2023 GEIS Guidelines for gastrointestinal stromal tumors.

Gastrointestinal stromal tumor (GIST) is the most common malignant neoplasm of mesenchymal origin. GIST spans a wide clinical spectrum that ranges from tumors with essentially no metastatic potential to malignant and life-threatening spread diseases. Gain-of-function mutations in KIT or PDGFRA receptor tyrosine kinases are the crucial drivers of most GISTs, responsible for tumor initiation and evolution throughout the entire course of the disease. The introduction of tyrosine kinase inhibitors targeting these receptors has substantially improved the outcomes in this formerly chemoresistant cancer. As of today, five agents hold regulatory approval for the treatment of GIST: imatinib, sunitinib, regorafenib, ripretinib, and avapritinib. This, in turn, represents a success for a rare neoplasm. During the past two decades, GIST has become a paradigmatic model in cancer for multidisciplinary work, given the disease-specific particularities regarding tumor biology and tumor evolution. Herein, we review currently available evidence for the management of GIST. This clinical practice guideline has been developed by a multidisciplinary expert panel (oncologist, pathologist, surgeon, molecular biologist, radiologist, and representative of patients' advocacy groups) from the Spanish Group for Sarcoma Research, and it is conceived to provide, from a critical perspective, the standard approach for diagnosis, treatment, and follow-up.

Implications of a positive sentinel node in oral squamous cell carcinoma.

BACKGROUND: The role of sentinel node biopsy in head and neck cancer is currently being explored. Patients with positive sentinel nodes were investigated to establish if additional metastases were present in the neck, their distribution, and their impact on outcome. METHODS: In all, 109 patients (n = 109) from 15 European centers, with cT1/2,N0 tumors, and a positive sentinel lymph node were identified. Kaplan-Meier and univariate and multivariate logistic regression analysis were used to identify variables that predicted for additional positive nodes and their position within the neck. RESULTS: A total of 122 neck dissections were performed in 109 patients. Additional positive nodes were found in 34.4% of cases (42/122: 18 same, 21 adjacent, and 3 nonadjacent neck level). Additional nodes, especially if outside the sentinel node basin, had an impact on outcome. CONCLUSIONS: The results are preliminary but suggest that both the number and the position of positive sentinel nodes may identify different prognostic groups that may allow further tailoring of management plans.

Primary pulmonary artery sarcoma extending retrograde into the superior vena cava.

Primary pulmonary artery sarcoma is a rare tumor that is highly fatal. It can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. Herein, we report the case of a 22-year-old woman with a preoperative diagnosis of pulmonary embolism and superior vena caval thrombosis. Intraoperatively, an extensive sarcoma was seen to extend retrograde from the pulmonary artery, past the right ventricle and right atrium, and into the superior vena cava. Surgical resection of the tumor and reconstruction of the central pulmonary arteries, followed by adjuvant chemotherapy, relieved the clinical symptoms. The patient remained free of cancer at 14 months postoperatively. We believe that this is the 1st report of a primary pulmonary artery sarcoma that extended retrograde into the superior vena cava.

Long-term remodeling in proximal femur around a hydroxyapatite-coated anatomic stem: ten years densitometric follow-up.

Bone remodeling after a hip arthroplasty has been quantified with dual energy x-ray absorptiometry, usually for short-term follow-up. We used this technique to determine the long-term remodeling produced by a hydroxyapatite-coated, anatomic stem. Eighty patients with unilateral hip osteoarthritis were included in the study. The contralateral, healthy hip was taken as control. Bilateral dual energy x-ray absorptiometry scans were done before the surgery, at 15 days, and 1 and 10 years postoperatively. There was a decrease of bone mineral density in zones 1 and 7, which ranged from 12.2% to 27.3% at the end of the first year. There were no changes in zones 1 to 6 from the 1st to the 10th year, but there was a late decrease, up to 42.9%, in zone 7. The changes of bone mineral density promoted by this stem occurred in the first postoperative year. Late loss was seen only in area 7.

Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and meta-analysis.

OBJECTIVES: To evaluate the efficacy of sentinel node biopsy (SNB) in oral squamous cell carcinoma (OSCC). DESIGN: A prospective study of a cohort of 25 consecutive patients with OSCC anatomopathological confirmation through biopsy, without oncological pre-treatment, in clinical stage T1-T4N0, of these 25 patients 14 were T1-T2N0. The absence of regional disease (N0) was determined by means of clinical exploration and cervical tomography (CT). To establish the overall sensitivity of the technique, a meta-analysis was carried out of 10 series published to February 2005 where SNB had been applied to head and neck cancer, adding our 14 T1-T2N0 cases, thus making a total of 260 patients. RESULTS: Identification by SNB was accurate in 96% of the 25 cases, with a sensitivity of 66.7%. Analyzing only the T1-T2N0 cases (n=14), the accuracy was 100% with a sensitivity of 1 (CI 95%, 0.29-1.00). The overall sensitivity was 93%. The accuracy in identifying the sentinel node varied between 66% and 100%. The SN was identified in 251 of 260 cases, of those, 71 were true positive, 5 false negative and 175 true negative. The overall sensitivity was 93.4% (CI 95%, 85.3-97.8), with a specificity of 100% (CI 95%, 0.98-100). The weighted negative probability quotient was 0.176 (CI 0.103-0.301) and that of positive probability 24.75 (CI 95%, 10.8-56.71). The weighted diagnostic odds ratio was 183.71 (CI 95%, 59.36-568.56). If we accept that the prevalence of hidden regional disease is 30%, a negative sentinel node has 5% possibility of having hidden disease. CONCLUSIONS: Our data provide a certain degree of evidence that, due to its high sensitivity, the SNB procedure can be applied to the initial stages of OSCC.

Interactions in solution of cobalt(II) and nickel(II) with nicotinamide adenine dinucleotide: a potentiometric and calorimetric study.

The equilibrium constants and the thermodynamic parameters enthalpy and entropy of the interaction between Ni(II) and Co(II) with NAD(+) in aqueous solution were determined by calorimetry and potentiometry methods (ionic strength adjusted to 0.1 with sodium nitrate at 25 degrees C). The macrochelation of the systems was also studied. All the data, including the protonation enthalpy data of NAD(+) (very similar to the protonation enthalpy of 5'-AMP) suggest a less restrictive model for the NAD(+) "folded" conformation without intramolecular stacking between the bases, in agreement both with recent theoretical calculations and with the X-ray structure of trimethylene-bisadeninium or the free acid form of NAD(+).

Paraganglioma de glomus carotídeo: un caso clínico de presentación inusual / Paraganglioma of carotid glomus: a clinical case of unusual presentation

Se presenta un caso clínico de un paraganglioma benigno, no cromafínico, del glomus carotídeo, en un hombre de 51 años que debutó con dolor torácico y al que posteriormente tras una punción aspiración con aguja fija (PAAF), el estudio citológico fue informado como compatible con oncocitoma de la glándula submaxilar

Rehabilitación quirúrgico-prostodóntica implantosoportada en fisurado palatino: a propósito de un caso clínico / Implant-supported surgical-prosthetic rehabilitation in a cleft palate patient. A propos of a clinical case

Se presenta el caso clínico de una mujer de 43 años con secuelas de una fisura palatina unilateral, a la que se realizó tratamiento quirúrgico previo a la inserción de una prótesis implantosoportada. El tratamiento quirúrgico consistió en la elevación del suelo del seno maxilar, en la preservación con hidroxiapatita porosa del alveolo de un incisivo central extraído por periodontitis aguda y en la instalación de cuatro implantes osteointegrados, en ambos segmentos de la fisura

Complexation of Nickel(II) with Guanosine 5'-Monophosphate and Inosine 5'-Monophosphate: A Potentiometric and Calorimetric Study.

The constants (K(s)) and enthalpies (DeltaH(s)) for stacking interactions between purine nucleoside monophosphates were determined by calorimetry; the values thus obtained were guanosine as follows: K(s) = 2.1 +/- 0.3 M(-)(1) and DeltaH(s) = -41.8 +/- 0.8 kJ/mol for adenosine 5'-monophosphate (5'AMP); K(s) = 1.5 +/- 0.3 M(-1) and DeltaH(s) = -42.0 +/- 1.5 kJ/mol for guanosine 5'-monophosphate (5'GMP); and K(s) = 1.0 +/- 0.2 M(-1) and DeltaH(s) = -42.3 +/- 1.1 kJ/mol for inosine 5'-monophosphate (5'IMP). The interaction of nickel(II) with purine nucleoside monophosphates was studied using potentiometric and calorimetric methods, with 0.1 M tetramethylammonium bromide as the background electrolyte, at 25 degrees C. The presence in solution of the complexes [Ni(5'GMP)(2)](2)(-) and [Ni(5'IMP)(2)](2)(-) was observed. The thermodynamic parameters obtained were log K(ML) = 3.04 +/- 0.02, log K(ML2) = 2.33 +/- 0.02, DeltaH(ML) = -18.4 +/- 0.9 kJ/mol and DeltaH(ML2) = -9.0 +/- 1.9 kJ/mol for 5'GMP; and log K(ML) = 2.91 +/- 0.01, log K(ML2) = 1.92 +/- 0.01, DeltaH(ML) = -16.2 +/- 0.9 kJ/mol and DeltaH(ML2) = -0.1 +/- 2.3 kJ/mol for 5'IMP. The relationships between complex enthalpies and the degree of macrochelation, as well as the stacking interaction between purine bases in the complexes are discussed in relation to previously reported calorimetric data.