Tooth loss in breast cancer patients: A comparison between tamoxifen-treated and non-treated patients.

BACKGROUND: Tooth loss (TL) affects quality of life and general health. The literature suggesting that tamoxifen treatment in patients with breast cancer (BC) could be associated with alterations in oral health, increasing the risk of TL, is still scarce. This work aimed to determine the relationship between TL and tamoxifen consumption in patients with BC. MATERIAL AND METHODS: This cross-sectional observational study was carried out from July to September 2023 in the medical oncology services of the "Virgen de la Puerta" - ESSALUD High Complexity Hospital and "Dr. Luis Pinillos Ganoza" - IREN Norte - Regional Institute of Neoplastic Diseases, in Trujillo - Peru. Overall, 200 adult patients diagnosed with BC were evaluated, of which 100 consumed tamoxifen and 100 did not. Inter- and intra-rater reliability was determined with respect to TL, resulting in intra-class correlation values RHO = 0.971 and interclass RHO = 0.938. The oncologist of the corresponding service performed BC diagnosis and stage. Poisson regression was used to analyze results with a significance level of p<0.05. RESULTS: No relationship was found between TL and tamoxifen consumption in patients with breast cancer (p= 0.221); however, greater TL was observed in women who consumed tamoxifen for more than one year compared to those who did not use it (p=0.025) and in older adult women compared to young women (p=0.030). CONCLUSIONS: There is a relationship between TL and time of use of tamoxifen in patients with BC, concluding that patients who consumed tamoxifen for more than one year had greater TL than those who did not. Furthermore, no relationship was found between TL and cancer stages, but there was greater TL in older adult patients and also in those who consumed tamoxifen and did not receive chemotherapy or radiotherapy.

Decoding clinical and molecular pathways of liver dysfunction in Psoriatic Arthritis: Impact of cumulative methotrexate doses.

BACKGROUND: The occurrence of liver abnormalities in Psoriatic Arthritis (PsA) has gained significant recognition. Identifying key factors at the clinical and molecular level can help to detect high-risk patients for non-alcoholic fatty liver disease in PsA. OBJECTIVES: to investigate the influence of PsA and cumulative doses of methotrexate on liver function through comprehensive in vivo and in vitro investigations. METHODS: A cross-sectional study involving 387 subjects was conducted, 200 patients with PsA, 87 NAFLD-non-PsA patients, and 100 healthy donors (HDs), age and sex-matched. Additionally, a retrospective longitudinal study was carried out, including 83 PsA patients since initiation with methotrexate. Detailed clinical, and laboratory parameters along with liver disease risk were analyzed. In vitro, experiments with hepatocyte cell line (HEPG2) were conducted. RESULTS: PsA patients present increased liver disease risk associated with the presence of cardiometabolic comorbidities, inflammatory markers, onychopathy, and psoriasis. The treatment with PsA serum on hepatocytes encompassed inflammatory, fibrotic, cell stress, and apoptotic processes. At the molecular level, methotrexate impacts liver biology, although the cumulative doses did not affect those alterations, causing any potential damage to liver function at the clinical level. Finally, anti-PDE-4 or anti-JAK decreased the inflammatory profile induced by PsA serum on hepatocytes. CONCLUSION: 1)This study identifies the complex link between liver disease risk, comorbidities, and disease-specific features in PsA patients. 2)Methotrexate dose in PsA patients had no significant effect on liver parameters, confirmed by hepatocyte in vitro studies. 3)Anti-PDE-4 and anti-JAK therapies show promise in reducing PsA serum-induced hepatocyte activation, potentially aiding liver complication management.

Dermoscopy of glomus tumour: a cross-sectional study of 86 cases.

BACKGROUND: Glomus tumours (GTs) are benign cutaneous neoplasms derived from the neuromyoarterial apparatus with a strong predilection for acral sites, especially the subungual space. Current data regarding dermoscopy of these lesions are very limited. OBJECTIVES: To analyse the dermoscopic structures and patterns seen in a large series of subungual (SUGTs) and extraungual glomus tumours (EUGTs) and to determine their diagnostic significance. METHODS: Clinical and dermoscopic images of 86 histopathologically proven cases of GTs (47 SUGTs and 39 EUGTs) collected from 9 hospitals in Spain, France, Italy, and Brazil were evaluated for the presence of dermoscopic structures and patterns. Similarly, 189 and 185 dermoscopic images of other ungual tumours and other extraungual non-pigmented tumours, respectively, were evaluated for the same structures and patterns. Finally, we evaluate diagnostic testing accuracy calculating sensitivity (S), specificity (Sp), and positive and negative predictive values of the different patterns for the diagnosis of GT. RESULTS: Regarding SUGTs, four patterns were built from the combination of different structures. The pattern composed of a structureless purplish/red subungual spot with or without vessels reached the highest S (S1, 78.8%). The combination of a structureless purplish/red subungual spot and longitudinal erythronychia (LE) (S2) is highly specific (96.3%). Patterns S3 (proximal purplish/red subungual spot, LE, and distal notch) and S4 (bed subungual spot and onycholysis) are the most specific and exclusive of matrix and bed tumours, respectively. The most consistent pattern in EUGTs is composed of a structureless purplish-white to reddish-white homogeneous area and linear unfocused vessels (E) (S: 61.5%, Sp: 95.7%). EUGTs did not show lacunae, unlike other vascular tumours. CONCLUSIONS: Dermoscopy is helpful in improving the diagnostic accuracy of GTs, not only in SUGTs but also when these lesions arise out of the ungual apparatus.

Unveiling axial involvement in psoriatic arthritis: An ancillary analysis of the ASAS-perSpA study.

OBJECTIVE: To determine the clinical profile of axial psoriatic arthritis (PsA) in a worldwide setting. Secondly, to identify factors associated with the development of axial involvement in patients with PsA. METHODS: Data from 3684 patients with axial spondyloarthritis (axSpA) or PsA from the ASAS-perSpA study were analysed. The ASAS-perSpA is a cross-sectional study that recruited consecutive patients with SpA (as diagnosed by their rheumatologist) from 68 centers worldwide and collected patient and disease data. First, 2651 axSpA patients and 367 PsA patients with any history of axial involvement (axPsA) were compared using logistic regression to later identify predictive factors for rheumatologist diagnosis of axPsA. Secondly, 367 axPsA patients were compared with 666 PsA patients lacking axial involvement (peripheral PsA [pPsA]) and the characteristics associated with axial manifestations were explored by logistic regression analysis. RESULTS: Patients with axPsA were older and less frequently males or HLA*B27 positive in comparison with axSpA patients. Additionally, while patients with axPsA had more peripheral manifestations and psoriasis, other extra-musculoskeletal manifestations (IBD and uveitis) were more frequent in those with axSpA. In the multivariable analysis, older age at diagnosis (OR = 1.04), peripheral arthritis (OR = 7.32) and dactylitis (OR = 2.82) were significantly associated with the diagnosis of axPsA. However, uveitis (OR = 0.22), IBD (OR = 0.12), HLA*B27 carriership (OR = 0.26) or sacroiliitis on imaging (OR = 0.5) were inversely associated with axPsA diagnosis as compared to axSpA. Axial involvement in patients with PsA was significantly associated with male gender (OR = 1.68), elevated CRP (OR = 2.87) and the absence of psoriasis (OR = 0.33). CONCLUSION: In this worldwide setting axPsA was defined by rheumatologists as a unique phenotype, with disease features lying between axSpA and pure pPsA.

Ultrafast carbon nanotubes growth on recycled carbon fibers and their evaluation on interfacial shear strength in reinforced composites.

The global demand for products manufactured with carbon fibers (CFs) has increased in recent years; however, the waste generated at the end of the product lifetime has also increased. In this research, the impact of the addition of carbon nanotubes (CNTs) on the interlaminated resistance of recycled carbon fibers (RCFs) was studied. In this work, a recycling process of the composite material was applied via thermolysis to obtain the CFs, followed by the growth of CNTs on their surface using the Poptube technique. The recycling temperature were 500 °C and 700 °C; and ferrocene and polypyrrole were used to grow CNTs on CFs surface. CNTs were verified by Raman spectroscopy and scanning electron microscopy (SEM). Finally, to determine the interlaminar resistance, a double cantilever beam (DCB) test was performed. The results indicate that with Poptube technique, CNTs can be grown on RCFs using both impregnations. Thermolysis recycling process at 500 °C allowed CFs without resin residues and without visible damage. The DCB tests showed a decrease in the fracture resistance in mode I loading of 34.9% for the polypyrrole samples and 29.3% for the ferrocene samples compared with the virgin carbon fibers (VCFs) samples with a resistance of 1052.5 J/m2.

Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists.

BACKGROUND: Some studies have been performed to assess the effects of levosimendan on cardiac function when administered to cardiac surgery patients with low cardiac output syndrome (LCOS) in the immediate postoperative period. Levosimendan is an inotropic agent for the treatment of low cardiac output syndrome that seems to have a protective effect on renal function. METHODS: It is a quasi-experimental study. A total of 100 patients with LCOS received either beta-agonists or levosimendan. We assessed the incidence of postoperative kidney failure in cardiac surgery patients. In patients who had kidney failure at diagnosis of LCOS, we examined whether differences existed in the evolution of kidney failure based on the treatment administered for LCOS. The parameters measured included haemodynamics, oxygen supply, and renal function as assessed by the AKI scale. ANOVA, Student's t-test and Wilcoxon or Friedman tests were used. RESULTS: Up to 30% of cardiac surgery patients had kidney failure at diagnosis of LCOS. Kidney failure at discharge from the ICU was more frequent in patients who received beta-agonist drugs as compared to those who received levosimendan (p < 0.05). CONCLUSION: The incidence of kidney failure decreased with the postoperative administration of levosimendan to cardiac surgery patients with LCOS, as compared to beta-agonists. TRIAL REGISTRATION: Current Controlled Trials ISRCTN 46058317. Date of registration: 7/10/2019. Retrospectively registered.

Manejo y desenlaces de la pancreatitis aguda en un hospital de cuarto nivel (Huila, Colombia), 3 años de experiencia / Outcomes of Three Years of Experience Managing Acute Pancreatitis at a Fourth Level Hospital in Huila, Colombia

Resumen Objetivo: describir el comportamiento clínico y quirúrgico de los pacientes con pancreatitis aguda manejados en un centro hospitalario de cuarto nivel. Método: se realizó un estudio descriptivo retrospectivo analítico de los pacientes con diagnóstico de pancreatitis aguda que ingresaron al Hospital Universitario de Neiva en el período comprendido entre el 1 de enero del 2015 al 31 de julio del 2017. Resultados: se identificaron 138 pacientes que ingresaron con impresión diagnóstica de pancreatitis aguda, de los cuales se confirmó el diagnóstico en 130 pacientes y se excluyeron 21 pacientes por no cumplir con los criterios de inclusión. Según la clasificación de Atlanta 2012, 73 (67 %) pacientes cursaban con una pancreatitis leve, 17 (16 %) con pancreatitis moderadamente severa y 19 (17 %) con pancreatitis severa. La principal causa de pancreatitis encontrada fue la biliar. La prueba de chi cuadrado (χ2) mostró una significancia estadística para la edad como factor de riesgo para pancreatitis severa (p = 0,04). De la totalidad de pacientes, en 8 pacientes se documentó necrosis pancreática, de los cuales 5 fueron manejados quirúrgicamente, con un abordaje por laparotomía en 3 pacientes y 2 por laparoscopia, con una mortalidad del 37,5 % en los pacientes con necrosis pancreática manejados quirúrgicamente. De los 109 pacientes incluidos en el estudio, 100 pacientes (91,74 %) resolvieron su cuadro de pancreatitis y egresaron vivos de la institución, para una mortalidad reportada en 9 pacientes (8,25 %), quienes cursaron con pancreatitis aguda severa. Conclusión: el estudio presentado es de tipo descriptivo estableciendo las características demográficas y el curso de la enfermedad de los pacientes con pancreatitis aguda incluidos las complicaciones y el manejo de estas. Con este estudio no se pretende estandarizar causalidad ni manejo de la patología descrita, solo se describe la experiencia realizada en un hospital de cuarto nivel tratando de contribuir con el desarrollo de estudios de cohortes y ensayos clínicos que permitan establecer guías de manejo con el fin de mejorar los desenlaces de los pacientes con pancreatitis aguda.

Abstract Objective: Our objective was to describe the clinical and surgical behavior of patients with acute pancreatitis managed at a fourth level hospital center. Method: This is a descriptive, retrospective and analytical study of patients diagnosed with acute pancreatitis who entered the University Hospital of Neiva in the period from January 1, 2015 to July 31, 2017. Results: We identified 138 patients who had been admitted with a diagnosis of acute pancreatitis. Of these, the diagnosis was confirmed for 130 patients, but 21 patients were excluded because they did not meet the inclusion criteria. According to the 2012 Atlanta classification, 73 (67%) patients had mild pancreatitis, 17 (16%) had moderately severe pancreatitis, and 19 (17%) had severe pancreatitis. The main cause of pancreatitis was biliary. The chi-square test showed statistical significance for age as a risk factor for severe pancreatitis (p = 0.04). Pancreatic necrosis was documented in 8 patients, five of whom were managed surgically. This included three laparotomies and two laparoscopic operations. The mortality rate for patients with surgically managed pancreatic necrosis was 37.5%. Of the 109 patients included in the study, the resolved their pancreatitis of 100 patients (91.74%) was resolved and they left the institution alive. Nine patients (8.25%), all of whom had severe acute pancreatitis, died. Conclusion: This descriptive study established the demographic characteristics and clinical course of patients with acute pancreatitis including complications and management of complications. This study is not intended to standardize causality or management of acute pancreatitis, but rather only describes the experience of a fourth level hospital in order to contribute to the development of cohort studies and clinical trials that will allow establishment of management guidelines to improve the outcomes of patients with acute pancreatitis.

Dermoscopy of cutaneous smooth muscle neoplasms: a morphological study of 136 cases.

BACKGROUND: A variety of cutaneous smooth muscle neoplasms may arise in the skin and are frequently unrecognized by clinicians. There is sparse data relating to the dermoscopy of piloleiomyomas (PL), and nothing has been published about the dermoscopy of angioleiomyomas (AL) and leiomyosarcomas (LS). OBJECTIVES: To evaluate the morphological findings of a large series of cutaneous PL, AL and LS under dermoscopic observation, comparing these findings among them. METHODS: Digital dermoscopic images of 136 histopathologically confirmed cases of cutaneous smooth muscle neoplasms (114 PL, 13 AL and 9 LS) collected from 10 Hospitals in Spain, Austria and Italy were evaluated for the presence of dermoscopic structures and patterns. RESULTS: The pattern composed of a symmetric, total delicate pigment network with the variable presence of multiple hypopigmented areas in a painful lesion is the most common dermoscopic pattern associated with PL. This pattern was found in 69.3% of PL and in no cases of AL and LS. The most common and characteristic pattern associated with AL was the one composed of symmetric pink-reddish tumour with vessels, white structures and the absence of ulceration, which was found in 46.2% of AL, but also in 3.5% of PL, and in 22.2% of LS. Finally, the most common pattern associated with LS was the one composed of an asymmetric, multilobulated tumour with linear-irregular or polymorphic-atypical vessels and white structures, which was found in 44.4% of cases, but also in 0.9% of PL and in 15.4% of AL. CONCLUSION: Dermoscopy is helpful in improving the diagnostic accuracy of PL. The dermoscopic patterns associated with AL and LS were more variable and less specific.

Dosis respuesta en la actividad analgésica periférica de la metformina en la prueba de contorsiones abdominales en ratones / Dose-response in the peripheral analgesic activity of metformin in the abdominal writhing test in mice

Objetivo: Evaluar el efecto analgésico dosis respuesta de la metformina en un evento de dolor agudo en roedores. Materiales y métodos: Se utilizaron 80 ratones. Se evaluó el efecto analgésico con la prueba de contorsiones abdominales en ratones. Se formaron 8 grupos de 10 ratones cada uno: 3 grupos recibieron diclofenaco 8 mg/kg, tramadol y un grupo blanco, y 5 grupos experimentales de metformina a dosis de 50, 100, 150, 200 y 250 mg/kg. Para el análisis estadístico se empleó la prueba de D'Agostino-Pearson, prueba de ANOVA de una cola, prueba de Tukey, y correlación de Pearson. Resultados: Prueba de normalidad de D'Agostino-Pearson reveló un valor p<0.05 en todos los grupos. La prueba de ANOVA arrojó un valor p<0.0001. La prueba de pareo de Tukey obtuvo un valor p<0.05 entre el grupo blanco y metformina en todas sus dosis, y entre diclofenaco y metformina a dosis de 100, 150, 200 y 250 mg/Kg, un valor p>0.05 entre tramadol y metformina a dosis de 100, 150, 200 y 250 mg/kg, la prueba de correlación de Pearson obtuvo un r=-0.6897 y R=0.4756 con valor p<0.0001. metformina presentó un porcentaje de inhibición del dolor en rango de 34.89 % - 92.62 %. Conclusiones: Se demuestra que metformina a dosis 100, 150, 200 y 250 mg/kg presentó efecto analgésico agudo en la prueba de contorsiones abdominales en ratón, siendo la dosis de 250 mg/kg la que tuvo mejor efecto. Además, se obtuvo efecto dosis-respuesta en dosis escalonada de metformina

Objective: To evaluate the dose-response analgesic effect of metformin in an acute pain event in rodents. Materials and methods: Eighty (80) mice were used. The analgesic effect was evaluated using the abdominal writhing test in mice. Eight (8) groups of 10 mice each were formed: one diclofenac 8 mg/kg group, one tramadol group, one target group, and five experimental groups of metformin at doses of 50, 100, 150, 200 and 250 mg/kg. For the statistical analysis, the D'Agostino-Pearson test, one-tailed ANOVA test, Tukey's test, and Pearson's correlation coefficient were used. Results: The D'Agostino-Pearson normality test revealed a p-value < 0.05 in all groups. The ANOVA test showed a p-value < 0.0001. The Tukey's range test obtained a p-value < 0.05 between the target group and metformin groups at all doses, and between the diclofenac group and metformin groups at doses of 100, 150, 200 and 250 mg/kg, and a p-value > 0.05 between the tramadol group and metformin groups at doses of 100, 150, 200 and 250 mg/kg. The Pearson's correlation coefficient was r = -0.6897 and R = 0.4756, and yielded a p-value < 0.0001. Metformin showed a pain inhibition percentage in the range of 34.89 % to 92.62 %. Conclusions: It has been demonstrated that metformin at doses of 100, 150, 200 and 250 mg/kg had an acute analgesic effect in the abdominal writhing test in mice, with the 250 mg/kg dose being the one that showed the best effect. In addition, a dose-response effect was obtained in escalated doses of metformin

Endoscopic Treatment for Vesicoureteral Reflux in Recurrent Urinary Tract Infections in Kidney Transplant: Experience of One Center.

Vesicoureteral reflux (VUR) after renal transplantation in adult patients has been reported. In renal transplant recipients, symptomatic urinary tract infection can cause high morbidity despite improved immunosuppressive and antibiotic treatment. In our country there have been few reported cases about use of copolymer of dextranomer and hyaluronic acid (DX-HA) injection in a renal transplant. We present 3 cases of recurrent or complicated infections with evidence of high-grade VUR, which were treated with DX-HA. Only 1 case had a partial remission; however, there were no episodes of urinary tract infection in 12 months of follow-up. Suburethral injection is an endoscopic treatment modality with low morbidity in our country.

Influencia de la vía de administración sobre el efecto del extracto etanólico de la semilla de Jatropha curcas L, en la motilidad intestinal en ratones albinos / Influence of the route of administration on the effect of ethanol extract of the Jatropha curcas L. seeds, on gut motility of albino mice

Objetivo: Determinar la influencia de la vía de administración sobre efecto de distintas dosis del extracto etanólico de la semilla de Jatropha curcas L en la motilidad intestinal de ratones. Materiales y Métodos: Se utilizaron ratones albinos machos con un peso promedio de 23 g, a los que, por vía oral e intraperitoneal, y a dosis escalonadas y no tóxicas, se les administraron extracto etanólico de la semilla de Jatropha curcas L. Los grupos experimentales fueron: suero fisiológico 0,1 mL/10 g, atropina 1 mg/Kg, extracto etanólico de semilla de Jatropha curcas L. 500, 750 y 1000 mg/Kg, respectivamente, y neostigmina 0,4 mg/Kg. Para la validación estadística se usó ANOVA con post-hoc de Sidak. Resultados: Se encontró diferencias significativas al analizar los porcentajes de motilidad intestinal de todos los grupos, sin embargo, al realizar la comparación por parejas solo se halló diferencias entre los grupos que recibieron atropina y neoestigmina (p=0,038), J. curcas L. vía oral a dosis de 500 mg/Kg y 1000 mg/Kg (p=0,001 en ambos casos). Se encontraron diferencias significativas (p>0,05) en las comparaciones entre la administración por vía oral y por vía peritoneal del extracto de J. curcas L. a dosis de 500 mg/Kg y 1000 mg/Kg. Conclusión: Se encontró influencia de la vía de administración, sobre el efecto del extracto etanólico de Jatropha curcas L. en la la motilidad intestinal en ratones albinos.

Objectives. To determine the influence of administration route of Jatropha curcas L. seeds ethanolic extract (in different doses) on intestinal motility of albino mice. Methods. Male albino mice were used with an average weight of 23 g., which the ethanolic extract of Jatropha curcas L. seeds were administered in different administration routes (oral and intraperitoneal), using staggered and non-toxic doses. The experimental groups were 0,1 mL/10 g physiological saline, atropine 1mg/Kg, neostigmine 0.4 mg/kg and Jatropha curcas L seed ethanolic extract in doses of 500, 750 and 1000mg/kg. One-way ANOVA test with Sidak post-hoc test were used to do a statistical inferences. Results. Significant differences were found when all-groups intestinal charcoal transit distance (%) were analyzed. However, when paired comparisons were made, significant differences were found between neostigmine group (p=0,038); and oral administration of J curcas L extracts in doses of 500 mg/Kg and 1000 mg/Kg (p=0.001 in both cases). Significant differences were found (p>0.05) in comparisons made between orally and intraperitoneal administration of J. curcas L. extract in doses of 500 mg/Kg and 1000 mg/Kg. Conclusion. There is some influence caused by route of administration of Jathropa curcas L. seeds ethanolic extract on intestinal motility in albino mice.

The SOS Chromotest applied for screening plant antigenotoxic agents against ultraviolet radiation.

In this work, we investigated the usefulness of the SOS Chromotest for screening plant antigenotoxic agents against ultraviolet radiation (UV). Fifty Colombian plant extracts obtained by supercritical fluid (CO2) extraction, twelve plant extract constituents (apigenin, carvacrol, ß-caryophyllene, 1,8-cineole, citral, p-cymene, geraniol, naringenin, pinocembrin, quercetin, squalene, and thymol) and five standard antioxidant and/or photoprotective agents (curcumin, epigallocatechin gallate, resveratrol, α-tocopherol, and Trolox®) were evaluated for their genotoxicity and antigenotoxicity against UV using the SOS Chromotest. None of the plant extracts, constituents or agents were genotoxic in the SOS Chromotest at tested concentrations. Based on the minimal extract concentration that significantly inhibited UV-genotoxicity (CIG), five plant extracts were antigenotoxic against UV as follows: Baccharis nítida (16 µg mL-1) = Solanum crotonifolium (16 µg mL-1) > Hyptis suaveolens (31 µg mL-1) = Persea caerulea (31 µg mL-1) > Lippia origanoides (62 µg mL-1). Based on CIG values, the flavonoid compounds showed the highest antigenotoxic potential as follows: apigenin (7 µM) > pinocembrin (15 µM) > quercetin (26 µM) > naringenin (38 µM) > epigallocatechin gallate (108 µM) > resveratrol (642 µM). UV-genotoxicity inhibition with epigallocatechin gallate, naringenin and resveratrol was related to its capability for inhibiting protein synthesis. A correlation analysis between compound antigenotoxicity estimates and antioxidant activity evaluated by the oxygen radical absorbance capacity (ORAC) assay showed that these activities were not related. The usefulness of the SOS Chromotest for bioprospecting of plant antigenotoxic agents against UV was discussed.

SECOND LATIN AMERICAN INTERCOMPARISON ON INTERNAL DOSE ASSESSMENT.

Internal dosimetry intercomparisons are essential for the verification of applied models and the consistency of results'. To that aim, the First Regional Intercomparison was organised in 2005, and that results led to the Second Regional Intercomparison Exercise in 2013, which was organised in the frame of the RLA 9/066 and coordinated by Autoridad Regulatoria Nuclear of Argentina. Four simulated cases covering intakes of (131)I, (137)Cs and Tritium were proposed. Ninteen centres from thirteen different countries participated in this exercise. This paper analyses the participants' results in this second exercise in order to test their skills and acquired knowledge, particularly in the application of the IDEAS Guidelines. It is important to highlight the increased number of countries that participated in this exercise compared with the first one and, furthermore, the improvement in the overall performance. The impact of the International Atomic Energy Agency (IAEA) Projects since 2003 has led to a significant enhancement of internal dosimetry capabilities that strengthen the radiation protection of workers.

Manejo odontopediátrico de pacientes con enferemedad de Von Willebrand. Reporte de un caso clínico / Dental management of patient with von Willebrand disease, Report of a case

La enfermedad de Von Willebrand es de origen autosómica dominante que se caracteriza por sangrado prolongado con recuento plaquetario normal debido a una deficiencia cualitativa o cuantitativa del factor Von Willebrand, que es una proteína necesaria para iniciar la adherencia plaquetaria al subendotelio e iniciar el proceso hemostático. Una deficiencia de este factor causa sangrados prolongados de diferente intensidad. Reporte del caso: Se presentó al Hospital del Niño DIF, Hidalgo, un paciente masculino de7 años 6 meses de edad, el cual fue diagnosticado a los 4 años con enfermedad de Von Willebrand y remitido para realizar exodoncias dentales. El paciente no contaba con subtipo de la enfermedad. Se decide realizar la rehabilitación integral en quirófano transfundiendo crioprecipitados. Debido a la presencia de lesiones cariosas de diversos grados y evidencia de infección de origen apical, se realizaron 4 tratamientos pulpares, 4 coronas de acero cromo y 3 extracciones con medios hemostáticos y sutura de heridas. Conclusiones: La rehabilitación odontológica bajo anestesia general de este paciente se consideró exitosa, ya que se realizó en una sola cita, transfundiendo crioprecipitados, sin tener complicaciones durante el procedimiento...

The Von Willebrand disease is an autosomal dominant origin characterized by prolonged bleeding with normal platelet count due to a qualitative or quantitative deficiency of Von Willebrand factor, a protein required to initiate platelet adhesion to sub-endothelium and initiate the process hemostatic. A deficiency of this factor causes prolonged bleeding of varying intensity. Case report: A male patient 7 years 6 months old, was presented to the Hospital del Niño DIF, Hidalgo, who was diagnosed at age 4 with Von Willebrand disease and referred for dental extractions. The patient had no disease subtype. It was decided to perform comprehensive surgical rehabilitation transfusing cryoprecipitate. Due to the presence of carious lesions of diverse degrees and evidence of infection of apical origin, 4 pulp treatments, 4 chrome steel crowns, 3 extractions were realized with hemostatic and wound closure means. Conclusions: The dental rehabilitation under general anesthesia in this patient was considered successful, as was done in one appointment, and transfusing cryoprecipitate, without complications during the procedure...

[Cystic tumors in the retrorectal space. Do these two cases have something in common?]. / Tumoraciones quísticas del espacio retrorrectal. ¿Tienen algo en común estos dos casos?

Cystic lesions in the retrorectal or presacral space present a broad differential diagnosis. Rare but typical lesions at this site are those related to embryonic development, which are the most frequent presacral congenital lesions in adults. Amongst these tumors, epidermoid cysts and cystic hamartomas are the most common lesions. Cystic masses, which are asymptomatic in approximately 50% of the cases at diagnosis, may show complications such as infection or malignant degeneration. Initial diagnosis is based on imaging techniques although definite lesion characterization, essential due to their malignancy risk, is given by the pathological analysis of the surgical piece.

Dermoscopy of apocrine hidrocystomas: a morphological study.

BACKGROUND: The dermoscopic morphology of apocrine hidrocystomas remains to be elucidated. OBJECTIVE: To evaluate the morphological findings of apocrine hidrocystomas under dermoscopic observation. METHODS: Dermoscopic examination of 22 cases of apocrine hidrocystomas was performed to evaluate specific dermoscopic criteria and patterns. RESULTS: The most frequently occurring dermoscopic features were found to be: (i) A translucent to opaque, homogeneous area which occupies the whole lesion in all apocrine hidrocystomas (100%). The colour of this homogeneous area was skin-colored in 31.8% of our cases; yellow, in 31.8% and blue, in 22.7% of apocrine hidrocystomas. (ii) Vascular structures were identified in 81.8% of our cases; arborizing vessels, in 68.2% and linear-irregular vessels in 9.1% of our cases; and (iii) Whitish structures were identified in 22.7% of the lesions. The results of our study reveal that the presence of a homogeneous area that occupies the whole lesion and arborizing vessels is the most common dermoscopic pattern in apocrine hidrocystomas (68.2%). CONCLUSION: Apocrine hidrocystomas, above all in its pigmented variant, may represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinomas.

Cisgenesis and Intragenesis: New tools For Improving Crops

Genetically Modified Organisms (GMO) could be the answer for many relevant problems affecting crops. However, improving crops through GMO is also often associated with safety concerns, environmental risks and health issues due to the presence of foreign DNA. These limitations have prompted the development of alternative technologies. Recently, cisgenesis and intragenesis have been developed as new tools aimed to modify crops. While cisgenesis involves genetic modification using a complete copy of natural genes with their regulatory elements that belong exclusively to sexually compatible plants, intragenesis refers to the transference of new combinations of genes and regulatory sequences belonging to that particular species. So far, application of cisgenesis and intragenesis as alternatives to conventional transgenesis are limited to a few species, mainly due to the lack of knowledge of the regulatory sequences required. The grape is one of the most cultivated crops worldwide and is the most economically relevant crop in Chile. Its genomic sequence has been completed, making available new sources of information to improve grape traits by genetic manipulation. This review is focused on the current alternatives to transgenesis in plants, including new approaches to develop marker-free crops, their application to economically relevant crops and future perspectives in the area. Also, the identification of grapevine promoters with a wide range of expression profiles is shown. The expression pattern of these genes was analyzed in different tissues and developmental stages, as well as under several stresses and stimuli, giving a broad range of expression patterns, including genes expressed exclusively during ripening, in response to sugars, senescence and biotic stress, among others. Genes with strong and constitutive expression were also identified. Functional analysis using reporter genes has been conducted in order to confirm the promoter's transcription activity, opening new possibilities for developing cisgenic/intragenic grapevines.

Prognostic significance of FLT3 mutational status and expression levels in MLL-AF4+ and MLL-germline acute lymphoblastic leukemia.

There is barely any information about the prognostic significance of FLT3 expression and mutational status in cytogenetically distinct subgroups of acute lymphoblastic leukemia (ALL). We analyzed the presence of FLT3-tyrosine kinase domain (TKD) and FLT3-internal tandem duplication (ITD) mutations as well as FLT3 expression levels in 54 newly diagnosed patients with B-ALL (n=49) or T-ALL (n=5). All B/T-ALL samples tested negative for the presence of FLT3-TKD or FLT3-ITD. None of the T-ALL and E2A-PBX1+ B-ALL overexpressed FLT3. In contrast, mainly MLL-AF4+ B-ALL but also ETV6-RUNX1+, BCR-ABL+ or B-ALL displaying normal cytogenetics exhibited significantly higher FLT3 expression levels than normal bone marrow, supporting that aberrantly increased transcription of FLT3, rather than activating FLT3 mutations, contributes to the pathogenesis of these B-ALL. Using the median FLT3 expression as cut-off value we found that high-level FLT3 expression is associated with an extremely poor 1-year overall survival (OS; 0 vs 71%; P=0.002) and disease-free survival (DFS; 0 vs 43%; P=0.03) in MLL-AF4+ B-ALL but not in MLL-germline B-ALL. Cox regression analysis with OS/DFS as end points showed that age>14 years and high-level FLT3 expression were independent prognostic factors when all ALL patients were analyzed together. Importantly, when the MLL-AF4+ B-ALL subgroup was analyzed separately, high-level FLT3 expression was the only independent prognostic factor for OS and treatment outcome. These findings indicate that high FLT3 expression identifies MLL-AF4+ ALL patients at very high risk of treatment failure and poor survival, emphasizing the value of ongoing/future clinical trials for FLT3 inhibitors.