Hair cortisol level as a molecular biomarker in retinitis pigmentosa patients.

PURPOSE: Retinitis pigmentosa (RP) patients commonly experience negative psychological states due to their progressive and unpredictable loss of vision and visual variations related to stress. The aim of this study was to examine hair cortisol concentrations (HCCs), which is usually associated with chronic stress, pretending to unveil possible associations between underlying psychological factors and disease severity in RP patients. METHODS: Seventy-eight RP patients and 148 healthy controls were included in this study. A complete ophthalmological exam was performed in all patients to grade into severity disease groups. Perceived stress and trait-anxiety were measured by the State-Trait Anxiety Inventory (STAI) questionnaire. RESULTS: Fifty-two (67%) patients had severe RP and 26 (33%) mild-moderate RP. Fifty-eight (58,9%) patients reported severely levels of stress and 18 (23.,1%) highly levels assessed by STAI questionnaire. RP patients exhibited higher HCCs (500.04 ± 120.99 pg/mg) than in controls (136.17 ± 60.51 pg/mg; p < 0.001). Severe RP patients had significant higher HCCs than mild-moderate patients differing in 274.27 pg/mg (p < 0.001). RP severity grade and perceived anxiety levels in the questionaries were not associated. Group differences were not affected by relevant covariates (age, grade of severity, stress status, and gender). CONCLUSIONS: HCC seems an effective biomarker associated with chronic stress in RP patients. This study shows that HCC in patients with RP are elevated compared to population-based controls, and association between HCC and RP severity was found. Future research is needed to characterize the effect of untreated negative psychological states on progression of the disease if any.

Rapid growth rate is associated with poor prognosis in cutaneous squamous cell carcinoma.

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) represents the most common form of skin cancer after basal cell carcinoma, and can be both locally invasive and metastatic to distant sites. Growth rate (GR) has been poorly evaluated in cSCC, despite clinical evidence suggesting that GR is an important risk factor in cSCC. AIM: To analyse the influence of GR in cSCC prognosis. METHODS: We retrospectively evaluated GR in a series of 90 cSCCs and tried to correlate GR with prognosis in cSCC. RESULTS: We demonstrated that tumours with a GR of > 4 mm/month exhibit a higher risk of nodal progression and a shorter progression time to lymph node metastasis in cSCC than those with GR of < 4 mm/month. As expected, GR correlated with tumour proliferation, as determined by Ki-67 expression. CONCLUSIONS: We consider a GR of 4 mm/month as the cutoff point that distinguishes between rapid- and slow-progressing tumours and, more importantly, to identify a subset of high-risk cSCCs.

Changes in ventricular size after endoscopic third ventriculostomy.

BACKGROUND: There is general consensus that a successful endoscopic third ventriculostomy is usually followed by a decrease of ventricular size without reaching their normal size. This study was performed to determine how the change related to clinical outcome, how it developed chronologically and whether the change in ventricular size was different in acute and chronic forms of hydrocephalus. METHOD: Fifty-five of 74 patients who had undergone endoscopic third ventriculostomy during the period 1997-2004 were selected by the criterion that they had both pre-operative and post-operative films and no neurosurgical manoeuvre other than a surgically successful endoscopic third ventriculostomy in the time span between both radiological studies. Ventricular size was measured with the Evans index, third ventricle index, cella media index and ventricular score. Median age was 51 years (interquartile range, 27-65 years). RESULTS: The change in ventricular size detected shortly after surgery is related to clinical outcome for all ventricular ratios, except the cella media index (p = 0.08). When third ventriculostomy is clinically successful, there is a gradual decrease of ventricular size over a period of more than three months (p < 0.0001 for all ventricular ratios). The reduction is more prominent in acute hydrocephalus than in chronic forms for all ventricular ratios, except the Evans index (p = 0.12). The third ventricle exhibits the greatest reduction (25% with a 95% confidence interval: 15.4-34.5) and determines a different pattern of change in ventricular size after endoscopic third ventriculostomy between acute and chronic hydrocephalus. CONCLUSIONS: A decrease of the ventricular size detected soon after endoscopic third ventriculostomy is associated with a satisfactory clinical outcome. This response continues during the first few months after surgery. The reduction is more prominent in acute forms of hydrocephalus.

Evolution of intracranial pressure during the immediate postoperative period after endoscopic third ventriculostomy.

OBJECTIVE: To establish a more accurate indication for endoscopic third ventriculostomy (ETV) in patients with noncommunicating hydrocephalus through the analysis of the evolution of postoperative mean intracranial pressure (ICPM). METHOD: Intracranial pressure (ICP) was recorded overnight during 8-hour periods with an intraventricular probe. A personal computer connected to the ICP monitor minutely recorded the values of ICP. Twenty-four patients were monitored from day 1 to day 3 after ETV. The evolution of ICPM was analysed with an ANOVA test for repeated measures. The relevance of different factors (age, etiology, size of the lesion leading to hydrocephalus, clinical course and outcome) on the evolution of ICPM was explored with a two-factor ANOVA. RESULTS: ICPM progressively decreased from day 1 to day 3 after ETV (p = 0.03). ICPM on the first postoperative day was 15.81 +/- 2.04 mm Hg (mean +/- standard error) and 13.43 +/- 1.44 mm Hg on the third postoperative day. Different patterns in the evolution of ICPM have been detected according to the age of the patient and the clinical course of hydrocephalus. CONCLUSION: ICPM progressively decreases after ETV. This pattern is not constant. It has been clearly detected in children and in acute forms of hydrocephalus.

Histerectomía laparoscópica frente a histerectomía abdominal: estudio clínico comparativo / Laparoscopic hysterectomy versus ab-dominal hysterectomy: a comparative clinical study

Objetivo: Se comparan los resultados de la histerectomía laparoscópica y la histerectomía abdominal en pacientes con similares características e indicación quirúrgica. Pacientes y método: El grupo estudio está formado por una serie prospectiva de 68 histerectomías laparoscópicas que cumplían los siguientes criterios: útero # 14 semanas; cáncer de endometrio en estadio I; ausencia de cáncer de cérvix y de ovario, y ausencia de prolapso genital parcial o total. El grupo control está formado por una serie de 49 pacientes con los mismos criterios de inclusión, a las que se realizó una histerectomía abdominal durante 1998. Se analizan y comparan en los dos grupos el tiempo quirúrgico, la necesidad de analgesia, la estancia hospitalaria y las complicaciones intra y (..) (AU)

Estudio cineantropometrico de futbolistas jóvenes / Kinanthropometric study of young soccer players

Hemos realizado, un estudio cineantropométrico de futbolistas jóvenes de dos equipos pertenecientes a Tercera División (n=28) y División de Honor Juvenil (n= 28) de la Unión Deportiva Salamanca, comparando los resultados con los obtenidos en una Población de estudiantes de la Universidad de Salamanca (grupo control). Nuestros resultados mostraron diferencias significativas en todos los valores de los pliegues grasos y en el sumatorio de los mismos (superiores en universitarios). Peso y porcentaje graso fueron superiores en el grupo control, mientras que los mayores pesos óseo y muscular correspondieron a los futbolistas. Al comparar los dos equipos observamos que los pliegues grasa fueron superiores en el grupo de División de Honor, mientras los pesos óseo y muscular mostraron valores superiores en el grupo de Tercera División. (AU)