[Prevalence of human papillomavirus in Spanish women from a population screening program]. / Prevalencia de virus del papiloma humano en mujeres españolas de un programa de cribado poblacionales de riesgo.

OBJECTIVE: The human papillomavirus (HPV), is necessary to cause a woman developing cervical cancer. The aim of the study was to estimate the prevalence of women with HPV infection, covered by the program of prevention and early detection of cervical cancer of Castile and León (Spain). METHODS: Samples of women included in the screening program were analyzed. Including a total of 120,326 cervical swab samples, collected in the period from January 2012 to December 2014. RESULTS: 12,183 HPV positive samples were detected, representing a prevalence of 9.6 ‰, (IC 95% 9.5%-9.8%) in the female population. High-risk HPV were found in higher proportion that HPV low-risk genotypes. HPV prevalence correlates inversely with women age. Coinfections of multiple genotypes were found in one third of screened women population. CONCLUSIONS: Data showed in this study are the first and wider Spanish results from a cervical cancer screening program population non opportunistic based on HPV detection. These results would serve as a reference for future prevalence studies and to evaluate the future impact of HPV vaccination campaigns.

Forced synchronization of a self-sustained chaotic oscillator.

This work presents a forced synchronization phenomenon like the asymptotic correlated behavior between chaotic oscillators forced by an external signal. Different kinds of forced synchronization are presented and given a theoretical justification explaining why it is possible to find some of them. Numerical results are presented for different cases such as antisymmetric, lag, phase, and identical forced synchronization.

Embarazo ectópico ovárico / Ovarian ectopic pregnancy

El embarazo ectópico se define como todo embarazo implantado fuera de la cavidad endometrial. La localización más frecuente es la tubárica, fundamentalmente en la porción ampular de la trompa, seguida del embarazo ectópico cornual, abdominal, ovárico y cervical. La incidencia del embarazo ectópico ha aumentado en los últimos años, pero la tasa de embarazo ectópico ovárico permanece estable. El diagnóstico se establece de manera similar al embarazo ectópico de otra localización, mediante ecografía y niveles de b-HCG en sangre; el diagnóstico preoperatorio de embarazo ectópico ovárico es más difícil. El tratamiento consiste en la resección del saco gestacional u ooforectomía por vía laparoscópica o el tratamiento con metotrexato en los casos precoces. Se exponen los casos clínicos de tres pacientes que acudieron por dolor abdominal y metrorragia a nuestro hospital; el tratamiento consistió en resección ovárica por laparoscopia y el diagnóstico se confirmó mediante estudio anatomopatológico (AU)

Ectopic pregnancy is defined as a gestation out of the endometrial cavity. The most frecuent implantation is the ampular portion of the tube, next to abdominal, ovarian and cervical location. The incidence of ectopic pregnancy is increasing in the last years, but the frecuency of ovarian pregnancies has remained stable. The clinical diagnosis is based in sonography and serum concentrations of b-HCG. The preoperative diagnosis of ovarian pregnancy is difficult. The treatment is ovarian wedge resection by laparoscopy or medical therapy with methotrexate. We report the management of three patients in our hospital. The clinical symptoms were abdominal pain and menstrual irregularities; the diagnosis was confirmed by histopathological study and the treatment was ovarian wedge resection by laparoscopy (AU)

Neoplasias mesenquimatosas vulvares: descripción de un caso de angiofibroma celular vulvar / Mesenchymal vulvar neoplasms: a case of cellular angiofibroma of the vulva

Se presenta el caso de una mujer de 61 años con una tumoración vulvar. Los análisis morfológico e inmunohistoquímico la identificaron como angiofibroma celular vulvar. Esta patología posee escaso poder de recurrencia local y no se han descrito metástasis. Las neoplasias mesenquimatosas vulvares requieren una extirpación con bordes libres y un correcto diagnóstico diferencial (AU)

We present the case of a 61-year-old woman who presented with a vulvar mass. Morphological and immunohistochemical analysis identified cellular angiofibroma. In this type of tumor, local recurrence is rare and metastasis has not bee described. Mesenchymal neoplasms of the vulva require surgical excision with free margins and accurate differential diagnosis (AU)

Filtering by nonlinear systems.

Synchronization of nonlinear systems forced by external signals is formalized as the response of a nonlinear filter. Sufficient conditions for a nonlinear system to behave as a filter are given. Some examples of generalized chaos synchronization are shown to actually be special cases of nonlinear filtering.

Dermatomiositis paraneoplásica en una paciente con cáncer de ovario / Sertoli-Leydig cell ovarian tumor

Se presenta el caso de una paciente de 67 años de edad con dermatomiositis (DM) asociada a cáncer de ovario. El término de síndrome paraneoplásico se refiere a la capacidad de ciertos tumores para producir diversos signos y síntomas a distancia del tumor primario o de sus metástasis. La DM es un síndrome paraneoplásico infrecuente que se asocia al diagnóstico de diferentes tumores y cursa con inflamación muscular (polimiositis) y manifestaciones cutáneas (dermatomiositis). Se estima que la incidencia de cáncer en pacientes con DM es del 15-30%. En las pacientes con dermatomiositis debe investigarse un tumor maligno subyacente

We present the case of a 67-year-old woman who developed dermatomyositis preceding diagnosis of ovarian carcinoma. Paraneoplastic syndromes are a group of disturbances associated with malignant neoplasms, but not directly related to invasion by the primary tumor or its metastases. Dermatomyositis is an uncommon paraneoplastic syndrome often associated with different tumors. This entity produces muscular inflammation (polymyositis) and cutaneous manifestations (dermatomyositis). The incidence of cancer in patients with dermatomyositis is estimated to be between 15 and 30%. In patients with dermatomyositis, underlying malignancy should be investigated

Reacción trofoblástica exagerada de implantación / Exaggerated response to implantation

El reconocimiento de nuevos tipos de enfermedad trofoblástica ha llevado a modificar la clasificación histológica de la enfermedad trofoblástica gestacional. Se incluyen en ésta un grupo heterogéneo de lesiones caracterizadas en su conjunto por la anormal proliferación del trofoblasto. La reacción trofoblástica exagerada de implantación se corresponde con una reacción exagerada del trofoblasto en el lecho placentario que nunca es neoplásica. Aunque se trata de un hallazgo benigno, se debe hacer diagnóstico diferencial con lesiones malignas, como el tumor del lecho placentario y el coriocarcinoma (AU)

Growth retardation in children receiving long-term total parenteral nutrition: effects of ornithine alpha-ketoglutarate.

We evaluated the effect of ornithine ketoglutarate (OKG) in reversing abnormal growth in six prepubertal children receiving total parenteral nutrition (TPN) for 5-10 y. They were 1-4 SDs below their expected 50th percentile for height. The energy and nitrogen intakes were unchanged from 8 mo before the beginning of the study until its completion. Two consecutive periods of 5 mo each were studied. OKG (15 g) was added to the parenteral solution during the first period (OKG+) but not during the second period (OKG-). Height velocity (HV) increased (P < 0.05) from a median of 3.8 cm/y to 6.45 cm/y (range 1.8-6.7) during the OKG+ period, and decreased (P < 0.05) to a median of 3.65 cm/y in the OKG- period. Plasma concentrations of insulin-like growth factor 1 (IGF1), glutamine, and glutamate increased (P < 0.05) during the OKG+ period. Variations of IGF1 concentrations correlated with HV variations (r = 0.82, P < 0.005) during both periods. This study demonstrates that OKG is associated with statural growth acceleration and increased IGF1 concentrations.

Iodine supplementation in children receiving long-term parenteral nutrition.

In 18 children receiving long-term total parenteral nutrition (TPN) without iodide supplements, thyroid function test results were normal but serum iodide levels were greater than in control subjects (p less than 0.01). Iodine contamination of TPN solutions and fat emulsions accounted for only half of the recommended parenteral intake. Skin absorption of topical iodinated disinfectant may explain the adequate, if not excessive, iodine intake. We conclude that iodine is an unnecessary supplement in TPN solutions.

Energy expenditure and substrate utilization in the course of renutrition of malnourished children.

Energy expenditure (EE) and substrate utilization in the course of renutrition of malnourished children is not well understood in children receiving total parenteral nutrition (TPN). The aim of this study was to evaluate, during protein-glucose renutrition, EE and substrate utilization and the relationship between EE and growth and/or protein metabolism. Seven malnourished children were studied during the first 3 weeks of TPN. Weight-for-height = 81.4 +/- 8.0%, with an initial weight of 4.5 +/- 3.3 kg. Caloric support was progressively increased according to a preestablished protocol. Every 7 days the following were determined: (1) EE at 3 different 3-hour intervals per day using an open circuit indirect calorimetric system, (2) anthropometrically defined fat free mass (FFM), and (3) 24-hour urinary 3-methylhistidine (3-M-His) and protein balance. Compared to initial values, EE increased 13% at day 7 and 36% at day 14. A negative relationship was found between the amount of perfused glucose and lipid utilization (r = -0.82; p less than 0.0001). EE per kilogram of total body FFM changes during renutrition were more than EE changes per kilogram of total body weight. There was a relationship between EE and weight gain (r = 0.62; p less than 0.005) and a positive relationship between EE and protein gain (r = 0.48; p = 0.012) and 3-M-His excretion (r = 0.51; p less than 0.026).(ABSTRACT TRUNCATED AT 250 WORDS)

Estimating resting energy expenditure by simple lean-body-mass indicators in children on total parenteral nutrition.

The aim of this study was to determine simple predictive factors of the resting energy expenditure (REE) in children. Two groups, A (n = 14) and B (n = 23), were defined by their weight-for-height index, less than 90% and greater than 90%, respectively. Anthropometrically assessed lean body mass (LBM), 24-h urinary creatinine, and REE were measured. From multiple-regression analysis, the best-fitting equation for calculating REE (REE = 54.4 LBM (kg) + 0.095 creatinine (mmol/kg) + 4.7) was highly significant (r = 0.987, p less than 0.0001). Although the regressions of REE on weight were significantly different between the two groups, the equations using LBM or 24-h urinary creatinine did not discriminate between them. These findings suggest that an equation based on LBM or 24-h urinary creatinine excretion could be a more accurate estimate of REE than are conventional methods based on weight or height, and it may be applicable to diverse nutritional states.