HLA-G as a new tumor biomarker: detection of soluble isoforms of HLA-G in the serum and saliva of patients with colorectal cancer.

INTRODUCTION: Recent medical investigations suggest that HLA-G, due to its tolerogenic properties, can be used as a biomarker in the diagnosis, treatment, and prognosis of different neoplasms. This observational prospective pilot study aims at detecting sHLA-G in the serum and saliva of patients diagnosed with colorectal cancer (CRC). For this purpose, we compared the expression of sHLA-G from patients with a control sample from a healthy population. MATERIALS AND METHODS: Using the specific enzyme-linked immunosorbent assay (ELISA) method, the expression of sHLA-G in the serum and saliva samples from patients affected by CRC (n = 20) and in a control sample (n = 10) were analyzed. RESULTS: The data showed that in patients with CRC, salivary sHLA-G values were significantly higher than in the control group (18.84 U/ml versus 6.3 U/ml, p = 0.036). In addition, higher levels of sHLA-G were observed in the saliva of patients with CRC in more advanced stages, compared with patients in early stages (24.2 U/ml vs. 8.1 U/ml, p = 0.019). A significant correlation was observed between the concentration of sHLA-G in the serum and saliva of the analyzed samples (Spearman correlation 0.7, p = 0.004). CONCLUSIONS: This study demonstrates, for the first time, the possibility of detecting sHLA-G in the saliva of patients with CRC, resulting in a less invasive alternative to venipuncture. Likewise, we propose that sHLA-G could be an attractive molecular target based on its significant high levels in advanced stages.

A propósito de un caso de hamartoma retiniano adyacente a cabeza de nervio óptico en un caso de esclerosis tuberosa / Peripapillar retinal hamartoma associated with tuberous sclerosis. Case report

Introducción: La esclerosis tuberosa es una enfermedad multisistémica rara, con un patrón de herencia autosómico dominante. Existen pocos casos documentados en la literatura de hamartomas retinales (astrocitomas) con progresión agresiva en el contexto de esta enfermedad. Caso clínico: Se presenta el caso de un varón de 31 años sin antecedentes de afecciones oftálmicas ni sistémicas conocidas, que refirió una historia de 6 meses de visión borrosa en el ojo derecho causada por un hamartoma unilateral de retina, en un caso no diagnosticado de esclerosis tuberosa. Discusión: Es necesario realizar un manejo multidisciplinario, con la colaboración del Departamento de Medicina Interna y de Oncología, así como ofrecer asesoramiento genético para los pacientes afectados. Las complicaciones están directamente relacionadas con el aumento del tamaño del tumor. El tratamiento no parece tener ninguna influencia en la historia natural de la enfermedad (AU)

Introduction: Tuberous sclerosis is a rare multisystemic disease with an autosomal dominant inheritance pattern. There are few documented cases in the literature of retinal hamartomas (astrocytomas) with aggressive progression in the context of this disease. Case report: A report is presented on a case of a 31 year-old male with unknown history of ophthalmic or systemic conditions, who referred to a history of 6 months of blurred vision in his right eye. This was caused by a unilateral retinal hamartoma due to an undiagnosed tuberous sclerosis. Discussion: Multidisciplinary management, with the cooperation of Internal Medicine and the Oncology Department, is needed in these cases, as well as genetic counselling for affected patients. Complications are directly related to increased tumour size. Treatment does not seem to have any influence on the natural history of the disease (AU)

Peripapillar retinal hamartoma associated with tuberous sclerosis. Case report. / A propósito de un caso de hamartoma retiniano adyacente a cabeza de nervio óptico en un caso de esclerosis tuberosa.

INTRODUCTION: Tuberous sclerosis is a rare multisystemic disease with an autosomal dominant inheritance pattern. There are few documented cases in the literature of retinal hamartomas (astrocytomas) with aggressive progression in the context of this disease. CASE REPORT: A report is presented on a case of a 31 year-old male with unknown history of ophthalmic or systemic conditions, who referred to a history of 6 months of blurred vision in his right eye. This was caused by a unilateral retinal hamartoma due to an undiagnosed tuberous sclerosis. DISCUSSION: Multidisciplinary management, with the cooperation of Internal Medicine and the Oncology Department, is needed in these cases, as well as genetic counselling for affected patients. Complications are directly related to increased tumour size. Treatment does not seem to have any influence on the natural history of the disease.

Metástasis de nervio óptico secundaria a adenocarcinoma de pulmón / Optic nerve metastasis caused by lung adenocarcinoma

Introducción: Las metástasis del nervio óptico aisladas son extremadamente infrecuentes. Muchos casos se asocian con afectación de otras localizaciones como la coroides, órbita o el sistema nervioso central. Caso clínico: Mujer de 57 años de edad con el diagnóstico de adenocarcinoma de pulmón con pérdida brusca de la visión del ojo derecho. Ante los hallazgos encontrados y los resultados de la RMN se realiza el diagnóstico de metástasis del nervio óptico. Discusión: Las metástasis de nervio óptico aisladas son un cuadro infrecuente, pero que tendremos que sospechar en todo paciente con antecedentes oncológicos que presenten un deterioro de la agudeza visual (AU)

Introduction: Isolated optic nerve metastases are extremely uncommon. Many cases are associated with involvement from locations such as the choroid, orbit, or central nervous system. Optic nerve metastases often have their origin in primary tumours of the breast, lung, and stomach, in adults. Case report: The case is presented of a 57 year-old woman with a diagnosis of lung adenocarcinoma. Her first complaint was a sudden loss of visual acuity in her right eye. The diagnosis of optic nerve metastases was made based on her history, and the results of the MRI scan. Discussion: Isolated optic nerve metastases are an uncommon condition, but should be suspected in any patient with a history of oncology who has deteriorated visual acuity (AU)

Optic nerve metastasis caused by lung adenocarcinoma. / Metástasis de nervio óptico secundaria a adenocarcinoma de pulmón.

INTRODUCTION: Isolated optic nerve metastases are extremely uncommon. Many cases are associated with involvement from locations such as the choroid, orbit, or central nervous system. Optic nerve metastases often have their origin in primary tumours of the breast, lung, and stomach, in adults. CASE REPORT: The case is presented of a 57 year-old woman with a diagnosis of lung adenocarcinoma. Her first complaint was a sudden loss of visual acuity in her right eye. The diagnosis of optic nerve metastases was made based on her history, and the results of the MRI scan. DISCUSSION: Isolated optic nerve metastases are an uncommon condition, but should be suspected in any patient with a history of oncology who has deteriorated visual acuity.

Complete atrioventricular block induced by rituximab in monotherapy in an aged patient with non-Hodgkin's diffuse large B-cell lymphoma.

Rituximab is a treatment option to non-Hodg kin's diffuse large B-cell lymphoma (NHDLBCL) in advanced stage and comorbility. It is known the cardiotoxicity effect of this drug, but there is no previous report describing a complete atrioventricular block (CAVB) secundary to treatment with Rituximab. We present an elderly woman treated with monotherapy with Rituximab who experienced a CAVB after administration of the fifth dose of this drug.

Which patients are more likely to benefit from postoperative shed blood salvage after unilateral total knee replacement? An analysis of 581 consecutive procedures.

INTRODUCTION: Requirements for allogeneic blood transfusion (ABT) after total knee replacement (TKR) are still high (30-50%), and salvage of unwashed filtered postoperative shed blood (USB) may represent an alternative to ABT. We evaluated that patients are more likely to benefit of USB reinfusion after TKR. PATIENTS AND METHODS: Data from 581 consecutive primary TKR, managed with (reinfusion group, n = 382) or without (control group, n= 199) reinfusion of USB, were retrospectively reviewed. RESULTS: Patients from reinfusion group received 119 +/- 88 ml of red blood cells from USB, without clinically relevant incidents, and showed a lower ABT rate (30.6% vs. 8.4%, for control and reinfusion groups, respectively; P = 0.001) (transfusion trigger, haemoglobin [Hb] < 9 g/dl). Differences in ABT rate between groups were significant for all preoperative Hb levels, except for Hb < or = 12 g/dl. A lower transfusion threshold (Hb < 8 g/dl) might have further decreased ABT rate (14.6% vs. 5.2%, respectively; P < 0.001), with differences being significant for preoperative Hb between 12 and 15 g/dl. There were no differences with respect to postoperative infection rate, but patients from reinfusion group had a shorter length of hospital stay (11 +/- 4 vs. 13 +/- 4 days, respectively; P= 0.001). CONCLUSIONS: Return of USB after TKR seems to reduce the need for ABT, especially in patients with preoperative Hb between 12 and 15 g/dl. There is little benefit of USB reinfusion for patients with preoperative Hb > 15 g/dl, whereas patients with preoperative Hb < 12 g/dl would probably benefit from the combination of USB with some other blood-saving method.

Necesidades transfusionales en la artroplastia primaria de rodilla: impacto de la utilización del recuperador de sangre postoperatorio / No disponible

No disponible

Quimioterapia neoadyuvante en un timoma invasor. Cirugía curativa con neumonectomía izquierda en bloque / Neoadjuvand chemotherapy of an invasive thymoma. Invasive surgery and left side in bloc pneumonectomy

Presentamos un paciente con un timoma invasor como hallazgo en un estudio radiológico por disneaprogresiva. Tras el diagnóstico histológico fue tratado con quimioterapia (Qt) neoadyuvante consiguiendo unareducción del volumen tumoral del 25%. El tratamiento quirúrgico consistió en una exéresis en bloque deltimoma junto con el pulmón izquierdo por afectación de los vasos pulmonares. La combinación de la Qtneoadyuvante con la cirugía posibilitan un tratamiento con intención curativa

We present a patient suffering from an invasive thymoma discovered in a chest roentgenogram because ofprogressive dyspnea. Neoadjuvant chemotherapy was used after histological diagnosis, observing a tumorvolume decrease of 25 %. The surgical treatment consisted of the thymoma en bloc resection, and a left sidepneumonectomy due to affected pulmonary vessels. The combination of neoadjuvant chemotherapy andsurgery is applied as a curative intention therapy