Relación genética entre las enfermedades pulmonares de origen ambiental u ocupacional y la osteoporosis: un enfoque bioinformático / Genetic relationship between pulmonary diseases of environmental or occupational origin and osteoporosis: a bioinformatic approach

Objetivo: Identificación de biomarcadores que relacionan la osteoporosis con enfermedades pulmonares ocupacionales y ambientales. Material y métodos: Mediante bases de datos de terminología médica unificada se obtuvieron enfermedades relacionadas con enfermedades pulmonares que, junto con la osteoporosis, fueron analizadas en DisGeNET para obtener los genes asociados a cada enfermedad y formar una red de interacción proteína-proteína (PPI) mediante el uso de STRING dentro de Cytoscape. A través de la aplicación de diferentes algoritmos de centralidad utilizando CythoHubba en Cytoscape, se seleccionaron las 5 proteínas de la red con el mayor grado de centralidad. Resultados: 9 enfermedades fueron incluidas en el grupo de enfermedades pulmonares. Se obtuvieron 2.698 genes asociados a enfermedades pulmonares y a osteoporosis. Los genes vinculados con osteoporosis y con al menos dos de las enfermedades pulmonares incluidas dieron lugar a una red PPI con 152 nodos y 1.378 ejes. Las proteínas con mayor grado de centralidad de la red fueron AKT1, ALB, IL6, TP53 y VEGFA. Conclusiones: Existe una elevada relación entre la osteoporosis y las enfermedades pulmonares ambientales estudiadas, a través de genes con una implicación dual. Nosotros proponemos cinco genes importantes que vinculan estas enfermedades y que podrían constituir una base coherente para investigaciones más profundas en este campo. (AU)

Objetives: Identifying biomarkers that relate osteoporosis to occupational and environmental lung diseases. Material and methods: Using integrated medical terminology databases, diseases related to lung diseases were obtained which, together with osteoporosis, were analyzed in DisGeNET to obtain the genes associated with each disease and form a protein-protein interaction network (PPI) through the Cytoscape StringApp. Applying different centrality algorithms using CythoHubba in Cytoscape, the 5 network proteins with the highest degree of centrality were selected. Results: 9 diseases were included in the group of pulmonary diseases. 2,698 genes associated with lung diseases and osteoporosis were obtained. Genes associated with osteoporosis and with at least two of the included lung diseases resulted in a PPI network with 152 nodes and 1,378 axes. The proteins with the highest degree of network centrality were AKT1, ALB, IL6, TP53 and VEGFA. Conclusions: There is a significant relationship between osteoporosis and the environmental lung diseases studied, through genes with dual involvement. We propose five important genes that link these diseases. This could provide a coherent basis for further research in this field. (AU)

Characterization of the flow of patients in a hospital from complex networks.

We study the efficiency of operations management in a hospital from the dynamics of the flow of patients. Our principal aim is to characterize strategic departments and seasonal patterns in a hospital from a complex networks approach. Process mining techniques are developed to track out-patients' pathways along different departments for the purpose of building weekly networks. In these networks, departments act as nodes with multiple out/in-going arrows connecting other departments. Strategic departments are classified into target and critical departments. On the one hand, target departments, which in this study belong to the oncology area, correspond to those affected by new management policies whose impact is to be assessed. On the other hand, critical departments correspond to the most active departments, the hubs of the networks. Using suitable networks parameters, strategic departments are shown to be highly efficient regardless of the season, which naturally translates into a high level of service offered to patients. In addition, our results show conformance with the new objectives concerning target departments. The methodology presented is shown to be successful in evaluating the efficiency of hospital services in order to enhance process performances, and moreover, it is suitable to be implemented in healthcare management systems at a greater scale and the service industry whenever the flow of clients or customers are involved.

Mesiodens, Trabajo presentado en la 1º Feria de Ciencias de la Salud Carrera Odontologia

El trabajo presenta ilustraciones a color de mesiodens (dientes suplementarios)

Bronchovascular mucormycosis: an urgent surgical problem.

The case of a 70-year-old male with lymphoblastic leukemia is reviewed, who presented the rare and almost always fatal complication of pulmonary mucormycosis, but who was treated satisfactorily with amphotericin B and surgery. The risk of massive hemoptysis in the course of mucormycosis that invades the lung vessels, makes us believe that surgery is an essential part of the management of this disease. It is suggested that the patient be operated as soon as the diagnosis is obtained, as we did in our case, to avoid other risks in combined management with amphotericin B.

[Primary sternal hemangiosarcoma]. / Hemangiosarcoma esternal primario.

We describe a 22-year-old man with a bone mass in the middle and lower third of the sternum with no signs of respiratory deterioration. After biopsy by incision established a diagnosis of hemangiosarcoma, appropriate resection and repair of the thoracic wall was scheduled. An adequate amount of tissue for analysis must be obtained to allow choice of a surgical technique that will assure the best prognosis in malignant tumors of the sternum and assignation of the most appropriate mechanical ventilation procedure.

Thoracotomy in patients over 70 years old.

One hundred cases of patients aged 70 yrs or older, who had undergone surgical intervention for a thoracic pathology between 1981 and 1990, were reviewed. The mean age was 73 yrs, and bronchial cancer the most frequent aetiology (55%). A systematic detailed study before surgery is recommended in the these patients, who have the highest operative risk, and whom we should try to treat most conservatively. Although the rate of complications was higher than the normal average, mortality was only 4%, and was related to the greater or lesser aggression of the surgery. In cases of diagnosed bronchial cancer, a survival of 2 yrs was obtained in 66%, 3 yrs in 50%, and 5 yrs in 26%. We conclude that, theoretically, at the age of 70 yrs or older there is no contraindication for surgery, although it does increase the postoperative morbidity.