Donor Age Influences Graft-Versus-Host Disease Relapse-Free Survival after Allogeneic Stem Cell Transplant in Elderly Patients in Two Countries from Latin America.

BACKGROUND AND OBJECTIVES: Allogeneic stem cell transplantation (Allo-SCT) in elderly patients is a growing practice. We aimed to determine the graft-versus-host disease (GVHD) relapse-free survival (GRFS) in patients ≥65 years who underwent Allo-SCT in two countries from Latin America. PATIENTS AND METHODS: We performed a retrospective analysis of patients ≥65 years who underwent Allo-SCT in Argentina and Brazil from 2007 to 2019. RESULTS: Ninety-eight patients were evaluated, with primary diagnoses of acute myeloid leukemia and myelodysplastic syndrome; 30% of patients had a hematopoietic cell transplant-comorbidity index (HCT-CI) score ≥3 and 49% were in complete remission. Donor types included matched sibling (n = 41), matched unrelated (n = 31), and haploidentical (HID; n = 26) donors. The conditioning regimen was myeloablative in 28 patients (14 busulfan pharmacokinetically [PK]-guided) and reduced-intensity in 70 patients. The two-year non-relapse mortality (NRM) was 29%, with a higher NRM in melphalan-based compared to other conditionings (51% vs. 33%, p = 0.02). The two-year relapse rate was 24%, with a reduction in PK-guided busulfan (0% vs. 28%, p = 0.03). The two-year overall survival (OS) and GRFS was 52% and 38%, respectively, with a significant reduction in GRFS in HCT-CI ≥3 (27% vs. others 42%, p = 0.02) and donors ≥40 years (29% vs. <40 years 55%, p = 0.02). These variables remained significantly associated with GRFS after multivariate analysis. CONCLUSION: In this cohort of elderly patients from Argentina and Brazil undergoing Allo-SCT, donor age and comorbidities significantly influenced GRFS. The role of the conditioning regimen in this population deserves further investigation.

The subjective feeling of a gap between conceptual and perceptual fluency is interpreted as a metacognitive signal of pastness.

The present study aimed to address the following question: does the discrepancy between an expected word and its readability enhances or impair its memorability? We used an adaptation of the sentence stem paradigm (Whittlesea in J Exp Psycol 19:1235-1253, 1993) and manipulated the perceptual clarity of the words by introducing some Gaussian noise (Reber in Psycol Sci 9:45-48, 1998). The target words were semantically predictable or otherwise (conceptual fluency) or were easy or difficult to read (perceptual fluency). The first experiment was conducted to ensure that the two manipulated factors had an impact on the readability of the words. In particular, results showed that when the words were written against a noisy background their predictability enhanced the judgement of readability. The second experiment aimed to test the hypothesis that recognition would be influenced by the discrepancy between conceptual and perceptual fluency. The results showed that with a noisy background, the predictability of the target words had an impact on recognition judgement; with a clear background, the effect on the recognition judgement was caused by the non-predictability of the target words. Conversely, confidence in judgement increased when the two factors went in the same direction, that is, predictability with clarity and non-predictability with low clarity. The results showed that (a) depending on the task, the effects of conceptual and perceptual fluency did not go in the same direction; (b) the kinds of fluency (conceptual and perceptual) were not independent; and (c) recognition judgements were affected by the gap between conceptual and perceptual fluency.

Fibrohistiocitoma maligno / Malignant fibrohystiocytoma

RESUMEN El fibrohistiocitoma maligno es el sarcoma de partes blandas más frecuente en adultos; es poco frecuente como tumor primario cutáneo. Presenta predilección por el sexo masculino con una mayor incidencia entre la quinta y sexta década de la vida. Se localiza predominantemente en las extremidades. Presentamos a continuación el caso clínico de un paciente con diagnóstico de fibrohistiocitoma maligno localizado en hallux de pie derecho y realizaremos una revisión de la literatura.

ABSTRACT Malignant fibrohistiocytoma is the most frequent soft tissue tumor in adults; it is rare as a primary cutaneous tumor. It presents a predilection for males with the highest incidence between the fifth and sixth decade of life. It is located predominantly on the extremities. We will perform a literature review. We present below the clinical case of a patient diagnosed with malignant fibrohistiocytoma located in hallux of the right foot.

Gran feto acardio: diagnóstico tardío de gestacion gemelar monocorial biamniótica complicada por secuencia TRAP: reporte de un caso y revisión de la literatura / Great acardiac fetus: late diagnosis of monochorionic diamniotic twin pregnancy complicated by sequence TRAP: case report and review of the literature

OBJETIVOS: reportar el caso de una paciente con gestación gemelar monocorial-biamniótica complicada por secuencia TRAP que dio lugar al nacimiento de un feto bomba de 1932 gramos sin malformaciones anatómicas y de un feto acardio anceps de 1800 gramos, y realizar una revisión sobre esta patología y la importancia de su diagnóstico y tratamiento precoces. MATERIALES Y MÉTODOS: se presenta el caso de un feto acardio en una gestante con embarazo sin control estricto en el Hospital San Pedro de Logroño en el año 2019, de interés por su diagnóstico tardío y elevado peso al nacimiento del feto acardio. Se realizó una búsqueda de la literatura en las bases de datos Medline vía PubMed, OVID, Embase y SciE-LO con las palabras clave DeCS y términos MeSH. Como criterios de inclusión se consideraron artículos tipo series y reportes de casos y artículos de revisión desde enero de 1950 hasta enero de 2020. RESULTADOS: la búsqueda incluyó 39 referencias bibliográficas sobre las que se repasaron las principales cuestiones teóricas a exponer. El peso del feto acardio de nuestro caso fue muy elevado sin provocar repercusión en el feto sano, en comparación con la bibliografía, lo que aporta singularidad al caso, siendo sólo equiparable la serie de casos de Brassard et al (1999), con pesos de los fetos acardio por encima de 1700 gramos y diferenciándose en 100 gramos del feto bomba. CONCLUSIONES: el feto acardio es una complicación infrecuente de embarazos gemelares monocoriales. Se requiere la presencia de anastomosis vasculares placentarias entre ambas circulaciones. El diagnóstico precoz es importante para disminuir la morbilidad y usar, en la medida de lo posible, técnicas terapéuticas no invasivas.

OBJECTIVES: to report the case of a patient with a monochorionic-biamniotic twin gestation complicated by TRAP sequence that gave rise to the birth of a pump fetus without anatomical malformations (1932 g) and an acardiac anceps fetus (1800 g), and to review this pathology and the importance of its early diagnosis and management. MATERIAL AND METHODS: the case of an acardiac fetus is presented in a pregnant woman without strict control at the Hospital San Pedro de Logroño in 2019, worthwhile because of its late diagnosis and high birth weight. A search of the literature was carried out in the Medline databases via PubMed, OVID, Embase and SciELO with the MeSH terms. As inclusion criteria, we considered series-type articles and case reports, cohorts and review articles from January 1950 to January 2020. RESULTS: 39 bibliographic references were included with the main theoretical questions to be reviewed. Our acardiac fetus weight was very high comparing with the bibiography and without causing repercussion in the healthy fetus, which contributes to the uniqueness of the case, only the series report by Brassard et al (1999) is comparable, with weights of the acardiac fetus above 1700 grams and differing by 100 grams from the pump fetus. CONCLUSIONS: the acardiac fetus is an infrequent complication of monochorionic twin pregnancies. The presence of placental vascular anastomoses between both circulations is required. Early diagnosis is important to decrease morbidity and to use, as far as possible, non-invasive therapeutic techniques.

Challenges of In-House Development and Implementation of a CPOE for Oncology.

Hospital Italiano de Buenos Aires (HIBA) is an academic tertiary care hospital highly specialized that has started the process of informatization of chemotherapy protocols. The objective is to describe the development of a computerized physician order entry (CPOE) oriented to the oncology adult patient and the members of the healthcare team that works with him (physicians, pharmacists, nurses and administrative staf) to improve the process and prevent errors at a critical point in the patient's health care: during prescription, preparation and / or administration. The development of this system consisted of several stages: inquiries about the usual work and perception of needs of the potential users; user-centered design; interoperability with the electronic health record (EHR) and development of a final prototype.

Evaluating the Use of a CPOE for Chemotherapy Protocols.

Chemotherapy drugs are one of the most common causes of serious and fatal medication errors, especially during prescribing, where computerized physician order entry (CPOE) take on importance. This study proposes the description of the post-implementation status of a CPOE in a highly specialized hospital between January and June 2018, among patients older than 18 years. Results: a total of 8835 protocols were indicated using the specific CPOE (93% use rate over all protocols) 91% completed the administration, 1.2% were rejected by pharmacy, and 6.8% was canceled. The most frequent cause of rejection by pharmacy and cancellation by oncologist was an inadequate dose. Most of the protocols indicated using the CPOE implemented, with a reject by pharmacy rate of 1.2%, indicates the utility of CPOE as an error prevention strategy.

Changes in Corneal Expression of MUC5AC after Autologous Serum Eyedrop Treatment in Patients with Limbal Stem Cell Deficiency.

Purpose: To evaluate the effect of autologous serum eyedrops treatment on corneal expression of the MUC5AC in patients with limbal deficiency. Methods: A prospective and comparative interventional case series study of 42 eyes of 21 patients was performed before and 8 weeks after treatment with autologous serum. All patients underwent a complete ophthalmic assessment of the tear film and ocular surface, corneal impression cytology (IC) and MUC5AC detection by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Results: Forty-one of the 42 eyes studied were available for both conventional cytology and MUC5AC analysis prior to and after treatment. Differences between outcomes obtained by impression cytology and MUC5AC detection were found in 9 of 82 samples (11%). We found changes in the corneal expression of MUC5AC after treatment in 19 of 41 eyes (46.3%): 18 of them (94.7%) changed from positive to negative expression, and 1 eye (5.3%) changed from negative to positive MUC5AC expression after autologous serum eyedrops. These changes were related with the corneal involvement prior to treatment (15 of them (78.9%) occurred in patients with slight corneal involvement), and with the improvement in the degree of squamous metaplasia after treatment (P = .001 and P = .003, respectively). Conclusions: The treatment significantly improved tear stability, squamous metaplasia, and subjective patient perception. Autologous serum eyedrops treatment diminished the corneal expression of MUC5AC mainly in patients with slight corneal involvement before treatment.

[Pathophysiology of the glutamate and the glycine transporters: new therapeutic targets]. / Fisiopatologia de los transportadores de glutamato y de glicina: nuevas dianas terapeuticas.

INTRODUCTION: The amino acids glutamate and glycine, apart from their role in protein synthesis, are two fundamental neurotransmitters in the central nervous system of mammals. The first one is ubiquitous and is involved in excitatory pathways of the neocortex, the retina and the cerebellum, and the second is involved in inhibitory pathways of brain caudal areas. However, both share their way of acting by integrating into the functioning of glutamate receptors of the NMDA type fundamentals in the regulation of motor, sensory and cognitive systems. AIM: To highlight the need for a fine regulation of glutamate and glycine concentrations in the intracellular and extracellular spaces of the nervous system through the action of very specific transporters for both neurotransmitters located in the plasma membrane of neurons and glial cells. DEVELOPMENT: The role of the glutamate and glycine transporters in glutamatergic and glycinergic neurotransmission and in the functioning of the nervous system is described. The pathological consequences of imbalances in these signaling pathways are pointed out. We also describe its involvement in pathologies such as schizophrenia, chronic pain, cerebral ischemia, diseases such as hereditary hyperekplexia and the non-ketotic hyperglycinemia, and neurodegenerative disorders. CONCLUSIONS: The knowledge at molecular level of the way of acting of these transporters for glutamate and glycine is allowing the identification and development of new therapeutic strategies for pathologies such as those described above and the development of new drugs.

TITLE: Fisiopatologia de los transportadores de glutamato y de glicina: nuevas dianas terapeuticas.Introduccion. Los aminoacidos glutamato y glicina, aparte de su papel en la sintesis de proteinas, son dos neurotransmisores fundamentales en el sistema nervioso central de los mamiferos. El primero es ubicuo y esta implicado en vias excitatorias de la neocorteza, la retina y el cerebelo, y el segundo esta asociado a vias inhibitorias de zonas caudales del cerebro. Sin embargo, ambos comparten su manera de actuar al integrarse en el funcionamiento de los receptores de glutamato del tipo NMDA, fundamentales en la regulacion de sistemas motores, sensitivos y cognitivos. Objetivo. Evidenciar la necesidad de una regulacion exquisita de las concentraciones de glutamato y de glicina en los espacios intra y extracelulares del sistema nervioso mediante la actuacion de transportadores muy especificos para ambos neurotransmisores localizados en la membrana plasmatica de las neuronas y de las celulas de la glia. Desarrollo. Se describe el papel de los transportadores de glutamato y glicina en la neurotransmision glutamatergica y glicinergica, y en el funcionamiento del sistema nervioso. Se señalan las consecuencias patologicas de los desequilibrios en estas vias de señalizacion. Tambien se describe su participacion en patologias como la esquizofrenia, el dolor cronico, la isquemia cerebral, la hiperplexia hereditaria, la hiperglicinemia no cetosica o trastornos neurodegenerativos. Conclusiones. El conocimiento de la forma molecular de actuar de los transportadores de glutamato y de glicina esta permitiendo la identificacion y el desarrollo de nuevas estrategias terapeuticas para patologias como las descritas y el desarrollo de nuevos farmacos.

The clinical utility of PGD with HLA matching: a collaborative multi-centre ESHRE study.

STUDY QUESTION: Has PGD-HLA been successful relative to diagnostic and clinical efficacy? SUMMARY ANSWER: The diagnostic efficacy of PGD-HLA protocols was found lower in this study in comparison to published PGD-HLA protocols and to that reported for general PGD by ESHRE (78.5 vs 94.1% and vs 92.6%, respectively), while the clinical efficacy has proven very difficult to assess due to inadequate follow-up of both the ART/PGD and HSCT procedure outcomes. WHAT IS KNOWN ALREADY: The first clinical cases for PGD-HLA were reported in 2001. It is now a well-established procedure, with an increasing number of cycles performed every year. However, PGD-HLA is still offered by relatively few PGD centres, the currently available data is fragmented and most reports on PGD-HLA applications are limited in number and scope. Published systematic details on methodology, diagnostic results, overall ART success and haematopoietic stem cell transplantation (HSCT) outcomes are limited, precluding an evaluation of the true clinical utility of PGD-HLA cycles. STUDY DESIGN, SIZE, DURATION: This retrospective multi-centre cohort study aimed to investigate the diagnostic and clinical efficacy of the PGD-HLA procedure and the aspects of PGD-HLA cycles influencing positive outcomes: birth of genetically suitable donor-baby (or babies) and HSCT. In April 2014, 32 PGD centres (Consortium members and non-members) with published/known PGD-HLA activity were invited to participate. Between February and September 2015, 14 centres submitted their data, through a custom-designed secure database, with unique login access for each centre. Data parameters covered all aspects of PGD-HLA cycles (ART, embryology and genetic diagnosis), donor-babies born and HSCT. PARTICIPANTS/MATERIALS, SETTING, METHODS: From 716 cycles submitted by 14 centres (performed between August 2001 and September 2015), the quality evaluation excluded 12 cycles, leaving 704, from 364 couples. The online database, based on REDCap, a free, secure, web-based data-capture application, was customized by Centre for Clinical Epidemiology and Outcomes Research (CLEO), Athens. Continuous variables are presented using mean, standard deviation, median and interquartile range, and categorical variables are presented as absolute and relative frequencies. MAIN RESULTS AND THE ROLE OF CHANCE: The data included 704 HLA-PGD cycles. Mean maternal age was 33.5 years. Most couples (81.3%) requested HLA-typing with concurrent exclusion of a single monogenic disease (58.6% for beta-thalassaemia). In 92.5% couples, both partners were fertile, with an average 1.93 HLA-PGD cycles/couple. Overall, 9751 oocytes were retrieved (13.9/cycle) and 5532 embryos were analysed (7.9/cycle). Most cycles involved fresh oocytes (94.9%) and Day 3 embryo biopsy (85.3%). In 97.5% of cycles, the genotyping method involved PCR only. Of 4343 embryos diagnosed (78.5% of analysed embryos), 677 were genetically suitable (15.4% of those analysed for HLA alone, 11.6% of those analysed for HLA with exclusion of monogenic disease). Of the 364 couples, 56.6% achieved an embryo transfer (ET) and 598 embryos were transferred in 382 cycles, leading to 164 HCG-positive pregnancies (pregnancy rate/ET 41.3%, pregnancy rate/initiated cycle 23.3%) and 136 babies born (live birth rate/ET 34.3%, live birth rate/initiated cycle 19.3%) to 113 couples. Data analysis identified the following limitations to the overall success of the HLA-PGD procedure: the age of the mother undergoing the treatment cycle, the number of oocytes collected per cycle and genetic chance. HSCT was reported for 57 cases, of which 64.9% involved combined umbilical cord-blood and bone marrow transplantation from the HLA-identical sibling donor; 77.3% of transplants reported no complications. LIMITATIONS REASONS FOR CAUTION: The findings of the study may be limited as not all PGD centres with PGD-HLA experience participated. Reporting bias on completion of the online database may be another potential limitation. Furthermore, the study is based on retrospective data collection from centres with variable practices and strategies for ART, embryology and genetic diagnosis. WIDER IMPLICATIONS OF THE FINDINGS: This is the first multi-centre study evaluating the clinical utility of PGD-HLA, indicating variations in practice and outcomes throughout 15 years and between centres. The study highlights parameters important for positive outcomes and provides important information for both scientists and couples interested in initiating a cycle. Above all, the study underlines the need for better collaboration between all specialists involved in the ART-PGD/HLA procedure, as well as the need for comprehensive and prospective long-term data collection, and encourages all specialists to aim to properly evaluate and follow-up all procedures, with the ultimate aim to promote best practice and encourage patient informed decision making. STUDY FUNDING/COMPETING INTEREST(S): The study wishes to acknowledge ESHRE for funding the customization of the REDCap database. There are no competing interests. TRIAL REGISTRATION NUMBER: N/A.

Rasgos de personalidad desadaptativos y trastornos de la personalidad en mujeres que denuncian a sus parejas. A propósito de un caso / Not well adapted personality features and personality disorders in women who denounce. Regarding to a case

La personalidad nace con la persona, se modela y supone un conjunto de rasgos flexibles (dimensión perdurable o persistente), que caracterizan a un individuo, explican su conducta y lo hacen distinto de los demás. Los trastornos de personalidad son patrones estables, permanentes e inflexibles de conductas mal adaptadas a las expectativas o esquemas establecidos. Los rasgos pueden tornarse anómalos y constituir trastornos de la personalidad cuando son inflexibles, desadaptativos y causan un deterioro funcional y un malestar subjetivo en el sujeto y en los demás. La persona del caso estudiado viene marcada por una personalidad con discrepancias con su entorno desde la infancia. Ha vivido con un sentimiento de abandono y un victimismo que la han llevado a la búsqueda constante de afectos y llamadas de atención, que han determinado sus acciones judicializadas. Se caracteriza por rasgos de personalidad histriónica, paranoide y esquizoide

The personality is born with the person, it is shaped and assumes a set of flexible traits (lasting or persistent dimension), that characterize an individual, explain their behavior and make it different from others. The personality disorders are stables, permanents and inflexible patterns of not well adapted behaviors to established expectations or patterns. Traits can become anomalous and constitute personality disorders when they are inflexible, maladaptive and cause functional worsening and subjective discomfort in the subject and in others. The individual analysed has a personality with discrepancies with her environment since the childhood. She has lived with a neglect feeling and claiming she was being victimized. These feelings have made her to look constantly for affection and to attract the attention, determining her judicial actions. She is characterized by a histrionic, paranoid and schizoid personality

Genetics of recurrent miscarriage and fetal loss.

Despite years of research, miscarriage, particularly when recurrent, continues to pose a medical challenge. An embryo chromosomal error is responsible for 50-60% of recurrent cases; however, up to 30-50% remains an enigma. Successful pregnancy involves different maternal physiologic changes and certain complex interactions between the fetus and the mother by cytokines, angiogenic mediators and hormones. To date, research lines have focused on genetic and epigenetic polymorphisms related mainly to immune response and inflammatory mediators, and have yielded a significant relationship between recurrent miscarriage and immune mechanisms. Thus, unknown causes of miscarriage could be due to an immune imbalance induced by T-helper Th1/Th2/Th17 cytokines and regulatory T cells. Furthermore, these genes and mediators have long been suspected of being blood markers for the clinical diagnosis and management of miscarriage; however, more evidence is required for them to be included in medical practice and obstetric guidelines.

Transverse Cervicothoracic Stabbing: Multidisciplinary Management of a Surgical Emergency.

Tracheobronchial injuries are closely related to orotracheal intubations and chest traumas. Stabbing injuries are very rare and often life threatening because of the damage to vital structures such as the respiratory tract and large arterial or venous vessels. Early diagnosis and treatment of penetrating neck injuries increase survival rates. We report a case of the tracheobronchial section with a penetrating stabbing wound on the left laterocervical area associated with contralateral pneumothorax, requiring urgent surgical pulmonary repair, tracheal suture, and tracheotomy. Prompt action with a multidisciplinary approach resulted in a favorable outcome.

Carcinoma de los ductos colectores de bellini: presentación de un caso clínico y revisión del diagnóstico diferencial / Collecting (bellini) duct carcinoma: a case presentation

Collecting (Bellini) duct carcinoma (CDC) is a rare and very aggressive variant of renal cell carcinoma. Objectives: To describe the radiological findings of a CDC case and to determine its differential diagnosis. Basic procedures: Review the published works regarding this tumor and compare the radiological findings of our case with those of other described cases. Most important findings: CDCs are well-defined tumors with a high hemorrhagic component, limited internal enhancement and nodal metastases. In the differential diagnosis, if the lesion presents an exophytic growth it should include papillary carcinoma, mainly the sarcomatoid variant and the complex benign lesions (complex cysts or hydatids). However, if the lesion combines an infiltrating pattern, other lesions such as medullary carcinoma or lymphoma will be taken into account. Main conclusions: In the presence of solid-cystic hypovascular lesions and regional lymphadenopathy, CDC must be included in the differential diagnosis.

El carcinoma de las células colectoras de Bellini (CCB), es una variante rara y muy agresiva del carcinoma de células renales. Objetivos: Describir los hallazgos radiológicos de un caso de CCB y determinar su diagnóstico diferencial. Procedimientos básicos: Revisión de los trabajos publicados sobre este tumor y comparar los hallazgos radiológicos de nuestro caso con los de otros casos descritos. Hallazgos más importantes: Los CCB son tumores bien delimitados con alto componente hemorrágico, escaso realce interno y metástasis ganglionares. En el diagnóstico diferencial si la lesión presenta un crecimiento exofítico debería incluirse el carcinoma papilar, fundamentalmente la variante sarcomatoide y las lesiones benignas complejas (quistes complejos o hidatídicos). En cambio, si la lesión asocia un patrón infiltrante se tendrán en cuenta otras lesiones como el carcinoma medular o el linfoma. Conclusiones principales: En presencia de lesiones sólido-quísticas hipovasculares y adenopatías regionales debe incluirse el CCB en el diagnóstico diferencial.

Estudio de los casos reconocidos en la Unidad de Valoración Integral de Violencia de Género (UVIVG) de Sevilla, durante los años 2013 y 2014 / Cases reports assessed by professionals of the UVIVG in Seville from 2013 to 2014

En la presente investigación, llevada a cabo por la Unidad de Valoración Integral de Violencia de Género de Sevilla (UVIVG), a lo largo de los años 2013 y 2014, se han incluido aquellos casos en los que se ha explorado la existencia de situaciones de violencia en la pareja, llegando a elaborar 562 informes. Dichos informes dan respuesta a las periciales solicitadas por jueces y magistrados, y en ellos se han valorado diferentes variables (edad, sexo, estudios, situación sociolaboral, raza, etc.) que tienen influencia en los comportamientos y respuestas dados por denunciantes y denunciados. Los resultados más elocuentes del estudio han sido el alto porcentaje de casos valorados como conflictividad de pareja, muy por encima de los casos valorados como violencia de género y maltrato, así como el alto porcentaje de las personas españolas y en trámites de separación, por encima de los extranjeros y parejas que mantienen sus relaciones en el momento de la denuncia. De las patologías emocionales más frecuentes que se observan en las mujeres afectas de las situaciones estudiadas tenemos la sintomatología ansiosa y depresiva, y han sido escasos los casos en que se ha valorado la existencia de secuelas psicológicas que impidan la realización de su vida cotidiana. La violencia de género, o cualquier tipo de maltrato en sus formas posibles, no elude a ninguna condición social, económica, cultural, etc. Sí se relacionan ciertas situaciones de trastorno metal y consumos de sustancias con conductas de marcada conflictividad (AU)

This study has been developed by UVIVG Seville, over the years 2013 and 2014. It includes those cases where the professionals of UVIVG have explored the existence of violence situations inside the couple. These professionals have elaborated 562 reports. The reports content the results of the expert investigations asked by the judges. The professionals have dealt different variables in the reports, as age, gender, socio-labour situation, race, etc., which influence over the behavior of the plaintiff and the defendant, and their given answers. The main results of this study have been the highest percentage of cases valuated as couple conflict, comparing with the cases considered as gender violence and maltreatment. Moreover, the study shows that the gender violence occurs more often in Spanish people than in foreigners, and during the process separation than in the stable couple situations. The most frequent emotional pathologies observed in women, who have been affected by the analyzed situations, are the anxiety and depressive symptoms. The existence of psychological aftermath, that impede their normal daily life, were analyzed in few cases. The gender violence or any other possible type of violence took place in every group, without differences between social, economic and social conditions, among others. However, certain mental derangements and narcotic consumption are closely related to conflictual behaviour (AU)

CRISPR-on system for the activation of the endogenous human INS gene.

Advances in the field of epigenetics have allowed the design of new therapeutic strategies to address complex diseases such as type 1 diabetes (T1D). Clustered regularly interspaced short palindromic repeats (CRISPR)-on is a novel and powerful RNA-guided transcriptional activator system that can turn on specific gene expression; however, it remains unclear whether this system can be widely used or whether its use will be restricted depending on cell types, methylation promoter statuses or the capacity to modulate chromatin state. Our results revealed that the CRISPR-on system fused with transcriptional activators (dCas9-VP160) activated endogenous human INS, which is a silenced gene with a fully methylated promoter. Similarly, we observed a synergistic effect on gene activation when multiple single guide RNAs were used, and the transcriptional activation was maintained until day 21. Regarding the epigenetic profile, the targeted promoter gene did not exhibit alteration in its methylation status but rather exhibited altered levels of H3K9ac following treatment. Importantly, we showed that dCas9-VP160 acts on patients' cells in vitro, particularly the fibroblasts of patients with T1D.

Mesenchymal stromal cells overexpressing vascular endothelial growth factor in ovine myocardial infarction.

Mesenchymal stromal cells (MSCs) are cardioprotective in acute myocardial infarction (AMI). Besides, we have shown that intramyocardial injection of plasmid-VEGF(165) (pVEGF) in ovine AMI reduces infarct size and improves left ventricular (LV) function. We thus hypothesized that MSCs overexpressing VEGF(165) (MSCs-pVEGF) would afford greater cardioprotection than non-modified MSCs or pVEGF alone. Sheep underwent an anteroapical AMI and, 1 week later, received intramyocardial MSCs-pVEGF in the infarct border. One month post treatment, infarct size (magnetic resonance) decreased by 31% vs pre-treatment. Of note, myocardial salvage occurred predominantly at the subendocardium, the myocardial region displaying the largest contribution to systolic performance. Consistently, LV ejection fraction recovered to almost its baseline value because of marked decrease in end-systolic volume. None of these effects were observed in sheep receiving non-transfected MSCs or pVEGF. Although myocardial retention of MSCs decreased steeply over time, the treatment induced significant capillary and arteriolar proliferation, which reduced subendocardial fibrosis. We conclude that in ovine AMI, allogeneic VEGF-overexpressing MSCs induce subendocardial myocardium salvage through microvascular proliferation, reducing infarct size and improving LV function more than non-transfected MSCs or the naked plasmid. Importantly, the use of a plasmid rather than a virus allows for repeated treatments, likely needed in ischemic heart disease.

Relación entre el consumo abusivo de alcohol y la violencia ejercida por el hombre contra su pareja en la unidad de valoración integral de violencia de género (UVIVG) de Sevilla / Relation between alcohol consumption and violence of men towards their relationships in the UVIVG of Seville (Spain)

Se ha estudiado la posible relación entre el consumo de alcohol y la violencia ejercida por el hombre hacia la mujer con la que mantiene o ha mantenido relación sentimental, en una muestra de 50 parejas analizadas en la Unidad de Valoración Integral de Violencia de Género (UVIVG) de Sevilla, a lo largo de los años 2013 y 2014. Para ello se ha empleado una entrevista estructurada creada ad hoc, así como los cuestionarios MINI, MALT y CAGE. De las 50 parejas, en 25, las mujeres que denunciaron afirmaban que sus parejas eran consumidoras de alcohol y en ocasiones de otras sustancias de adicción, diagnosticándose tal consumo únicamente en 16 de estos hombres; la otra mitad de la muestra negaba el consumo de sustancias de adicción en sus parejas. Los resultados obtenidos muestran que los hombres que consumen alcohol ejercen violencia hacia su pareja en mayor proporción en estado sobrio que en estado ebrio. No obstante, el consumo de alcohol supone un incremento añadido en la frecuencia de la violencia ejercida. Igualmente, los resultados del estudio ponen de manifiesto que los hombres que no consumen alcohol ejercen violencia en menor porcentaje que los que sí lo hacen (AU)

This article examines the possible relation between alcohol consumption and violence of men towards women with whom they share or have shared a relationship. Our sample is composed of 50 couples analyzed under the Comprehensive Assessment of Gender Violence Unit (UVIVG) of Seville (Spain), during 2013 and 2014. It has been used an structured interview which has been created ad hoc, as well as the MINI, MALT and CAGE questionnaires. In 25 of the 50 analyzed couples, the woman, who had denounced, declared that her partner consumed alcohol and that he often consumed other substances of abuse. Nevertheless, this consumption was only diagnosed in 16 of those men. The women of the other half of the sample denied any consumption of substances of abuse by their partners. The results obtained from the analyzed sample shows that men who consume alcohol are more violent towards their partners when they are sober, than when they are drunk. However, the alcohol consumption increases the frequency of violent actions. Moreover, the results of the analysis reveal that men who do not consume alcohol resort to violence in a lower percentage than those who consume alcohol (AU)

Human health risk assessment with spatial analysis: study of a population chronically exposed to arsenic through drinking water from Argentina.

Arsenic (As) is a ubiquitous element widely distributed in the environment. This metalloid has proven carcinogenic action in man. The aim of this work was to assess the health risk related to As exposure through drinking water in an Argentinean population, applying spatial analytical techniques in addition to conventional approaches. The study involved 650 inhabitants from Chaco and Santiago del Estero provinces. Arsenic in drinking water (Asw) and urine (UAs) was measured by hydride generation atomic absorption spectrophotometry. Average daily dose (ADD), hazard quotient (HQ), and carcinogenic risk (CR) were estimated, geo-referenced and integrated with demographical data by a health composite index (HI) applying geographic information system (GIS) analysis. Asw covered a wide range of concentration: from non-detectable (ND) to 2000 µg/L. More than 90% of the population was exposed to As, with UAs levels above the intervention level of 100 µg/g creatinine. GIS analysis described an expected level of exposure lower than the observed, indicating possible additional source/s of exposure to inorganic arsenic. In 68% of the locations, the population had a HQ greater than 1, and the CR ranged between 5·10(-5) and 2,1·10(-2). An environmental exposure area through ADD geo-referencing defined a baseline scenario for space-time risk assessment. The time of residence, the demographic density and the potential health considered outcomes helped characterize the health risk in the region. The geospatial analysis contributed to delimitate and analyze the change tendencies of risk in the region, broadening the scopes of the results for a decision-making process.

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion.

Transverse maxillary deficiency is commonly found in patients with sleep apnea and is also related to abnormal breathing patterns. Maxillary expansion procedures promote widening of the nasal floor and reduce the resistance to airflow, and have a positive influence on nasopharynx function. In order to evaluate volume changes in the upper airway, 15 adult patients with transverse maxillary deficiency underwent surgically assisted rapid maxillary expansion (RME) until a slight overcorrection of the crossbite was obtained. Cone beam computed tomography (CBCT) volumetric images were obtained at three predefined time points. The mean age of the patients was 30.2 (±7.4) years; nine were females and six were males. The area, volume, and the smallest transverse section area of the airway were assessed using Dolphin Imaging 3D software. Statistical comparisons were made of the changes between time periods. No statistically significant differences were found for volume or area. However a significant difference was found between the preoperative and immediate postoperative smallest transverse section area (P<0.05). Maxillary expansion, as an isolated procedure, does not result in a statistically significant improvement in the airway dimensions and results in an inferior relocation of the smallest transverse section area.