Correlation between Demodex species in primary and recurrent chalazia.

OBJECTIVE: To determine the correlation between the infestation by species of Demodex spp. and the occurrence of primary and recurrent chalazia. METHODS: Prospective and observational study. Patients with primary or recurrent chalazia were included. Eyelash samples were taken to determine the microscopic presence of Demodex spp. The correlation between the recurrence of the chalazia and the infestation by Demodex spp. mites was determined using Spearman's rank correlation coefficient test. RESULTS: Sixty-eight adult patients diagnosed with chalazia were included. In 63.2% of the total cases, the presence of one or more parasites of the genus Demodex spp. was documented. In the quantitative parasitological study, it was found that 25% of all cases presented infestation by Demodex spp. defined by an index greater than or equal to 0.5 parasites per eyelash. The most frequently found species was Demodex folliculorum. Of the 14 patients with recurrent chalazia, 50% presented infestation by Demodex spp. and in 91.7% of the cases the infestation was by D. folliculorum. There is a positive, directly proportional correlation between these factors (rθ=+0.665, P<.05). In the group of patients with primary chalazion, only 18.5% presented infestation by Demodex spp., and in 81.6% of these cases it was caused by D. folliculorum. There is a non-statistically significant correlation between these two factors. CONCLUSION: There is a direct, high and statistically significant correlation between the recurrence of the chalazion and the infestation by Demodex spp., there is no statistically significant correlation between the primary chalazia and the presence of Demodex spp.

Congenital mature orbital teratoma: A case report.

Teratomas are gonadal or extragonadal neoplasms, derived from the three embryonic tissues, composed of germ cells of the neuroectoderm, mesoderm and ectoderm. Congenital orbital teratoma (OCT) commonly affects the left orbit, primarily affecting women over men at a ratio of 2:1. We present the case of a female patient of 9 days of extrauterine life with a left mature congenital orbital teratoma. The orbit and oculoplastic service performed an orbital exenteration and total resection of the tumor mass.

How we approach the treatment of patients with high-risk neuroblastoma with naxitamab: experience from the Hospital Sant Joan de Déu in Barcelona, Spain.

Naxitamab [humanized 3f8 (hu3F8)] is a humanized monoclonal antibody (mAb) targeting the disialoganglioside GD2. It was approved in 2020 by the United States Food and Drug Administration (FDA) in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) for treatment of pediatric and adult patients with relapsed/refractory high-risk neuroblastoma, limited to the bone or bone marrow (BM). The team at Sant Joan de Déu Children's Hospital in Barcelona, Spain, have been using naxitamab to treat neuroblastoma under clinical trial protocols [e.g. Trial 201, and hu3F8, irinotecan, temozolomide, and sargramostim (GM-CSF) (HITS) study] and compassionate use since 2017. The team has experience with two primary regimens: naxitamab with GM-CSF only, or naxitamab in combination with irinotecan, temozolomide, and GM-CSF (chemoimmunotherapy). This article aims to provide a practical overview of the team's experience with naxitamab to date, including preparing the treatment room and selecting the team. Adverse event management, including the use of ketamine to manage pain during anti-GD2 mAb infusions, is also discussed. We hope this will provide practical information for other health care providers considering offering this treatment.

Challenges in early phase clinical trials for childhood cancer during the COVID-19 pandemic: a report from the new agents group of the Spanish Society of Paediatric Haematology and Oncology (SEHOP).

PURPOSE: The COVID-19 pandemic has forced healthcare stakeholders towards challenging decisions. We analyse the impact of the pandemic on the conduct of phase I-II trials for paediatric cancer during the first month of state of alarm in Spain. METHODS: A questionnaire was sent to all five ITCC-accredited Spanish Paediatric Oncology Early Phase Clinical Trial Units, including questions about impact on staff activities, recruitment, patient care, supply of investigational products, and legal aspects. RESULTS: All units suffered personnel shortages and difficulties in enrolling patients, treatment continuity, or performing trial assessments. Monitoring activity was frequently postponed (73%), and 49% of on-going trials interrupted recruitment. Only two patients could be recruited during this period (75% reduction in the expected rate). CONCLUSIONS: The COVID-19 crisis has significantly impacted clinical research practice and access to innovation for children with cancer. Structural and functional changes are under way to better cope with the expected future restrictions.

Preoperative central macular thickness as a risk factor for pseudophakic macular edema.

PURPOSE: This study aims to determine whether elevated central macular thickness (CMT) before uncomplicated cataract surgery may be a risk factor for developing cystic macular edema (CMEs) as measured by Cirrus-OCT and defined as the presence of macular intraretinal cysts. METHODS: A prospective study in Hospital Universitario Poniente, Almeria, Spain, where 379 patients were included for optical coherence tomography (OCT) before cataract surgery, the following day, at 1 month and at 3 months and the presence of macular intraretinal cysts assessed by OCT. Patients with known risk factors for developing CME and patients who developed major surgical complications were excluded. RESULTS: One hundred seventy-nine patients completed the study. The pre-surgical CMT was 257.75 (20.60) µm measured by Cirrus-OCT. After 1 month, there was an average increase in CMT of 277.86 (45.29) µm, and this increase in thickness decreased after 3 months to an average value of 267.86 (20.17) µm. There were 10.34% of patients with cysts in some of the controls after surgery. This study proposes a binary logistic model to predict the presence of CME depending on the pre-surgery CMT. The cut-off point was 260.5 µm. CONCLUSION: Patients with pre-surgical macular thickness > 260.5 µm measured by Cirrus- OCT before cataract surgery, no known risk factors for developing CME and no major surgical complications presented 9.08 times more probability to develop macular intraretinal cysts after uncomplicated cataract surgery.

Actitudes frente al alcohol de los estudiantes de enfermería en dos universidades Latinoamericanas / Nursing students' attitudes towards alcohol in two Latin-American universities / Atitudes em relação ao álcool por estudantes de enfermagem em duas universidades latino-americanas

Objetivo: Comparar las actitudes de los estudiantes de enfermería de dos universidades: una de México y otra de Colombia, respecto al consumo de alcohol, el alcoholismo y los trastornos relacionados al abuso de este. Método: Estudio cuantitativo comparativo transversal. Muestra de 231 estudiantes del último año de la carrera de enfermería en dos universidades públicas latinoamericanas; participantes voluntarios mayores de edad que cursaron al menos 6 asignaturas práctico-teóricas, a quienes se les aplicó el instrumento Escala de Actitudes Frente al Alcohol, el Alcoholismo y la persona con trastornos relacionados al uso del alcohol- EAFAA, así como una encuesta sociodemográfica y académica. Se utilizó SPSS 22 y Microsoft Excel® para el análisis estadístico y se tuvieron en cuenta los principios bioéticos. Resultados: La percepción de los estudiantes respecto a las personas con trastornos relacionados al uso de alcohol (p=0.003), es diferente según la universidad, lo cual conlleva una visión distinta con relación a su fuerza de voluntad, competencia de autocuidado, entre otras características. Asimismo, se determinó que la formación brinda herramientas al estudiante para afrontar situaciones de miedo, inseguridad, frustración, que favorecen un mejor cuidado (p=0.045). Conclusiones: La presente investigación aporta al conocimiento de enfermería, ya que muestra en qué dimensiones la actitud puede afectar el trato brindado al paciente y cómo esta relación puede mejorarse a través de la formación en el área y de experiencias exitosas.

Objective: To compare the attitudes of nursing students towards alcohol consumption, alcoholism, and alcohol-related diseases, in two universities: one in Mexico and the other in Colombia. Method This is a quantitative, comparative, and transversal study with a sample of 231 legal aged senior nursing students from two public universities of Latin-America who volunteered to participate. The Scale of Attitudes Towards Alcohol, Alcoholism, and Persons with Alcohol Related Diseases (SATAAP) instrument was administered in conjunction with a sociodemographic and academic survey. SPSS 22 and Excel were used to carry out the calculations. The corresponding bioethical principles were respected. Results: The perception of students regarding to persons with alcohol-related diseases (p = 0.003) was not the same between the two universities, suggesting that differences in their views about strength of will and self-care competence, among other characteristics could be present. It was also found that the school formation gives the students tools to address situations of fear, insecurity, and frustration, thus fostering better self-care (p = 0.045). Conclusions The present research builds on the nursing knowledge because it shows the importance of the attitude towards the use of alcohol, as well as its associated relationship between good school formation and better health care provided.

Objetivo: Comparar atitudes sobre álcool, alcoolismo e pessoas com transtornos relacionados ao uso de álcool por estudantes de enfermagem sênior de duas universidades no México e na Colômbia. Método: Estudo quantitativo comparativo transversal. Com amostra censo de 231 estudantes sênior de enfermagem de duas universidades públicas latino-americanas, participantes voluntários maiores de idade que cursaram pelo menos 6 disciplinas prático-teóricas, para os que foi aplicado o instrumento Escala de Atitudes frente ao Álcool, ao Alcoolismo e ao Alcoolista-EAFAA, e um questionário demográfico e acadêmico. SPSS 22 e Microsoft Excel® foram utilizados para análise estatística e tiveram-se em conta os princípios bioéticos de autonomia, justiça, beneficência e não maleficência. Resultados: Encontrou-se diferenças entre as universidades sobre a percepção das pessoas com transtornos relacionados ao consumo de álcool (p=0,003), o que acarreta uma visão diferente em relação à sua força de vontade, competição pelo autocuidado, entre outras características. Da mesma forma, determinou-se que o treinamento proporciona ao aluno ferramentas para enfrentar situações de meda, insegurança, frustração, favorecendo um melhor cuidado (p=0.045). Conclusões: Essa pesquisa contribui para o conhecimento de enfermagem, pois mostra em quais dimensões a atitude pode afetar o tratamento proporcionado ao paciente e como essa relação pode ser melhorada por medio de treinamento na área e experiências bem-sucedidas.

Tuberculosis, granulomatosis with polyangiitis, or both? A case report. / ¿Tuberculosis, granulomatosis con poliangeítis, o ambos? Caso clínico inusual.

INTRODUCTION: Tuberculosis (TB) is a chronic granulomatose infection, and granulomatosis with polyangiitis (GP) is a small vessel vasculitis, both of which affect the lungs. The combination of these diseases is rare. Both have similar clinical features, making the differential diagnosis difficult. CASE REPORT: It concerns a 37 year-old female undergoing treatment for pulmonary TB, who presented with left ocular proptosis, eyelid and conjunctival edema and erythema. Orbital biopsy revealed GP. C-Anti-neutrophil cytoplasmic antibodies were elevated. The patient responded well to immunosuppressive treatment. CONCLUSION: TB and GP can associate. Diagnosis should include not only C-anti-neutrophil cytoplasmic antibodies, but also a biopsy, in order to select the appropriate treatment.

GEIS-21: a multicentric phase II study of intensive chemotherapy including gemcitabine and docetaxel for the treatment of Ewing sarcoma of children and adults: a report from the Spanish sarcoma group (GEIS).

BACKGROUND: First Spanish trial of Ewing sarcoma (ES) including adults and children with the aim to test the efficacy of Gemcitabine and Docetaxel (G/D) in newly diagnosed high-risk (HR) patients. METHODS: This was a prospective, multicentric, non-randomised, open study for patients ⩽40 years with newly diagnosed ES. HR patients (metastatic, axial-pelvic primaries or bone marrow micrometastasis) received 2 window cycles of G/D. Patients with an objective response (OR) to G/D received 12 monthly cycles of G/D after completion of mP6. The primary end point was the OR rate to the G/D window phase and the event-free survival (EFS) and overall survival (OS) for all patients. The study is registered at ClinicalTrials.gov (identifier: NCT00006734). RESULTS: Forty-three patients were enroled, median age 17 years (range, 3-40). After a median follow-up of 43.4 months, the 5-year OS rate is 55.0% (95% CI, 41-74%) with an EFS of 50.0% (95% CI, 36-68%). The 5-year OS and EFS rates for standard risk (SR) patients was 76.0% (95% CI, 57-100%) and 71.0% (CI, 54-94%); for HR 36.0% (CI, 20-65%) and 29.0% (CI, 15-56%). Twelve of 17 (70.6%) high-risk (HR) patients showed an OR (7 PR and 5 SD) to G/D window therapy. The 5-year OS rate for patients ⩽18 years of age was 74.0% (CI, 56-97%) and 31.0% for >18 years (95% CI, 15-66%), P<0.001. Grade 4 adverse events during mP6 occurred in 28/39 of patients (72%) and did not correlate with age. Multivariate survival analyses with <18 vs ⩾18 and risk groups significant differences, P<0.00001. Using a Cox model for OS, both age and risk group were statistically significant (P=0.0011 and P=0.0065, respectively). CONCLUSIONS: Age at diagnosis is an independent prognostic factor superior to the presence of metastases with 18 years as the strongest cut-off. The mP6 regimen provided survival curves that plateau at 3 years and G/D produced significant responses in HR-ES that is worth further exploring.

Evisceration surgery in a highly specialized center in Mexico: A retrospective study of 7 years of experience. / Cirugía de evisceración ocular en un centro de alta especialidad en México: estudio retrospectivo de 7 años de experiencia.

INTRODUCTION: Evisceration is currently becoming the technique of choice in the treatment of certain eye diseases, including, among others, painful blind eye and endophthalmitis. The most widely used implants are currently the hydroxyapatite and porous polyethylene for the rehabilitation of the anophthalmic socket. OBJECTIVE: To describe the indications, type of implant material used, and complications in evisceration surgery. METHODS: A retrospective, observational, descriptive study based on clinical records of patients that underwent evisceration between 2008 and 2015 in the Instituto Fundación Conde de Valenciana, Mexico. RESULTS: A total of 186 evisceration surgeries were performed, of which 52.7% of the patients were men. The mean age was 54 years. The right eye was eviscerated in 53% of cases, and 79.2% had a vision of no light perception. Most patients had preoperative pain. The most common diagnosis for which evisceration was performed was endophthalmitis. Phthisis bulbi was reported in 20 eyes. A primary implant was inserted in 86.81% of the cases, with 34.81% of the implants being made of porous polyethylene. Four cases showed extrusion of the implant, with 2 cases of porous polyethylene. The ocular prosthesis was tolerated in 91% of cases. There were no cases of sympathetic ophthalmia. CONCLUSION: Evisceration is shown to be a good alternative to enucleation in cases where the sclera can be preserved, showing a low incidence of sympathetic ophthalmia.

Granulomatosis with polyangiitis confined to lacrimal gland, a case report. / Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso.

CLINICAL CASE: A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. DISCUSSION: Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease.

[Update of diabetic retinopathy for Primary Care physicians: Towards an improvement of telematic medicine]. / Actualización de la retinopatía diabética para médicos de atención primaria: hacia una mejora de la medicina telemática.

Diabetic retinopathy (DR) is considered the most common cause of blindness in the working-age population in industrialised countries, with diabetic macular oedema being the most common reason of decreased visual acuity in diabetics. According to the results of large multicentre studies, blindness prevention for RD involves conducting periodic check-ups, which include examinations of the back of the eye, so they can be treated in time. The use of non-mydriatic cameras and telemedicine have been shown to be useful in this regard (sensitivity>80% and specificity>90%). If this procedure is followed, the first retinography should be performed 5 years from diagnosis in type 1 diabetics and immediately after diagnosis in type 2 diabetics. Therefore the role of the Primary Care physician is crucial to enable early diagnosis of this disease.

Histopathologic characteristics of gastric adenocarcinoma in Mexican patients: a 10-year experience at the Hospital Juárez of Mexico.

BACKGROUND: Gastric cancer is the second cause of death by cancer worldwide. Histologic classification may predict tumor biology, clinical behavior, and outcome. According to the Lauren classification, the disease is divided into 2 types, diffuse and intestinal, and the latter has a better prognosis. AIM: To determine the frequency of gastric adenocarcinoma and compare the histopathologic characteristics of intestinal and diffuse-type gastric adenocarcinoma in Mexican patients treated at a tertiary referral hospital. METHODOLOGY: A retrospective study evaluated the pathology reports of patients with gastric adenocarcinoma corresponding to the time frame of January 2003 to December 2012. Adenocarcinomas of the gastric cardia were excluded. Frequencies were expressed as percentages and the categorical variables were compared with the chi-square test. Statistical significance was set at a P<.05. RESULTS: A total of 417 cases of gastric adenocarcinoma were found, 230 (55.2%) of which were diffuse-type and 118 (28.2%) were intestinal-type. The mean age of the patients with diffuse type gastric cancer was 54.02±14.93 and 119 (51.3%) of those patients were men. The mean age of the patients with intestinal-type gastric cancer was 63.43±13.78, and 69 (62.2%) were men. Ninety-two of the diffuse-type patients were under the age of 50 years, compared with 22 of the patients with intestinal-type carcinoma. CONCLUSIONS: This is the first study on the Mexican population to analyze the differences in the histologic types of adenocarcinoma. Diffuse-type gastric carcinoma was the most frequent subtype in our study population and it is associated with worse outcome.

Cell cycle inhibition therapy that targets stathmin in in vitro and in vivo models of breast cancer.

Stathmin is the founding member of a family of microtubule-destabilizing proteins that have a critical role in the regulation of mitosis. Stathmin is expressed at high levels in breast cancer and its overexpression is linked to disease progression. Although there is a large body of evidence to support a role for stathmin in breast cancer progression, the validity of stathmin as a viable therapeutic target for breast cancer has not been investigated. Here, we used a bicistronic adenoviral vector that co-expresses green fluorescent protein and a ribozyme that targets stathmin messenger RNA in preclinical breast cancer models with different estrogen receptor (ER) status. We examined the effects of anti-stathmin ribozyme on the malignant phenotype of breast cancer cells in vitro and in xenograft models in vivo both as a single agent and in combination with chemotherapeutic agents. Adenovirus-mediated gene transfer of anti-stathmin ribozyme resulted in a dose-dependent inhibition of proliferation and clonogenicity associated with a G2/M arrest and increase in apoptosis in both ER-positive and ER-negative breast cancer cell lines. This inhibition was markedly enhanced when stathmin-inhibited breast cancer cells were exposed to low concentrations of taxol, which resulted in virtually complete loss of the malignant phenotype. Interestingly, breast cancer xenografts treated with low doses of anti-stathmin therapy and taxol showed regression in a majority of tumors, while some tumors stopped growing completely. In contrast, combination of anti-stathmin ribozyme and adriamycin resulted in only a modest inhibition of growth in vitro and in breast cancer xenografts in vivo. Although inhibition of tumor growth was observed in both the combination treatment groups compared with groups treated with single agent alone, combination of anti-stathmin therapy and taxol had a more profound inhibition of tumorigenicity, as both agents target the microtubule pathway. Clinically, these findings are highly relevant because taxol is one of the most active chemotherapeutic agents in breast cancer. These studies provide the proof-of-principle that stathmin provides an attractive molecular target, which could serve as a primary focus of novel approaches to breast cancer.

Larvicultura de Rhamdia quelen (Pisces, Pimelodidae) con proteína vegetal y animal, suplementadas con plancton / Larviculture of Rhamdia quelen (Pisces, Pimelodidae) with vegetal and animal proteins, supplemented with plankton

Objetivo. Determinar el efecto de dietas con diferentes proporciones de fuentes proteicas animales y vegetales suplementadas con plancton sobre el crecimiento y sobrevivencia en larvas de Rhamdia quelen. Materiales y métodos. Fueron formuladas dos dietas experimentales, dieta-1 con 70% de proteína de origen vegetal (torta de soya) y dieta-2 con 70% de proteína proveniente de animales (corazón bovino y harina de pescado); se utilizaron cuatro protocolos de alimentación (cinco réplicas por tratamiento): dieta-1 + plancton filtrado en tamiz de 50-200 micras (T1), dieta-2 + plancton filtrado en tamiz de 50-200 micras (T2), dieta-1 (T3), dieta-2 (T4). Las larvas fueron manejadas a una densidad de 20 animales L-1 suministrando alimento hasta aparente saciedad diariamente a las 07:00, 11:00, 16:00 y 21:00 horas; la suplementación con plancton se realizó a las 11:00 y 21:00 horas. Resultados. Entre T1 y T2 no se observaron diferencias estadísticas (p>0.05) en peso final (21.89 ± 15.17mg vs 20.37 ± 10.37mg), longitud total (13.41±2.34mm vs 13.39±1.99 mm), factor de condición (K) (0.80±0.13 vs 0.78±0.13 ) y sobrevivencia (46.6±2.68% vs 36.0±7.41%); las diferencias entre T3 y T4 tampoco fueron significativas (3.35±1.40 mg vs 2.98±1.48 mg; 7.54±0.91mm vs 7.33±0.96mm; 0.75±0.13 vs 0.71±0.12; 33.6±9.07% vs 24.8±6.76%, respectivamente); hubo diferencias significativas (p<0.05) entre los grupos suplementados con plancton y los alimentados solo con ración. Conclusiones. La suplementación con plancton fue más efectiva que el ofrecimiento solo de ración. La inclusión del 62.9% de torta de soya en la formulación (T1), aparentemente no afectó el crecimiento ni la sobrevivencia.

Mental disorders in young adulthood.

BACKGROUND: The effect of mental disorders may be particularly detrimental in early adulthood, and information on mental disorders and their correlates in this age group is important. METHOD: A questionnaire focusing on mental health was sent to a nationally representative two-stage cluster sample of 1863 Finns aged 19 to 34 years. Based on a mental health screen, all screen-positives and a random sample of screen-negatives were asked to participate in a mental health assessment, consisting of the Structured Clinical Interview for DSM-IV (SCID-I) interview and neuropsychological assessment. We also obtained case-notes from all lifetime mental health treatments. This paper presents prevalences, sociodemographic associations and treatment contacts for current and lifetime mental disorders. RESULTS: Forty percent of these young Finnish adults had at least one lifetime DSM-IV Axis I disorder, and 15% had a current disorder. The most common lifetime disorders were depressive disorders (17.7%) followed by substance abuse or dependence (14.2%) and anxiety disorders (12.6%). Of persons with any lifetime Axis I disorder, 59.2% had more than one disorder. Lower education and unemployment were strongly associated with current and lifetime disorders, particularly involving substance use. Although 58.3% of persons with a current Axis I disorder had received treatment at some point, only 24.2% had current treatment contact. However, 77.1% of persons with a current Axis I disorder who felt in need of treatment for mental health problems had current treatment contact. CONCLUSIONS: Mental disorders in young adulthood are common and often co-morbid, and they may be particularly harmful for education and employment in this age group.