The -514C>T polymorphism in the LIPC gene modifies type 2 diabetes risk through modulation of HDL-cholesterol levels in Mexicans.

PURPOSE: Both type 2 diabetes (T2D) and low levels of high-density lipoprotein cholesterol (HDL-C) are very prevalent conditions among Mexicans. Genetic variants in the LIPC gene have been associated with both conditions. This study aimed to evaluate the association of the -514C < T (rs1800588) LIPC gene polymorphism with different metabolic traits, particularly the effects of this polymorphism on HDL-C plasma levels and T2D risk. METHODS: Mediation analysis was used to assess the direct and indirect effects of the -514C>T LIPC gene variant on HDL-C levels, T2D risk, and body mass index (BMI), in 2105 Mexican mestizo participants. We also assessed the functional effect of the -514C>T LIPC variant on the promoter activity of a reporter gene in the HepG2 cell line. RESULTS: Direct effects show that the -514C>T LIPC polymorphism is significantly associated with increased HDL-C plasma levels (ß = 0.03; p < 0.001). The -514C>T variant resulted in an indirect protective effect on T2D risk through increasing HDL-C levels (ß = - 0.03; p < 0.001). Marginal direct association between -514C>T and T2D was found (ß = 0.08; p = 0.06). Variables directly influencing T2D status were European ethnicity (ß = - 7.20; p < 0.001), age (ß = 0.04; p < 0.001), gender (ß = - 0.15; p = 0.017) and HDL-C (ß = - 1.07; p < 0.001). In addition, we found that the -514C>T variant decreases the activity of LIPC promoter by 90% (p < 0.001). CONCLUSIONS: The -514C>T polymorphism was not directly associated with T2D risk. HDL-C acts as a mediator between -514C>T LIPC gene variant and T2D risk in the Mexican population.

No todo es lo que parece: miastenia gravis, una rara manifestación paraneoplásica del cáncer de ovario: caso clínico / Not all is what it seems: Myasthenia gravis, a rare paraneoplastic manifestation of ovarian cancer: Clinical case

Los síndromes neurológicos paraneoplásicos son un conjunto de trastornos, raramente asociados a tumores ginecológicos. Su presencia debe alertarnos sobre la posible existencia de un tumor maligno subyacente. Presentamos un caso de miastenia gravis, como manifestación paraneoplásica de un cáncer de ovario primario avanzado

Paraneoplastic neurological syndromes are an unusual diseases rarely associated with gynaecological tumours. Their presence must alert on the possible existence of an underlying malignant tumour. A rare case is presented of myasthenia gravis as a paraneoplastic manifestation of an advanced primary ovarian cancer

Melatonin expression in periodontitis and obesity: An experimental in-vivo investigation.

BACKGROUND AND OBJECTIVE: Melatonin deficiency has been associated with obesity and systemic inflammation. This study aims to evaluate whether melatonin could interfere with the mechanisms of co-morbidity linking obesity and periodontitis. MATERIAL AND METHODS: Twenty-eight male Wistar rats were randomly divided in 4 groups: control group (Con) (fed with standard diet); high-fat diet group (HFD) (fed with a diet containing 35.2% fat); Con group with induced periodontitis (Con-Perio) and HFD group with induced periodontitis (HFD-Perio). To induce periodontitis, the method of oral gavages with Porphyromonas gingivalis ATCC W83K1 and Fusobacterium nucleatum DMSZ 20482 was used. Circulating melatonin levels were analyzed by multiplex immunoassays. Periodontitis was assessed by alveolar bone loss (micro-computed tomography and histology) and by surrogate inflammatory outcomes (periodontal pocket depth, modified gingival index and plaque dental index). RESULTS: Plasma melatonin levels were significantly decreased (P < .05) in the obese rats with periodontitis when compared with controls or with either obese or periodontitis rats. Alveolar bone loss increased 27.71% (2.28 µm) in HFD-Perio group compared with the Con group. The histological analysis showed marked periodontal tissue destruction with osteoclast activity, particularly in the HFD-Perio group. A significant negative correlation (P < .05) was found between periodontal pocket depth, modified gingival index and circulating melatonin levels. CONCLUSION: Obese and periodontitis demonstrated significantly lower melatonin concentrations when compared with controls, but in obese rats with periodontitis these concentrations were even significantly lower when compared with either periodontitis or obese rats. These results may indicate that melatonin deficiency could be a key mechanism explaining the co-morbidity effect in the association between obesity and periodontitis.

Evaluación de terapias alternativas en mucositis oral experimental / Therapy evaluation of the oral mucositis experimental

La mucositis oral es una complicación importante de la terapia antineoplásica En la actualidad, la mucositis es uno de los efectos secundarios del tratamiento del cáncer al cual se le está dedicando un gran esfuerzo terapéutico para encontrar medidas farmacológicas, que reduzcan su incidencia, así como su impacto o gravedad debido a las consecuencias planteadas. El objetivo de este trabajo es revisar la patogénesis de la enfermedad y presentar los resultados de las diferentes alternativas terapéuticas estudiadas de forma experimental (AU)

Oral mucositis is a complication of antineoplastic therapy. Currently, it is devoting a great effort to find pharmacological therapeutic measures to reduce its incidence and its impact or severity due to raised consequences. The aim of this paper is to review the pathogenesis and the different therapeutic drugs in experimental oral mucositis (AU)

Membrana neovascular coroidea yuxtapapilar secundaria a hipertensión intracraneal idiopática tratada con bevacizumab intravítreo: a propósito de un caso / Juxtapapillary neovascular membrane secondary to idiopathic intracranial hypertension treated with intravitreal bevacizumab: A case report

CASO CLÍNICO: Mujer de 48 años con pérdida de agudeza visual (AV) en el ojo izquierdo (OI): 0,3. Funduscópicamente presentaba papiledema y membrana neovascular (MNV) en el OI. Todas las pruebas neurológicas fueron normales excepto la punción lumbar con presión de apertura de 35 cmH2O, siendo diagnosticada de hipertensión intracraneal idiopática (HII). Tras 4 dosis de bevacizumab, la AV del OI no ha mejorado y es de cuenta dedos. DISCUSIÓN: La patogénesis de la MNV asociada a HII no es bien conocida. Se ha visto eficacia con el tratamiento de anti-VEGF. En nuestro caso no hemos conseguido mejora de la AV tras 4 dosis de bevacizumab intravítreo

CASE REPORT: A 48 year-old woman with visual acuity loss in left eye (0.3). Funduscopic examination showed papillary oedema and neovascular membrane in the left eye. All neurological tests were normal, except the lumbar puncture with opening pressure of 35cmH2O, being diagnosed with idiopathic intracranial hypertension (IIH). After four doses of bevacizumab, the visual acuity of the left eye has not improved and is counting fingers. DISCUSSION: Pathogenesis of the juxtapapillary neovascular membrane associated with IIH is not well known. An effect was observed after the anti-VEGF treatment. In our case, there was no improvement after four doses of intravitreal bevacizumab

Juxtapapillary neovascular membrane secondary to idiopathic intracranial hypertension treated with intravitreal bevacizumab: A case report. / Membrana neovascular coroidea yuxtapapilar secundaria a hipertensión intracraneal idiopática tratada con bevacizumab intravítreo: a propósito de un caso.

CASE REPORT: A 48 year-old woman with visual acuity loss in left eye (0.3). Funduscopic examination showed papillary oedema and neovascular membrane in the left eye. All neurological tests were normal, except the lumbar puncture with opening pressure of 35cmH2O, being diagnosed with idiopathic intracranial hypertension (IIH). After four doses of bevacizumab, the visual acuity of the left eye has not improved and is counting fingers. DISCUSSION: Pathogenesis of the juxtapapillary neovascular membrane associated with IIH is not well known. An effect was observed after the anti-VEGF treatment. In our case, there was no improvement after four doses of intravitreal bevacizumab.

[Psychiatrists' decision making and monitoring of antipsychotic prescription for elderly schizophrenia patients]. / Prescription et surveillance d'antipsychotiques chez les patients âgés souffrant de schizophrénie: pratiques des psychiatres et leurs déterminants.

OBJECTIVE: Advancing age entails specific treatment modalities for patients with schizophrenia. The choice of appropriate antipsychotic therapy (AP) and the monitoring of treatment is a major challenge. However, little is known about the real-world prescribing practices of psychiatrists for elderly schizophrenia patients. The aim of this study was to assess prescribing practices and treatment monitoring in elderly schizophrenia patients and whether socio-professional psychiatrists' characteristics are related to their practices. METHODS: We contacted by mail 190 psychiatrists to take part in an observational survey of their AP prescribing practices for elderly (aged over 65) schizophrenia patients. RESULTS: The response rate was 44.2%, and of the psychiatrists who replied 75% were treating elderly schizophrenia patients. A second-generation AP (SGAP) was prescribed as first-line of treatment by 87.7% of the psychiatrists. The most frequently used SGAPs were risperidone and olanzapine (respectively preferred by 54.4% and 19.3% of the psychiatrists taking part). At the beginning of treatment, 91.1% of the psychiatrists prescribed a lower dose than for middle-aged patients. Of the psychiatrists taking part, 64.9% prescribed monotherapy; and among these psychiatrists, 65% cited insufficient control of the disease as the reason for their choice, while 48.7% of those who elected not to prescribe combined AP did so in order to limit the side-effects. Of the psychiatrists taking part, 54.4% prescribed long-acting injectable AP (LAAP); better therapeutic compliance and alliance was the main argument in the choice of LAAP given by the psychiatrists taking part who prescribed the drug, whereas the absence of indications and problems of tolerance were arguments against for those who did not. "Personal experience" emerged as the governing factor in the choice of AP. The AP side-effect profile was the main criterion of choice of the AP agent for 3.5% of the psychiatrists taking part, and the most frequently chosen secondary criterion (29.8%). Monitoring of treatment was partly performed according to professional recommendations: pre-treatment and post-prescription assessments of waist circumference and ophthalmological monitoring were very infrequent (8.8 to 18.5%) as were pre-treatment and early post-prescription assessments of prolactinaemia (14.8 to 20.4%); long-term cardiac monitoring was infrequent (43.9%). The psychiatrists taking part whose first-line drug was SGAP were more familiar with professional recommendations than those who prescribed first generation antipsychotic (FGA) drugs (72% as against 14.3%, P=0.006). Of the psychiatrists taking part in the study, 64.9% reported they commonly use professional recommendations. Psychiatrists who declared they commonly use professional recommendations measured pulse rate and blood pressure significantly more often over the long-term than those who did not (74.3% as against 41.2%, P=0.0315). They also measured waist circumference over the long-term significantly more often than psychiatrists who did not commonly use professional recommendations (22.9% as against 0%, P=0.0420). Psychiatrists treating more than ten of these patients yearly measured significantly more often over the long-term pulse rate and blood pressure than those treating fewer patients (80% as against 50%, P=0.0399). Over the long-term monitoring, psychiatrists with a larger number of elderly schizophrenia patients in their care also performed more often fasting blood glucose test, lipid profile and referral for cardiac consultation with ECG (respectively, 95.5% as against 70.8%, P=0.0489; 90.9% as against 58.3%, P=0.0182; 81.8% as against 29.2%, P<0.0001). CONCLUSIONS: The results of this survey need to be confirmed in a larger population sample. The antipsychotic prescribing practices were broadly in agreement with current recommendations except for the tolerance profile which was not the first element taken into account in the choice of the AP agent. Some clinical and paraclinical medical examinations were carried out infrequently, in particular cardiac monitoring over the long-term, which is essential in this elderly patient population. One important element to emerge from our results was that common use of professional recommendations is associated with better monitoring.

[Survival by surgical approach in patients with endometrial adenocarcinoma treated in Navarra in the 2001-2009]. / Supervivencia según vía de abordaje quirúrgico en pacientes con adenocarcinoma de endometrio tratadas en Navarra en el periodo 2001-2009.

BACKGROUND: Endometrial adenocarcinoma is the most frequent gynaecological neoplasia after breast cancer and represents 6% of cancers in women. The treatment for this disease is surgery. The majority of cases are diagnosed in their initial stages and surgery is curative; on other occasions it is necessary to add radiotherapy and chemotherapy. The classical treatment for endometrial adenocarcinoma is hysterectomy with double adnexectomy by laparotomy, with the addition of pelvic and para-aortic lymphadenectomy and omentectomy according to the characteristics of the case. During the last 10-15 years laparoscopy has been introduced in the surgical treatment of endometrial adenocarcinoma. The main aim of this study is to analyze the cases of endometrial adenocarcinoma treated surgically in the former Virgen de Camino Hospital (nowadays the Hospital Complex of Navarra) during 2001-2009. METHODS: Historical cohort of 444 patients with endometrial adenocarcinoma during 2001-2009 who received surgical treatment, followed four years. CONCLUSIONS: The results confirm that laparoscopy is a safe alternative to classical laparotomy as it does not affect either survival or time free of disease, in both endometrioid adenocarcinoma and non-endometrioid adenocarcinoma.

Supervivencia según vía de abordaje quirúrgico en pacientes con adenocarcinoma de endometrio tratadas en Navarra en el periodo 2001-2009 / Survival by surgical approach in patients with endometrial adenocarcinoma treated in Navarra in the 2001-2009

Fundamento: El adenocarcinoma de endometrio es la neoplasia ginecológica más frecuente tras el cáncer de mama y representa el 6% de todos los cánceres de la mujer. El tratamiento fundamental de dicha enfermedad es la cirugía. La mayoría de los casos se diagnostican en estadios iniciales y la cirugía será curativa; en otras ocasiones es necesario añadir radioterapia o quimioterapia. El tratamiento clásico del adenocarcinoma de endometrio es la histerectomía con doble anexectomía por vía laparotómica, añadiendo según las características del caso la linfadenectomía pélvica, paraaórtica y omentectomía. Durante los últimos 10-15 años se ha introducido la laparoscopia en el tratamiento quirúrgico del adenocarcinoma de endometrio. El objetivo principal de este trabajo es analizar los casos de adenocarcinoma de endometrio intervenidos quirúrgicamente en el antiguo hospital Virgen de Camino (hoy Complejo Hospitalario de Navarra) durante el periodo 2001-2009. Material y métodos: Se ha recogido una cohorte histórica de 444 pacientes con diagnóstico de adenocarcinoma de endometrio durante el periodo 2001-2009, que recibieron tratamiento quirúrgico, así como su seguimiento durante 4 años. Conclusiones: Los resultados confirman que la vía laparoscópica es una alternativa segura a la laparotomía clásica ya que no afecta a la supervivencia ni al tiempo libre de enfermedad tanto en el adenocarcinoma endometrioide como en el no endometrioide (AU)

Background: Endometrial adenocarcinoma is the most frequent gynaecological neoplasia after breast cancer and represents 6% of cancers in women. The treatment for this disease is surgery. The majority of cases are diagnosed in their initial stages and surgery is curative; on other occasions it is necessary to add radiotherapy and chemotherapy. The classical treatment for endometrial adenocarcinoma is hysterectomy with double adnexectomy by laparotomy, with the addition of pelvic and para-aortic lymphadenectomy and omentectomy according to the characteristics of the case. During the last 10-15 years laparoscopy has been introduced in the surgical treatment of endometrial adenocarcinoma. The main aim of this study is to analyze the cases of endometrial adenocarcinoma treated surgically in the former Virgen de Camino Hospital (nowadays the Hospital Complex of Navarra) during 2001-2009. Methods: Historical cohort of 444 patients with endometrial adenocarcinoma during 2001-2009 who received surgical treatment, followed four years. Conclusions: The results confirm that laparoscopy is a safe alternative to classical laparotomy as it does not affect either survival or time free of disease, in both endometrioid adenocarcinoma and non-endometrioid adenocarcinoma (AU)

Quemaduras químicas por agresión: características e incidencia recogidas en el Hospital Simón Bolívar, Bogotá, Colombia / Chemical burns due to assault: characteristics and incidence at the Simón Bolívar Hospital, Bogotá, Colombia

Presentamos la experiencia del Hospital Simón Bolívar en Bogotá (Colombia) en el abordaje de las quemaduras químicas por agresión. Realizamos un estudio retrospectivo de 18 años consecutivos, entre septiembre de 1996 hasta diciembre del 2013, periodo durante el cual ingresaron en nuestro centro un total de 45 víctimas. Protocolizamos el tratamiento médico-quirúrgico y analizamos el entorno en el que se presentaron estas agresiones. Un 82% de los casos de quemaduras por químicos en el ámbito de una agresión se produjeron en mujeres jóvenes (media de edad 25,8 años). Las áreas anatómicas más afectadas fueron la cara, el cuello, las manos y la zona genital. La mayoría de los pacientes requirieron múltiples procedimientos reconstructivos durante periodos prolongados de tiempo. Estas lesiones, además de ser de muy difícil abordaje y de provocar graves secuelas cicatriciales y funcionales en las víctimas, se han convertido en un serio problema desde el punto de vista legal y social en nuestro país, colocando a Colombia entre los primeros lugares mundiales en cuanto a incidencia de este tipo de crímenes (AU)

We present the experience of Simon Bolivar Hospital, Bogotá (Colombia) in the management of chemical burns due to attack during 18 consecutive years, since September 1996 to December 2013, through a retrospective study in which 45 victims were admitted. We establish the protocol for the medical treatment as well as the surgical management of these type of burns and we also describe the environment in which these attacks took place. It was determined that 82% of the victims were young women (age average 25,8 years old). Face, neck, hands and genitals are the most affected body areas, and most of them required multiple reconstructive procedures for extended periods of time. These lesions besides being unwieldy and leave serious scarring and functional consequences in the victims, have become a serious legal and social problem, placing Colombia at the top of these type of crimes worldwide (AU)

Effects of polymer-coated metal oxide nanoparticles on goldfish (Carassius auratus L.) neutrophil viability and function.

Exposure effects from polyacrylic acid (PAA) metal-oxide nanoparticles (TiO2, CeO2, Fe2O3, ZnO) on fish neutrophil viability and effector functions (degranulation, respiratory burst, inflammatory gene expression) were investigated using primary kidney goldfish (Carassius auratus L.) neutrophils as a model. Several studies have reported cytotoxic effects of NPs but there are limited reports on their potential to perturb the innate immune system of aquatic organisms. PAA-TiO2 significantly decreased neutrophil viability in a time and dose-dependent manner at all measured time points (0-48 h) and concentrations (0-200 µg/mL). Maximum viability decreased by (mean ± SEM): 67.1 ± 3.3%, 78.4 ± 4.2% and 74.9 ± 5.0% when exposed to 50, 100 and 200 µg/mL for 48 h, respectively. PAA-ZnO also significantly decreased neutrophil viability but only at 48 h exposures at higher concentrations. Neutrophil degranulation increased by approximately 3% after 30 min and by 8% after 4 h when exposed to sublethal doses (10 µg/mL) of PAA-CeO2 or PAA-Fe2O3. All PAA-NPs induced an increase in neutrophil respiratory burst when exposed to 10 µg/mL for 30 and 60 min, however, PAA-Fe2O3 was the only NP where the response was significant. Lastly, NPs altered the expression of a number of pro-inflammatory and immune genes, where PAA-TiO2 most significantly increased the mRNA levels of pro-inflammatory genes (il-1b, ifng) in neutrophils by 3 and 2.5 times, respectively. Together, these data demonstrate that goldfish neutrophils can be negatively affected from exposures to PAA-coated NPs and are functionally responsive to specific core-material properties at sublethal doses. These changes could perturb the innate response and affect the ability of fish to respond to pathogens.

Chemopreventive potential of phenolic compounds in oral carcinogenesis.

OBJECTIVE: To evaluate the chemopreventive potential of phenolic compounds - potassium apigenin, cocoa, catechins, eriocitrin and rosmarinic acid in oral carcinogenesis induced in hamsters by means of the topical application of 7,12-dimethylbenz(a)anthracene(DMBA). STUDY DESIGN: An experimental study at the University of Murcia. METHODS: 50 male Syrian hamsters (Mesocricetus auratus) were divided into five groups of ten: Group I (control group): 0.5% DMBA; Group II: 0.5% DMBA+1.1mg/15ml potassium apigenin; Group III: 05% DMBA+2.5mg/15ml cocoa catechins; Group IV: 0.5% DMBA+6mg/15ml eriocitrin; Group V: 0.5% DMBA+1.3mg/15ml rosmarinic acid. The flavonoids were administered orally. All the animals were sacrificed after 12 weeks. Macroscopic, microscopic and immunohistochemical (PCNA and p53) analyses of the lesions were performed. RESULTS: All the groups treated with phenolic compounds showed lower incidences of tumour, greater differentiation and lower scores in the tumour invasion front grading system in comparison with the control group. Potassium apigenin and rosmarinic acid achieved the best results, the former considerably reduced the carcinoma tumour volumes developed and both significantly reduced the intensity and aggression of the tumours. Immunoexpression of PCNA and p53 were significantly altered during DMBA-induced oral carcinogenesis. CONCLUSIONS: Animals treated with phenolic compounds, particularly potassium apigenin and rosmarinic acid, showed a lower incidence of tumours.

Pharmacogenetics of beta2 adrenergic receptor agonists in asthma management.

Beta2 (ß2) adrenergic receptor agonists (beta agonists) are a commonly prescribed treatment for asthma despite the small increase in risk for life-threatening adverse responses associated with long-acting beta agonist (LABA). The concern for life-threatening adverse effects associated with LABA and the inter-individual variability of therapeutic responsiveness to LABA-containing combination therapies provide the rationale for pharmacogenetic studies of beta agonists. These studies primarily evaluated genes within the ß2-adrenergic receptor and related pathways; however, recent genome-wide studies have identified novel loci for beta agonist response. Recent studies have identified a role for rare genetic variants in determining beta agonist response and, potentially, the risk for rare, adverse responses to LABA. Before genomics research can be applied to the development of genetic profiles for personalized medicine, it will be necessary to continue adapting to the analysis of an increasing volume of genetic data in larger cohorts with a combination of analytical methods and in vitro studies.

PKA/AMPK signaling in relation to adiponectin's antiproliferative effect on multiple myeloma cells.

Obesity increases the risk of developing multiple myeloma (MM). Adiponectin is a cytokine produced by adipocytes, but paradoxically decreased in obesity, that has been implicated in MM progression. Herein, we evaluated how prolonged exposure to adiponectin affected the survival of MM cells as well as putative signaling mechanisms. Adiponectin activates protein kinase A (PKA), which leads to decreased AKT activity and increased AMP-activated protein kinase (AMPK) activation. AMPK, in turn, induces cell cycle arrest and apoptosis. Adiponectin-induced apoptosis may be mediated, at least in part, by the PKA/AMPK-dependent decline in the expression of the enzyme acetyl-CoA-carboxylase (ACC), which is essential to lipogenesis. Supplementation with palmitic acid, the preliminary end product of fatty acid synthesis, rescues MM cells from adiponectin-induced apoptosis. Furthermore, 5-(tetradecyloxy)-2-furancarboxylic acid (TOFA), an ACC inhibitor, exhibited potent antiproliferative effects on MM cells that could also be inhibited by fatty acid supplementation. Thus, adiponectin's ability to reduce survival of MM cells appears to be mediated through its ability to suppress lipogenesis. Our findings suggest that PKA/AMPK pathway activators, or inhibitors of ACC, may be useful adjuvants to treat MM. Moreover, the antimyeloma effect of adiponectin supports the concept that hypoadiponectinemia, as occurs in obesity, promotes MM tumor progression.

Effect of a diet and physical activity intervention on body weight and nutritional patterns in overweight and obese breast cancer survivors.

Energy restriction from a low-calorie diet and increased energy expenditure induced by physical activity (PA) could promote weight loss/maintenance and be important determinants of breast cancer (BC) prognosis. The aim of this study was to assess participation and adherence of overweight and obese BC survivors to a lifestyle intervention and to demonstrate the capacity of this intervention to induce weight loss and nutritional changes. This single-arm pre-post study, which involved one-hourly weekly diet sessions delivered by a dietician and 75-min bi-weekly PA sessions of moderate-to-high intensity led by PA monitors, was offered to overweight and obese BC survivors shortly after treatment. Before and after the intervention, anthropometry, dietary information, quality of life (QoL) and cardiorespiratory fitness (CRF) were collected. A total of 112 BC survivors were invited to participate: 42 of them started the intervention and 37 completed it. Participants attended more than 90 % of the sessions offered and showed a significant weight loss of 5.6 ± 2.0 kg, as well as significant decreases in body mass index, fat mass and waist circumference. Significant decreases in total energy (-25 %), fat (-35 %), saturated fat (-37 %) and carbohydrate (-21 %) intakes were observed while QoL and CRF showed significant increases. This feasibility study demonstrated the success of a short-term diet and PA intervention to induce weight loss and promote healthful changes in BC survivors. Assessing the long-term effects of these changes, and in particular their possible impact of BC prognosis, and designing interventions reaching a wider number of BC survivors are still issues to be addressed.

Colestasis y listeriosis en el tercer trimestre de la gestación / Cholestasis and listeriosis in the third trimester of pregnancy

La listeriosis es una infección producida por Listeria monocytogenes. Poco frecuente, afecta a personas en edades extremas de la vida, gestantes, inmunodeprimidos y, ocasionalmente, a individuos sanos. Su incidencia ha aumentado en los últimos años y presenta cierta tendencia a la estacionalidad, aumentando en verano. Puede aparecer de forma esporádica o a brotes. En gestantes, la infección se produce más frecuentemente en el tercer trimestre y la clínica suele ser leve. Sin embargo, la infección sobre el feto es severa, pudiendo producir abortos, muertes fetales, corioamnionitis y partos pretérmino con recién nacidos infectados, manifestándose en forma de granulomatosis infantiséptica con abscesos y granulomas diseminados o, tardíamente, como meningitis y sepsis. La colestasis intrahepática es una forma reversible de colestasis, de causa desconocida y específica de la gestación, siendo mas frecuente en multíparas, en el tercer trimestre y rara antes de la semana 26ª. Desaparece tras el parto y constituye la segunda causa de ictericia en la gestación, por detrás de la hepatitis. El diagnóstico de colestasis es fundamentalmente clínico. Se manifiesta por prurito palmo plantar pero también puede cursar con náuseas, vómitos y molestias abdominales localizadas en hipocondrio derecho. Dado que la listeriosis y colecistitis pueden compartir sintomatología, habrá que tener en cuenta la posibilidad de listeriosis para poner en marcha los mecanismos de confirmación diagnóstica (cultivo de fluidos o tejidos estériles: sangre, LCR neonatal, líquido amniótico o placenta)y el tratamiento específico precozmente. Se presenta un caso de colestasis y listeriosis en el tercer trimestre con buen resultado maternofetal (AU)

Listeriosis is an infection produced by Listeria monocytogenes. It is infrequent and affects people at extreme ages, pregnant women, immune compromised people and, occasionally, healthy people. Its incidence has increased in recent years and shows a certain tendency to seasonality, increasing in summer. It can appear sporadically or as outbreaks.In pregnant women the infection is most frequently produced in the third trimester and the symptoms are usually light. Nonetheless, the infection of the fetus is severe, and can produce miscarriages, fetal deaths, corioamnionitis and premature births with the newborn infected, manifested in the form of granulomatosis infantiseptica with abscesses and scattered granulomas or at a later stage , as meningitis or sepsis. Intrahepatic cholestasis is a reversible form of cholestasis, its cause is unknown, it is specific to pregnancy and is more frequent in multiparous women, in the third trimester and rarely before the 26th week. It disappears following childbirth and is the second cause of jaundice in pregnancy, after hepatitis. The diagnosis of cholestasis is basically clinical. It appears as palmoplantar pruritus but can also produce nausea, vomiting and abdominal discomfort localized in the right hypochondrium. Given that listeriosis and cholestasis can have a shared symptomology, the possibility of listeriosis must be borne in mind in order for early implementation of the mechanisms of diagnostic confirmation (cultivation of sterile fluids or tissues: blood, neonatal CSF, amniotic liquid or placenta) and specific treatment. We present a case of cholestasis and listeriosis in the third trimester with a good maternofetal result (AU)

Patología implanto-endodóncica: concepto, tipos, diagnóstico, tratamiento y prevención / Endodontic-implant pathology: concept, types, diagnosis, treatment and prevention

La patología implanto-endodóncica (PIE) está descrita en la literatura implantológica como una de las causas de periimplantitis apical, entendida como la lesión osteolítica en la región apical del implante, con normal osteointegración de su porción coronal, provocada por la infección por contigüidad a partir de la lesión periapical del diente adyacente. Pero el concepto de PIE no sólo abarca la periimplantitis retrógrada por contaminación diente-a-implante, sino también los procesos inflamatorios periapicales en dientes adyacentes al implante por contaminación implante-a-diente, cuando la colocación del implante provoca la necrosis del diente adyacente y la consiguiente periodontitis apical. Incluso podríamos incluir dentro de la PIE los casos de periimplantitis apical en implantes postextracción provocada por la infección residual presente en el alvéolo de un diente extraído con periodontitis apical. En definitiva, la PIE incluye las lesiones endodóncicas e implantarias apicales que son el resultado de infecciones residuales o por contigüidad entre diente e implante. En esta revisión bibliográfica se define y clasifica la PIE, repasándose la casuística publicada así como su influencia en el resultado del tratamiento implantológico

The implant-endodontic pathology is described in the literature as a cause of apical periimplantitis, understood to be an osteolytic lesion that appears in the apical region of the implant during the coronal osseointegration normally. This implant-endodontic pathology researches the relation of endodontic and implants apical lesions leading to infection contiguity between teeth and implants. The first way of contamination is implant-tooth, when the implant placement causes necrosis of the adjacent tooth and subsequent contamination of the implant; the second way is tooth-implant, when there is an exacerbation of latent apical lesion in a tooth, root canal or not, after placing an implant adjacent to it, resulting in apical periimplantitis later. In this work we have summoned the cases of occurring periimplantitis by apical residual infection present in the socket of an extracted tooth with apical periodontal pathology and replaced by an implant. This review aims to make an update of the relationship between periimplantitis and endodontics

[Cholestasis and listeriosis in the third trimester of pregnancy]. / Colestasis y listeriosis en el tercer trimestre de la gestación.

Listeriosis is an infection produced by Listeria monocytogenes. It is infrequent and affects people at extreme ages, pregnant women, immunocompromised people and, occasionally, healthy people. Its incidence has increased in recent years and shows a certain tendency to seasonality, increasing in summer. It can appear sporadically or as outbreaks. In pregnant women the infection is most frequently produced in the third trimester and the symptoms are usually light. Nonetheless, the infection of the fetus is severe, and can produce miscarriages, fetal deaths, corioamnionitis and premature births with the newborn infected, manifested in the form of granulomatosis infantiseptica with abscesses and scattered granulomas or at a later stage , as meningitis or sepsis. Intrahepatic cholestasis is a reversible form of cholestasis, its cause is unknown, it is specific to pregnancy and is more frequent in multiparous women, in the third trimester and rarely before the 26th week. It disappears following childbirth and is the second cause of jaundice in pregnancy, after hepatitis. The diagnosis of cholestasis is basically clinical. It appears as palmoplantar pruritus but can also produce nausea, vomiting and abdominal discomfort localized in the right hypochondrium. Given that listeriosis and cholestasis can have a shared symptomology, the possibility of listeriosis must be borne in mind in order for early implementation of the mechanisms of diagnostic confirmation (cultivation of sterile fluids or tissues: blood, neonatal CSF, amniotic liquid or placenta) and specific treatment. We present a case of cholestasis and listeriosis in the third trimester with a good maternofetal result.

Effect of the phenolic compounds apigenin and carnosic acid on oral carcinogenesis in hamster induced by DMBA.

OBJECTIVE: To investigate oral carcinogenesis in hamster induced by the topical application of 7,12-dimethyl benzanthracene (DMBA) to evaluate the different lesions produced and the possible preventive effects of the phenolic compounds apigenin (flavone) and carnosic acid (diterpene). MATERIALS AND METHODS: Thirty-two Syrian hamsters were divided into three groups: I: 0.5% DMBA (n = 12); II: 0.5% DMBA + potassium apigenin (n = 8); III: 0.5% DMBA + carnosic acid (n = 12). All the animals were sacrificed after 11 weeks, and a macroscopic and light microscopic study was made of the lesions. RESULTS: The largest number of neoplasms, showing the most aggressive biological behavior, corresponded to the control group. The group treated with potassium apigenin ranked second in tumor incidence, although the tumors were not very aggressive behavior. In the group treated with carnosic acid, only one malignancy was recorded, showing the smallest volume of all the recorded tumor lesions. CONCLUSIONS: Our findings indicate that both potassium apigenin and carnosic acid have chemoprotective effects against carcinogenesis induced by DMBA in hamster.

Management of the axilla in early breast cancer patients in the genomic era.

Management of the axilla in early breast cancer (EBC) patients has dramatically evolved in recent years from more radical to increasingly conservative approaches. Classically, the EBC patients with a clinically positive axilla are offered axillary lymph node dissection (ALND) and those with a clinically negative axilla (cN0) are offered sentinel lymph node (SLN) biopsy, which obviates the complications related to ALND and provides adequate surgical staging and comparable locoregional control and survival. The need for performing ALND when the SLN is positive and contemporary adjuvant treatment is delivered has been questioned in recent years. On the other hand, ongoing trials are testing whether node-positive patients can be spared chemotherapy, based on intrinsic primary tumor biology. Because the integration of novel surgical management and tumor biology is needed, this article provides an overview of the current challenges that a more detailed knowledge of tumor biology has brought to EBC staging and treatment. We propose that breast cancer oncologists (surgeons, radiation therapists, and medical oncologists) should focus their efforts on offering therapy tailored to each patient's needs in such a way that no matter which treatment is used, no overtreatment occurs.