MicroARN: la biología molecular como herramienta de predicción en preeclampsia / MicroRNAs: molecular biology as a tool for preeclampsia prediction

La preeclampsia es una patología con una importante incidencia a nivel mundial que se encuentra asociada directamente con el 15% de las muertes maternas. Esta se caracteriza usualmente por la presencia de hipertensión y proteinuria, que se manifiestan desde la mitad de la gestación. Los microARN son moléculas de ARN monocatenario que actúan principalmente degradando el ARN mensajero transcrito o inhibiendo la traducción de microARN. Los microARN placentarios ejercen un papel en el crecimiento y función de la placenta, se considera factible su uso potencial como biomarcadores de diagnóstico debido a la capacidad de entrar en la circulación materna y ser detectables en el plasma materno.

Preeclampsia is a disease with a significant incidence worldwide that is directly associated with 15% of maternal deaths. This is usually characterized by the presence of hypertension and proteinuria, which manifests itself from the middle of pregnancy. MicroRNAs are single-stranded RNA molecules that act primarily by degrading transcribed messenger RNA or inhibiting microRNA translation. Placental microRNAs play a role in the growth and function of the placenta, their potential use as diagnostic biomarkers is considered feasible due to the ability to enter the maternal circulation and be detectable in maternal plasma.

Oviposition dynamics of Aedes aegypti in Central Argentina.

Aedes (Stegomyia) aegypti (L.) (Diptera: Culicidae) is the vector of multiple arboviruses. To evaluate the association between environmental factors and the oviposition activity of Ae. aegypti in Argentina, data on the presence and abundance of eggs were collected using ovitraps, between September of 2018 and May of 2019, in the cities of Villa María, Río Cuarto and Salsipuedes (Córdoba province, Argentina). We analysed the relationships between oviposition and five environmental factors: Temperature, precipitation, vegetation cover, human population density and distance to sites with a potential high density of larval habitats, like cemeteries and trash dumps. Environmental factors' data were collected using satellite image products. The oviposition activity was randomly distributed in three cities. Using generalized linear mixed models, we show that the house where each ovitrap was placed was a source of variability in oviposition, suggesting the relevance of microsite factors and the importance of domestic control actions. Ae. aegypti oviposition was positively correlated with night-time temperature of the previous 3 weeks, and in a context-dependent manner, it was positively correlated with human population density, vegetation cover and precipitation. The consistency and magnitude of these relationships varied between cities, indicating that oviposition is related to a complex system of environmental variables.

Evolución del síndrome de desgaste profesional, ansiedad y depresión en personal sanitario durante la pandemia de la COVID-19 / Evolution of burnout syndrome, anxiety and depression in healthcare personnel during the COVID-19 pandemic

Introducción. La pandemia de la COVID-19 ha producido un impacto en la esfera psicológica de los trabajadores sanitarios. El objetivo de este estudio es analizar la evolución del síndrome de desgaste profesional, la ansiedad y la depresión en el personal sanitario a lo largo de la pandemia de la COVID-19. Material y métodos. Estudio observacional de los profesionales sanitarios del Servicio de Neumología del Hospital Gregorio Marañón que ha prestado servicio entre diciembre de 2019 y enero de 2021. Se evaluó el síndrome de desgaste profesional mediante el cuestionario Maslach Burnout Inventory (MBI) y la ansiedad y depresión mediante los cuestionarios de Zung referido a diciembre de 2019 (situación basal), marzo de 2020 (primera ola) y enero de 2021 (tercera ola) en diferentes profesiones sanitarias. Resultados. Se incluyeron 62 participantes, de los cuales 15 (24,2%) eran varones. En cuanto a las profesiones sanitarias, 24 (38,7%) eran médicos, 22 eran diplomados universitarios de enfermería (DUE), 12 (19,4%) eran técnicos en cuidados auxiliares de enfermería (TCAE), y 4 (6,5%) eran otros profesionales. Se documentó un cambio significativo al alza del estrés emocional y de despersonalización y a la baja de realización personal tanto de forma global como estratificado por diferentes profesiones sanitarias excepto en otros profesionales. Se objetivó un aumento progresivo de la ansiedad, mientras que el aumento de la depresión no fue estadísticamente significativo. Conclusión. Durante la pandemia de la COVID-19, los profesionales sanitarios sufrieron un aumento progresivo del desgaste profesional y de la ansiedad. Es importante tener en cuenta la salud psicológica de los sanitarios (AU)

Introduction. The COVID-19 pandemic has impacted the psychological sphere of healthcare workers. The objective of this study is to analyze the evolution of burnout syndrome, anxiety and depression in healthcare personnel throughout the COVID-19 pandemic Material and methods. Observational study of the healthcare professionals of the Respiratory Department of Gregorio Marañón Hospital that worked between December 2019 and January 2021. Burnout syndrome was evaluated using the Maslach Burnout Inventory (MBI) questionnaire and anxiety and depression using the Zung questionnaires referred to December 2019 (baseline situation), March 2020 (first wave) and January 2021 (third wave) in different healthcare professions. Results. Sixty-two participants were included, of which 15 (24.2%) were male. Regarding the healthcare professions, 24 (38.7%) were doctors, 22 were nurses, 12 (19.4%) were technicians in auxiliary nursing care, and 4 (6, 5%) were other professionals. A significant upward change in emotional stress and depersonalization and a downward personal fulfillment were documented both globally and stratified by different healthcare professions except in other professionals. A progressive increase in anxiety was observed, meanwhile, the increase in depression was not statistically significant. Conclusion. During the COVID-19 pandemic, healthcare professionals suffered a progressive increase in burnout and anxiety. It is important to consider the psychological health of the healthcare personnel (AU)

Pápulas en el dorso de las manos / Papules on the Dorsum of the Hands

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[Carcinoma of the Fallopian tube: a case]. / Un caso de carcinoma de trompa de Falopio.

The case of a 43-years old woman with previous history of mental retardation and major depressive syndrome, consulting for metrorrhagia is presented. At physical examination a right adnexal mass was detected on palpation. Transvaginal echography showed a 3-cavity cyst in right ovary. A surgical intervention with total hysterectomy and dual adnexectomy was performed. Pathological study showed proliferative endometrium, bilateral follicular cysts and well differentiated serous adenocarcinoma located at fallopian tube. The patient refused adjuvant chemotherapy, a close follow-up is ongoing in outpatient Oncology Unit. Then some epidemiologic, etiologic, clinica, diagnostic and therapeutic issues related to this rare tumour are discussed.

Un caso de carcinoma de trompa de Falopio / Carcinoma of the fallopian tube: a case

Presentamos el caso de una mujer de 43 años de edad, con antecedentes personales de retraso mental y síndrome depresivo mayor, que consultó por metrorragias. A la exploración física se palpaba una masa anexial derecha. En la ecografía transvaginal se observó un quiste en el ovario derecho con 3 cavidades. Se decidió realizar intervención quirúrgica, efectuándose una histerectomía total con doble anexectomía. El resultado de la anatomía patológica fue de endometrio proliferativo, quistes foliculares bilaterales y adenocarcinoma seroso bien deferenciado de la trompa de Falopio. La paciente rechazó la realización de tratamiento con quimioterapia adyuvante y se está efectuando un seguimiento estrecho de la misma en las consultas de Oncología. Posteriormente comentamos algunos aspectos epidemiológicos, etiológicos, clínicos, diagnósticos y terapéuticos de esta rara tumoración

The case of a 43-years old woman with previous history of mental retardation and major depressive syndrome, consulting for metrorrhagia is presented. At physical examination a right adnexal mass was detected on palpation. Transvaginal echography showed a 3-cavity cyst in right ovary. A surgical intervention with total hysterectomy and dual adnexectomy was performed. Pathological study showed proliferative endometrium, bilateral follicular cysts and well differentiated serous adenocarcinoma located at fallopian tube. The patient refused adyuvant chemotherapy, a close follow-up is ongoing in outpatient Oncology Unit. Then some epidemiologic, etiologic, clinica, diagnostic and therapeutic issues related to this rare tumour are discussed

Un nuevo caso de carcinoma de células de Merkel / A new case of MErkel´s cell carcinoma

Presentamos el caso de una paciente de 80 años a la que le fue extirpada una voluminosa tumoración localizada en la región axilar derecha. El diagnóstico histológico fue de carcinoma neuroendocrino primario de piel (carcinoma de células de Merkel).El estudio de extensión realizado encontró un adenoma velloso de sigma con displasia severa. Tras la cirugía se realizó tratamiento de radioterapia. Posteriormente comentamos algunos aspectos clínicos, diagnósticos y terapéuticos de esta infrecuente neoplasia (AU)

Schwannoma maligno en paciente con antecedentes de melanoma y de exposición a radiaciones atómicas / Malignant schwannoma in a patient with antecedents of melanoma and exposition to atomic radiation

Presentamos el caso de una paciente de 50 años, natural y residente durante 40 años en Ucrania. Tenía antecedentes de melanoma maligno, 6 años atrás, actualmente en remisión completa. Fue intervenida de una tumoración de partes blandas localizada en la región dorsal. El estudio histológico fue compatible con Schwannoma maligno. Presentó metástasis óseas al mes de la cirugía y metástasis pulmonares y hepáticas, diagnosticadas dos meses más tarde. Se inició tratamiento de quimioterapia. Posteriormente comentamos algunos aspecto etiológicos, postulando sobre el posible papel de la exposición a las radiaciones atómicas que sufrió nuestra paciente; clínicos, diagnósticos y terapéuticos de este infrecuente tumor (AU)

Prospects, problems and pitfalls of urban water reuse: a case study.

This paper presents a successful water reclamation and reuse project in the San Francisco Bay area. The project, which includes a water reclamation facility and a separate distribution system, is operated by a wastewater utility and reclaims approximately 4% of its dry-weather flow. Project history, its design and implementation are further discussed. Planning, and especially demand analysis, was critical for project development. Earlier attempts of water reuse were not successful because reclaimed water quality did not match the requirements of potential large industrial customers. Current customers are a mix of public, commercial and residential users who apply the reclaimed water solely for landscape irrigation. In addition, a large fraction of the reclaimed water is used internally in the main wastewater treatment plant. Early connection of largest customers, innovative collaboration with a neighboring reclamation project and cooperation of the local water supplier were very important for project success. Distribution of internal process water consumes most energy. The second major energy use is for the treatment of reclaimed water while distribution of reclaimed water to external customers requires least energy.

[Factors related to treatment adherence in schizophrenic patients]. / Factores relacionados con la adherencia al tratamiento en pacientes esquizofrénicos.

BACKGROUND: The percentage of lack of adherence in schizophrenia is estimated in 50%. Non-compliance cause higher rates of relapses, rehospitalizations, suicide, homicide and violent behaviour among schizophrenic patients. The aim of this study was to find several factors related to adherence in schizophrenia. MATERIAL AND METHODS: 40 schizophrenic patients were assessed with a protocol which examined sociodemographic, clinical and therapeutical variables, scales in order to evaluate insight (Birchwood), drug attitude (Drug Attitude Inventory), psychopathology (BPRS) and side effects (UKU). Variables of outcome and overall functioning (GAS) in the previous year were also included. RESULTS: Multiple regression analysis revealed that BPRS thought disorder subscale and UKU neurologic side effects subscale predicted 24% of the variance of adherence. Adherence is related to insight and attitude to medication too. An adequate adherence was related to better overall functioning, less psychopathology and fewer hospitalizations during the year prior to the study.

Monocytoid B cells. A comparative clinical pathological study of their distribution in different types of low-grade lymphomas.

Neoplastic monocytoid B-cells (MBCs) are present in different amounts in several types of non-Hodgkin's lymphomas (NHLs), including monocytoid B-cell lymphoma (MBCL), splenic marginal zone lymphoma (SMZL), mucosa-associated lymphoid tissue (MALT) low-grade B-cell lymphomas, and follicular centroblastic-centrocytic (CB-CC) lymphomas. In an attempt to clarify the relationships between different groups of tumors with a significant monocytoid component, we studied six primary lymph node MBCL, three SMZL, seven MALT lymphomas, and four CB-CC with monocytoid differentiation. Their clinical, morphological, immunohistochemical and molecular features were compared. The results show wide overlapping between MALT and MBCL in terms of morphology, immunophenotype, and molecular features. Follicular colonization was a characteristic finding in both groups. Some MBCL revealed mucosal involvement during the course of the disease, suggesting a possible MALT origin. Our data support the suggestion that the use of the term MBCL should be discontinued in cases with mucosal involvement, as they are probably examples of lymph node involvement brought about by MALT lymphomas. Although SMZL have some overlapping features with MBCL and MALT lymphomas, some of the clinical and morphological specific findings justify their distinction from the other groups. The CB-CCs with monocytoid differentiation frequently harbored t(14;18), lacking any significant differentiating features from conventional follicular CB-CC lymphomas. Additional studies are needed to define the molecular features of MBCL and other marginal zone tumors.

[Acute thoracic syndrome]. / Síndrome torácico agudo.

The acute chest syndrome is a clinical entity appearing in patients suffering from sickle cell anaemia. It presents with pleuritic pain, fever, leucocytosis and pulmonary infiltrates in the thoracic radiology. The etiological diagnosis is difficult, and it is necessary to distinguish between pneumonia and pulmonary infarction. This syndrome is quite frequent among the patients at risk, and can be lethal according to the severity and the etiology of the event. A case of acute chest syndrome due to a S. pneumoniae sepsis is presented. The interest of the case lies in the rareness of this disease in our population and the peculiar evolutive clinical features of this case, with the development of intracranial hypertension and death.