Autopercepção da voz, audição e saúde geral no rastreio de distúrbio vocal em idosas / Self-perception of voice, hearing, and general health in screening for voice changes in older women

RESUMO Objetivo Verificar a associação de fatores sociodemográficos, do comportamento vocal, morbidades e autopercepção da voz, auditiva e de saúde geral de idosas com distúrbio vocal. Método Participaram 95 idosas com idades entre 60 e 84 anos (média 69,5). Realizou-se uma entrevista com apoio de um questionário estruturado contendo questões sociodemográficas, de saúde e do comportamento vocal. Utilizou-se o Protocolo para Rastreamento de Alterações Vocais em Idosos (RAVI) para identificar a presença de distúrbio vocal. Resultados Houve o predomínio de participantes com ensino médio completo e aposentadas. O número de idosas que apresentaram distúrbio vocal segundo o RAVI foi de 46,3%. Queixas relacionadas às sensações físicas como garganta seca, pigarro e coceira na garganta foram as mais presentes. O grupo de idosas com distúrbio vocal apresentou pior autopercepção da qualidade vocal, audição, saúde geral e maior frequência de infecções de vias aéreas superiores quando comparadas àquelas sem distúrbio vocal (p≤0,05). Conclusão Houve associação estatística entre a autoavaliação vocal mensurada pelo RAVI e a autopercepção da qualidade da voz, da audição, da saúde geral, inflamações de garganta, sinusite e alergias respiratórias.

ABSTRACT Purpose To verify the association between sociodemographic factors, vocal behavior, morbidities, and self-perception of voice, hearing, and general health in older women with voice disorders. Methods The sample had 95 older women aged 60 to 84 years (mean of 69,5). They were interviewed with a structured questionnaire on sociodemographic aspects, health, and vocal behavior. The Screening Protocol for Voice Disorders in Older Adults (RAVI) was used to identify the presence of voice disorders. Results Participants who had finished high school and were retired predominated. The number of older women with voice disorders according to RAVI was 46.3%. Physical sensations such as dry throat, throat clearing, and itchy throat were the most common complaints. The group of older women with voice disorders had worse self-perception of voice quality, hearing, and general health and a higher frequency of upper airway infections than those without voice disorders (p ≤ 0.05). Conclusion The vocal self-assessment measured with RAVI was statistically associated with self-perception of voice quality, hearing, general health, sore throat, sinusitis, and respiratory allergies.

Larotrectinib versus infigratinib for adult patients with both glioma and tyrosine kinase alterations after failure of initial therapies: Efficacy and safety analysis

Abstract Objectives To compare the efficacy and safety of larotrectinib with those of infigratinib in adult glioma patients with tyrosine kinase alterations. Methods Patients received oral infigratinib 125 mg (IN cohort, n = 125) or oral larotrectinib (LB cohort, n = 105) until unacceptable toxicity or disease progression. Results Duration of treatment was longer in the LB cohort than in the IN cohort (8 [9.5-6.25] months vs. 5.5 [6-5.25] months, p < 0.0001). Patients with partial responses (p = 0.0424) and overall survival (p = 0.03) were higher in the IN cohort than those in the LB cohort. The number of patients with disease progression was higher in the LB cohort (p = 0.0015). All the patients reported diarrhea, fatigue, vomiting, constipation, and decreased appetite. Patients in the IN cohort reported hyperphosphatemia, hyperlipasemia, stomatitis, dry skin, alopecia, dyspepsia, onycholysis, palmar-plantar erythrodysesthesia, nail disorders, and dry eyes. Patients in the LB cohort reported upper respiratory tract infections, pyrexia, cough, anemia, bacterial/viral infections, conjunctivitis, urinary tract infections, headaches, ataxia, dizziness, and muscle tremors. A total of 30 (24 %) and 40 (38 %) patients from the IN and the LB cohorts died at the follow-up of 18 months (p = 0.03). Patients who received bevacizumab initial therapy had higher overall survival (p = 0.048). Conclusions Infigratinib has higher efficacy and overall survival than larotrectinib but has higher adverse effects in the management of both glioma and tyrosine kinase alterations after failure of initial therapies. Initial bevacizumab therapy is associated with a higher overall survival.

Alteraciones del comportamiento como contenido en la formación de estudiantes para la orientación a las familias

La formación de estudiantes para la prevención de las alteraciones del comportamiento en los niños de la primera infancia, es imprescindible porque contribuye a elevar la calidad de la atención educativa de salud y educación en ambas modalidades de atención educativa de la primera infancia. El artículo que se presenta tiene como objetivo exponer acciones dirigidas a los estudiantes en formación que los prepara para la orientación de las familias, en función de la prevención de las alteraciones del comportamientoen niños de infancia preescolar. Las acciones se aplicaron durante el periodo del 2019 al 2022 como parte de la preparación para la práctica laboral, lo que posibilitó que se elevara la calidad de la orientación familiar en función de la prevención de las alteraciones del comportamiento en los niños de infancia preescolar, en ambas modalidades de atención educativa.

The training of students for the prevention of behavioral disorders in early childhood children is essential because it contributes to raising the quality of educational health care and education in both modalities of early childhood educational care. The article that is presented aims to expose actions aimed at students in training that prepare them for the orientation of families, based on the prevention of behavioral disorders in preschool children. The actions were applied during the period from 2019 to 2022 as part of the preparation for labor practice, which made it possible to raise the quality of family guidance based on the prevention of behavioral disorders in preschool children, in both modalities of educational attention.

Calidad del sueño y factores que lo alteran en los pacientes críticos en la uti en una institución privada de córdoba 2022 / Sleep quality and factors that alter it in critical patients in the icu in a private institution in Córdoba 2022

Los pacientes que están hospitalizados tienen un desequilibrio en de sus necesidades, más si hablamos de los pacientes que se encuentran en una unidad de terapia intensiva donde el movimiento es dinámico segundo a segundo debido a la inestabilidad hemodinámica de cada paciente. Una vez que se haya estabilizado la salud del paciente orientado, aparece la dificultad de poder dormir, por diversos factores que rodean al paciente ya sea intrínsecos, lo que siente la misma persona o ambientales propiamente de la terapia. Objetivo: determinar la calidad del sueño y los factores que lo alteran los pacientes orientados críticos en la Unidad de Terapia Intensiva. Metodología: estudio descriptivo y transversal, como instrumento se utilizó el cuestionario de Richard Campbell que correspondía 5 preguntas sobre la calidad del sueño y la 6ta pregunta que corresponde al Cuestionario de Freedman sobre los factores que impide obtener un sueño óptimo. Resultado: Se realizó 40 entrevistas a los pacientes orientados de la unidad intensiva de diferentes edades, sexo y patología. Conclusión: El sueño en los pacientes orientados en la unidad de terapia intensiva dio una mala calidad de sueño, es decir un sueño superficial con despertares intermitentes. Los pacientes que tuvieron más dificultad para conciliar el sueño son lo que sufrieron enfermedades respiratorias y oncológicas en los cuales influyo los factores intrínsecos la ansiedad y el extrínseco la postura corporal y el ruido[AU]

The patients who are hospitalized have an imbalance in all their needs, more so if we talk about patients who are in an intensive care unit where movement is dynamic second by second due to the hemodynamic instability of each patient. Once the health of the oriented patient has stabilized, the deficit of being able to sleep appears, due to various factors that surround the patient, whether intrinsic, what the person feels, or the environment of the therapy itself. Objective: to determine the quality of sleep and the factors that alter it in critically oriented patients in the Intensive Care Unit.Methodology: descriptive and cross-sectional study, the Richard Campbell questionnaire was used as an instrument, corresponding to 5 questions on sleep quality and the 6th question corresponding to the Freedman Question-naire on the factors that prevent optimal sleep. Result: 40 interviews were con-ducted with oriented patients from the intensive unit of different ages, sex and pathology. Conclusion: The sleep in the patients oriented in the intensive care unit gave a poor quality of sleep, that is, a superficial sleep with intermittent awakenings. The patients who had more difficulty falling asleep are those who suffered respiratory and oncological diseases in which the intrinsic factors influ-ence anxiety and the extrinsic body posture and noise[AU]

Factores del estrabismo incomitante para mejorar el pronóstico de los casos / Factors of incomitant strabismus to improve the prognosis of cases / Fatores no estrabismo incomitante para melhorar o prognóstico dos casos

El estrabismo es una alteración de la visión binocular, es decir, la pérdida de paralelismo de los ejes visuales. Las personas que padecen estrabismo presentan disminución de la profundidad visual y percepción de dimensionalidad. Se estima que este padecimiento ocular, afecta alrededor del 2 al 4 % de la población infantil. La clasificación de los estrabismos y su misma definición han sido parte de un debate mundial durante años. La edad de aparición, el ángulo de desviación, el ojo desviado, y la magnitud del ángulo en distancia de enfoque tambien; sin embargo, siempre debe confirmarse con exámenes más exhaustivos luego de un primer diagnóstico realizado por un profesional de la salud visual. Objetivo. Identificar las características de los estrabismos incomitantes, formas de diagnóstico, clasificación y factores para poder manejarlos específicamente y mejorar el pronóstico del caso. Metodología. Se realizó una síntesis de la información disponible de literatura sobre el estrabismo incomitante a través de un análisis bibliográfico donde se empleó descriptores de búsqueda para lo cual se revisaron las bases de datos: Google académico y Proquest Prisma. Se realizó el análisis de referencias desde el año 2010 al 2020 y como resultado se obtuvieron 34 referencias que describen una clasificación de estrabismos, tipo de diagnóstico y tratamiento. Conclusión. Se considera fundamental aumentar la conciencia pública sobre el tema del diagnóstico temprano de afectaciones oculares para generar medidas de prevención que busquen atenuar la ocurrencia de esta alteración. Delimitar el tipo de estrabismo incomitante podría evitar consecuencias irreparables para el paciente.

Strabismus is an alteration of binocular vision, that is, the loss of parallelism of the visual axes. People suffering from strabismus have decreased visual depth and dimensionality perception. It is estimated that this ocular condition affects about 2 to 4% of the child population. The classification of strabismus and its very definition have been part of a worldwide debate for years. The age of onset, the angle of deviation, the deviating eye, and the magnitude of the angle in focusing distance as well; however, it should always be confirmed with more exhaustive examinations after a first diagnosis by an eye care professional. Objective. To identify the characteristics of incomitant strabismus, ways of diagnosis, classification and factors to be able to manage them specifically and improve the prognosis of the case. Methodology. A synthesis of the information available in the literature on incomitant strabismus was made through a bibliographic analysis using search descriptors for which the following databases were reviewed: Google Scholar and Proquest Prisma. The analysis of references from 2010 to 2020 was carried out and as a result 34 references were obtained describing a classification of strabismus, type of diagnosis and treatment. Conclusion. It is considered essential to increase public awareness on the issue of early diagnosis of ocular disorders in order to generate preventive measures that seek to mitigate the occurrence of this disorder. Delimiting the type of incomitant strabismus could avoid irreparable consequences for the patient.

O estrabismo é um distúrbio da visão binocular, ou seja, a perda do paralelismo dos eixos visuais. As pessoas que sofrem de estrabismo têm uma percepção de profundidade e dimensionalidade visual reduzida. Estima-se que essa condição ocular afete cerca de 2 a 4% da população infantil. A classificação do estrabismo e sua própria definição têm sido parte de um debate mundial há anos. A idade de início, o ângulo de desvio, o olho desviado e a magnitude do ângulo na distância de focalização também; no entanto, devem sempre ser confirmados por exames adicionais após um primeiro diagnóstico feito por um oftalmologista. Objetivo. Identificar as características do estrabismo incomitante, as formas de diagnóstico, a classificação e os fatores para poder tratá-los especificamente e melhorar o prognóstico do caso. Metodologia. Foi feita uma síntese das informações disponíveis na literatura sobre estrabismo incomitante por meio de uma análise bibliográfica usando descritores de pesquisa para os quais foram revisados os seguintes bancos de dados: Google Scholar e Proquest Prisma. A análise das referências de 2010 a 2020 foi realizada e, como resultado, foram obtidas 34 referências que descrevem a classificação do estrabismo, o tipo de diagnóstico e o tratamento. Conclusões. Considera-se essencial aumentar a conscientização pública sobre a questão do diagnóstico precoce de distúrbios oculares para gerar medidas preventivas que busquem mitigar a ocorrência desse distúrbio. Delimitar o tipo de estrabismo incomitante poderia evitar consequências irreparáveis para o paciente.

Cancer genomics and precision medicine / 药学学报

It has been noted for decades that cancer is essentially a genomic disease. Benefiting from the latest development of high-throughput sequencing and bioinformatics technologies, a variety of genetic alterations have been identified for their roles in cancer occurrence and development, giving rise to new opportunities for anti-cancer drug discovery. In particular, the rapid advancement of cancer genomics has paved the way for the precision medicine that has gained compelling achievement in the past years and significantly benefited cancer patients. In this review, we summarize the main types of genomic abnormalities in cancer, the application of functional genomics research in cancer research, and in particular the translational application of cancer genomics in clinical diagnosis, drug discovery and cancer precision medicine. With this review, we hope to better understand cancer genomics research and provide future perspectives for its application in precision medicine.

Progress of gene alterations and molecular typing of peripheral T-cell lymphoma / 白血病·淋巴瘤

Peripheral T-cell lymphoma (PTCL) is a group of heterogeneous malignant tumors with poor prognosis, with a lack of standard treatment regimen and poor efficacy of traditional chemotherapy. Therefore, finding new and more effective therapeutic targets to improve the efficacy of PTCL is an urgent clinical problem. In recent years, as the exploration of PTCL at the genetic and molecular levels has intensified, novel therapeutic targets based on gene alterations and molecular typing have been identified. This article summarizes the research progress of main gene alterations and molecular typing of PTCL in recent years.

Progress and challenges in RET-targeted cancer therapy / 医学前沿

The rearranged during transfection (RET) is a receptor protein tyrosine kinase. Oncogenic RET fusions or mutations are found most often in non-small cell lung cancer (NSCLC) and in thyroid cancer, but also increasingly in various types of cancers at low rates. In the last few years, two potent and selective RET protein tyrosine kinase inhibitors (TKIs), pralsetinib (BLU-667) and selpercatinib (LOXO-292, LY3527723) were developed and received regulatory approval. Although pralsetinib and selpercatinib gave high overall response rates (ORRs), < 10% of patients achieved a complete response (CR). The RET TKI-tolerated residual tumors inevitably develop resistance by secondary target mutations, acquired alternative oncogenes, or MET amplification. RET G810 mutations located at the kinase solvent front site were identified as the major on-target mechanism of acquired resistance to both selpercatinib and pralsetinib. Several next-generation of RET TKIs capable of inhibiting the selpercatinib/pralsetinib-resistant RET mutants have progressed to clinical trials. However, it is likely that new TKI-adapted RET mutations will emerge to cause resistance to these next-generation of RET TKIs. Solving the problem requires a better understanding of the multiple mechanisms that support the RET TKI-tolerated persisters to identify a converging point of vulnerability to devise an effective co-treatment to eliminate the residual tumors.

Diferencias en el tamaño corporal y la abundancia de peces altoandinos, arriba y abajo de la represa Neusa, Colombia / Differences in body size and abundance of high Andean fishes, above and below the Neusa dam, Colombia

Resumen Introducción: Los ríos tropicales se ven cada vez más afectados por la fragmentación y la regulación; y, en Colombia, se sabe que las represas ponen en peligro a los peces endémicos debido, entre otros, a la migración limitada y la disponibilidad reducida de redes alimenticias basadas en el detrito. Sin embargo, el conocimiento de la ictiofauna nativa afectada por represas en ríos altoandinos es aún incipiente. Objetivo: Evaluar los efectos de la represa del Neusa sobre la ictiofauna. Métodos: Comparamos dos secciones del río, una aguas arriba y otra aguas abajo de la represa con el Sistema Richter IHA, muestreamos tres transectos de 100 m de largo en cada sección, cada dos meses, entre 2017 y 2019. Los peces fueron devueltos al río después de efectuadas las mediciones corporales. Resultados: Recolectamos 729 individuos de cinco familias; los Trichomycterus bogotense eran más pequeños aguas abajo de la represa; Oncorhynchus mykiss fue más pequeño y menos abundante; y no hubo diferencias para Grundulus bogotensis y Eremophilus mutisii. Independientemente de los factores climáticos, O. mykiss y G. bogotensis fueron más abundantes aguas arriba, y E. mutisii y T. bogotense aguas abajo de la represa. Conclusión: Las cinco especies de peces diferían en cómo las poblaciones se diferencian aguas arriba y aguas abajo de la represa, lo que sugiere que algunas se benefician de la represa, mientras que otras se vuelven más pequeñas y menos abundantes.

Abstract Introduction: Tropical rivers are increasingly being affected by fragmentation and regulation; and, in Colombia, dams are known to endanger endemic fishes through, among others, limited migration and reduced availability of sediment-based feeding networks. However, knowledge of native ichthyofauna affected by dams in high Andean rivers is still incipient. Objective: To assess the effects of the Neusa dam on the ichthyofauna. Methods: We compared two rivers' sections, one above and one below the dam with the Richter IHA System, we sampled three 100 m long transects in each section, every two months, between 2017 and 2019. The fishes were returned to the river after body measurements. Results: We collected 729 individuals from five families; Trichomycterus bogotense were smaller under the dam; Oncorhynchus mykiss was smaller and less abundant; and there were no differences for Grundulus bogotensis and Eremophilus mutisii. Independently of climatic factors, O. mykiss and G. bogotensis were more abundant above the dam, and E. mutisii and T. bogotense under the dam. Conclusion: The five fish species differed in how the populations differed above and under the dam, suggesting that some are benefited by the dam, while others become smaller and less abundant.

Objectively measuring anterior segment alterations in the eyes of mucopolysaccharidoses: Its utility in early diagnosis of glaucoma

Purpose: Our study aimed to evaluate the utility of the anterior segment morphometry for objectively assessing anterior segment architectural changes of corneal clouding in the mucopolysaccharidoses (MPS) cohort and to investigate whether these measurements correlate with the slit?lamp findings on the cornea and early diagnosis of glaucoma. Methods: This retrospective study involved 70 eyes of 35 children with cloudy cornea due to MPS variants. Anterior segment architectural alterations were measured using anterior segment imaging and biometry in MPS children and compared with controls. Results: Mean age of the cohort at the time of assessment was 7.9 ± 4.5 years. Males constituted two?thirds of the cohort. Variants of MPS with cloudy cornea were as follows: Type I (62%), Type IV (11%), and Type VI (22%). Morphometric measurements were available in 22 eyes of 11 MPS children and an age?matched healthy control group. There were significant differences between MPS cohort and controls in refraction in Diopters (5.03 ± 0.39 and 0.01 ± 0.04; P < 0.0001), axial length (AXL) in mm (21.39 ± 0.28 and 23.04 ± 0.28; P = 0.0002), average keratometry in Diopters (40.67 ± 0.44 and 42.83 ± 0.44; P < 0.0001), anterior chamber depth (ACD) in mm (2.92 ± 0.07 and 3.65 ± 0.07; P < 0.0001), and intraocular pressure (IOP) in mmHg (25.2 ± 2.0 and 14.1 ± 2.3; P = 0.0003). Secondary glaucoma was observed in 28% of the MPS cohort. Conclusion: The anterior segment morphometry in the cloudy cornea due to MPS provides an objective measurement of anterior segment architectural changes, thus diagnosing early?onset secondary glaucoma. These findings highlight that cloudy cornea due to MPS variants merits close monitoring throughout life

Visualizing the spatial distribution and alteration of metabolites in continuously cropped Salvia miltiorrhiza Bge using MALDI-MSI / 药物分析学报

Salvia miltiorrhiza Bge(SMB)has long been used in traditional Chinese medicine to treat cardiovascular and cerebrovascular diseases.Growing clinical usage has led to a huge demand for artificial planting of SMB.Thus,continuous cropping of SMB is an important challenge that needs to be addressed.Contin-uous cropping can alter the metabolic profile of plants,resulting in poor growth and low yield.In this study,we tried to image the spatial location and variation of endogenous metabolites in continuously cropped SMB using matrix-assisted laser desorption/ionization mass spectrometry imaging(MALDI-MSI).Spatially resolved expressions of tanshinones,salvianolic acids,polyamines,phenolic acids,amino acids,and oligosaccharides in normal and continuously cropped SMB roots were compared.The ex-pressions of dihydrotanshinone Ⅰ,tanshinone Ⅱ A,dehydromiltirone,miltirone,dehydrotanshinone ⅡA,spermine,salvianolic acid B/E,tetrasaccharide,and pentasaccharide in continuously cropped SMB roots were much lower than those in normal roots.There was little difference in the expressions of caffeic acid and salvianolic acid A in normal and continuously cropped SMB roots.Ferulic acid was more widely distributed in xylem of normal SMB but strongly expressed in xylem,phloem,and cambium of continuously cropped SMB.The spatially resolved metabolite information enhances our understanding of the metabolic signature of continuously cropped SMB and also provides insights into the metabolic ef-fects of continuous cropping in other plants.

Detection of Genetic Alterations in Oral Squamous Cell Carcinoma Using Multiplex LigationDependent Probe Amplification (MLPA)

@#Deletions and amplifications of genes often occur during multistep progression from oral precancer, seen as oral epithelial dysplasia (OED) to cancerous stage. These genetic alterations could be used as markers to aid in detection of oral squamous cell carcinomas (OSCC). This study explored the use of multiplex ligation-dependent probe amplification (MLPA) technique in detecting OSCC and OED specific genetic alterations. MLPA was used to detect gains and losses of 106 genes in DNA extracted from frozen tissue samples of 10 OSCC and 10 noncancer patients. Two biopsies of OED were analyzed to explore the alterations in oral potentially malignant disorders. There were significant differences (p<0.001) in the number of alterations in OSCC and dysplasia compared to non-cancer samples respectively. The most frequently altered genes in OSCC were PTP4A3, RECQL4, ATM, and KLK3 (60%). Five genes (MYC, SLA, TNFRSF1A, MESDC1, MIF) were altered in 50% of OSCC samples. These nine genes were specific to OSCC samples (p<0.05). Some genes, including MYB, MET, CASP2, SLA and PTEN occurred in 50% of OED samples. MLPA was able to detect genetic alterations, that are present only in the OSCC samples and showed potential to be used as an adjunctive tool in early diagnosis of OSCC.

A new species of Characidium (Characiformes: Crenuchidae) from the rio Doce basin, Brazil

A new species of Characidium is described from the tributaries of the upper and middle rio Doce basin, Minas Gerais, Brazil. The new species is distinguished from most congeners, except C. cricarense, C. hasemani, C. helmeri, C. kalunga, C. pterostictum, C. schubarti, C. summus, and C. travassosi by lacking scales in the area between the anterior limit of the isthmus and the anterior margin of cleithrum. The new species differs from the aforementioned species by a series of characters, including the presence of the adipose fin, 2­-4 scales between the anus and anal fin, two rows of dentary teeth, presence of the parietal branch of the supraorbital canal, 4 scale rows above the lateral line, and absence of two conspicuous inclined dark bands on each caudal-fin lobe. The new species further differs from most congeners with an unscaled ventral surface of the isthmus by the presence of 33-34 pored scales on the lateral line and by the dark dashes on the caudal fin-rays not forming well-defined bands.(AU)

Uma nova espécie de Characidium é descrita de afluentes do alto e médio curso da bacia do rio Doce, Minas Gerais, Brasil. A nova espécie se distingue da maioria das congêneres, exceto C. cricarense, C. hasemani, C. helmeri, C. kalunga, C. pterostictum, C. schubarti, C. summus e C. travassosi pela falta de escamas na área entre o limite anterior do istmo e a margem anterior do cleitro. A nova espécie difere das espécies acima mencionadas por uma série de caracteres, incluindo a presença de nadadeira adiposa, 2-4 escamas entre o ânus e a nadadeira anal, duas séries de dentes no dentário, ramo parietal do canal supraorbital presente, 4 séries de escamas acima da linha lateral e ausência de duas bandas escuras inclinadas em cada lobo da nadadeira caudal. A nova espécie difere ainda mais da maioria das congêneres com superfície ventral sem escamas no istmo por ter 33-34 escamas perfuradas na linha lateral e traços escuros nos raios da nadadeira caudal não formando bandas bem definidas.(AU)

Comparative genomic analysis of esophageal squamous cell carcinoma and adenocarcinoma: New opportunities towards molecularly targeted therapy

Esophageal cancer is one of the most lethal cancers worldwide because of its rapid progression and poor prognosis. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are two major subtypes of esophageal cancer. ESCC predominantly affects African and Asian populations, which is closely related to chronic smoking and alcohol consumption. EAC typically arises in Barrett's esophagus with a predilection for Western countries. While surgical operation and chemoradiotherapy have been applied to combat this deadly cancer, molecularly targeted therapy is still at the early stages. With the development of large-scale next-generation sequencing, various genomic alterations in ESCC and EAC have been revealed and their potential roles in the initiation and progression of esophageal cancer have been studied. Potential therapeutic targets have been identified and novel approaches have been developed to combat esophageal cancer. In this review, we comprehensively analyze the genomic alterations in EAC and ESCC and summarize the potential role of the genetic alterations in the development of esophageal cancer. Progresses in the therapeutics based on the different tissue types and molecular signatures have also been reviewed and discussed.

Puentes mucosos de la cuerda vocal, en la Unidad de Voz del Hospital Clínico de la Universidad de Chile: diagnóstico y manejo desafiante

Resumen Introducción: Los puentes mucosos (PM) corresponden a una banda de mucosa paralela al borde libre de la cuerda vocal, unido por anterior y posterior como un ojal. Su manejo no está estandarizado y la literatura al respecto es escueta, con cirugías con resultados no siempre predecibles. Objetivo: Descripción de las características clínicas de pacientes con PM y las técnicas quirúrgicas para su manejo, en la Unidad de Voz del Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile (HCUCH), discutiendo el desafío para su diagnóstico y manejo. Material y Método: Estudio retrospectivo, descriptivo, incluyendo pacientes con PM, entre los años 2013 y 2019 en HCUCH. La evaluación preoperatoria incluye anamnesis, examen físico, nasofibroscopía y/o telelaringoscopía, junto con estroboscopía. Resultados: Se incluyen 7 casos, con edad promedio de 37,4 años; todas mujeres, con diagnóstico realizado en pabellón, en una sola cuerda vocal. Se asoció a alteración estructural mínima (AEM) en el 100% de los casos y a patología benigna en 75%. Todos los pacientes consultaron por disfonía. El tratamiento fue elegido de acuerdo a cada paciente, con resección en todos los casos, con variadas técnicas de microcirugía laríngea, con infiltración de corticoides y/o grasa, además de fonoterapia. Conclusión: Los PM, deben sospecharse en disfonía crónica con respuesta no favorable a fonoterapia, en asociación a otras AEM, en particular en mujeres, con diagnóstico en el intraoperatorio con equipos adecuados, incluyendo consentimiento informado para eventual manejo quirúrgico. Es una patología poco frecuente, cuyo manejo no ha sido estandarizado, por lo que nuestra experiencia resulta relevante.

Abstract Introduction: Mucosal bridges (MB) correspond to a mucosa loop parallel to the free edge of the vocal fold, which is joined forward and backward. There is not a standardized procedure for its treatment and the literature in this regard is scarce and surgical management have not resulted in predictable outcomes. Aim: Description of clinical characteristics of patients with MB and the surgical techniques, in the Otorhinolaryngology Service at the Clinical Hospital Universidad de Chile (HCUCH), reflecting upon the challenge for its diagnosis and management. Material and Method: Retrospective and descriptive study, including patients with diagnosis of MB, between 2013 and 2019 in HCUCH. The preoperative evaluation includes anamnesis, physical examination, nasofibroscopy and/or telelaryngoscopy, along with the use of stroboscopy. Results: 7 cases were included, with an average age of 37.4 years; all women, with diagnosis made in the operating room, on a single vocal fold. It was associated with another minimal structural abnormality (MSA) in 100% of the cases, and with benign pathology in 75% of them. Dysphonia was the main symptom. The treatment was chosen individually, with resection in all cases, various laryngeal microsurgery techniques, infiltration of steroids and/or fat, in addition to speech therapy. Conclusion: MB should be suspected in cases of chronic dysphonia with an unfavorable response to speech therapy, in association with other MSAs, particularly in women, diagnosed intraoperatively with adequate equipment, including informed consent for eventual surgical management. It is a rare pathology, whose management has not been standardized therefore our experience is relevant.

Exercício resistido promove reparo no musculoesquelético em modelo experimental de artrite reumatoide / Resisted exercise promotes repair in musculoskeletal structure in experimental model of rheumatoid arthritis

Distúrbios decorrentes da artrite reumatoide (AR) resultam em incapacitação funcional, com reflexos econômicos e sociais aos sistemas de saúde. Uma alternativa terapêutica que tem sido proposta é a atividade física na modalidade resistida. O presente estudo analisou os efeitos do exercício resistido de subida em escada (ERSE) na histomorfologia do músculo extensor longo dos dedos (EDL) de ratos Wistar, em modelo experimental de AR. Ratos machos (n=20) foram distribuídos aleatoriamente em quatro grupos. A lesão da AR foi induzida por administração intra-articular de Adjuvante Completo de Freund (CFA). Os resultados revelaram que a AR alterou a histomorfometria das fibras do EDL e que o ERSE promoveu reparo muscular, sugerindo sua eficiência na restauração da funcionalidade muscular. Ainda, o ERSE pode ser uma opção de tratamento voltado à melhoria na qualidade de vida dos portadores de AR.

Disorders from rheumatoid arthritis (RA) result in functional disability, with economic and social impacts on health systems. A therapeutic alternative that has been proposed is physical activity in the resisted modality. Current study analyzed the effects of resistance exercise on stairs (ERSE) on the histomorphology of the extensor digitorum longus muscle (EDL) of Wistar rats in an experimental model of RA. Male rats (n=20) were randomly assigned to four groups. RA injury was induced by intra-articular administration of Freund's Complete Adjuvant (CFA). Results revealed that RA altered the histomorphometry of EDL fibers and that ERSE promoted muscle repair, suggesting its efficiency in restoring muscle functionality. Furthermore, ERSE may be a treatment option to improve the life quality of people with RA.

Manifestaciones pulmonares y sistémicas de la hipertensión arterial pulmonar: Un enfoque panvascular

La hipertensión arterial pulmonar (HAP) es una grave enfermedad cuyo resultado final de la interacción entre el tono vascular y la alteración progresiva de la remodelación de las arterias pulmonares provoca insuficiencia cardíaca derecha y muerte. El remodelado vascular pulmonar es la alteración estructural clave en la hipertensión pulmonar. Este proceso implica cambios en la íntima, media, adventicia y espacio perivascular, a menudo con la interacción de células inflamatorias. Los mecanismos fisiopatológicos de la HAP abarcan una serie de modificaciones vasculares que producen un aumento de la resistencia vascular pulmonar. Las modificaciones vasculares que se producen en la HAP incluyen: la vasoconstricción, la proliferación del músculo liso, la inflamación, la apoptosis endotelial, la proliferación endotelial resistente a la apoptosis, la fibrosis, la trombosis in-situ, y finalmente, las lesiones plexiformes. Hasta hace poco, la HAP se consideraba una enfermedad restringida a la circulación pulmonar. Sin embargo, existe una creciente evidencia de que los pacientes con HAP también exhiben disfunción vascular sistémica, como lo demuestra la alteración de la dilatación mediada por el flujo de la arteria braquial, el flujo sanguíneo cerebral anormal, la miopatía esquelética y la enfermedad renal intrínseca. Los datos recientes apoyan un vínculo con los eventos genéticos y moleculares detrás de la patogénesis de la HAP. Esta revisión sirve de introducción a los principales hallazgos sistémicos en la HAP y la evidencia que apoya un vínculo común con la fisiopatología de la HAP. Sobre la base de la evidencia disponible, proponemos un paradigma en el que las anomalías metabólicas, la lesión genética y la disfunción vascular sistémica contribuyen a las manifestaciones sistémicas de la HAP. Este concepto no sólo abre interesantes posibilidades de investigación, sino que también anima a considerar las manifestaciones extrapulmonares en el tratamiento de los pacientes con HAP, pues la disfunción vascular sistémica contribuiría a las manifestaciones sistémicas de la HAP.

Pulmonary arterial hypertension (PAH) is a serious disease whose end result of the interaction between vascular tone and the progressive alteration of the remodeling of the pulmonary arteries causes right heart failure and death. Pulmonary vascular remodeling is the key structural alteration in pulmonary hypertension. This process involves changes in the intima, media, adventitia, and perivascular space, often with the interaction of inflammatory cells. The pathophysiological mechanisms of PAH include a series of vascular modifications that produce an increase in pulmonary vascular resistance. Vascular modifications that occur in PAH include: vasoconstriction, proliferation of smooth muscle, inflammation, Endothelial apoptosis, apoptosis-resistant endothelial proliferation, fibrosis, in-situ thrombosis, and finally, plexiform lesions. Until recently, PAH was considered a disease restricted to the pulmonary circulation. However, there is growing evidence that patients with PAH also exhibit systemic vascular dysfunction, as evidenced by impaired brachial artery flow-mediated dilation, abnormal cerebral blood flow, skeletal myopathy, and intrinsic kidney disease. Recent data support a link to the genetic and molecular events behind the pathogenesis of PAH. This review serves as an introduction to the main systemic findings in PAH and the evidence supporting a common link with the pathophysiology of PAH. Based on the available evidence, we propose a paradigm in which metabolic abnormalities, genetic injury, and systemic vascular dysfunction contribute to the systemic manifestations of PAH. This concept not only opens up interesting research possibilities, but also encourages consideration of extrapulmonary manifestations in the treatment of patients with PAH, since systemic vascular dysfunction would contribute to the systemic manifestations of PAH.

A hipertensão arterial pulmonar (HAP) é uma doença grave cujo resultado final da interação entre o tônus vascular e a alteração progressiva da remodelação das artérias pulmonares causa insuficiência cardíaca direita e morte. A remodelação vascular pulmonar é a principal alteração estrutural na hipertensão pulmonar. Esse processo envolve mudanças na íntima, média, adventícia e espaço perivascular, muitas vezes com a interação de células inflamatórias. Os mecanismos fisiopatológicos da HAP incluem uma série de modificações vasculares que produzem um aumento na resistência vascular pulmonar. As modificações vasculares que ocorrem na HAP incluem: vasoconstrição, proliferação do músculo liso, inflamação, apoptose endotelial, proliferação endotelial resistente à apoptose, fibrose, trombose in situ e, finalmente, lesões plexiformes. Até recentemente, a HAP era considerada uma doença restrita à circulação pulmonar. No entanto, há evidências crescentes de que os pacientes com HAP também apresentam disfunção vascular sistêmica, conforme evidenciado pela dilatação prejudicada mediada pelo fluxo da artéria braquial, fluxo sanguíneo cerebral anormal, miopatia esquelética e doença renal intrínseca. Dados recentes suportam uma ligação com os eventos genéticos e moleculares por trás da patogênese da HAP. Esta revisão serve como uma introdução aos principais achados sistêmicos em HAP e as evidências que apoiam uma ligação comum com a fisiopatologia da HAP. Com base nas evidências disponíveis, propomos um paradigma em que anormalidades metabólicas, lesão genética e disfunção vascular sistêmica contribuem para as manifestações sistêmicas da HAP. Esse conceito não apenas abre possibilidades interessantes de pesquisa, mas também incentiva a consideração das manifestações extrapulmonares no tratamento de pacientes com HAP, uma vez que a disfunção vascular sistêmica contribuiria para as manifestações sistêmicas da HAP.

Multi-omics approaches identify

Autophagy is a critical cellular homeostatic mechanism, and its dysfunction is linked to invasive breast carcinoma (BRCA). Recently, several omics methods have been applied to explore autophagic regulators in BRCA; however, more reliable and robust approaches for identifying crucial regulators and druggable targets remain to be discovered. Thus, we report here the results of multi-omics approaches to identify potential autophagic regulators in BRCA, including gene expression (EXP), DNA methylation (MET) and copy number alterations (CNAs) from The Cancer Genome Atlas (TCGA). Newly identified candidate genes, such as

Analysis of Awareness and Perception Alteration of Simple Suspension Method by a Workshop for Hospital Pharmacists / 社会薬学

The conventional crushing method for administration of drugs to patients with feeding tubes has been commonly used at the Hyogo College of Medicine College Hospital. Compared with this conventional method, the simple suspension method can reduce drug degradation due to light and moisture absorption as well as avoid drug loss and contamination. We conducted a workshop to introduce this method to pharmacists. We asked the participants to fill a questionnaire-based survey both before and after the workshop to determine the effects of the workshop on the change in the degree of awareness among participants about these methods. The awareness of participants about the simple suspension method was approximately 80% before the workshop. Approximately 60% of participants answered that they had questions about simple suspension method from individuals from other occupations, suggesting a high awareness of this method. After the workshop, approximately 98% of participants answered that they were “satisfied” or “slightly satisfied,” suggesting that they were in favor of introducing the suspension method. The results of text mining indicated a requirement for participants to consider incompatibilities and to educate the nursing department. Participants who actively considered the proposal of simple suspension method had an altered perception toward the introduction and utilization of this method. Therefore, this survey suggested that workshops could alter the perception and behavior of pharmacists about the methods of drug administration via feeding tube.

Odontoma complejo en posición supernumeraria. Reporte de caso / Complex odontoma in supernumerary position. Case report

RESUMEN Fundamento: Los odontomas son entidades odontogénicas benignas mixtas, compuestas por una mezcla de células odontogénicas epiteliales y mesenquimatosas diferenciadas, las mismas pueden ser compuestas y complejas. Los hallazgos radiográficos de estos tumores en posiciones supernumerarias son raras menores al 1 %. Objetivo: Describir el caso clínico de un odontoma complejo infrecuente. Presentación de caso: Paciente femenina de 18 años con un trauma facial, que durante el diagnóstico imagenológico se le encontró una imagen anterosuperior de aspecto tumoral en posición supernumeraria, por lo que se decidió realizar la exéresis quirúrgica de la lesión después de finalizado el tratamiento del trauma. El diagnóstico clínico histopatológico fue de un odontoma complejo. Conclusiones: Se recomienda realizar las vistas imagenológicas tipo ortopantomografías o panorámicas a cada paciente que vaya a ser operado de cirugía bucal a fin de poder detectar de forma precoz cualquier alteración en la anatomía y de esta manera estudiar tanto el comportamiento de los odontomas como de otras lesiones intraóseas, lo que puede garantizar un tratamiento temprano y con ello un mejor pronóstico para el paciente.

ABSTRACT Background: Odontomas are mixed benign odontogenic entities, composed of a mixture of odontogenic epithelial and differentiated mesenchymal cells, they can be compound and complex. Radiographic findings of these tumors in supernumerary positions are rare, less than 1%. Objective: To describe the clinical case of a non-frequent complex odontoma. Case report: 18-year-old female patient with facial trauma, during the imaging diagnosis it was found an anterosuperior tumor image in supernumerary position, thus decided to perform the surgical excision of the lesion after the trauma treatment. The histopathological clinical diagnosis was a complex odontoma. Conclusions: It is recommended to perform standard panoramic radiograph imaging for each patient to be operated on oral surgery to detect any early anatomy alteration, so this way to study both, the behavior of odontomas as well as other intraosseous lesions, which can guarantee an early treatment and a better prognosis for the patient.