Metamorphic Effect of Angiogenic Switch in Tumor Development: Conundrum of Tumor Angiogenesis Toward Progression and Metastatic Potential.

Our understanding of angiogenesis has significantly expanded over the past five decades. More recently, research has focused on this process at a more molecular level, looking at it through the signaling pathways that activate it and its non-direct downstream effects. This review discusses current findings in molecular angiogenesis, focusing on its impact on the immune system. Moreover, the impairment of this process in cancer progression and metastasis is highlighted, and current anti-angiogenic treatments and their effects on tumor growth are discussed.

Role of Surface Adsorbates on the Photoresponse of (MO)CVD-Grown Graphene-MoS2 Heterostructure Photodetectors.

A promising strategy toward ultrathin, sensitive photodetectors is the combination of a photoactive semiconducting transition-metal dichalcogenide (TMDC) monolayer like MoS2 with highly conductive graphene. Such devices often exhibit a complex and contradictory photoresponse as incident light can trigger both photoconductivity and photoinduced desorption of molecules from the surface. Here, we use metal-organic chemical vapor deposition (MOCVD) to directly grow MoS2 on top of graphene that is deposited on a sapphire wafer via chemical vapor deposition (CVD) for realizing graphene-MoS2 photodetectors. Two-color optical pump-electrical probe experiments allow for separation of light-induced carrier transfer across the graphene-MoS2 heterointerface from adsorbate-induced effects. We demonstrate that adsorbates strongly modify both magnitude and sign of the photoconductivity. This is attributed to a change of the graphene doping from p- to n-type in case adsorbates are being desorbed, while in either case, photogenerated electrons are transferred from MoS2 to graphene. This nondestructive probing method sheds light on the charge carrier transfer mechanisms and the role of adsorbates in two-dimensional (2D) heterostructure photodetectors.

Harmony COVID-19: a ready-to-use kit, low-cost detector, and smartphone app for point-of-care SARS-CoV-2 RNA detection

RNA amplification tests allow sensitive detection of SARS-CoV-2 infection, but their complexity and cost are prohibitive for expanding COVID-19 testing. We developed "Harmony COVID-19", a point-of-care test using inexpensive consumables, ready-to-use reagents, and a simple device that processes up to 4 samples simultaneously. Our lyophilized reverse-transcription, loop-mediated isothermal amplification (RT-LAMP) can detect as little as 15 SARS-CoV-2 RNA copies per reaction, and it can report as early as 17 min for samples with high viral load (2 x 105 RNA copies per reaction). Analysis of RNA extracted from clinical nasal specimens (n = 101) showed 95% concordance with RT-PCR, including 100% specificity in specimens positive for other viruses and bacteria. Analysis of contrived samples in the nasal matrix showed detection of 92% or 100% in samples with [≥]20 or [≥]100 particles per reaction, respectively. Usability testing showed 95% accuracy by healthcare workers operating the test for the first time. ONE SENTENCE SUMMARYHarmony COVID-19: point-of-care SARS-CoV-2 RNA detection

Correction: Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study.

[This corrects the article DOI: 10.2196/22161.].

Undergraduate Medical Competencies in Digital Health and Curricular Module Development: Mixed Methods Study.

BACKGROUND: Owing to an increase in digital technologies in health care, recently leveraged by the COVID-19 pandemic, physicians are required to use these technologies appropriately and to be familiar with their implications on patient care, the health system, and society. Therefore, medical students should be confronted with digital health during their medical education. However, corresponding teaching formats and concepts are still largely lacking in the medical curricula. OBJECTIVE: This study aims to introduce digital health as a curricular module at a German medical school and to identify undergraduate medical competencies in digital health and their suitable teaching methods. METHODS: We developed a 3-week curricular module on digital health for third-year medical students at a large German medical school, taking place for the first time in January 2020. Semistructured interviews with 5 digital health experts were recorded, transcribed, and analyzed using an abductive approach. We obtained feedback from the participating students and lecturers of the module through a 17-item survey questionnaire. RESULTS: The module received overall positive feedback from both students and lecturers who expressed the need for further digital health education and stated that the field is very important for clinical care and is underrepresented in the current medical curriculum. We extracted a detailed overview of digital health competencies, skills, and knowledge to teach the students from the expert interviews. They also contained suggestions for teaching methods and statements supporting the urgency of the implementation of digital health education in the mandatory curriculum. CONCLUSIONS: An elective class seems to be a suitable format for the timely introduction of digital health education. However, a longitudinal implementation in the mandatory curriculum should be the goal. Beyond training future physicians in digital skills and teaching them digital health's ethical, legal, and social implications, the experience-based development of a critical digital health mindset with openness to innovation and the ability to assess ever-changing health technologies through a broad transdisciplinary approach to translate research into clinical routine seem more important. Therefore, the teaching of digital health should be as practice-based as possible and involve the educational cooperation of different institutions and academic disciplines.

Adenomioepitelioma de mama. Presentación de un caso / Adenomyoepithelioma of the breast. A case presentation

RESUMEN El adenomioepitelioma es un tumor de la mama poco frecuente, generalmente de comportamiento benigno, de histología variable, que puede simular otras lesiones epiteliales, mioepiteliales y bifásicas de la mama. Patológicamente es un desorden raro caracterizado por la proliferación simultánea de las células del epitelio ductal y células mioepiteliales. Es más común en las glándulas salivales o en la piel, raras veces es encontrado en el tejido mamario. Afecta fundamentalmente al sexo femenino, alrededor de los 50 años de edad. Clínicamente se presenta por una pequeña masa palpable que ocupa cuadrantes centrales de la mama. El tratamiento de elección es la exéresis amplia de la lesión. Es frecuente la recidiva local y en algunas ocasiones puede tener degeneración maligna. Se presentó una paciente 13 años de edad, que acudió al Servicio de Cirugía del Hospital "Dr. Mario Muñoz Monroy" , municipio Colón, provincia de Matanzas con un tumor de consistencia dura; pero no pétreo, de 8-10 cm de diámetro, en cuadrantes inferiores y región retroareolar de la mama derecha. El estudio sonográfico informó la presencia de una imagen hipoecoica, de forma oval. Se realizó exéresis de la lesión. El estudio patológico e inmunohistoquímico aportó un adenomioepitelioma de la mama. La paciente no presentó complicaciones postoperatorias. Actualmente se sigue por consulta a 7 años de la cirugía (AU).

ABSTRACT Adenomyoepithelioma is a very rare and generally benign tumor of varying histology that can simulate other epithelial, myoepithelial and biphasic lesions of the breast. Pathologically it is rare disorder characterized by the simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands and in skin. Rarely found in mammal tissue, it mainly affects women, aged around 50 years, and clinically presents like a palpable mass occupying central breast quadrants. The treatment of choice is the extensive excision of the lesion. Local recidivisms is very frequent, and sometimes they could have malignant degeneration. The authors present the case of a female patient, aged 13 years, who assisted the service of Surgery of the Hospital "Dr. Mario Muñoz Monroy", municipality of Colon, province of Matanzas with a tumor of hard consistence, of 8-10 cm diameter, in lower quadrants and retro alveolar region of the right mamma. The sonographic study informed the presence of a hypoechoic, oval image. The lesion was excised. The pathological and immunohistochemical study showed a breast adenomyoepithelioma. The patient did not have post-surgery complications. Currently she is followed in consultation after seven years of the surgery (AU).

Adenomioepitelioma de mama. Presentación de un caso / Adenomyoepithelioma of the breast. A case presentation

RESUMEN El adenomioepitelioma es un tumor de la mama poco frecuente, generalmente de comportamiento benigno, de histología variable, que puede simular otras lesiones epiteliales, mioepiteliales y bifásicas de la mama. Patológicamente es un desorden raro caracterizado por la proliferación simultánea de las células del epitelio ductal y células mioepiteliales. Es más común en las glándulas salivales o en la piel, raras veces es encontrado en el tejido mamario. Afecta fundamentalmente al sexo femenino, alrededor de los 50 años de edad. Clínicamente se presenta por una pequeña masa palpable que ocupa cuadrantes centrales de la mama. El tratamiento de elección es la exéresis amplia de la lesión. Es frecuente la recidiva local y en algunas ocasiones puede tener degeneración maligna. Se presentó una paciente 13 años de edad, que acudió al Servicio de Cirugía del Hospital "Dr. Mario Muñoz Monroy" , municipio Colón, provincia de Matanzas con un tumor de consistencia dura; pero no pétreo, de 8-10 cm de diámetro, en cuadrantes inferiores y región retroareolar de la mama derecha. El estudio sonográfico informó la presencia de una imagen hipoecoica, de forma oval. Se realizó exéresis de la lesión. El estudio patológico e inmunohistoquímico aportó un adenomioepitelioma de la mama. La paciente no presentó complicaciones postoperatorias. Actualmente se sigue por consulta a 7 años de la cirugía.

ABSTRACT Adenomyoepithelioma is a very rare and generally benign tumor of varying histology that can simulate other epithelial, myoepithelial and biphasic lesions of the breast. Pathologically it is rare disorder characterized by the simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands and in skin. Rarely found in mammal tissue, it mainly affects women, aged around 50 years, and clinically presents like a palpable mass occupying central breast quadrants. The treatment of choice is the extensive excision of the lesion. Local recidivisms is very frequent, and sometimes they could have malignant degeneration. The authors present the case of a female patient, aged 13 years, who assisted the service of Surgery of the Hospital "Dr. Mario Muñoz Monroy", municipality of Colon, province of Matanzas with a tumor of hard consistence, of 8-10 cm diameter, in lower quadrants and retro alveolar region of the right mamma. The sonographic study informed the presence of a hypoechoic, oval image. The lesion was excised. The pathological and immunohistochemical study showed a breast adenomyoepithelioma. The patient did not have post-surgery complications. Currently she is followed in consultation after seven years of the surgery.

Complejo extrofia vesical-epispadias. Reporte de un caso / Bladder exstrophy-epispadias complex. A case report

RESUMEN La extrofia vesical es una grave anomalía del desarrollo embriológico del seno urogenital y del sistema esquelético vecino. Se caracteriza por una falla de la pared anterior del abdomen y de la vejiga, cuya cara posterior-inferior, evertida hacia afuera, protruye en forma de hernia y exterioriza por completo el trígono, con los meatos ureterales eyaculando directamente hacia la pared abdominal; la asociación con epispadias es la regla. Se describió el caso de una paciente pediátrica con diagnóstico del complejo extrofia vesical-epispadias, entidad poco frecuente en nuestro medio, la cual evolucionó de manera favorable y se encuentra en espera de un segundo tiempo quirúrgico como parte de su tratamiento (AU).

ABSTRACT The bladder exstrophy is a serious anomaly of theurogenital sinus´ embryologic development and the close skeletal system, characterized by a failure of the abdomen anterior wall and bladder, whose posterior inferior face, turned outside out, protrudes like an hernia and completely exteriorizes the trigone, with the ureteral meatuses ejaculating right down to the abdominal wall; the association with epispadias is the rule. It was described the case of a pediatric patient with diagnosis of exstrophy- epispadias complex, infrequent entity in our country, who has evolved with great results and is waiting a second surgical time to finish her treatment (AU).

Complejo extrofia vesical-epispadias. Reporte de un caso / Bladder exstrophy-epispadias complex. A case report

RESUMEN La extrofia vesical es una grave anomalía del desarrollo embriológico del seno urogenital y del sistema esquelético vecino. Se caracteriza por una falla de la pared anterior del abdomen y de la vejiga, cuya cara posterior-inferior, evertida hacia afuera, protruye en forma de hernia y exterioriza por completo el trígono, con los meatos ureterales eyaculando directamente hacia la pared abdominal; la asociación con epispadias es la regla. Se describió el caso de una paciente pediátrica con diagnóstico del complejo extrofia vesical-epispadias, entidad poco frecuente en nuestro medio, la cual evolucionó de manera favorable y se encuentra en espera de un segundo tiempo quirúrgico como parte de su tratamiento (AU).

ABSTRACT The bladder exstrophy is a serious anomaly of theurogenital sinus´ embryologic development and the close skeletal system, characterized by a failure of the abdomen anterior wall and bladder, whose posterior inferior face, turned outside out, protrudes like an hernia and completely exteriorizes the trigone, with the ureteral meatuses ejaculating right down to the abdominal wall; the association with epispadias is the rule. It was described the case of a pediatric patient with diagnosis of exstrophy- epispadias complex, infrequent entity in our country, who has evolved with great results and is waiting a second surgical time to finish her treatment (AU).

Complications of polypropylene mesh for the treatment of female pelvic floor disorders.

OBJECTIVES: To assess the complications of polypropylene mesh in the treatment of female pelvic floor disorders. METHODS: Retrospective study of patients with pelvic floor pathology (SUI, cystocele, rectocele, enterocele) undergoing pelvic floor intervention with surgical meshes from March 2002 to October 2009. We evaluated complications, effectiveness of the technique and distribution of the impact of the results. For statistical analysis SPSS software was used and the curve of impact was estimated by Cox model. RESULTS: We analyzed 363 patients. Of these 363 patients, 290 (79.9%) suffered from Stress Urinary Incontinence 37 (10.2%)cystocele, 33 (9.4%) SUI and cystocele, 1 (0.3%) SUI and enterocele, 1 (0.3%) cystocele and enterocele and 1 (0.3%) cystocele, enterocele and rectocele. The interventions done were: 34 (9.4%) anterior and middle compartment meshes, 1 (0.3%) middle and posterior compartment meshes, 1 (0.3%) TOT and middle and posterior compartment mesh, 36 (9.9%) TVT and 3 (0.8%) TVT and anterior and middle compartment mesh. The median follow-up was 36 (3-90) months. 50 patients (13.8%) presented complications: 21 (42%) had lower urinary tract irritative symptoms, 10 (20%) externalization of the mesh, 3 (6%) necrotizing fascitis, 3 (6%)obturator fossa, thigh root or vaginal abscess, 5 (10%) chronic pelvic pain, thigh pain or dyspareunia, 2 (4%) bruising and bleeding, 3 (6%) urinary tract infections, 1 (2%)mesh entering bladder and 2 (4%) obstructive symptoms. The procedures were effective in 350 (96.4%)patients. The impact of complications was manifested in the first 10 months after surgery. CONCLUSIONS: Polypropylene meshes are very effective in the treatment of female pelvic floor disorders. Approximately 10% of the patients had complications that resolved spontaneously or with medical treatment in most cases. One third of the complications are subsidiaries of surgery, by removing the mesh totaly or partialy, without affecting the intervention results.