The role of dopamine receptors in lymphocytes and their changes in schizophrenia.

Dopamine and its 5 receptors, which are grouped into two families (D1-like and D2-like), modulate functions at a systemic level in both the central nervous system and periphery. The central nervous system and the immune system are the main adaptive systems, which participate in a continuous and functional crosstalk to guarantee homeostasis. On binding to its 5 dopamine receptors, dopamine acts as a co-regulator of the immune system, contributing to the interaction of the central nervous system and inflammatory events and as a source of communication between the different immune cells. Dopaminergic perturbations in the central nervous system are observed in several neurological and psychiatric disorders. Schizophrenia is one of the most common mental disorders with a poorly understood pathoaetiology that includes genetic and environmental components that promote alterations in the dopaminergic system. Interestingly, abnormalities in dopamine receptors expression in lymphocytes of schizophrenia patients have been reported, often significantly correlating with the severity of the psychotic illness. Here, we review the current literature regarding the dopaminergic system in human lymphocytes and its alterations in schizophrenia.

Important role of microglia in HIV-1 associated neurocognitive disorders and the molecular pathways implicated in its pathogenesis.

The development of effective combined anti-retroviral therapy (cART) led to a significant reduction in the death rate associated with human immunodeficiency virus type 1 (HIV-1) infection. However, recent studies indicate that considerably more than 50% of all HIV-1 infected patients develop HIV-1-associated neurocognitive disorder (HAND). Microglia are the foremost cells infected by HIV-1 in the central nervous system (CNS), and so, are also likely to contribute to the neurotoxicity observed in HAND. The activation of microglia induces the release of pro-inflammatory markers and altered secretion of cytokines, chemokines, secondary messengers, and reactive oxygen species (ROS) which activate signalling pathways that initiate neuroinflammation. In turn, ROS and inflammation also play critical roles in HAND. However, more efforts are required to understand the physiology of microglia and the processes involved in their activation in order to better understand the how HIV-1-infected microglia are involved in the development of HAND. In this review, we summarize the current state of knowledge about the involvement of oxidative stress mechanisms and role of HIV-induced ROS in the development of HAND. We also examine the academic literature regarding crucial HIV-1 pathogenicity factors implicated in neurotoxicity and inflammation in order to identify molecular pathways that could serve as potential therapeutic targets for treatment of this disease. KEY MESSAGES Neuroinflammation and excitotoxicity mechanisms are crucial in the pathogenesis of HAND. CNS infiltration by HIV-1 and immune cells through the blood brain barrier is a key process involved in the pathogenicity of HAND. Factors including calcium dysregulation and autophagy are the main challenges involved in HAND.

Diseminación inusual de un adenocarcinoma endometrial / Unusual dissemination of an endometrial adenocarcinoma

El cáncer de endometrio es la 4.a causa de cáncer en la mujer en los países desarrollados, después del de mama, pulmón y colon. La edad de aparición suele ser en la menopausia y la principal sintomatología es el sangrado vaginal. La profundidad de invasión del miometrio y el grado de diferenciación del tumor son los principales predictores de adenopatías y metástasis. Menos del 5% de las pacientes presentan un estadio IV en el momento del diagnóstico siendo la presencia inicial de metástasis inguinales todavía más infrecuente. Presentamos el caso de una paciente de 68 años con cáncer de endometrio que debuta con metrorragia y varias tumoraciones inguinales. La histología del útero revela un adenocarcinoma papilar seroso con infiltración miometrial limitada (menor del 50%) y adenopatías inguinales con carcinoma pobremente diferenciado, lo que representa una progresión inusual en este tipo de cánceres (AU)

Endometrial cancer is the fourth leading cause of cancer in women in developed countries, after breast, lung and colon cancer. The age of onset is usually at menopause and the main symptom is vaginal bleeding. The main predictors of lymph node involvement and metastasis are the depth of myometrial invasion and the degree of tumoral differentiation. Less than 5% of patients have stage IV cancer at diagnosis, and the initial presence of inguinal metastases is even more uncommon. We report the case of a 68-year woman with endometrial cancer who presented with vaginal bleeding and multiple inguinal tumors. Histological analysis of the uterus revealed a papillary serous adenocarcinoma with limited myometrial infiltration (less than 50%) and inguinal lymph nodes with poorly differentiated carcinoma, representing unusual progression of this type of cancer (AU)

Torsión anexial bilateral en la posmenopausia / Bilateral adnexal torsion in the postmenopause

La torsión anexial es una complicación relativamente frecuente de las masas anexiales que se presenta sobre todo en edad reproductiva. Su diagnóstico es complicado y habitualmente definitivo tras intervención quirúrgica. Presentamos el caso de una torsión bilateral de ovario en una paciente posmenopáusica que consulta por dolor abdominal súbito. Tras laparotomía se descubren 2 cistoadenomas serosos, el mayor de 26cm, con ambos anejos torsionados. Se realiza histerectomía subtotal más doble anexectomía resolviendo el cuadro clínico de la paciente (AU)

Adnexal torsion is a relatively common complication of adnexal masses that occur mainly in reproductive age. Diagnosis is difficult and the definitive diagnosis is usually established after surgery. We report a case of bilateral ovarian torsion in a post-menopausal woman who complained of sudden abdominal pain. After laparotomy, two serous cystadenomas were discovered, the largest measuring 26cm. Both adnexa were twisted. Subtotal hysterectomy and bilateral oophorectomy was performed, producing symptom resolution (AU)

Síndrome ELLP, un diagnóstico diferencial complicado / ELLP Syndrome: a difficult differential diagnosis

El síndrome hemolysis (H), elevated liver enzimes (EL) y low platelets count (LP) (HELLP) es una microangiopatía trombótica propia del embarazo. Puede haber síndromes de HELLP incompletos. En éstos se pueden observar sólo algunos parámetros del síndrome: EL (enzimas hepáticas elevadas), ELLP (enzimas hepáticas elevadas y trombopenia) y LP (trombopenia aislada). El síndrome de ELLP supone un diagnóstico diferencial difícil en el que hay que descartar las principales causas de trombopenia en el embarazo y otras patologías. En la práctica clínica actual su manejo es similar al síndrome de HELLP completo. Sin embargo, la morbilidad materno-fetal es menor en el síndrome de ELLP. Esto podría sugerir la necesidad de valorar un protocolo de actuación distinto para estas dos variantes de una misma enfermedad (AU)

HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelet count) is a thrombotic microangiopathy of pregnancy. This syndrome may be incomplete, with manifestations of only a few of its parameters: EL (elevated liver enzymes), ELLP (elevated liver enzymes and thrombocytopenia) and LP (thrombocytopenia alone). ELLP syndrome is a difficult differential diagnosis in which the main causes of thrombocytopenia in pregnancy and other diseases must be excluded. In current clinical practice, the management of ELLP is similar to that of complete HELLP syndrome. However, maternal and fetal morbidity is lower in ELLP syndrome, which may suggest the need to evaluate different protocols for these two variants of the same disease (AU)

2-DE-based proteomic analysis of common bean (Phaseolus vulgaris L.) seeds.

Common bean (Phaseolus vulgaris L.) is the most important grain legume for direct human consumption. Proteomic studies in legumes have increased significantly in the last years but few studies have been performed to date in P. vulgaris. We report here a proteomic analysis of bean seeds by two-dimensional electrophoresis (2-DE). Three different protein extraction methods (TCA-acetone, phenol and the commercial clean-up kit) were used taking into account that the extractome can have a determinant impact on the level of quality of downstream protein separation and identification. To demonstrate the quality of the 2-DE analysis, a selection of 50 gel spots was used in protein identification by mass spectrometry (MALDI-TOF MS and MALDI-TOF/TOF). The results showed that a considerable proportion of spots (70%) were identified in spite of incomplete genome/protein databases for bean and other legume species. Most identified proteins corresponded to storage protein, carbohydrate metabolism, defense and stress response, including proteins highly abundant in the seed of P. vulgaris such as the phaseolin, the phytohemagglutinin and the lectin-related α-amylase inhibitor.

Leiomiosarcoma uterino: tumoración abdominal de rápido crecimiento / Uterine leiomyosarcoma: a rapidly-growing abdominal tumor

Los sarcomas son el grupo de neoplasias uterinas menos frecuente. El propósito del caso que presentamos es tener en cuenta estos tumores en el diagnóstico diferencial de una paciente con masa abdominal de rápido crecimiento y síndrome constitucional. Esto permitirá un diagnóstico temprano y una estadificación quirúrgica adecuada, que podría ser curativa en etapas tempranas de la enfermedad (AU)

Uterine sarcomas are the least frequent group of uterine neoplasms. The aim of this case report is to serve as a reminder of the importance of including these tumors in the differential diagnosis of women with a rapidly-growing abdominal mass and constitutional syndrome. Bearing these tumors in mind could allow early diagnosis and appropriate surgical staging. Surgery can be curative in the early stages of the disease (AU)

Tumores uterinos con componente sarcomatoso: análisis retrospectivo de 18 casos / Uterine sarcomas: A retrospective analysis of 18 cases

Resumen Los sarcomas uterinos son tumores malignos del cuerpo uterino de clasificación histológica heterogénea y poco frecuentes. Suelen diagnosticarse en mujeres posmenopáusicas y tras el estudio de la pieza quirúrgica. Objetivos Revisar las características clínicas, procedimientos diagnósticos empleados, tratamiento y evolución de sarcomas uterinos en una serie de casos a 5 años. Material y métodos Se realizó un estudio descriptivo y retrospectivo de 18 casos de sarcomas uterinos diagnosticados y tratados en el Complexo Hospitalario de Pontevedra entre octubre de 2002 y diciembre de 2007. Analizamos la edad más frecuente de presentación, paridad, estudio premenopáusico y posmenopáusico, patologías asociadas, tipo histológico más prevalente, clínica más habitual, métodos diagnósticos empleados, estadios patológicos, tratamientos efectuados y seguimiento de las pacientes. Resultados La edad media global fue de 64,22 años. La nuliparidad se observó sólo en el 11,1%. El 66,6% eran posmenopáusicas. La patología médica asociada a mayor frecuencia fue la hipertensión arterial, en un 50% de los casos. El tumor más prevalente fue el carcinosarcoma, en el 33,3% de casos. El síntoma principal fue la menorragia, presente en un 61,11% de los casos, seguida del dolor abdominal, en un 22,2% de los casos. El 66,6% de las pacientes presentaba una tumoración abdominopélvica en la exploración y el 94% presentaba un valor normal del marcador tumoral CA 125. El diagnóstico definitivo se estableció por el análisis de la pieza operatoria en 13 casos (72,2%). Al 88,8% de las pacientes se las sometió a tratamiento (..) (AU)

Abstract Uterine sarcomas are a rare form of endometrial cancer with heterogeneous histologic classification. These tumors are usually diagnosed in postmenopausal women and the diagnosis is often postoperative. Objectives To review the clinical features, diagnostic procedures, treatment and outcomes of uterine sarcomas in a series of cases over a 5-year period. Material and methods We performed a retrospective descriptive study of 18 patients with uterine sarcoma diagnosed and treated in Pontevedra Hospital between October 2002 and December 2007. The following variables were analyzed: the most frequent age at presentation, parity, pre- or postmenopausal status, associated diseases, most prevalent histologic type, principal symptoms, diagnostic methods used, pathological stages, treatment, and follow-up. Results The overall mean age was 64.22 years. Nulliparity was observed in only 11.1% and 66.6% were postmenopausal. The most frequent medical disorder was hypertension in 50% of the patients. The most prevalent histological type was malignant mixed mesodermal tumor in 33.3%. The principal symptom was metrorrhagia in 61.11%, followed by abdominal pain in 22.2%. On pelvic examination, the uterus was enlarged in 66.6% of the patients and 94% showed normal serum CA 125 levels. The definitive diagnosis was established by histopathologic analysis of the surgical specimen in 13 patients (72.2%). Treatment consisted of surgery in 88.8%. Adjuvant treatment (chemotherapy, radiotherapy or hormonotherapy) was used in 77.7%. The 5-year survival rate was 22.22% in our series of cases and all four survivors had low-grade endometrial stromal sarcomas. Conclusions A high percentage of the patients underwent surgery without a correct diagnosis, frequently leading to incomplete surgery. As expected, most women with advanced-stage tumors died from the disease. Even in the early stages, this type of tumor is aggressive and has a poor prognosis (AU)

[Ulegyria and epilepsy]. / Ulegiria y epilepsia.

Ulegyria is a derangement of the architecture of the cerebral cortex characterised by the presence of multiple small cerebral convolutions. It is caused by hypoxic-ischaemic damage of these convolutions in the perinatal period. This differentiates it from polimcrogyria which is due to damage during the period of late neuronal migration or early postmigration. The clinical findings vary from cases with hardly any symptoms to more severe forms which show psychomotor retardation, convulsive crises and/or motor defects. We describe the case of a 21-year-old patient who suffered anoxia during delivery, with a very low Apgar score, who presented with epileptic crises in childhood (motor foci which became generalized) with good anticonvulsant control. On examination, there was a slight mental handicap. On magnetic resonance an uligyric area was seen in the occipital cortex. High resolution magnetic resonance allows the diagnosis of this type of change in the cerebral cortex in the living patient since the differences between grey and white matter can be distinguished better than with computerized tomography.