Expression of BAFF and BAFF receptors in primary Sjögren's syndrome patients with ectopic germinal center-like structures.

B cell-activating factor (BAFF) is an essential cytokine in primary Sjögren's syndrome (pSS) physiopathology. It has been reported that pSS patients develop germinal center-like (GC-like) structures in their minor salivary glands (MSGs). BAFF, BAFF-R, TACI, and BCMA expression was analyzed in MSGs from 29 subjects (nonspecific chronic sialadenitis and focal lymphocytic sialadenitis with the presence [pSS-GC(+)] or absence [pSS-GC(-)] of GC-like structures). Twenty-four percent of patients showed ectopic GC-like structures and a high focus score [p < 0.001 vs pSS-GC(-)]. BAFF serum levels (sBAFF) were high in pSS patients (p = 0.025 vs healthy subjects). However, the pSS-GC(-) group showed higher sBAFF levels than pSS-GC(+) patients. BAFF and BAFF-R glandular expression levels were higher in pSS-GC(+) patients, without significant differences compared to pSS-GC(-) patients. Soluble levels of BAFF correlated with anti-La/SSB antibodies and disease duration. Our results showed that BAFF could contribute to focal lymphocytic infiltration. The role of BAFF-binding receptors in MSGs is proposed as a mechanism for the possible establishment of ectopic GC-like structures and disease progression in some patients. In conclusion, this study supports previous evidence that considers the active BAFF system role in the pathogenesis of pSS and the need for strong biomarkers in this disease.

Diving into Exoplanets: Are Water Seas the Most Common?

One of the basic tenets of exobiology is the need for a liquid substratum in which life can arise, evolve, and develop. The most common version of this idea involves the necessity of water to act as such a substratum, both because that is the case on Earth and because it seems to be the most viable liquid for chemical reactions that lead to life. Other liquid media that could harbor life, however, have occasionally been put forth. In this work, we investigate the relative probability of finding superficial seas on rocky worlds that could be composed of nine different, potentially abundant, liquids, including water. We study the phase space size of habitable zones defined for those substances. The regions where there can be liquid around every type of star are calculated by using a simple model, excluding areas within a tidal locking distance. We combine the size of these regions with the stellar abundances in the Milky Way disk and modulate our result with the expected radial abundance of planets via a generalized Titius-Bode law, as statistics of exoplanet orbits seem to point to its adequateness. We conclude that seas of ethane may be up to nine times more frequent among exoplanets than seas of water, and that solvents other than water may play a significant role in the search for extrasolar seas.

Long-term Prognosis After Lung Transplantation: A Monocentric Study in 510 Patients.

INTRODUCTION: Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant. OBJECTIVE: This study aims to perform a survival analysis of transplanted patients in our center and determine predictive variables of mortality. PATIENTS AND METHODS: This study is a retrospective assessment of data collected from 510 patients at the Hospital University Reina Sofía from October 1993 to December 31, 2016. Patients who were retransplanted were excluded. We collected data regarding basal characteristics of the donors and candidates to receive a transplant. We analyzed the impact in terms of future survival of basal variables from donor and donor recipients. RESULTS: Five hundred ten patients were included (average age 44 ± 17 years, 69% male), with a maximum follow-up period of 21.6 years (average follow-up 4.52 years, interquartile ratio: 0.13 to 6.97 years). Two hundred twenty-seven patients died (54.3% of the total amount). The influence of donor's basal characteristics on mortality was analyzed; moreover, the relationship between basal variables and survival were analyzed using univariate analysis. Available variables were analyzed through multivariate analysis. CONCLUSION: Lung transplantation is a treatment option with an acceptable risk of morbidity and mortality. Increased awareness of features of evolution could help to reduce postoperative complications.

Indicadores de calidad en los informes de alta por neumonía adquirida en la comunidad / Quality indicators in medical history by Community-Adquired Pneumonia

INTRODUCCIÓN: Como fase inicial de un proyecto para elaborar una guía clínica sobre neumonía adquirida en la comunidad, se plantea conocer la situación de partida en nuestro centro. OBJETIVO: Evaluar el abordaje diagnóstico y terapéutico en pacientes hospitalizados por neumonía, analizando en los informes clínicos de alta parámetros de calidad previamente publicados. PACIENTES Y MÉTODOS: Estudio observacional, retrospectivo de pacientes ingresados por neumonía en el Hospital Universitario Reina Sofía, de Córdoba, en los últimos 5 años (2010 - 2014). La fuente de información han sido los informes de alta hospitalaria y su correspondiente episodio de urgencias. Se estudiaron variables generales, clínicas e indicadores de calidad, medidos mediante proporciones. RESULTADOS: El total de pacientes ingresados por neumonía fue de 884, seleccionándose aleatoriamente 196 de ellos, 131 hombres (66,8 %) y 65 mujeres (33,2 %), con una edad media de 58 años y una estancia media de 11,56 días. Cumplimiento de los indicadores de calidad: Cualquier tipo de cultivo 70,4%; hemocultivos antes del tratamiento antibiótico 32,7%; determinación antígeno de Legionella y S. Pneumoniae 60,2%; cultivo de esputo 40,8%; broncoaspirado 8,7%; realización de radiografía de tórax al 99%; realización de gasometría arterial 82,1%; tratamiento empírico de acuerdo a las guías 94,9%; pruebas complementarias (hemograma y bioquímica) 99,5%; índices de gravedad PSI/CURB65 0%. CONCLUSIONES: Se reflejan de manera adecuada en un alto porcentaje de pacientes los criterios de calidad indicados en las guías, aunque un claro punto a mejorar es hacer referencia a los índices de gravedad (PSI y CURB65) como criterios de hospitalización

INTRODUCTION: As a project initial stage to draw up a practical guide about Community-Adquired Pneumonia, to know the initial situation in our centre it is approached. OBJECTIVE: To evaluate the diagnostic and therapeutic approach between hospital patients due to pneumonia by analysing quality indicators previously published. METHODS AND MATERIALS: Retrospective observational study of hospitalized patients with pneumonia in University Hospital Reina Sofía, located in Córdoba in the last 5 years (2010- 2014). The source of information was the medical history. General and clinical variable were studied just like quality parameters both measures in proportion. RESULTS: The total amount of hospitalized patients due to pneumonia was 884, chosen at random 196, 131 men (66,8%) and 65 women (33,2%) an average age of 58 and an hospitalized period of 11,56 days. Fulfilment of the quality parameters: any kind of culture 70,4%; blood culture before antibiotic treatment 32,7%; determining Legionella antigen and S. Pneumoniae antigem 60,2%; sputum culture 40,8%; bronchial suction 8,7%; chest X-Ray 99%; arterial blood gas analysis 82,1%; empirical treatment according to regulations 94,9%; additional evidences (blood count and biochemistry) 99,5%; severity rates PSI/CURB65 0%. CONCLUSIONS: It is showed a high rate of patient's percentage quality parameters reordered in regulations, however it is necessary to improve severity rates (PSI and CURB65) such as medical criteria for hospitalization

Analysis of the Incidence of Noncutaneous Neoplasia After Lung Transplantation and Its Impact on Prognosis.

INTRODUCTION: Increased survival in lung transplant recipients, the need for immunosuppressive therapy, and many risk factors before and after transplantation enhance the development of malignancies. This study sought to analyze the incidence of noncutaneous tumors after lung transplantation in our hospital, the risk factors for malignancy, and its impact on prognosis. PATIENTS AND METHODS: A retrospective analysis of clinical records of patients after lung transplantation in our hospital from October 1993 to December 2014. RESULTS: The study population included 443 patients. In total, 35 neoplasia developed in 33 patients (9.6%). Twelve cases were posttransplant lymphoproliferative disorders (PTLDs), 7 localized in the native lung, 7 gynecologic neoplasia (2 in the breast, 4 in the vulva, and 1 in the cervix), 3 in the colon, 2 in the nervous system (one was an astrocytoma), 2 in the prostate, 1 in the kidney, and 1 in the esophagus. The average time between transplantation and malignancy detection was 52.7 ± 45.4 months, being earlier in patients with PTLDs than in non-PTLD. Eleven patients who developed malignancy (all patients with neoplasia in native lung and in cervix, 1 in the colon, 1 PTLD, and 1 in the nervous system) died as a result of it. The only factor associated with an increased risk of malignancy in our population was smoking history. CONCLUSIONS: Almost 10% of lung transplant recipients developed some type of noncutaneous neoplasia and the most frequently diagnosed were PTLDs. Lung neoplasia compromised most survival in these patients.

Mujer de 58 años con dolor centrotorácico y alteración en la radiografía de tórax / 58 year old woman with central-thoracic pain and alterations in the thorax X-Ray

La microlitiasis alveolar es una enfermedad pulmonar difusa infrecuente que se caracteriza por el depósito intraalveolar de formaciones esféricas de fosfato cálcico (microlitos). Se puede presentar a cualquier edad diagnosticándose, en gran parte de los casos, de forma incidental. Aunque la etiología no está del todo aclarada, un 30 - 50% de los pacientes presentan un componente familiar, heredándose de forma autosómica recesiva. Se conoce que dichas alteraciones se relacionan con un gen transportador del fosfato sódico en las células alveolares (SLC34A2), localizado en el cromosoma 4. Esta enfermedad suele ser asintomática hasta estadios finales, existiendo una clara disociación clínico-radiológica. No existe ningún tratamiento específico, siendo el trasplante pulmonar una alternativa posible en estados avanzados. Se presenta el caso de una paciente de 58 años, diagnosticada de forma incidental de microlitiasis alveolar y su evaluación como potencial candidata a trasplante pulmonar

Pulmonary alveolar microlithiasis (PAM) is a rare disease of unknown cause, characterized by intra-alveolar spherical deposits of calcium phosphate (microlites). These may appear at any age, and for the most part, are diagnosed incidentally. Although the etiology is not fully understood, between 30 - 50% of the patients seem to have a genetic component, inheriting it in an autosomal recessive pattern. It is known that said alteration is linked to a gene transporting sodium phosphate in the alveolar cells (SLC34A2), located in chromosome 4. This disorder is usually asymptomatic until the final stages, with a clear clinicalradiological dissociation. There is no specific treatment, with lung transplant being the only possible alternative in advanced stages. The case of a 58 year old patient is presented. She was diagnosed with alveolar microlithiasis by chance and assessed as a potential candidate for lung transplant

Fractal analysis of laplacian pyramidal filters applied to segmentation of soil images.

The laplacian pyramid is a well-known technique for image processing in which local operators of many scales, but identical shape, serve as the basis functions. The required properties to the pyramidal filter produce a family of filters, which is unipara metrical in the case of the classical problem, when the length of the filter is 5. We pay attention to gaussian and fractal behaviour of these basis functions (or filters), and we determine the gaussian and fractal ranges in the case of single parameter a. These fractal filters loose less energy in every step of the laplacian pyramid, and we apply this property to get threshold values for segmenting soil images, and then evaluate their porosity. Also, we evaluate our results by comparing them with the Otsu algorithm threshold values, and conclude that our algorithm produce reliable test results.

Idiopathic sudden sensorineural hearing loss: classic cardiovascular and new genetic risk factors.

BACKGROUND: The main causative process in idiopathic sudden sensorineural hearing loss (iSSNHL) has yet to be explained or demonstrated. The clinical picture supports vascular involvement, but obvious limitations of inner ear study make this difficult to corroborate. OBJECTIVES: To determine the role of thrombophilic genetic variants that may affect platelet function and to assess the cardiovascular risk profile in a cohort of patients with iSSNHL. PATIENTS AND METHODS: 118 Caucasian patients with iSSNHL were recruited from the same geographical area and enrolled prospectively in this study. Clinical data were obtained for each patient. Polymorphisms of the platelet glycoprotein subunit IIIa gene, ITGB3 (PLA1/A2, rs5918), and of the platelet glycoprotein subunit Ia gene, ITGA2 (C807T, rs1126643) were analyzed. A control group of 161 age- and gender-matched healthy individuals from the same geographical area was recruited for genetic comparisons. In order to determine the cardiovascular risk profile of each patient and of our cohort, a cross-sectional assessment was performed by means of a calibrated Framingham coronary heart disease risk scale. Risk factor proportions were compared to those recommended in European guidelines for coronary prevention, which are also based on the Framingham function. RESULTS: A significantly high prevalence of the 807T allele of platelet glycoprotein subunit Ia was found in patients compared to controls. There was a significant correlation between the 807TT homozygous genotype and a low probability of recovery. The PLA1/A2 polymorphism of platelet glycoprotein subunit IIIa was not associated with recovery, with a similar genotype prevalence being found in patients and controls. In terms of cardiovascular risk profile, patients did not present an excess of baseline coronary risk factors compared to the general population in the same geographical area. CONCLUSIONS: Patients with iSSNHL had a higher prevalence of the 807T thrombophilic polymorphism of platelet glycoprotein Ia/IIa. Patients homozygous for this polymorphism are less likely to recover from iSSNHL. Classical cardiovascular risk factors were not related to iSSNHL.

Horizontal visibility graphs: exact results for random time series.

The visibility algorithm has been recently introduced as a mapping between time series and complex networks. This procedure allows us to apply methods of complex network theory for characterizing time series. In this work we present the horizontal visibility algorithm, a geometrically simpler and analytically solvable version of our former algorithm, focusing on the mapping of random series (series of independent identically distributed random variables). After presenting some properties of the algorithm, we present exact results on the topological properties of graphs associated with random series, namely, the degree distribution, the clustering coefficient, and the mean path length. We show that the horizontal visibility algorithm stands as a simple method to discriminate randomness in time series since any random series maps to a graph with an exponential degree distribution of the shape P(k)=(1/3)(2/3)(k-2), independent of the probability distribution from which the series was generated. Accordingly, visibility graphs with other P(k) are related to nonrandom series. Numerical simulations confirm the accuracy of the theorems for finite series. In a second part, we show that the method is able to distinguish chaotic series from independent and identically distributed (i.i.d.) theory, studying the following situations: (i) noise-free low-dimensional chaotic series, (ii) low-dimensional noisy chaotic series, even in the presence of large amounts of noise, and (iii) high-dimensional chaotic series (coupled map lattice), without needs for additional techniques such as surrogate data or noise reduction methods. Finally, heuristic arguments are given to explain the topological properties of chaotic series, and several sequences that are conjectured to be random are analyzed.

Is there an overlap between sudden neurosensorial hearing loss and cardiovascular risk factors?

INTRODUCTION: Sudden sensorineural hearing loss (SSHL) has been proposed as a symptom of underlying vascular problems. The purpose of this work is to evaluate the genetic and acquired risk factors. METHODS: Ninety-nine patients were tested for the presence of common polymorphisms related to thrombophilia (prothrombin and factor V Leiden) in order to assess genetic risk factors, and several parameters classically associated with vascular disorders (cardiovascular events, brain stroke and antiphospholipid syndrome) were evaluated. Additional assessments of personal and familial history risk factors for vascular disorders were performed in each patient. RESULTS: Thrombophilia studies did not demonstrate statistically relevant differences between the patients and control group. However, lipidemia profile and directed personal and familial histories showed positive trends for SSHL. CONCLUSION: The lack of clear relationships between SSHL and other vascular risk factors suggests multicausality as a predominant disease profile. Although preliminary results point at a vascular involvement in SSHL, a long-term prospective study is necessary to demonstrate that SSHL represents an early vascular symptom.

¿Está indicado el tratamiento tópico en las otitis que cursan con otorrea en el niño? Aportación terapéutica de ciprofloxacina tópico / Is topical treatment indicated in otitis that occurs with otorrhea in the child? Therapeutic contribution of topical ciprofloxacin

La otorrea es un síntoma no un diagnóstico presente en distintas entidades clínicas. Existen diversas e importantes razones para considerar el abordaje tópico como una terapia útil en el tratamiento de la otorrea en el niño. La bajas concentraciones con las que son eficaces los agentes farmacológicos administrados por vía tópica, así como el bajo grado de reacciones adversas unido al bajo riesgo de complicaciones sistemáticas, son premisas lo suficientemente válidas para considerar el tratamiento tópico como una alternativa o complemento terapéutico altamente eficaz en distintas situaciones clínicas que cursan con otorrea. Los tratamientos tópicos incluyen habitualmente agentes antimicrobianos. Hay evidencia de que los aminoglucósidos tópicos pueden causar ototoxicidad. Los antimicrobianos noaminoglucósidos, especialmente las fluoroquinolonas, están recomendadas cuando hay que acceder a oído medio. Ciprofloxacina tópica ha demostrado su elevada eficacia terapéutica en otitis externa, otorrea persistente post otitis media aguada, otitis media crónica simple, profilaxis pre-timpanostomía y otorrea a través de tubos de ventilación transtimpánicos, todas ellas patologías de elevada prevalencia en la edad pediátrica (AU)

Otorrhea is a symptom present in different clinical conditions and not a diagnosis. There are several and important reasons to consider topical treatment as a useful therapy in the treatment of otorrhea in the child. The low concentrations needed for the pharmacological agents administered topically to be effective and the low grade of adverse events together with low risk of systemic complications are sufficiently valid premises to consider topical treatment as a higher effective alternative or therapeutic complement in different clinical conditions that occur with otorrhea. Topical treatments generally include antimicrobial agents. There is evidence that the topical aminoglycosides may cause ototoxicity. Non-aminoglycoside antimicrobial agents, especially fluoroquinolones, are recommended when it is necessary to access the middle ear. Topical ciprofloxacin has demonstrated its elevated therapeutic efficacy in external otitis, persistent otorrhea, post acute otitis media, simple chronic otitis media, pre-tympanostomy prophylaxis and otorrhea through transtympanic ventilationtubes, diseases with elevated prevalence in the pediatric age (AU)

Combining visible and near-infrared spectroscopy with chemometrics to trace muscles from an autochthonous breed of pig produced in Uruguay: a feasibility study.

Visible (Vis) and near-infrared reflectance (NIR) spectroscopy combined with chemometrics was explored as a tool to trace muscles from autochthonous and crossbreed pigs from Uruguay. Muscles were sourced from two breeds, namely, the Pampa-Rocha (PR) and the Pampa-Rocha x Duroc (PRxD) crossbreed. Minced muscles were scanned in the Vis and NIR regions (400-2,500 nm) in a monochromator instrument in reflectance. Principal component analysis (PCA), discriminant partial least square regression (DPLS), linear discriminant analysis (LDA) based on PCA scores and soft independent modelling of class analogy (SIMCA) were used to identify the origin of the muscles based on Vis and NIR data. Full cross validation was used as validation method when classification models were developed. DPLS correctly classified 87% of PR and 78% of PRxD muscle samples. LDA calibration models correctly classified 87 and 67% of muscles as PR and PRxD, respectively. SIMCA correctly classified 100% of PR muscles. The results demonstrated the usefulness of Vis and NIR spectra combined with chemometrics as rapid method for authentication and identification of muscles according to the breed of pig.

The impact of bronchiectasis associated to sinonasal disease on quality of life.

BACKGROUND: Bronchiectasis (BQs) is an uncommon disease with the potential to cause devastating complications. All patients with BQs have cough and chronic sputum production that may have a great impact on patient's quality of life. Upper airway symptoms are also frequent in patients with BQs. Associations between upper and lower airways diseases have been demonstrated in allergic rhinitis and asthma, nasal polyposis and asthma, chronic obstructive lung disease and chronic rhinosinusitis. OBJECTIVE: (1) To investigate the impact of bronchiectasis and nasal symptoms on quality of life. (2) To evaluate the added impact of nasal polyposis on quality of life in patients with BQs. METHODS: Sixty patients with bronchiectasis and upper airway symptoms were included. Patients were evaluated for nasal symptoms, nasal polyp size by endoscopy, and quality of life using the SF-36 generic questionnaire. RESULTS: In comparison with the Spanish general population, patients with BQs had worse scores in all SF-36 domains (P<0.05). Males reported significantly higher quality of life scores on physical functioning and social functioning than females did. Although the age, pulmonary function, presence of nasal polyps, upper airway symptoms, tobacco smoking history, and disease duration was similar between them. Males with BQs had worse quality of life than males from the Spanish general population on body pain, general health, and vitality (P<0.05). Females with BQs had worse quality of life than females from the Spanish general population on physical function, body pain, general health, vitality, social function, and emotional role (P<0.05). Nasal polyps were found in 25 (41.6%) of 60 patients with BQs. No significant differences were observed on quality of life outcomes between patients with BQs with and without nasal polyposis. CONCLUSION: These results suggest that BQs has a considerable impact on quality of life while nasal polyposis has no additional impact on the quality of life of patients with BQs.

Bulky cervical liposarcoma associated with sleep apnea syndrome.

Sarcomas of the head and neck are relatively infrequent tumors. Liposarcomas represent 10-16% of all soft tissue sarcomas and <5% of them arise from the head and neck. The retropharyngeal area is rarely involved. We present the case of a middle-aged male with clinical symptoms of sleep apnea. A fiber-optic examination revealed a soft submucosal lesion compressing the posterior pharyngeal wall, with partial obstruction of the airway tract. CT showed a large heterogeneous prevertebral mass (6 x 20 cm(2)) occupying the posterior mediastinum. A transoral submucosal biopsy was performed. Histological findings were compatible with a low-grade liposarcoma. The mass was removed in monoblock using a classical laterocervical neck incision. The surgical specimen weighed 500 g. After 24 months of follow-up no signs of tumor recurrence or sleep apnea syndrome were noted.

Hyoid and laryngeal chondrosarcomas have different clinicopathologic features.

Hyoid chondrosarcomas (CSs) are uncommon cervical tumours with different features compared to laryngeal CSs. Herein we report a hyoid CS in a 36-year-old male and review the literature. Only eight cases of hyoid CS have been reported to date. We have found important differences between hyoid and laryngeal CSs in terms of the age at presentation, gender, clinical symptoms, time before diagnosis, histologic findings and tumour size.