Intervenciones cognitivas a través de realidad virtual en personas con Deterioro Cognitivo Leve: Una Revisión Sistemática

Introducción: La posibilidad de reversión del Deterioro Cognitivo Leve (DCL) ha generado diversas investigaciones en búsqueda de tratamiento, entre ellas la estimulación cognitiva a través de realidad virtual (RV). No obstante su uso, no existe aún evidencia acerca de las modalidades y efectos en personas con DCL. Objetivo: Sistematizar las características de los estudios que han utilizado intervenciones cognitivas con RV en personas con DCL, describir sus efectos y establecer recomendaciones para futuras investigaciones en base a las limitaciones reportadas. Métodos: revisión sistemática de estudios publicados entre 2010 y 2020, en las bases de datos Web of Science, Scopus y Pubmed. Resultados: Se identificaron 14 estudios con programas que emplearon mayoritariamente RV de tipo inmersiva, con el "supermercado" como escenario virtual más frecuente. En siete trabajos se intervino una función cognitiva, siendo la memoria y las funciones ejecutivas las más intervenidas. Los instrumentos de evaluación se concentraron en medidas cognitivas, con escasa evaluación de variables neuropsiquiátricas y de calidad de vida. Trece estudios informaron mejoras a nivel cognitivo general o por dominio específico. Conclusiones: La utilización de RV, inmersiva y no inmersiva, ha tenido resultados positivos en el rendimiento cognitivo general o específico por dominio, de personas con DCL, sin embargo, debido a la incipiente y limitada evidencia de su uso en personas con esta patología, no es posible determinar la sostenibilidad de estos resultados y la generalización de estas intervenciones hacia las actividades de la vida diaria. Se recomienda realizar intervenciones con entornos reales y seguimiento post-intervención.

Introduction: The possibility of Mild Cognitive Impairment (MCI) reversal has generated numerous studies in search of treatment, including cognitive stimulation through virtual reality (VR). Despite its use, there is still no evidence about the modalities and effects in people with MCI. Aim: To systematize the characteristics of the studies that have used cognitive interventions with VR cognitive in people with MCI, describe their effects and to establish recommendations for future research based on the limitations reported. Methods: systematic review of studies published between 2010 and 2020, in the Web of Science, Scopus and Pubmed databases. Results: 14 studies were identified with programs that mostly used immersive VR, with the "supermarket" as the most frequent virtual scenario. In seven studies only one cognitive function was involved, with memory and executive functions being the most intervened. The assessment instruments focused on cognitive measures, with little assessment of neuropsychiatric and quality of life variables. Thirteen studies reported improvements on the general cognitive level or by specific domain. Conclusions: The use of immersive and non-immersive VR has had positive results in the general or domain-specific cognitive performance of people with MCI, however, due to the incipient and limited evidence of its use in people with this pathology, it is not possible to determine the sustainability of these results and the generalization of these interventions regarding daily living activities. Interventions with real environments and post-intervention follow-up are recommended.

Cáncer de vesícula biliar ¿la contaminación por bilis afecta el pronóstico? / Gallbladder Cancer: does bile contamination affect the prognosis?

Resumen Introducción: En algunas áreas el cáncer de la vesícula biliar se detecta en hasta el 3,5% de los pacientes intervenidos por colelitiasis. Con el objetivo de evaluar el rol de la ruptura de la vesícula y la consiguiente contaminación por bilis, se evaluó una serie de pacientes portadores de cáncer de vesícula diagnosticado posterior a la colecistectomía. Materiales y Método: El estudio se efectuó en 109 pacientes en quienes se diagnosticó un cáncer de vesícula posterior a la colecistectomía. El grupo a estudiar se dividió de acuerdo a la ocurrencia o no de contaminación por bilis al momento de la colecistectomía, como también de acuerdo a la magnitud de ésta. Resultados: De los pacientes estudiados, en 32 se documentó la ocurrencia de contaminación por bilis al momento de la colecistectomía. De estos, en 13 la contaminación fue considerada mayor. El tiempo promedio de seguimiento fue de 33 meses, 35 pacientes (32,1%) fallecieron durante el seguimiento. La sobrevida media de la totalidad de la serie que tuvo contaminación por bilis no se diferenció de los pacientes sin contaminación. Sin embargo, el grupo que tuvo una contaminación catalogada como mayor, presentó una sobrevida estadísticamente inferior al resto de los pacientes. Finalmente, se realizó un análisis mediante el modelo de regresión de COX que incluyó edad, género, nivel de invasión y tipo de contaminación, resultando la existencia de contaminación mayor por bilis un factor independientemente asociado al pronóstico. Conclusión: La presencia de ruptura vesicular y contaminación mayor por bilis debiera considerarse un factor pronóstico.

Background: Incidental gallbladder cancer is observed in up to 3.5% of patients undergoing laparoscopic cholecystectomy. To study the role of wall perforation on the prognosis, we evaluated a series of patients in whom perforation occurred during the cholecystectomy. Materials and Method: 109 patients who underwent a laparoscopic cholecystectomy in whom final diagnosis was gallbladder cancer were the focus of the study. We divided the patients according the occurrence of spillage. Furthermore, patients with spillage were divided into two categories according the spillage magnitude. Results: Of the patients, spillage was documented in 32 (29.3%). In 13 patients spillage was considered major. The median follow-up of patients was 36 months, while 35 (32.1%) patients died during the follow-up. Five-year survival of all patients with spillage was not statistically different from the group without spillage. However, the group with major spillage had a statistically worse survival than the rest. A Cox regression analysis including age, gender, level of invasion and spillage category showed that major spillage was independently associated with a worse prognosis.

Hybrid density functional based study on the band structure of trioctahedral mica and its dependence on the variation of Fe(2+) content.

A hybrid density functional based study of a phyllosilicate (PS) is presented here for the first time. Using all-electron electronic structure calculations with the B3LYP hybrid functional, we have investigated the electronic and structural properties of a series of trioctahedral 1M-polytype K-bearing micas starting from phlogopite (the Mg-end member), ending with the annite (the Fe-end member), and passing through the biotite (a solid solution of the end members). Electronic band gap is calculated for all the compositions and nature of the electronic transition is discussed with the aid of band structure and density of states plots. An excellent agreement with the available experimental data has been observed. An insulator to semiconductor transition is explained on the basis of orbital hybridization. A further comparison is made using the pure GGA functional. For the completeness of the study, the dielectric properties of phlogopite are calculated using the coupled perturbed Kohn-Sham scheme, as implemented within the CRYSTAL09 code.

Ictericia obstructiva secundaria a migración de fragmentos de hepatocarcinoma a la vía biliar / Obstructive jaundice secondary to hepatocellular carcinoma fragments migrated to common bile duct

Obstructive j aundice is a rare presentation of hepatocellular carcinoma (HC), and when it occurs, usually is due to progressive damage from cirrhosis, or extensive tumor infiltration. Tumor growth through the bile duct is being described with increasing frequency as a cause of obstructive j aundice. Rarely, it may be hepatocarcinoma fragments that migrate to the bile duct, obstructing it. We present a case of obstructive jaundice due to migration of fragments of hepatocellular carcinoma to the bile duct in a patient treated 7 years before, for an HC with a curative resection.

La ictericia obstructiva es una presentación poco común en un hepatocarcinoma (HC). Cuando en estos casos existe ictericia, habitualmente se debe a daño progresivo por cirrosis, o a infiltración tumoral extensa. El crecimiento o vaciamiento tumoral hacia la vía biliar se ha descrito ocasionalmente como causa de ictericia obstructiva. En raras ocasiones, puede tratarse de fragmentos de hepatocarcinoma que migran hacia la vía biliar, obstruyéndola. Presentamos un caso de ictericia obstructiva por migración de fragmentos de hepatocarcinoma a la vía biliar, en un paciente tratado 7 años antes por un HC, con resección curativa.

Colesterolosis y cáncer de la vesícula biliar / Association between cholesterolosis and gallbladder cancer

Background: Cholesterolosis is frequently observed in cholecystectomies performed for lithiasis or chronic cholecystitis. Aim: To determine the degree of association between cholesterolosis and gallbladder cancer. Material and Methods: In a prospective study of gallbladder cancer, all gallbladders obtained during cholecystectomies were processed for pathological study, following a special protocol. As part of this study, 23304 surgical samples obtained between 1993 and 2002 were studied, looking for a relationship between cholesterolosis and chronic cholecystitis, adenomas, dysplasia and gallbladder cancer. Results: Seventy nine percent of patients were women. Cholesterolosis was observed in 3,123 cases (13.4 percent). Cholesterolosis was more common in women (14.2 percent) than in men (10.2 percent) (p < 0.001). In the same period, 29 patients were diagnosed with adenomas (0.12 percent), 179 cases with dysplasia not associated with gallbladder cancer (0.8 percent) and 739 gallbladder cancer (3.2 percent). The frequency of cholesterolosis was 13.8 percent in chronic cholecystitis, 13.7 percent in adenomas, 12.1 percent in dysplasias and 1.35 percent in patients with gallbladder cancer (p < 0.01). Of the thirteen cases with gallbladder cancer and cholesterolosis, 10 were early gallbladder carcinomas. Patients with cholesterolosis were 9.2 times less likely to have cancer than those who did not have cholesterolosis. Conclusions: Cholesterolosis has a strong negative association with gallbladder cancer.

[p53 and p27 gene expression in subserosal gallbladder carcinoma]. / Carcinoma subseroso de la vesícula biliar (pT2): valor pronóstico de la expresión de los genes supresores de tumores p53 y p27 en matrices de tejidos.

BACKGROUND: Subserosal carcinoma is the stage that presents the greatest difficulty in the diagnosis therapeutic handling and prognosis evaluation. AIM: To study the expression of p53 and p27 genes in subserosal gallbladder cancer. MATERIAL AND METHODS: One hundred twenty seven tissue samples of subserosal gallbladder cancer (coming from 112 females aged 62+/-13 years and 15 men aged 67+/-17 years) and 50 control samples were selected to construct tissue arrays. p53 and p27 genes were determined by immunohistochemistry. RESULTS: Thirty eight percent of tumors were not detected at the macroscopic examination, 52% and 17% had lymph node and blood vessel involvement, respectively. Fifty six and 46% were positive for p53 and p27, respectively. No association between the expression of both genes and gender, degree of differentiation, lymph node or blood vessel involvement, was observed. Overall five years actuarial survival was 32%. Patients with positive or negative p53 expression had a 22% and 53% survival, respectively (p=0.05). No association between survival and p27 expression was observed. CONCLUSIONS: p53 gene expression is a prognostic factor for subserosal gallbladder cancer.

[Natural history of gallbladder cancer. Analysis of biopsy specimens]. / Desde la displasia hasta el cáncer de la vesícula biliar.

BACKGROUND: There is scarcity of knowledge about the development of gallbladder cancer. AIM: To study the features of development and progression of gallbladder cancer. MATERIAL AND METHODS: Review of histopathological studies of gallbladder obtained in 25,971 cholecytectomies performed in patients aged 45+/- 16 years, 79% females, between 1993 and 2004. Among these, 210 had a dysplasia not associated to cancer and 1,039 had a gallbladder cancer Clinical and morphological parameters of preneoplastic and neoplastic lesions were analyzed. Ninety five percent of patients were followed. RESULTS: All cases of dysplasia were incidental findings. Metaplasia, dysplasia and carcinoma in situ were present in the adjacent mucosa in 66%, 81% y 69% of gallbladder carcinomas, respectively. Twenty five percent of gallbladders studied were carcinomas (mucous carcinoma in 18% and muscular carcinoma in 7%). Ninety two percent of cases had chronic inflammation in the gallbladder wall. Seventy two percent of mucous carcinomas were not detected macroscopically Five years survival of mucous carcinoma was 92%. There was an association between the intensity of the lesion and the age of the patients. The age difference between chronic cholecystitis and gallbladder cancer was 11 years for women and nine for men. CONCLUSIONS: From a morphological standpoint, the period in which a dysplasia becomes a carcinoma is approximately 10 years.

[Immunohistochemical expression of Ki-67 as a marker of proliferation in gallbladder mucosa samples with or without cancer]. / Proliferación celular en la mucosa de la vesícula biliar no tumoral en colecistitis crónicas litiásicas. Expresión de Ki-67 en matrices de tejidos.

BACKGROUND: There is paucity of knowledge on the proliferative features of normal or chronically inflamed gallbladder and the mechanisms of development of gallbladder cancer. AIM: To study the proliferation features of non tumoral gallbladder mucosa through the expression of Ki-67 antigen in tissue micro array analysis. MATERIAL AND METHODS: The immunohystochemical expression of Ki-67 in tissue micro array was studied in 96 samples of non tumoral gallbladder mucosa (coming from 74 females aged 45+/-16 years and 22 males aged 53+/-16 years) and 102 samples of gallbladder cancer (coming from 84 females aged 62+/- 14 years and 18 males aged 70+/- 13 years). RESULTS: The staining index of Ki-67 expression was 19+/-25% (range 096-8996) in samples of non tumoral mucosa and 46+/-29% (range 396-9896) in gallbladder cancer (p <0.01). Ki-67 was expressed in less than 10% of epithelial cells in 55% of non tumoral mucosa samples and 6% of gallbladder cancer samples. Seventy five percent of gallbladder cancer samples had a staining index of more than 20%. An expression of Ki-67 over 20% or 50% was observed in 25% and 15% of non tumoral mucosa samples, respectively. CONCLUSIONS: Non tumoral gallbladder mucosa samples have a high proliferation index, measured using Ki-67 immunohystochemical expression. There is a group of samples with cellular hyper-proliferation that maybe related to the pathogenesis of gallbladder cancer.

Carcinoma subseroso de la vesícula biliar (pT2): valor pronóstico de la expresión de los genes supresores de tumores p53 y p27 en matrices de tejidos / p53 and p27 gene expression in subserosal gallbladder carcinoma

Background: Subserosal carcinoma is the stage that presents the greatest difficulty in the diagnosis therapeutic handling and prognosis evaluation. Aim To study the expression of p53 and p27 genes in subserosal gallbladder cancer. Material and methods: One hundred twenty seven tissue samples of subserosal gallbladder cancer (coming from 112 females aged 62 ± 13years and 15 men aged 67 ± 17years) and 50 control samples were selected to construct tissue arrays. p53 andp27genes were determined by immunohistochemistry. Results: Thirty eight percent of tumors were not detected at the macroscopic examination, 52 percent and 17 percent had lymph node and blood vessel involvement, respectively. Fifty six and 46 percent were positive for p53 and p27, respectively. No association between the expression of both genes and gender, degree of differentiation, lymph node or blood vessel involvement, was observed. Overall five years actuarial survival was 32 percent. Patients with positive or negative p53 expression had a 22 percent and 53 percent survival, respectively (p =0.05). No association between survival and p27 expression was observed. Conclusions: p53 gene expression is a prognostic factor for subserosal gallbladder cancer.

Desde la displasia hasta el cáncer de la vesícula biliar / Natural history of gallbladder cancer Analysis of biopsy specimens

Background: There is scarcity of knowledge about the development of gallbladder cancer. Aim: To study the features of development and progression of gallbladder cancer. Material and methods: Review of histopathological studies of gallbladder obtained in 25,971 cholecytectomies performed in patients aged 45± 16 years, 79 percent females, between 1993 and 2004. Among these, 210 had a dysplasia not associated to cancer and 1,039 had a gallbladder cancer Clinical and morphological parameters of preneoplastic and neoplastic lesions were analyzed. Ninety five percent of patients were followed. Results: All cases of dysplasia were incidental findings. Metaplasia, dysplasia and carcinoma in situ were present in the adjacent mucosa in 66 percent, 81 percent y 69 percent of gallbladder carcinomas, respectively. Twenty five percent of gallbladders studied were carcinomas (mucous carcinoma in 18 percent and muscular carcinoma in 7 percent). Ninety two percent of cases had chronic inflammation in the gallbladder wall. Seventy two percent of mucous carcinomas were not detected macroscopically Five years survival of mucous carcinoma was 92 percent. There was an association between the intensity of the lesion and the age of the patients. The age difference between chronic cholecystitis and gallbladder cancer was 11 years for women and nine for men. Conclusions: From a morphological standpoint, the period in which a dysplasia becomes a carcinoma is approximately 10 years.

Proliferación celular en la mucosa de la vesícula biliar no tumoral en colecistitis crónicas litiásicas. Expresión de Ki-67 en matrices de tejidos / Immunohistochemical expression of Ki-67 as a marker of proliferation in gallbladder mucosa samples with or without cancer

Background: There is paucity of knowledge on the proliferative features of normal or chronically inflamed gallbladder and the mechanisms of development of gallbladder cancer. Aim: To study the proliferation features of non tumoral gallbladder mucosa through the expression of Ki-67 antigen in tissue micro array analysis. Material and methods: The immunohystochemical expression of Ki-67 in tissue micro array was studied in 96 samples of non tumoral gallbladder mucosa (coming from 74 females aged 45±16 years and 22 males aged 53±16 years) and 102 samples of gallbladder cancer (coming from 84 females aged 62± 14 years and 18 males aged 70± 13 years). Results: The staining index of Ki-67 expression was 19±25 percent (range 096-8996) in samples of non tumoral mucosa and 46±29 percent (range 396-9896) in gallbladder cancer (p <0.01). Ki-67 was expressed in less than 10 percent of epithelial cells in 55 percent of non tumoral mucosa samples and 6 percent of gallbladder cancer samples. Seventy five percent of gallbladder cancer samples had a staining index of more than 20 percent. An expression of Ki-67 over 20 percent or 50 percent was observed in 25 percent and 15 percent of non tumoral mucosa samples, respectively Conclusions: Non tumoral gallbladder mucosa samples have a high proliferation index, measured using Ki-67 immunohystochemical expression. There is a group of samples with cellular hyper-proliferation that maybe related to the pathogenesis of gallbladder cancer.

[A pilot experience with a tumor bank]. / Banco de tumores en Chile, su aporte a la investigación: resultados de un proyecto piloto.

BACKGROUND: Despite having the technical facilities and the knowledge, Chile did not have a tumor bank until recently. AIM: To describe the results of the first three years of a tumor bank. MATERIAL AND METHODS: All cases stored in a tumor bank from June 2004 to June 2007 were included. Samples were frozen in isopentane, afterwards in liquid nitrogen and finally transferred to freezers at -80 degrees C. Quality controls with DNA and RNA extraction and immunohistochemistry, were per formed. RESULTS: In the study period, 1239 cases were collected and 79% were malignant tumors. In 78% of cases, samples from the tumor and of normal neighboring tissue, were stored. Twenty six percent of samples were from breast cancer and 22% for digestive tumors. Immunohistochemical expression of vimentin was measured in 30 cases and the expression of Ki67 and p53 in 20 cases. Thirteen of 15 breast cancer samples had expression of estrogen receptors. In 30 cases, DNA and RNA extraction was carried out, amplifying B-globin and B-actin. Moreover RNA was extracted from 63 gastric cancer, 30 colon cancer and gallbladder cancer samples, for specific projects. CONCLUSIONS: The creation of a tumor bank is feasible, preserving samples of high biological quality.

bioNMF: a web-based tool for nonnegative matrix factorization in biology.

In the last few years, advances in high-throughput technologies are generating large amounts of biological data that require analysis and interpretation. Nonnegative matrix factorization (NMF) has been established as a very effective method to reveal information about the complex latent relationships in experimental data sets. Using this method as part of the exploratory data analysis, workflow would certainly help in the process of interpreting and understanding the complex biology mechanisms that are underlying experimental data. We have developed bioNMF, a web-based tool that implements the NMF methodology in different analysis contexts to support some of the most important reported applications in biology. This online tool provides a user-friendly interface, combined with a computational efficient parallel implementation of the NMF methods to explore the data in different analysis scenarios. In addition to the online access, bioNMF also provides the same functionality included in the website as a public web services interface, enabling users with more computer expertise to launch jobs into bioNMF server from their own scripts and workflows. bioNMF application is freely available at http://bionmf.dacya.ucm.es.

Banco de tumores en Chile, su aporte a la investigación: resultados de un proyecto piloto / A pilot experience with a tumor bank

Background: Despite having the technical facilities and the knowledge, Chile did not have a tumor bank until recently. Aimn: To describe the results of the first three years of a tumor bank. Material and methods: All cases stored in a tumor bank from June 2004 tojune 2007 were included. Samples were frozen in isopentane, afterwards in liquid nitrogen and finally transferred to freezers at -80°C. Quality controls with DNA and RNA extraction and immunohistochemistry, were per formed. Results: In the study period, 1239 cases were collected and 79 percent were malignant tumors. In 78 percent of cases, samples from the tumor and of normal neighaboring tissue, were stored. Twenty six percent of samples were from breast cáncer and 22 percent for digestive tumors. Immunohistochemical expression ofvimentin was measured in 30 cases and the expression of Ki67 an p53 in 20 cases. Thirteen of 15 breast cáncer samples had expression of estrogen receptors. In 30 cases, DNA and RNA extraction was carried out, amplifying B-globin and B-actin. Moreover RNA was extracted from 63 gastríc cáncer, 30 colon cáncer and gallbladder cáncer samples, for specific projects. Conclusions: The creation of a tumor bank is feasible, preserving samples of high biológical quality.

[White matter anatomy using tensor diffusion tractography]. / Anatomía de la sustancia blanca mediante tractografía por tensor de difusión.

Tractography of cerebral white matter fibers based on diffusion tensor imaging (DTI) is a recent magnetic resonance technique that enables the visualization of the anatomy and integrity of white matter tracts. This article aims to provide two- and three-dimensional representations of the main white matter tracts in the brain from high spatial resolution DTI data and to explain the physical basis of the technique, its main clinical applications, and how we use it. We provide examples of the use of DTI in the study of the corpus callosum, the anterior white commissure, the corticospinal tract, the limbic system, the long association fibers, the cerebellar peduncles, and the optic tract.

Anatomía de la sustancia blanca mediante tractografía por tensor de difusión / White matter anatomy using tensor diffusion tractography

La tractografía de las fibras de la sustancia blanca cerebral basada en el tensor de difusión es una reciente técnica de resonancia magnética que proporciona la visualización de la anatomía y la integridad de los tractos de dicha sustancia blanca. El propósito de este trabajo es representar de forma bidimensional y tridimensional las principales vías de la sustancia blanca cerebral a partir de los datos de la imagen del tensor de difusión de alta resolución espacial, y exponer las bases físicas de la técnica, nuestra metodología y sus principales aplicaciones clínicas. Se estudian y representan el cuerpo calloso, la comisura blanca anterior, el tracto corticoespinal, el sistema límbico, las fibras largas de asociación, los pedúnculos cerebelosos y la vía óptica (AU)

Tractography of cerebral white matter fibers based on diffusion tensor imaging (DTI) is a recent magnetic resonance technique that enables the visualization of the anatomy and integrity of white matter tracts. This article aims to provide two- and three-dimensional representations of the main white matter tracts in the brain from high spatial resolution DTI data and to explain the physical basis of the technique, its main clinical applications, and how we use it. We provide examples of the use of DTI in the study of the corpus callosum, the anterior white commissure, the corticospinal tract, the limbic system, the long association fibers, the cerebellar peduncles, and the optic tract (AU)

A double-blind, controlled, multicenter, randomized study comparing the antihypertensive effectiveness and tolerance of a daily dose of two nifedipine formulations: nifedipine microgranules versus nifedipine osmotic pump.

INTRODUCTION: Controlled clinical studies have clearly established the advantages of blood pressure (BP) reduction. However, optimal control of BP in the population is still not adequate. Monotherapy is ineffective in the majority of hypertensive patients, and multidrug therapy increases costs. OBJECTIVE: The objective of the study was to assess to what extent and how uniformly BP can be controlled with two different 24-hour drug-releasing formulations of nifedipine, used as monotherapy. METHODS: One hundred ninety-two patients of both genders, aged 18 to 65 years, with mild to moderate (Stage 1 and 2) essential hypertension with systolic BP <200 mm Hg and diastolic BP between 90 and 115 mm Hg were randomized in a double-blind, double-dummy fashion to receive sustained-release formulations of 30 mg nifedipine/day either as microgranules (NMG) or via osmotic pump (NOP) for 8 weeks. Office BP was measured at baseline (after 2 weeks of placebo) and after the third to fourth week of treatment. If at the third to fourth week the systolic BP/diastolic BP did not reach values of <140/<90 mm Hg, the dose was doubled to 60 mg/day. Monotherapy that did not yield these BP values at 8 weeks was considered a failure. Ambulatory monitoring of blood pressure (AMBP) was also performed after the placebo period and at the end of treatment. Smoothness index (SI) and trough/peak ratio (T/P) were calculated and their correlation was checked. RESULTS: The initial systolic/diastolic BP values were similar at baseline and decreased significantly after the third to fourth week of treatment, with no difference between the groups. The proportions of patients reaching the goal BP (<140/<90 mm Hg) were similar in the two groups: NMG, 71%, and NOP, 78% (P = 0.12). There were no changes in the heart rate in either group. There was no difference between groups in the reduction in mean arterial pressure measured by AMBP. The frequency of SI values >1.4 and T/P ratios of >0.5 was similar in both groups. An important correlation was found between the SI and T/P values. The incidence of adverse effects was low and similar in both groups. CONCLUSIONS: Target BP was reached in more than 70% of patients receiving monotherapy with either formulation. Both formulations were tolerated well.

[Microsatellite instability and human papilloma virus genotypes in preneoplastic and neoplastic uterine cervix lesions]. / Inestabilidad microsatelital en lesiones preneoplásicas y neoplásicas del cuello uterino: Correlación con el genotipo del virus papiloma humano.

BACKGROUND: The association between some specific human papilloma virus (HPV) types and cervix cancer is well known. However, the genetic conditions that favor the development of cervical cancer are less well known. AIM: To determine the presence of satellite instability (MSI) in preneoplastic and neoplastic lesions of the cervix and correlate these findings with HPV genotypes. MATERIAL AND METHODS: Biopsy samples of cervical lesions were studied. Sixteen had low grade lesions, 22 had high grade lesions and 28 had an epidermoid cancer. Viral types were identified with polymerase chain reaction, dot-blot hybridization and restriction fragment length polymorphism. MSI was determined using a panel of eight highly informative microsatellites. RESULTS: Microsatellite instability in at least one locus was observed in 91, 56 and 69% of low grade lesions, high grade lesions and epidermoid carcinomas, respectively. MSI-High grade, MSI-Low grade instability and microsatellite stability were observed in 5, 60 and 46% of samples, respectively. Two of three samples with high grade instability had HPV 52 genotype. Other viral subtypes had frequencies that ranged from 78% to 100%, with the exception of HPV16 that was present in only 53% of samples with low grade instability. CONCLUSIONS: Two thirds of biopsy samples from cervical lesions had MSI, mechanism that can be involved in the first stages of cervical carcinogenesis. The low frequency of high grade instability, its association with HPV52 and the low frequency of HPV16 in samples with low grade instability, suggest different coadjutant mechanisms in cervical carcinogenesis.

Inestabilidad microsatelital en lesiones preneoplásicas y neoplásicas del cuello uterino: Correlación con el genotipo del virus papiloma humano / Microsatellite instability and human papilloma virus genotypes in preneoplastic and neoplastic uterine cervix lesions

Background: The association between some specific human papilloma virus (HPV) types and cervix cancer is well known. However, the genetic conditions that favor the development of cervical cancer are less well known. Aim: To determine the presence of satellite instability (MSI) in preneoplastic and neoplastic lesions of the cervix and correlate these findings with HPV genotypes. Material and methods: Biopsy samples of cervical lesions were studied. Sixteen had low grade lesions, 22 had high grade lesions and 28 had an epidermoid cancer. Viral types were identified with polymerase chain reaction, dot-blot hybridization and restriction fragment length polymorphism. MSI was determined using a panel of eight highly informative microsatellites. Results: Microsatellite instability in at least one locus was observed in 91, 56 and 69 percent of low grade lesions, high grade lesions and epidermoid carcinomas, respectively. MSI-High grade, MSI-Low grade instability and microsatellite stability were observed in 5, 60 and 46 percent of samples, respectively. Two of three samples with high grade instability had HPV 52 genotype. Other viral subtypes had frequencies that ranged from 78 percent to 100 percent, with the exception of HPV16 that was present in only 53 percent of samples with low grade instability. Conclusions: Two thirds of biopsy samples from cervical lesions had MSI, mechanism that can be involved in the first stages of cervical carcinogenesis. The low frequency of high grade instability, its association with HPV52 and the low frequency of HPV16 in samples with low grade instability, suggest different coadjutant mechanisms in cervical carcinogenesis

[Osteonecrosis associated with the use of biphosphonates: Case report]. / Osteonecrosis asociada al uso de bifosfonatos: A propósito de un caso clínico.

Biphosphonates reduce the risk of skeletal events and are currently part of standards of therapy in myeloma. Recently, zoledronate and pamidronate have been linked to osteonecrosis of the jaw, specially after surgical dental procedures. We report a 84 year-old man with multiple myeloma who developed spontaneous osteonecrosis of both jaws, after 36 months of therapy with zoledronate with a cumulative dose of 136 mg. We discuss the pathogenic mechanisms, and review the recommendations on prevention and management of this new complication for neoplastic patients under prolonged therapy with biphosphonates.