DNA oxidative damage in oral cancer: 8-hydroxy-2´-deoxyguanosine immunoexpression assessment.

BACKGROUND: The development and establishment of oral squamous cell carcinoma are confined to carcinogenesis, which involves oxidative stress via oxygen-free radical production as a hydroxyl radical (HO•), considered the most important cause of oxidative damage to basic biomolecules since it targets DNA strands. 8-Hydroxy-2´-deoxyguanosine (8-OHdG) is considered a free radical with a promutagenic capacity due to its ability to pair with adenosine instead of cytosine during replication. MATERIAL AND METHODS: We collected 30 paraffin-embedded tissue samples of OSCC from patients treated between 2013 and 2018. We recorded risk habits, disease stage, disease free survival and death with at least 3 years of follow-up. 8-Hydroxyguanosine was evaluated by immunohistochemistry and subsequently classified as weak-moderate or strong positive expression. Additionally, we noted whether it was expressed in the cytoplasm and/or nucleus. RESULTS: Most of the cases expressed 8-OHdG with a strong intensity (80%). All neoplastic cells were preferentially stained in only the cytoplasm (70.0%), but nuclear positivity was found in 30%, independent of the intensity. Based on the location in the cytoplasm and/or nucleus, tumors >4 cm showed a high frequency (95.5%) of 8-OHdG expression in only the cytoplasm, with a significant difference (p value 0.001). Additionally, overall survival was affected when immunoexpression was present in the cytoplasm and nucleus because all deaths were in this group were statistically significant (p value = 0.001). CONCLUSIONS: All tumors showed DNA oxidative damage, and 8-OHdG was preferentially expressed in the cytoplasm. This finding was associated with tumor size and, when present in the nucleus, might also be related to death.

Ep-CAM (MOC-31) expression in tooth germ and ameloblastoma.

BACKGROUND: Ep-CAM, a transmembrane glycoprotein expressed in most epithelium in normal conditions, has diverse roles in these tissues, including in cell adhesion, proliferation, differentiation, cell cycle regulation, migration and intracellular signaling. It is also over-expressed in most malignant neoplasia, participating in the initiation, progression, and metastatic dissemination of the tumor. The expression and roles of this protein in oral neoplasia, particularly in odontogenic tumors, remain unestablished. The objective of this study consisted in analyzing the expression of this protein in ameloblastoma and tooth germ. MATERIAL AND METHODS: Ep-CAM (MOC-31) expression was evaluated by immunohistochemistry in tooth germs (TG) (n = 16) ameloblastomas (AM) (n = 60) and 2 ameloblastic carcinomas. Sections were visualized in their totality with an optical microscope, and positivity observed in cell membrane and cytoplasm was graded according to the following semi-quantitative scale: Neg, "essentially unstained", for negative sections or staining <5% of cells; + for staining of 5-50% of cells; ++ for staining >50% of cells. RESULTS: Most tooth germs expressed MOC-31 (81.3%), strong staining was observed both in the inner epithelium of the enamel organ and in the adjacent stellate reticulum. 16.7% of the AM cases showed MOC-31 expression, the immunoexpression expression was diffuse at the cytoplasmic and membrane level. The only two cases of ameloblastic carcinoma included were strong positive to MOC-31. No correlation was observed between protein expression and gender, age, clinical variants, or histological subtypes. CONCLUSIONS: Overexpression was found in TG and ameloblastic carcinoma compared to AM; further studies with different experimental strategies are suggested to clarify the biological significance of this finding.

Expression of caveolin-1 in tooth germ, ameloblastoma and ameloblastic carcinoma.

BACKGROUND: The caveolin-1 protein (structural component of membrane caveolae) plays important roles in several biological functions, such as endocytosis, cell adhesion, and cell signaling. However, this protein has been associated with mechanisms of tumorigenesis in several neoplasms. The expression patterns and roles of caveolin-1 in the oral epithelium and in embryonic and odontogenic tumor tissues are still unclear. MATERIAL AND METHODS: The expression of caveolin-1 was evaluated in samples of the normal gingival epithelium (n=7), human tooth germ (TG) (n=12), ameloblastoma (AM) (n=83), and ameloblastic carcinoma (AC) (n=9) by immunohistochemistry. Additionally, AM samples were analyzed by qRT-PCR and Western blot. RESULTS: Most TG (91.7%), AM (73.5%) and AC (100%) samples showed diverse patterns of immunohistochemical positivity for caveolin-1, while only one gingival sample was positive. The transcript levels of cav-1 were significantly upregulated by 14.9-fold in AM tissue (P = 0.0014) compared to those in normal gingival epithelial tissue, as shown by qRT-PCR. Presence of caveolin-1 protein was confirmed by Western blot analysis. The caveolin-1 immunoexpression patterns throughout the stages of TG show its importance during odontogenesis. CONCLUSIONS: The overexpression of caveolin-1 in AM and AC compared to its expression in normal gingival epithelium (adult tissue) suggests a possible role of caveolin-1 in protumoral events, but due to the similar immunoexpression observed in AM and AC, caveolin-1 may not necessarily participate in the malignant transformation process. However, future studies are needed to clarify and confirm these hypotheses.

Immunoexpression of galectin-3 and its potential relation to hypoxia-inducible factor-1α in ameloblastomas.

In tumor biology, hypoxia triggers signaling pathways that induce transcription of genes related to angiogenesis, metastasis, glucose metabolism and apoptosis. We investigated the expression of hypoxia related proteins, galectin-3 (Gal-3) and hypoxia-inducible factor-1α (HIF-1α), in conventional (CA) and unicystic ameloblastomas (UA). We applied immunohistochemistry for Gal-3 and HIF-1α to 72 cases of ameloblastoma: 59 cases of CA and 13 cases of unicystic UA. Immunoexpression was evaluated semiquantitatively. Gal-3 expression was observed in 40% of the cases: 23/59 CA and 6/13 UA. HIF-1α immunostaining was observed in 55% of cases: 36/59 CA and 4/13 UA. 19 CA and 2 UA were positive for both markers. Immunostaining was evident in the center of the tumor islands, which exhibited squamous metaplasia or cystic degeneration. The expression of Gal-3 and HIF-1α in ameloblastomas could be interpreted as a response to hypoxic stress. Co-expression of both proteins in CA may suggest a potential interaction that participates in the biological behavior of this ameloblastoma variant.

[Learning with COVID-19: what about anticoagulation?]

Infection caused by SARS-CoV-2 (COVID-19) is associated with an increased risk of thromboembolic disease. So-me authors recommend anticoagulation at therapeutic doses for, at least, the most severely ill patients; this practice is not free of risks, which is why only thromboembolic prophylaxis is recommended by other consensuses. In the case of previously anticoagulated patients, changing the oral anticoagulant for a low molecular weight heparin (LMWH) is generally recommended. We present the cases of two patients admitted due to COVID-19, without serious clinical data, in whom anticoagulation (acenocoumarol and rivaroxaban, respectively) was replaced by LMWH at therapeutic doses, both presenting abdominal bleeding. This type of bleeding is an infrequent complication in anticoagulated patients, but the concurrence of two cases in a short period of time in the context of the COVID-19 pandemic leads us to consider that there is not yet any clear evidence on therapeutic anticoagulation in SARS-CoV-2 infection.

Aprendiendo con el COVID-19: ¿qué pasa con la anticoagulación? / Learning with COVID-19: what about anticoagulation?

La infección por SARS-CoV-2 (COVID-19) se relaciona con un aumento del riesgo de enfermedad tromboembólica. Algunos autores recomiendan la anticoagulación en dosis terapéuticas de, al menos, los pacientes más graves, práctica no exenta de riesgos, por lo que otros consensos solo recomiendan la profilaxis tromboembólica. La recomendación generalizada en pacientes previamente anticoagulados es el cambio del anticoagulante oral por heparina de bajo peso molecular (HBPM). Presentamos dos pacientes ingresados por COVID-19 sin datos de gravedad, en los que se sustituyó la anticoagulación (acenocumarol en un caso y rivaroxabán en el otro) por HBPM a dosis terapéuticas, presentando ambos sangrados abdominales. Estos sangrados son una complicación infrecuente en pacientes anticoagulados, pero la concurrencia de dos casos en un breve espacio de tiempo en el contexto de la pandemia por COVID-19 nos plantea que aún no se dispone de una evidencia clara sobre la anticoagulación terapéutica en la infección por SARS-CoV-2

Infection caused by SARS-CoV-2 (COVID-19) is associated with an increased risk of thromboembolic disease. Some authors recommend anticoagulation at therapeutic doses for, at least, the most severely ill patients; this practice is not free of risks, which is why only thromboembolic prophylaxis is recommended by other consensuses. In the case of previously anticoagulated patients, changing the oral anticoagulant for a low molecular weight heparin (LMWH) is generally recommended. We present the cases of two patients admitted due to COVID-19, without serious clinical data, in whom anticoagulation (acenocoumarol and rivaroxaban, respectively) was replaced by LMWH at therapeutic doses, both presenting abdominal bleeding. This type of bleeding is an infrequent complication in anticoagulated patients, but the concurrence of two cases in a short period of time in the context of the COVID-19 pandemic leads us to consider that there is not yet any clear evidence on therapeutic anticoagulation in SARS-CoV-2 infection

Primordial odontogenic tumor: A systematic review.

BACKGROUND: The primordial odontogenic tumor (POT) is a recently described benign entity with histopathological and immunohistochemical features suggesting its origin during early odontogenesis. AIM: To integrate the available data published on POT into a comprehensive analysis to better define its clinicopathological and molecular features. MATERIAL AND METHODS: An electronic systematic review was performed up to September 2019 in multiple databases. RESULTS: A total of 13 publications were included, representing 16 reported cases and 3 molecular studies. The mean age of the affected patients was 11.6 years (range 2-19), with a slight predominance in males (56.25%). The posterior mandible was the main location (87.5%), with only two cases affecting the posterior maxilla. All cases appeared as a radiolucent lesion in close relationship to an unerupted tooth. Recurrences have not been reported to date. Microscopically, POT comprises fibromyxoid tissue with variable cellularity surrounded by a cuboidal to columnar odontogenic epithelium but without unequivocal dental hard tissue formation. A delicate fibrous capsule surrounds (at least partially) the tumor. The epithelial component shows immunohistochemical positivity for amelogenin, CK19, and CK14, and variable expression of Glut-1, Galectin-3 and Caveolin-1, Vimentin, p-53, PITX2, Bcl-2, Bax and Survivin; the mesenchymal tissue is positive for Vimentin, CD90, p-53, PITX2, Bcl-2, Bax, and Survivin, and the subepithelial region exhibits the strong expression of Syndecan-1 and CD34. The Ki-67 index is low (<5%). The negative or weak expression of dentinogenesis-associated genes could explain the inhibition of dentin and subsequent enamel formation in this neoplasm. CONCLUSION: POT is an entity with a well-defined clinicopathological, immunohistochemical and molecular profile that must be properly diagnosed and differentiated from other odontogenic lesions and treated consequently.

New two-dimensional carbon nitride allotrope with 1 : 1 stoichiometry featuring spine-like structures: a structural and electronic DFT-D study.

In this communication the prediction of a two-dimensional carbon nitride allotrope (CN) featuring a 1 : 1 stoichiometry is considered. Calculations were carried out under ambient conditions of pressure and temperature (1 atm, 300 K), to prove its dynamic (phonon) and thermal stability. The novel CN structure contains pentagonal rings (c-C3N2) linked by nitrogen atoms, and separated by holes, whereas the sp3-like C atoms are bonded to isocyano (C[triple bond, length as m-dash]N-) groups projecting out of its surface and resembling spine-like formations. The predicted structure has a calculated indirect bandgap of approximately 2.78 eV (hybrid HSE06 approximation), that is in the range of visible light, and this it might increase its use in the field of photocatalysis.

E-Cadherin gene expression in oral cancer: Clinical and prospective data.

BACKGROUND: Low protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. OBJECTIVE: The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. MATERIAL AND METHODS: Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. RESULTS: E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. CONCLUSIONS: E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression.

Expression of proteoglycans in two types of ameloblastoma: novel Immunohistochemical findings.

Alterations in cellular and extracellular matrix components play an important role during tumorigenesis; proteoglycans are included among these components. Ameloblastomas are odontogenic tumors distinguished as invasive and infiltrative neoplasms and are divided into different histological types, the most common of which are the unicystic ameloblastoma and the conventional ameloblastoma. The aim of this study was to identify the presence of two proteoglycans, perlecan and biglycan, in different types of ameloblastoma. Using immunohistochemistry, we determined the presence of both proteins in 28 unicystic ameloblastomas and 23 conventional ameloblastomas. We identified the cytoplasmic and nuclear presence of perlecan and the cytoplasmic presence of biglycan in both types of ameloblastoma. The mean values of immunoexpression were higher in the conventional type compared to the unicystic type. Neither the presence of biglycan in ameloblastomas nor the nuclear presence of perlecan in any odontogenic tumor has previously been reported. The differential immunoexpression of perlecan and biglycan in these types of ameloblastomas suggests their participation in the developmental process of these tumors.

Renal Transplantation in Second-Level Private Hospitals in the State of Mexico.

BACKGROUND: Kidney transplantation (KT) is the replacement therapy of choice in patients with end-stage renal disease (ESRD). Here we show a cohort of kidney transplant recipients from the period of May 1994 to May 2016 in 2 2nd-level private hospitals from the city of Toluca in the state of Mexico. METHODS: We checked the clinical files of all the patients that received KT in the period of study. RESULTS: We report 25 KT: 23 performed in Sanatorio Toluca and 2 in Sanatorio Florencia; 16 (64%) male and 9 (26%) female; mean age 36.03 ± 15.9 years (range, 10-66); 19 (76%) hemodialysis and 9 (24%) continuous ambulatory peritoneal dialysis before KT; ESRD etiology unknown in 16 (64%), diabetes in 5 (20%), IgA nephropathy in 2 (8%), and other in 2 (8%); living donors in 13 (52%) and deceased donors in 12 (48%); blood group 0+ in 18 (72%), A+ in 5 (20%), and B+ in 2 (8%); 21 (84%) with 0 and 4 (16%) with 1 HLA mismatch; and delayed graft function in 8 (32%), of which 7 were from deceased donors and 1 from a living donor. All 25 (100%) had a functional kidney at 1 year of follow-up. Immunosuppression regime consisted of multitarget maintenance therapy in all 25 (100%): cyclosporine in 18 (72%) and tacrolimus in 7 (28%). We used only methylprednisolone (MTP) as induction therapy. There were only 2 cases (8%) of acute rejection during the 1st 6 months of follow-up, and both responded to treatment with MTP. CONCLUSIONS: KT is the treatment of choice for patients with ESRD. The obtained results using only an MTP induction regime are satisfactory, with graft and patient survivals of 100% in the 1st year of follow-up.

Expression of hMLH1 and hMSH2 proteins in ameloblastomas and tooth germs.

BACKGROUND: Mismatch repair proteins (MMRPs) are a group of nuclear enzymes that participate in the repair of base mismatches that occur during DNA replication in all proliferating cells. The most studied MMRPs are hMSH2 and hMLH1, which are known to be highly expressed in normal tissues. A loss of MMRPs leads to the accumulation of DNA replication errors in proliferating cells. Ki-67 is a biomarker regarded to be the gold-standard tool for determining cell proliferation by immunohistochemical methods. The aim of this study was to investigate the immunohistochemical expression of hMLH1, hMSH2 and Ki-67 proteins in ameloblastomas and tooth germs, to contribute to the understanding of the development of this odontogenic neoplasm. MATERIAL AND METHODS: Immunohistochemical assays to determine the presence of proteins hMSH2, hMLH1 and Ki-67 were performed in 80 ameloblastomas (40 solid and 40 unicystic) and five tooth germs. RESULTS: Unicystic ameloblastomas showed higher MMRP expression (hMLH1: 62.5 ± 43.4; hMSH2: 83.3 ± 47.8) than did solid ameloblastomas (hMLH1: 59.4 ± 13.5; hMSH2: 75.8 ± 40.2). Additionally, the cell proliferation index assessed by Ki-67 was inversely proportional to the expression of MMRP. Comparison between tooth germs and ameloblastoma revealed significantly higher expression of hMLH1, hMSH2 and Ki-67 in tooth germs (p=0.02). CONCLUSIONS: The differences of MMRP and Ki-67 immunoexpression between ameloblastomas and tooth germ suggest that alterations in the MMRP mechanisms could participate in the biological behavior of ameloblastomas.

Ecotoxicidad aguda en Physa cubensis P. y Artemia salina L. de 8 antibacterianos con riesgo ambiental / Acute toxicity in Physa cubensis P. and Artemia salina L. of 8 antibiotics with environmental risk

Los productos farmacéuticos son ampliamente utilizados en todo el planeta. Existe una creciente preocupación por los efectos que los medicamentos consumidos y los desechos de estos producen en el ambiente. A pesar del gran uso de los antibacterianos no son muy investigados como contaminantes, prestándose mayor atención a la antibioresistencia por lo que el objetivo de la investigación fue evaluar la ecotoxicidad aguda de antibacterianos. Teniendo en cuenta el consumo de los antibacterianos y la predicción de sus concentraciones ambientales así como su ecoxicidad en Lactuca sativa L ya previamente determinados en anteriores investigaciones se determinó el riesgo ecotoxicológico en Artemia salina L. y Physa cubensis P. En el ensayo de Artemia salina la Ceftazidima se clasifica como muy tóxico con valor de CL50 de 0,060773 g/L, la Cefepima con valor de 0,993731 g/L como moderadamente tóxica y el resto de los antibacterianos evaluados se clasifican como no tóxicos. En los bioensayos en Physa cubensis Cefepima y Cefazolina ocasionaron la mayor mortalidad con CL50 de 0,000270 y 0,025684 g/L respectivamente y los que indujeron menor mortalidad fueron Vancomicina y Amoxicilina/Sulbactam con CL50 de 1,528440 y 1,055492 g/L. El vertimiento de residuos de antibacterianos puede ser causa de contaminación ambiental perjudicial para algunas especies (AU)

Pharmaceuticals are widely used all over the planet. There is growing concern about the effects that drugs and its residues produce in the environment. Despite the wide use of antibacterial, they are not very investigated as pollutants, paying greater attention to the antibiotic resistance, so the objective of this research was to evaluate the antibacterial acute ecotoxicity. Taking into account the antibacterial consumption and the prediction of their environmental concentrations as well as their ecotoxicity in Lactuca sativa L already determined in previous research, the ecotoxicological risk was determined in Artemia salina L. and Physa cubensis P. In the Artemia salina trial Ceftazidime is classified as very toxic with LC50 value of 0.060773g/L, Cefepime with value of 0.993731g/L is classified as moderately toxic and the rest of antibacterial evaluated are classified as non-toxic. In bio trials of Physa cubensis, Cefepime and Cefazolin caused the greatest mortality with LC50 0.000270 and 0.025684g/L respectively, and the ones that led lower mortality were Vancomycin and Amoxicillin/Sulbactam with LC50 of 1.528440 and 1.055492 g/L. The dumping of antibiotics residues can be the cause of environmental pollution, detrimental to some species (AU)

Patients with advanced oral squamous cell carcinoma have high levels of soluble E-cadherin in the saliva.

BACKGROUND: The objective of this study was to assess the potential clinical value of the concentration of soluble salivary E-cadherin (sE-cadherin) compared with the clinical value of the presence of membranous E-cadherin (mE-cadherin) in oral squamous cell carcinoma tumor tissues. MATERIAL AND METHODS: Data regarding patient demographics, clinical stage, saliva and tumor tissue samples were collected. The saliva was analyzed for sE-cadherin protein levels and was compared to the mE-cadherin immunohistochemical expression levels in tumor tissues, which were assessed via the HercepTest® method. Patients without cancer were included in the study as a control group for comparisons of the sE-cadherin levels. RESULTS: sE-cadherin levels in the saliva of patients without cancer were lower than those in patients with cancer, and the difference was statistically significant (p=0.031). Low mE-cadherin expression was statistically significantly associated with lymph node positivity (p=0.015) and advanced clinical stage (p=0.001). The inverse relationship between mE-cadherin and sE-cadherin was significant in terms of lymph node positivity (p=0.014) and advanced clinical stage (p=0.037). CONCLUSIONS: The results suggest that sE-cadherin levels are significantly increased in patients with oral cancer and that its low expression within the membrane as well as the progression of the disease appear to be inversely associated with levels of sE-cadherin in the saliva.

Expresión de E-Cadherina y Syndecan-1 en Liquen Plano de Piel y de Mucosa Oral / Expression of E-Cadherin and Syndecan-1 in Oral and Skin Lichen Planus

El liquen plano es una lesión inmunológica que se caracteriza por presentar apoptosis de los queratinocitos basales, licuefacción de la membrana basal e infiltrado linfoplasmocitario en banda, estas características pudieran estar asociadas con la pérdida de adhesiones celulares y riesgo de transformación maligna. Para identificar el potencial regulatorio asociado a la adhesión celular de los queratinocitos basales y la posible capacidad de transformación maligna, se investigó la expresión "in situ" de E-cadherina y Syndecan-1 el liquen plano de piel y de mucosa oral. En un total de 37 casos de liquen plano de piel y 5 casos de liquen plano oral, se realizaron estudios de inmunohistoquímica para la detección de E-cadherina y Syndecan-1. En las áreas de enfermedad activa del liquen plano de piel los queratinocitos basales no expresaron E-cadherina y la expresión de Syndecan-1 fue focal, en las áreas de tejido epitelial libre de enfermedad la expresión de ambas proteínas fue muy similar. Los cambios de expresión de las proteínas E-cadherina y Syndecan-1 sugieren una posible asociación de las mismas a la patogénesis de Liquen plano de piel y de mucosa oral.

Lichen planus is an immunological lesion is characterized by basal keratinocytes apoptosis, liquefaction of the basal membrane and linphoplasmocitary infiltration, these features may be associated with loss of cellular adhesion and risk of malignant transformation. To identify the regulatory potential associated with cell adhesion of basal keratinocytes and the malignant transformation potential, the "in situ" expression of E-cadherin and Syndecan-1 proteins in skin and oral lichen planus were investigated. A total of 37 cases of skin lichen planus and 5 cases of oral lichen planus we reevaluated by immunohistochemical approach, using E-cadherin and Syndecan-1antibodies. In areas of active disease in skin lichen planus the basal keratinocytes did not express E-cadherin and Syndecan-1 expression was focal, in the of epithelial tissue areas of free lesion the expression of both proteins were similar. Changes in E-cadherin and Syndecan-1 expression suggest a possible association of this proteins with the pathogenesis of skin and oral lichen planus.

Cost structure and profitability of Assaf dairy sheep farms in Spain.

Twenty dairy sheep farms of Assaf breed, located in the Spanish autonomous community of Castilla y León and included in a group receiving technical support, were used to study their production cost structure and to assess their economic profitability during 2009. On average, farms had 89.2±38.0 ha (own, 38%), 592±63 ewes, yielded 185.9±21.1×10(3) L/yr (i.e., 316±15 L/ewe), and were attended by 2.3±0.2 annual working units (family, 72%). Total annual income was €194.4±23.0×10(3)/yr (€1.0=$1.3) from milk (78.6%), lamb (13.2%), culled ewes (0.5%), and other sales (0.8%, wool and manure), and completed with the European Union sheep subsidy (6.9%). Total costs were €185.9±19.0×10(3)/yr to attend to feeding (61.6%), labor (18.2%), equipment maintenance and depreciation (7.6%), finances (3.0%), animal health (2.5%), energy, water and milking supplies (2.2%), milk recording (0.5%), and other costs (4.4%; assurances, shearing, association fees, and so on). Mean dairy sheep farm profit was €8.5±5.8×10(3)/yr (€7.4±8.3/ewe) on average, and varied between -€40.6 and €81.1/ewe among farms. Only 60% of farms were able to pay all costs, the rest had negative balances. Nevertheless, net margin was €31.0±6.5×10(3)/yr on average, varying between €0.6 and €108.4×10(3)/yr among farms. In this case, without including the opportunity costs, all farms had positive balances. Total annual cost (TAC; €/ewe) and total annual income (TAI; €/ewe) depended on milk yield (MY; L/ewe) and were TAC=161.6 + 0.502 MY (R(2)=0.50), and TAI=78.13 + 0.790 MY (R(2)=0.88), respectively, with the break-even point being 291 L/ewe. Conversely, farm TAC (€/yr) and farm TAI (€/yr) were also predicted as a function of the number of ewes (NOE) per flock, as TAC=18,401 + 282.8 NOE (R(2)=0.89) and TAI=330.9 NOE (R(2)=0.98), with the break-even point being 383 ewes/flock. Finally, according to the increasing trend expected for agricultural commodity prices, it was calculated that a 10% increase of concentrate price will require 5.2% milk price increase for constant profit. Similarly, a 10% increase of forage price will require 2.0% milk price increase to maintain profitability. Under these scenarios of increasing the commodity prices of key feedstuffs, a change of flock feeding should be expected to compensate the losses in farm profitability. Most Assaf dairy sheep farms studied were economically profitable, with flock size, milk yield, and feeding costs key for their profitability.

Prognostic factors and treatment strategies for adult head and neck soft tissue sarcoma.

Adult head and neck soft tissue sarcomas are rare and display a variety of histological types and clinical characteristics; they are also associated with a variety of mortality risks. The purpose of this study was to examine all patients treated at the Instituto Nacional de Cancerologia for head and neck sarcoma during a 5-year period. Fifty-one adult patients were examined and treated for head and neck sarcomas from 2004 to 2009. The 51 tumours were histologically re-evaluated by expert pathologists and classified as low, intermediate or high grade sarcomas. A multivariate analysis was performed to evaluate the surgical margins, histological grades, and clinical stages as prognostic factors for the disease. Adult head and neck soft tissue tumours are rare, and they are associated with poor prognosis for patients, especially at clinical stages III and IV. The average survival rate after 2 years is 45%, and most of these patients die because of disease progression and metastases.

Validación de herramienta informática para el cálculo de linfedema en pacientes con afectación unilateral de extremidad superior / Validation of computer tool for the calculation of lymphedema in patients with unilateral involvement of upper limb

Introducción. El linfedema secundario a linfadenectomía axilar es una secuela grave que afecta a la calidad de vida de las pacientes con cáncer de mama. Hay diversas técnicas para la valoración del linfedema. Nuestro objetivo es presentar y validar una herramienta informática para el cálculo del volumen de linfedema a partir de la circometría y mostrar los resultados de su análisis de fiabilidad. El diseño de la herramienta se ha realizado en el seno de un ensayo clínico aleatorizado con grupo control. Material y métodos. Se seleccionó a 29 pacientes al azar, de la consulta de rehabilitación de dos centros de Madrid, con linfedema unilateral tras mastectomía. Dos rehabilitadores calcularon el volumen de los brazos de cada paciente mediante circometría tomando como referencia estructuras anatómicas y a partir de la fórmula de los conos truncados, utilizando una macro de Excel. Se obtuvo el tamaño medio de las cuatro determinaciones, su desviación estándar (DE) y su coeficiente de variación (CV). El grado de acuerdo intraobservador y entre observadores se cuantificó mediante la estimación del coeficiente de correlación intraclase (CCI) y su intervalo de confianza (IC). Resultados. La media±DE de los volúmenes del brazo afecto y el sano fue 3.155,82±877ml y 2.748,76±667,1ml, respectivamente (p=0,001). No hubo diferencias significativas en cuanto a la dispersión. El CCI intraobservador para el brazo afecto fue 0,991 y 0,979, y para el brazo sano, 0,967 y 0,961. El CCI interobservador del brazo afecto fue 0,952, y el brazo sano, 0,976. Conclusiones. La calculadora de linfedema es una herramienta fiable, reproducible, de manejo sencillo y bajo coste, que permite cuantificar el volumen del linfedema(AU)

Background. Lymphedema following breast cancer surgery is a serious sequel that affects the quality of life of breast cancer patients. There are several methods to evaluate lymphedema. We have aimed to present and validate a computer tool that calculates the lymphedema volume based on perimeter measurements and to show the results of its reliability analysis. This tool design was developed without a randomized clinical trial with a control group. Material and methods. A total of 29 patients were randomly selected from the Rehabilitation consultations of two centers in Madrid suffering unilateral lymphedema after mastectomy. Two rehabilitation doctors measured the arm perimeters of each patient using anatomic structures and with the frustum formula, using an Excel macro. Mean volume, standard deviation (SD) and variation coefficient (VC) were obtained for each measurement. Intra-and inter-rater reliability were calculated by estimation of the intra-class correlation coefficient (ICC) and its confidence interval (CI). Results. Mean volume of affected arm was 3155.82mL (877 SD) and for the healthy arm 2748.76mL (667.1 SD). There were no significant differences in the SD and CV dispersion. Intra-rater ICC for the affected arm was 0.991 and 0.979, and for healthy arm 0.967 and 0.961 for each observer. Inter-rater ICC for the affected arm was 0.952 and for the healthy arm 0.976. Conclusions. The «lymphedema calculator» is a reliable, reproducible, easy to use and low cost computer tool that helps the clinician to evaluate lymphedema volume as well as to objectify its distribution(AU)

Niveles de dosis en radiología convencional / Radiation doses in conventional radiology

Se ha medido la dosis en la superficie de entrada de ojos, tiroides y gónadas en pacientes sometidos a estudio de radiografía de tele de tórax mediante dosimetría termoluminiscente. Se usaron 5 dosímetros en cada una de las exploraciones; encontrándose los siguientes rangos de dosis: 20 mGy a 350 mGy. En el caso de los pacientes pediátricos se propone incluir la información de las dosis recibidas en su cartilla de vacunación con el fin de hacer un seguimiento de los posibles efectos nocivos en su salud.

Doses have been measured at the entrance surface of eyes, thyroid and gonads in patients undergoing chest x-ray studies, using thermo-luminiscent dosimetry. Five dosimeters were used in each investigation, and doses ranged from 20 mGy to 350 mGy. In the case of pediatric patients, it is proposed that dose information from diagnostic examinations is included in the vaccination chart in order to correlate with findings at follow-up.

Structure and performance of Awassi and Assaf dairy sheep farms in northwestern Spain.

Data of 69 dairy sheep farms (70% Assaf and 30% Awassi crossbred), located in the Spanish Autonomous Community of Castilla y León and grouped for receiving technical advice, were used to study their structure and performance. Farm surface was 55.4ha, on average. Approximately 25% of the farms did not have cultivation land, and the other 75% had, on average, 73ha (from which 67% were devoted to forage). Farms used 2.1 annual work units (familiar, 90%), 493 ewes, and yielded 147,000 L/yr of milk. Farmers were tenant (84%), younger than 45 yr (70%), had new houses, and were grouped in cooperatives (83%). Sheep were fed indoors (occasional grazing only) in modern loose stalls and had machine milking. Planned mating (summer to fall) was done in 91% of farms (hormonal treatment, 54%) but artificial insemination was scarce (23%). Annual milk sales averaged 309 L/ewe (fat, 6.5%; protein, 5.3%; log(10) somatic cell count, 5.7), and milk was sent to local dairy industries for cheese production, and 1.35 lambs/ewe were harvested as milk-fed lambs (lechazo). Artificial lamb rearing was done in 38% of farms (automatic, 81%; manual, 19%). Total mixed rations were used in 33% of farms, and the rest used rationed concentrate (including self-produced cereals) according to physiological stage of the ewes (0.45 to 1.97 kg/d) and ad libitum forage (dehydrated, 70%; hay, 68%; fresh, 25%; silage, 12%). The concentrate-to-forage ratio ranged between 32 and 61%. In total, 68% of farms bought more than half of the forage, and 87% of them bought more than half of the required concentrates. According to structural, productive, and managerial traits, 4 types of farms were differentiated by using multiple correspondence analysis and cluster analysis. Type groups were: 1) large-surface farms, devoted to cereal and forage production, predominantly with Awassi crossbreed sheep and a high level of self-consumed commodities (12% of the farms); 2) large flocks with intermediate farm surfaces devoted to forage production and predominantly with Assaf sheep (30% of the farms); 3) high-yielding farms, with intermediate sized flocks of Assaf sheep and very intensive management (42% of the farms); and, 4) no-land farms predominantly with Assaf sheep (16% of the farms). In conclusion, the dairy sheep farms studied showed more adoption of intensive production systems than traditional farms, which resulted in higher milk and lamb yields. Despite all of them being based on familiar units, as traditional farms, they were highly dependent on external resources and became more vulnerable, faced with future uncertainties of the market.