Hallazgos mastográficos benignos que simulan malignidad: un dilema diagnóstico / Benign mammographic findings that simulate malignancy: a diagnostic dilemma

Resumen OBJETIVO: Identificar los principales hallazgos histopatológicos benignos y determinar la tasa de falsos positivos que suelen causar conflicto al categorizar las mastografías en el sistema BI-RADS por su aspecto, que puede simular un proceso maligno. MATERIALES Y MÉTODOS: Estudio de cohorte, retrospectivo, efectuado en pacientes atendidas en la Unidad Médica de Alta Especialidad 4 Luis Castelazo Ayala (2019-2023) con reporte mastográfico alterado o sospecha clínica de malignidad. Para el análisis estadístico se utilizó el programa JASP 2.0 y χ2 para la diferencia de proporciones entre grupos. RESULTADOS: De un grupo de 11,481 pacientes, se reportaron 1643 mastografías alteradas: 444 con reportes falsos positivos, 23 pacientes con sospecha clínica y exclusión de 16 que no cumplieron con los criterios de inclusión establecidos. La muestra poblacional estudiada fue de 451 pacientes. La mayoría permaneció asintomática al momento del estudio (42.1%). El hallazgo histopatológico benigno con mayor prevalencia fue el fibroadenoma y su síntoma más relevante el nódulo palpable. La tasa de falsos positivos fue de 4.3%. CONCLUSIONES: En la actualidad, gracias a la implementación de programas de tamizaje es posible establecer diagnósticos de cáncer de mama en etapas tempranas, aunque con la desventaja que el reporte puede resultar falso positivo y ello dar lugar a incremento de la morbilidad y sobretratamiento. Los estándares internacionales indican que estos no deben sobrepasar el 10%.

Abstract OBJECTIVE: To identify the main benign histopathological findings that often cause conflict when categorizing mastographies in the BI-RADS system due to their appearance, which may simulate a malignant process and false positive rate. MATERIALS AND METHODS: Retrospective cohort study carried out in patients attended at the Unidad Médica de Alta Especialidad 4 Luis Castelazo Ayala (2019-2023) with an altered mastographic report or clinical suspicion of malignancy. For statistical analysis we used the JASP 2.0 programme and χ2 for the difference in proportions between groups. RESULTS: From a group of 11,481 patients, 1,643 altered mastograms were reported: 444 with false positive reports, 23 patients with clinical suspicion and exclusion of 16 who did not meet the established inclusion criteria. The population sample studied was 451 patients. The majority remained asymptomatic at the time of the study (42.1%). The most prevalent benign histopathological finding was fibroadenoma and the most relevant symptom was a palpable nodule. The false positive rate was 4.3%. CONCLUSIONS: Currently, thanks to the implementation of screening programmes it is possible to establish breast cancer diagnoses in early stages, although with the disadvantage that the report may be false positive and this may lead to increased morbidity and overtreatment. International standards indicate that these should not exceed 10%.

Solar heterogeneous photo-Fenton for complete inactivation of Escherichia coli and Salmonella typhimurium in secondary-treated wastewater effluent.

In this work, complete elimination of Escherichia coli and Salmonella typhimurium was achieved in 120 min using a heterogeneous photo-Fenton process under sunlight at pH 6.5 in distilled water. A face-centered composite central design 22 with one categoric factor and three replicates at the central point was used to evaluate the effect of iron (III) oxide concentration (0.8-3.4 mg L-1), H2O2 (2-10 mg L-1), and the type of iron oxide phase (maghemite and hematite) on the inactivation of both bacteria. The results showed that the amount of catalyst, H2O2 concentration and their interaction were significant factors (p < 0.05) in the elimination of the microorganisms. Thus, under the best conditions (3.4 mg L-1 of iron (III) oxide and 10 mg L-1 of H2O2) in the experimental ranges, complete inactivation of E. coli and S. typhimurium was achieved (6-log reduction) in 120 min using the photo-Fenton treatment with both iron-oxide phases. Furthermore, the photocatalytic elimination of both bacteria by the photo-Fenton process using hematite and maghemite in secondary-treated wastewater effluent was performed obtaining slower inactivation rates (1.2-5.9 times) than in distilled water due to the matrix effect of the effluent from a wastewater treatment plant. Nevertheless, the process continued to be effective in the effluent, achieving complete bacterial elimination in 150 min using the hematite phase. Additionally, the SEM images of the bacterial cells showed that the heterogeneous photo-Fenton treatment generated permanent and irreversible cell damage, resulting in complete cell death.

Inequality and the social construction of urban disaster risk in multi-hazard contexts: the case of Lima, Peru and the COVID-19 pandemic.

This field note examines the disaster risk construction process in Lima, Peru. More commonly experienced hazard contexts are considered in the light of the COVID-19 pandemic. We provide an empirical analysis based on Lima-wide data and using findings from a single case study settlement to illustrate more general conclusions. We attempt to reveal how exposure and vulnerability factors signify that very different hazards, including COVID-19, predominantly affect the same population groups. Underlying causes and drivers, all related to different expressions of urban inequality, include problems of access to suitable urban land, land trafficking and invasion, State exclusion from social housing and basic services, unsafe building practice and corruption. The research confirms the usefulness of a social construction approach to disaster risk, based on the notion of underlying causes and drivers, and the need to reconfigure urban planning processes, breaking sector silos and encouraging integrated intersectoral and interspatial approaches.

Depressive symptomatology in adults during the COVID-19 pandemic.

Depression entails changes in the mental health of individuals worldwide. Episodes of depression lead to mood swings and changes in the motivational dimension. Our research focused on the prevalence of depression in the adult population and on how it affected the social and affective dimensions. Owing to the current pandemic, we deemed it necessary to explore how protective measures against COVID-19 infection, such as quarantines, could be related to mental health. Moreover, we found it important to determine the prevalence of depressive and anxious symptomatology in adults from the Valle del Cauca region in Colombia during the social isolation connected to COVID-19. Our study was descriptive, analytical and cross-sectional, and involved 1248 subjects. As tools, we used the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale. The data demonstrated that women were more likely to display symptoms of depression and that individuals aged between 24 and 29 were less likely to reveal symptoms of anxiety than those aged between 18 and 23. Moreover, childless or economically dependent individuals proved to be more likely to display symptoms of depression during the pandemic.

Religiosidad y cerebro: Las funciones neuropsicológicas en personas creyentes / Religiosity and Brain: Neuropsychological Functions in Believers

Resumen La neuropsicología de la religión permite una apertura científica a la explicación del fenómeno religioso y su impacto en el psiquismo, el presente documento intenta una reflexión que da cuenta de esa estrecha relación e influencia que ejerce la práctica religiosa en la salud mental y en el desarrollo de funciones neuropsicológicas en las personas. Dicha relación, se fortalece con los descubrimientos contemporáneos de la neurociencia cognitiva y la antropobiología.

Abstract Neuropsychology of religion allows a scientific openness to the explanation of the religious phenomenon, and its impact on psychism. This document attempts a re flection, which gives an account of this close relationship, and influence exerted by religious practice on mental health and the development of neuropsychological functions in people. This relationship is strengthened by contemporary discoveries of cognitive neuroscience and anthropology.

Desempeño neuropsicológico ejecutivo de adultos mayores con riesgo cardiovascular: evidencia desde el departamento del Quindío, Colombia / Executive neuropsychological performance of older adults with cardiovascular risk: evidence from Quindío, Colombia

El presente artículo introduce un estudio cuantitativo en el que se compararon los desempeños neuropsicológicos ejecutivos en 20 adultos mayores con antecedentes de riesgo cardiovascular o ACV y sus pares sin dicha condición. Para dicho objetivo se empleó el tamizaje mini mental como criterio de inclusión en la muestra. Igualmente, la investigación indagó la correlación entre el nivel de rendimiento ejecutivo ante la batería neuropsicológica de funciones ejecutivas BANFE 2 y los factores de riesgo cardiovascular. Finalmente, los resultados indicaron que sujetos con historial de ACV presentaron un desempeño más bajo en las funciones ejecutivas orbito frontales y frontal anterior.

The following article introduces a quantitative study in which executive neuropsychological performances were compared in 20 older adults with a history of cardiovascular risk or stroke and their peers without such condition. Mini-mental screening was used as a criterion for inclusion in the sample. The research investigated the correlation between the level of executive performance in the neuropsychological battery of executive functions BANFE 2 and cardiovascular risk factors. Finally, the results indicated that subjects with a history of stroke presented a lower performance in executive functions at the orbitofrontal and frontal lobe.

Filogenia y desarrollo de funciones ejecutivas * / Phylogeny and executive functions development

Resumen El presente documento reflexiona acerca del valor filogenético que tiene para la especie humana el desarrollo de la corteza prefrontal y las funciones ejecutivas. Dicho análisis parte de la revisión de estudios empíricos sobre la génesis de estas en la infancia y la patología de las mismas durante el desarrollo, así como de las evidencias etológicas y paleoantropológicas del proceso de hominización. Igualmente, se discute en el artículo la forma como estas funciones neuropsicológicas le permiten al homo sapiens compensar su carácter biológico de inmadurez y falta de especialidades anatómicas.

Abstract This paper aims to reflect on the phylogenetic value that the development of the pre-frontal cor tex and its executive functions represent for human beings. This analysis is based on the review of empirical studies related to genesis and pathology during childhood, as well as ethological evidence and the process of paleo-anthropological hominization. This paper also analyzes the way these neuropsychological functions allow Homo sapiens to compensate for their biological charac ter of immaturity and lack of anatomical specialties.

Síndrome de McCune-Albright: a propósito de un caso y revisión de la literaturá / McCune-Albright syndrome: a case report and literature review

El síndrome de McCune-Albright (SMA) es una enfermedad rara que produce la mutación del gen codificador de la subunidad alfa de la proteína estimulatoria G de la adenilciclasa que estimula a presentar endocrinopatías múltiples. Esta enfermedad no es hereditaria, sino esporádica y no es transmitida a sus descendientes; causa un amplio espectro de manifestaciones endócrinas y no endócrinas. Es más frecuente en mujeres 3:2 que en hombres. El inicio de estas manifestaciones ocurre usualmente durante la infancia o la niñez. Las manifestaciones clínicas son la triada de: displasia fibrasa ósea, pigmentación irregular en la piel (manchas color café con leche) y pubertad precoz. En cuanto al tratamiento, se debe controlar todo tipo de endocrinopatías con la medicación adecuada así como también en el caso de fracturas patológicas en especial en huesos largos, el empleo de fijación intramedular es la recomendada. Se presenta el caso clínico de una paciente mujer de 6 años de edad con antecedentes de fractura patológica de fémur izquierdo hace 4 meses resuelta con material de osteosintesis (placa DCP) que posteriormente presenta fatiga de material y refractura, además de alteraciones en la pigmentación de la piel, menarquia temprana a los 2 años, por lo que se diagnosticó de Síndrome de Mccune-Albright.