Factores dietéticos asociados al cáncer de próstata. Beneficios de la dieta mediterránea / Dietetic Factors Associated With Prostate Cancer. Protective Effects of Mediterranean Diet

Objetivo: Revisar los factores de riesgo (FR) dietéticos implicados, con mayor o menor evidencia científica, en la etiopatogenia del carcinoma de próstata (CP), especialmente los característicos de la tradicional dieta mediterránea (DM). Material y métodos: Revisión bibliográfica de los FR dietéticos asociados al CP obtenida de MedLine, CancerLit, Science Citation Index y Embase. Los perfiles de búsqueda han sido Dietetic Factors/ Nutritional Factors/ Mediterranean Diet/ Primary Prevention y Prostate Cancer. Resultados: Los FR dietéticos se asocian al 35% de las muertes por cáncer y al 10-12% del CP. Los principales FR dietéticos, implicados en el CP y característicos de la DM, son los siguientes: ingesta diaria y elevada de alimentos vegetales (cereales, legumbres, frutas frescas-secas, tubérculos, verduras, etc.); consumo de aceite de oliva como lípido habitual; baja ingesta de grasa saturada animal, carne roja y procesada, leche y derivados; consumo regular de pescado pequeño; y escaso consumo alcohólico (vino en las comidas). La DM proporciona numerosos compuestos fitoactivos (licopeno, lupeol, quercetina, genisteína, carnosol, resveratrol, catequinas, vitaminas, etc.) con efectos protectores del CP. Conclusiones: Los FR dietéticos influencian la carcinogénesis prostática. Para conocer con más exactitud los FR dietéticos implicados en el CP son necesarios mejores diseños epidemiológicos. La mayor adherencia a la DM, en contraste con las dietas occidentales, se asocia a menor riesgo de CP. El denominador común del efecto preventivo de la DM se basa en la gran cantidad y calidad de fitoquímicos con propiedades antioxidantes y antiinflamatorias (AU)

Objective: To review diet risk factors (RF) implied, more or less evidence-based, in the etiopathology of prostate carcinoma (PC), especially those that characterize the traditional mediterranean diet (MD). Material and methods: Literature review of PC related diet RF in MedLine, CancerLit, Science Citation Index y Embase. Search profiles were "Dietetic Factors/Nutritional Factors/Mediterranean Diet/Primary Prevention", and "Prostate Cancer". Results: Diet RF are associated with 35% of cancer mortality and 10-12% of PC mortality. The main diet RF, implied in the development of PC but with a protective effect, which are considered characteristic of MD are: high daily ingestion of vegetarian products (cereals, legums, dried and fresh fruits, tubercles, vegetables..); olive oil as main lipid source; low intake of animal saturated fat, processed red meat, milk and dairy products; regular consumption of small fish; and low alcohol intake (wine with meals). The MD contains many phytoactive compounds (lycopene, lupeol, quercetin, genistein, carnosol, resveratrol, catechins, vitamins...) with PC protective effects. Conclusions: Diet RF have a role on prostatic carcinogenesis. Further epidemiologic studies with better designs are needed to clarify PC related diet RF. PC risk is reduced in persons on MD compared with those on western diet. The preventive effect of MD is due to the great number and quality of phytochemicals with antioxidant and antinflammatory properties that contains (AU)

[Dietetic factors associated with prostate cancer: protective effects of Mediterranean diet]. / Factores dietéticos asociados al cáncer de próstata. Beneficios de la dieta mediterránea.

OBJECTIVE: To review diet risk factors (RF) implied, more or less evidence-based, in the etiopathology of prostate carcinoma (PC), especially those that characterize the traditional Mediterranean diet (MD). MATERIAL AND METHODS: Literature review of PC related diet RF in MedLine, CancerLit, Science Citation Index y Embase. Search profiles were "Dietetic Factors/Nutritional Factors/Mediterranean Diet/Primary Prevention", and "Prostate Cancer". RESULTS: Diet RF are associated with 35% of cancer mortality and 10-12% of PC mortality. The main diet RF, implied in the development of PC but with a protective effect, which are considered characteristic of MD are: high daily ingestion of vegetarian products (cereals, legumes, dried and fresh fruits, tubers, vegetables..); olive oil as main lipid source; low intake of animal saturated fat, processed red meat, milk and dairy products; regular consumption of small fish; and low alcohol intake (wine with meals). The MD contains many phytoactive compounds (lycopene, lupeol, quercetin, genistein, carnosol, resveratrol, catechins, vitamins..) with PC protective effects. CONCLUSIONS: Diet RF have a role on prostatic carcinogenesis. Further epidemiologic studies with better designs are needed to clarify PC related diet RF. PC risk is reduced in persons on MD compared with those on Western diet. The preventive effect of MD is due to the great number and quality of phytochemicals with antioxidant and antinflammatory properties that contains.

[Neonatal tumours and congenital malformations]. / Tumores neonatales y malformaciones congénitas.

INTRODUCTION: The association between pediatric cancer and congenital abnormalities is well known but, there is no exclusive data on the neonatal period and the underlying etiopathogenic mechanisms are unknown. OBJECTIVES: First, to analyze the frequency of neonatal tumours associated with congenital abnormalities; and second, to comment on the likely etiopathogenic hypotheses of a relationship between neonatal tumours and congenital abnormalities. MATERIALS AND METHOD: Historical series of neonatal tumours from La Fe University Children's Hospital in Valencia (Spain), from January 1990 to December 1999. Histological varieties of neonatal tumours and associated congenital abnormalities were described. A systematic review of the last 25 years was carried out using Medline, Cancerlit, Index Citation Science and Embase. The search profile used was the combination of "neonatal/congenital-tumors/cancer/neoplasms" and "congenital malformations/birth defects". RESULTS: 72 neonatal tumours were identified (2.8% of all pediatric cancers diagnosed in our hospital) and in 15 cases (20.8%) there was some associated malformation, disease or syndrome. The association between congenital abnormalities and neonatal tumours were: a) angiomas in three patients: two patients with congenital heart disease with a choanal stenosis, laryngomalacia; b) neuroblastomas in two patients: horseshoe kidney with vertebral anomalies and other with congenital heart disease; c) teratomas in two patients: one with cleft palate with vertebral anomalies and other with metatarsal varus; d) one tumour of the central nervous system with Bochdaleck hernia; e) heart tumours in four patients with tuberous sclerosis; f) acute leukaemia in one patient with Down syndrome and congenital heart disease; g) kidney tumour in one case with triventricular hydrocephaly, and h) adrenocortical tumour: hemihypertrophy. The publications included the tumours diagnosed in different pediatric periods and without unified criteria to classify the congenital abnormalities. Little data exist on the neonatal period and the majority are from medical institutions registers. The prevalence varies from 15 to 31.6%. To explain this association, the hypotheses are based on prenatal exposures (preconceptional and transplacental exposure), to mutagenic and carcinogenic risk factors. CONCLUSIONS: Neonatal tumours are more often associated to congenital abnormalities than other pediatric cancers. The inclusion and classification criteria needs to be unified to better understand the association between the neonatal tumours and congenital abnormalities. The environmental history in all neonatal tumours associated to congenital abnormalities, including the constitutional and environmental risk factors, will help to improve our knowledge of the underlying prenatal mechanisms and to an advance in its prevention.

Tumores neonatales y malformaciones congénitas / Neonatal tumours and congenital malformations

Introducción: La asociación entre tumores y malformaciones congénitas está bien establecida, pero no existen datos exclusivos en el período neonatal y se desconocen los mecanismos subyacentes que generan dicha relación. Objetivos: Este trabajo tiene dos objetivos: primero, analizar la frecuencia de los tumores neonatales asociados a malformaciones congénitas, y segundo, comentar las posibles hipótesis etiopatogénicas de la relación entre ambas entidades. Materiales y método: Estudio retrospectivo de las historias clínicas de los tumores neonatales, en el Hospital Universitario Materno-Infantil La Fe de Valencia, desde enero de 1990 hasta diciembre de 1999. Selección y descripción de las variedades histológicas asociadas a malformaciones congénitas. Éstas se han agrupado siguiendo los criterios de la Clasificación Internacional de Enfermedades CIE-9, códigos 740.0-759.9. Revisión sistemática bibliográfica de los últimos 25 años, obtenida del Medline, Cancerlit, Index Citation Science y Embase. El perfil de búsqueda utilizado fue la combinación de "neonatal/congenital-tumors/cancer/ neoplasms" y "congenital malformations/birth defects". Resultados: Se identificaron 72 tumores neonatales (2,8 % del total de tumores pediátricos diagnosticados en dichos años) y 15 de ellos (20,8 %) asociados a malformaciones congénitas, enfermedades o síndromes congénitos. Las asociaciones entre tumores neonatales y malformaciones congénitas fueron las siguientes: a) angioma en 3 pacientes: con dos cardiopatías congénitas y una atresia de coanas-laringomalacia; b) neuroblastoma en 2 pacientes: uno con riñón en herradura y anomalías vertebrales, y otro con cardiopatía congénita; c) teratoma en 2 pacientes: uno con fisura palatina y anomalías vertebrales, y otro con metatarso varo; d) tumor del sistema nervioso central en un paciente con hernia de Bochdaleck; e) tumor cardíaco en 4 pacientes con esclerosis tuberosa; f) leucemia aguda en un paciente con síndrome de Down y cardiopatía congénita; g) tumor renal en un caso con hidrocefalia triventricular, y h) tumor adrenal en un caso con hemihipertrofia. En la bibliografía específica, las publicaciones engloban tumores de diferentes épocas pediátricas y sin unanimidad de criterios para clasificar las malformaciones congénitas. Apenas existen datos en el período neonatal y la asociación entre ambas entidades se obtiene de registros de instituciones médicas. La prevalencia oscila entre el 15 y el 31,6 %. Las hipótesis etiopatogénicas que explican la asociación entre tumores neonatales y malformaciones congénitas están basadas en las exposiciones prenatales (preconcepcionales y transplacentarias) a factores de riesgo potencialmente mutagénicos y carcinogénicos. Conclusiones: Probablemente, los tumores neonatales se asocian con mayor frecuencia a malformaciones congénitas que los tumores diagnosticados en épocas posteriores de la vida. Para conocer la prevalencia real de la asociación entre tumores neonatales y malformaciones congénitas, es necesario unificar los criterios de inclusión y definición de ambas entidades. La obtención de una minuciosa historia medioambiental en todos los tumores neonatales asociados a malformaciones congénitas, donde se detallen y registren todos los factores de riesgo constitucionales y ambientales, es fundamental para mejorar nuestros escasos conocimientos de los mecanismos prenatales subyacentes y avanzar en su prevención (AU)

Introduction: The association between pediatric cancer and congenital abnormalities is well known but, there is no exclusive data on the neonatal period and the underlying etiopathogenic mechanisms are unknown. Objectives: First, to analyze the frequency of neonatal tumours associated with congenital abnormalities; and second, to comment on the likely etiopathogenic hypotheses of a relationship between neonatal tumours and congenital abnormalities. Materials and method: Historical series of neonatal tumours from La Fe University Children’s Hospital in Valencia (Spain), from January 1990 to December 1999. Histological varieties of neonatal tumours and associated congenital abnormalities were described. A systematic review of the last 25 years was carried out using Medline, Cancerlit, Index Citation Science and Embase. The search profile used was the combination of "neonatal/congenital-tumors/cancer/neoplasms" and "congenital malformations/birth defects". Results: 72 neonatal tumours were identified (2.8 % of all pediatric cancers diagnosed in our hospital) and in 15 cases (20.8 %) there was some associated malformation, disease or syndrome. The association between congenital abnormalities and neonatal tumours were: a) angiomas in three patients: two patients with congenital heart disease with a choanal stenosis, laryngomalacia; b) neuroblastomas in two patients: horseshoe kidney with vertebral anomalies and other with congenital heart disease; c) teratomas in two patients: one with cleft palate with vertebral anomalies and other with metatarsal varus; d) one tumour of the central nervous system with Bochdaleck hernia; e) heart tumours in four patients with tuberous sclerosis; f) acute leukaemia in one patient with Down syndrome and congenital heart disease; g) kidney tumour in one case with triventricular hydrocephaly, and h) adrenocortical tumour: hemihypertrophy. The publications included the tumours diagnosed in different pediatric periods and without unified criteria to classify the congenital abnormalities. Little data exist on the neonatal period and the majority are from medical institutions registers. The prevalence varies from 15 to 31.6 %. To explain this association, the hypotheses are based on prenatal exposures (preconceptional and transplacental exposure), to mutagenic and carcinogenic risk factors. Conclusions: Neonatal tumours are more often associated to congenital abnormalities than other pediatric cancers. The inclusion and classification criteria needs to be unified to better understand the association between the neonatal tumours and congenital abnormalities. The environmental history in all neonatal tumours associated to congenital abnormalities, including the constitutional and environmental risk factors, will help to improve our knowledge of the underlying prenatal mechanisms and to an advance in its prevention (AU)

Neurotóxicos medioambientales (y II). Metales: efectos adversos en el sistema nervioso fetal y posnatal / Environmental toxins. Metals: adverse effects on the fetal and postnatal nervous systems

Objetivo. Divulgar entre los pediatras la neurotoxicidad del plomo (Pb), mercurio (Hg), manganeso (Mn) y cadmio (Cd) sobre el SNC y las medidas preventivas para minimizar y eliminar su uso en los hábitats fetal, infantil y juvenil. Material y métodos. Revisión bibliográfica sistemática de los efectos del Pb, Hg, Mn, y Cd en el SNC en desarrollo. Búsqueda en las bases de datos Medline, Science Citation Index y Embase de los últimos 20 años de los trabajos observacionales de exposición a bajas dosis en humanos y de experimentación en animales. Resultados. 1) Los principales efectos neurotóxicos de la exposición fetal e infantil a niveles incrementados de Pb son: déficit de atención, disminución del rendimiento y fracaso escolar, impulsividad, agresividad y conducta delictiva; 2) la exposición a Hg en dosis altas provoca retraso mental, alteraciones visuales y de la marcha, y en bajas dosis, del lenguaje, la atención y la memoria; 3) en diversas comunidades autónomas, la población pediátrica supera los límites de seguridad de ingestión de Hg recomendados por la U.S. Environmental Pro-tection Agency; 4) el Mn provoca trastornos de hiperactividad y aprendizaje; 5) la leche materna contiene 6 μg/L de Mn, las fórmulas artificiales unos 77 μg/L, si han sido suplementadas, alrededor de 100 μg/L, y las fórmulas de soja, hasta 300 μg/L; y 6) la exposición al Cd produce trastornos de hiperactividad, alteraciones de la capacidad verbal y disminución del coeficiente intelectual. Conclusiones. 1) Los efectos del Pb, Hg, Mn y Cd sobre el SNC fetal e infantil pueden aparecer con niveles inferiores a los considerados como «seguros»; 2) los pediatras debemos recomendar alternativas para minimizar y eliminar los metales neurotóxicos del entorno infantil; 3) es necesario cuantificar la ingestión diaria de Hg y reducir de forma cautelar el consumo de algunos peces (atún, caballa, emperador, perca, lucio...) en niños, madres lactantes y en mujeres embarazadas y en edades fértiles; 4) los lactantes con fórmulas artificiales ingieren más cantidad de Mn; y 5) las unidades de salud medioambiental pediátrica deben poner en marcha las historias ambientales en los niños con enfermedades neurológicas

Objective. To make pediatricians aware of the effects of the neurotoxicity of lead (Pb), mercury (Hg), manganese (Mn) and cadmium (Cd) on the CNS and inform them of the preventive measures that can minimize or eliminate their use in fetal, childhood and adolescent environments. Material and methods. A systematic literature search was carried out to explore the effects of Pb, Hg, Mn and Cd on the developing CNS. The search was carried out in the Medline, Science Citation Index and Embase databases and involved observational studies on low-dose exposure in humans and in laboratory animals over the past 20 years. Results. 1) The major neurotoxic effects derived from fetal and postnatal exposure to elevated levels of Pb are attention deficits, below average school performance, increased impulsiveness, aggressiveness and delinquent behavior. 2) Fetal exposure to high-dose Hg causes mental retardation and gait and visual disturbances, and fetal exposure to lower doses may cause lasting impairments in language, attention and memory. 3) In certain autonomous communities, the pediatric population surpasses the safety limits of Hg recommended by the US Environmental Protection Agency. 4) Mn causes hyperactivity and learning disabilities. 5) Breast milk contains 6 μg of Mn per liter; infant formulas about 77 μg/L; the latter, when supplemented, around 100 μg/L; and soy-based formulas up to 300 μg/L. 6) Exposure to Cd in children has been shown to result in hyperactivity and lower verbal and performance intelligence quotients. Conclusions. 1) The effects of Pb, Hg, Mn and Cd on the fetal and postnatal CNS can occur at lower levels of exposure considered "safe". 2) Pediatricians have to recommend alternatives to minimize and eliminate the neurotoxic metals in the childhood environment. 3) As a preventive measure, it is necessary to quantify and decrease the daily Hg intake of children, nursing mothers, pregnant women and women of reproductive age, and reduce the consumption of certain fish (tuna, mackerel, sword fish, perch, pike, etc.). 4) Formula-fed infants ingest a much greater quantity of Mn. 5) Pediatric Environmental Health Units should implement environmental histories in children with neurological disorders

[Environment and pediatric cancer]. / Medio ambiente y cáncer pediátrico.

BACKGROUND: Cancer is the final result of the variable combination of two determinants: endogenous or constitutional factors and exogenous or environmental factors. Between 85 % and 96 % of pediatric cancers (PC) are probably associated with environmental risk factors (RF), most of which have not been identified. The spectacular progress made in survival in PC contrasts with the lack of knowledge of the RF implicated in its etiopathogenesis. OBJECTIVE: 1) To analyze up-to-date knowledge of the interaction among environmental RF in the etiopathogenesis of PC, and 2) to inform pediatricians of the "Environment and Pediatric Cancer" research project directed by the Pediatric Environmental Health Specialty Unit of the Hospital Infantil Universitari La Fe in Valencia (Spain). MATERIAL AND METHODS: Current medical records focus almost exclusively on the diagnosis and treatment of cancer. The Pediatric Environmental Medical Record will contain the validated items required to document and presence or absence of endogenous and exogenous RF associated with PC described in the literature, as well as the main human cancerogenic agents identified by the International Agency for Research on Cancer and the US National Toxicology Program. RESULTS: The project aims to determine the frequency of endogenous and exogenous RF associated with PC in Spain. This project will enable hypotheses to be formulated for future epidemiologic case-control and cohort studies in Spain and other European countries, thus stimulating the introduction of educational and preventive policies in the Spanish population. CONCLUSIONS: The project requires the aid of all hospital and non-hospital pediatricians involved in pediatric cancer in informing parents and offering them the possibility of voluntarily collaborating in the "Environment and Pediatric Cancer" project by contacting the Pediatric Health Specialty Unit (Unidad de Salud Medioambiental del Hospital Infantil La Fe de Valencia [www.pehsu.org]). The collaboration of our colleagues will be essential in gaining greater insight into the RF associated with PC and in achieving prevention in the medium and long term.

Medio ambiente y cáncer pediátrico / Environment and pediatric cancer

Antecedentes. El cáncer es el resultado final de la combinación variable de dos determinantes, el endógeno o constitucional y el exógeno o medioambiental. Entre el 85-96 por ciento de los cánceres pediátricos están probablemente asociados a factores de riesgo medioambientales, siendo la mayoría de ellos desconocidos. El progreso espectacular en la supervivencia del cáncer pediátrico contrasta con la ignorancia de los factores de riesgo implicados en su etiopatogenia. Objetivo. Analizar el estado actual del conocimiento de las interacciones de los factores de riesgo medioambientales en la etiopatogenia del cáncer pediátrico. Divulgar entre los pediatras el proyecto de investigación "Medio ambiente y cáncer pediátrico" dirigido por la Unidad de Salud Medioambiental (Pediatric Environmental Health Speciality Unit, PEHSU) del Hospital Infantil Universitario La Fe de Valencia. Material y métodos. Las historias clínicas actuales están pensadas, diseñadas y dirigidas casi exclusivamente hacia el diagnóstico y tratamiento del cáncer. La denominada historia medioambiental pediátrica, contendrá los ítems validados necesarios para documentar la presencia o ausencia de los factores de riesgo ambientales y constitucionales asociados al cáncer pediátrico descritos en la literatura específica, así como los principales agentes cancerígenos humanos tipificados por la International Agency for Research on Cancer y por el U.S. National Toxicology Program. Resultados. El proyecto pretende conocer la frecuencia en España de los factores de riesgo medioambientales y constitucionales asociados al cáncer pediátrico. Analizando nuestra realidad se podrán formular hipótesis para futuros estudios epidemiológicos de casos-controles y de cohortes en el ámbito nacional y europeo, fomentando la instauración de políticas educativas y preventivas en la población española. Conclusiones. Es necesaria la ayuda de todos los pediatras hospitalarios y extrahospitalarios que atienden a niños oncológicos, para que informen a los padres y les ofrezcan la posibilidad de colaborar voluntariamente en el proyecto "Medio ambiente y cáncer pediátrico", contactando con la Unidad de Salud Medioambiental del Hospital Infantil La Fe de Valencia (www.pehsu.org). La colaboración de todos nuestros compañeros será fundamental para avanzar en el conocimiento de los factores de riesgo asociados a los cánceres pediátricos y conseguir su prevención a medio y largo plazo (AU)

[Risk factors for Hodgkin's lymphomas]. / Factores de riesgo para los linfomas de Hodgkin.

OBJECTIVE: To divulge the risk factors associated with Hodgkin's lymphoma (HL) in children and adults among pediatricians. METHODS: We performed a literature review of the last 25 years through the Medline, IAR Cancer, and Cancerlit databases. The search profile was "HL risk factors". The most interesting papers, as well as those cited and published more than 25 years prior to the search, were selected. RESULTS: The following risk factors for HL were reported with greater or lesser evidence: a) genetic (variation in the HLA class II region); b) viral infections (Epstein-Barr virus); c) childhood environment and socio-economic status; d) congenital and acquired immunodeficiency; e) medical conditions and f) occupational exposure (the wood industry and its derivatives). CONCLUSIONS: The etiology of most HL is unknown. The most important risk factors are: 1) genetic; 2) Epstein-Barr virus (infectious mononucleosis); 3) congenital and acquired immunodeficiency; 4) occupational exposure (the wood industry).

[Risk factors for non-Hodgkin's lymphomas]. / Factores de riesgo para los linfomas no hodgkinianos.

OBJECTIVE: To divulge the risk factors for non-Hodgkin lymphomas (NHL) in children and adults among pediatricians. METHODS: We performed a literature review of articles published in the last 25 years through the Medline, IAR Cancer and Cancerlit databases. The search profile was "NHL risk factors". The most interesting papers, as well as the most relevant articles cited and published more than 25 years prior to the search, were selected. RESULTS: The following risk factors for the development of NHL were reported with greater or lesser evidence: socioeconomic status, family factors, immunodeficiencies, bacterial and viral infections, vaccinations and drugs, radiation,occupational exposure, exposure to animals, diet, and lifestyle. CONCLUSIONS: The etiology of most NHLs is unknown. The most important risk factors are: a) congenital and acquired immunodeficiency; b) viral (human T-cell leukemia virus type-I, Epstein-Barr virus, AIDS virus), and bacterial (Helicobacter pylori) infections; c) therapy with diphenylhydantoin and antineoplastic drugs, and d) exposure to pesticides and organic solvents.

Factores de riesgo para los linfomas no hodgkinianos / Risk factors for non-Hodgkin's lymphomas

Objetivo: Divulgar entre los pediatras los factores de riesgo asociados a los linfomas no hodgkinianos (LNH) durante las épocas pediátrica y adulta. Métodos: Revisión bibliográfica de los últimos 25 años obtenida principalmente del Medline, IAR Cancer y Cancerlit, sobre los factores de riesgo para los LNH. Se han seleccionado los trabajos más interesantes y de sus referencias se han recuperado los más relevantes de los años previos a la búsqueda. Resultados: Los diversos factores de riesgo asociados con mayor o menor consistencia al desarrollo de LNH son los siguientes: nivel socioeconómico, factores familiares, déficit inmunológicos, infecciones virales y bacterianas, vacunas y medicamentos, radiaciones, ocupaciones profesionales, exposiciones a animales, factores dietéticos y otros factores relacionados con el estilo de vida. Conclusiones: La etiología de la mayoría de los LNH es desconocida. Los factores de riesgo convincentemente asociados a un mayor riesgo de LNH son: a) inmunodeficiencias congénitas y adquiridas; b) infecciones virales (virus de la leucemia humana T tipo I, virus de Epstein-Barr [VEB] y virus de la inmunodeficiencia humana [VIH]) y bacterianas (Helicobacter pylori); c) administración de difenilhidantoína y quimioterapia antineoplásica, y d) exposiciones ocupacionales a pesticidas y solventes orgánicos (AU)

Factores de riesgo para los linfomas de Hodgkin / Risk factors for Hodgkin's lymphomas

Objetivo: La finalidad del presente trabajo es divulgar entre los pediatras los factores de riesgo asociados al linfoma de Hodgkin (LH) durante las épocas pediátrica y adulta. Métodos: Revisión bibliográfica de los últimos 25 años obtenida principalmente del Medline, IAR Cancer y Cancerlit sobre los factores de riesgo de LH. Se han seleccionado los trabajos más interesantes y de sus referencias se han recuperado los más relevantes de los años previos a la búsqueda. Resultados: Los principales factores de riesgo asociados con mayor o menor consistencia al desarrollo de LH son los siguientes: a) genéticos (variaciones en las regiones de la clase II HLA); b) infecciosos (virus de Epstein-Barr); c) ambiente infantil y clase social; d) inmunodeficiencias congénitas y adquiridas; e) condiciones médicas, y f) exposiciones profesionales (industria de la madera y derivados). Conclusiones: La etiología de la mayoría de los LH es desconocida. Los factores de riesgo convincentemente asociados a un mayor riesgo de LH son: a) genético-familiares; b) virus de Epstein-Barr (mononucleosis infecciosa); c) inmunodeficiencias congénitas y adquiridas, y d) exposición ocupacional a la industria de la madera y derivados (AU)

A poroid neoplasia arising close to a seborrheic keratosis and a trichoepithelioma.

A 69-year-old woman had a well-defined, slightly raised, brownish, keratotic plaque with an eccentric group of roughly circular, bluish, dome nodules on her right scapular area. Histological study revealed the presence of an eccrine poroma demonstrating features of eccrine poroma, hidroacanthoma simplex, and dermal duct tumor and arising in a lesion of seborrheic keratosis and a trichoepithelioma. In the eccrine poroma region, an area with malignant changes was evident. The findings in this case support the view of eccrine poroma as a spectrum of histological variants and the possibility of malignant transformation from a eccrine poroma towards porocarcinoma. The association with seborrheic keratosis is most probably coincidental, and the trichoepithelioma was probably due to induction of the tumoral stroma on adjacent follicular epithelia.

[Papillary transitional cell carcinoma of the frontal sinus]. / Carcinoma papilar de células transicionales del seno frontal.

INTRODUCTION: A case is reported of primary transitional-cell carcinoma in the frontal sinus of a 54-year-old woman, which was interesting because of the histological type, evolution, and difficulty of follow-up. CLINICAL CASE: A 54-year-old woman with no history of exposure to risk factors presented swelling of the frontal area of 3 months duration. Fine needle aspiration biopsy revealed an adenoma but TAC showed an intrasinusal tumor with destruction of the inner and outer walls. Surgical exeresis revealed the correct histological diagnosis. Local recurrence at 12 months, without cervical lymph nodes or distant metastases, was treated surgically and the patient remained asymptomatic and disease-free 24 months later. DISCUSSION: Malignant tumors of the frontal sinus are rare in the literature. We describe the histological features of transitional-cell tumor and emphasize its similarity with papilloma, benign behavior and management options, in which surgery is of choice. Prognostic and survival factors in the literature are reviewed.