Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future.

Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a "female neurosurgery" and a "male neurosurgery" is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.

Pediatric Case of Li-Fraumeni Syndrome in Honduras.

Li-Fraumeni syndrome is an inherited, autosomal dominant disease. It is categorized as a rare disease caused by mutations of the TP53 gene, which causes increased susceptibility of the patients and their children to many types of cancer. Choroid plexus tumor is rare, which occurs in 0.3 cases per 1,000,000 people, of which 40% turn out to be carcinomas. We present a 12-year-old boy with a history of worsening headaches of more than one month, gait disturbance, projectile vomiting, and right hemiparesis. An intraventricular tumor was identified in the occipital of the left lateral ventricle, which turned out to be a TP53-mutant choroidal plexus carcinoma.

Hábitos alimenticios en comerciantes del mercado campesino. Sucre, Bolivia. 2019 / Food habits in traders of the campesino marketplace. Sucre, Bolivia. 2019

OBJETIVO: describir los hábitos alimenticios y estilo de vida de los comerciantes del mercado Campesino. MÉTODOS: se realizó un estudio descriptivo, transversal con 170 personas comprendidas entre 14 a 80 años. Para la recolección de datos se aplicó una encuesta. RESULTADOS: la mayor parte de la población encuestada es del sexo femenino, comparando el número de veces durante la semana del consumo de comida chatarra entre hombres y mujeres se encontró que con más frecuencia las mujeres consumen de 1 a 3 veces por semana la comida chatarra. Hay más jóvenes de entre 14 y 21 años que realizan actividad deportiva que el resto de las edades, hay más sujetos en la población de entre 38 a 45 años que consumen sustancias como alcohol, nicotina y tabaco.

OBJECTIVE: describe the eating habits and lifestyle of the farmers of the peasant market. METHODS: a descriptive, cross - sectional study was carried out with 170 people between 14 and 80 years old. For data collection, a survey was applied. RESULTS: most of the surveyed population is female, comparing the number of times during the week of junk food consumption between men and women, it was found that women consume junk food more frequently 1 to 3 times a week. There are more young people between 14 and 21 years of age who perform sports activity than the rest of the ages, there are more subjects in the population between 38 and 45 years of age who consume substances such as alcohol, nicotine and tobacco.

Datasets acquired with correlative microscopy method for delineation of prior austenite grain boundaries and characterization of prior austenite grain size in a low-alloy high-performance steel.

Prior studies on martensitic steel microstructures have either delineated the prior austenite grain boundaries via chemical etching or reconstructed the prior austenite grains from crystallographic orientations measured with electron backscattered diffraction (EBSD). To appropriately validate the reconstruction algorithms, the EBSD data need to be collected on martensitic microstructures, where the prior austenite grain boundaries are delineated with techniques such as chemical etching that can serve as ground truth for comparison with the reconstructed prior austenite grains. In this article, the method of correlative microscopy is employed to collect scanning electron microscope (SEM) image and automated EBSD scan data from the same region of an appropriately etched steel specimen. The SEM images and automated EBSD scan data are presented for five different fields of view in the specimen. These datasets are analyzed and discussed in the accompanying article titled "Correlative microscopy for quantification of prior austenite grain size in AF9628 steel" [1].

Phylogenetic analysis of Histoplasma capsulatum var duboisii in baboons from archived formalin-fixed, paraffin embedded tissues.

Histoplasma capsulatum var. duboisii (Hcd) infections have been well documented to cause chronic granulomatous disease, mainly involving the skin of baboons and humans in African countries primarily. This retrospective study classified the subspecies of Histoplasma and developed a phylogenetic tree utilizing DNA sequences extracted from formalin-fixed, paraffin embedded (FFPE) tissues from 9 baboons from a research colony in Texas histologically diagnosed with Hcd. Based on sequence analysis of ITS-2, Tub-1, and ARF, Hcd isolated from the archived samples closely aligns with the African clade and has 88% sequence homology with a sample isolated from an individual in Senegal.

MRI Features Can Predict 1p/19q Status in Intracranial Gliomas.

BACKGROUND AND PURPOSE: The 2016 revision of the World Health Organization Classification of Tumors of the Central Nervous System mandates codeletion of chromosomes 1p and 19q for the diagnosis of oligodendroglioma. We studied whether conventional MR imaging features could predict 1p/19q status. MATERIALS AND METHODS: Patients with previous 1p/19q testing were identified through pathology department records, typically performed on the basis of an oligodendroglial component on routine histology; 69 patients met the inclusion criteria. Preoperative imaging of patients with grade II or III gliomas was retrospectively assessed by 2 neuroradiologists, blinded to the 1p/19q status. Thirteen MR imaging features were first assessed in a small initial cohort (n = 10), after which the criteria were narrowed for the remaining patients as a validation cohort. RESULTS: There was 85% agreement between radiologists for the overall prediction of 1p/19q status in the validation cohort, with an accuracy of 84%. The presence of >50% T2-FLAIR mismatch and calcification was found to be the most useful for predicting 1p/19q status. The >50% T2-FLAIR mismatch variable was demonstrated in 14 tumors and had 100% specificity for identifying a noncodeleted tumor (P = .001), with 97% interobserver correlation. Calcification was visualized in 7 tumors, 6 of which were 1p/19q codeleted (specificity, 97%; P = .006), with 100% interobserver correlation. CONCLUSIONS: The presence of >50% T2-FLAIR mismatch is highly predictive of a noncodeleted tumor, while calcifications suggest a 1p/19q codeleted tumor. If formal 1p/19q testing is not possible, a combined MR imaging-histologic assessment may improve the diagnostic accuracy over histology alone.

Impact of CXCR4/CXCL12 Blockade on Normal Plasma Cells In Vivo.

Plasma cells (PCs) are a major source of alloantibody in transplant patients and are resistant to current therapy. Because receptor-ligand interactions in stromal microenvironments play important roles in the localization, development, and survival of normal PCs, we hypothesized that interfering with CXCR4/CXCL12 interactions with plerixafor might cause PC depletion and enhance the efficacy of the proteasome inhibitor bortezomib. PCs in mouse spleen, bone marrow, and peripheral blood demonstrated CXCR4 expression. We then treated with plerixafor in doses ranging from 240 µg/kg in a single dose to a 1-mg/kg daily dose for 10 days. CXCR4/CXCL12 blockade with plerixafor resulted in increased mobilization of PCs into the peripheral blood. Splenectomy completely abrogated this effect, suggesting that all plerixafor-mobilized cells were from the spleen. The total number of PCs in the spleen and marrow remained constant despite treatment with plerixafor. Bortezomib caused a reduction in PCs, but adding plerixafor did not increase killing. We conclude that CXCR4/CXCL12 interactions are important for the retention of a subpopulation of PCs in the spleen, but this interaction has minimal effect on PCs in the marrow. The lack of enhancement of bortezomib-mediated depletion suggests that factors other than CXCR4/CXCL12 interactions are responsible for drug resistance.

Mosaic-activating FGFR2 mutation in two fetuses with papillomatous pedunculated sebaceous naevus.

Papillomatous pedunculated sebaceous naevus (PPSN) has been described as a subtype of sebaceous naevus (SN), typically affecting the scalp and face. In contrast with Schimmelpenning syndrome, no cerebral, ocular or skeletal anomalies have hitherto been reported. We report two unrelated fetuses with PPSN, one with large pink exophytic tumours, the other with minor features but similar microscopic findings. We performed whole-exome sequencing in affected skin tissue from fetus 1, which identified a postzygotic de novo FGFR2 c.1144T>C (p.Cys382Arg) mutation in 34·6% of reads which was absent in the parents' blood. Targeted deep sequencing of FGFR2 confirmed its mosaic status in additional affected skin from fetus 1, and identified the same substitution in 26% of reads in affected skin from fetus 2. FGFR2 p.Cys382Arg is a known somatic driver mutation in human cancer, previously reported to result in activation of RAS signalling. A similar paralogous missense mutation in the transmembrane domain of FGFR3 (p.Gly380Arg) has been reported in keratinocytic epidermal naevi. Our findings define a distinct clinical and molecular subgroup of SN, beside HRAS or KRAS-related SN, and expand the spectrum of mosaic skin conditions associated with receptor tyrosine kinase mutations.

Selective CREB-dependent cyclin expression mediated by the PI3K and MAPK pathways supports glioma cell proliferation.

The cyclic-AMP response element binding (CREB) protein has been shown to have a pivotal role in cell survival and cell proliferation. Transgenic rodent models have revealed a role for CREB in higher-order brain functions, such as memory and drug addiction behaviors. CREB overexpression in transgenic animals imparts oncogenic properties on cells in various tissues, and aberrant CREB expression is associated with tumours. It is the central position of CREB, downstream from key developmental and growth signalling pathways, which gives CREB this ability to influence a spectrum of cellular activities, such as cell survival, growth and differentiation, in both normal and cancer cells. We show that CREB is highly expressed and constitutively activated in patient glioma tissue and that this activation closely correlates with tumour grade. The mechanism by which CREB regulates glioblastoma (GBM) tumour cell proliferation involves activities downstream from both the mitogen-activated protein kinase and phosphoinositide 3-kinase (PI3K) pathways that then modulate the expression of three key cell cycle factors, cyclin B, D and proliferating cell nuclear antigen (PCNA). Cyclin D1 is highly CREB-dependent, whereas cyclin B1 and PCNA are co-regulated by both CREB-dependent and -independent mechanisms. The precise regulatory network involved appears to differ depending on the tumour-suppressor phosphatase and tensin homolog status of the GBM cells, which in turn allows CREB to regulate the activity of the PI3K itself. Given that CREB sits at the hub of key cancer cell signalling pathways, understanding the role of glioma-specific CREB function may lead to improved novel combinatorial anti-tumour therapies, which can complement existing PI3K-specific drugs undergoing early phase clinical trials.

[Postoperative radiation therapy in lung carcinom]. / La radiothérapie postopératoire a-t-etlle une place dans le cancer pulmonaire ?

Locally advanced non-small-cell lung carcinoma (NSCLC) is a very heterogeous disease, the role of postoperative radiation therapy (PORT) in pN2 patients with completly resected NSCLC remains controversial. Although an improvment in local control has been described in several studies, the effect on survival has been contradictory or inconclusive. Retrospective evaluation suggest a positive effect of PORT in high risk patients with pN2 disease: RI-resected NSCLC, bulky and multilevel N2. However further evaluation of PORT in prospectively randomized studies in completely resected pN2 NSCLC is needed.

Three-dimensional helical computed tomography in prenatal diagnosis of fetal skeletal dysplasia.

OBJECTIVES: (1) To study the use and diagnostic value, as a complement to ultrasound, of helical computed tomography (helical CT) to differentiate normal fetuses from cases of skeletal dysplasia; (2) to define the most relevant indications for helical CT; and (3) to evaluate its diagnostic performance with respect to radiological criteria considered discriminatory. METHODS: This was a retrospective study from 2005 to 2008 in 67 pregnant women who underwent helical CT after 26 weeks of gestation for suspected fetal skeletal dysplasia due to fetal shortened long bones on ultrasound (≤ 10(th) percentile), either alone or associated with other bone abnormalities. The results were compared with pediatric examinations in 41 cases and with fetal autopsy findings after elective termination of pregnancy in the others. RESULTS: Helical CT had a sensitivity of 82%, specificity of 91% and positive and negative predictive values of 90% and 83%, respectively, for diagnosis of fetal skeletal dysplasia. An etiological diagnosis that had not been suspected at ultrasound was specified in 15% of cases and diagnoses suspected at ultrasound were confirmed in 24% and discounted in 43% of cases. The prevalence of skeletal dysplasia was increased in cases of micromelia < 3(rd) percentile or if there was a combination of bone signs. Helical CT showed 69% sensitivity in identifying individual predefined pathological bone signs which were confirmed on fetal autopsy findings. CONCLUSION: Helical CT is a key examination, in combination with ultrasound, in the diagnosis of fetal skeletal dysplasia from 26 weeks of gestation. It should be reserved for cases with severe micromelia below the 3(rd) percentile and for those with micromelia ≤ 10(th) percentile associated with another bone sign. A checklist of discriminatory signs is proposed.

Brain metastases from hepatocellular carcinoma in two Caucasian Australian patients.

Hepatocellular carcinoma (HCC) is one of the world's most common malignant cancers. Its incidence is particularly high in Asia and sub-Saharan Africa but, in recent years, significant increases in HCC have been observed in Australia and other Western countries. Therapeutic advances have contributed to improved survival rates in patients with HCC although intracranial metastases are extremely rare. Here we report the first two published Australian cases of brain metastases from HCC, both in Caucasian patients.

Assessing quality of life in patients with head and neck cancer in Spain by means of EORTC QLQ-C30 and QLQ-H&N35.

OBJECTIVES: The aim of this project was to evaluate the quality of life in patients undergoing treatment for head and neck cancer in the Murcia region (Spain). MATERIALS AND METHODS: The Quality of Life (QoL) of patients suffering head and neck cancer was assessed using Spanish translations of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Head and Neck Cancer Module (QLQ-H&N35). The questionnaires' scales and single items were compared according to age, sex, tumour location, stage of cancer and treatment type. RESULTS: Of the 109 patients who met the study's inclusion criteria, 94 completed the questionnaire. Quality of life was found to be associated with patient age (with patients <65 years obtaining higher scores) and also with tumour location. With regard to the stage of cancer, early stages obtained better scores than advanced ones. Patients who underwent surgical treatment combined with adjuvant radiotherapy and chemotherapy generally showed lower scores. CONCLUSIONS: The routine use of quality of life questionnaires among cancer patients enables health practitioners to discover in which areas and to what extent patients find their lives affected by the treatment they receive and its consequences. This allows health practitioners to provide information and treatments which are better adapted to patient needs. These results are similar to those obtained in populations from the north and centre of Europe.

Intragenic rearrangements in LARGE and POMGNT1 genes in severe dystroglycanopathies.

Dystroglycanopathies are a heterogeneous group of muscular dystrophies with autosomal recessive inheritance characterized by abnormal glycosylation of alpha-dystroglycan. The most severe phenotypes are Walker-Warburg Syndrome (WWS) and muscle-eye-brain disease (MEB) presenting with lissencephaly type II (LIS II) and in which muscular dystrophy is associated with mental retardation and eye abnormalities. To date, six distinct genes, POMT1, POMT2, POMGNT1, FKTN, FKRP, LARGE and recently in one case DPM3, have been shown to be involved in dystroglycanopathies. Genomic sequencing alone is still frequently used for diagnosis purpose, not allowing detection of intragenic rearrangements at the heterozygous state contrarily to RNA analysis, quantitative PCR and CGH array analysis. These latter methods enabled us to identify four new intragenic rearrangements in the LARGE gene in three fetuses with WWS, born to two unrelated families: deletion of exons 9-10 and duplication of introns 1-4 for the first family and deletion of exons 4 and 7 for the second one; and a deletion of the last six exons of the POMGNT1 gene in two unrelated MEB patients. Genomic dosage studies using emerging tools such as CGH array should be included in routine molecular analysis of dystroglycanopathies, not only for the screening of the LARGE gene in which this kind of mutation seems to be more frequent than point mutations, but also for the other involved genes, especially in severe clinical cases.

Plantas alimenticias, medicinales y biocidas de las comunidades de Muñani y Suatia, provincia de Lampa (Puno-Perú) / Food, medicinal and biocide plants from the communities of Muñani and Suatia, province of Lampa (Puno-Peru)

Este trabajo de investigación fue desarrollado durante noviembre y diciembre de 2004 y entre enero y marzo de 2005, en las comunidades de Muñani (Región natural Suni) y Suatía (Región natural Puna) de la provincia de Lampa, Región Puno. El objetivo fue determinar las especies vegetales y el uso alimenticio, medicinal y biocida en ambas comunidades. Para determinar la riqueza se aplicaron cuadrantes de 1 m2 al azar y para determinar su uso, se realizó entrevistas a los pobladores de mayor de edad. Comparando la riqueza vegetal en ambas comunidades, el índice de diversidad de Shannon - Weaner expresó 2.2963 para la comunidad de Suatía y 2.4964 para Muñani. Aplicando la prueba de significancia, se encontró diferencia significativa entre ambas comunidades (P < 0.05). Se recopiló información sobre el uso de la flora etnobotánica, encontrándose 15 especies alimenticias, 56 medicinales y 6 biocidas para la comunidad de Suatía; en Muñani son 4 especies alimenticias y 25 medicinales.

Determination of heterocyclic aromatic amines by capillary high-performance liquid chromatography with diode array detection in ready-to-eat cooked ham treated with electron-beam irradiation.

Heterocyclic aromatic amines (HAs) are a group of mutagenic and carcinogenic substances present in significant amounts in cooked meat and fish that can potentially be formed during food processing operations. This paper proposes a capillary liquid chromatography method with diode array detection for the trace-level determination of three HAs, namely, MeIQx (2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline), norharman (9H-pyrido[3,4-b]indole) and harman (1-methyl-9H-pyrido[3,4-b]indole), in ready-to-eat (RTE) cooked ham processed by electron-beam (accelerated electrons) irradiation to eliminate pathogenic microorganisms and to extend its shelf-life. The HAs selected have frequently been detected and quantified in a wide range of food and could be potential markers to indicate the presence of these toxic compounds. The method is based on the separation in an Inertsil C(8) capillary column (150 mm x 0.3-mm internal diameter, 3 microm) by gradient elution mode using a mixture of acetonitrile and 30 mM ammonium acetate pH 4.5 buffer as the mobile phase. Detection was at 250 and 265 nm and, to improve sensitivity, large injection volumes (20 microL) and on-column focusing techniques based on the injection of HA samples in low organic solvent strength solutions were employed. A simple and short solid-phase extraction and purification procedure was also optimized for sample preparation. Nonirradiated and irradiated RTE cooked ham samples at doses between 1 and 8 kGy were analyzed. HAs were not detected in any of the samples analyzed; so both types of samples were spiked at concentration levels in the range 5-25 ng g(-1), which may be found in meat products. The quality parameters of the method developed in the food matrix were established, and detection limits around 0.3 ng g(-1) were obtained. Spiked recoveries between 70 and 79% (n = 3 for each spiked level) relative standard deviations between 1 and 5% were also obtained, showing the effectiveness of the proposed method.