Validation of voice scales into Spanish: Systematic review of the psychometric properties / Validación de escalas de voz al español: revisión sistemática de las propiedades psicométricas

Introduction: To use a test in a language or culture other than the original it is necessary to carry out, in addition to its adaptation, a psychometric validation. This systematic review assesses the validation studies of the voice self-report scales in Spanish. Methods: A systematic review was performed searching ten databases. The assessment was carried out following the criteria proposed by Terwee et al. (2007) together with some specifically proposed for this study. Validation studies in Spanish of self-report voice scales published in indexed journals were included and the search was updated on February 2nd, 2023. Results: 15 studies that evaluated 12 scales were reviewed. It was verified that not all the validations were adjusted to the criteria used and that the properties to verify the metric strength of the validations were, in general, few. Conclusions: This systematic review shows that the included studies do not report much evidence of metric quality. It should be considered that different strategies have currently been developed to obtain more and better evidence of reliability and validity. Our contribution is to reflect on the usual practice of validation of self-report scales in Spanish language. The most important weakness is the possibility of using broader and more current evaluation protocols. We also propose to continue this work, completing it with a meta-analytic study.(AU)

Introducción: Para utilizar una prueba en una lengua o cultura distinta de la original es preciso realizar, además de su adaptación, una validación psicométrica. Esta revisión sistemática valora los estudios de validación de las escalas de autoinforme de voz en español. Método: Se realizó una revisión sistemática buscando en diez bases de datos. La valoración se llevó a cabo siguiendo los criterios propuestos por Terwee et al. (2007) junto con algunos específicamente propuestos para este trabajo. Se incluyeron estudios de validación en español de escalas de autoinforme publicados en revistas indexadas. La última búsqueda fue realizada el 2 de febrero de 2023. Resultados: Se revisaron 15 trabajos que evaluaron 12 escalas. Se comprobó que no todas las validaciones se ajustaron a los criterios utilizados y que las propiedades para comprobar la robustez métrica de estas fueron, por lo general, pocas.Conclusiones: Esta revisión sistemática muestra que los estudios incluidos no reportan demasiada evidencia de calidad métrica. Debería considerarse que en la actualidad se han desarrollado diferentes estrategias para obtener más y mejor evidencia de fiabilidad y validez. Nuestra contribución ha sido valorar la práctica de la validación de las escalas de autoinforme en lengua española. La más importante debilidad es la posibilidad de usar algún protocolo más amplio y actual. También proponemos continuar este trabajo con un estudio metaanalítico.(AU)

Breast-Conserving Surgery Guided with Magnetic Seeds vs. Wires: A Single-Institution Experience.

PURPOSE: The aim of this study is to describe our initial experience using magnetic seeds (Magseed®) to guide breast-conserving surgery in non-palpable breast lesions and compare the use of magnetic seed with wires to guide breast-conserving surgery in terms of clinical and pathological characteristics. METHODS: We performed a retrospective study including all breast-conserving surgeries for non-palpable breast lesions under 16 mm from June 2018 to May 2021. We compared breast-conserving surgeries guided with magnetic seeds (Magseed®) to those guided with wires, analyzing tumor and patient characteristics, surgical time, and pathological results of the surgical specimens. RESULTS: Data from 225 cases were collected, including 149 cases guided by magnetic seeds and 76 cases guided by wires. The breast lesion was localized in every case. Both cohorts were similar regarding clinical and pathological characteristics. We found significant statistical differences (p < 0.02) in terms of the median volume (cm3) of the excised specimen, which was lower (29.3%) in the magnetic seed group compared with the wire group (32.5 [20.5-60.0]/46.0 [20.3-118.7]). We did not find significant differences regarding surgical time (min) or the affected or close margins. CONCLUSION: In our experience, the use of magnetic seed (Magseed®) is a feasible option to guide breast-conserving surgery of non-palpable lesions and enabled us to resect less breast tissue.

The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study.

Purpose: Neoadjuvant endocrine treatment (NET) has become a useful tool for the downstaging of luminal-like breast cancers in postmenopausal patients. It enables us to increase breast- conserving surgery (BCS) rates, provides an opportunity for us to assess in vivo NET effectiveness, and allows us to study any biological changes that may act as valid biomarkers. The purpose of this study was to evaluate the safety and effectiveness of NET, and to assess the role of Ki67 proliferation rate changes as an indicator of endocrine responsiveness. Methods: From 2016 to 2020, a single-institution cohort of patients, treated with NET and further surgery, was evaluated. In patients with Ki67 ≥ 10%, a second core biopsy was performed after four weeks. Information regarding histopathological and clinical changes was gathered. Results: A total of 115 estrogen receptor-positive (ER+)/HER2-negative patients were included. The median treatment duration was 5.0 months (IQR: 2.0−6.0). The median maximum size in the surgical sample was 40% smaller than the pretreatment size measured by ultrasound (p < 0.0001). The median pretreatment Ki67 expression was 20.0% (IQR: 12.0−30.0), and was reduced to 5.0% (IQR: 1.8−10.0) after four weeks, and to 2.0% (IQR: 1.0−8.0) in the surgical sample (p < 0.0001). BCS was performed on 98 patients (85.2%). No pathological complete responses were recorded. A larger Ki67 fold change after four weeks was significantly related to a PEPI score of zero (p < 0.002). No differences were observed between luminal A- and B-like tumors, with regard to fold change and PEPI score. Conclusions: In our cohort, NET was proven to be effective for tumor size and Ki67 downstaging. This resulted in a higher rate of conservative surgery, aided in therapeutic decision making, provided prognostic information, and constituted a safe and well-tolerated approach.

Aloe vera Flowers, a Byproduct with Great Potential and Wide Application, Depending on Maturity Stage.

Flowers of Aloe vera are a byproduct providing a valuable source of bioactive compounds with different functions for health benefits. The characterization in amino acids, organic acids, sugars, trigonelline, volatiles compounds, fatty acids, total phenolic, carotenoids, vitamin C content, and antioxidant capacity of Aloe flowers (Aloe barbadensis Miller) has been studied at three maturity stages (I: immature; II: mature; III: mature, with flowers buds opened). Immature flowers presented the highest content in phenyl alanine, tyrosine, citric acid, trigonelline, carotenoids, retinol activity equivalent, vitamin C, and total phenolic and antioxidant capacity. As the flower develops, the content of these compounds decreases. Aloe vera flowers presented an important content in fatty acids, and the principal concentration was identified in polyunsaturated unsaturated fatty acids (PUFAs) as α-linolenic acid, and linoleic acid, with a ratio close to one. The main saturated fatty acid was palmitic acid, followed by stearic acid. Maturity stage III showed the lowest fatty acid content. The bioactive compounds found in Aloe vera flowers have potential applications in the cosmetic, pharmaceutical, nutraceutical, and food industries. Depending on the compound of interest, it could be worthwhile harvesting flowers at maturity stage I, thereby reducing the energy consumption of flowers from the plant and thus favoring plant development. This is an example of a circular economy for Aloe vera producers, generating economic and business opportunities and thus providing environmental and social benefits.

Hemorragia digestiva alta como complicación de un adenoma de glándulas de Brunner. Una presentación inusual / Upper gastrointestinal bleeding as a complication of Brunner's gland adenoma. An unusual presentation

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A comparison of semi-quantitative methods suitable for establishing volatile profiles.

BACKGROUND: Full scent profiles emitted by living tissues can be screened by using total ion chromatograms generated in full scan mode and gas chromatography-mass spectrometry technique using Headspace Sorptive Extraction. This allows the identification of specific compounds and their absolute quantification or relative abundance. Quantifications ideally should be based on calibration curves using standards for each compound. However, the unpredictable composition of Volatile Organic Compounds (VOCs) and lack of standards make this approach difficult. Researchers studying scent profiles therefore concentrate on identifying specific scent footprints i.e. relative abundance rather than absolute quantities. We compared several semi-quantitative methods: external calibration curves generated in the sampling system and by liquid addition of standards to stir bars, total integrated peak area per fresh weight (FW), normalized peak area per FW, semi-quantification based on internal standard abundance, semi-quantification based on the nearest n-alkane and percentage of emission. Furthermore, we explored the usage of nearest components and single calibrators for semi-quantifications. RESULTS: Any of the semi-quantification methods based on a standard produced similar or even identical results compared to quantification by a true-standard for a compound, except for the method based on standard addition. Each method beholds advantages and disadvantages regarding level of accuracy, experimental variability, acceptance and retrieved quantities. CONCLUSIONS: Our data shows that, except for the method of standard addition to the biological sample, the rest of the semi-quantification methods studied give highly similar statistical results. Any of the methodologies presented here can therefore be considered as valid for scent profiling. Regarding relative proportions of VOCs, the generation of calibration curves for each compound analysed is not necessary.

Xantogranulomatous pyeloneprhritis in children.

Xanthogranulomatous pyelonephritis (XPN) is an unusual and severe form of chronic inflammatory lesion of the kidney, characterised by the destruction of the renal parenchyma and the presence of multinucleated giant cells and lipid-laden macrophages, inflammatory infiltration and intensive renal fibrosis. There are a few cases in the literature which describe the disease in children. The pathomechanism of XPN is poorly understood. Renal obstruction with concomitant urinary tract infection is the most commonly associated pathological finding. The process is typically unilateral and may be focal or diffuse. In both cases, the perirenal infiltration is possible and can be mistaken for common renal neoplasm or inflammatory process. The symptoms are non-specific. Diagnostic imaging techniques with clinical suspicion have enabled XPN to be diagnosed and differentiated from malignancy with a high degree of confidence. Computed tomography (CT) is the mainstay of diagnostic imaging. The definitive diagnosis of XPN is based on pathological assessment after nephrectomy. We review and illustrate the clinical, radiological, surgical and pathological characteristics of XPN in children. All cases shown are surgically and histopathologically proven. TEACHING POINTS: • XPN can present different clinical manifestations. • CT is the mainstay of diagnostic imaging in XPN. • Focal type of XPN should be included in the differential diagnosis of children with a renal mass. • There are no clear guidelines on the management of XPN. • Conservative and surgical treatments should be considered for each individual case. • Histopathological examination confirms the diagnosis and excludes other benign and malign diseases.

Diagnóstico molecular de enfermedades genéticas: del diagnóstico genético al diagnóstico genómico con la secuenciación masiva / Molecular diagnosis of genetic diseases: from genetic to genomic diagnosis using next generation sequencing

En la actualidad se conocen 8.000 enfermedades genéticas monogénicas. La mayoría de ellas son heterogéneas, por lo que el diagnóstico molecular por técnicas convencionales de secuenciación suele ser largo y costoso debido al gran número de genes implicados. El tiempo estimado para el diagnóstico molecular se encuentra entre 1 y 10 años, y este retraso impide que los pacientes reciban medidas terapéuticas y de rehabilitación específicas, que sus familiares entren en programas preventivos y que reciban asesoramiento genético. La secuenciación masiva está cambiando el modelo de diagnóstico molecular de los afectos, sin embargo, los médicos y profesionales de la salud se enfrentan al dilema de la selección del método más eficiente, con el menor coste sanitario y con la mayor precisión de sus resultados. El objetivo de este trabajo es revisar la tecnología de secuenciación masiva y definir las ventajas y los problemas en su utilización.

Currently 8000 monogenic genetic diseases are known. Most of them are heterogeneous, so their molecular diagnosis by conventional sequencing techniques is labour intensive and time consuming due to the large number of genes involved. The estimated time is between 1 and 10 years for molecular diagnosis and this delay prevents patients from receiving therapy and rehabilitation measures, and their families from entering prevention programs and being given genetic counselling. Next generation sequencing (NGS) is changing the model of molecular diagnosis of patients; however, doctors and health professionals are faced with the dilemma of choosing the most efficient method, with lower health care costs and the most accurate results. The aim of this paper is to review the NGS technology and define the advantages and problems in the use of this technology.

Analgesia del parto en adolescentes: resultados de nuestra experiencia desarrollada en el Hospital de la Mujer – Centro Hospitalario Pereira Rossell / Adolescent use of analgesia for delivery: results of an experience at the Women´s Hospital - Pereira Rossell Hospital Center

Introducción: el embarazo adolescente constituye un impacto biopsicosocial. La analgesia obstétrica mejora la satisfacción materna y el vínculo madre-hijo. Objetivo: describir las embarazadas adolescentes que recibieron analgesia epidural y la eficacia de la misma, para conocer la realidad de estas pacientes y el trabajo que realizamos en el Hospital de la Mujer. Material y método: estudio retrospectivo, descriptivo, de enero de 2012 a enero de 2013. Revisamos 186 historias registrando: edad, paridad, escala verbal análoga (EVA) previo a la analgesia y a los 10 minutos, duración, parto o cesárea, complicaciones maternas, test de satisfacción, Apgar. Resultados: el promedio de edad fue de 17,3 ? 0,1 años. El 85,5% eran primigestas; 9,7% secundigestas, y 1,1% tercigestas. El 80,1% presentaban EVA de 10; 5,9% EVA de 9; 8,6% EVA de 8. A los 10 minutos, el 97,3% presentaban EVA de 0 y el 4,8% un EVA entre 1 y 4. Se encontró una diferencia estadísticamente significativa entre el EVA al inicio y a los 10 minutos en 179 pacientes, valor p < 0,001. El 67,2% estuvieron totalmente calmadas y el 32,8% parcialmente calmadas. La duración de la analgesia presentó un promedio de 198,9 ± 8,1 minutos. El 84,9% tuvo parto y el 15,1% cesárea. No existieron complicaciones maternas graves. El 98,4% de los neonatos fueron vigorosos. Conclusiones: la mayoría de las adolescentes estaban en etapa tardía, eran primigestas y presentaban dolor severo. La analgesia del parto representó una técnica eficaz. Se requieren más estudios para evaluar el impacto sobre la vía de finalización del parto...

Cellular intrinsic factors involved in the resistance of squamous cell carcinoma to photodynamic therapy.

Photodynamic therapy (PDT) is widely used to treat non-melanoma skin cancer. However, some patients affected with squamous cell carcinoma (SCC) do not respond adequately to PDT with methyl-δ-aminolevulinic acid (MAL-PDT) and the tumors acquire an infiltrative phenotype and became histologically more aggressive, less differentiated, and more fibroblastic. To search for potential factors implicated in SCC resistance to PDT, we have used the SCC-13 cell line (parental) and resistant SCC-13 cells obtained by repeated MAL-PDT treatments (5th and 10th PDT-resistant generations). Xenografts assays in immunodeficient mice showed that the tumors generated by resistant cells were bigger than those induced by parental cells. Comparative genomic hybridization array (aCGH) showed that the three cell types presented amplicons in 3p12.1 CADM2, 7p11.2 EFGR, and 11q13.3 CCND1 genes. The 5th and 10th PDT-resistant cells showed an amplicon in 5q11.2 MAP3K1, which was not present in parental cells. The changes detected by aCGH on CCND1, EFGR, and MAP3K1 were confirmed in extracts of SCC-13 cells by reverse-transcriptase PCR and by western blot, and by immunohistochemistry in human biopsies from persistent tumors after MAL-PDT. Our data suggest that genomic imbalances related to CCND1, EFGR, and particularly MAP3K1 seem to be involved in the development of the resistance of SCC to PDT.

Satisfacción y calidad en analgesia del parto / Satisfaction and quality in delivery analgesics

La satisfacción de la paciente en analgesia del parto es uno de los objetivos más importantes que perseguimos y es también una medida de resultado y calidad. Los factores asociados a la satisfacción materna resultan aún desconocidos. Objetivos: Nuestro objetivo es medir la satisfacción de las pacientes asociada a la analgesia del parto y analizar las características demográficas de nuestra población obstétrica. Métodos: Realizamos un estudio descriptivo prospectivo a las parturientas, mediante una encuesta a cada paciente. La satisfacción materna fue medida en forma cualitativa y el dolor mediante la escala visual análoga, al inicio y luego de la analgesia para medir la eficacia de la misma. Resultados: Se recogieron un total de 151 encuestas. De estas 151 pacientes, un altísimo porcentaje estuvieron satisfechas y calmadas, 98.01% recomendarían la técnica y 93.37% volverían a solicitarla en un futuro parto. Conclusiones: La satisfacción materna está fuertemente determinada por la efectividad de la técnica (alivio del dolor), no dependiendo solo de éste sino también de otros factores como son el apoyo percibido durante el trabajo de parto y experiencias previas...

Poorly differentiated primary monophasic synovial sarcoma of the lung.

Primary monophasic synovial sarcoma of the lung is rarely seen in clinical practice. We report the case of a 60-year-old male who underwent a left lower lobectomy for lung sarcoma. The patient received adjuvant therapy after surgery. Diagnosis was confirmed with SYT-SSX2 translocation detection.

Surgical treatment of solitary metastasis in the male breast from non-small cell lung cancer.

Detection of metastases in the breast from extramammary neoplasms is rare. We present a case of metastases in breast tissue from surgically treated non-small cell bronchogenic carcinoma. A histologic and immunohistologic study was essential for choosing the appropriate treatment for the patient. The patient is alive and disease-free 18 months after the breast surgery.

Factores de recidiva precoz tras la resección de las metástasis pulmonares / Factors related to early recurrence after resection of pulmonary metastases

Introducción. Clásicamente, las metástasis pulmonares se consideraban una diseminación sistémica del tumor que no precisaban cirugía. Sin embargo, hay estudios que muestran los beneficios de la metastasectomía en casos seleccionados. El objetivo es analizar la morbimortalidad de la metastasectomía pulmonar y determinar los factores de recidiva precoz. Pacientes y método. De los 42 pacientes intervenidos por metástasis pulmonares se excluyó a 4 por considerarlas irresecables intraoperatoriamente; se analizó a los 38 restantes. Las variables analizadas fueron la edad, el sexo, el tumor primario, el tiempo libre de enfermedad, las metástasis extrapulmonares resecadas, el número de metástasis, la bilateralidad, la morbimortalidad, las recidivas, las reintervenciones, el tiempo libre de enfermedad y la supervivencia. Resultados. El abordaje quirúrgico fue una toracotomía posterolateral extraserrática, y no se presentó mortalidad perioperatoria. La morbilidad fue del 11 por ciento (n = 4), y fue precisa una reintervención por un hemotórax posquirúrgico. La supervivencia a 1, 2 y 3 años fue del 87, el 61 y el 25 por ciento, respectivamente, y el índice de pacientes libres de enfermedad, del 71, el 56 y el 17 por ciento, respectivamente. Los principales factores de recidiva precoz fueron el tipo histológico del tumor (más recidivas en los sarcomas y menos en los adenocarcinomas), el tiempo libre de enfermedad entre el tumor primario y la metástasis pulmonar, y el número de metástasis. Cinco de las recidivas pulmonares fueron resecadas una segunda vez, y se pudo extirpar sólo 4 de ellos, 3 de los cuales están libres de enfermedad a los 6, 12 y 24 meses, y el cuarto presenta recidiva pulmonar a los 18 meses. Conclusiones. Las metástasis pulmonares pueden resecarse con baja morbimortalidad, y los principales factores pronósticos de supervivencia son la cirugía completa, el tipo histológico, el tiempo libre de enfermedad entre el tumor primario y la metástasis, y el número de metástasis pulmonares (AU)