Studies published in the last ten years investigating MI versus other interventions or no intervention in patients with MS were included. PEDro scale was used to assess methodological quality of included studies. Eight studies met the eligibility criteria. For fatigue, the MI and its combination with relaxation seem to be superior compared with other types of interventions or no intervention. The MI combined with music also showed significant improvements in gait and quality of life (QoL). CONCLUSIONS: MI and its combination with relaxation exercises have been shown to be effective in the treatment of fatigue, gait, balance, depression and QoL in patients with MS. The action observation therapy is useful in upper limb rehabilitation and improvement in attention, executive control and activation of sensorimotor networks. Further research with high methodological quality is needed to support these findings and to evaluate their effectiveness in long term.

TITLE: Eficacia de la imagen motora en la esclerosis múltiple: revisión sistemática.Introducción. La esclerosis múltiple (EM) es una enfermedad inflamatoria desmielinizante del sistema nervioso central. Se ha propuesto la imagen motora (IM) como tratamiento para mejorar la marcha, la fatiga y la calidad de vida en esta patología. Objetivo. Evaluar la eficacia del abordaje mediante IM, terapia de observación de acciones (AOT) o terapia en espejo, en comparación con una modalidad diferente de rehabilitación o la no intervención en la EM. Desarrollo. Se realizó una revisión sistemática de ensayos controlados aleatorizados. Se incluyeron estudios de los últimos 10 años que comparasen la IM frente a otras intervenciones o la no intervención en pacientes con EM. Se utilizó la escala PEDro para evaluar la calidad metodológica de los estudios incluidos. Ocho estudios cumplieron los criterios de elegibilidad. Para la fatiga, la IM y su combinación con la relajación parecen ser superiores en comparación con otros tratamientos o la no intervención. La IM combinada con música también mostró mejoras significativas en la marcha y en la calidad de vida. Conclusiones. La IM combinada con ejercicios de relajación ha demostrado eficacia en el tratamiento de la fatiga, la marcha, el equilibrio, la depresión y la calidad de vida en personas con EM. La AOT resulta útil en la rehabilitación del miembro superior y en la mejora de la atención, el control ejecutivo y la activación de las redes sensoriomotoras. Son necesarios estudios de mayor calidad metodológica que respalden estos resultados y valoren su efectividad a largo plazo.

Myofascial pain, widespread pressure hypersensitivity, and hyperalgesia in the face, neck, and shoulder regions, in survivors of head and neck cancer.

PURPOSE: Medical treatment for head and neck cancer may induce the presence of inflammation, pain, and dysfunction. The purpose of the current study was to assess the presence of myofascial trigger points (TrPs) and their relationship with widespread pressure hypersensitivity and hyperalgesia in survivors of head and neck cancer (sHNC). METHODS: TrPs and pressure-pain thresholds (PPTs) were quantified in different muscles/joints in the head and neck of 30 sHNC (59.45 ± 13.13 years) and 28 age- and sex-matched controls (58.11 ± 12.67 years). RESULTS: The sHNC had more TrPs in all muscles on the affected side (p < 0.05) than did the healthy controls, and in the temporalis, masseter, and suboccipitalis muscles on the unaffected side (p < 0.05). They also had lower PPTs in all places (p < 0.05) except for the temporalis muscle (p = 0.114) and C5-C6 joint (p = 0.977). The intensity of cervical pain correlated positively with the presence of upper trapezius TrPs. CONCLUSIONS: sHNC suffering cervical and/or temporomandibular joint pain have multiple active TrPs and experience widespread pressure hypersensitivity and hyperalgesia, suggestive of peripheral and central sensitization.

Plasmocitoma solitario de costilla como presentación inicial de mieloma múltiple: reporte de un caso / Lone rib plasmacytoma as a presentation of initial multiple myeloma: a case report

Resumen Introducción: El 50% de los tumores de pared torácica son malignos, dentro de los que destaca el plasmocitoma de costilla. Objetivo: Presentar un caso clínico que debutó inicialmente como un plasmocitoma de costilla, y que terminó presentándose como mieloma múltiple. Materiales y Método: Registro clínico de un paciente sometido a resección de tumor de parrilla costal. Resultados: Paciente masculino de 58 años, con un año de dolor costal, asociado a aumento de volumen a nivel de la octava costilla derecha en línea media axilar, indurada. TC de tórax que demuestra imagen sugerente de plasmocitoma de 79 × 44 mm. Se realiza resección quirúrgica, con instalación de malla de prolene en el defecto. Biopsia diferida con compromiso neoplásico por lesión monoclonal de células plasmáticas. Se complementa estudio con biopsia de médula ósea confirmando mieloma múltiple. Se inicia tratamiento con quimioterapia adyuvante. Conclusiones: El plasmocitoma óseo solitario es una entidad de baja frecuencia, que se asocia a la presencia de mieloma múltiple. Es por esto que al momento de la sospecha se hace necesario descartar su presencia, con el fin de mejorar el pronóstico del paciente.

Introduction: Up to 50% of chest wall tumors are malignant; among which rib plasmocytoma stand out. Aim: Showcase a clinical case that debuted as a rib plasmacytoma, and that ended up presenting as Multiple Myeloma. Materials and Method: Records of a patient with resection of chest wall tumor. Results: Male patient of 58 years, with one year of costal pain, associated with an indurated increase in volume at the level of the eighth right rib in the mid-axillary line. Chest CT scan demonstrated a suggestive image of plasmacytoma of 79 × 44 mm. Surgical resection was performed, with prolene mesh installation in the defect. Biopsy showed neoplastic compromise due to monoclonal lesion of plasma cells. Study is complemented with bone marrow biopsy confirming multiple myeloma. The patient was treated with adjuvant chemotherapy. Conclusions: Solitary bone plasmacytoma is a low frequency entity, which is associated with the presence of multiple myeloma. At the moment of suspicion, it is necessary to rule out their presence, in order to improve the patient's prognosis.

Diagnostic Approach for Suspected Allergic Cutaneous Reaction to a Permanent Tattoo.

The last few decades have seen a notable increase in the number of people who have a tattoo. This practice is not free from complications. Most adverse effects appear early and are temporary, although they can occasionally develop later and be permanent and serious. Recent research has generated new knowledge on the composition of inks, their degradation over time, the immune activity that is stimulated, and the various clinical disorders that can arise. This information enables better approaches to diagnosis and management when complications arise. Diagnosing allergic reactions to permanent tattoo ink can be very challenging. This review aims to identify clinical and histological clues to help practitioners differentiate allergic reactions from other complications. We discuss the yield and appropriateness of skin tests and biopsies and propose an algorithm to guide the diagnostic process.

Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale. / Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS).

INTRODUCTION: The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. OBJECTIVE: To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. METHODS: Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. RESULTS: The optimal cut-off point for S-LANSS was ≥12 points (AUC=.89; sensitivity=88.7; specificity=76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P<.05). The S-LANSS showed a significant correlation with ID-Pain (r=.734, α=.71). CONCLUSION: The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features.

Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital. / ¿Qué procedimientos diagnósticos deberíamos realizar ante una sospecha de reacción alérgica a un tatuaje? Propuesta basada en nuestra casuística.

INTRODUCTION: Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS: We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS: We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS: Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment.

Physical impairments and quality of life of colorectal cancer survivors: a case-control study.

The aim of the study is to determine the physical performance, quality of life and fatigue in colorectal cancer survivors compared with healthy controls. Twenty-three colorectal cancer survivors and 22 matched controls were recruited for this case-control study. Fitness level (muscle trunk flexor endurance test, 6-min walk test, chair sit and reach test and flamingo test) was assessed in both groups. Participants completed the European Organization of Research and Treatment of Cancer, the Quality of Life Questionnaire (QLQ-C30), the Piper Fatigue Scale (PFS) and the International Fitness Scale (IFIS). Significant differences between groups were found for all fitness parameters (P < 0.05). In addition, the anova revealed significant differences in all of the IFIS scores (P < 0.001), PFS (P < 0.01) and functioning scores of the QLQ-C30 (P < 0.05) between colorectal cancer survivors and the control group. The Mann-Whitney U-test showed a significant increase in symptom scores such as fatigue, dyspnoea and diarrhoea in the cancer survivors (P < 0.05). This study shows the existence of perceived and objective deterioration of health-related fitness level, presence of moderate cancer fatigue and reduced perceived quality of life in colorectal cancer survivors compared with healthy controls.

Carcinoma Seroso Papilar Peritoneal Primario: serie de casos Hospital Clínico Universidad de Chile 2010-2015 / Primary Serous Papillary Carcinoma: Case Report, Hospital Clinico Universidad de Chile 2010-2015

Los cánceres peritoneales primarios son una patología de baja prevalencia, dentro de los cuales el carcinoma seroso papilar primario de peritoneo es el más frecuente con una incidencia de 6,78 casos por millón de habitantes. Predomina en el sexo femenino y su principal diagnóstico diferencial es el carcinoma papilar seroso de ovario avanzado, para lo cual la inmunohistoquímica, junto a sus clasificaciones clínicas y anatomopatológicas son la forma de diferenciar en base a la clasificación de la Organización Mundial de la salud para lesiones tumorales. Objetivo: Describir los resultados inmuno-histoquímicos de una serie de casos estudiados en el Hospital Clinico de la Universidad de Chile y compararlos con la literatura médica. Material y Método: Estudio retrospectivo, descriptivo en base a análisis de 12 biopsias entre Enero 2010 y Marzo 2015 clasificándolos según edad, sexo y registro de biopsia. Se realizó técnica histológica rutinaria además de las tinciones inmunohistoquímicas para WT1, citoqueratinas y otros reactivos de acuerdo a los diagnósticos diferenciales. Resultados: La distribución etaria fue de 47 a los 75 años, media de 60 años, el 100% de los casos de sexo femenino. Los reactivos de Inmunohistoquímica predominantes fueron WT1 (53,8%), Citoqueratina-7 (38,5%). Conclusiones: Este carcinoma es una entidad poco común en la clínica, con similitudes al carcinoma seroso ovárico. Existe consenso sobre el diagnóstico de esta patología, el cual se debe orientar, según los criterios de la Gynecologic Oncology Group. Ante la sospecha clínica, el patólogo puede realizar el estudio inmunohistoquímico dirigido y así tener un diagnóstico preciso para determinar la conducta terapéutica del cirujano.

The primary peritoneal cancer is a low prevalence disease, within which primary papillary serous carcinoma of the peritoneum is the most frequent with an incidence of 6.78 cases per million inhabitants. Predominates in females and its main differential diagnosis is advanced ovarian papillary serous carcinoma, for which immunohistochemistry and clinical and pathological classifications are the way to differentiate base on the World Health Organization classification for tumor lesions. Objective: Describe the immunohistochemical results of a series of cases studied in Universidad de Chile Clinical Hospital and to compare them with the literature. Material and Methods: Descriptive retrospective study based on analysis of biopsies from 12 cases between January 2010 and March 2015 classifying them according to age, sex and biopsy register. Routine histological technique was performed in addition to the immunohistochemical staining for WT1, cytokeratin and other reagents according to the differential diagnoses. Results: The age distribution was 47 to 75 years, mean 60 years, 100% of cases female. Immunohistochemical reagents were predominant WT1 (53.8%) and cytokeratin-7 (38.5%). Conclusion: This carcinoma is a rare entity in routine clinical practice, with similarities to ovarian serous carcinoma.There is consensus on the diagnosis of this condition, which must be oriented according to the criteria of the Gynecologic Oncology Group. Clinical suspicion can lead the pathologist to perform immunohistochemical study and thus have an accurate diagnosis to determine the therapeutic approach of the surgeon.

Hallazgos histológicos gástricos en obesos mórbidos sometidos a gastrectomía vertical laparoscópica / Pathological findings in resected gastric segments after laparoscopic sleeve gastrectomy

Background: Laparoscopic sleeve gastrectomy (LSG) is used for the treatment of obesity and may provide gastric tissue for pathological studies. The association of obesity with dyslipidemias, diabetes and cardiovascular disease is of common knowledge. However its association with gastrointestinal diseases and gastritis is less well known. Aim: To analyze the pathological findings of the resected gastric segment during LSG. Material and Methods: Two hundred fifty patients aged 37 +/- 12 years and with a body mass index of 37.7 +/- 3.1 kg/m² (189 women), subjected to LSG, were included in a prospective protocol. Resected gastric segments were sent for a pathological study. Results: A gastric disease was identified in 220 (88 percent) cases. Chronic follicular gastritis was diagnosed in 117 patients (46.8 percent), chronic superficial gastritis in 76 (30.4 percent), chronic nonspecific gastritis in 38 (15.2 percent), intestinal metaplasia in 14 percent (5.6 percent) and in one case (0.4 percent) an early gastric carcinoma. Helicobacterpylori was present in 34 (13.6 percent) patients. Conclusions: This study shows a high prevalence of histopathological gastric lesions detected after the LSG, reaffirming the need for detection of these lesions before surgery.

Introducción: La gastrectomía vertical laparoscópica (GVL) es un procedimiento quirúrgico efectivo en el tratamiento de la obesidad. La obesidad está asociada con algunas comorbilidades como diabetes, dislipidemia y enfermedad cardiovascular, pero también se ha demostrado que tiene efectos potenciales sobre la gastritis y diversas enfermedades gastrointestinales. El objetivo de este estudio es determinar los hallazgos histológicos del segmento gástrico resecado durante la GVL realizada en una serie de pacientes obesos. Material y Método: Entre enero de 2006 y diciembre de 2008, 250 pacientes consecutivos a los que se realizó GVL, fueron incluídos en un protocolo prospectivo. La serie consistió en 189 mujeres (75,6 por ciento) y 61 hombres (24,4 por ciento), con edad promedio de 37,5 +/- 12,1 años. El Índice de Masa Corporal (IMC) promedio fue 37,7 +/- 3,1 kg/m². Resultados: Los resultados histológicos identificaron 220 casos (88 por ciento) con patología gástrica. Se diagnosticó gastritis crónica folicular en 117 pacientes (46,8 por ciento), gastritis crónica superficial en 76 (30,4 por ciento), gastritis crónica inespecífica en 38 (15,2 por ciento), metaplasia intestinal en 14 percent (5,6 por ciento) y en un caso (0,4 por ciento) adenocarcinoma in situ. Helicobacter pylori (HP) estuvo presente en 34 pacientes (13,6 por ciento). Conclusiones: Los hallazgos de este estudio, muestran una prevalencia incrementada de lesiones gástricas histopatológicas detectadas posterior a la GVL, reafirmando la necesidad de una detección de estas lesiones antes de la cirugía.

Agreement between telerehabilitation involving caregivers and face-to-face clinical assessment of lymphedema in breast cancer survivors.

Lymphedema is a lifetime complication of breast cancer survivors that can limit their participation in recreational or strenuous daily activities. Follow-up of lymphedema using an Internet application could help patients to determine the influence on their condition of these activities and adapt them accordingly. We aimed to determine the level of agreement between lymphedema assessment by telerehabilitation and by the traditional face-to-face method. Thirty breast cancer survivors participated in a descriptive study of repeated measures using a crossover design. Patients attended a session for clinical face-to-face and real-time online telerehabilitation assessments of lymphedema. There was a 120-min interval between these two sessions. The order of sessions was randomly selected for each patient. A caregiver (relative or friend) conducted the telerehabilitation assessment using a system that includes a specific tool based on an arm diagram for measuring the participant's arm circumferences via a telehealth application. All outcome measures showed reliability estimates (α) ≥ 0.90; the lowest reliability was obtained for the total volume on the non-affected side (α = 0.90). The diagnosis of lymphedema by the two methods also showed good inter-rater reliability (Rho = 0.89). These preliminary findings support the use of an Internet-based system to assess lymphedema in breast cancer survivors, offering carers a useful role in helping patients to follow up this lifetime health problem.

Cuerno cutáneo y carcinoma sebáceo: diagnóstico diferencial a propósito de un caso / Cutaneous horn and sebaceous carcinoma: differential diagnosis of a case report

El cuerno cutáneo es un concepto semiológico. Se define como una lesión tumoral hiperqueratósica de aspecto cónico y tamaño variable, que puede tener como base una lesión de origen benigno, premaligno o maligno. El tratamiento consiste en la resección completa de la lesión, seguido de un estudio histopatológico para precisar el diagnóstico. El carcinoma sebáceo, neoplasia maligna derivada del epitelioanexial de las glándulas sebáceas, se ha descrito como una etiología poco frecuente de cuerno cutáneo. Su diagnóstico es difícil, ya que carece de elementos clínicos característicos y su histología puede ser similar al carcinoma espinocelular o basocelular, pero importante ya que constituye una neoplasia agresiva, con riesgo de recurrencia local y metástasis. A continuación, presentamos el caso de un hombre de 68 años con diagnóstico clínico de cuerno cutáneo palpebral y diagnóstico histopatológico de carcinoma sebáceo.

The cutaneous horn is a semiological concept. It is defined as an hyperkeratotic tumor of conical appearance and variable size, which may be based on benign, premalignant or malignant lesion. The treatment is the complete resection followed by an histopathology study to clarify the diagnosis. Sebaceous carcinoma, malignant neoplasm derived from adnexal epithelium of sebaceous glands, has been described as a rare etiology of cutaneous horn. Diagnosis is difficult because it doesn’t have characteristic clinical features and histology may be similar to squamous or basal cell carcinoma, but it is important because is an aggressive neoplasm with risk of local recurrence and metastasis. We present a case of a 68-year-old man, with a clinical diagnosis of eyelid cutaneous horn and histopathological diagnosis of sebaceous carcinoma.

Influence of physical inactivity in psychophysiological state of breast cancer survivors.

Physical inactivity has been postulated as mediator of the relationship between cancer-related symptoms and psychoneurobiological alterations. The aim of the study was to evaluate the influence of physical inactivity level on mood state, fitness level as well as on salivary markers of the hypothalamic-pituitary-adrenal axis (cortisol) and the SNS (α-amylase) in breast cancer survivors. One hundred and eight breast cancer survivors (stages I-IIIa) participated in this cross-sectional study. Data were gathered on the following: Minnesota Leisure Time Physical Activity Questionnaire, profile of mood state, 6-min walk test, force handgrip, blood pressure, salivary cortisol concentration and salivary α-amylase activity. For our analysis, two groups were formed based on physical activity level measured as energy expenditure during diary leisure activities of the participants at the moment of the study, a physical inactivity level group (<3 METs × h/week) and an adequate physical activity level group (>3 METs × h/week). Fitness level was significantly higher in the active than the inactive group, while anger, fatigue, depression, confusion, mood disturbance, diastolic blood pressure and salivary α-amylase activity were significantly greater in the inactive than the active group. These results suggest that physical inactivity induces a worse psychoneurobiological state in inactive than in active breast cancer survivors.

Psychometric properties of the QuickPIPER: a shortened version of the PIPER Fatigue scale.

This paper proposes 'QuickPIPER', a 15-item, validated one-dimensional model representing cancer-related fatigue, based on factor analysis testing of the Piper Fatigue Scale-revised (R-PFS). One hundred and eleven breast cancer survivors participated in this prospective, observational study of the QuickPIPER validation. Participants completed the R-PFS and the Profile of Mood States (POMS) Fatigue and Vigor subscales. The questionnaires were tested concurrently before and after a multimodal exercise programme trial. Psychometric characteristics assessed from the sample included internal consistency and factor analysis, concurrent criterion validity and predictive ability. The results shows that the correlation matrix for the QuickPIPER questionnaire was determined as suitable with the Kaiser-Meyer-Oklin values (0.89) and Bartlett's Test of Sphericity (P < 0.001). The total cumulative variance explained was 65.32%. The goodness-of-fit indices of confirmatory factor analysis were satisfactory (normed fit index = 0.91 and comparative fit index = 0.92). Test-retest reliability was very good (r = 0.947, P < 0.001). The QuickPIPER scores correlated with POMS Fatigue (r = 0.800) and POMS Vigor (r = -0.352) subscales. Predictive ability showed that the area under the curves for the screening questionnaires was 0.743 (95% confidence interval 0.579-0.906). The 15-item QuickPIPER possesses similar properties to the 22-item R-PFS and offers the important advantage of brevity.

The role of thyroid hormones as inductors of oxidative stress and neurodegeneration.

Reactive oxygen species (ROS) are oxidizing agents amply implicated in tissue damage. ROS production is inevitably linked to ATP synthesis in most cells, and the rate of production is related to the rate of cell respiration. Multiple antioxidant mechanisms limit ROS dispersion and interaction with cell components, but, when the balance between ROS production and scavenging is lost, oxidative damage develops. Many traits of aging are related to oxidative damage by ROS, including neurodegenerative diseases. Thyroid hormones (THs) are a major factor controlling metabolic and respiratory rates in virtually all cell types in mammals. The general metabolic effect of THs is a relative acceleration of the basal metabolism that includes an increase of the rate of both catabolic and anabolic reactions. THs are related to oxidative stress not only by their stimulation of metabolism but also by their effects on antioxidant mechanisms. Thyroid dysfunction increases with age, so changes in THs levels in the elderly could be a factor affecting the development of neurodegenerative diseases. However, the relationship is not always clear. In this review, we analyze the participation of thyroid hormones on ROS production and oxidative stress, and the way the changes in thyroid status in aging are involved in neurodegenerative diseases.

Aquatic exercise in a chest-high pool for hormone therapy-induced arthralgia in breast cancer survivors: a pragmatic controlled trial.

OBJECTIVE: To investigate the impact of aquatic exercise on pressure pain threshold in breast cancer survivors with hormone therapy-associated arthralgia. DESIGN: Single-blind, controlled trial. SETTING: Two major metropolitan hospitals and a Sport and Spa Club in Granada, Spain. SUBJECTS: Forty women aged 29-71 years with stage I-III breast cancer who reported arthralgia. INTERVENTION: Patients were allocated alternately to either aquatic exercise in a chest-high pool or usual care while on the waiting list; control patients received treatment later. The two-month hydrotherapy intervention consisted of 24 sessions 3 days per week. Each session included 5 minutes of warm-up, 15-20 minutes of aerobic exercise, 15 minutes of mobility exercise and 20 minutes of recovery techniques. MAIN MEASURES: Pressure pain threshold at neck, shoulder, hand and leg were evaluated as primary outcomes. Cancer-related fatigue, as measured by the Piper Fatigue Scale, body mass index and waist circumference were secondary outcomes. A 2 × 2 repeated-measure ANCOVA was used in this study. RESULTS: No adverse events or development of worsening of pain was observed. Almost all the participants in the intervention group (89%) adhered to the hydrotherapy programme. Participants experienced a decrease in pressure pain threshold measured in neck, hand, shoulder and leg, as measured by algometry pressure, and waist circumference; all P < 0.05. Cancer-related fatigue (P = 0.06) and body mass index (P = 0.42) did not show significant improvement. CONCLUSIONS: These data suggest that hydrotherapy in a chest-high pool may reduce the pain threshold and waist circumference in breast cancer survivors with hormone therapy-associated arthralgia.

Tumor híbrido parotídeo / Parotid hybrid tumor

Los tumores de glándulas salivales representan el 3%-10% de las neoplasias de cabeza y cuello. La localización más común es en la glándula parótida, representando el 50%-85% de los casos, siendo 20%-30% de ellos malignos. Los siguientes son indicadores de malignidad: Crecimiento acelerado, masa dolorosa, parálisis facial asociada y linfoadenopatía. La mayoría de las neoplasias de parótida derivan de un único tipo histológico, pero eventualmente puede ocurrir el desarrollo de más de un tipo en la misma glándula. Este trabajo presenta un caso de una neoplasia en parótida con dos tipos histológicos diferentes, con una presentación clínica atípica. El paciente se presentó inicialmente con otalgia y otorrea, al examen destacaba un tumor en el canal auditorio externo. El estudio complementario evidenció una neoplasia de parótida y se realizó resección total de la glándula. La biopsia informó un carcinoma adenoideo-quístico con áreas basaloideas diferenciadas. Se administró radioquimioterapia adyuvante, y el control imagenológico con PET-TC mostró la ausencia de recurrencias o diseminación del tumor.

Tumors of the salivary glands represent 33%-10% of head and neck neoplasms. The most common location is the parotid gland, accounting for 50%-85% of the cases, with 20%-30% of them being malignant. The following are known to be indicative of a malignant tumor: fast growing, painless mass, associated facial paralysis and lymphadenopathy. Most parotid neoplasm derive from a single histological type but eventually the development of more than one type on the same gland can occur. This paper presents a case of a parotid neoplasm with two different histological tumors, with uncharacteristic clinical presentation. The patient presented initially with ear pain and otorrhoea, in the clinical examination highlighted an external auditory canal tumor. The complementary study revealed a parotid neoplasm and a total resection of the gland was performed. The biopsy revealed an adenoid-cystic carcinoma with differentiated basaloid areas. Adjuvant radio-chemotherapy was administered, and the imaging control with PET-CT showed no evidence of recurrence or dissemination of the tumor.