Cefalea e hipertensión como forma de presentación de un feocromocitoma y simulando un síndrome post-COVID-19 / Headache and hypertension as a form of presentation of pheochromocytoma and simulating a post-COVID-19 syndrome

El síndrome post-COVID-19 es un conjunto de síntomas y signos que persisten durante más de 12 semanas después de una infección por COVID-19 y actualmente carece de una definición clínica estandarizada. Únicamente se ha informado un caso en el que un feocromocitoma se confundió con un síndrome post-COVID-19. La sintomatología de este síndrome es variable y abarca desde la cefalea y la fatiga hasta la disnea persistente y las alteraciones neurocognitivas. Además, el SARS-CoV-2 puede afectar al sistema nervioso autónomo, contribuyendo a síntomas que se asemejan a los del feocromocitoma. Se recalca la importancia y la necesidad de discernir entre síntomas relacionados con la COVID-19 y otras afecciones, ya que la especificidad de las manifestaciones clínicas del síndrome post-COVID-19 es muy baja y puede ser confundido con otras enfermedades vitales. Se presenta un caso en el que un feocromocitoma fue confundido con un síndrome post-COVID-19 en una paciente sin antecedentes médicos.(AU)

Post-COVID-19 syndrome is a set of symptoms and signs that persist for more than 12 weeks after COVID-19 infection and currently lacks a standardised clinical definition. Only one case has been reported in which a pheochromocytoma was mistaken for post-COVID-19 syndrome. The symptomatology of this syndrome is variable and ranges from headache and fatigue to persistent dyspnoea and neurocognitive disturbances. In addition, SARS-CoV-2 can affect the autonomic nervous system, contributing to symptoms resembling those of pheochromocytoma. The importance and need to discern between COVID-19-related symptoms and other conditions is emphasised, as the specificity of the clinical manifestations of post-COVID-19 syndrome is very low and can be confused with other vital pathologies. A case is presented in which a pheochromocytoma was mistaken for post-COVID-19 syndrome in a patient with no medical history.(AU)

[Headache and hypertension as a form of presentation of pheochromocytoma and simulating a post-COVID-19 syndrome]. / Cefalea e hipertensión como forma de presentación de un feocromocitoma y simulando un síndrome post-COVID-19.

Post-COVID-19 syndrome is a set of symptoms and signs that persist for more than 12 weeks after COVID-19 infection and currently lacks a standardised clinical definition. Only one case has been reported in which a pheochromocytoma was mistaken for post-COVID-19 syndrome. The symptomatology of this syndrome is variable and ranges from headache and fatigue to persistent dyspnoea and neurocognitive disturbances. In addition, SARS-CoV-2 can affect the autonomic nervous system, contributing to symptoms resembling those of pheochromocytoma. The importance and need to discern between COVID-19-related symptoms and other conditions is emphasised, as the specificity of the clinical manifestations of post-COVID-19 syndrome is very low and can be confused with other vital pathologies. A case is presented in which a pheochromocytoma was mistaken for post-COVID-19 syndrome in a patient with no medical history.

Very-high-frequency oscillations in the main peak of a magnetar giant flare.

Magnetars are strongly magnetized, isolated neutron stars1-3 with magnetic fields up to around 1015 gauss, luminosities of approximately 1031-1036 ergs per second and rotation periods of about 0.3-12.0 s. Very energetic giant flares from galactic magnetars (peak luminosities of 1044-1047 ergs per second, lasting approximately 0.1 s) have been detected in hard X-rays and soft γ-rays4, and only one has been detected from outside our galaxy5. During such giant flares, quasi-periodic oscillations (QPOs) with low (less than 150 hertz) and high (greater than 500 hertz) frequencies have been observed6-9, but their statistical significance has been questioned10. High-frequency QPOs have been seen only during the tail phase of the flare9. Here we report the observation of two broad QPOs at approximately 2,132 hertz and 4,250 hertz in the main peak of a giant γ-ray flare11 in the direction of the NGC 253 galaxy12-17, disappearing after 3.5 milliseconds. The flare was detected on 15 April 2020 by the Atmosphere-Space Interactions Monitor instrument18,19 aboard the International Space Station, which was the only instrument that recorded the main burst phase (0.8-3.2 milliseconds) in the full energy range (50 × 103 to 40 × 106 electronvolts) without suffering from saturation effects such as deadtime and pile-up. Along with sudden spectral variations, these extremely high-frequency oscillations in the burst peak are a crucial component that will aid our understanding of magnetar giant flares.

The nucleus acts as a ruler tailoring cell responses to spatial constraints.

The microscopic environment inside a metazoan organism is highly crowded. Whether individual cells can tailor their behavior to the limited space remains unclear. In this study, we found that cells measure the degree of spatial confinement by using their largest and stiffest organelle, the nucleus. Cell confinement below a resting nucleus size deforms the nucleus, which expands and stretches its envelope. This activates signaling to the actomyosin cortex via nuclear envelope stretch-sensitive proteins, up-regulating cell contractility. We established that the tailored contractile response constitutes a nuclear ruler-based signaling pathway involved in migratory cell behaviors. Cells rely on the nuclear ruler to modulate the motive force that enables their passage through restrictive pores in complex three-dimensional environments, a process relevant to cancer cell invasion, immune responses, and embryonic development.

CD81 controls sustained T cell activation signaling and defines the maturation stages of cognate immunological synapses.

In this study, we investigated the dynamics of the molecular interactions of tetraspanin CD81 in T lymphocytes, and we show that CD81 controls the organization of the immune synapse (IS) and T cell activation. Using quantitative microscopy, including fluorescence recovery after photobleaching (FRAP), phasor fluorescence lifetime imaging microscopy-Föster resonance energy transfer (phasorFLIM-FRET), and total internal reflection fluorescence microscopy (TIRFM), we demonstrate that CD81 interacts with ICAM-1 and CD3 during conjugation between T cells and antigen-presenting cells (APCs). CD81 and ICAM-1 exhibit distinct mobilities in central and peripheral areas of early and late T cell-APC contacts. Moreover, CD81-ICAM-1 and CD81-CD3 dynamic interactions increase over the time course of IS formation, as these molecules redistribute throughout the contact area. Therefore, CD81 associations unexpectedly define novel sequential steps of IS maturation. Our results indicate that CD81 controls the temporal progression of the IS and the permanence of CD3 in the membrane contact area, contributing to sustained T cell receptor (TCR)-CD3-mediated signaling. Accordingly, we find that CD81 is required for proper T cell activation, regulating CD3ζ, ZAP-70, LAT, and extracellular signal-regulated kinase (ERK) phosphorylation; CD69 surface expression; and interleukin-2 (IL-2) secretion. Our data demonstrate the important role of CD81 in the molecular organization and dynamics of the IS architecture that sets the signaling threshold in T cell activation.

Additive value of diabetes and peripheral arterial disease in the risk stratification of patients admitted after an acute coronary syndrome: a subanalysis of the PAMISCA Study.

BACKGROUND: There is an increasing interest in the use of non-invasive methods for the detection of subclinical atherosclerosis to better identify patients with high risk of cardiovascular events The presence of diabetes mellitus (DM) and peripheral arterial disease (PAD) is associated with increased risk of events but their value in the acute coronary syndrome (ACS) patient has not been ascertained. METHODS: We performed a subanalysis of the PAMISCA study, designed to investigate the prevalence of PAD in patients admitted to Spanish hospitals with a diagnosis of an ACS. RESULTS: A total of 1410 patients were analysed (71.4% men, age 66 +/- 11.9 years, 35% DM). The prevalence of PAD was higher in DM vs. no-DM (41.5% vs. 30.6% respectively, p < 0.001). Patients with PAD and DM had more in-hospital cardiac complications such as atrial fibrillation/flutter, recurrent myocardial ischaemia and heart failure and a trend towards higher in-hospital mortality (p = 0.08). Non-DM patients with PAD and DM without PAD shared similar cardiac complications and the group without neither PAD nor DM had the best prognosis. In patients without PAD, DM was an independent predictor of three-vessel coronary disease (OR 1.6; 95% CI: 1.1-2.5, p < 0.05) after adjustment by age, sex, low density lipoproteins (LDL), smoking and the previous myocardial infarction. However, in PAD patients, DM failed to be an independent risk factor in the multivariate analysis (OR 1.0; 95% CI 0.6-1.6, p < 0.05). CONCLUSIONS: The concurrence of DM and PAD helps identify patients with an adverse risk profile.

La ciclooxigenasa-2 (COX-2) y el factor de crecimiento epidérmico (EFG) en lesiones epiteliales orales premalignas / Cyclooxygenase-2 (COX-2) and epidermal growth factor (EGF) in oral premalignant epithelial lesions

Las lesiones premalignas orales incluyen eritroplasias (manchasrojas) y leucoplasias (manchas blancas), las cuales se desarrollan a lo largo desuperficies epiteliales. Estas lesiones son considerados marcadores en la “carcinogénesisde campo” ya que pacientes con lesiones premalignas orales puedendesarrollar carcinoma de células escamosas (CCS) en el sitio de las lesiones,así como en otros lugares de tracto aerodigestivo superior. Se está haciendoun gran esfuerzo para identificar nuevos biomarcadores SEBs (surrogateendpoint biomarkers) para el carcinoma de células escamosas de cabeza y cuello.Los SEBs candidatos para el carcinoma de células escamosas invasivo en eltrato aerodigestivo superior deben ser detectables con los cambios molecularescelulares y tisulares que tienen lugar durante la formación del tumor. Entrelos diferentes marcadores que se han propuesto hasta la actualidad, la ciclooxigenasa-2 (COX-2) y el receptor del factor de crecimiento epidérmico (EGFR)parecen ser los más prometedores. COX-2 se sobre expresa durante el procesotumoral, desde hiperplasia temprana a enfermedad metastásica. EGFRtambién está anormalmente activado en tumores epiteliales, pues las célulasde casi todas estas neoplasias expresan altos niveles de este receptor, una característicaasociada con un peor pronóstico clínico. En este sentido el tracto aerodigestivosuperior proporciona un sistema o modelo único para el estudio deCCS y para la investigación de nuevos candidatos SEBs(AU)

Oral premalignant lesions include leukoplakia (whitepatch) and erythroplakia (red patch), which develop on epithelialsurfaces. These lesions are markers for field cancerization becausepatients with oral premalignancy can develop squamous cellcarcinoma at the site of the lesion(s) and at other sites in the upperaerodigestive tract. An effort is being made to identify surrogateendpoint biomarkers (SEBs) for head and neck squamous cellcarcinoma (HNSCC). Candidate SEBs for invasive squamous cellcarcinoma (SCC) of the upper aerodigestive tract are detectablemolecular, cellular, and tissue changes that take place duringtumorigenesis. Among the markers that have been proposed todate, cyclooxygenase-2 (COX-2) and the epidermal growth factorreceptor (EGFR) seem to be the most promising. COX-2 isoverexpressed during tumor transformation from early hyperplasiato metastasic disease. EGFR is also abnormally activated in epithelialtumors, since cells of almost all these kinds of neoplasm expresshigh levels of this receptor, a characteristic associated with poorclinical outcome. The upper aerodigestive tract provides a uniquemodel for studying the development of squamous cell carcinomaand for investigating candidate SEBs(AU)

Mucocele del seno maxilar post-traumático / Post-traumatic mucocele of the maxillary sinus

Los mucoceles de los senos paranasales son lesiones benignaspero con un considerable potencial destructivo por la reabsorción ósea quepueden generar. La localización en el seno maxilar es muy poco frecuenteasí como el origen postraumático. Presentamos el caso de un mucocele deseno maxilar tras 28 años después de un traumatismo facial. Analizamos laetiopatogenia, el diagnóstico y el tratamiento de este tipo de lesiones(AU)

Mucoceles of the paranasal sinuses are benign lesions butthey can be destructive because they cause bone resorption. Thelocation in a maxillary sinus and a traumatic origin are uncommon.We report a case of mucocele of the maxillary sinus 28 years afterfacial trauma. We analyzed the etiopathogenesis, diagnosis, andtreatment of this type of lesions(AU)

Metástasis mandibular de adenocarcinoma gástrico. Presentación de un caso / Mandibular metastases of gastric adenocarcinoma. A case report

Los tumores malignos de la cavidad oral y mandíbula representanaproximadamente un 5% de todas las neoplasias malignas del cuerpo,y sólo entre el 1 y el 4% son consideradas como metástasis. Tienensu localización más frecuente a nivel de la mandíbula (80%), fundamentalmenteen la región molar. Las metástasis mandibulares, cuando aparecen,suelen tener su origen en tumores primarios que asientan en la mama,pulmón, riñón, tiroides, intestinos y próstata; y con menor frecuencia enel estómago, testículos y vesícula biliar.Suelen afectar a pacientes de edad avanzada (4ª-7ª décadas de la vida) sinpredilección por el sexo.El tratamiento en general es paliativo y pasa por el uso de la radioterapia,quimioterapia y hormonoterapia, reservando la cirugía para casos aislados.Describimos un caso de metástasis mandibular en un paciente adulto comoprimera manifestación clínica de un adenocarcinoma gástrico(AU)

Malignant tumors of the mouth and jaws representsapproximately 5% of all malignant neoplasms in thebody, and only 1-4% are considered to be metastatic. Theyare most frequently located in the mandible (80%), fundamentallyin the molar region. Metastases to the jaws areusually from breast, lung, kidney, thyroid gland, intestines,and prostate gland; and less frequently from stomach, testes,and bladder.They are more frequent in elderly patients (between 4th and7th decades) with no gender differences.Treatment is usually palliative and based on the use of radiotherapy,chemotherapy and hormonal therapy. Surgery isonly used in selected cases.A case of mandibular metastases as first sign of malignantdisease of gastric adenocarcinoma is reported(AU)

Hemangioma intramandibular. Abordaje intraoral / Intraosseous hemangioma of the mandible. An intraoral approach

No disponible

No disponible

Carcinoma fusocelular de cavidad oral. Revisión de 9 casos / Spindle cell carcinoma of the oral cavity. A review of 9 cases

El carcinoma fusocelular es una variedad maligna y poco frecuente del carcinoma de células escamosas. Es una tumoración constituida por una doble proliferación celular: una sarcomatosa de células fusocelularesy otra carcinomatosa de células epiteliales. Aunque puede afectar a cualquier parte del organismo, es más frecuente encontrarla en vías aerodigestivas superiores. Afecta con mayor frecuencia a varones entre la6ª y 7ª décadas de la vida. Tiene un comportamiento agresivo con tendencia a la recurrencia. El alcohol y tabaco han sido identificados como los factores de riesgo más importantes. Su diagnóstico histológico es complicado y muchas veces es necesario recurrir a técnicas de inmunohistoquímica y al uso del microscopio electrónico. En la actualidad, se le atribuye un origen epitelial.El objetivo de este trabajo es presentar una revisión de 9 casos de carcinoma fusocelular localizados en cavidad oral recogidos en nuestro servicio entre los años 1985 a 2004, describiendo su comportamiento clínico y tratandode comprender la patogenia de esta controvertida estirpe tumoral (AU)

Spindle cell carcinoma is a malignant and rare variant ofsquamous cell carcinoma. The histological pattern is composed of a double cell proliferation: a sarcomatous component made up of spindle-shaped cells and a carcinomatous component made up of epithelial cells. Nearly all the anatomy of the body can be affectedby these tumors although the most common location is theupper aerodigestive tract. With regard to sex distribution, it is more frequent in males than in females in their sixth and seventh decades of life. Its behavior is aggressive and it tends to recur after treatment. The most important risk factors are alcohol and tobacco. The histological diagnosis is complicated, so immunohistochemical techniques and the use of electron microscopy are usually necessary.Nowadays, its epithelial origin is accepted.The aim of this article is to report a retrospective study of 9 cases of oral cavity spindle cell carcinoma treated in our service of Oral and Maxillofacial Surgery, between 1985 and 2004. We describethe clinical behavior and the pathogeny of this tumor (AU)

Large-scale analysis of 73 329 physcomitrella plants transformed with different gene disruption libraries: production parameters and mutant phenotypes.

Gene targeting in the moss Physcomitrella patens has created a new platform for plant functional genomics. We produced a mutant collection of 73 329 Physcomitrella plants and evaluated the phenotype of each transformant in comparison to wild type Physcomitrella. Production parameters and morphological changes in 16 categories, such as plant structure, colour, coverage with gametophores, cell shape, etc., were listed and all data were compiled in a database (mossDB). Our mutant collection consists of at least 1804 auxotrophic mutants which showed growth defects on minimal Knop medium but were rescued on supplemented medium. 8129 haploid and 11 068 polyploid transformants had morphological alterations. 9 % of the haploid transformants had deviations in the leaf shape, 7 % developed less gametophores or had a different leaf cell shape. Other morphological deviations in plant structure, colour, and uniformity of leaves on a moss colony were less frequently observed. Preculture conditions of the plant material and the cDNA library (representing genes from either protonema, gametophore or sporophyte tissue) used to transform Physcomitrella had an effect on the number of transformants per transformation. We found correlations between ploidy level and plant morphology and growth rate on Knop medium. In haploid transformants correlations between the percentage of plants with specific phenotypes and the cDNA library used for transformation were detected. The number of different cDNAs present during transformation had no effect on the number of transformants per transformation, but it had an effect on the overall percentage of plants with phenotypic deviations. We conclude that by linking incoming molecular, proteome, and metabolome data of the transformants in the future, the database mossDB will be a valuable biological resource for systems biology.

Reconstrucción microquirúrgica de cabeza y cuello: revisión de dos años de experiencia en nuestro servicio

Introducción. La reconstrucción de los grandes defectos de cabeza y cuello, especialmente de tipo oncológico ha experimentado un avance considerable en los últimos años merced a la inclusión de las técnicas microquirúrgicas como elemento terapéutico básico. En la actualidad, la realización convencional de este tipo de técnicas es imprescindible en cualquier Servicio de Cirugía Maxilofacial que se ocupe de esta patología. Incluímos en este concepto servicios de reciente remodelación y en fase de expansión, como el del Complejo Hospitalario Juan Canalejo de La Coruña. Material y Método. En los dos últimos años se han realizado 67 reconstrucciones microquirúrgicas en nuestro Servicio. Presentamos nuestra experiencia al respecto, incidiendo en los resultados obtenidos hasta el momento, las complicaciones que nos hemos encontrado y la morbilidad en zonas donantes. Resultados. En nuestro Servicio, 59 de las 67 reconstrucciones han sido viables. Los resultados obtenidos, considerando la morbilidad asociada y la situación actual de nuestros pacientes, se pueden cataogar como satisfactorios. Conclusiones. La realización de reconstrucciones microquirúrgicas en grades defectos orofaciales debe constituir una actividad convencional en cualquier Servicio de Cirugía Maxilofacial. Las ventajas funcionales y estéticas que aportan estas técnicas justifican plenamente los costes que suponen (AU)

Ventriculoperitoneal shunt infection by Candida glabrata in an adult.

We describe the first case of infection of a neurosurgical shunt by Candida glabrata in an adult. The risk factors, clinical picture and response to therapy have been similar to similar cases caused by other Candida sp. We must emphasize the unequivocal features of infection and the rapid and probably complete response to removal of the device.

Oncocitoma de la glándula parótida. A propósito de un caso / Oncocytoma of the parotid gland. A report of a case

El onocitoma es una neoplasia de infrecuente presentación. Habitualmente benigna, puede localizarse en cualquier parte del organismo, siendo típica su ubicación en la glándula parótida. En el presente artículo, se documenta el caso de una mujer de 83 años con una masa de 9 x 8,5 x 11,5 cm que afectaba a la totalidad de la glándula parótida izquierda. El examen microscópico mostró una oncocitosis difusa en una neoplasia bien encapsulada. Realizamos una breve revisión de la literatura, incluyendo patogenia, características histológicas y modadlidades terapéuticas de este tumor (AU)

Syringolin-mediated activation of the Pir7b esterase gene in rice cells is suppressed by phosphatase inhibitors.

Inoculation of rice plants (Oryza sativa) with the nonhost pathogen Pseudomonas syringae pv. syringae leads to the activation of defense-related genes and ultimately to induced resistance against the rice blast fungus Pyricularia oryzae. One of the molecular determinants of P. syringae pv. syringae that is recognized by the plant cells and evokes these defense responses is syringolin A, an elicitor that is secreted by the bacteria under appropriate conditions. In order to investigate signal transduction events elicited by syringolin A, the response of cultured rice cells to syringolin A application was analyzed. Cultured rice cells were able to sense syringolin A at concentrations in the nanomolar range as observed by the transient accumulation of Pir7b esterase transcripts. Syringolin A-mediated Pir7b transcript accumulation was inhibited by cycloheximide, indicating that de novo protein synthesis was required. Calyculin and okadaic acid, two protein phosphatase inhibitors, blocked Pir7b gene induction, whereas the serine/threonine protein kinase inhibitors staurosporine and K-252a had no effect on Pir7b transcript levels. Actin transcript levels were essentially not affected by inhibitor treatments over the experimental time span. These results imply that dephosphorylation of a phosphoprotein is an important step in the syringolin A-triggered signal transduction pathway.

Rapid isolation of genes from an indexed genomic library of C. cinereus in a novel pab1+ cosmid.

In this study we present an indexed genomic library of homokaryon AmutBmut constructed within a novel cosmid carrying pab1+ as a selectable Coprinus marker. The average insert size per cosmid comprises 41 kb. We screened the library and detected copies of known (a1-2, beta-tub, cgl1, ras, trp1) and of new Coprinus genes (cac, lac1, lac2, lac3). Screening was performed either by Southern blot hybridisation or more efficiently by non-radioactive PCR amplification. We successfully applied PCR with specific and with degenerate primers, multiplex PCR and colony PCR in library screening. Our results suggest a new, more efficient pooling strategy for future high throughput screenings to be used in PCR with pooled cosmid DNAs, or in a less laborious approach using pooled Escherichia coli colonies for PCR.

The A mating type and blue light regulate all known differentiation processes in the basidiomycete Coprinus cinereus.

Monokaryons of Coprinus cinereus constitutively form small spores (oidia) in the aerial mycelium. Some strains also produce large, inflated single cells (chlamydospores) at the agar/air interface, and hyphal aggregates (hyphal knots) that can develop into sclerotia. Monokaryons show various reactions upon transformation with heterologous A mating type genes. Production of oidia in such A-activated transformants is repressed in the dark and induced by blue light. Five of six monokaryons tested following transformation with A genes showed induced production of hyphal knots and sclerotia in the dark, and at least three strains showed enhanced chlamydospore production in the dark. Continuous incubation under blue light inhibited formation of hyphal knots, sclerotia and chlamydospores in both competent monokaryons and in A-activated transformants. On artificial medium and on a 12 h light/12 h dark regime, A-activated transformants of one distinct monokaryon (218) formed fruit-body primordia that were arrested in development before karyogamy. Our studies show that A mating type genes control all major differentiation processes in Coprinus, but whether developmental processes can proceed depends on the genetic background of the strain.