Paraspinal Desmoid Tumor in a Pediatric Patient with No Surgical History: A Case Report.

Desmoid tumors are locally aggressive, benign neoplasms originating in connective tissues. Although the exact pathophysiology remains unknown, antecedent trauma or surgery are believed to be important contributing factors. The occurrence of paraspinal desmoid tumor in pediatric patients is extremely uncommon. Here, we present an exceedingly rare case of a pediatric patient with no surgical or family history who developed a paraspinal desmoid tumor. A 9-year-old female patient presented with 4 months of progressive back pain, right lower extremity weakness, and numbness. Spinal imaging revealed a left epidural paraspinal mass compressing her thoracic spinal cord and extending into the left thoracic cavity. A multidisciplinary approach with neurosurgery and thoracic surgery enabled gross total resection of the lesion. The patient had complete resolution of her symptoms with no signs of residual tumor on postoperative imaging. Pathology revealed a desmoid tumor that avidly stained for beta-catenin. On her last follow-up, she developed a recurrence, to which she was started on sorafenib therapy. Desmoid tumors are rare connective tissue neoplasms that often occur after local tissue trauma, such as that caused by surgery. This report presents a rare case of a pediatric paraspinal desmoid tumor that occurred in a patient with no surgical or family history. Such tumors should undergo surgical resection for symptomatic relief and tissue diagnosis. Close clinical and radiographic surveillance are essential in these patients due to the high recurrence rates of desmoid tumor.

Outcomes After Preoperative Chemoradiation With or Without Pazopanib in Non-Rhabdomyosarcoma Soft Tissue Sarcoma: A Report From Children's Oncology Group and NRG Oncology.

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.ARST1321 was a phase II study designed to compare the near complete pathologic response rate after preoperative chemoradiation with/without pazopanib in children and adults with intermediate-/high-risk chemotherapy-sensitive body wall/extremity non-Rhabdomyosarcoma Soft Tissue Sarcoma (ClinicalTrials.gov identifier: NCT02180867). Enrollment was stopped early following a predetermined interim analysis that found the rate of near complete pathologic response to be significantly greater with the addition of pazopanib. As a planned secondary aim of the study, the outcome data for this cohort were analyzed. Eight-five eligible patients were randomly assigned to receive (regimen A) or not receive (regimen B) pazopanib in combination with ifosfamide and doxorubicin + preoperative radiotherapy followed by primary resection at week 13 and then further chemotherapy at week 25. As of December 31, 2021, at a median survivor follow-up of 3.3 years (range, 0.1-5.8 years), the 3-year event-free survival for all patients in the intent-to-treat analysis was 52.5% (95% CI, 34.8 to 70.2) for regimen A and 50.6% (95% CI, 32 to 69.2) for regimen B (P = .8677, log-rank test); the 3-year overall survival was 75.7% (95% CI, 59.7 to 91.7) for regimen A and 65.4% (95% CI, 48.1 to 82.7) for regimen B (P = .1919, log-rank test). Although the rate of near complete pathologic response was significantly greater with the addition of pazopanib, outcomes were not statistically significantly different between the two regimens.

Mesotheliomas in Children.

Mesotheliomas are rare and aggressive tumors that originate from mesothelial cells. Although exceedingly rare, these tumors may occur in children. Different from adult mesotheliomas, however, environmental exposures particularly to asbestos do not appear to play a major role in mesotheliomas in children, in whom specific genetic rearrangements driving these tumors have been identified in recent years. These molecular alterations may increasingly offer opportunities for targeted therapies in the future, which may provide better outcomes for these highly aggressive malignant neoplasms.

Intususcepción intestinal en el contexto de una apendicitis aguda / Intestinal intussusception in the context of acute appendicitis: a case report and lit-erature review

Introducción: La intususcepción es una patología abdominal idiopá-tica o secundaria a procesos intesti-nales que actúan como puntos de partida para la invaginación. Se han descrito casos de arrastre de estruc-turas que derivan en otros procesos inflamatorios como la apendicitis aguda. Caso clínico: Niño 3 años, con dolor abdominal de 6 horas de evolución. Al examen físico se pre-senta pálido, somnoliento, taqui-cárdico y deshidratado. El abdo-men con signos apendiculares posi-tivos, con palpación en masa en fosa iliaca derecha. Taller diagnóstico: Leucocitos 9690 u/mm3, neutrófilos 58.1%. Ecografía con imagen sugerente de intususcepción intestinal con cam-bios inflamatorios en la grasa me-sentérica. Se realiza tomografía abdominal que reporta intususcep-ción ileocolónica de 47 x 50 mm, con múltiples ganglios reactivos mesentéricos, con imagen apendicu-lar en dirección pélvica, con apendi-colito en su interior. Evolución: El manejo quirúrgico incluyó una laparotomía explorato-ria con desinvaginación manual y apendicectomía convencional. El reporte de patología fue apendicitis aguda supurativa. El paciente 48 horas hospitalizado, recibió Ampici-lina + Sulbactam y analgesia. Al mejorar la función abdominal fue dado de alta. Conclusiones: En este caso la apendicitis aguda fue la causa de intususección intestinal con el signo ecográfico de la "diana" en un paciente de 3 años de edad.

Introduction: Intussusception is an idiopathic abdominal pathology or secondary to intestinal processes that act as starting points for intussusception. Cases of dragging of structures that lead to other inflammatory processes, such as acute appendicitis, have been described. Clinical case: 3-year-old boy with abdominal pain of 6 hours of evolution. On physical examination, he appears pale, drowsy, tachycardic, and dehydrated. The abdomen with positive appendiceal signs, with palpation of a mass in the right iliac fossa. Diagnostic workshop: leukocytes 9690 u/mm3, neutrophils 58.1%. Ultrasound with image suggestive of intestinal intussusception with inflammatory changes in the mesenteric fat. An abdominal tomography was performed that reported ileocolonic intussusception of 47 x 50 mm, with multiple mesenteric reactive nodes, an appendicular image in the pelvic direction, and an appendicolith inside. Evolution: Surgical management included an exploratory laparotomy with manual evagination and conventional appendectomy. The pathology report was acute suppurative appendicitis. The patient was hospitalized for 48 hours and received Ampicillin + Sulbac-tam and analgesia. When abdominal function improved, he was discharged. Conclusions: In this case, acute appendicitis was the cause of intestinal intussusception with the ultrasound sign of the "target" in a 3-year-old patient.

Morphologic and Ancillary Studies of Pediatric Acinic Cell Carcinoma: A Single Institute Experience.

BACKGROUND: Acinic cell carcinoma (AciCC) is the second most common pediatric malignant salivary gland tumor. However, there are limited pathology publications about this tumor in the pediatric population. METHODS: We describe four pediatric AciCC cases diagnosed between 2000 and 2021 in our institute. Reticulin histochemistry plus immunohistochemistry for NR4A3 and DOG1 were performed on all cases. RESULTS: Histologically, all four cases featured a tumor-associated lymphoid proliferation and collagenous stroma, in which two formed central scars. The tumors were predominantly solid, with a lobular pattern and variably sized dilated spaces, including one case with focal microcysts. High-grade transformation was not observed in any of our cases. Reticulin stain and immunohistochemistry for NR4A3 showed distinct features between AciCC and non-neoplastic salivary gland parenchyma. DOG1 immunohistochemistry confirmed the acinar origin of AciCC. CONCLUSIONS: Our study reveals that pediatric AciCCs often present with tumor-associated lymphoid proliferation (TALP) and sclerosis. Special stains such as reticulin histochemistry and NR4A3 immunohistochemistry are helpful to separate tumor from adjacent benign parenchyma. The ancillary study is helpful for the diagnosis of small specimens. Our study is limited by its low case number, but we hope that our results will promote more studies on this rare salivary gland tumor in the pediatric population.

Morphologic Spectrum of Rhabdomyomatous Mesenchymal Hamartomas (Striated Muscle Hamartomas) in Pediatric Dermatopathology.

BACKGROUND: Rhabdomyomatous mesenchymal hamartomas (RMHs), also termed striated muscle hamartomas, are rare benign tumors of skin and subcutis, which mostly occur at birth with a predilection for the head and neck. Simple surgical excision is the treatment modality of choice with excellent prognosis. OBJECTIVE: To review the spectrum of the different clinical and pathologic features of RMHs in pediatric patients and recognize their characteristics to avoid confusion with other lesions in their list of differential diagnosis. METHODS: Six cases of RMH diagnosed at our institution from 2009 to 2021 were retrieved from our files and reviewed retrospectively after anonymization by an honest broker. This review is IRB-approved by the University of Pittsburgh School of Medicine, study STUDY19080192. RESULTS: The patients' age ranged from 6 days to 8 years, with a female predominance (2:1). In all cases, the lesion was present at birth. All lesions, except for 2, occurred in the head and neck regions. One patient had multiple additional small nodules in the face, whereas all others presented with solitary RMHs. The size of the lesions varied, and their composition included bundles of skeletal muscle (the landmark finding) associated with variable amounts of adipose, fibrous, vascular, nerve, and adnexal structures. CONCLUSIONS: RMH is a benign hamartomatous lesion with a variable phenotypic spectrum. RMHs predominate in the head and neck. Familiarity with these lesions, including their presentation in less frequent anatomical sites, is important to avoid diagnostic misinterpretations and potential overtreatment. This study represents one of the largest series of RMHs in the literature, including an unusual case in a perianal location.

Esplenectomía Laparoscópica en el Hospital Pediátrico Baca Ortiz, estudio retrospectivo de los últimos 10 años / Laparoscopic splenectomy at Baca Ortiz Pediatric Hospital, a retrospective study of the last 10 years. Observational Study

Introducción: La esplenectomía es un tratamiento estandarizado en niños con trombocitopenia. El método de laparoscopía, en este tratamiento, minimiza los procesos post-operatorios y se ha difundido su aplicación en la comunidad científica. El objetivo del presente estudio es realizar una descripción de la casuística y utilidad de la esplenectomía laparoscópica en los niños con patología hematológica. Métodos: El presente estudio observacional, retrospectivo se realizó en el Hospital Pediátrico Baca Ortiz. Se revisaron expedientes clínicos de los últimos 10 años de pacientes con indicación de esplenectomía quirúrgica. Se analizan variables demográficas, clínicas y de resultados. Se utiliza estadística descriptiva. Resultados: Ingresaron al estudio 14 pacientes que tuvieron una esplenectomía quirúrgica vía laparoscópica. La mayoría de estos pacientes son del sexo femenino, con patologías hematológicas como esferocitosis y púrpura trombocitopénica idiopática (PTI). En el 50% se realizó colecistectomía además de esplenectomía. El tiempo quirúrgico varió de 60 a 120 minutos. Conclusiones: La esplenectomía laparoscópica es considerada una técnica compleja dentro de los procedimientos de laparoscopia, pero es ideal para los pacientes con patología hematológica, por lo que es la técnica de elección. Una ventaja de la esplenectomía laparoscópica es el menor tiempo de recuperación y hospitalización, con heridas quirúrgicas más pequeñas.

Introduction: Splenectomy is a standardized treatment in children with thrombocytopenia. The laparoscopic method, in this treatment, minimizes post-operative processes and its application has become widespread in the scientific community. The objective of this study is to describe the casuistry and usefulness of laparoscopic splenectomy in children with hematological pathology. Methods: This retrospective, observational study was conducted at Baca Ortiz Pediatric Hospital. Medical records of the last 10 years of patients with an indication for surgical splenectomy were reviewed. Demographic, clinical and outcome variables are analyzed. Descriptive statistics are used. Results: Fourteen patients who had a laparoscopic surgical splenectomy entered the study. Most of these patients are female, with hematological pathologies such as spherocytosis and idiopathic thrombocytopenic purpura (ITP). In 50% a cholecystectomy was performed in addition to splenectomy. The surgical time ranged from 60 to 120 minutes. Conclusions: Laparoscopic splenectomy is considered a complex technique within laparoscopic procedures, but it is ideal for patients with hematological pathology, so it is the technique of choice. An advantage of laparoscopic splenectomy is the shorter recovery time and hospitalization, with smaller surgical wounds

Pathological response in children and adults with large unresected intermediate-grade or high-grade soft tissue sarcoma receiving preoperative chemoradiotherapy with or without pazopanib (ARST1321): a multicentre, randomised, open-label, phase 2 trial.

BACKGROUND: Outcomes for children and adults with advanced soft tissue sarcoma are poor with traditional therapy. We investigated whether the addition of pazopanib to preoperative chemoradiotherapy would improve pathological near complete response rate compared with chemoradiotherapy alone. METHODS: In this joint Children's Oncology Group and NRG Oncology multicentre, randomised, open-label, phase 2 trial, we enrolled eligible adults (aged ≥18 years) and children (aged between 2 and <18 years) from 57 hospitals in the USA and Canada with unresected, newly diagnosed trunk or extremity chemotherapy-sensitive soft tissue sarcoma, which were larger than 5 cm in diameter and of intermediate or high grade. Eligible patients had Lansky (if aged ≤16 years) or Karnofsky (if aged >16 years) performance status score of at least 70. Patients received ifosfamide (2·5 g/m2 per dose intravenously on days 1-3 with mesna) and doxorubicin (37·5 mg/m2 per dose intravenously on days 1-2) with 45 Gy preoperative radiotherapy, followed by surgical resection at week 13. Patients were randomly assigned (1:1) using a web-based system, in an unmasked manner, to receive oral pazopanib (if patients <18 years 350 mg/m2 once daily; if patients ≥18 years 600 mg once daily) or not (control group), with pazopanib not given immediately before or after surgery at week 13. The study projected 100 randomly assigned patients were needed to show an improvement in the number of participants with a 90% or higher pathological response at week 13 from 40% to 60%. Analysis was done per protocol. This study has completed accrual and is registered with ClinicalTrials.gov, NCT02180867. FINDINGS: Between July 7, 2014, and Oct 1, 2018, 81 eligible patients were enrolled and randomly assigned to the pazopanib group (n=42) or the control group (n=39). At the planned second interim analysis with 42 evaluable patients and a median follow-up of 0·8 years (IQR 0·3-1·6) in the pazopanib group and 1 year (0·3-1·6) in the control group, the number of patients with a 90% pathological response or higher was 14 (58%) of 24 patients in the pazopanib group and four (22%) of 18 patients in the control group, with a between-group difference in the number of 90% or higher pathological response of 36·1% (83·8% CI 16·5-55·8). On the basis of an interim analysis significance level of 0·081 (overall one-sided significance level of 0·20, power of 0·80, and O'Brien-Fleming-type cumulative error spending function), the 83·8% CI for response difference was between 16·5% and 55·8% and thus excluded 0. The improvement in pathological response rate with the addition of pazopanib crossed the predetermined boundary and enrolment was stopped. The most common grade 3-4 adverse events were leukopenia (16 [43%] of 37 patients), neutropenia (15 [41%]), and febrile neutropenia (15 [41%]) in the pazopanib group, and neutropenia (three [9%] of 35 patients) and febrile neutropenia (three [9%]) in the control group. 22 (59%) of 37 patients in the pazopanib group had a pazopanib-related serious adverse event. Paediatric and adult patients had a similar number of grade 3 and 4 toxicity. There were seven deaths (three in the pazopanib group and four in the control group), none of which were treatment related. INTERPRETATION: In this presumed first prospective trial of soft tissue sarcoma spanning nearly the entire age spectrum, adding pazopanib to neoadjuvant chemoradiotherapy improved the rate of pathological near complete response, suggesting that this is a highly active and feasible combination in children and adults with advanced soft tissue sarcoma. The comparison of survival outcomes requires longer follow-up. FUNDING: National Institutes of Health, St Baldrick's Foundation, Seattle Children's Foundation.

Inversión social responsable: una forma de potenciar los agronegocios - caso Colombia / Socially responsible investment: a way to impulse agribusinesses - the case of Colombia

RESUMEN El presente trabajo busca establecer la forma en que la inversión social responsable tiene el potencial de dinamizar el desarrollo empresarial de un país y, al mismo tiempo, asumir los objetivos de sostenibilidad, como propósitos propios de las actividades productivas en los agronegocios. Para ello, se propone una aproximación a un modelo teórico ideal, que expone la dinámica de la inversión social responsable, como impulsor del desarrollo empresarial. En lo metodológico, mediante el análisis de la literatura existente, se estudia el fenómeno desde la perspectiva teórica y, posteriormente, desde la perspectiva empírica, se hace uso de un análisis de framework sobre siete casos de estudio colombianos. De esta forma, se abordan conceptos relacionados con el desarrollo empresarial y la influencia de modelos de agronegocio de doble y triple impacto, así como en factores condicionantes para el otorgamiento de la figura de financiación respectiva. A manera de resultados, junto al modelo teórico expuesto, se suministra un planteamiento basado en cinco proposiciones de asociación, lo cual, prepara el terreno para su futura comprobación deductiva, tanto cualitativa como cuantitativamente.

ABSTRACT This work aims to determine the way in which social responsible investments has the potential of providing dynamism to the entrepreneurial development in agribusiness initiatives. At the same time, it seeks to integrate this concept with sustainable development objectives, and with conventional financial purposes within this particular industry. To do it, this work proposes an ideal theoretical model that exposes the dynamics of the social responsible investments and its positive influence on the entrepreneurial development. Methodologically, by using relevant literature, a conceptual analysis is performed from a theoretical perspective, followed by a framework analysis through the lens of seven Colombian case studies in order to perform a theory-building approach. Specifically, this work examines several concepts related with entrepreneurial development and the influence of double- and triple-bottom-line agribusiness models, together with conditioning factors for obtaining responsible financing. Together with the model at issue, this work provides a duly supported conceptual approach with five associative propositions, which ultimately fosters the prospective testing of the model trough deductive methods in both ways: qualitative and quantitative.

Diagnosing Epithelioid Hemangioendothelioma With Pericardial Involvement.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that commonly affects lung, liver, and bone. Among all known EHE cases, only 20% have a pulmonary origin, with metastases to the pericardium occurring in less than 1% of these. Because of its low prevalence, variable presentation, and unknown latency period, a thoracic EHE diagnosis can be easily missed. This case outlines the unique pathologic features of EHE in a patient with cardiovascular disease, provides further insight into diagnosing a rare tumor, and provides a better understanding of the pathophysiology and progression of thoracic EHE.

Solitary Fibrous Tumors in Pediatric Patients: A Rare and Potentially Overdiagnosed Neoplasm, Confirmed by STAT6 Immunohistochemistry.

Pathological diagnosis of solitary fibrous tumor (SFT) in the pediatric population is challenging, as it occurs uncommonly in this age-group and resembles other spindle cell neoplasms. SFT contains a NAB2-STAT6 fusion gene, which can be reliably detected using STAT6 immunohistochemistry. Positive staining is highly sensitive and specific. We sought to investigate the utility of STAT6 immunohistochemistry, to show how commonly SFT was historically recognized at 3 academic pediatric institutions, to reclassify them when appropriate, and to demonstrate features of major mimics of SFT. Our series included cases with a previous diagnosis of SFT or for which SFT was among key considerations, from 3 major academic pediatric hospitals seen over the past 30 years. Of 18 tumors identified, only 3 tumors from 2 patients demonstrated positive STAT6 staining as well as the typical histology and immunophenotype seen in SFT. The remaining 15 tumors were reclassified based on morphology, additional immunohistochemistry and fluorescence in situ hybridization as desmoid-type fibromatosis (3 tumors), nerve sheath/neural tumors (3 tumors), low-grade fibromyxoid sarcoma, medallion-like dermal fibroma, poorly differentiated Sertoli cell tumor, nodular/proliferative fasciitis, calcifying fibrous tumor, aneurysmal bone cyst of soft tissue, STAT6-negative SFT with adipocytic differentiation, undifferentiated small round blue cell tumor, and scar (1 tumor each). Our study confirms that SFT is rare in the pediatric population and that it is potentially overdiagnosed. STAT6 immunohistochemistry is recommended to confirm the diagnosis of SFT in the pediatric population.

Modelo de vigilancia tecnológica para la gestión de un grupo de investigación en salud / Technological surveillance model applied to the management of a health-related research group / Modelo tecnológico de vigilância para a gestão de um grupo de pesquisa em saúde

Introducción. La dinámica constante de la ciencia, la tecnología y la innovación, con el volumen de información disponible, constituyen un reto para el quehacer de los grupos de investigación en su compromiso como unidades generadoras de resultados de conocimiento y de aportes relevantes a su entorno. Una alternativa a la planeación que dé soporte a la toma de decisiones con mayor conocimiento, menor riesgo y oportuna anticipación a los cambios debería estar soportada en un proceso organizado, selectivo y sistemático como lo es la vigilancia tecnológica. Objetivo. Revisión de literatura de tipo descriptivo sobre la vigilancia tecnológica y generación de una propuesta de un modelo de vigilancia tecnológica para la gestión de la actividad científica del grupo de investigación Estudio Genético de Enfermedades Complejas (EGEC). Metodología. Revisión de la literatura de tipo descriptivo. Se consultaron las bases de datos de Medline, SciELO, Ebsco e IEEE y el buscador Google Scholar, mediante la combinación de las palabras clave "vigilancia tecnológica/technological surveillance", "salud/health", "enfermedad/disease", "ejemplos en salud", "universidad" e "investigación". Se incluyeron artículos científicos de los últimos cinco años y se excluyeron artículos que solo consideraran la difusión de resultados de ejercicios de vigilancia tecnológica. Con base en el análisis de los resultados, se propone un modelo de vigilancia tecnológica para la gestión de la actividad científica del grupo de investigación EGEC, para lo que se estructuró el diagrama de las etapas, insumos y recursos que integran el modelo propuesto, incluyendo como estrategia de validación el desarrollo de una prueba piloto sobre cáncer, a partir de la cual se hicieron ajustes adicionales al mismo. Resultados. Como referente internacional se encuentra la Norma UNE 166006:2011 de la Asociación Española de Normalización y Certificación (AENOR) y, como referente nacional, España y sus Regiones Intercambian Conocimiento con Antioquia (ERICA) e Innovaciones a partir de la Vigilancia Tecnológica (InnoViTech). Se establecen las etapas conceptuales, buenas prácticas para el ejercicio y recursos para el desarrollo de la vigilancia tecnológica. Los principales componentes del modelo propuesto incluyen la identificación de necesidades, planeación, recolección, auditoría, análisis, documentación y comunicación de información. Conclusiones. El modelo planteado es una base para el desarrollo de una estrategia de gestión del conocimiento de un grupo de investigación y plantea la importancia de escalar hacia el uso de la inteligencia competitiva al interior del mismo. [Carrillo- Zambrano E, Páez-Leal MC, Suárez JM, Luna-González ML. Modelo de vigilancia tecnológica para la gestión de un grupo de investigación en salud. MedUNAB. 2018;21(1): 84-99. doi: 10.29375/01237047.2746].

Introduction. The steady dynamics of science, technology and innovation plus the volume of information that these subjects have, represent a challenge to the research groups endeavor and to the commitment of the later ones to be knowledge developing units that give significant outputs to its social and academic settings. Therefore, there must be a planning alternative that supports the decisionmaking processes in order to give it a better knowledge founding, to reduce the possible risks and to think ahead the possible changes. This alternative must be supported by an organized, selective and systematic procedure, such as the technological surveillance. Objective. To create a descriptive literature review regarding technological surveillance and a proposal for the technological surveillance method applied to the management of scientific activity of the Estudio Genetico de Enfermedades Complejas (EGEC ­ Genetic Study for Complex Diseases) research group. Methodology. Descriptive literature review. The following academic databases were consulted: Medline, SciELO, Ebsco e IEEE and Google Scholar search engine. The combination of keywords used when consulting the academic databases, was "vigilancia tecnológica/technological surveillance", "salud/health", "enfermedad/disease", "ejemplos en salud", "universidad" and "investigación". Articles of the last five years are included, while articles that only had to deal with the results dissemination of technological surveillance exercises, were excluded. Based on the literature review analysis of results, a technological surveillance model is proposed which its objective is to manage the EGEC research group's scientific activities. In order to do so, a stages, inputs and funds diagrams that integrated the surveillance model, were created. Thus, the already mentioned diagrams included a cancer pilot test as a validation strategy, and with the test results, the model was subjected to additional adjustments. Results. The Spanish standard UNE 166006:2011 created by the Spanish Association for Standarization and Certification (AENOR), was taken as an international reference whilst the program España y sus Regiones Intercambian Conocimiento con Antioquia (ERICA) and the methodology for technological surveillance Innovaciones a partir de la Vigilancia Tecnológica (InnoViTech), were taken as national referents. Additionally, conceptual stages, good practices for processes execution and defined budget for the development of technological surveillance, are established. The main components for the proposed model include needs identification, plus the planning, collection, auditing, analysis, documentation, and information spreading processes. Conclusions. The proposed model works as a foundation for developing a knowledge management strategy of a research group. Also, the model highlights the importance of climbing towards the usage of competitive intelligence systems within itself. [Carrillo- Zambrano E, Páez-Leal MC, Suárez JM, Luna-González ML. Technological surveillance model applied to the management of a health-related research group. MedUNAB. 2018;21(1):84-99. doi: 10.29375/01237047.2746].

Introdução. A constante dinâmica da ciência, tecnologia e inovação junto com o volume de informação disponível, representam um desafio para o trabalho dos grupos de pesquisa como unidades geradoras de resultados de conhecimento e de contribuições relevantes ao seu ambiente. Uma alternativa ao planejamento que apoia a tomada de decisões com maior conhecimento, menor risco e antecipação oportuna das mudanças deve estar sustentada em um processo organizado, seletivo e sistemático, como a vigilância tecnológica. Objetivo: Revisão de literatura de caráter descritivo sobre a vigilância tecnológica e elaboração de uma proposta de modelo tecnológico de vigilância para a gestão da actividade científica do grupo de pesquisa de estudo genético de doenças complexas (EGEC). Métodos. Revisão de literatura de caráter descritivo. Foram consultadas as bases de dados Medline, SciELO, Ebsco, IEEE e o Google Académico, combinando as seguintes palavras-chave em espanhol e inglês: "vigilancia tecnológica/technological surveillance", "salud/health", "enfermedad/disease", "ejemplos en salud", "universidad" e "investigación". Foram incluídos artigos científicos dos últimos cinco anos excluindo os artigos que consideraram apenas a divulgação de resultados de exercícios de vigilância tecnológica. Com base na análise dos resultados, propõe-se um modelo tecnológico de vigilância para a gestão da atividade científica do grupo de pesquisa EGEC, para o qual foi estruturado o diagrama das etapas, insumos e recursos que compõem o modelo proposto, incluindo como estratégia de validação, o desenvolvimento de um teste piloto sobre o câncer e os ajustes adicionais necessários para o teste. Resultados. Temos como referência internacional a Norma UNE 166006:2011 da Associação Espanhola de Normalização e Certificação (AENOR) e, como referência local, Espanha e suas regiões trocam conhecimento com Antioquia (ERICA) e Inovações da Vigilância Tecnológica (InnoViTech). São estabelecidos os estágios conceituais, as boas práticas para o exercício e os recursos para o desenvolvimento da vigilância tecnológica. Os principais componentes do modelo proposto incluem a identificação das necessidades, planejamento, coleta, auditoria, análise, documentação e comunicação de informações. Conclusões. O modelo proposto é uma base para o desenvolvimento de uma estratégia de gestão de conhecimento de um grupo de pesquisa que destaca a importância do uso da inteligência competitiva dentro dele. [Carrillo-Zambrano E, Páez-Leal MC, Suárez JM, Luna-González ML. Modelo tecnológico de vigilância para a gestão de um grupo de pesquisa em saúde. MedUNAB. 2018;21(1):84-99. doi: 10.29375/01237047.2746].

Hernia de Amyand en un neonato de 22 días de vida con masa inguinal derecha / Amyand's hernia in a newborn of 22 days of life with right inguinal mass

Se trató de un paciente masculino, con 22 días de vida, nacido de 40 semanas de gestación y sin problemas durante el embarazo o el parto. Fue transferido desde otra casa de salud, por presentar una masa ínguinoescrotal derecha irreductible, de tres días de evolución. Al examen físico se observó una hernia inguinal derecha incarcerada, por lo cual se decidió intervención quirúrgica de emergencia. Se realizó incisión transversa inguinal derecha, a través de la cual se identifcó el canal inguinal derecho y tejidos circundantes con importante edema. Debido a la imposibilidad de reducir el contenido herniario, se exteriorizó el testículo y se abrió el saco herniario, evidenciándose la apéndice cecal perforada. Se realizó apendicectomía, cierre de conducto peritoneo vaginal y orquidopexia. La evolución postquirúrgica fue adecuada, tolerando la alimentación al segundo día postoperatorio y presentando tránsito intestinal al tercer día. Fue dado de alta del hospital al séptimo día postoperatorio

It was a male patient, with 22 days of life, born of 40 weeks of gestation and without problems during pregnancy or childbirth. He was transferred from another health house, due to an irreducible right-insoluble right and left mass, three days old. At the physical examination observed an incarcerated right inguinal hernia, which is why it was decided emergency surgical intervention. Inguinal transverse incision right, through which the right inguinal canal and tissues were identified surrounding with important edema. Due to the impossibility of reducing the hernial content, the testicle was externalized and the hernia sac was opened, evidencing the perforated cecal appendix. It has been made appendectomy, vaginal peritoneal duct closure and orchiopexy. Postoperative evolution was adequate, tolerating food at second postoperative day and presenting intestinal transit on the third day. He was discharged from the hospital on the seventh postoperative day

Biofunctional properties of bioactive peptide fractions from protein isolates of moringa seed (Moringa oleifera).

Moringa oleifera (Moringaceae) is a specie of significant importance because of its multiple nutraceutical properties, that has led to increase in its consumption. The seeds contain a high percentage of protein (37.48%). However, little is known about the bioactive properties of these proteins and peptides, especially those generated by enzymatic hydrolysis. The objective of this study was to evaluate the biofunctional properties of total hydrolysates (TH) and peptide fractions from protein isolates of moringa seeds. Isoelectric protein isolates were prepared and TH were obtained by digestion with trypsin, chymotrypsin and pepsin-trypsin for 2.5 and 5 h. TH were fractioned by ultrafiltration (UF) with a 10 kDa membrane to generate the peptide fractions. In all treatments, the antioxidant capacity was significantly higher in peptide fractions > 10 kDa with 5 h of hydrolysis. The results showed that the fraction > 10 kDa of pepsin-trypsin digested for 5 h presented a better Angiotensin Converting Enzyme inhibition (ACE-I) activity with an IC50 of 0.224 µg/µl. Also, antidiabetic activity was enhanced in pepsin-trypsin treatment with 5 h of hydrolysis showing an IC50 of 0.123 µg/µl. Finally, this study showed that hydrolysates of moringa seed proteins had excellent in vitro nutraceutical potential.

Solving the kidney shortage via the creation of kidney donation co-operatives.

Many people object to the creation of a market for kidneys on the grounds that such reform would hurt those patients unable to afford the market price of a kidney and that donors do not understand the risks they are taking when donating. In this paper, we propose a mechanism, the kidney co-operative, designed to provide sufficient incentives to alleviate the kidney shortage while at the same time addressing the concerns regarding the potential losers from reform. We show that it is reasonable to expect that the number of transplants will be larger under the kidney co-operative mechanism than under either the status quo or a conventional market mechanism.

Tumor-induced Osteomalacia in a 3-Year-Old With Unresectable Central Giant Cell Lesions.

Tumor-induced osteomalacia (TIO) is a rare cause of hypophosphatemia involving overproduction of fibroblast growth factor 23. TIO has been described largely in adults with small mesenchymal tumors. We report a case of TIO in a child who presented with knee pain and radiographic findings concerning for rickets, and was found to have maxillomandibular giant cell lesions. The patient was treated with oral phosphorus and calcitriol, surgical debulking, and intralesional corticosteroids, which resulted in tumor regression and normalization of serum fibroblast growth factor 23 and phosphorus. This case illustrates the occurrence of this rare paraneoplastic syndrome in children and adds to our knowledge about clinical manifestations and pathologic findings associated with pediatric TIO.

PAX7 Expression in Rhabdomyosarcoma, Related Soft Tissue Tumors, and Small Round Blue Cell Neoplasms.

Rhabdomyosarcoma, the most common soft tissue malignancy of childhood, is a morphologically variable tumor defined by its phenotype of skeletal muscle differentiation. The diagnosis of rhabdomyosarcoma often relies in part on the identification of myogenic gene expression using immunohistochemical or molecular techniques. However, these techniques show imperfect sensitivity and specificity, particularly in scant tissue biopsies. Here, we expand the toolkit for rhabdomyosarcoma diagnosis by studying the expression of PAX7, a transcriptional regulator of mammalian muscle progenitor cells implicated in the pathogenesis of rhabdomyosarcoma. Immunohistochemical analysis of tissue microarrays using a monoclonal anti-PAX7 antibody was used to characterize PAX7 expression in 25 non-neoplastic tissues, 109 rhabdomyosarcomas, and 697 small round blue cell or other soft tissue tumors. Among non-neoplastic tissues, PAX7 was specifically expressed in adult muscle progenitor cells (satellite cells). In embryonal rhabdomyosarcoma, PAX7 expression was positive in 52 of 63 cases (83%), negative in 9 of 63 cases (14%), and focal in 2 of 63 cases (3%). PAX7-positive embryonal rhabdomyosarcoma cases included several showing focal or negative myogenin expression. PAX7 expression in alveolar rhabdomyosarcoma was positive in 6 of 31 cases (19%), negative in 14 of 31 cases (45%), and focal in 11 of 31 cases (36%). In addition, PAX7 was expressed in 5 of 7 pleomorphic rhabdomyosarcomas (71%) and 6 of 8 spindle cell rhabdomyosarcomas (75%). Among histologic mimics, only Ewing sarcoma showed PAX7 expression (7/7 cases, 100%). In contrast, expression of PAX7 was not seen in the large majority (688/690, 99.7%) of examined cases of other soft tissue tumors, small round blue cell neoplasms, and leukemias/lymphomas. In summary, immunohistochemical analysis of PAX7 expression may be a useful diagnostic tool in the assessment of skeletal muscle differentiation in human tumors.

Thermodynamics of firms' growth.

The distribution of firms' growth and firms' sizes is a topic under intense scrutiny. In this paper, we show that a thermodynamic model based on the maximum entropy principle, with dynamical prior information, can be constructed that adequately describes the dynamics and distribution of firms' growth. Our theoretical framework is tested against a comprehensive database of Spanish firms, which covers, to a very large extent, Spain's economic activity, with a total of 1,155,142 firms evolving along a full decade. We show that the empirical exponent of Pareto's law, a rule often observed in the rank distribution of large-size firms, is explained by the capacity of economic system for creating/destroying firms, and that can be used to measure the health of a capitalist-based economy. Indeed, our model predicts that when the exponent is larger than 1, creation of firms is favoured; when it is smaller than 1, destruction of firms is favoured instead; and when it equals 1 (matching Zipf's law), the system is in a full macroeconomic equilibrium, entailing 'free' creation and/or destruction of firms. For medium and smaller firm sizes, the dynamical regime changes, the whole distribution can no longer be fitted to a single simple analytical form and numerical prediction is required. Our model constitutes the basis for a full predictive framework regarding the economic evolution of an ensemble of firms. Such a structure can be potentially used to develop simulations and test hypothetical scenarios, such as economic crisis or the response to specific policy measures.

First case of infectious endocarditis caused by Parvimonas micra.

P. micra is an anaerobic Gram-positive cocci, and a known commensal organism of the human oral cavity and gastrointestinal tract. Although it has been classically described in association with endodontic disease and peritonsillar infection, recent reports have highlighted the role of P. micra as the primary pathogen in the setting of invasive infections. In its most recent taxonomic classification, P. micra has never been reported causing infectious endocarditis in humans. Here, we describe a 71 year-old man who developed severe native valve endocarditis complicated by aortic valvular destruction and perivalvular abscess, requiring emergent surgical intervention. Molecular sequencing enabled identification of P. micra.