Myxoinflammatory fibroblastic sarcoma of the face.

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare low-grade tumor of modified fibroblasts, with tendency to local recurrence. This unusual entity typically presents as a slow-growing painless mass in the distal extremities of middle-aged subjects. A 48-year-old woman presented to our clinic with a painless subcutaneous mass in the right temporal region. Excisional biopsy made the rare diagnosis of MIFS. Histologic examination showed the unique features that characterize this lesion: a myxoid component with a superimposed inflammatory infiltrate and the presence of distinctive, large, and bizarre Reed-Stemberg-like cells. A second wide tumor bed resection was performed, achieving clear margins. No adjuvant therapy was administered, and the patient is free of disease at 18 months postoperatively. To the best of our knowledge, this is the first reported case of MIFS presenting in the face. This adds another possibility for differential diagnoses of soft tissue tumors of the face.

A Mediterranean diet with additional extra virgin olive oil and pistachios reduces the incidence of gestational diabetes mellitus (GDM): A randomized controlled trial: The St. Carlos GDM prevention study.

BACKGROUND: Gestational diabetes mellitus (GDM) prevalence is increasing and becoming a major public health concern. Whether a Mediterranean diet can help prevent GDM in unselected pregnant women has yet to be studied. METHODS: We conducted a prospective, randomized controlled trial to evaluate the incidence of GDM with two different dietary models. All consecutive normoglycemic (<92 mg/dL) pregnant women at 8-12 gestational weeks (GW) were assigned to Intervention Group (IG, n = 500): MedDiet supplemented with extra virgin olive oil (EVOO) and pistachios; or Control Group (CG, n = 500): standard diet with limited fat intake. Primary outcome was to assess the effect of the intervention on GDM incidence at 24-28 GW. Gestational weight gain (GWG), pregnancy-induced hypertension, caesarean section (CS), preterm delivery, perineal trauma, small and large for gestational age (SGA and LGA) and admissions to neonatal intensive care unit were also assessed. Analysis was by intention-to-treat. RESULTS: A total of 874 women completed the study (440/434, CG/IG). According to nutritional questionnaires and biomarker analysis, women in the IG had a good adherence to the intervention. 177/874 women were diagnosed with GDM, 103/440 (23.4%) in CG and 74/434(17.1%) in IG, p = 0.012. The crude relative risk (RR) for GDM was 0.73 (95% CI: 0.56-0.95; p = 0.020) IG vs CG and persisted after adjusted multivariable analysis, 0.75(95% CI: 0.57-0.98; p = 0.039). IG had also significantly reduced rates of insulin-treated GDM, prematurity, GWG at 24-28 and 36-38 GW, emergency CS, perineal trauma, and SGA and LGA newborns (all p<0.05). CONCLUSIONS: An early nutritional intervention with a supplemented MedDiet reduces the incidence of GDM and improves several maternal and neonatal outcomes.

Dietary behavior and type 2 diabetes care.

OBJECTIVE: To explore risk factors modification, as well as barriers and facilitators for behavioral change in Mexican type 2 diabetics and their families. METHODS: Risk assessment and impact evaluation included measurements on anthropometrics, diet, physical activity, nutrition knowledge, and HbA(1c.) The intervention included discussion groups and promoted behavioral change on dietary risk, physical exercise, and basic diabetic knowledge of 48 urban diabetic patients and 38 relatives. The educational method consisted of cognitive reframing and situational problem solving during five meetings over an 8-month period. RESULTS: Diabetics were older and less educated than their participating relatives (55.8+/-11 and 34.7+/-13.7 years old, and 4.5+/-3.4 and 7.8+/-3.7 years of schooling, respectively). Factors such as diet, degree of obesity, physical activity and HbA(1c), reflected that 92% of diabetic patients and 83% of their relatives were at high health risk. After the intervention, nutritional knowledge and diet-health awareness increased (p=.013 and .001 respectively); however, no significant health-risks reduction was observed. DISCUSSION: Focus group analysis suggested that lack of support from family and health services, low income, neighborhood insecurity and misleading "popular knowledge" and advice are key barriers to behavioral change. PRACTICE IMPLICATIONS: The study supports the understanding of constrains to health promotion campaigns and better health provider-patient interactions in Mexican population. Additionally, the study contributes to the general knowledge of ethnic socio-cultural environment influences over health care issues, primarily to diet modifications.

Food components and dietary patterns of two different groups of Mexican lactating women.

OBJECTIVE: To evaluate the energy, nutrient intakes and dietary patterns of Mexican lactating women at one month postpartum, and the associations of maternal age and region on their intakes. METHODS: A total of 60 women were studied: 41 from Northwest and 19 from Central Mexico, 33 adolescent and 27 adult women. Data were collected through two quantitative 24 h recalls. Two more recalls were used in a sub sample to calculate the coefficient of variation of intakes. Menus were based on the consumption frequency of foods. RESULTS: The mean energy intake of the adolescent women (2354 +/- 1199 kcal) and those of Central Mexico (1690 +/- 981 kcal) was lower than the recommendations. Zinc, calcium, vitamin E, C and folate were inadequate (55 to 85% prevalence of inadequacy). Energy, dietary fiber, sodium, potassium, iron and folate intakes were higher (P < 0.05) in Northwest Mexico. Northwestern women consumed less variety of vegetables or fruits compared to Mexico City region women. Wheat tortillas and beans were from Northwestern but not from the Mexico City region diet. CONCLUSIONS: The energy and nutrient intakes of women were different by regional hospital and not by age. Education about the importance of the maternal diet during lactation should be directed toward increasing consumption of foods rich in micronutrients.