Identifying key environmental factors to model Alt a 1 airborne allergen presence and variation.

Fungal spores, commonly found in the atmosphere, can trigger important respiratory disorders. The glycoprotein Alt a 1 is the major allergen present in conidia of the genus Alternaria and has a high clinical relevance for people sensitized to fungi. Exposure to this allergen has been traditionally assessed by aerobiological spore counts, although this does not always offer an accurate estimate of airborne allergen load. This study aims to pinpoint the key factors that explain the presence and variation of Alt a 1 concentration in the atmosphere in order to establish exposure risk periods and improve forecasting models. Alternaria spores were sampled using a Hirst-type volumetric sampler over a five-year period. The allergenic fraction from the bioaerosol was collected using a low-volume cyclone sampler and Alt a 1 quantified by Enzyme-Linked ImmunoSorbent Assay. A cluster analysis was executed in order to group days with similar environmental features and then analyze days with the presence of the allergen in each of them. Subsequently, a quadratic discriminant analysis was performed to evaluate if the selected variables can predict days with high Alt a 1 load. The results indicate that higher temperatures and absolute humidity favor the presence of Alt a 1 in the atmosphere, while time of precipitation is related to days without allergen. Moreover, using the selected parameters, the quadratic discriminant analysis to predict days with allergen showed an accuracy rate between 67 % and 85 %. The mismatch between daily airborne concentration of Alternaria spores and allergen load can be explained by the greater contribution of medium-to-long distance transport of the allergen from the major emission sources as compared with spores. Results highlight the importance of conducting aeroallergen quantification studies together with spore counts to improve the forecasting models of allergy risk, especially for fungal spores.

Beyond cancer treatment: dermo-aesthetic and other wellness recommendations for breast cancer patients.

Breast cancer, a prevalent malignancy among women, has various physical and psychological impacts. This comprehensive review offers an in-depth look at multidisciplinary dermo-aesthetic intervention approaches, emphasizing the balance between oncological therapies and the management of these effects. The information presented spans specialties such as aesthetic medicine, plastic surgery, dermatology, physiotherapy, nutrition, odontology, and gynecology. This review, which serves as a clinical guide, aims to establish a safe protocol for non-medical interventions involving oncologists, physicians, and specialists from various areas in patients with breast cancer focused on improving their quality of life. This work offers personalized and integrative care strategies for the eradication of cancer. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment. However, it is still necessary for patients to consult with their oncologist before undergoing any dermo aesthetic treatment.

Characterization of aerosol sources in León (Spain) using Positive Matrix Factorization and weather types.

A one-year aerosol sampling campaign, between 2016 and 2017, was conducted in a suburban area of León city, Spain. An association between the Positive Matrix Factorization (PMF) results and air masses through circulation weather types was carried out, through the construction of linear models from the PM10 concentrations and its chemical composition. The aerosol sources, identified by PMF six-factor solution, were: traffic (29%), aged sea salt (26%), secondary aerosols (16%), dust (13%), marine aerosol (7%) and biomass burning (3%). Traffic and secondary factors showed the highest PM10 contribution in the hybrid cyclonic types with wind component from the first and second quadrant. Anticyclonic types with wind component from the first quadrant exhibited high values of secondary, aged sea salt and dust factors. The highest contributions of the dust factor were also associated with northerly types. The linear models built for estimating the source apportionment of PM10, from aerosol chemical composition and geostrophic flow, showed positive coefficients for: westerly flows (WF) in marine factor, southerly flows (SF) in secondary and traffic factors, and shear southerly vorticities (ZS) in dust factor. Negative dependences were observed for ZS in aged sea salt factor and for SF in dust factor. The PM10 mass concentration calculated by the linear models and by the PMF model were strongly correlated. This can be very useful to determine the contribution of a specific source to PM10 in León, only by knowing some meteorological and chemical variables.

Towards a model for aerosol removal by rain scavenging: The role of physical-chemical characteristics of raindrops.

A one-year study was carried out in León, Spain, in order to characterize physically and chemically the precipitation. With the aim of studying the scavenging process of atmospheric pollutants, scavenging ratio and removal coefficients were calculated through physical parameters of raindrops (obtained by disdrometer data) and through chemical properties of aerosols. Finally, linear models for the prediction of the chemical composition of rainwater and the efficiency of the removal effect were established. In general, the rainwater was dominated by NH4+ > SO42- > NO3- in all seasons. Higher ion concentrations and conductivity and lowest pH were observed in summer, due to the low volume of rain. In winter, the high values of Na+ and Cl- in the rainwater showed the contribution from marine sources, while in summer the high concentrations of Ca2+, Mg2+, SO42-, NH4+ and NO3- reflected the contribution from both crustal and anthropogenic sources. The linear models revealed that the amount of dissolved organic carbon and of the water-soluble ions in rain samples, Ca2+, SO42-, NO3-, increases with the volume swept by the falling drops. Insoluble carbon fraction has a negative dependence with the volume swept and positive with the diameter of the raindrop. Removal coefficients are affected by the concentration in the air of each species before precipitation, the duration of the event and the time elapsed between two precipitation events.

Mutilación genital femenina / Female genital mutilation

La mutilación genital femenina es una práctica realizada generalmente por razones religiosas o culturales no médicas que afecta a más de 125 millones de mujeres y niñas en todo el mundo, principalmente en África y Oriente Medio. Debido a las importantes complicaciones que asocia para la vida sexual de la mujer afectada así como los riesgos obstétricos que conlleva, debe ser identificada precozmente y tratada si es preciso. La defibulación es un procedimiento quirúrgico sencillo, eficaz y desprovisto de complicaciones mayores asociadas (AU)

Female genital cutting is a practice generally performed for religious or cultural non-medical reasons. It affects more than 125 million women and girls around the world, mainly in Africa and the Middle East. Female genital cutting should be identified early and treated if necessary due to the significant complications to sex life and obstetric risks that associates. Defibulation is a simple, effective surgical procedure and it is devoid of major complications associated (AU)

Criterios de calidad en el manejo del cáncer de mama en Castilla y León, mejorando nuestra eficiencia / Improving our efficiency: quality criteria in the management of breast cancer in Castile-Leon

Objetivo. Evaluar la calidad de la asistencia prestada a los pacientes con cáncer de mama en los hospitales públicos de Castilla y León (Sacyl). Material y métodos. La recogida de datos se realizó a través de una encuesta de criterios de calidad avalados por EUSOMA, enviada a hospitales del Sacyl, con un total de 1.235 pacientes diagnosticadas de cáncer de mama en el 2011. Resultados. El 81,81% de los criterios se cumplen. El 90% recibe tratamiento antes de 6 semanas del diagnóstico. En el tratamiento quirúrgico, radioterápico y sistémico, se cumplen criterios de calidad. Sin embargo, hay (se realizan) demasiadas exéresis quirúrgicas en afección benigna; el 87% de los casos se llevan a comité de tumores; excesivo seguimiento en pacientes asintomáticas y excesivo estudio de extensión. Conclusión. Aunque la asistencia prestada supera la mayoría de los criterios de calidad, se han identificado aspectos a mejorar para lograr un mejor rendimiento de nuestros recursos (AU)

Objectives. To assess the quality of care provided to breast cancer patients in the public hospitals of Castile-Leon. Material and methods. Data collection was carried out through a survey on quality criteria endorsed by the European Society of Breast Cancer Specialists (EUSOMA), which was sent to the public hospitals in Castile-Leon. A total of 1235 patients diagnosed with breast cancer in 2011 participated in the survey. Results. A total of 81.81% of criteria were achieved. Ninety percent of patients received treatment within 6 weeks of diagnosis. Surgical, radiotherapeutic, and systemic treatment complied with quality criteria. However, too many surgical excisions were performed in benign disease. The cases of 87% of cancer patients were discussed by a multidisciplinary team. There was excessive follow-up in asymptomatic patients and excessive study of tumoral extension. Conclusion. Although the healthcare provided exceeded most quality criteria, we identified areas that could be improved to achieve more efficient resource use (AU)

Carcinoma oculto de vulva en neoplasia vulvar intraepitelial diferenciada / Occult carcinoma of the vulva in a differentiated vulvar intraepithelial neoplasia

Presentamos el caso de una mujer de 74 años con una lesión vulvar asociada a prurito vulvar, de 2 años de evolución. La paciente ha sido tratada con múltiples tratamiento tópicos y, por persistencia de la lesión y sintomatología, fue derivada a nuestra consulta. Se realiza una biopsia de la lesión y corresponde a una neoplasia vulvar intraepitelial diferenciada. El tratamiento inicial fue una escisión amplia, con el hallazgo anatomopatológico de carcinoma oculta escamoso de vulva. Posteriormente, se realiza una vulvectomía radical con biopsia selectiva de ganglio centinela, confirmando el diagnóstico de carcinoma epidermoide vulva estadio i B (AU)

We present the case of a 74-year-old woman with a 2-year history of a vulvar lesion associated with pruritus. The patient was treated with multiple topical treatments but, due to the persistence of the lesion and symptoms, she was referred to our clinic. The results of biopsy of the lesion corresponded to differentiated vulvar intraepithelial neoplasia. The initial treatment was wide local excision, with the pathological finding of occult differentiated squamous carcinoma of the vulva. The lesion was treated surgically through radical vulvectomy with sentinel node biopsy, which confirmed the diagnosis of stage IB squamous vulvar carcinoma (AU)

Estudio comparativo de conizaciones realizadas en la provincia de Segovia antes y después del uso del test del virus del papiloma humano (2007-2010) / Comparative study of conizations performed in the province of Segovia before and after the use of the human papilloma virus test (2007-2010)

Objetivo. Este estudio pretende evaluar los cambios epidemiológicos, diagnósticos y terapéuticos en la provincia de Segovia desde la introducción de técnicas de detección de ADN del virus del papiloma humano (VPH) en el cribado de cáncer de cerviz, en mujeres mayores de 30 años en atención primaria en enero de 2009. Material y métodos. Estudio observacional, descriptivo, transversal, retrospectivo, de conizaciones realizadas desde enero de 2007 hasta diciembre de 2010. Se incluye a 86 pacientes: 40 mujeres conizadas en el período 2007-2008 y 46 en el período 2009-2010. Resultados. No se ha incrementado significativamente el número de conizaciones pero sí ha aumentado el número de lesiones de alto grado en citología (p=0,017) y en el estudio histológico posquirúrgico (p=0,047). Observamos un incremento del valor predictivo positivo (VPP) del cribado para lesiones de alto grado, aunque sin significación estadística (p=0,059). Conclusiones. El VPP del cribado de cáncer de cérvix ha aumentado en nuestra provincia con el test de VPH sin aumentar el número de conizaciones (AU)

Objective. To assess epidemiological, diagnostic and therapeutic changes in the province of Segovia since the introduction of techniques for the detection of human papillomavirus (HPV) DNA in cervical cancer screening in women aged more than 30 years in primary care in January 2009. Material and methods. We carried out an observational retrospective study of conization procedures undertaken from January 2007 to December 2010. Eighty-six patients were included: 40 women who underwent conization from 2007-2008 and 46 who underwent the procedure from 2009-2010. Results. The number of conization procedures showed no significant change but the number of high-grade lesions found in cytology (P = .017) and postsurgical histological analysis (P=.047) increased. The positive predictive value (PPV) of screening for high-grade lesions showed a nonsignificant increase (P=.059). Conclusions. The PPV of cervical cancer screening increased in our province with the HPV test, without increasing the number of conization procedures (AU)

Impacto en la supervivencia del cribado del cáncer de mama en el Hospital General de Segovia / Impact of breast cancer screening on survival in the General Hospital of Segovia (Spain)

Objetivos: Analizar si el programa de cribado del cáncer de mama en la provincia de Segovia ha supuesto una mejora en la supervivencia en la población afecta por este tumor. Objetivo secundario: analizar la magnitud de esta mejora a los 5, 10 y 15 años de seguimiento. Material y métodos: Estudio retrospectivo descriptivo, analiza la supervivencia de 253 pacientes diagnosticadas de cáncer de mama por el programa de cribado (desde 1992-2007) y la supervivencia de 312 diagnosticadas a través del marco asistencial habitual, todas ellas tratadas en el Hospital General de Segovia. Resultados: La supervivencia en el grupo de cribado es netamente superior a la del grupo de diagnóstico clínico, siendo la diferencia ma ́s marcada a medida que aumenta el seguimiento: 93% vs 78% a los 5 años; 89% vs 68% a los 10 años; 86% vs 56% a los 15 años. Conclusiones: Se ha conseguido mejorar la supervivencia desde la puesta en marcha del programa de cribado, especialmente se observa a los 15 años de seguimiento, una diferencia del 30% (AU)

Objectives: To analyze whether the program for breast cancer screening in the Spanish province of Segovia has increased the survival rate among the population with this disease. Secondary objective: to analyze the magnitude of this improvement at 5, 10 and 15 years of follow-up. Materials and methods: We performed a descriptive, retrospective study that analyzed the survival rates in 253 patients diagnosed with breast cancer by the breast cancer screening program (1992-2007), as well as survival in 312 patients, diagnosed in routine clinical practice. All patients were treated in the General Hospital of Segovia. Results: The survival rate in the screening group was clearly higher than that in the group diagnosed in routine clinical practice. This difference was more marked with increasing follow- up: 93% vs 78% at 5 years, 89% vs 68% at 10 years and 86% vs 56% at 15 years. Conclusions: Survival has improved since the start of the screening program. This increase was especially marked in the 15 years of follow-up, representing a difference of 30% (AU)