Tres tareas para la exploración de la fluidez verbal: evidencias de su fiabilidad test-retest en adultos argentinos / Three tasks for the exploration of verbal fluency: evidence of test-retest reliability in Argentine adults

Introducción: Las tareas de fluidez fonológica y semántica son de uso frecuente en la evaluación neuropsicológica por su fácil aplicación y buena sensibilidad al deterioro cognitivo. En Argentina es limitado el cuerpo de evidencia psicométrica para dichas tareas, con especial desconocimiento de la estabilidad temporal de sus medidas. La producción psicométrica es aún menor para la variante fluidez de acción (emisión de verbos en infinitivo en un minuto). En efecto, este estudio analiza la fiabilidad test-retest de tres tareas de fluidez en adultos argentinos. Sujetos y métodos: La muestra se compuso de 85 argentinos (medida de edad, 63,7) de población general no clínica, un 75,3% mujeres, de nivel de instrucción medio-alto. Se efectuó un diseño longitudinal-prospectivo administrando tareas de fluidez fonológica, semántica y de acción en dos momentos distintos con un intervalo hasta de cuatro meses. Se analizó el coeficiente de correlación intraclase (CCI), método estadístico sugerido para estudios de fiabilidad test-retest. Para interpretar el CCI se adoptaron los criterios de Fleiss. Resultados: Las tareas de fluidez fonológica y semántica demostraron buena fiabilidad, con un CCI de 0,77 y 0,79. La fluidez de acción obtuvo excelente fiabilidad, con un CCI de 0,9. Conclusión: Las tareas de fluidez relevadas poseen apropiada estabilidad temporal, por lo que se sugiere su uso en investigaciones neuropsicológicas prospectivas (cuando se evalúe el lenguaje en distintos momentos) o cuando se requiera un seguimiento de la evolución de pacientes afásicos en neurorrehabilitación. Basándose en su excelente fiabilidad, se recomienda utilizar con más frecuencia la variante de acción.(AU)

Introduction: The phonological and semantic verbal fluency tasks are frequently used in neuropsychological assessment due to their easy application and good sensitivity to dementia. In Argentina, the psychometric evidence for these tasks is limited, with a special lack of knowledge of the temporal stability of its measurements. The psychometric production is even lower for the action fluency variant (emission of verbs in the infinitive in one minute). In effect, this research analyzes the test-retest reliability of three verbal fluency tasks in Argentine adults. Subjects and methods: The sample was made up of 85 Argentine (average age, 63.7 years), 75,3% women and with a medium-high educational level. A prospective longitudinal design was carried out, administering phonological, semantic and action fluency tasks at two different times with an interval of up to four months. The intraclass correlation coefficient (ICC), a statistical method suggested for test-retest reliability studies, was analyzed. For the interpretation of the ICC, the Fleiss criteria were adopted. Results: The phonological and semantic fluency tasks showed good reliability, with ICCs of 0.77 and 0.79. The fluidity of action variant yielded ICC of 0.90, indicating excellent reliability. Conclusions: All fluency tasks have appropriate temporal stability, and their use is recommended when prospective neuropsychological research is planned (with language evaluation at di fferent times) or as a method of monitoring the evolution of aphasic patients undergoing neurorehabilitation. Based on its excellent reliability, it is recommended to use the action variant more frequently.(AU)

[Three tasks for the exploration of verbal fluency: evidence of test-retest reliability in Argentine adults]. / Tres tareas para la exploración de la fluidez verbal: evidencias de su fiabilidad test-retest en adultos argentinos.

INTRODUCTION: The phonological and semantic verbal fluency tasks are frequently used in neuropsychological assessment due to their easy application and good sensitivity to dementia. In Argentina, the psychometric evidence for these tasks is limited, with a special lack of knowledge of the temporal stability of its measurements. The psychometric production is even lower for the action fluency variant (emission of verbs in the infinitive in one minute). In effect, this research analyzes the test-retest reliability of three verbal fluency tasks in Argentine adults. SUBJECTS AND METHODS: The sample was made up of 85 Argentine (average age, 63.7 years), 75,3% women and with a medium-high educational level. A prospective longitudinal design was carried out, administering phonological, semantic and action fluency tasks at two different times with an interval of up to four months. The intraclass correlation coefficient (ICC), a statistical method suggested for test-retest reliability studies, was analyzed. For the interpretation of the ICC, the Fleiss criteria were adopted. RESULTS: The phonological and semantic fluency tasks showed good reliability, with ICCs of 0.77 and 0.79. The fluidity of action variant yielded ICC of 0.90, indicating excellent reliability. CONCLUSIONS: All fluency tasks have appropriate temporal stability, and their use is recommended when prospective neuropsychological research is planned (with language evaluation at different times) or as a method of monitoring the evolution of aphasic patients undergoing neurorehabilitation. Based on its excellent reliability, it is recommended to use the action variant more frequently.

TITLE: Tres tareas para la exploración de la fluidez verbal: evidencias de su fiabilidad test-retest en adultos argentinos.Introducción. Las tareas de fluidez fonológica y semántica son de uso frecuente en la evaluación neuropsicológica por su fácil aplicación y buena sensibilidad al deterioro cognitivo. En Argentina es limitado el cuerpo de evidencia psicométrica para dichas tareas, con especial desconocimiento de la estabilidad temporal de sus medidas. La producción psicométrica es aún menor para la variante fluidez de acción (emisión de verbos en infinitivo en un minuto). En efecto, este estudio analiza la fiabilidad test-retest de tres tareas de fluidez en adultos argentinos. Sujetos y métodos. La muestra se compuso de 85 argentinos (medida de edad, 63,7) de población general no clínica, un 75,3% mujeres, de nivel de instrucción medio-alto. Se efectuó un diseño longitudinal-prospectivo administrando tareas de fluidez fonológica, semántica y de acción en dos momentos distintos con un intervalo hasta de cuatro meses. Se analizó el coeficiente de correlación intraclase (CCI), método estadístico sugerido para estudios de fiabilidad test-retest. Para interpretar el CCI se adoptaron los criterios de Fleiss. Resultados. Las tareas de fluidez fonológica y semántica demostraron buena fiabilidad, con un CCI de 0,77 y 0,79. La fluidez de acción obtuvo excelente fiabilidad, con un CCI de 0,9. Conclusión. Las tareas de fluidez relevadas poseen apropiada estabilidad temporal, por lo que se sugiere su uso en investigaciones neuropsicológicas prospectivas (cuando se evalúe el lenguaje en distintos momentos) o cuando se requiera un seguimiento de la evolución de pacientes afásicos en neurorrehabilitación. Basándose en su excelente fiabilidad, se recomienda utilizar con más frecuencia la variante de acción.

Cuestionario de reserva cognitiva: análisis psicométrico desde la teoría de respuesta al ítem / Cognitive Reserve Questionnaire: psychometric analysis from the item response theory

Introducción: La reserva cognitiva es la capacidad para tolerar mejor el daño cerebral mediante recursos cognitivos preexistentes y compensatorios. Un método de evaluación es el cuestionario de reserva cognitiva (CRC) de Rami. El objetivo fue realizar un análisis de la calidad informativa del CRC desde la teoría de respuesta al ítem (TRI), con el fin de aportar datos más precisos sobre la fiabilidad de consistencia interna. Se probó, además, la validez convergente con medidas de atención, memoria de trabajo y fluidez. Sujetos y métodos: Participaron 210 argentinos de población general (media edad, 66,8 años). El CRC se administró junto con el test de dígitos y tres tareas de fluidez. Se ajustó un modelo de respuesta graduada desde la TRI con estimación de parámetros de discriminación (a) y dificultad (b), y se elaboró una curva de información del CRC. Se efectuaron correlaciones bivariadas y parciales. Resultados: La TRI indicó una alta discriminación para los ítems del CRC ‘Escolaridad’ y ‘Nivel de ocupación’ (tanto para la versión de ocho ítems como para la versión de seis ítems). En el CRC de ocho ítems se obtuvo una baja discriminación para ‘Formación musical’ y ‘Juegos intelectuales’. En ambas versiones del CRC, la curva indica mayor valor informacional a bajo nivel del constructo. Hubo correlación con el test de dígitos y con las tareas de fluidez, incluso al controlar por edad. Conclusiones: El presente estudio es el primer análisis del CRC desde la TRI, que concluye que el instrumento resulta más confiable cuando se aplica a sujetos con menor reserva. El CRC posee aceptable validez convergente.(AU)

INTRODUCTION: Cognitive reserve is the ability to better tolerate brain damage through pre-existing and compensatory cognitive resources. One assessment method is the Rami CRQ-Cognitive Reserve Questionnaire. The objective was to carry out an analysis of the informative quality of the CRQ from the item response theory (IRT), in order to provide more precise data on the reliability of internal consistency. Convergent validity was also tested with measures of attention, working memory, and fluency. SUBJECTS AND METHODS: 210 Argentines from the general population (mean age, 66.8 years) participated. The CRQ was administered together with the digits test and three fluency tasks. A graded response model was fitted from IRT with estimation of discrimination parameters (a) and difficulty (b), and a CRQ information curve was created. Bivariate and partial correlations were made. RESULTS: The IRT indicated high discrimination for the CRQ items ‘Education’ and ‘Occupation level’ (both for the 8-item version and the 6-item version). In the CRQ of 8 items, low discrimination was obtained for ‘Musical training’ and ‘Intellectual games’. In both versions of the CRQ, the curve indicates greater informational value at a low level of the construct. There was a correlation with the digits test and with fluency tasks, even when controlling for age. CONCLUSIONS: This study is the first analysis of CRQ from IRT, concluding that the instrument is more reliable when applied to subjects with less reserve. The CRQ has acceptable convergent validity.(AU)

[Cognitive Reserve Questionnaire: psychometric analysis from the item response theory]. / Cuestionario de reserva cognitiva: análisis psicométrico desde la teoría de respuesta al ítem.

INTRODUCTION: Cognitive reserve is the ability to better tolerate brain damage through pre-existing and compensatory cognitive resources. One assessment method is the Rami CRQ-Cognitive Reserve Questionnaire. The objective was to carry out an analysis of the informative quality of the CRQ from the item response theory (IRT), in order to provide more precise data on the reliability of internal consistency. Convergent validity was also tested with measures of attention, working memory, and fluency. SUBJECTS AND METHODS: 210 Argentines from the general population (mean age, 66.8 years) participated. The CRQ was administered together with the digits test and three fluency tasks. A graded response model was fitted from IRT with estimation of discrimination parameters (a) and difficulty (b), and a CRQ information curve was created. Bivariate and partial correlations were made. RESULTS: The IRT indicated high discrimination for the CRQ items 'Education' and 'Occupation level' (both for the 8-item version and the 6-item version). In the CRQ of 8 items, low discrimination was obtained for 'Musical training' and 'Intellectual games'. In both versions of the CRQ, the curve indicates greater informational value at a low level of the construct. There was a correlation with the digits test and with fluency tasks, even when controlling for age. CONCLUSIONS: This study is the first analysis of CRQ from IRT, concluding that the instrument is more reliable when applied to subjects with less reserve. The CRQ has acceptable convergent validity.

TITLE: Cuestionario de reserva cognitiva: análisis psicométrico desde la teoría de respuesta al ítem.Introducción. La reserva cognitiva es la capacidad para tolerar mejor el daño cerebral mediante recursos cognitivos preexistentes y compensatorios. Un método de evaluación es el cuestionario de reserva cognitiva (CRC) de Rami. El objetivo fue realizar un análisis de la calidad informativa del CRC desde la teoría de respuesta al ítem (TRI), con el fin de aportar datos más precisos sobre la fiabilidad de consistencia interna. Se probó, además, la validez convergente con medidas de atención, memoria de trabajo y fluidez. Sujetos y métodos. Participaron 210 argentinos de población general (media edad, 66,8 años). El CRC se administró junto con el test de dígitos y tres tareas de fluidez. Se ajustó un modelo de respuesta graduada desde la TRI con estimación de parámetros de discriminación (a) y dificultad (b), y se elaboró una curva de información del CRC. Se efectuaron correlaciones bivariadas y parciales. Resultados. La TRI indicó una alta discriminación para los ítems del CRC 'Escolaridad' y 'Nivel de ocupación' (tanto para la versión de ocho ítems como para la versión de seis ítems). En el CRC de ocho ítems se obtuvo una baja discriminación para 'Formación musical' y 'Juegos intelectuales'. En ambas versiones del CRC, la curva indica mayor valor informacional a bajo nivel del constructo. Hubo correlación con el test de dígitos y con las tareas de fluidez, incluso al controlar por edad. Conclusiones. El presente estudio es el primer análisis del CRC desde la TRI, que concluye que el instrumento resulta más confiable cuando se aplica a sujetos con menor reserva. El CRC posee aceptable validez convergente.

El polimorfismo de un solo nucleótido rs1800795 en el gen IL6 no está asociado con el glaucoma primario de ángulo abierto en la población mexicana / The rs1800795 single nucleotide polymorphism in the IL6 gene is not associated with primary open angle glaucoma in Mexican population

Objetivo La interleucina 6 (IL-6) es una citoquina proinflamatoria con efectos pleiotrópicos que se ha relacionado con el glaucoma primario de ángulo abierto (GPAA) debido a su efecto particular de protección de las células ganglionares de la retina (CGR) contra la apoptosis. Se han asociado diferentes polimorfismos de un solo nucleótido (PSN) con el GPAA. El objetivo de este estudio fue determinar si existe una asociación entre el PSN de IL-6 rs1800795 (−174 G>C) y un mayor riesgo de padecer GPAA en la población mexicana occidental. Métodos Se incluyeron 165 pacientes mestizos mexicanos no emparentados con GPAA y 108 sujetos de control. Se extrajo el ADN genómico de los leucocitos y se purificó, seguido de la genotipificación y la amplificación por reacción en cadena de la polimerasa (PCR) con sondas TaqMan® Biosystem®. Se evaluó la diversidad alélica y genotípica entre los casos y los sujetos de control. Resultados No hubo asociación estadísticamente significativa entre las frecuencias alélicas y genotípicas, ni con modelos de asociación genética dominante ni recesiva (p>0,05). Conclusiones Aunque existe un papel de la IL6 en la fisiopatología del GPAA, nuestros resultados descartan la asociación entre la IL-6 y el PSN rs1800795 mostrando no ser un índice de mayor riesgo de GPAA en la población mexicana (AU)

Purpose Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (−174 G>C) SNP and a higher risk for POAG is present in western Mexican population. Methods One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. Results There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (P>.05). Conclusion Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population (AU)

Condroma pulmonar y paraganglioma carotídeo como manifestaciones de la tríada de Carney: reporte de un caso / Pulmonary chondroma and carotid paraganglioma as expressions of Carney's triad: report of a case

Resumen Objetivos: Presentar caso clínico y revisión de la literatura sobre asociación de tumores poco frecuentes compatibles con diagnóstico de tríada de Carney. Paciente y Métodos: Revisión de ficha clínica de paciente de sexo femenino de 39 años de edad con antecedentes de asma, quien acude a servicio de urgencias por síntomas respiratorios. En estudio con imágenes se evidencia masa pulmonar en lóbulo superior derecho probablemente hamartoma y masa en la bifurcación carotídea izquierda compatible con posible paraganglioma. Se completó el estudio con endoscopia digestiva alta sin evidencia de tumor gástrico y PET-CT (tomografía de emisión de positrones-tomografía computarizada) que descartó otras lesiones. Resultados: La paciente fue sometida a resección quirúrgica de ambos tumores (pulmonar y carotídeo). En estudio histopatológico diferido, se plantean los diagnósticos de paraganglioma carotideo y hamartoma pulmonar, el cual, luego de una segunda revisión histopatológica, es corregido a condroma pulmonar. Discusión: La tríada de Carney se compone por la asociación de al menos 2 de 3 tumores: tumor estromal gastrointestinal (GIST), paraganglioma extra-adrenal y condroma pulmonar. Su expresión es variable, coexistiendo en forma completa en solo el 22% de los casos. Conclusión: Los pacientes con sospecha de tríada de Carney deben recibir evaluación multidisciplinaria, estudio completo en búsqueda de tumores asociados y seguimiento a largo plazo por posibles recurrencias o metástasis.

Objective: To present a clinical case and review of the literature on the infrequent association of pulmonary and extra thoracic tumors compatible with Carney's triad. Patient and Methods: Review of clinical records of a 39 years-old female patient with history of asthma who presented in the emergency department with respiratory symptoms. An imaging study showed a pulmonary mass in the right upper lobe with the aspect of hamartoma and a mass in the left carotid artery bifurcation compatible with a possible paraganglioma. Upper gastrointestinal endoscopy showed no evidence of gastric tumor and a PET-CT (Positron Emission Tomography - Computed Tomography) excluded other lesions. Results: Patient underwent surgical resection of both tumors (pulmonary and carotid). Diagnosis of carotid paraganglioma and pulmonary hamartoma were stated by histopathology. However, lung tumor after a second pathological analysis was confirmed to be a pulmonary chondroma. Discussion: Carney's triad is defined by the association of at least 2 of 3 tumors: Gastrointestinal Stromal Tumor (GIST), extraadrenal paraganglioma and pulmonary chondroma. Its expression is variable, coexisting completely in only 22% of cases. Conclusion: Patients with suspected Carney's triad should receive a multidisciplinary assessment, a complete study searching associated tumors and long-term follow-up for recurrences or metastases.

The rs1800795 single nucleotide polymorphism in the IL6 gene is not associated with primary open angle glaucoma in Mexican population.

PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (p > 0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.

Breast adenomyoepithelioma from a radiologic perspective.

Adenomyoepithelioma of the breast (AB) is an uncommon tumor that is characterized by the biphasic proliferation of epithelial and myoepithelial cells. The radiologic findings for AB have been scantly reported. This paper aims to analyze the characteristic findings for AB on ultrasonography (US) and mammography. This retrospective descriptive study used the Breast Imaging-Reporting and Data System (BI-RADS) to analyze the US and mammography findings for histologically confirmed AB in patients attended at our institution between 2007 and 2019. We identified a total of 13 AB in 13 women. All patients underwent US. On US, 12 lesions were seen as oval nodules, and the remaining lesion was irregular-shaped; 8 lesions had circumscribed margins, 3 had angled margins, and 2 had microlobulated margins. Regarding the echo pattern, 8 lesions were hypoechoic and 5 were complex (solid-cystic). On color Doppler, 11 lesions were vascularized nodules and 2 were avascular nodules. In conclusion, we present the imaging characteristics for a series of cases of AB. It is unlikely that this lesion can be suspected solely on the basis of the imaging findings; nevertheless, it is important for radiologists to be familiar with AB to carry out a good radiopathologic correlation.

Protease Inhibitors from Plants as Therapeutic Agents- A Review.

Plant-based diets are a great source of protease inhibitors (PIs). Two of the most well-known families of PIs are Bowman-Birk inhibitors (BBI) and Kunitz-type inhibitors (KTI). The first group acts mainly on trypsin, chymotrypsin, and elastase; the second is on serine, cysteine, and aspartic proteases. PIs can retard or inhibit the catalytic action of enzymes; therefore, they are considered non-nutritional compounds; nevertheless, animal studies and cell line experiments showed promising results of PIs in treating human illnesses such as obesity, cardiovascular diseases, autoimmune diseases, inflammatory processes, and different types of cancer (gastric, colorectal, breast, and lung cancer). Anticarcinogenic activity's proposed mechanisms of action comprise several inhibitory effects at different molecular levels, i.e., transcription, post-transcription, translation, post-translation, and secretion of cancer cells. This work reviews the potential therapeutic applications of PIs as anticarcinogenic and anti-inflammatory agents in human diseases and the mechanisms by which they exert these effects.

Breast adenomyoepithelioma from a radiologic perspective. / Adenomioepitelioma de la mama desde una perspectiva radiológica.

Adenomyoepithelioma of the breast (AB) is an uncommon tumor that is characterized by the biphasic proliferation of epithelial and myoepithelial cells. The radiologic findings for AB have been scantly reported. This paper aims to analyze the characteristic findings for AB on ultrasonography (US) and mammography. This retrospective descriptive study used the Breast Imaging-Reporting and Data System (BI-RADS) to analyze the US and mammography findings for histologically confirmed AB in patients attended at our institution between 2007 and 2019. We identified a total of 13 AB in 13 women. All patients underwent US. On US, 12 lesions were seen as oval nodules, and the remaining lesion was irregular-shaped; 8 lesions had circumscribed margins, 3 had angled margins, and 2 had microlobulated margins. Regarding the echo pattern, 8 lesions were hypoechoic and 5 were complex (solid-cystic). On color Doppler, 11 lesions were vascularized nodules and 2 were avascular nodules. In conclusion, we present the imaging characteristics for a series of cases of AB. It is unlikely that this lesion can be suspected solely on the basis of the imaging findings; nevertheless, it is important for radiologists to be familiar with AB to carry out a good radiopathologic correlation.

Pérdidas hemáticas en UCI: Breve estudio descriptivo / Blood loss in ICU: Brief descriptive study

Background: Anaemia and transfusions are frequent in critically ill patients and there are avoidable causes such as routine laboratory tests. Patients and methods: Descriptive study during one continuous week including patients over 18-years old in a medical-surgical ICU. Results: 18 patients were included during a week in 12 beds in our unit, median age 62,5 years, 50% male. Median daily blood loss was 35ml, 45% in laboratory samples and 27% related to renal replacement therapy. 3 patients required 1 transfusion of red blood cells. Conclusions: There is a pattern of continuous blood loss in critically ill patients, primarily in routine laboratory tests. (AU)

Tumor del seno endodérmico extragonadal de localización vulvar: descripción de un caso y revisión de la literatura / Extragonadal yolk sac tumour of the vulva. A case report and a review of the literature

La localización extragonadal del tumor del seno endodérmico es excepcional y puede presentar niveles normales de alfafetoproteína sérica (AFP). Describimos el caso de una mujer de 34 años con una tumoración vulvar con diagnóstico inicial en otro centro de carcinoma indiferenciado de vulva. Una nueva valoración histológica e inmunohistoquímica y una posterior determinación de AFP en suero permitieron realizar el diagnóstico. El tumor del seno endodérmico en la región vulvar es excepcional. Solamente se han descritos 16 casos en la literatura. No obstante, es posible realizar un diagnóstico específico y, por lo tanto, un tratamiento acorde con este tipo de neoplasia (AU)

An extragonadal location of a yolk sac tumour is rare and may display normal levels of serum alpha-fetoprotein. We report a case of a 34-year-old woman with a vulvovaginal tumour initially thought to be an undifferentiated carcinoma of the vulva. However, a new histological and immunohistochemical assessment and subsequent determination of serum AFP confirmed the diagnosis of yolk sac tumour. Vulvar yolk sac tumor is rare with only 16 cases described in the literature. However, an accurate differential diagnosis should be made in order to indicate the correct treatment (AU)

Kca3.1 Activation Via P2y2 Purinergic Receptors Promotes Human Ovarian Cancer Cell (Skov-3) Migration.

Disorders in cell signaling mediated by ATP or histamine, activating specific membrane receptors, have been frequently associated with tumorigenesis. Among the elements of response to purinergic (and histaminergic) signaling, ion channel activation controls essential cellular processes in cancer, such as cell proliferation, motility, and death. Here, we studied the effects that ATP had on electrical properties of human ovarian adenocarcinoma cells named SKOV-3. ATP caused increase in intracellular Ca2+ concentration ([Ca2+]i) and, concurrently, it evoked a complex electrical response with a conspicuous outward component. This current was generated through P2Y2 receptor activation and opening of K+ channels, KCa3.1, as indicated by electrophysiological and pharmacological analysis, as well as by immunodetection and specific silencing of P2Y2 or KCa3.1 gene by esiRNA transfection. Low µM ATP concentration increased SKOV-3 cell migration, which was strongly inhibited by KCa3.1 channel blockers and by esiRNA-generated P2Y2 or KCa3.1 downregulation. Finally, in human ovarian tumors, the P2Y2 and KCa3.1 proteins are expressed and co-localized in neoplastic cells. Thus, stimulation of P2Y2 receptors expressed in SKOV-3 cells promotes motility through KCa3.1 activation. Since P2Y2 and KCa3.1 are co-expressed in primary tumors, our findings suggest that they may play a role in cancer progression.

Análisis de factores asociados a la detección de cáncer en la primera biopsia prostática / Associated factors analysis in the detection of cancer in the first prostatic biopsy

Introducción. La biopsia prostática transrectal ecoguiada (BxP) es la técnica más utilizada para el diagnóstico de cáncer. El objetivo de este estudio fue analizar los factores asociados a la de detección de cáncer en la primera BxP en nuestro centro. Métodos. Se incluyeron BxP primarias entre 2008 y 2014. La indicación para BxP se clasificó como: (I) APE normal y velocidad elevada, (II) APE normal con tacto rectal sospechoso, (III) valor único de APE elevado, (IV) APE repetido elevado y (V) APE ≥10 ng/ml. Resultados Serie de 917 pacientes. Un 41 por ciento de las BxP incluyeron 12 a 19 muestras y un 44 por ciento 20 a 22. La tasa de detección global fue 43 por ciento. Se encontraron diferencias significativas al relacionar la tasa de detección con el valor del APE, tacto rectal sospechoso, edad, densidad de APE y volumen prostático. La tasa de detección en el grupo de 12 a 19 muestras fue 34 por ciento y un 41 por ciento con 20 a 22 muestras (p=0,092). Se reportaron 7 complicaciones mayores. Conclusiones. La tasa de detección en esta serie es alta al compararla con lo publicado. Los factores asociados a mayor detección son similares a lo descrito habitualmente. El templado con más muestras se asocia a una tendencia más alta en la tasa de detección, aunque no significativa, sin encontrar mayor proporción de cáncer de bajo riesgo y con una frecuencia de complicaciones comparable con lo reportado. (AU)

Introduction. Transrectal ultrasound guided prostate biopsy is the most widely used method for the diagnosis of prostate cancer. The goal of this study was to analyse the variables associated with the detection of cancer in the first biopsy. Primary biopsies of our centre dating between 2008 and 2014 were included. Biopsy indications were classified as: (I) Normal PSA with elevated growth rate, (II) Normal PSA with suspicious digital rectal examination, (III) Isolated elevation of PSA, (IV) Persistent elevation of PSA and (V) PSA ≥10 ng/ml. Results. Among 917 patients, 41pertcent of biopsies included between 12 and 19 samples, 44 percent ranged from 20 to 22 samples. Global detection rate was 43 pertcent. Significant differences were found when correlating detection rate with PSA value, suspicious digital rectal examination, patient age, PSA density and prostate volume. Detection rate in the 12 to 19 samples group was 34 pertcent and 41 pertcent in the 20 to 22 samples group (p=0,092). 7 mayor complications were reported. Conclusion. In this series the detection rate is higher than the reported in published literature. Variables associated with a higher detection rate were similar as those reported by literature. A higher number of samples template is associated with a higher detection rate, nevertheless the differences were not statistically significant, it did not have a higher low risk cancer detection rate and had an incidence of complications similar to the previously reported. known risk factors of upgrading are a high level of PSA and the prostate volumen. Interesting is that we encounter asociation between of CAPRA score => 2 and upgrading, this is other element to consider in the evaluation of the patient prior to treatment. (AU)

Colesterolosis vesicular: algunos aspectos de su fisiopatología / Vesicular cholesterolosis: some aspects of its pathophysiology

Gallbladder cholesterolosis is a nosological clinical entity where the central element is the deposit of lipids in immune cells that reside under the gallbladder epithelium. The mechanisms involved in its development are not entirely clear, but they seem to have some resemblances that are observed in the wall of the arteries with atherosclerosis. The lipid-laden cells observed in the gallbladder wall appear to share many of the characteristics of atherosclerosis foam cells, which by means of scavenger receptors have endocited oxidized low-density lipoproteins and accumulate them in their cytoplasm. Foam cells, in themselves, are not dangerous, but in atherosclerosis at least they can become a problem when they are located in vessels and specific anatomic sites. The role they may have in the gallbladder is not known to date. We will review some considerations that seem relevant to us to elucidate if these entities share the same protagonist: macrophages transformed by modified lipids. (AU)

Patrón de revascularización de injertos de tendones flexores rotos en reconstrucción de ligamento cruzado anterior: un estudio histológico / Revascularisation pattern of ruptured flexor tendon grafts in anterior cruciate ligament reconstruction: a histological study

Introducción. Para la reconstrucción exitosa del ligamento cruzado anterior (LCA) son necesarias la revascularización y la maduración histológica del injerto. Fallos en este proceso pueden causar la rotura del neoligamento. Objetivo. Describir las diferencias en la maduración histológica de plastias fallidas precoces (menos de 12 meses poscirugía) y tardías (más de 12 meses poscirugía) en pacientes con rerrotura de reconstrucción de LCA con tendones flexores. Materiales y métodos. Estudio observacional descriptivo. Serie consecutiva de 20 pacientes con fallo en la reconstrucción de LCA con tendones flexores. Muestras obtenidas mediante biopsia de los remanentes del injerto (porción proximal, corporal y distal) durante la cirugía de revisión. Las muestras fueron evaluadas por microscopia de luz y la vascularización y la maduración fueron establecidas mediante un puntaje histológico descrito en la literatura. Resultados. La causa más común de fallo de reconstrucción (86,6%) fue un evento identificable sin mediar traumatismo directo. Los pacientes con rotura precoz de la plastia del LCA presentaron vasos sanguíneos más superficiales en comparación con los con rotura tardía. El segmento distal del injerto en los pacientes con roturas precoces mostró una menor maduración histológica con menor número de fibras de colágeno. Conclusión. En los pacientes que presentaron fallos en las reconstrucciones de LCA precoces (dentro de los 12 meses poscirugía) encontramos una distribución menor de vasos sanguíneos y fibras de colágeno en la región distal del injerto. Estos resultados indican un retraso en la maduración, pudiendo generar mayor riesgo de fallo del injerto (AU)

Introduction. For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture. Purpose. The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons. Material and methods. A descriptive observational study was conducted on a consecutive series of 20 patients whose ACL reconstruction had failed. Graft biopsy samples were obtained during the revision surgery from the proximal, medial, and distal graft remnants. The samples were evaluated by light microscopy, and the vascularity and maturation of the samples were established by histological scoring. Results. The most common aetiology of reconstruction failure (86.6%) was a specific event with non-contact mechanism. The patients with re-rupture of their ACL plasty less than 12 months after surgery had substance vessels that were less deep. The distal segment of the graft in those patients showed a delay in histological maturation with fewer collagen fibres. Conclusion. In patients whose ACL grafts failed less than 12 months after surgery, a lower distribution of blood vessels and collagen fibres was found that were less ordered in the distal graft. These results indicate a delay in maturation, which leads to a higher risk of graft failure (AU)

Revascularisation pattern of ruptured flexor tendon grafts in anterior cruciate ligament reconstruction: A histological study. / Patrón de revascularización de injertos de tendones flexores rotos en reconstrucción de ligamento cruzado anterior: un estudio histológico.

INTRODUCTION: For successful anterior cruciate ligament (ACL) reconstruction, revascularisation and histological maturation are necessary, as their failure can cause graft rupture. PURPOSE: The purpose of this study was to describe differences in the histological maturation of early failed plasty (less than 12 months after surgery) and late failed plasty (more than 12 months after surgery) in patients with re-rupture after ACL reconstruction with hamstring tendons. MATERIAL AND METHODS: A descriptive observational study was conducted on a consecutive series of 20 patients whose ACL reconstruction had failed. Graft biopsy samples were obtained during the revision surgery from the proximal, medial, and distal graft remnants. The samples were evaluated by light microscopy, and the vascularity and maturation of the samples were established by histological scoring. RESULTS: The most common aetiology of reconstruction failure (86.6%) was a specific event with non-contact mechanism. The patients with re-rupture of their ACL plasty less than 12 months after surgery had substance vessels that were less deep. The distal segment of the graft in those patients showed a delay in histological maturation with fewer collagen fibres. CONCLUSION: In patients whose ACL grafts failed less than 12 months after surgery, a lower distribution of blood vessels and collagen fibres was found that were less ordered in the distal graft. These results indicate a delay in maturation, which leads to a higher risk of graft failure.

Tumor adenomatoide pleural / Adenomatoid pleural tumor

Introduction: Adenomatoid tumors are rare benign neoplasms, pleural is a very rare location, reporting only 4 cases worldwide and none in our country. Case report: A 30 year-old female patient, that in the context of a preventive health examination, presents a mediastinal solid mass in the right hemithorax, in the thorax radiography. The lesion of 8 cm x 7 cm x 2.4 cm was surgically removed. Histology shows a lesion compatible with pleural adenomatoid tumor and inmunohistochemistry is positive for markers such as calretinin and cytokeratin 5/6. Discussion: The pleural adenomatoid tumor is an uncommon neoplasm with benign behavior and several differential diagnoses.

Introducción: Los tumores adenomatoides son neoplasias benignas poco frecuentes, cuya ubicación pleural es de muy baja frecuencia, reportándose sólo 4 casos a nivel mundial y ninguno nacional a la fecha. Las muestras parciales en biopsia intraoperaratoria, en ausencia de antecedentes clínico-radiológicos puede representar un desafío diagnóstico. Caso clínico: Paciente de sexo femenino, 30 años que en contexto de un examen preventivo de salud se pesquisa en la radiografía de tórax una masa sólida mediastínica en hemitórax derecho. Se extirpa lesión redondeada de 8 cm. La histología muestra lesión compatible con tumor adenomatoide pleural y la inmunohistoquímica positividad para marcadores Calretinina y Citoqueratina 5/6. Discusión: El tumor adenomatoide pleural en una entidad poco frecuente, de comportamiento benigno, con diversos diagnósticos diferenciales.

Abordaje vaginoscópica para la realización de histeroscopía oficinal: experiencia, resultados y revisión de la literatura / Vaginoscopic approach to perform officinal hysteroscopy: experience, results and literature review

OBJETIVO: Presentar nuestra experiencia y una revisión de la literatura sobre la utilización de la vaginohisteroscopia oficinal. Describir las principales indicaciones, su tolerancia, los procedimientos realizados y las complicaciones resultantes. MÉTODO: Estudio descriptivo de todos los procedimientos vaginohisteroscópicos ambulatorios realizados en la Unidad de Medicina Reproductiva e Infertilidad del Departamento de Obstetricia y Ginecología del Hospital Clínico de la Universidad de Chile, entre el 1° de enero de 2008 y el 31 de enero de 2014. RESULTADOS: Se realizaron un total de 632 vaginohisteroscopias: 63,7% diagnósticas y 36,2% quirúrgicas. El tiempo promedio de realización fue de 13 ± 8 minutos. La percepción de dolor presentó una mediana de EVA 4 con intercuartiles de 3 y 6. La principal indicación fue por sospecha de pólipos endometriales (33%) y engrosamiento endometrial en un 12%. El hallazgo histeroscópico más frecuente fue cavidad endometrial normal (27%) y pólipos endometriales (27%). Los procedimientos más frecuentes fueron polipectomías (27%) y biopsias endometriales (20%). Se registraron 17 complicaciones (2,6%): 14 reacciones vasovagales (2,2%) y 3 lipotimias (0,4%). CONCLUSIONES: El abordaje vaginohisteroscópico ha demostrado ser una técnica segura, resolutiva, bien tolerada por las pacientes y de menor costo.

OBJECTIVE: To present our experience and a review of the literature of the vaginohysteroscopic technique. To describe the main indications, the tolerance, the procedures performed and their complications. METHOD: This is a descriptive study of all outpatient procedures performed with the vaginohysteroscopic technique in the Reproductive Medicine and Infertility Unit of the Department of Obstetrics and Gynecology at University Hospital of Chile between 1st January of 2008 and 31st January of 2014. RESULTS: A total of 632 vaginohysteroscopys were performed: 63.7% diagnostic and 36.2% surgical. The average procedure time was 13 ± 8 minutes. Pain showed a median of VAS of 4. The main indication was suspected endometrial polyps (33%) and endometrial thickening (12%). The most frequent finding was normal endometrial cavity (27%) and endometrial polyps (27%). The most common procedures were polypectomy (27%) and endometrial biopsies (20%). We registered 17 complications (2.6%): 14 vasovagal reactions (2.2%) and 3 lipothymias (0.4%). CONCLUSIONS: vaginohisteroscopy approach has proven to be a safe and very resolutive technique, well tolerated by patients and considerably cost-effective.