Neuropsychological assessment protocol in an ongoing randomized controlled trial on posterior subthalamic area vs. ventral intermediate nucleus deep brain stimulation for essential tremor.

Objective: Patients with essential tremor (ET) may experience cognitive-affective impairment. Deep brain stimulation (DBS) of different targets, such as the ventral intermediate nucleus (VIM) of the thalamus or the posterior subthalamic area (PSA), has been shown to be beneficial for refractory ET. However, there is little evidence regarding the possible neuropsychological effects of PSA-DBS on patients with ET, and there are few studies comparing it with VIM-DBS in this population.In this study, we aim to present the evaluation protocol and neuropsychological battery as used in an ongoing trial of DBS for ET comparing the already mentioned targets. Methods: As part of a randomized, double-blind, crossover clinical trial comparing the effectiveness and safety of PSA-DBS vs. VIM-DBS, 11 patients with refractory ET will undergo a multi-domain neuropsychological battery assessment. This will include a pre-/post-implantation assessment (3 months after the stimulation of each target and 6 months after an open stage of DBS on the most optimal target). Conclusion: Evidence on the neuropsychological effects of DBS in patients with refractory ET is very scarce, particularly in lesser-explored targets such as PSA. This study could contribute significantly in this field, particularly on pre-procedure safety analysis for tailored patient/technique selection, and to complete the safety analysis of the procedure. Moreover, if proven useful, this proposed neuropsychological assessment protocol could be extensible to other surgical therapies for ET.

Tratamiento percutáneo del cáncer infiltrante de mama en estado clínico I/II mediante crioablación en pacientes sin indicación de cirugía axilar / Percutaneous cryoablation of clinical stage I/II breast cancer in patients without indication for axillary surgery

Objetivo: revisar la eficacia del tratamiento percutáneo del cáncer infiltrante de mama (CM) mediante crioablación guiada con ecografía en pacientes con estadio clínico I/II en las que se desestima la cirugía axilar. Métodos: se recogieron de nuestros archivos las pacientes con CM en estadio clínico I/II que fueron tratadas mediante crioablación guiada con ecografía en las que se desestimó la cirugía axilar. Se seleccionaron las pacientes que tuvieron un seguimiento mínimo de 12 meses. Las revisiones fueron ecográficas: la primera entre 1 y 2 meses (para valorar lesiones residuales por tratamiento incompleto) y posteriormente semestrales (para valorar las recidivas). Las lesiones residuales y las recidivas se confirmaron con BAG y en todos los casos se valoró el tratamiento con nueva crioablación (de rescate). Se analizó la eficacia del procedimiento en función del control local en la mama. Resultados: desde marzo de 2019 hasta septiembre de 2022 fueron tratadas mediante crioablación guiada con ecografía 84 pacientes con 92 CM en estadio clínico I/II en las que la cirugía axilar fue desestimada. Se estudiaron retrospectivamente las 43 pacientes (58-96 años, media 83, DE ±7,64) con 48 CM (entre 5 y 60 mm, media 17, DE ±13,75) que tuvieron un seguimiento mínimo de 12 meses (entre 12 y 40 meses, media 20). Hubo 2 pacientes con tratamiento incompleto en la primera ecografía y 5 pacientes recidivaron (entre 9 y 27 meses, media 17). Todas se trataron con crioablaciones de rescate. El control local a los 12 meses fue del 90,5% (probabilidad 0,905 error estándar 0,045) y en el 95% de las pacientes (41/43) se consiguió controlar localmente el CM. Fallecieron 6 pacientes, 3 por evolución del CM y 3 por otras causas. Todos los procedimientos fueron bien tolerados y no hubo complicaciones graves. (AU)

Objective: To review the efficacy of percutaneous treatment of infiltrating breast cancer (BC) by ultrasound-guided cryoablation in patients with clinical stage I/II without indication for axillary surgery Methods: Patients with clinical stage I/II BC who were treated by ultrasound-guided cryoablation in whom axillary surgery was ruled out were collected from our files. Patients who had a minimum follow-up of 12 months were selected. The ultrasound follow up were: the first between 1-2 months (to assess residual lesions due to incomplete treatment) and subsequently every six months (to assess recurrences). Residual lesions and recurrences were confirmed with CNB and in all cases treatment with new (salvage) cryoablation was considered. The efficacy of the procedure was assessed on local control in the breast. Results: Between March 2019 and September 2022, 84 patients with 92 BC in clinical stage I/II were treated with ultrasound-guided cryoablation without indication for axillary surgery. The inclusion criteria of the retrospective study were met by 43 patients (58-96 years, mean 83, SD ±7,64) with 48 BC (between 5-60mm, mean 17, SD ±13,75) who were reviewed during a mean period of 20 months (between 12-40 months). There were two patients with incomplete treatment at the first ultrasound and five patients relapsed (between 9-27 months, mean 17). All were treated with salvage cryoablation. Local control at 12 months was 90.5% (probability 0.905 standard error 0.045) and in 95% of patients (41/43) the BC was locally controlled. Six patients died, three due to progression of the BC and three due to other causes. All procedures were well tolerated and there were no serious complications. (AU)

Posterior Lingual Abscess; Report of Two Cases.

The lingual abscess is rare due to several protective mechanisms against infection in this location. Concretely, the abscess in the base of the tongue (posterior lingual abscess) is even more exceptional. Its prompt detection is crucial to avoid potentially fatal airway complications. To familiarize physicians with this condition, we report 2 cases of posterior lingual abscess. Both were referred to our emergency department due to minor oropharyngeal complaints. Finally, both were diagnosed and required surgical drainage. The clinical evolution was successful: both were discharged in less than 72 hours and follow-up one week later confirmed clinical recovery.

Employability of University Graduates with Disabilities in Spain.

One of the most important challenges that Spanish universities face is the employability of graduates, a key factor to socioeconomic development. The analysis of the relationship between higher education and employment is a topic of obvious relevance, with greater interest in vulnerable groups-such as graduates with disabilities-who have a lower relative participation in university studies, a lower relative number of graduates, and lower employment rates. Thus, based on the Labor Insertion Survey of University Graduates (EILU-2019) by the Spanish National Institute of Statistics, this study addresses the influence of academic factors on the success of the employability of graduates in Spain, differentiating its effect in the case of people with disabilities. The results show the great importance of work experience during one's studies and a knowledge of ICT to increase the employability and quality of employment among graduates with disabilities. This should become a key aspect of university training to reduce the economic vulnerability of this group.

Basic behavior guidance techniques: A survey of members of the Spanish Society of Paediatric Dentistry.

BACKGROUND: Over the last 20-30 years social trends, educational and parenting patterns, and the ethical and legal factors guiding them have led to the revaluation and even abandonment of some traditionally used behavior guidance techniques (BGTs). AIMS: To profile the professionals providing specialized pediatric treatments in Spain and understand changes in their preferences and use of basic BGTs, and the evolution of these preferences. SETTINGS AND DESIGN: A cross-sectional, descriptive, and correlational study was designed. METHODS: One hundred and twenty-six dentists completed a previously validated survey. STATISTICAL ANALYSIS: Descriptive statistics and Chi-square tests were performed to analyze the questionnaire data. RESULTS: The most common BGTs were "Tell/Show/Do" (98%) and positive reinforcement (92.1%), and the most abandoned BGT was: "hand-over-mouth" (15%), because it was rejected by parents and because of potential legal problems and psychological consequences for the patients. Of note, 37% of the professionals allowed the patient's parents to be present during the treatment. CONCLUSIONS: There has been a notable decrease in the use of certain BGTs in Spain, especially hand-over-mouth and voice control, because they are becoming less socially acceptable as the way society relates to and educates children changes.

Selective Extraction of Bioactive Phenylethanoids from Digitalis obscura.

Cardenolide-free extracts from Digitalis obscura showed significant antifeedant effects against the aphid Myzus persicae and this activity correlated with their phenylethanoid content. The content in phenylethanoids of Digitalis obscura has been studied. Maceration of the aerial parts of D. obscura was used for the selective extraction of the natural compound rengyolone (1) and the aglycone of cornoside (compound 3). Pure rengyolone (1) can be obtained from D. obscura in approximately 90% purity from fresh plant from the CHCl3 soluble fraction of the ethanolic extract (0.8% yield). The ethanol extraction of freshly collected D. obscura showed the presence of compound 3 as the only phenylethanoid. Compound 3 was proven to easily evolve to rengyolone. Due to this instability, and although its presence in plants has been previously reported, the spectroscopical data of 3 are reported herein for the first time. Selective mono-acetylation of compound of 3 led to the active natural compound hallerone (5). The aphid antifeedant (against Myzus persicae) and nematicidal (against root-knot nematode Meloidogyne javanica) activities of these compounds have been evaluated. Here we report for the first time on the aphid antifeedant effects of 1, 3, and 5. Additionally, the nematicidal activity of hallerone (5) is described here for the first time.

Análisis bibliométrico de las funciones ejecutivas de adultos mayores en Iberoamérica / Bibliometric analysis of executive functions of older adults in Ibero-America

RESUMEN Objetivos: a) Verificar la cantidad de estudios efectuados en Iberoamérica sobre función ejecutiva (FE) en adultos mayores; b) Identificar los instrumentos utilizados para medir las FE en adultos mayores durante los años 2009-2018. Material y métodos: Se efectuó un estudio bibliométrico sobre las FE en adultos mayores de Iberoamérica. La búsqueda de información se hizo en las base de datos Scopus y Scielo. Se consideraron estudios iberoamericanos publicados en idioma español y portugués, utilizándose ocho palabras clave y cinco indicadores registrados. Resultados: Se identificaron un total de 12 investigaciones originales en seis países iberoamericanos (España, Argentina, Chile, Colombia, Cuba, y Perú). La mayor cantidad de investigaciones relacionadas con FE en asultos mayores tuvo lugar en los periodos 2009-2010 y 2013-2014. En estos estudios, se han utilizado varios instrumentos con el Trail Making Test (TMT) y la Frontal Assessment Battery (FAB) como los de uso más frecuente. Conclusiones: Parece existir un interés limitado por investigar las FE en adultos mayores de Iberoamérica. La mayoría de los estudios idntificados en esta indagación utilizaron como tests cognitivos el TMT y la FAB.

SUMMARY Objectives: a) To verify the number of studies on executive functions (EF) in older adults carried out in Ibero-America; b) To identify the instruments used to measure EF in older adults during the years 2009-2018. Material and methods: A bibliometric study on EF in older adults in Latin America was carried out through the Scopus and Scielo databases. Studies published in Spanish and Portuguese languages using eight keywords and five registered indicators. Results: Between 2009 and 2018, a total of 12 original investigations have been carried out in six Iberoamerican countries (Spain, Argentina, Chile, Colombia, Cuba, and Peru). Most EF-related investigations were reported duing the 2010-2009 and 2013-2014 periods. Several instruments were used, the Trail Making Test and the Frontal Assessment Battery being the most frequent. Conclusions: There seems to be a limited interest in investigating EF in older adults in Ibero-America. Most of these studies identified in this inquiry used the TMT and the FAB as cognitive tests.

Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica. / Metodologias inovadoras sobre abuso infantil para para uma formação integral dos futuros odontólogos na Iberoamérica. Revisão bibliográfica / Innovative methodologies in dental teaching about child abuse for a comprehensive training of future oral health professionals in Ibero-America. A bibliographic review

Según la Organización Mundial de la Salud, los odontólogos tienen un papel fundamental en el diagnóstico y la denuncia de posibles casos de maltrato infantil. Además, en la mayoría de los países, se han ido implementando regulaciones legales para la protección infantil que exigen a los profesionales de salud incluyendo a los odontólogos, informar de cualquier sospecha justificada, sin embargo el porcentaje de profesionales de la salud oral que lo hacen no es consecuente con las cifras anuales publicadas sobre este grave problema social, indicando muchas veces como principal razón un déficit en el entrenamiento académico durante los estudios universitarios de Odontología. Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica.Noemi Gutierrez Vigo,1........Dra. Ana María Leyda Menéndez,2........ Fátima González Galván,3........Dra. María José Gavara Navarro,2........Revista de Odontopediatría Latinoamericana¹ Odontopediatra de práctica privada2 Profesora asociada del Máster Propio en Odontopediatría Integral. Universidad CEU Cardenal Herrera. Valencia. España³ Profesora asociada de Odontopediatría y del Máster Propio en Odontopediatría Integral. Universidad CEU Cardenal Herrera. Valencia. España.Artículo de RevisiónDOI: 10.47990/alop.v11i2.273En otros casos, la formación académica recibida parece mejorar los conocimientos teóricos sobre el tema, pero no fortalece la confianza de los odontólogos para reconocer un posible caso, y definir la ruta de atención al menor posible víctima de malos tratos. Actualmente, las facultades de Odontología han fortalecido sus procesos de enseñanza-aprendizaje de la práctica clínica. Este estudio realizó una revisión de la literatura sobre las nuevas metodologías de aprendizaje que pueden colaborar a mejorar la formación, capacitación y compromiso de los estudiantes de Odontología en relación al maltrato infantil planteando una propuesta docente al respecto.

Innovative methodologies in dental teaching about child abuse for a comprehensive training of future oral health professionals in Ibero-America. A bibliographic review. Article of revisionAbstractAccording to the World Health Organization, dentists have a fundamental role in the diagnosis and reporting of possible cases of child abuse. In addition, in most countries, legal regulations for the protection of children have been implemented that require health professionals, including dentists, to report any justified suspicion. However, the percentage of oral health professionals who do so is not consistent with the annual figures published on this serious social problem, often indicating as the main reason a deficit in academic Metodologías innovadoras sobre maltrato infantil para una formación integral de los futuros odontólogos Iberoamericanos. Revisión bibliográfica.e-320200Vol 11 N° 2 Julio - Diciembre 2021ResumoDe acordo com a Organização Mundial da Saúde, os dentistas desempenham um papel fundamental no diagnóstico e reporte dos potenciais casos de abuso infantil, além disso, na maioria dos países, foram implementados regulamentos legais para a proteção da criança que exigem que os profissionais de saúde, incluindo os dentistas, reportem quaisquer suspeitas justificadas, no entanto a percentagem de profissionais de saúde oral que o fazem não é consistente com os números anuais publicados sobre este grave problema social, muitas vezes indicando como a principal razão para um défice na formação académica durante os estudos universitários em Medicina Dentária. Noutros casos, a formação académica recebida parece melhorar o conhecimento teórico sobre o assunto, mas não reforça a confiança dos médicos dentistas em reconhecer um possível caso, e definir o percurso de cuidados para a menor vítima possível de maus tratos.Atualmente, as faculdades de medicina dentária reforçaram os seus processos de ensino-aprendizagem da prática clínica. Este estudo realizou uma revisão literária sobre as novas metodologias de aprendizagem que podem ajudar a melhorar a formação e envolvimento dos estudantes de medicina dentária em relação ao abuso infantil apresentando uma proposta docente a este respeito.

According to the World Health Organization, dentists have a fundamental role in the diagnosis and reporting of possible cases of child abuse. In addition, in most countries, legal regulations for the protection of children have been implemented that require health professionals, including dentists, to report any justified suspicion. However, the percentage of oral health professionals who do so is not consistent with the annual figures published on this serious social problem, often indicating as the main reason a deficit in academic

Seroprevalence of SARS-CoV-2-specific antibodies in cancer outpatients in Madrid (Spain): A single center, prospective, cohort study and a review of available data.

BACKGROUND: Coronavirus disease in 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a global pandemic. Published data suggests that patients with a history of or active malignancy are at increased risk of infection and developing COVID-19 related complications. To date, the published data has analyzed the seroprevalence of COVID-19 infection in the general population, but not in cancer patients. Here we present the results of prevalence of IgG and IgM antibodies against SARS-CoV-2 in cancer patients from the University Hospital of Torrejón (Torrejón de Ardoz, Madrid, Spain). METHODS: SARS-CoV-2 IgG and IgM antibodies was assessed using a commercially available rapid test (Testsealabs® IgG/IgM Rapid Test Cassette) and collect the result from cancer outpatients who attended the medical oncology consult at University Hospital of Torrejón between June 1st and June 19th, 2020. FINDINGS: We analyzed the serological test results of 229 cancer patients. We estimated an overall seroprevalence (IgG or IgM positive) of 31.4%. The probability of SARS-CoV-2 seropositivity was similar between men and women, type of treatment and cancer stage. The probability of seropositivity was significantly higher in cancer patients with pneumonia compared with cancer patients without pneumonia (Odds Ratio (OR) 7.65 [95% confidence interval (CI) 1,85-31,58]). INTERPRETATION: Our results show a higher rate of SARS-CoV-2 antibodies in cancer patients than in the general population. The role of those antibodies in the immune response against the virus infection is unclear.

Biodentine y su uso en dentición temporal. Revisión de la literatura

La biocompatibilidad y bioactividad se han convertido en características casi imprescindibles en cualquier material de uso dental. De manera reciente disponemos del Biodentine®. Se trata de un cemento con altas propiedades físico-mecánicas que comenzó a ser comercializado en el 2009 y fue especialmente diseñado como sustituto dentinario. Para la odontopediatría, esta búsqueda de nuevos materiales eficaces, resistentes y biocompatibles es especialmente importante en algunos tratamientos como la pulpotomía en los que los fármacos clásicamente utilizados, como el formocresol, han sido apartados del uso clínico por su potencial tóxico. Debido, por un lado, a un mayor uso del Biodentine® en la clínica dental, especialmente en el tratamiento odontopediátrico, y por otro, a la mayor producción científica al respecto, se ha creído conveniente realizar esta revisión de la literatura con el objetivo de recoger de manera sistematizada el conocimiento actualizado sobre este material y su empleo en odontopediatría.

Los anticoagulantes orales de acción directa en el tratamiento de la enfermedad tromboembólica venosa asociada a cáncer / Direct oral anticoagulants for the treatment of venous thromboembolism in patients with cancer

No disponible

Association of Parkinson's disease and treatment with aminosalicylates in inflammatory bowel disease: a cross-sectional study in a Spain drug dispensation records.

OBJECTIVES: To analyse the association between aminosalicylate-treated inflammatory bowel disease (IBD) and Parkinson's disease (PD) at population level. DESIGN: Cross-sectional study. SETTING: The study was performed based on electronic drug prescription and dispensation records of the Andalusian Public Health System. PARTICIPANTS: All individuals aged ≥50 years with at least one drug dispensation during December 2014 were identified from the records. PRIMARY AND SECONDARY OUTCOME MEASURES: Groups were formed: 'possible PD' group, including all who received an anti-Parkinson agent; 'possible IBD' group, those treated with mesalazine and/or derivatives (5-aminosalicylic acid (5-ASA)); and 'possible PD and IBD', including those receiving both anti-Parkinson agent and 5-ASA. Prevalence of possible PD was determined among those with possible IBD and among those without this condition. The age-adjusted and sex-adjusted OR was calculated. RESULTS: We recorded 2 020 868 individuals (68±11 years, 56% female), 19 966 were included in possible PD group (75±9 years, 53% female) and 7485 in possible IBD group (64±10 years, 47% female); only 56 were included in both groups (76±8 years, 32% female). The prevalence of possible PD was 0.7% among those with possible IBD and 1% among those without this condition (adjusted OR=0.94; 95% CI 0.72 to 1.23; p=0.657). OR was 0.28 in individuals aged ≤65 years (95% CI 0.10 to 0.74; p=0.01) and 1.17 in older individuals (95% CI 0.89 to 1.54; p=0.257). CONCLUSIONS: Within the limitations of this study, the results suggest a protective role for IBD and/or 5-ASA against PD development, especially among under 65-year olds. Further studies are warranted to explore this association given its scientific and therapeutic implications.

Anticoagulantes orales directos: puesta al día / Direct oral anticoagulants: An update

Durante medio siglo los antagonistas de la vitamina K han sido la única opción disponible para la terapia anticoagulante oral. En los últimos años se han desarrollado anticoagulantes orales directos: un inhibidor directo de la trombina (dabigatrán etexilato) y 3 inhibidores directos del factor X activado (rivaroxabán, apixabán y edoxabán). Todos ellos han demostrado un beneficio-riesgo favorable, comparables en eficacia y seguridad a los anticoagulantes tradicionales antagonistas de la vitamina K, en la prevención del ictus y la embolia sistémica en pacientes con fibrilación auricular no valvular, la profilaxis y el tratamiento del tromboembolismo venoso y el síndrome coronario agudo. En 2008 la Agencia Europea del Medicamento aprobó el primer anticoagulante oral directo, dabigatrán. Posteriormente, rivaroxabán, apixabán y edoxabán fueron autorizados. En este artículo se revisa la experiencia acumulada con cada uno de estos fármacos

Vitamin K antagonists were the only choice for chronic oral anticoagulation for more than half a century. Over the past few years, direct oral anticoagulants have emerged, including one direct thrombin inhibitor (dabigatran etexilate) and three factor Xa inhibitors (apixaban, edoxaban and rivaroxaban). In randomised controlled trials comparing direct oral anticoagulants with traditional vitamin K antagonists, the direct oral anticoagulants all showed a favourable benefit-risk balance in their safety and efficacy profile, in prevention of thromboembolic events in patients with atrial fibrillation and in the prevention and treatment of venous thromboembolism and acute coronary syndrome. In 2008, dabigatran was the first direct oral anticoagulant approved by the European Medicine Agency. Subsequently, rivaroxaban, apixaban and edoxaban were also authorised. This article reviews the evidence related to the use of these drugs

[Outbreak of Ébola in Lunsar. Effectiveness of a socio-sanitary intervention]. / Rebrote de Ébola en Lunsar. Efectividad de una intervención socio-sanitaria.

OBJECTIVE: Ebola Virus Disease (EVD) is a severe and, often fatal illness. Ebola spread is fast among human beings. Monitoring and surveillance of contacts is an effective measure to stop an epidemic. The aim of this research is to analyze the effectiveness of an intervention based on contact tracing and monitoring the quarantine people. METHODS: Longitudinal analytical study with community intervention. The intervention consisted of establishing a continuous surveillance of the population of Lunsar (Sierra Leone) to detect new cases of Ebola, establishing quarantine to 96 people. During the process, Health Promotion activities were carried out. The study period includes from February 9 to March 24, 2015. The data obtained were analyzed with the statistical package SPSS, version 20.0. RESULTS: 7 houses, with 96 people in total, were quarantined (the average quarantine was 24.2 ± 4.9 days). At the end of the follow-up, 16 (16.7%) people tested positive for Ebola, 13 (81.2%) of whom ended up dying. The Ebola risk of infection was higher after having performed funeral practices at home (OR = 3.64, p<0.001). Furthermore, the odds ratio associated with survival result 21 times greater (OR = 21, p <0.001) in people not infected during quarantine. CONCLUSIONS: The contagions have occurred in families where there has been a deceaded at home. The tasks performed by the outreach team have been able to influence that only 16.7% of the quarantine people were infected. Nurses were essential in health promotion and social support to families.

OBJETIVO: El Ébola es una enfermedad grave y mortal, su contagio es rápido entre personas. El seguimiento y vigilancia de los contactos es una medida efectiva para frenar una epidemia. El objetivo de este trabajo fue analizar la efectividad de una intervención basada en la detección de nuevos casos de Ébola y el seguimiento de personas en cuarentena. METODOS: Estudio analítico longitudinal con intervención comunitaria. Se instauró una vigilancia continua a la población de Lunsar (Sierra Leona) para detectar nuevos casos de Ébola, estableciendo una cuarentena con seguimiento y control a 96 personas. Durante el proceso, se realizaron actividades de Promoción de la Salud. El periodo de estudio comprende desde el 9 de Febrero al 24 de Marzo de 2015. Los datos obtenidos se analizaron con el paquete estadistico SPSS versión 20.0. RESULTADOS: casas, con 96 personas, fueron puestas en cuarentena con una media de 24,2±4,9 días. Al finalizar el seguimiento, 16 (16,7%) personas fueron positivas al Ébola, falleciendo 13 (81,2%) de ellas. El odds de prevalencia de riesgo de contagio es mayor en personas tras haber realizado prácticas funerarias en casa (OR=3,64, p <0,001). En las personas, no contagiadas durante la cuarentena, la odds ratio asociada a la supervivencia se multiplica por 21 veces (OR=21, p <0,001). CONCLUSIONES: Los contagios se han producido en las familias donde ha habido un fallecido en casa. Las tareas realizadas por el equipo sociosanitario han podido influir, dado que solamente se contagiaron el 16,7% de las personas en cuarentena. Las enfermeras resultaron imprescindibles a través de la educación sanitaria y el apoyo social a las familias.

Derivative chromosomes involving 5p large rearranged segments went unnoticed with the use of conventional cytogenetics.

BACKGROUND: In countries where comparative genomic hybridization arrays (aCGH) and next generation sequencing are not widely available due to accessibility and economic constraints, conventional 400-500-band karyotyping is the first-line choice for the etiological diagnosis of patients with congenital malformations and intellectual disability. Conventional karyotype analysis can rule out chromosomal alterations greater than 10 Mb. However, some large structural abnormalities, such as derivative chromosomes, may go undetected when the analysis is performed at less than a 550-band resolution and the size and banding pattern of the interchanged segments are similar. Derivatives frequently originate from inter-chromosomal exchanges and sometimes are inherited from a parent who carries a reciprocal translocation. CASE PRESENTATION: We present two cases with derivative chromosomes involving a 9.1 Mb 5p deletion/14.8 Mb 10p duplication in the first patient and a 19.9 Mb 5p deletion/ 18.5 Mb 9p duplication in the second patient. These long chromosomal imbalances were ascertained by aCGH but not by conventional cytogenetics. Both patients presented with a deletion of the Cri du chat syndrome region and a duplication of another genomic region. Each patient had a unique clinical picture, and although they presented some features of Cri du chat syndrome, the phenotype did not conclusively point towards this diagnosis, although a chromosomopathy was suspected. CONCLUSIONS: These cases highlight the fundamental role of the clinical suspicion in guiding the approach for the etiological diagnosis of patients. Molecular cytogenetics techniques, such as aCGH, should be considered when the clinician suspects the presence of a chromosomal imbalance in spite of a normal karyotype.

Plocabulin, a novel tubulin-binding agent, inhibits angiogenesis by modulation of microtubule dynamics in endothelial cells.

BACKGROUND: Vascular supply of tumors is one of the main targets for cancer therapy. Here, we investigated if plocabulin (PM060184), a novel marine-derived microtubule-binding agent, presents antiangiogenic and vascular-disrupting activities. METHODS: The effects of plocabulin on microtubule network and dynamics were studied on HUVEC endothelial cells. We have also studied its effects on capillary tube structures formation or destabilization in three-dimensional collagen matrices. In vivo experiments were performed on different tumor cell lines. RESULTS: In vitro studies show that, at picomolar concentrations, plocabulin inhibits microtubule dynamics in endothelial cells. This subsequently disturbs the microtubule network inducing changes in endothelial cell morphology and causing the collapse of angiogenic vessels, or the suppression of the angiogenic process by inhibiting the migration and invasion abilities of endothelial cells. This rapid collapse of the endothelial tubular network in vitro occurs in a concentration-dependent manner and is observed at concentrations lower than that affecting cell survival. The in vitro findings were confirmed in tumor xenografts where plocabulin treatment induced a large reduction in vascular volume and induction of extensive necrosis in tumors, consistent with antivascular effects. CONCLUSIONS: Altogether, these data suggest that an antivascular mechanism is contributing to the antitumor activities of plocabulin.