SEOM Clinical Guideline for the diagnosis and treatment of esophageal cancer (2016).

Esophageal cancer (EC) is an aggressive tumor that represents the 6th most common cause of cancer death worldwide. The estimated incidence in Spain is 2090 cases/year. Two main pathological subtypes exist, squamous cell carcinoma and adenocarcinoma. The main differences between them are localization and underlying factors which are the principal cause of the recent incidence changes observed in west countries. Staging techniques and treatment options which combine surgery, chemotherapy and radiotherapy, reflected the high complexity of the EC management. An undeniably multidisciplinary approach is, therefore, required. In this guide, we review the status of current diagnosis and treatment, define evidence and propose recommendations.

Utilidad del omalizumab en un paciente con asma grave y aspergilosis broncopulmonar alérgica / Use of omalizumab in a patient with severe asthma and allergic bronchopulmonary aspergilosis

Mujer de 64 años diagnositicada de asma bronquial en la juventud, catalogada como asma de difícil control y corticode pendiente. En las pruebas complementarias se ha objetivado una eosinofilia mantenida (>7%), IgE total elevada con un pico (..) (AU)

A 64 year-old woman diagnosed with bronchial asthma, proven difficult to control and corticoid-dependent since an early age, was studied. Complementary test performed demonstrated (..) (AU)

Prostaglandin E2 modulates the expression of antimicrobial peptides in the fat body and midgut of Anopheles albimanus.

Prostaglandins (PGs) participate in the regulation of vertebrate and in at least six insect orders' immune responses. We identified PGE2 in midgut, fat body, Malpighian tubules, and ovarioles of Anopheles albimanus (Aa) mosquitoes. Our data indicate that PGE2 synthesis in cultured midguts responds to the presence of two bacterial species, Micrococcus luteus and Klebsiella pneumoniae. The production of mRNA coding for antimicrobial peptides Aa-Attacin, Aa-Cecropin, and Aa-Gambicin was observed in cultured fat bodies and midguts. The production of these messengers was reduced in the presence of dexamethasone, and this effect was reversed by arachidonic acid. Adding PGE2 to cultures resulted in increased Aa-cecropin mRNA and decreased Aa-attacin and Aa-gambicin mRNAs.

Cambios en la prevalencia de síntomas de asma e hiperreactividad bronquial en el seguimiento de dos cohortes poblacionales de la ciudad de Huelva / Changes in the prevalence of asthma symptoms and bronchial hyper-reactivity in the follow-up of two population groups of the Huelva city

Objetivo: Analizar los cambios en la prevalencia de síntomas asmáticos e hiperreactividad bronquial (HB) que ocurren con la edad en dos cohortes de adolescentes y adultos jóvenes de la ciudad de Huelva. Material y métodos: Se ha realizado una segunda evaluación en el seguimiento de las dos poblaciones estudiadas entre 1991 y1993: jóvenes adolescentes de 11 a 16 años (n= 714), incluidos en el Estudio de Enfermedades Respiratorias de Huelva (EERH-I), y adultos jóvenes de 20-44 años (n=271), incluida en el Estudio Europeo de Enfermedades Respiratorias (ECRHS-I) de la ciudad de Huelva, a las que se realizaron cuestionario de síntomas respiratorios(SR) y prueba de hiperreactividad bronquial inespecífica con metacolina (MT). En la segunda evaluación, realizada con un seguimiento promedio de 9 años, se consiguió estudiar a 401 de los “niños - adolescentes” y 204 de los “adultos jóvenes”. Al igual que en la fase previa, se ha realizado en ambas población es el mismo cuestionario sobre síntomas respiratorios, una espirometría y una prueba de provocación bronquial inespecífica con metacolina. Se comparan las prevalencias de sibilancias (Sib), HB y asma encontradas en la misma población (niños o adultos), en ambos cortes trasversales (1991 y 2.001). Se comparan los resultados obtenidos entre ambas poblaciones. Resultados: Entre los años 1991 a 2001, tanto en jóvenes como en adultos, se incrementan los síntomas respiratorios, especialmente las sibilancias y la disnea, en reposo y al ejercicio. La hiperreactividad bronquial se incrementa claramente en los jóvenes(p<0.001) y sólo ligeramente en los adultos (NS). Como consecuencia de lo anterior, el diagnóstico epidemiológico de asma (sibilancias+ HB) se incrementó de forma significativa sólo en los jóvenes. Otro dato destacable en los niños era que recibían tratamiento para el asma sólo la mitad de los que estaban diagnosticados de asma por un médico y que éstos eran menos que los que referían haber tenido sibilancias en los últimos 12 meses. La discrepancia entre sibilancias y diagnóstico de asma era más evidente en adultos. Conclusiones: En la década de los 90 y en la ciudad de Huelva, una ciudad con elevada prevalencia de sibilancias (Sib) y nivel medio-bajo de hiperreactividad bronquial (HB) y asma, los SR y la HB se van incrementando durante la adolescencia y se estabilizan en la edad adulta. Esto podría explicarse tanto por la historia natural de la enfermedad como por la diferente influencia de las condiciones ambientales en las diferentes edades

Objective: To analyze the changes in the prevalence of asthmatic symptoms and bronchial hyper-reactive (BHR) conditions, which occur with age, in two groups of adolescents and young adults from the city of Huelva. Material and Methods: A second follow-up evaluation was performed on the two populations studied between 1991 and 1993:adolescents between 11 and 16 years of age (n = 714), included in the Study of Breathing Illnesses of Huelva (EERH-I), and young adults 20-44 years old (n=271), included in the European Study of Breathing Illnesses (ECRHS-I) of the city of Huelva. A questionnaire about breathing symptoms (BS) and a non-specific test of bronchial hyper-reactivity with methacholine (MT) were administered. In the second evaluation, carried out with an average follow up of 9 years, it was possible to study 401 of those “child-adolescents” and 204 of those “young adults.” The same as in the previous phase, both populations were administered the same questionnaire about breathing symptoms, aspirometry and a non-specific bronchial provocation test with methacholine was performed. The prevalence of wheezing, BHR and asthma found in the same population (children or adults) was compared in both cross samples (1991 and 2001). The results obtained were compared between both populations. Results: Between the years 1991 and 2001, both in adolescents and adults, the breathing symptoms increased, especially wheezing and dyspnea, at rest and at exercise. Bronchial hyper-reactivity had a clear increase in the adolescents (p < 0.001) and only a slight increase in the adults (NS). As a consequence of the above, the epidemiologic diagnosis of asthma (wheezing + BHR) increased significantly in adolescents. Another outstanding fact in the children was that only half of those medically diagnosed with asthma received treatment for their asthma, and amongst these, there were fewer that said they had experienced wheezing in the last 12 months. The discrepancy between wheezing and the diagnosis of asthma was more evident in adults. Conclusions: In the 90s and in the city of Huelva, a city with a high prevalence of wheezing and medium-low level of bronchial hyper-reactivity (BHR) and asthma, BS and the HR have increased during adolescence and stabilized in adulthood. This could be explained both by the natural evolution of the disease and by the different influences of the environmental conditions at the different ages

[Usefulness of electromagnetic fields in the treatment of hip avascular necrosis: a prospective study of 30 cases]. / Utilidad de los campos electromagnéticos en el tratamiento de la necrosis avascular de cadera: estudio prospectivo de 30 casos.

A series is here reported of 30 hips from 21 patients with the diagnosis of avascular necrosis in different stages (Ficat 0 = 1, I = 4, II = 13, III = 10, IV = 2). Patients underwent external electro-stimulation by means of a electromagnetic field generator, and results were evaluated by NMR at three-month intervals. Lesions were categorized by NMR: < 25%, 25%-50%, and > 50% of involved head volume. The grading of lesions yielded the following distribution: grade 1 = 12, grade 2 = 10, and grade 3 = 7. Results were categorized in "clinical success", "NMR success" and "combined success" when symptoms decreased or disappeared, the lesion stabilized by NMR, or both, respectively. Overall, the corresponding figures were 80%, 76.6%, and 63.3%, and were remarkably influenced by the NMR grading of the lesion.