Proof of concept for a nonadditive stochastic model of supercooled liquids.

The recently proposed nonadditive stochastic model (NSM) offers a coherent physical interpretation for diffusive phenomena in glass-forming systems. This model presents nonexponential relationships between viscosity, activation energy, and temperature, characterizing the non-Arrhenius behavior observed in supercooled liquids. In this work, we fit the NSM viscosity equation to experimental temperature-dependent viscosity data corresponding to 25 glass-forming liquids and compare the fit parameters with those obtained using the Vogel-Fulcher-Tammann (VFT), Avramov-Milchev (AM), and Mauro-Yue-Ellison-Gupta-Allan (MYEGA) models. The results demonstrate that the NSM provides an effective fitting equation for modeling viscosity experimental data in comparison with other established models (VFT, AM, and MYEGA), characterizing the activation energy in fragile liquids, presenting a reliable indicator of the degree of fragility of the glass-forming liquids.

Effect of initial inoculum on the temporal and spatial dynamics of wheat blast under field conditions in Bolivia.

Epidemiological studies to better understand wheat blast (WB) spatial and temporal patterns were conducted in three field environments in Bolivia between 2019 and 2020. The temporal dynamics of wheat leaf blast (WLB) and spike blast (WSB) were best described by the logistic model compared to the Gompertz and exponential models. The non-linear logistic infection rates (rL) were higher under defined inoculation in experiments two and three than under undefined inoculation in experiment one, and they were also higher for WSB than for WLB. The onset of WLB began with a spatial cluster pattern according to autocorrelation analysis and Moran's Index (I) values, with higher severity and earlier onset for defined than for undefined inoculation until the last sampling time. The WSB onset did not start with a spatial cluster pattern; instead, it was detected later until the last sampling date across experiments, with higher severity and earlier onset for defined than for undefined inoculation. Maximum severity (Kmax) was 1.0 for WSB, and less than 1.0 for WLB. Aggregation of WLB and WSB was higher for defined than for undefined inoculation. The directionality of hotspot development was similar for both WLB and WSB, mainly occurring concentrically for defined inoculation. Our results show no evidence of synchronized development but suggest a temporal and spatial progression of disease symptoms on wheat leaves and spikes. Thus, we recommend that monitoring and management of WB should be considered during early growth stages of wheat planted in areas of high risk.

Different mutational profiles of subcutaneous panniculitis-like T-cell lymphoma and lupus panniculitis: an additional case series.

BACKGROUND AND OBJECTIVE: subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare cytotoxic T-cell lymphoma with indolent behavior, mostly present in women and associated with immunological diseases whose pathogenic background is still poorly understood. SPTCL is associated with lupus erythematosus panniculitis (LEP) and histologically misdiagnosed. OBJECTIVES: the aim of our study was to identify mutations affecting the pathogenesis of both SPTCL and LEP. MATERIALS AND METHODS: we studied a total of 10 SPTCL and 10 LEP patients using targeted Next Generation Sequencing and pyrosequencing. Differences in gene expression between molecular subgroups were investigated using NanoString technology. Clinical data were collected, and correlations sought with the molecular data obtained. RESULTS: the mutational profile of SPTCL and LEP is different. We identified fewer pathogenic mutations than previously reported in SPTCL, noting a single HAVCR2-mutated SPTCL case. Interestingly, 40% of our SPTCL cases showed the pathogenic TP53 (p.Pro72Arg) (P72R) variant. Although cases showing HAVCR2 mutations or the TP53 (P72R) variant had more severe symptomatic disease, none developed hemophagocytic syndrome (HPS). Furthermore, TP53 (P72R)-positive cases were characterized by a lower metabolic signaling pathway and higher levels of CD28 expression and Treg signaling genes. In addition, 30% of our cases featured the same mutation (T735C) of the epigenetic modificatory gene DNMT3A. None of the LEP cases showed mutations in any of the studied genes. CONCLUSIONS: the mutational landscape of SPTCL is broader than previously anticipated. We describe, for the first time, the involvement of the TP53 (P72R) pathogenic variant in this subgroup of tumors, consider the possible role of different genetic backgrounds in the development of SPTCL, and conclude that LEP does not follow the same pathogenic pathway as SPTCL.

High-throughput combination assay for studying biofilm formation of uropathogenic Escherichia coli.

Uropathogenic Escherichia coli, the most common cause for urinary tract infections, forms biofilm enhancing its antibiotic resistance. To assess the effects of compounds on biofilm formation of uropathogenic Escherichia coli UMN026 strain, a high-throughput combination assay using resazurin followed by crystal violet staining was optimized for 384-well microplate. Optimized assay parameters included, for example, resazurin and crystal violet concentrations, and incubation time for readouts. For the assay validation, quality parameters Z' factor, coefficient of variation, signal-to-noise, and signal-to-background were calculated. Microplate uniformity, signal variability, edge well effects, and fold shift were also assessed. Finally, a screening with known antibacterial compounds was conducted to evaluate the assay performance. The best conditions found were achieved by using 12 µg/mL resazurin for 150 min and 0.023% crystal violet. This assay was able to detect compounds displaying antibiofilm activity against UMN026 strain at sub-inhibitory concentrations, in terms of metabolic activity and/or biomass.

Limited Immunogenicity of an HLA-A*03:01-restricted Epitope of Erv-k-env in Non-hiv-1 Settings: Implications for Adoptive Cell Therapy in Cancer.

Repetitive elements (REs) are often expressed at higher levels in tumor cells than normal cells, implicating these genomic regions as an untapped pool of tumor-associated antigens. In ovarian cancer (OC), protein from the RE ERV-K is frequently expressed by tumor cells. Here we determined whether the targeting of a previously identified immunogenic epitope in the envelope gene (env) of ERV-K resulted in target antigen specificity in non-HIV-1 settings. We found that transducing healthy donor T cells with an ERV-K-Env-specific T cell receptor construct resulted in antigen specificity only when co-cultured with HLA-A*03:01 B lymphoblastoid cells. Furthermore, these transduced T cells were not specific for HLA-A*03:01 + OC cells nor for the cognate peptide in HLA-matched systems from multiple healthy donors. These data suggest that the ERV-K-Env epitope recognized by this T cell receptor is of low immunogenicity and has limited potential as a T cell target for OC.

Effects of a dual-task activity on gait parameters of people with and without intellectual disabilities.

BACKGROUND: The main objective of this study was to evaluate gait parameters in people with intellectual disability (ID) and without intellectual disability (WID) in two different walking conditions [single task vs. dual task (DT)]. A secondary aim was to evaluate the dual-task cost (DTC) that the DT causes in each group. METHODS: A total of 119 participants joined in this study: 56 ID (30 men) and 63 WID (30 men). The OptoGait system was used to assess gait. In addition, Witty photocells were added to assess gait under the DT condition. RESULTS: Single support time was lower for participants with ID (P < 0.01), while double support time was higher (P < 0.05). All coefficients of variation for gait parameters were higher in participants with ID. Additionally, changes in gait were observed in both groups during the DT condition compared with the single-task condition. These changes were larger for participants with ID in step length, double support time and gait speed (P < 0.001), resulting in a higher DTC in these variables in the ID group (P < 0.01). CONCLUSIONS: Both groups reduced gait performance in the DT condition. However, greater gait variability occurred in the ID group. In addition, DTC was higher for the ID group in all variables analysed. Therefore, people with ID show worse gait performance during a DT than people WID.

Papiledema como posible signo guía en el diagnóstico del síndrome periódico asociado a la criopirina: a propósito de un caso / Papilledema as a possible key sign for diagnosis of cryopyrin-associated periodic syndromes (CAPS): A case report

El síndrome periódico asociado a la criopirina es una enfermedad rara y probablemente infradiagnosticada. Se presenta con manifestaciones sistémicas, entre ellas oftalmológicas, muy diversas, por lo que su diagnóstico supone un reto para el clínico. Presentamos el caso de una niña de 4 años en la que la identificación de papiledema en el examen oftalmológico constituyó el signo guía para el diagnóstico de síndrome periódico asociado a la criopirina. Pretendemos así concienciar sobre esta enfermedad de graves implicaciones y cuyo diagnóstico precoz resulta esencial para los afectados, para que sea tenido en cuenta con mayor frecuencia como diagnóstico diferencial (AU)

Cryopyrin-associated periodic syndrome is a rare and probably underdiagnosed disease. It presents with various systemic manifestations, including ophthalmological, making its diagnosis a challenge for the clinician. We present the case of a 4-year-old girl for which the identification of papilledema in the ophthalmological examination was the key sign for the diagnosis of cryopyrin-associated periodic syndrome. Our aim is to raise awareness of this syndrome with serious implications for affected patients, so that it is taken into account more frequently as a differential diagnosis, allowing an early diagnosis (AU)

Risk Factors in Severe Anaphylaxis: Which Matters the Most, Food or Cofactors?

Background: The prevalence of anaphylactic shock, the most severe manifestation of anaphylaxis, remains unknown. Risk factors and biomarkers have not been fully identified. Objective: To identify risk factors in patients who experience anaphylactic shock. Methods: Using lipid transfer protein (LTP) allergy as a model, we compared the characteristics of patients who developed anaphylaxis and anaphylactic shock. We recorded demographics, pollen sensitization, foods ingested up to 2 hours before onset of the reaction, and the presence of cofactors. Culprit foods were identified through a compatible clinical history and positive allergology work-up (skin prick test and/or sIgE). Results: We evaluated 150 reactions in 55 patients with anaphylaxis (134 reactions) and 12 with anaphylactic shock (16 reactions). Patients in the anaphylaxis group experienced twice as many reactions (mean [SD], 2.4 [2.5] for anaphylaxis vs 1.3 [1.5] for anaphylactic shock; P<.02). No relationship was found between any food group and severity of the reaction. The most frequent food involved in both groups of patients was the combination of several plant-derived foods (plant food mix), followed by peach and nuts. Indeed, in the reactions caused by plant food mix, the presence of a cofactor was observed more often than in other food groups. On the other hand, cofactors were not present in peach- and nut-related reactions. Exercise was the most frequent cofactor in all groups. Conclusion: In our series, the severity of the reactions was not determined by the kind of food or presence of a cofactor. Anaphylactic shock seems to be an infrequent presentation that may be associated with other individual-related factors requiring further evaluation (AU)

Antecedentes: La prevalencia del shock anafiláctico sigue siendo desconocida. Aún no se han identificado completamente factores de riesgo ni biomarcadores. Objetivo: Identificar factores de riesgo de shock anafiláctico. Método: Utilizando la alergia a proteína de transferencia de lípidos (LTP) como modelo, se han comparado características de pacientes que han presentado una anafilaxia (An) y pacientes que han desarrollado un shock anafiláctico (SAn). Se recopilaron datos demográficos, sensibilización a pólenes, alimentos ingeridos hasta 2 horas antes del inicio de la reacción y la presencia o no de cofactores. El alimento implicado se identificó mediante historia clínica compatible y estudio alergológico positivo (prick test y/o IgE). Resultados: Se evaluaron un total de 150 reacciones; 55 pacientes del grupo An sufrieron 134 reacciones, y 12 pacientes del grupo SAn sufrieron 16 reacciones. El grupo An experimentó el doble de reacciones por paciente (media [DS] 2,4 [2,5] en An vs 1,3 [1,5] en SAn, p<0,02). No se observó relación entre el tipo de alimento y la gravedad de la reacción. El alimento implicado con más frecuencia en ambos grupos fue la combinación de varios vegetales (“mix de vegetales”), seguido por el melocotón y frutos secos. No hubo cofactores implicados en las reacciones con melocotón ni con frutos secos. En ambos grupos el eje rcicio fue el cofactor involucrado con más frecuencia.Conclusión: En nuestra serie, el alimento y la presencia de cofactor no determinan la gravedad de una reacción. Los shocks anafilácticos parecen ser una presentación infrecuente y podrían estar relacionados con factores individuales que precisarán una evaluación más extensa (AU)

Características del pie y equilibrio dinámico en basquetbolistas juveniles colombianos / Foot characteristics and dynamic balance in young Colombian basketball players

Introducción En el baloncesto las articulaciones de los miembros inferiores están constantemente sometidas a cambios de dirección, fuerzas de cizallamiento y presión constante, poniendo en riesgo de presentar lesiones. La deficiencia en el equilibrio dinámico se ha definido como un factor de riesgo para lesiones de rodilla y tobillo en estos deportistas; de la misma manera se han atribuido posibles riesgos lesionales a las características morfológicas del pie. Objetivo El objetivo del presente trabajo fue identificar la relación entre algunas características del pie y el equilibrio dinámico en deportistas de la liga vallecaucana de baloncesto categoría sub-19. Materiales y métodos Cuenta con un diseño descriptivo de tipo correlacional y corte transversal, realizado entre el último trimestre de 2019 y el primer trimestre de 2020. Quince jóvenes pertenecientes a la liga vallecaucana de baloncesto participaron en el estudio, con una masa promedio de 83,6±8,1kg, edad promedio de 19,3±0,7 años y una altura promedio de 180±0,8cm. Las variables de estudio fueron extraídas de los modelos teóricos científicos. Se analizaron las características sociodemográficas, la estabilidad dinámica medida con el Y Balance Test, el tipo de pie con el método Herzco y la presencia del mecanismo de windlass. Resultados Las características del pie se dividieron entre lateralidad y tipo de pie. El 73,3% son diestros y el 26,67% zurdos. Tipo de pie: normal, 53,3%; normal/cavo, 26,7%; cavo, 13,33%; cavo/fuerte, 6,67%. La relación entre el resultado corregido del Y test y el tipo de pie fue: p=0,728 en miembro inferior derecho y p=0,48 en miembro inferior izquierdo. Conclusiones El presente trabajo señala que en la población estudiada no se encuentra relación entre las características del tipo de pie, el equilibrio dinámico y la presencia del mecanismo de windlass (AU)

Introduction In basketball, the joints of the lower limbs are constantly subjected to changes in direction, shear forces and constant pressure, putting them at risk of injury. Dynamic balance deficiency has been defined as a risk factor for knee and ankle injuries in these athletes, and possible injury risks have been attributed to the morphological characteristics of the foot. Objective The objective of the present work was to identify the relationship between some characteristics of the foot, presence of the windlass mechanism and dynamic balance in sportsmen of the Vallecaucana Basketball League, under 19 category. Materials and methods The research study design was descriptive, correlational and cross-sectional, carried out between the last quarter of 2019 and the first quarter of 2020. Fifteen youths from the Vallecaucana Basketball League participated in the study, with an average mass of 83.6±8.1kg, average age of 19.3±.7 years and average height of 180±.8cm. The study variables were extracted from the theoretical scientific models. Sociodemographic characteristics, dynamic stability measured with the Y Balance Test, type of foot with the HERZCO method and presence of the windlass mechanism. Results The characteristics of the foot were divided between laterality and type of foot. Of the players, 73.3% were right-handed and 26.67% left-handed. Type of foot: Normal 53.3%, Normal/cavus 26.7%, cavus 13.33%, cavus/strong 6.67%. Relationship between the corrected result of the Y test and type of foot: p=.728 in lower right limbs and p=.48 lower left limb. Conclusions The present work indicates that in the population studied there is no relationship between the characteristics of type of foot, dynamic balance and presence of the windlass mechanism. However, more studies are needed that can isolate other factors that could determine the impact on balance (AU)

Síndrome de la uña verde: revisión actualizada de una patología emergente en la era COVID-19 / 19Green nail syndrome: updated review of an emerging disease in the era of COVID-19

El síndrome de la uña verde o cloroniquia corresponde a la infección por Pseudomonas aeruginosa de una lámina ungueal dañada en pacientes con algún factor de riesgo identificable, siendo los más frecuentes la inmunosupresión, el ambiente húmedo constante y la patología ungueal preexistente. Su diagnóstico es relativamente sencillo si se logra observar la tríada característica de coloración verdosa de la lámina ungueal, paroniquia proximal crónica y onicolisis distal; en casos de duda diagnóstica se puede enviar una muestra de la uña afectada para cultivos o estudio histopatológico. El pilar de su tratamiento corresponde al uso de antibióticos tópicos o sistémicos en conjunto con medidas generales que protejan de la humedad. Es muy importante enfatizar la prevención de esta patología en el personal de salud, especialmente en el contexto del lavado de manos frecuente y riguroso implementado durante la pandemia COVID-19, ya que existen reportes de transmisión nosocomial de P. aeruginosa por profesionales de la salud con infección ungueal.(AU)

Green nail syndrome or chloronychia is the infection of a damaged nail plate by Pseudomonas aeruginosa in a patient with an identifiable risk factor; the most frequently described are immunosuppression, a persistent moist environment and preexisting nail disease. Its diagnosis is relatively simple if the characteristic triad of green discoloration of the nail plate, chronic proximal paronychia and distal onycholysis can be observed, in cases of doubt a sample of the affected nail can be sent for cultures or histopathology. The cornerstone of treatment is the use of topical or systemic antibiotics along with measures to protect the nail from moisture. Prevention of this disease must be emphasized in health care personnel, especially in the context of frequent and rigorous handwashing practices implemented during the COVID-19 pandemic, since there are reports of nosocomial transmission of P. aeruginosaby health care professionals with nail infection.(AU)

Variante Ómicron SARS-CoV-2: una nueva variante de preocupación / Ómicron SARS-CoV-2 variant: anew variant of concern

Ha surgido una nueva variante de preocupación de SARS-CoV-2, cuyos efectos en la evolución de la pandemia parecen inciertos. Sin embargo, ha comenzado a surgir evidencia con respecto al comportamiento viral en cuanto a su transmisibilidad, unión a receptor de la célula hospedadora y escape del sistema inmune. Presentamos una revisión actualizada de los datos existentes en la literatura respecto a los aspectos microbiológicos y epidemiológicos que pueden ayudarnos a comprender las futuras investigaciones en esta variante.(AU)

A new variant of concern for SARS-CoV-2 has emerged, the effects of which on the evolution of the pandemic appear uncertain. However, evidence has begun to emerge regarding viral behavior in terms of its transmissibility, receptor binding on the host cell, and escape from the immune system. We present an updated review of the existing data in the literature regarding the microbiological and epidemiological aspects that can help us understand future research on this variant.(AU)

Pertinence of Telehealth in a Rush Conversion to Virtual Allergy Practice During the COVID-19 Outbreak

No disponible

Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable / 18F-FDG PET/CT quantitative parameters as prognostic factor in localized and inoperable lung cancer

OBJETIVO: Evaluar la utilidad de parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en pacientes diagnosticados de cáncer de pulmón localizado e inoperable, tratado únicamente mediante radioterapia estereotáxica corporal (SBRT). MATERIAL Y MÉTODOS: Se valoraron mediante estudio prospectivo 50 pacientes (42 hombres) diagnosticados en los últimos 7años de neoplasia pulmonar en estadios precoces y tratados únicamente mediante SBRT. Tras realización del estudio PET/TC, se determinaron los parámetros metabólicos SUV máximo (SUVmax), volumen metabólico tumoral (MTV) y glucólisis tumoral total (TLG) a diferentes umbrales. Se analizaron los factores pronósticos para la supervivencia global (SG), supervivencia por causa específica (SCE) y supervivencia libre de enfermedad (SLE) mediante regresión de Cox, y las curvas de supervivencia mediante el método de Kaplan-Meier. RESULTADOS: El seguimiento medio fue de 39,6meses, produciéndose 21 recurrencias y 24 fallecimientos. El análisis determinó como factores predictivos MTV30 y MTV40 para la SG; MTV30, MTV40, TLG30 y TLG40 para la SCE, y MTV2, MTV30, MTV40, TLG2, TLG30 y TLG40 para la SLE. El análisis de supervivencia halló diferencias estadísticamente significativas para la SCE y la SLE dependiendo del tamaño tumoral y para la SLE dependiendo de los valores de MTV2 y TLG2 (umbral de SUVmax=2). El SUVmax, la edad y el sexo no fueron factores significativos. CONCLUSIÓN: La valoración cuantitativa pretratamiento mediante los parámetros metabólicos MTV2 y TLG2, así como el tamaño tumoral, demostraron ser factores pronósticos en pacientes con neoplasia pulmonar localizada e inoperable tratados mediante SBRT. Los resultados podrían ayudar a personalizar el tratamiento

AIM: To assess the utility of 18F-FDG PET/CT quantitative parameters as prognostic factor in patients diagnosed with localized and inoperable lung cancer treated by stereotactic body radiotherapy (SBRT). MATERIAL AND METHODS: Fifty patients (42 men) diagnosed in the last 7years with early-stage lung cancer and treated with SBRT alone were assessed by a prospective study. After PET/CT study, metabolic parameters maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were determined at different thresholds. The prognostic factors for overall survival (OS), cause-specific survival (CS) and disease-free survival (DFS) were analysed by Cox proportional hazards model and the survival analysis by Kaplan-Meier method. RESULTS: The average follow-up was 39.6months, with 21 recurrences and 24 dead. Univariate analysis determined MTV30 and MTV40 as predictors for OS; MTV30, MTV40, TLG30 and TLG40 for CS, and MTV2, MTV30, MTV40, TLG2, TLG30 and TLG40 for DFS. Survival analysis found statistically significant differences for CS and DFS depending on tumor size and for DFS considering the cut-off values of MTV2 and TLG2 (threshold SUVmax=2). SUVmax, age and sex were not shown to be significant factors. CONCLUSION: Pre-treatment quantitative assessment using metabolic parameters MTV2 and TLG2 as well as tumor size proved to be prognostic factors in patients diagnosed with localized and inoperable lung cancer treated by SBRT. Results could help to personalize treatment

Uso del aprendizaje automático en el diagnóstico del melanoma. Limitaciones por superar / Machine Learning in Melanoma Diagnosis. Limitations About to be Overcome

ANTECEDENTES: La clasificación automática de imágenes es una rama prometedora del aprendizaje automático (de sus siglas en inglés Machine Learning [ML]), y es una herramienta útil en el diagnóstico de cáncer de piel. Sin embargo, poco se ha estudiado acerca de las limitaciones de su uso en la práctica clínica diaria. OBJETIVO: Determinar las limitaciones que existen en cuanto a la selección de imágenes usadas para el análisis por ML de las neoplasias cutáneas, en particular del melanoma. MÉTODOS: Se diseñó un estudio de cohorte retrospectivo, donde se incluyeron de forma consecutiva 2.849 imágenes dermatoscópicas de alta calidad de tumores cutáneos para su valoración por un sistema de ML, recogidas entre los años 2010 y 2014. Cada imagen dermatoscópica fue clasificada según las características de elegibilidad para el análisis por ML. RESULTADOS: De las 2.849 imágenes elegidas a partir de nuestra base de datos, 968 (34%) cumplieron los criterios de inclusión. De los 528 melanomas, 335 (63,4%) fueron excluidos. La ausencia de piel normal circundante (40,5% de todos los melanomas de nuestra base de datos) y la ausencia de pigmentación (14,2%) fueron las causas más frecuentes de exclusión para el análisis por ML. DISCUSIÓN: Solo el 36,6% de nuestros melanomas se consideraron aceptables para el análisis por sistemas de ML de última generación. Concluimos que los futuros sistemas de ML deberán ser entrenados a partir de bases de datos más grandes que incluyan imágenes representativas de la práctica clínica habitual. Afortunadamente, muchas de estas limitaciones están siendo superadas gracias a los avances realizados recientemente por la comunidad científica, como se ha demostrado en trabajos recientes

BACKGROUND: Automated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice. OBJECTIVE: To determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma. METHODS: Retrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis. RESULTS: Of the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis. DISCUSSION: Only 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show

Análisis de la proporción de derivaciones potencialmente evitables desde Atención Primaria a Dermatología por lesiones quísticas o tumorales benignas en España. Datos del estudio DIADERM / Proportion of Potentially Avoidable Referrals From Primary Care to Dermatologists for Cystic Lesions or Benign Neoplasms in Spain: Analysis of Data From the DIADERM Study

Antecedentes y objetivo: Las lesiones cutáneas constituyen un motivo de consulta frecuente en Atención Primaria (AP). Aquellas que no supongan un problema de salud, sino una cuestión estética, no deben ser tratadas en el Sistema Nacional de Salud, según la legislación vigente. El objetivo de este trabajo es estimar qué porcentaje de derivaciones remitidas desde AP a Dermatología por lesiones quísticas o tumores benignos corresponde a lesiones que podríamos considerar potencialmente evitables. Material y método: Utilizamos los diagnósticos principales de los pacientes derivados de AP, recogidos en el estudio representativo nacional DIADERM. Cada uno de los diagnósticos derivados fue clasificado como potencialmente evitable si se correspondía con alguno de los diagnósticos con criterio de alta desde AP, establecidos en el documento de consenso propuesto por la sección territorial andaluza de la Academia Española de Dermatología y Venereología. Resultados: Se recogieron datos de 2.171 motivos principales de consulta derivados de AP como primeras consultas. De estos, 686 (31,6%) son diagnósticos que podrían corresponderse con derivaciones potencialmente evitables por lesiones quísticas o tumorales benignas. Un 22% (478) del total de las consultas fueron dadas de alta en la primera visita. Los diagnósticos más frecuentes entre estos fueron las queratosis seborreicas (9,3%) y los nevus melanocíticos (8,6%). Conclusiones: La proporción de derivaciones potencialmente evitables a Dermatología desde AP por lesiones quísticas y tumorales benignas supone casi un tercio de las consultas. El conocimiento de la realidad asistencial de nuestro entorno puede ser útil para mejorar la planificación, la formación y la gestión sanitaria

Background and objective: Skin lesions are a common reason for consulting a primary care physician. Current legislation in Spain states that purely aesthetic skin problems that do not pose a health problem are not to be treated within the National Health Service. The aim of this study was to estimate the proportion of referrals from primary care physicians to dermatologists that were for cystic lesions or benign tumors and could potentially have been avoided. Material and methods: We consulted cases registered in the DIADERM study dataset, which is representative of dermatology practice in Spain, and collected the main diagnoses given on referring patients from primary care. A referral diagnosis was classified as potentially avoidable if it corresponded to one of the primary care discharge diagnoses listed in a consensus paper of the Andalusian section of the Spanish Academy of Dermatology and Venereology (AEDV). Results: We collected 2171 main reasons for first-visit referrals to dermatologists; 686 of them (31.6%) were for cystic lesions or benign tumors and classified as potentially avoidable. In 478 cases (22%) the patients were discharged on the first visit. The most frequent diagnoses in such cases were seborrheic keratosis (9.3%) and melanocytic nevus (8.6%). Conclusions: Nearly a third of referrals from primary care to a dermatologist were for cystic lesions and benign tumors and could have been avoided. A clearer understanding of our caseload can be useful for improving planning, training, and health care system management

Pápulas faciales induradas / Indurated Papules on the Face

No disponible

Religiosidade, estratégias de coping e satisfação com a vida: Verificação de um modelo de influência em estudantes universitários / Religiosity, coping strategies and satisfaction with life: Verification of a model of influence in university students / Religiosidad, estrategias de coping y satisfacción con la vida: Verificación de un modelo de influencia en estudiantes universitarios

CONTEXTO: O ambiente universitário pode muitas vezes favorecer o desenvolvimento de problemas de saúde mental, uma vez que os universitários são submetidos a intenso nível de estresse e carga cognitiva. OBJETIVO: Verificar a influência da religiosidade na satisfação com a vida e na adoção de estratégias para lidar com os problemas. MÉTODOS: Estudo quantitativo com coleta de dados utilizando instrumentos psicométricos validados com 588 estudantes universitários de 18 a 63 anos. Foi utilizada a técnica de modelagem de equações estruturais para verificar um modelo de influência. RESULTADOS: Os resultados indicam que a Religiosidade influencia positivamente e de forma significativa a Satisfação com a Vida, bem como a adoção de Estratégias para Enfrentamento de Problemas. Os resultados não são generalizáveis, entretanto constituem evidência empírica da importância da religiosidade em termos de saúde mental. CONCLUSÃO: De forma geral, esta pesquisa pretendeu verificar um modelo teórico sistêmico, o qual hipotetizava uma interdependência entre as variáveis Religiosidade, Coping e Satisfação com a vida que se comprovou. Com isso, acredita-se que os resultados observados, teoricamente, sustentam as propostas sugeridas pela psicologia positiva.

BACKGROUND: The university environment can often favor the development of mental health problems, since university students are subjected to intense levels of stress and cognitive load. AIM: To verify the influence of religiosity on satisfaction with life and on the adoption of strategies to deal with problems. METHODS: Quantitative study with data collection using validated psychometric instruments with 588 university students aged 18 to 63 years. The structural equation modeling technique was used to verify an influence model. RESULTS: The results indicate that Religiosity influences positively and significantly the Satisfaction with Life, as well as the adoption of Strategies to Confront Problems. The results are not generalizable, however they constitute empirical evidence of the importance of religiosity in terms of mental health. CONCLUSION: In general, this research aimed to verify a systemic theoretical model, which hypothesized an interdependence between the variables Religiosity, Coping and Satisfaction with life; Thus, not only has the desired model been proved, but it is believed that the results observed theoretically support the proposals suggested by positive psychology.

CONTEXTO: El ambiente universitario puede a menudo favorecer el desarrollo de problemas de salud mental, ya que los universitarios son sometidos a intenso nivel de estrés y carga cognitiva. OBJETIVO: Verificar la influencia de la religiosidad en la satisfacción con la vida y en la adopción de estrategias para lidiar con los problemas. MÉTODOS: Estudio cuantitativo con recolección de datos utilizando instrumentos psicométricos validados con 588 estudiantes universitarios de 18 a 63 años. Se utilizó la técnica de modelado de ecuaciones estructurales para verificar un modelo de influencia. RESULTADOS: Los resultados indican que la Religiosidad influye positivamente y de forma significativa en la Satisfacción con la Vida, así como la adopción de Estrategias para Enfrentamiento de Problemas. Los resultados no son generalizables, sin embargo constituyen evidencia empírica de la importancia de la religiosidad en términos de salud mental. CONCLUSIÓN: En general, esta investigación pretendió verificar un modelo teórico sistémico, el cual hipotetizaba una interdependencia entre las variables Religiosidad, Coping y Satisfacción con la vida; con ello, no sólo se comprobó el modelo pretendido, pero, se cree que los resultados observados, teóricamente, sostienen las propuestas sugeridas por la psicología positiva.

Injerto dermograso para cavidad anoftálmica en niños enucleados por retinoblastoma / Dermal-fat graft for anophthalmic socket in children enucleated for retinoblastoma

El retinoblastoma (RB) es el tumor intraocular maligno más frecuente en niños. El tratamiento definitivo es la enucleación. El manejo de la anoftalmia consiste en colocar una esfera plástica dentro del cono muscular. Sin embargo, estos implantes suelen extruirse y tienen alto coste. Los injertos dermograsos minimizan el riesgo de hipoplasia hemifacial. Se ha observado que estos injertos crecen junto con el macizo facial y ayudan a expandir los huesos orbitarios limitando las consecuencias físicas y psicológicas. OBJETIVO: Describir la presencia de hipoplasia facial usando imágenes de resonancia después la colocación de injerto dermograso en pacientes enucleados por RB. MÉTODO: Se incluyeron pacientes de RB enucleados a quienes se les colocó injerto dermograso y se les hizo resonancia magnética en el Instituto Nacional de Pediatría durante el periodo junio de 2010 a diciembre de 2012. Se midió el crecimiento facial y la cosmeticidad. RESULTADOS: Se incluyeron 12 pacientes de 6 a 41 meses de edad al momento de la enucleación y colocación de injerto dermograso por diagnóstico de RB. A los 24 meses ninguno desarrolló hipoplasia hemifacial. Todos presentaron adecuada cosmeticidad con el uso de la prótesis. No se presentó ninguna complicación. CONCLUSIONES: El injerto dermograso es una opción adecuada para la cavidad anoftálmica en pacientes a los que se les realiza enucleación por RB

Retinoblastoma is the most frequent intraocular tumour in childhood. The definitive treatment is enucleation. The management of the anophthalmic socket consists in the use of a plastic implant. The problem is that they are expensive and they usually extrude. The use of dermal-fat grafts minimises the hemi-facial hypoplasia. They usually grow with the face, and help to expand the orbital bones, thus avoiding the psychological and physical consequences. OBJECTIVE: To determine if there is hemi-facial hypoplasia, using MRI images after the use of a dermal-fat implant in patients enucleated for RB. METHOD: The study included patients enucleated for RB in which a dermal-fat implant was used and MRI images were taken in the period between June 2010 and December 2012. Facial growth and cosmesis was measured. RESULTS: The study included 12 patients, aged between 6 to 41 months. After 24 months of follow up, none of them developed hemifacial hypoplasia. All had a good cosmesis with the prosthesis. There were no complications after the surgery. CONCLUSIONS: The use of dermal-fat implant is a good option for the anophthalmic socket in patients with RB after enucleation

Germline BRCA testing is moving from cancer risk assessment to a predictive biomarker for targeting cancer therapeutics

Purpose: Originally, BRCA testing was used for risk assessment and prevention strategies for breast and ovarian cancer. Nowadays, BRCA status may influence therapeutic decision making at cancer diagnosis. Our objective was to analyze whether the medical advances have changed the burden and pattern of referral, and the pathogenic mutation detection rate. Methods: We included 969 probands from our hereditary cancer registry who undertook a full BRCA analysis between 2006 and 2014. Chi-square tests were used to compare categorical variables. Results: The number of genetic tests have raised from 28 to 170, representing a sixfold increase. In 2006, we tested 1.6 relatives/proband while this proportion was four in 2014. Overall, 20 % harbored a deleterious mutation and 11 % had a variant of unknown significance (VUS). There has been a downward trend in the detection rate of VUS. Testing patients with breast cancer during neoadjuvancy has raised from 4 to 25 % (p = 0.002), while testing them during remission has decreased from 79 to 29 % (p < 0.001). The proportion of patients assessed during the first 6 months after their cancer diagnosis has increased from 3 to 34 % (p = 0.001). Risk reducing mastectomy and salpingoophorectomy have raised from 0 to 24 %, and from 36 to 65 %, respectively. Conclusions: BRCA testing has experienced a sixfold increase, the number of relatives being tested has doubled, and the test is being performed at earlier phases of the disease. It is necessary to adequate the health resources to preserve the BRCA genetic counseling quality while incorporating BRCA testing for therapeutic decision making

No disponible