Plasmocitoma extramedular de canal auditivo externo: caso clínico / Extramedullary plasmacytoma of external auditory canal: a case report

Resumen El plasmocitoma extramedular es una neoplasia de células plasmáticas poco frecuente, que se ubica en 80% a 90% de los casos en la cabeza o cuello. Esta neoplasia representa menos del 1% de toda la patología maligna de cabeza y cuello. Dada la poca frecuencia de la patología y la escasez de casos publicados, esta entidad presenta una gran dificultad clínica y terapéutica. El diagnóstico se basa en el análisis histológico con inmunohistoquímica de la muestra obtenida, y el tratamiento varía según la ubicación, donde se puede realizar radioterapia o cirugía. En este artículo presentamos el caso de una paciente de 56 años, con antecedentes de otorrea de larga data en oído derecho, al examen físico presentaba un tumor que obstruía todo el conducto auditivo externo. Se realizó exéresis tumoral y la biopsia evidenció un plasmocitoma.

Abstract Extramedullary plasmacytoma is a rare plasma cell neoplasm, affecting 80% to 90% of the head or neck. This neoplasm represents less than 1% of all malignant head and neck pathology. Given the infrequency of the pathology and the scarcity of published cases, this entity presents great clinical and therapeutic difficulty. Diagnosis is based on histology and immunohistochemistry and treatment varies depending on the location, where radiation therapy or surgery can be performed. In this article, we present the case of a 56-year-old patient with a history of long-standing otorrhea in the right ear. Physical examination presented a tumor that obstructed the entire external auditory canal. Tumor excision was performed, and the biopsy revealed a plasmacytoma.

Proteomic profile of the effects of low-dose bisphenol A on zebrafish ovaries.

Human exposure to bisphenol-A (BPA) is largely unavoidable because BPA is an environmental contaminant found in soil, water, food and indoor dust. The safety of authorized BPA amounts in consumer products is under question because new studies have reported adverse effects of BPA at doses far below that previously established by the NOAEL (50 µg/kg per day). To protect public health, the consequences of low-dose BPA exposure in different organs and organismal functions must be further studied to generate relevant data. This study attempted to investigate the effects and potential molecular mechanisms of short-term exposure to 1 µg/L BPA on zebrafish ovarian follicular development. We observed only minor changes at the histopathological level with a small (3 %) increase in follicular atresia. However, a shotgun proteomics approach indicated deep alterations in BPA-exposed ovarian cells, including induction of the oxidative stress response, metabolic shifts and degradome perturbations, which could drive oocytes towards premature maturation. Based on these results, it could be suggested that inadvertent exposure to small concentrations of BPA on a continuous basis causes alteration in biological processes that are essential for healthy reproduction.

Angiomiolipoma nasal: reporte de dos casos y revisión de la literatura

Resumen El angiomiolipoma es una lesión hamartomatosa, habitualmente de localización renal asociado a esclerosis tuberosa. La ubicación nasosinusal es extremadamente infrecuente y se puede presentar con obstrucción nasal y epistaxis. Se presentan dos casos de angiomiolipoma de cavidad nasal diagnosticados en el Hospital Carlos Van Buren de Valparaíso. Ambos casos se presentaron como masa nasal unilateral, se estudiaron con tomografía computada y fueron tratados con biopsia escisional, sin presentar recidivas durante su seguimiento. El anigiomiolipoma está compuesto por vasos sanguíneos, músculo liso y adipocitos. Existen diferencias entre el angiomiolipoma del riñón versus el de piel, cavidad oral y nasal (angiomiolipomas mucocutáneos); estos últimos son extremadamente infrecuentes, de menor tamaño, con presencia de agregados linfoides, negativos para antígeno específico de melanoma HMB-45 y sin asociación a esclerosis tuberosa. Existen pocos casos reportados en la literatura de esta patología, por lo que existe poca evidencia. Clínicamente, se presentan con obstrucción nasal, epistaxis recurrente, sensación de masa nasal. El estudio preoperatorio depende de su extensión y puede incluir una tomografía computada y/o angiografía para identificar su irrigación. El diagnóstico definitivo es anatomopatológico. Si se logra la escisión completa, no se han reportado recidivas, por lo que presenta un excelente pronóstico.

Abstract Angiomyolipoma is a hamartomatous lesion, usually of a renal location associated with tuberous sclerosis. Nasosinusal location is extremely rare and can present with nasal obstruction and epistaxis. Two cases of angiomyolipoma of the nasal cavity diagnosed at the Carlos Van Buren Hospital in Valparaíso are presented. Both cases presented as a unilateral nasal mass, and were studied with computed tomography, and treated with an excisional biopsy, with no recurrences during follow-up. Anigiomyolipoma is composed of blood vessels, smooth muscle and adipocytes. There are differences between angiomyolipoma of the kidney versus skin, oral and nasal cavity (mucocutaneous angiomyolipomas). The latter are extremely infrequent, smaller in size, with the presence of lymphoid aggregates, negative for the HMB-45 specific melanoma antigen and without association with tuberous sclerosis. There are few cases reported in the literature of this pathology, so there is little evidence. Clinically, they present with nasal obstruction, recurrent epistaxis, sensation of nasal mass. The preoperative study depends on its extension and may include a computed tomography and/or angiography to identify its irrigation. The definitive diagnosis is pathological. If complete excision is achieved, no recurrences have been reported, so it has an excellent prognosis.

Rationale, design and methodology of TESEO study: a registry of thrombosis and neoplasia of SEOM (Spanish Society of Medical Oncology).

BACKGROUND AND RATIONALE: Thromboembolic complications are a serious, preventable and common event in cancer patients that contributes to increasing morbidity and mortality. Despite increasing knowledge on cancer-associated thrombosis (CAT), there are still several aspects of diagnosis, clinical management, treatment and prognosis with uncertainties that are under-represented in randomized clinical trials. For this reason, the Spanish Society of Medical Oncology (SEOM) launched in June 2018 a registry of CAT. METHODS/DESIGN: TESEO is an ongoing prospective, non-interventional, multicentric study in consecutive cancer patients with newly diagnosed of thromboembolic event (TEE). Eligibility criteria include being > 18 years with a histologically confirmed diagnosis of cancer and a symptomatic or incidental TEE confirmed with an imaging technique in the previous month or any time after the cancer diagnosis and signing of informed consent. The study consists of two types of integrated but independent prospective registries. Regular CAT sub-registry includes information on patient's cancer´s characteristics, anticoagulant treatment provided and outcome data. Special CAT sub-registry includes variables related to special situations of CAT that comprise patients with severe kidney failure, thrombocytopenia, high risk of bleeding related to the cancer or with coexistence of bleeding and patients who receive new treatments such a targeted therapy, antiangiogenics agents and immunotherapy. The registry considers the status of the cancer and the time to assess how the prognosis is changed based on when the thrombus occurs. Some outcomes such as rethrombosis, major bleeding, tumor progression and survival will be valued in various time intervals including 1, 3, 6 and 12 months after the even in the first year; and then every 6 months until the patient's death. RESULTS: After 18 months and with 35 centers and researchers, the registry has 1128 patients. CONCLUSION: TESEO registry will provide clinical real-world evidence for prevention, treatment and complications of CAT in different scenarios that are under-represented in randomized clinical trials.

Síndrome trófico trigeminal secundario a recidiva de meningioma / Trigeminal Trophic Syndrome Secondary to Meningioma Recurrence

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Síndrome de Ehlers-Danlos clásico: hallazgos clínicos y ecográficos / Classic Ehlers-Danlos Syndrome: Clinical and Ultrasound Findings

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caso clínico: basofilia y eosinofilia asociada a parasitosis por echinococcus granulosus en pediatría

El leucograma, es uno de los estudios de rutina más solicitados en el laboratorio, la desviación de los valores de las diferentes subpoblaciones leucocitarias respecto al intervalo de referencia contribuye a la orientación sobre la posible etiología de un estado de enfermedad. El hallazgo de eosinofilia y/o basofilia absolutas, debe ser estudiado para conocer la causa subyacente. En el curso de una parasitosis, puede ser el único signo anormal o formar parte del cuadro clínico-biológico del paciente. Se presenta el caso de un niño de 4 años que cursa con una parasitosis por Echinococcus granulosus

The leukogram is one of the most requested routine studies in the laboratory; the deviation of the values of the different leukocyte subpopulations from the reference interval contributes to the orientation on the possible etiology of a disease state. The finding of absolute eosinophilia and/or basophilia must be studied to know the underlying cause. In the course of parasitosis, it may be the only abnormal sign or form part of the patient's clinical-biological state. The case of a 4-yearold boy with an Echinococcus granulosus parasite is presented

Insights into mechanochemical reactions at the molecular level: simulated indentations of aspirin and meloxicam crystals.

Although solvent-free mechanochemical synthesis continues to gain ever greater importance, the molecular scale processes that occur during such reactions remain largely uncharacterised. Here, we apply computational modelling to indentations between particles of crystals of aspirin and meloxicam under a variety of conditions to mimic the early stages of their mechanochemical cocrystallisation reaction. The study also extends to the effects of the presence of small amounts of solvent. It is found that, despite the solid crystalline nature of the reactants and the presence of little or no solvent, mixing occurs readily at the molecular level even during relatively low-energy collisions. When indented crystals are subsequently drawn apart, a connective neck formed by a mixture of the reactant molecules is observed, suggesting plastic-like behaviour of the reacting materials. Overall the work reveals some striking new insights including (i) relatively facile mixing of crystals under solvent-free conditions, (ii) no appreciable local temperature increases, (iii) localised amorphisation at the contact region and neck of the reacting crystals, and (iv) small amounts of solvent have relatively little effect during this early stage of the reaction, suggesting that their accelerating effect on the reaction may be exerted at later stages.

Inducción de fototolerancia con ultravioleta B de banda estrecha en urticaria solar / Induction of Light Tolerance Using Narrowband UV-B in Solar Urticaria

INTRODUCCIÓN: La urticaria solar (US) es una fotodermatosis infrecuente. Los antihistamínicos constituyen la primera línea de tratamiento, incluyéndose en segunda línea la inducción de fototolerancia mediante fototerapia con ultravioleta. OBJETIVOS: Describir y evaluar la eficacia de un protocolo de desensibilización, con UVB de banda estrecha (UVB-BE) en pacientes con US. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes diagnosticados de US con espectro de acción en UVA, luz visible (LV) o ambas, que habían realizado fototerapia con UVB-BE para inducir fototolerancia. Se realizan cursos cortos (menos de 20 sesiones, 3 por semana) durante la primavera, con dosis inicial determinada por el fototipo. Se recogen resultados del Skindex-29 antes del tratamiento y después del verano, y un cuestionario no validado de efectividad terapéutica después del verano para valorar actividad de la enfermedad y grado de satisfacción. RESULTADOS: Se incluyen 8 pacientes con espectro de acción: 50% LV y 50% UVA más luz visible. Se realizaron 17 cursos anuales (1-6 cursos por paciente), de 11 a 20 sesiones. La dosis media de UVB-BE por curso fue 7,45J/cm2. Ningún paciente presentó brotes o efectos adversos durante el tratamiento. La respuesta fue satisfactoria en 6 pacientes. En el 78,6% de los tratamientos la mejoría en el Skindex-29 global fue superior al 20%. La mejoría en las subescalas sintomática y funcional fue superior al 20% en el 71% y el 64% respectivamente. CONCLUSIÓN: La inducción de fototolerancia con UVB-BE en la US es un procedimiento seguro y efectivo en un elevado porcentaje de pacientes

INTRODUCTION: Solar urticaria is an uncommon photodermatosis. First-line treatment is with antihistamines; second-line treatment includes induction of light tolerance using UV phototherapy. OBJECTIVES: We aimed to describe and evaluate the effectiveness of a desensitization protocol with narrowband UV-B in patients with solar urticaria. MATERIAL AND METHODS: We performed a retrospective study of patients with solar urticaria with an action spectrum in the UV-A range, the visible light range, or both who had received therapy with narrowband UV-B for induction of light tolerance. Short courses of treatment were administered (< 20 sessions, 3 per week) during spring. The initial dose was determined according to the skin type. The Skindex-29 was administered before treatment and after summer; a nonvalidated questionnaire was also administered after summer to evaluate disease activity and satisfaction with treatment. RESULTS: We included 8 patients with an action spectrum (4 with visible light and 4 with UVA plus visible light). Seventeen courses (1-6 per patient) were administered per year. The number of sessions per year ranged from 11 to 20. The mean dose of narrowband UV-B per course was 7.45J/cm2. No patients experienced flares or adverse effects during treatment. The response was satisfactory in 6 patients. The improvement in the overall Skindex-29 score was greater than 20% in 78.6% of cases. The improvement in the function and symptoms subscales was over 20% in 71% and 64% of cases, respectively. CONCLUSION: Induction of light tolerance with narrowband UV-B in solar urticaria is safe and effective in a high percentage of patients

Calcinosis cutis facial en una paciente con dermatomiositis paraneoplásica / Facial Calcinosis Cutis in a Woman with Paraneoplastic Dermatomyositis

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Induction of Light Tolerance Using Narrowband UV-B in Solar Urticaria. / Inducción de fototolerancia con ultravioleta B de banda estrecha en urticaria solar.

INTRODUCTION: Solar urticaria is an uncommon photodermatosis. First-line treatment is with antihistamines; second-line treatment includes induction of light tolerance using UV phototherapy. OBJECTIVES: We aimed to describe and evaluate the effectiveness of a desensitization protocol with narrowband UV-B in patients with solar urticaria. MATERIAL AND METHODS: We performed a retrospective study of patients with solar urticaria with an action spectrum in the UV-A range, the visible light range, or both who had received therapy with narrowband UV-B for induction of light tolerance. Short courses of treatment were administered (<20 sessions, 3 per week) during spring. The initial dose was determined according to the skin type. The Skindex-29 was administered before treatment and after summer; a nonvalidated questionnaire was also administered after summer to evaluate disease activity and satisfaction with treatment. RESULTS: We included 8 patients with an action spectrum (4 with visible light and 4 with UVA plus visible light). Seventeen courses (1-6 per patient) were administered per year. The number of sessions per year ranged from 11 to 20. The mean dose of narrowband UV-B per course was 7.45J/cm2. No patients experienced flares or adverse effects during treatment. The response was satisfactory in 6 patients. The improvement in the overall Skindex-29 score was greater than 20% in 78.6% of cases. The improvement in the function and symptoms subscales was over 20% in 71% and 64% of cases, respectively. CONCLUSION: Induction of light tolerance with narrowband UV-B in solar urticaria is safe and effective in a high percentage of patients.

Carcinoma papilar de tiroides no captante de radioyodo (I131): a propósito de un caso / Papillary thyroid carcinoma not collecting radioiodine (I131): presentation of a case

RESUMEN El carcinoma papilar de tiroides (CPT) corresponde a una neoplasia frecuente en el mundo y en nuestro país. Generalmente se asocia a buen pronóstico y altas tasas de sobrevida, gracias a características propias del tumor, precisas herramientas diagnósticas y terapias eficaces. Formas infrecuentes de CPT suelen tener comportamientos más agresivos y respuestas parciales a tratamientos habituales, tales como el CPT no captante de radioyodo (5% de los casos). Poca literatura existe respecto a este último y a su manejo. Diversas opciones de tratamiento han sido propuestas, según si hay evidencia de tejido tumoral, como el uso empírico de I131, cirugía, radioterapia, embolización e inhibidores de tirosina kinasa, sin embargo, sigue habiendo una respuesta incierta.

ABSTRACT Papillary thyroid carcinoma (PTC) is a common cancer in the world and in our country. It is usually associated with good prognosis and high survival rates, due to the tumor's characteristics, precise diagnostic tools and effective therapies. Unusual varieties of PTC have more aggressive behaviors and partial responses to usual treatments, such as negative uptake to radioiodine PTC (5% of cases). There is few literature about this variety and its treatment. Diverse treatment options have been proposed, according to whether there is evidence of tumor tissue, such as the empirical use of I131, surgery, radiotherapy, embolization and inhibitors of thyrosine kinase, however an uncertain response remains.