Brazilian Society of Otology task force - single sided deafness - recommendations based on strength of evidence.

OBJECTIVE: To make evidence-based recommendations for the treatment of Single-Sided Deafness (SSD) in children and adults. METHODS: Task force members were instructed on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on SSD were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS: The topics were divided into 3 parts: (1) Impact of SSD in children; (2) Impact of SSD in adults; and (3) SSD in patients with temporal bone tumors. CONCLUSIONS: Decision-making for patients with SSD is complex and multifactorial. The lack of consensus on the quality of outcomes and on which measurement tools to use hinders a proper comparison of different treatment options. Contralateral routing of signal hearing aids and bone conduction devices can alleviate the head shadow effect and improve sound awareness and signal-to-noise ratio in the affected ear. However, they cannot restore binaural hearing. Cochlear implants can restore binaural hearing, producing significant improvements in speech perception, spatial localization of sound, tinnitus control, and overall quality of life. However, cochlear implantation is not recommended in cases of cochlear nerve deficiency, a relatively common cause of congenital SSD.

Does rest interval between unilateral exercise protocols influences on contralateral neuromuscular responses in untrained individuals?

INTRODUCTION: Effects on strength performance and muscle activation in the contralateral limb have been observed after training with the ipsilateral limb (IL). Cross fatigue effects in the contralateral limb (CL) can occur at intervals of up to 48 h after a training session performed with the ipsilateral limb. The objective of this study was to verify the effect of a training session in the ipsilateral limb, on the strength and activation of the muscles in the contralateral limb also submitted to the training protocol. METHODS: 10 untrained men (mean ± SD: age = 23.7 ± 4.9 years) performed unilateral knee extension with both limbs in equated protocols, in two conditions with different intervals between limbs - 20 min and 24 h. RESULTS: There were no differences in the comparison of the force produced between the pre x post interventions with the CL limb, as well as in the activation of the quadriceps during its performance. These results were similar for the two different intervals between the protocols. CONCLUSION: It was concluded that when the CL member performs the protocol after the IL, the responses in the CL depend mainly on the requirement imposed on the protocol performed by this member, without influence of the training protocol performed previously with the IL member.

Renal cell carcinoma with contralateral adrenal metastasis: Case report.

Renal cell carcinoma is the major cause of kidney malignancy. Its adrenal metastasis is less frequent and is even rarer when it is affected contralaterally or bilaterally. We present the case of a 55-year-old man with diffuse abdominal pain. An irregular mass in the lower third of the left renal cortex and another in the right adrenal gland. Pathology showed it was a renal cell carcinoma with metastasis in the contralateral adrenal gland.

Ectopic pregnancy with a contralateral corpus luteum: Case report.

The following report describes the case of an ectopic pregnancy with contralateral corpus luteum after spontaneous conception. The patient was a 33- year-old female (gravida 3, segmentary C sections 3), with positive pregnancy test, and an Intrauterine Device (IUD). The patient was asymptomatic. At vaginal ultrasound, we observed an anteverted uterus of normal shape and size, a 20 x 12 mm intramural myoma and an irregular endometrial thickness of 16.5 mm, with no intrauterine sac. An ectopic pregnancy in the left Fallopian tube and a contralateral corpus luteum were detected, possibly as consequence of ovum pick up through the opposite tube (oocyte transmigration). Further laparoscopic and histopathologic studies confirmed our findings, and the ectopic pregnancy was successfully removed. In conclusion, oocyte transmigration is a common event and should be account when we wish to provide medical advice to patients with a single Fallopian tube trying to conceive. There are real chances for a patient to become pregnant even when only a single tube is present.

Metástasis axilares contralaterales en cáncer de mama: ¿Enfermedad sistémica, carcinoma oculto o progresión locorregional? Unidad de Mastología Hospital J.A. Fernández / Contralateral axillary metastases in breast cancer: systemic disease, occult carcinoma, or locoregional progression? Mastology Unit Hospital J.A. Fernandez

Introducción: Las metástasis de los ganglios axilares contralaterales (MAC) en cáncer de mama (CM), son consideradas metástasis a distancia, aunque estudios retrospectivos muestran mejor pronóstico comparado con la enfermedad sistémica. Objetivo: Reportar la estrategia terapéutica de una paciente con CM y MAC metacrónicas. Caso clínico: Paciente de 73 años diagnosticada en 2019 con CM izquierda locorregionalmente avanzado, luminal B like. Realizó neoadyuvancia, con enfermedad clínica estable. Se efectuó cirugía radical, obteniendo respuesta patológica parcial (ypT4bypN2). Cumple radioterapia e inicia hormonoterapia adyuvante. En 2021, presenta una metástasis axilar contralateral aislada. Realizó cirugía axilar, radioterapia y hormonoterapia adyuvante. Discusión: La biología de las MAC es controvertida, pudiendo originarse por drenaje linfático aberrante o por diseminación sistémica. Según AJCC, se consideran metástasis a distancia aunque por su comportamiento clínico podrían abordarse terapéuticamente como enfermedad locorregional. Conclusiones: El pronóstico de las MAC parece ser más favorable que el de la enfermedad sistémica, por lo que el tratamiento con intención curativa estaría ampliamente justificado(AU)

Introduction: Contralateral axillary lymph node metastases (MAC) in breast cáncer (BC) are considered distant metastases, although retrospective studies show a better prognosis compared to systemic disease. Objetivo: To report the therapeutic strategy of a patient with BC and metachronous MAC. Clinical case: 73-year-old patient diagnosed in 2019 with locoregionally advanced left BC, luminal B like. She underwent neoadjuvant therapy, with stable clinical disease. A radical surgery was performed, obtaining a partial pathological response (ypT4bypN2). She completed radiotherapy and started adjuvant hormone therapy. In 2021, She presented an isolated contralateral axillary metastasis and performed axillary surgery, radiotherapy and adjuvant hormonal therapy. Discussion : The biology of MAC is controversial, and may be caused by aberrant lymphatic drainage or systemic dissemination. According to the AJCC, it is considered distant metastasis, although due to its clinical behavior it could be treated therapeutically as locoregional disease. Conclusions: The prognosis of MAC seems to be more favorable than a systemic disease, so treatment with curative intent would be highly justified(AU)

Contralateral Interhemispheric Transfalcine Approach for Supratentorial Extraventricular Ependymoma Resection.

BACKGROUND/AIM: Extraventricular supratentorial ependymomas are rare entities. Most ependymomas are located at the infratentorial and intraventricular level, and only in a small group of cases they do not present continuity with the ventricular system. This is a case report of a patient with an atypical location of a cerebral ependymoma, which required the implementation of a complex and infrequent approach for its complete microsurgical removal. CASE REPORT: A 16-year-old male patient was referred at our department with a diagnosis of a 40 mm × 50 mm × 60 mm solid-cystic space-occupying lesion, sited between the left superior frontal-cingulate gyri. A contralateral transfalcine interhemispheric approach was selected, which achieved total resection of the tumor. The histopathological diagnosis of Grade II ependymoma was obtained according to WHO classification. CONCLUSION: The contralateral transfalcine interhemispheric approach represents a favorable surgical corridor to achieve a total resection of the tumor lesion and is favored by an adequate working angle and reduced brain manipulation.

Tympanic membrane perforations: a critical analysis of 1003 ears and proposal of a new classification based on pathogenesis.

PURPOSE: To present a large series ears with tympanic membrane perforations (TMP), to describe their characteristics, and to propose a new classification system based on the pathogenesis of TMP. METHODS: This cross-sectional study was conducted at a tertiary university hospital with 1003 ears (792 consecutive patients with TMP in at least 1 ear). Otoendoscopy and audiometry were performed. Perforation measurements and their locations were digitally assessed. TMP with no suggestive signs of previous retraction were classified as Group 1, and those with possible previous retraction were classified as Group 2. Signs of retraction previous to the TMP, symptom length, perforation size and location, status of the contralateral ear, and hearing status were compared. RESULTS: Group 1 comprised 63.5% of the included ears. Compared to Group 2, Group 1 presented a higher rate of central perforations (99% vs. 53%), a shorter duration of symptoms, smaller perforations (mean area: 18.5% vs. 41.4%), a higher rate of perforations in the anterior quadrants, better hearing levels (mean tritonal gap: 23.9 dB vs. 29.2 dB), and a lower rate of abnormal contralateral ears (28% vs. 66%). CONCLUSION: The classification of TMP into two groups based on signs of previous retractions is feasible and indicates two different levels of disease severity. While the group without previous signs of retraction comprises ears with more limited disease, membranes with previous retraction seem to show more severe disease and, consequently, a less functional middle ear.

Can the use of the CROS system provide head shadow effect contribution to unilateral Cochlear Implant Users? / O Sistema CROS pode oferecer contribuição do efeito sombra da cabeça a usuários de implante coclear unilateral?

ABSTRACT Purpose The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. Methods Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. Results The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. Conclusion Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito do sistema CROS em fenômenos como efeito sombra da cabeça em usuários de implante coclear unilateral. Método Estudo transversal prospectivo, aprovado pelo conselho de ética sob protocolo 2.128.869. Onze adultos com surdez de instalação pós-lingual usuários de IC Advanced Bionics unilateral foram selecionados. O reconhecimento de fala foi avaliado com palavras gravadas apresentadas a 65dBA a 0o azimute e a (90o no lado contralateral ao IC), com ruído a 55dBA, usando somente o IC e IC+sistema CROS. Os resultados foram analisados usando teste t pareado com alfa de 0,05. Resultados Os escores médios de reconhecimento de fala foram significativamente melhores com IC + CROS em relação à condição apenas IC (p <0,05, p <0,005 e p <0,005 respectivamente). Na apresentação à frente não foram encontradas diferenças significantes. Conclusão Os usuários de IC unilateral sem resíduo útil para uso de prótese auditiva ou impossibilitados de submeter-se à cirurgia bilateral podem se beneficiar do dispositivo CROS para o reconhecimento de fala, sobretudo quando a fala for apresentada ao lado contralateral ao IC.

Interhemispheric Contralateral Transfalcine Approach for Subparacentral Arteriovenous Malformation: 3-Dimensional Operative Video.

Neurovascular procedures along the interhemispheric fissure harbor unique features differentiating them from those arteriovenous malformations (AVMs) located at the lateral surface of the brain.1-4 The aim of this 3-dimensional operative video is to present a microsurgical resection of an AVM in a subparacentral location, operated through an interhemispheric contralateral transfalcine approach.1,3,5 This is a case of a 29-yr-old female, with headaches and history of seizures. The patient presented an interhemispheric bleeding 6 mo before the surgery. The magnetic resonance imaging (MRI) showed a vascular lesion located on the medial surface of the right hemisphere at the confluence between the cingulate sulcus and its ascending sulcus. In the cerebral angiography, a right medial AVM was observed, receiving afference from the right anterior cerebral artery and draining to the superior longitudinal sinus. The patient signed an informed consent for the procedure and agreed with the use of her images and surgical video for research and academic purposes. The patient was in a supine position, and a left interhemispheric contralateral transfalcine approach was performed,1-3 a circumferential dissection of the nidus, and, finally, the AVM was resected in one piece. The patient evolved without neurological deficits after the surgery. The postoperative MRI and angiography showed a complete resection of the AVM. In the case presented, to avoid exposing the drainage vein first and to use the gravity of the exposure, the contralateral transfalcine interhemispheric approach was used,1,2 which finally accomplished the proposed objectives.

Abordaje interhemisférico contralateral. Nota técnica / Contralateral interhemispheric approach. Technical note

El abordaje interhemisférico contralateral es una variante del abordaje interhemisférico transcalloso que permite optimizar el acceso a lesiones ubicadas en los ventrículos laterales o en sus paredes. La planificación del ángulo de entrada mediante neuronavegador nos permitió el manejo de un Cavernoma ubicado sobre el núcleo caudado e inmediato a la cápsula interna sin realizar callosotomía convencional ni comprometer las estructuras sensibles adyacentes.

Contralateral interhemispheric approach is a variant of the well-know interhemispheric transcallosal approach that allows to optimize the lateral wall ventricle lesions management. Neuronavigation planning allowed us to deal with a caudate nucleus cavernoma contiguous to internal capsule without conventional callosotomy and additional damage neither.

Effects of resistance training at different intensities of load on cross-education of muscle strength.

The objectives of this study were to 1) compare the extent of cross-transfer of muscle strength of high- versus low-load unilateral resistance training performed with external pacing of the movement (URTEP) and 2) compare the time course of the 2 approaches. Fifty subjects were randomized to 1 of the following 3 groups: G80 [2 sets at 80% and 2 sets at 40% of 1 repetition maximum (1RM), 1 concentric second and 3 eccentric seconds controlled by a metronome]; G40 (4 sets at 40% of 1RM, 1 s and 3 s controlled by a metronome); or control group. At week 1, the G80 increased the elbow flexion 1RM (P < 0.05) in contralateral arm. At week 4, both G80 and G40 increased the elbow flexion 1RM (P < 0.05) in contralateral arm. However, a greater 1RM gain was observed in the G80 than in the G40 (P < 0.05). Thus, although higher-load URTEP seems to enhance the cross-education effect when compared with lower-load URTEP, the cross-education of dynamic strength can be achieved in the 2 approaches after 4 weeks. Many patients would benefit from cross-education of muscle strength through URPEP, even those who are unable to exercise with high loads and in short periods of immobilization. Novelty: Unilateral resistance training promotes cross-education of dynamic muscle strength. However, higher-load resistance training enhances the effects of cross-education of muscle strength.

Lumbar disc herniation with contralateral radiculopathy: a systematic review on pathophysiology and surgical strategies.

Lumbar disc herniation (LDH) is a relatively common pathology usually presenting with unilateral radiculopathy ipsilateral to the disc herniation. Some patients can present with contralateral radicular symptoms. The objective of this article is to review the current literature on lumbar disc herniations with contralateral radiculopathy regarding its pathophysiology and surgical strategies. A systematic review of the literature on LDH with contralateral radiculopathy was performed using MEDLINE (via PubMed) using MeSH terms. This review was done following recommendations of PRISMA statement and PICOT strategy of search. Initial electronic search identified 126 papers. Finally, 18 articles were reviewed. None of the included papers was described as comparative. Pathophysiological processes underlying contralateral pain may include prominent spondylotic changes and the accompanying stenosis; hypertrophic yellow ligament; dural attachments along the posterior longitudinal ligament; nerve root traction forces; and friction radiculitis, migrated epidural fat, nerve root anomaly, and venous congestion inside the vertebral canal. In our pooled analysis, 11 patients reported were treated by bilateral approach with 100% of clinical success and no complications. Eight patients were treated by unilateral approach ipsilateral to pain with 100% of clinical success and no complications. Forty-eight patients were treated by unilateral approach ipsilateral to herniation with 100% of clinical success and no complications. Pathophysiology underlying contralateral pain in LDH is probably multifactorial. There is not enough scientific evidence to define the best surgical approach for patients with LDH and contralateral pain.

Experience With the Endoscopic Contralateral Transmaxillary Approach to the Petroclival Skull Base.

OBJECTIVES/HYPOTHESIS: The contralateral transmaxillary (CTM) approach is a new surgical approach that improves the surgical trajectory relative to the petrous segment of the internal carotid artery (ICA). Here, we present our clinical experience with the CTM approach to the petroclival region of the skull base. STUDY DESIGN: Retrospective review. METHODS: A retrospective review of 29 patients who underwent a CTM approach for skull base pathology from 2015 to 2020 was performed. Assessment of gross total resection (GTR) was based on postoperative imaging. RESULTS: The male:female ratio was 15:14, with an average age of 52 years (range = 19-78 years). Diagnoses included: 12 chondrosarcomas, 11 chordomas, two meningiomas, one schwannoma, one metastasis, one petrous apicitis, and one arachnoid cyst. CTM was performed in addition to a transclival approach and ipsilateral transpterygoid approach in all patients. Reconstruction of surgical defects included a vascularized flap in all but two patients: 24 nasoseptal flaps and three lateral nasal wall flaps. The reconstructive flap was on the same side as the CTM approach in 22 of 28 (79%) patients. There were no ICA injuries. In a subset of patients with chondromatous tumors, GTR of the targeted area was achieved in 16 of 22 (73%) evaluable chondromatous tumors. With a median follow-up of 13 months, 64% of these patients are without disease or dead of other causes; the remainder are alive with disease. CONCLUSIONS: The CTM approach improves the degree of resection of skull base tumors involving the petroclival region using an endoscopic endonasal approach and may minimize risk to the ICA. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:294-298, 2021.

Central versus marginal tympanic membrane perforations: does it matter? An analysis of 792 patients.

BACKGROUND: There is a lack of studies concerning chronic otitis media without cholesteatoma. OBJECTIVES: To perform an analysis of tympanic membrane perforations (TMP), compare the parameters of central and marginal TMP, combining both the traditional and more recent technologies available. MATERIAL AND METHODS: 792 consecutive patients. The TMP subgroups were divided by central and marginal locations and compared based on signs suggestive of previous tympanic retraction, namely, medialized malleus, tympanic remnants over the promontory, tympanic remnants over the ossicular chain, and incus/stapes erosion. Analysis of the status of the contralateral ear (CLE). RESULTS: Central TMP was diagnosed in 79.8%. Compared with the central group, the marginal group had more reported hearing loss (95.6%), greater conductive hearing loss (pure tone average for air-conduction 43.3 dB and average air-bone gap of 28.7 dB), a larger perforated area (46.45%), more posteroinferior quadrant involvement, a greater number retraction signs prior to the TMP, and more changes in the CLE (71%). CONCLUSION: The differences between TMP subgroups are highlighted when we use all technologies available to compare them. Marginal TMPs have more altered parameters than central TMPs. SIGNIFICANCE: There is a great possibility to enhance the knowledge of TMPs and to improve the pathogenesis-based treatment.

Prevalencia de hernia inguinal contralateral diagnosticada por peritoneoscopía con factores de riesgo, en niños y niñas menores de 5 años del 1 de marzo de 2015 al 31 de marzo de 2018 / Prevalence of contralateral inguinal hernia diagnosed by peritoneoscopy with risk factors, in boys and girls under 5 years of age from March 1, 2015 to March 31, 2018

Las hernias inguinales son las anomalías más comunes en pediatría que requieren de tratamiento quirúrgico. El 70% desarrolla una hernia inguinal unilateral y el 30% restante desarrolla hernia inguinal contralateral. La finalidad de llevar a cabo una exploración contralateral es disminuir el riesgo de recurrencia de hernias metacrónicas en pacientes de riesgo que tienen persistencia del processus vaginalis, así como evitar el daño a estructuras subyacentes por llevar a cabo una exploración abierta1,2. El objetivo fue determinar la prevalencia de hernias inguinales contralaterales en niños y niñas menores de 5 años con factores de riesgo, identificadas a través de peritoneoscopía del 1 de marzo de 2015 al 31 de marzo del 2018 en el Hospital Roosevelt. El diseño de este estudio fue descriptivo y transversal. Se realizó en el departamento de Cirugía Pediátrica del Hospital Roosevelt en la ciudad de Guatemala. Los materiales y métodos empleados consistieron en un estudio realizado a través de la revisión de 128 expedientes de menores de 5 años del Departamento de Cirugía Pediátrica del Hospital Roosevelt que hayan presentado una hernia inguinal entre el período indicado y a quiénes se les practicó peritoneoscopía. Como resultado se comprobó que la prevalencia de hernia inguinal contralateral diagnosticada por peritoneoscopía fue del 59% IC(44,72), 26 casos, en cuyos casos se efectuó cirugía correctiva bilateral, sin recurrencia. Esto permitió concluir que la prevalencia de hernias inguinales se da con mayor frecuencia en niños y niñas menores. (AU)

Inguinal hernias are the most common anomalies in pediatrics that require surgical treatment. 70% develop a unilateral inguinal hernia and the remaining 30% develop a contralateral metachronous inguinal hernia. The purpose of performing a contralateral examination is to decrease the risk of recurrence of metachronoushernias in risk patients who have persisten tprocessus vaginalis, as well as to avoid damage to underlying structures by conducting an open exploration1,2. The objective was to determine the prevalence of contralateral inguinal hernias in boys and girls under 5 years of age with risk factors, identified through peritoneoscopy from March 1, 2015 to March 31, 2018 at Roosevelt Hospital. The design of this study was descriptive and transversal. It was performed in the Pediatric Surgery department of the Roosevelt Hospital in Guatemala City. The materials and methods used consisted of a study conducted through the review of 128 records of children under 5 years of the Department of Pediatric Surgery at Roosevelt Hospital who presented an inguinal between the indicated period and who underwent peritoneoscopy. As a result, it was found that the prevalence of contralateral inguinal hernia diagnosed by peritoneoscopy was 59% IC(44,72) 26 cases, in which cases bilateral corrective surgery was performed, without recurrence. This allowed us to conclude that the prevalence of inguinal hernias occurs more frequently in boys and girl. (AU)

An alternative path to atrial lesions through a contralateral interhemispheric transfalcine transcingular infra-precuneus approach: A case report.

BACKGROUND: The surgical management of lesions located in the trigone of the lateral ventricle remains a neurosurgical challenge. Previously described approaches to the atrium include the transtemporal, parietal transcortical, parietal trans intraparietal sulcus, occipital transcingulate, posterior transcallosal, and transfalcine transprecuneus. However, reaching this area specifically through the cingulate cortex below the subparietal sulcus has not been described thus far. CASE DESCRIPTION: We present here the removal of a left atrial meningioma through a right parietal "contralateral interhemispheric transfalcine transcingular infra-precuneus" approach and compare it with previously described midline approaches to the atrium. To accomplish this, a right parietal craniotomy was performed. After the left subprecuneus cingulate cortex was exposed through a window in the falx, a limited corticotomy was performed, which allowed the tumor to be reached after deepening the bipolar dissection by 8 mm. Postoperative magnetic resonance imaging showed complete resection of the lesion sparing the corpus callosum, forceps major, and sagittal stratum. Although this approach disrupts the posterior cingulate fasciculus, no deficits have been described so far after unilaterally disrupting the posterior cingulate cortex or the posterior part of the cingulate fasciculus. In fact, a thorough postoperative cognitive examination did not show any deficits. CONCLUSION: The "contralateral interhemispheric transfalcine transcingular infra-precuneus" approach combines the advantages of several previously described approaches. Since it conserves the major white matter tracts that surround the atrium and has a shorter attack angle than the contralateral transfalcine transprecuneus approach, we believe that it could be a potentially new alternative path to reach atrial lesions.

Data from brain activity during visual working memory replicates the correlation between contralateral delay activity and memory capacity.

This article provides data from statistical analysis of event-related brain potentials (ERPs) and behavioural performance from 23 participants during a working memory task. Specifically, we used the change detection task from Vogel 2004, using the same timing but a modified size and distance between stimuli. Contralateral delay activity (CDA) was calculated from posterior parieto-occipital electrodes and then it was compared between conditions with different memory load (one, two and four items). Working memory capacity (WMC) was calculated from behavioural data using the formula developed by Pashler (1988). Correlation was performed between WMC and the CDA amplitude difference (from two to four items). The correlation replicates the results from the original paper of Vogel 2004 [1], even though some parameters are different from the original design.

Stereological Analysis of Early Gene Expression Using Egr-1 Immunolabeling After Spreading Depression in the Rat Somatosensory Cortex.

Early growth response-1 (Egr-1), defined as a zinc finger transcription factor, is an upstream master switch of the inflammatory response, and its expression can be used to investigate the spatial and temporal extent of inflammatory changes in the brain. Cortical spreading depression (CSD) is characterized as a slowly propagating (2-5 mm/min) depolarization wave through neurons and astrocytes in humans that contributes to migraines and possibly to other brain pathologies. In rodents, CSD can be induced experimentally, which involves unilateral depolarization that is associated with microglial and astrocyte responses. The impact of CSD on structures beyond the affected hemisphere has not been explored. Here, we used an optical fractionator method to investigate potential correlations between the number of and period of the eletrophysiologic record of CSD phenomena and Egr-1 expression in ipsilateral and contralateral hemispheres. CSD was elicited by the restricted application of a 2% KCl solution over the left premotor cortex. Electrophysiological events were recorded using a pair of Ag/AgCl agar-Ringer electrodes for 2 or 6 h. An optical fractionator was applied to count the Egr-1 positive cells. We found that CSD increased Egr-1 expression in a time- and event-dependent manner in the ipsilateral/left hemisphere. Although CSD did not cross the midline, multiple CSD inductions were associated with an increased number of Egr-1 positive cells in the contralateral/right hemisphere. Thus, repeated CSD waves may have far reaching effects that are more global than previously considered possible. The mechanism of contralateral expression is unknown, but we speculate that callosal projections from the depolarized hemisphere may be related to this phenomenon.

High-throughput mass spectrometry and bioinformatics analysis of breast cancer proteomic data.

Data present here describe a comparative proteomic analysis among the malignant [primary breast tumor (PT) and axillary metastatic lymph nodes (LN)], and the non-tumor [contralateral (NCT) and adjacent (ANT)] breast tissues. Protein identification and quantification were performed through label-free mass spectrometry using a nano-liquid chromatography coupled to an electrospray ionization-mass spectrometry (nLC-ESI-MS/MS). The mass spectrometry proteomic data have been deposited to the ProteomeXchange Consortium via PRIDE partner repository with the dataset identifier PXD012431. A total of 462 differentially expressed proteins was identified among these tissues and was analyzed in six groups' comparisons (named NCTxANT, PTxNCT, PTxANT, LNxNCT, LNxANT and PTxLN). Proteins at 1.5 log2 fold change were submitted to the Ingenuity® Pathway Analysis (IPA) software version 2.3 (QIAGEN Inc.) to identify biological pathways, disease and function annotation, and interaction networks related to cancer biology. The detailed data present here provides information about the proteome alterations and their role on breast tumorigenesis. This information can lead to novel biological insights on cancer research. For further interpretation of these data, please see our research article 'Quantitative label-free mass spectrometry using contralateral and adjacent breast tissues reveal differentially expressed proteins and their predicted impacts on pathways and cellular functions in breast cancer' [2].

Mastectomía de Reducción de Riesgo Contralateral: impacto en la evolución de las pacientes. Experiencia del Hospital Británico de Buenos Aires / Contralateral prophylactic mastectomy: impact on the outcome of patients at the Buenos Aires British Hospital

Introducción La Mastectomía de Reducción de Riesgo Contralateral (mrrc) se ha incrementado considerablemente en los últimos años. Este aumento llama la atención debido a que la incidencia del carcinoma de mama contralateral ha disminuido gracias al diagnóstico temprano y a los avances en los tratamientos adyuvantes. No se ha podido demostrar un claro beneficio de la mrrc en la Supervivencia Global (sg), en especial en las pacientes de bajo riesgo. Objetivos Describir la evolución y las características de las pacientes con diagnóstico de cáncer de mama unilateral que optaron por realizar mrrc en el Servicio de Mastología del Hospital Británico de Buenos Aires, analizando la aparición de carcinoma contralateral, la Supervivencia Libre de Enfermedad (sle) y la Supervivencia Global (sg), y compararla con un grupo de pacientes a quienes se les realizó Mastectomía Terapéutica Unilateral (mtu). Material y método Se realizó un estudio retrospectivo de pacientes con diagnóstico de cáncer de mama unilateral tratadas con mastectomía y sometidas a mrrc entre octubre de 2005 y noviembre de 2014. Se incluyeron 46 pacientes que recibieron mrrc, y en el grupo control a 140 pacientes a las que se les realizó mtu en el mismo período de tiempo y rango etario. El seguimiento medio en el grupo de mrrc fue de 49,3 meses y en el grupo de mtu de 43,3 meses. Resultados La incidencia anual del carcinoma contralateral fue de 0,5% en nuestra casuística. Las curvas de Kaplan Meier para supervivencia libre de enfermedad y supervivencia global no muestran diferencias significativas entre ambos grupos. Tampoco se observan diferencias en los subgrupos analizados de mujeres menores de 50 años y receptores estrogénicos (re) negativos. Conclusiones No hubo beneficio en cuanto a sle y sg en las pacientes sometidas a mrrc comparadas con el grupo de mtu, aun en los subgrupos considerados de mayor riesgo como aquellas pacientes menores de 50 años y Receptores de Estrógenos (re) negativos. No hubo desarrollo de carcinomas contralaterales en el grupo de mrrc. Al ser un procedimiento solicitado por las pacientes, es importante que el cirujano cuente con la información adecuada para poder brindar la mejor recomendación para cada una de ellas

Introduction Contralateral Prophylactic Mastectomy (cpm) has considerably increased in recent years. Such increase calls our attention, since the incidence of contralateral breast carcinoma has decreased as a result of early diagnosis and of the progress made with adjuvant therapies. No clear benefit in Overall Survival (os) was proven, particularly in low risk patients. Objectives To describe the evolution and characteristics of patients with unilateral breast cancer who decided to undergo cpm at the Buenos Aires British Hospital Breast Services Unit, analyzing the appearance of contralateral carcinoma, Disease-Free Survival (dfs) and Overall Survival (os), compared to a group of patients who underwent unilateral mastectomy. Materials and method A retrospective trial was conducted on patients diagnosed with unilateral breast cancer who underwent mastectomy and cpm between October 2005 and November 2014. During the same time period and among the same age group, 46 patients received cpm and 140 patients, from the control group, underwent unilateral mastectomy. The mean follow-up period was of 49.3 months for the cpm group, and of 43.3 months for the unilateral mastectomy group. Results The annual incidence of contralateral carcinoma was 0.5% in our cases. Kaplan Meier curves for disease-free survival (dfs) and overall survival (os) show no significant differences between both groups. The same is true for subgroups of women under 50 years old with negative estrogen receptors. Conclusions There was no benefit in terms of dfs and os in patients who underwent cpm against the unilateral mastectomy group, even in subgroups considered of higher risk, such as patients under 50 and with negative er. There were no contralateral carcinomas in the cpm group. Since this procedure is requested by patients, it is important for the surgeon to have the correct information to be able to provide the best recommendation in each case