Antiprogestins for breast cancer treatment: We are almost ready.

The development of antiprogestins was initially a gynecological purpose. However, since mifepristone was developed, its application for breast cancer treatment was immediately proposed. Later, new compounds with lower antiglucocorticoid and antiandrogenic effects were developed to be applied to different pathologies, including breast cancer. We describe herein the studies performed in the breast cancer field with special focus on those reported in recent years, ranging from preclinical biological models to those carried out in patients. We highlight the potential use of antiprogestins in breast cancer prevention in women with BRCA1 mutations, and their use for breast cancer treatment, emphasizing the need to elucidate which patients will respond. In this sense, the PR isoform ratio has emerged as a possible tool to predict antiprogestin responsiveness. The effects of combined treatments of antiprogestins together with other drugs currently used in the clinic, such as tamoxifen, CDK4/CDK6 inhibitors or pembrolizumab in preclinical models is discussed since it is in this scenario that antiprogestins will be probably introduced. Finally, we explain how transcriptomic or proteomic studies, that were carried out in different luminal breast cancer models and in breast cancer samples that responded or were predicted to respond to the antiprogestin therapy, show a decrease in proliferative pathways. Deregulated pathways intrinsic of each model are discussed, as well as how these analyses may contribute to a better understanding of the mechanisms involved.

Robotic versus Laparoscopic Surgery for Spleen-Preserving Distal Pancreatectomies: Systematic Review and Meta-Analysis.

BACKGROUND: When oncologically feasible, avoiding unnecessary splenectomies prevents patients who are undergoing distal pancreatectomy (DP) from facing significant thromboembolic and infective risks. METHODS: A systematic search of MEDLINE, Embase, and Web Of Science identified 11 studies reporting outcomes of 323 patients undergoing intended spleen-preserving minimally invasive robotic DP (SP-RADP) and 362 laparoscopic DP (SP-LADP) in order to compare the spleen preservation rates of the two techniques. The risk of bias was evaluated according to the Newcastle-Ottawa Scale. RESULTS: SP-RADP showed superior results over the laparoscopic approach, with an inferior spleen preservation failure risk difference (RD) of 0.24 (95% CI 0.15, 0.33), reduced open conversion rate (RD of -0.05 (95% CI -0.09, -0.01)), reduced blood loss (mean difference of -138 mL (95% CI -205, -71)), and mean difference in hospital length of stay of -1.5 days (95% CI -2.8, -0.2), with similar operative time, clinically relevant postoperative pancreatic fistula (ISGPS grade B/C), and Clavien-Dindo grade ≥3 postoperative complications. CONCLUSION: Both SP-RADP and SP-LADP proved to be safe and effective procedures, with minimal perioperative mortality and low postoperative morbidity. The robotic approach proved to be superior to the laparoscopic approach in terms of spleen preservation rate, intraoperative blood loss, and hospital length of stay.

Portal venous gas after a failed endoscopic retrograde cholangiopancreatography attempt in a patient with a large hepatocellular carcinoma: A case report.

The cause of hepatic portal vein gas (HPVG) is variable. Good knowledge of the possible causes, combined with the clinical assessment of the patient and a good quality imaging, is required to correctly identify the underlying cause of HPVG and to best predict the prognosis.

Imperforación coanal congénita: presentación de un caso / Congenital choanal imperforation: report of a case

Se realiza la presentación de una paciente operada en el servio de Otorrinolaringología (ORL) del Hospital Docente Clinicoquirúrgico "10 de Octubre", de imperforación coanal congénita unilateral completa. Se hace la revisión bibliográfica de dicha entidad

Empiema del seno maxilar: presentación de un caso / Empyema of the maxillary sinces: reprt of a case

Se estudia el caso de una paciente de 65 años de edad, que presentó empiema del seno maxilar derecho, celulitis de la cara y osteítis del maxilar superior con punto partida odontógeno y sin fístula oroantral

Pesquisaje del cáncer del pulmón por endoscopia / Endoscopic screening of lung cancer

Se seleccionaron al azar y procedentes de las Salas de Medicina Interna de este hospital, 25 pacientes afectados de enfermedades broncopulmonares que presentaban diferentes diagnósticos clinicorradiográficos y les practicamos broncoscopia diagnóstica con el fin de investigar cáncer en el pulmón. Se demostró la efectividad del examen broncoscópico en el diagnóstico de las enfermedades broncopulmonares y sobre todo para lograr el diagnóstico precoz del cámcer pulmonar

Estudio evolutivo de la otitis media secretoria tratada con drenaje transtimpánico: resultados funcionales al año / Evolutive study of secretory otitis media treated with transtympanic drainage: functional results after a year

En este trabajo se realizó un estudio de la evolución auditiva que observamos en 126 oídos afectados de otitis secretoria crónica, a los que se les realizó miringotomía y colocación de drenaje transtimpánico. Se evaluaron la audición preoperatoria comparativamente con la alcanzada a los 6 meses y al año del posoperatorio, mediante audiometría tonal. La mayoría de los 75 adultos estudiados tenían más de 51 años de edad. Comprobamos en este trabajo que en la mayor cantidad de los oídos estudiados se alcanzaron mejoras auditivas, tanto en la evolución a los 6 meses, como al año de colocados los tubos de ventilación