Clinical, Pathological Characteristics and Progression of Urothelial Bladder Cancer in Young Adult Patients. Our Experience and Literature Review.

BACKGROUND: Bladder cancer is highly prevalent even though its incidence is considerably lower in patients younger than 40 years, thus raising the issue of the influence of age at diagnosis on the natural history of this disease. This study aimed to evaluate the characteristics and progression of young patients with urothelial bladder carcinoma with at least 10 years of follow-up and to compare the results with those of previously reported studies. MATERIAL AND METHODS: A retrospective study between 1990 and 2007 was conducted. The medical records and tissue samples of patients with urothelial bladder tumours were reviewed, and patients with a first diagnosis of urothelial carcinoma of the bladder at age 40 years or younger were selected. Their clinical and pathological data and disease-free survival were analysed. RESULTS: This study included 43 patients, with a median follow-up of 152 months (interquartile range (IQR): 96-222) and a mean age at diagnosis of 34 years (SD: 4.6). Thirty-five patients (81.4%) had non-muscle invasive tumours at diagnosis, and 53.5%, 27.9% and 18.6% had tumour grades of G1, G2 and G3, respectively. Fifteen patients (34.9%) experienced recurrence, and eight (18.6%) progressed. At 24 and 60 months, the recurrence-free survival rates were 84.8% (95% confidence interval (CI): 69.2%-92.9%) and 68.9% (95% CI: 51.7%-81%), respectively, and the progression-free survival rates were 94.9% (95% CI: 81%-98.7%) and 92.2% (95% CI: 77.8%-97.4%), respectively. CONCLUSIONS: Bladder cancer is an uncommon disease in young patients. In most cases, it consists of non-muscle-invasive tumours, with a low rate of recurrence and progression. The prognosis is based on the tumour's characteristics and not on the patient's age.

Effectiveness of Treatment Approaches in COVID-19 Pneumonia: A Comparative Evaluation between a Specialized Center and Conventional Hospitals.

BACKGROUND: The early stages of the COVID-19 pandemic overwhelmed general hospitals in Spain. In response, a dedicated hospital for COVID-19 care, the Hospital de Emergencias Enfermera Isabel Zendal (HEEIZ), was established. This study aimed to compare clinical outcomes of COVID-19 patients treated at the specialized HEEIZ with those at conventional general hospitals (CGHs) in Madrid, Spain. METHODS: The study was a prospective, observational cohort study including COVID-19 patients admitted to the HEEIZ and 14 CGHs (December 2020 to August 2021). Patients were assigned based on hospital preference. Clinical data were collected and analyzed using multivariate regression to assess primary and secondary outcomes, including hospital mortality, need of invasive mechanical ventilation (IMV), and pharmacological treatments. RESULTS: The HEEIZ cohort (n = 2997) was younger and had lower Charlson comorbidity scores than the CGH cohort (n = 1526). Adjusted HEEIZ hospital mortality was not significantly higher compared with CGHs (OR: 1.274; 95% CI: 0.781-2.079; p = 0.332). CONCLUSIONS: During the study period, patients admitted to the HEEIZ showed no significant differences in clinical outcomes, compared with patients admitted at CGHs. These results might support the use of specialized centers in managing pandemic surges, allowing CGHs to handle other needs.

Clostridium and Cryptosporidium outbreak linked to a splash pad.

BACKGROUND: . Splash pads for recreational purposes are widespread. Using these pads can pose a health risk if they lack installation regulation and water quality supervision. Our aim was to describe a waterborne disease outbreak caused by Clostridium perfringens and Cryptosporidium spp. in a Barcelona district and the measures taken for its control. METHODS: . On August 2018, 71 cases of acute gastroenteritis were detected, affecting people who used a splash pad or were in contact with a user. Microbiological and environmental investigations were carried out. A descriptive analysis of the sample and Poisson regression models adjusted for age and sex were performed, obtaining frequencies, median values, and adjusted prevalence ratios with their 95% confidence intervals. RESULTS: The median age of the cases was 6.7 years, 27 (38%) required medical care, and three (4.2%) were hospitalized. The greater the number of times a person entered the area, the greater the number of symptoms and their severity. Nineteen (76%) of the 25 stool samples collected from cases showed the presence of one or both pathogens. Environmental investigations showed deficiencies in the facilities and identified the presence of both species in the splash pad. Health education and hygiene measures were carried out, and 14 days after the closure of the facilities, no more cases related to the pad were recorded. CONCLUSIONS: . Specific regulations are needed on the use of splash pads for recreational purposes. Until these regulations are in place, these types of facility should comply with the regulations that apply to swimming pools and spas, including those related to the design of the tanks, water recirculation systems, and adequate disinfection systems.

Synergistic impact of N-antigenemia profiled by a rapid antigen test and low anti-S1 antibodies on the risk of hospitalization in COVID-19.

OBJECTIVES: Identifying patients with COVID-19 who are at risk of poor evolution is key to early decide on their hospitalization. We evaluated the combined impact of nucleocapsid (N)-antigenemia profiled by a rapid test and antibodies against the S1 subunit of the SARS-CoV S protein (S1) on the hospitalization risk of patients with COVID-19. METHODS: N-antigenemia and anti-S1 antibodies were profiled at admission to the emergency department in 146 patients with COVID-19 using the Panbio® antigen Rapid Test and the SARS-CoV-2 immunoglobulin G II Quant/SARS-CoV-2 immunoglobulin G assay from Abbott. A multivariable analysis was used to evaluate the impact of these factors on hospitalization. RESULTS: Patients with a positive N-antigen test in plasma and anti-S1 levels <2821 arbitrary units/mL needed hospitalization more frequently (20 of 23, 87%). A total of 20 of 71 (28.2%) of those showing a negative N-antigen test and anti-S1 ≥2821 arbitrary units/mL were hospitalized for 18 of 52 (34.6%) of the patients with only one of these conditions. Patients with a positive N-antigen test and low antibody levels showed an odds ratio, 95% confidence interval, and P-value for hospitalization of 18.21, 2.74-121.18, and 0.003, respectively, and exhibited the highest mortality (30.4%). CONCLUSIONS: Simultaneous profiling of a rapid N-antigen test in plasma and anti-S1 levels could help to early identify patients with COVID-19 needing hospitalization.

Impact of Physical Activity on Autonomy and Quality of Life in Individuals with Down Syndrome: A Systematic Review.

Down syndrome (DS) is the most common genetic alteration in humans, resulting from the trisomy of chromosome 21. Individuals with DS are characterized by physical traits and limitations related to intellectual functioning and the development of motor skills. People with DS tend to have lower levels of physical activity (PA) than the general population, despite its benefits for health and quality of life, which could be caused by barriers such as the lack of adapted programs or knowledge on how to adapt them. Therefore, this systematic review aimed to examine the impact of physical activity or sports programs on autonomy and quality of life in individuals with DS. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to search four databases (Scopus, Web of Science, PubMed, and SportDiscus), adhering to the population, intervention, comparison, and outcome strategy. A total of 13 studies were selected that followed different training programs (combined training, adapted football, technology-based, pulmonary training, gymnastics and dance, water-based, and whole body vibration). Most of the interventions provided benefits for autonomy or quality of life (physical, psychological, cognitive, emotional, and social) in people with DS. In conclusion, the benefits of physical activity and sports programs adapted to people with DS are positive.

Acute human leptospirosis in a Caribbean region of Colombia: From classic to emerging risk factors.

BACKGROUND: Leptospirosis is a zoonosis of worldwide incidence, with a broad spectrum of health risk factors. AIM: The objective was to determine risk factors associated with acute human leptospirosis and to explore predictive variables of risk to human leptospirosis. METHODS: The study was carried out in the Department of Córdoba, in the north of Colombia. We conducted a longitudinal prospective descriptive study with non-probabilistic sampling, which included 339 patients suspected of leptospirosis. Positive cases were confirmed by MAT and PCR. The determination of social and environmental risk factors was done with a survey on epidemiological and environmental variables to establish an association between cases of leptospirosis and risk factors as well as predictive variables. RESULTS: We found 19.8% (67/339) cases of acute leptospirosis, and the seroprevalence was 27.1% (92/339). The most frequent serogroups were Sejroe, Australis, Pomona, Batavie, Pyrogenes and Grippotyphosa. We identified the following risk factors: age between 10 and 19 years (OR = 2.571; 95% CI); pig ownership (OR = 2.019; 95% CI); bathing or recreational activities in lake/lagoon (OR = 3.85; 95% CI) and in dams (OR = 3.0; 95% CI); floodings 30 days before the onset of symptoms (OR = 2.019; 95% CI), and a mean temperature of 28°C (p 0.044; 95%CI). As significant predictor variables, we identified age (10-19 years), bathing or recreational activities in the lake/lagoon, and flooding 30 days before symptoms were again evidenced. This region presents classic risk factors (pig ownership) and emerging environmental risk factors (recreational practice or bathing in a lake/lagoon and flooding 30 days before the onset of symptoms), and demographic factors such as young age (10-19 years). CONCLUSIONS: These factors are also predictors of human cases of acute leptospirosis and provide contextual information on environmental and public health that should be considered for epidemiological surveillance in this endemic area.

A human genome editing-based MLL::AF4 ALL model recapitulates key cellular and molecular leukemogenic features.

Cellular ontogeny and MLL breakpoint site influence the capacity of MLL-edited CD34+ hematopoietic cells to initiate and recapitulate infant patients' features in pro-B-cell acute lymphoblastic leukemia (B-ALL). We provide key insights into the leukemogenic determinants of MLL-AF4+ infant B-ALL.

Kinetics of Na- and K- uranyl arsenate dissolution.

We integrated aqueous chemistry analyses with geochemical modeling to determine the kinetics of the dissolution of Na and K uranyl arsenate solids (UAs(s)) at acidic pH. Improving our understanding of how UAs(s) dissolve is essential to predict transport of U and As, such as in acid mine drainage. At pH 2, Na0.48H0.52(UO2)(AsO4)(H2O)2.5(s) (NaUAs(s)) and K0.9H0.1(UO2)(AsO4)(H2O)2.5(s) (KUAs(s)) both dissolve with a rate constant of 3.2 × 10-7 mol m-2 s-1, which is faster than analogous uranyl phosphate solids. At pH 3, NaUAs(s) (6.3 × 10-8 mol m-2 s-1) and KUAs(s) (2.0 × 10-8 mol m-2 s-1) have smaller rate constants. Steady-state aqueous concentrations of U and As are similarly reached within the first several hours of reaction progress. This study provides dissolution rate constants for UAs(s), which may be integrated into reactive transport models for risk assessment and remediation of U and As contaminated waters.

A story of a lone star tick: an imported case of Amblyomma americanum (Linnaeus, 1758) infected with Rickettsia amblyommatis that parasitized a US traveler returning to Mexico.

In this study, we report the presence of a female Amblyomma americanum tick attached to a former resident of the East Coast of the United States who moved to Mexico city. The amplification and sequencing of gene fragments of the 16S-rDNA and cytochrome c oxidase subunit 1 corroborated the identification of the species of the tick. Additionally, the presence of DNA of Rickettsia amblyommatis was confirmed. This work is the first report of an exotic tick of the genus Amblyomma in a traveler from the US to Mexico and represents the second record of an imported tick attached to humans in Mexico.

Electrospray Ionization Tandem Mass Spectrometry With Collision Induced Dissociation of Uranyl Peroxide Nanoclusters Containing Various Uranyl Bridging Ligands.

Electrospray ionization tandem mass spectrometry with collision-induced dissociation (ESI-MS/MS) was utilized to study the gas phase fragmentation of uranyl peroxide nanoclusters with hydroxo, peroxo, oxalate, and pyrophosphate bridging ligands. These nanoclusters fragment into uranium monomers and dimers with mass-to-charge (m/z) ratios in the 280-380 region. The gas phase fragmentation of each cluster studied yields a distinct UO6 - anion attributed to the cleavage of a uranyl ion bound to 2 peroxide groups, along with other anions that can be attributed to the initial composition of the nanoclusters.

The Role of a Sn Promoter on an Anodic Pt Electrocatalyst Prepared over H2 O2 -Functionalized Carbon Supports for Direct Ethanol Fuel Cell (DEFC) Applications.

Multiwalled carbon nanotubes and Vulcan carbon were functionalized with a 30 %v/v hydrogen peroxide solution and employed as supports for Pt and PtSn catalysts prepared by the polyol method. PtSn catalysts with a Pt loading of 20 wt.% and a Pt : Sn atomic ratio equal to 3 : 1 were evaluated in the ethanol electrooxidation reaction. The effects of the oxidizing treatment on the surface area and the surface chemical nature were analyzed through N2 adsorption, isoelectric point, and temperature-programmed desorption measurements. Results showed that the H2 O2 treatment affects the surface area of the carbons to a great extent. Characterization results indicated that the performance of the electrocatalysts strongly depends both on the presence of Sn and on the support functionalization. PtSn/CNT-H2 O2 electrocatalyst displays a high electrochemical surface area and enhanced catalytic activity for ethanol oxidation in comparison to other catalysts in the present study.

A Comparative Study Regarding the Impact of Covid-19 on Latin American College Students

COVID-19 has changed educational opportunities for students around the world, and, in the process, affected their lifestyle, happiness, and engagement. The present research is part of a project from six universities in different countries across Latin America to examine the impact of COVID-19 on university students. Objectives: The purpose of this study was to assess and compare the impact of COVID-19 on lifestyle changes, orientations to happiness, and student engagement among a sample of college students in Mexico, El Salvador, Colombia, the Dominican Republic, Peru, and the US. Methods: Participants were 1764 students from the six previously identified countries. Data were collected using the Student Health Behavior Inventory, the Orientations to Happiness Scale, and the University Student Engagement Inventory. Results: Student respondents were mostly female, with a median age of 22. Most reported no changes in academic performance and statistically significant changes in some lifestyle behaviors such as nutrition and physical activity. Conclusions: The global pandemic led to behavioral changes among college students in Latin America, and it affected their orientations to happiness and engagement. Institutions of higher learning are called to create opportunities for their students to reintegrate into an in-person learning environment to facilitate positive lifestyle changes for their students.

El COVID-19 ha cambiado las oportunidades educativas para los estudiantes de todo el mundo y en el proceso afectó su estilo de vida, felicidad y compromiso. La presente investigación es parte de un proyecto de seis universidades en diferentes países de América Latina para determinar el impacto de COVID-19 en estudiantes universitarios. Objetivos: El propósito de este estudio fue evaluar y comparar el impacto del COVID-19 en los cambios de estilo de vida, las orientaciones hacia la felicidad y el compromiso de los estudiantes entre una muestra de estudiantes universitarios en México, El Salvador, Colombia, República Dominicana, Perú y Estados Unidos. Métodos: Los participantes fueron 1764 estudiantes de los seis países previamente identificados. Los datos se recolectaron utilizando el Inventario de Conducta de Salud del Estudiante, la Escala de Orientaciones a la Felicidad y el Inventario de Participación de los Estudiantes Universitarios. Resultados. Los estudiantes encuestados eran en su mayoría mujeres con una edad promedio de 22 años. La mayoría informó que no hubo cambios en el rendimiento académico y cambios estadísticamente significativos en algunos comportamientos de estilo de vida, como la nutrición y la actividad física. Conclusiones: La pandemia global provocó cambios de comportamiento entre los estudiantes universitarios de América Latina y afectó sus orientaciones hacia la felicidad y su compromiso. Las instituciones de educación superior están llamadas a crear oportunidades para que sus estudiantes se reintegren en un entorno de aprendizaje en persona para facilitar cambios positivos en el estilo de vida de sus estudiantes.

Electrochemistry of Uranyl Peroxide Solutions during Electrospray Ionization.

The ionization of uranyl triperoxide monomer, [(UO2)(O2)3]4- (UT), and uranyl peroxide cage cluster, [(UO2)28(O2)42 - x(OH)2x]28- (U28), was studied with electrospray ionization mass spectrometry (ESI-MS). Experiments including tandem mass spectrometry with collision-induced dissociation (MS/CID/MS), use of natural water and D2O as solvent, and use of N2 and SF6 as nebulizer gases, provide insight into the mechanisms of ionization. The U28 nanocluster under MS/CID/MS with collision energies ranging from 0 to 25 eV produced the monomeric units UOx- (x = 3-8) and UOxHy- (x = 4-8, y = 1, 2). UT under ESI conditions yielded the gas-phase ions UOx- (x = 4-6) and UOxHy- (x = 4-8, y = 1-3). Mechanisms that produce the observed anions in the UT and U28 systems are: (a) gas-phase combinations of uranyl monomers in the collision cell upon fragmentation of U28, (b) reduction-oxidation resulting from the electrospray process, and (c) ionization of surrounding analytes, creating reactive oxygen species that then coordinate to uranyl ions. The electronic structures of anions UOx- (x = 6-8) were investigated using density functional theory (DFT).

Post-infectious irritable bowel syndrome following a diagnosis of traveller's diarrhoea: a comprehensive characterization of clinical and laboratory parameters.

BACKGROUND: Prolonged or recurrent gastrointestinal symptoms may persist after acute traveller's diarrhoea (TD), even after adequate treatment of the primary cause. This study aims to describe the epidemiological, clinical and microbiological characteristics of patients with post-infectious irritable bowel syndrome (PI-IBS) after returning from tropical or subtropical areas. METHODS: We conducted a retrospective study of patients presenting between 2009 and 2018 at the International Health referral centre in Barcelona with persistent gastrointestinal symptoms following a diagnosis of TD. PI-IBS was defined as the presence of persistent or recurrent gastrointestinal manifestations for at least 6 months after the diagnosis of TD, a negative stool culture for bacterial pathogens and a negative ova and parasite exam after targeted treatment. Epidemiological, clinical and microbiological variables were collected. RESULTS: We identified 669 travellers with a diagnosis of TD. Sixty-eight (10.2%) of these travellers, mean age 33 years and 36 (52.9%) women, developed PI-IBS. The most frequently visited geographical areas were Latin America (29.4%) and the Middle East (17.6%), with a median trip duration of 30 days (IQR 14-96). A microbiological diagnosis of TD was made in 32 of these 68 (47%) patients, 24 (75%) of whom had a parasitic infection, Giardia duodenalis being the most commonly detected parasite (n = 20, 83.3%). The symptoms persisted for a mean of 15 months after diagnosis and treatment of TD. The multivariate analysis revealed that parasitic infections were independent risk factors for PI-IBS (OR 3.0, 95%CI 1.2-7.8). Pre-travel counselling reduced the risk of PI-IBS (OR 0.4, 95%CI 0.2-0.9). CONCLUSIONS: In our cohort, almost 10% of patients with travellers' diarrhoea developed persistent symptoms compatible with PI-IBS. Parasitic infections, mainly giardiasis, seem to be associated with PI-IBS.

Solubility and Thermodynamic Investigation of Meta-Autunite Group Uranyl Arsenate Solids with Monovalent Cations Na and K.

We investigated the aqueous solubility and thermodynamic properties of two meta-autunite group uranyl arsenate solids (UAs). The measured solubility products (log Ksp) obtained in dissolution and precipitation experiments at equilibrium pH 2 and 3 for NaUAs and KUAs ranged from -23.50 to -22.96 and -23.87 to -23.38, respectively. The secondary phases (UO2)(H2AsO4)2(H2O)(s) and trögerite, (UO2)3(AsO4)2·12H2O(s), were identified by powder X-ray diffraction in the reacted solids of KUA precipitation experiments (pH 2) and NaUAs dissolution and precipitation experiments (pH 3), respectively. The identification of these secondary phases in reacted solids suggest that H3O+ co-occurring with Na or K in the interlayer region can influence the solubilities of uranyl arsenate solids. The standard-state enthalpy of formation from the elements (ΔHf-el) of NaUAs is -3025 ± 22 kJ mol-1 and for KUAs is -3000 ± 28 kJ mol-1 derived from measurements by drop solution calorimetry, consistent with values reported in other studies for uranyl phosphate solids. This work provides novel thermodynamic information for reactive transport models to interpret and predict the influence of uranyl arsenate solids on soluble concentrations of U and As in contaminated waters affected by mining legacy and other anthropogenic activities.

A story of a lone star tick: an imported case of Amblyomma americanum (Linnaeus, 1758) infected with Rickettsia amblyommatis that parasitized a US traveler returning to Mexico

ABSTRACT In this study, we report the presence of a female Amblyomma americanum tick attached to a former resident of the East Coast of the United States who moved to Mexico city. The amplification and sequencing of gene fragments of the 16S-rDNA and cytochrome c oxidase subunit 1 corroborated the identification of the species of the tick. Additionally, the presence of DNA of Rickettsia amblyommatis was confirmed. This work is the first report of an exotic tick of the genus Amblyomma in a traveler from the US to Mexico and represents the second record of an imported tick attached to humans in Mexico.

Seroprevalencia de leptospirosis y brucelosis en búfalos de agua (Bubalus bubalis) en Tierralta Córdoba, Colombia

En la producción zootécnica, la brucelosis y la leptospirosis ocasionan problemas reproductivos y son una limitante en salud y en producción animal. El objetivo fue determinar la presencia de anticuerpos contra Leptospira spp. y Brucella abortus, en una población bufalera, en el municipio de Tierralta, Córdoba. Se realizó un estudio descriptivo de corte transversal, que incluyó un total de 144 búfalos de la raza Murrah, destinados al doble propósito. Para el diagnóstico de Leptospira spp., se implementó la prueba de aglutinación microscópica, con 13 serogrupos, 19 serovares pertenecientes a 5 especies de Leptospira patógenas y para brucelosis Rosa de Bengala y C-Elisa. La seroprevalencia para Leptospira spp. fue del 87,5 %, el serogrupo Mini fue el de mayor frecuencia, pero Grippotyphosa presentó el mayor título. El 16,67 % de los búfalos evaluados presentaron títulos iguales o superiores a 1:800, asociados con infección actual o reciente. La alta seroprevalencia, se puede deber a las características ambientales de la zona, que brinda las condiciones favorables para el crecimiento y el mantenimiento de este patógeno que, sumado al comportamiento de los búfalos de revolcarse, los hace propensos a las infecciones con bacterias del género Leptospira sp., porque a menudo, las fuentes de agua están contaminadas por este patógeno. La seroprevalencia contra B. abortus por Rosa de Bengala y Elisa-C fue del 2,08 %. Todos los títulos determinados corresponden a procesos infecciosos. No hubo signos clínicos de enfermedad y la carencia de registros productivos no permitió determinar el efecto sobre los parámetros reproductivos.

In animal production, brucellosis and leptospirosis cause reproductive problems and limit animal health and production. The objective was to determine the presence of antibodies against Leptospira spp. and Brucella abortus in a buffalo population in the municipality of Tierralta, Cordoba. A descriptive, transversal study was carried out including a population of 144 Murrah´s breed buffalos destined for beef and milk production. For the Leptospira spp. diagnostic, was used a rapid slide agglutination test with 13 serogrups and 19 serovars belonging to 5 pathogenic Leptospira species was implemented and for Brucella abortus Rose Bengal and C-Elisa was used. Seroprevalence of Leptospira spp. was 87,5 %, serogrup Mini was the most frequent, but Grippotyphosa showed the higher titer. The 16,67 % of the buffaloes evaluated presented titles equal to or above than 1:800 associated with current or recent infection. High seroprevalence may be due to environmental characteristics of the zone, which gives favorable conditions for the growth and maintenance of this pathogen, these factors in conjunction with the habit of wallowing makes them prone to suffering infections caused by bacteria of the genera Leptospira sp. since water sources are often contaminated. Seroprevalence against B. abortus by Rose-Bengal and C-Elisa was 2,08 %, the determined titers correspond to infectious processes. There were no clinical manifestations of disease and the effects on reproductive parameters were not determined because of the lack of productive registries.

Anti-Doping Knowledge of Students Undertaking Bachelor's Degrees in Sports Sciences in Spain.

In Spain, students pursuing a career in athletic training, physical education, or scientific evaluation of sports enroll in a bachelor's degree in sports sciences. This degree provides knowledge and skills in a broad array of sports settings and promotes research-based interdisciplinary knowledge. However, the student's syllabus rarely includes specific academic training on anti-doping regulations or doping prevention. The purpose of this study was to assess the anti-doping knowledge of the students undertaking a bachelor's degree in sports sciences in Spanish universities. One thousand two hundred and thirty-three bachelor students in sport science (907 males, 322 females, and 4 participants with non-binary sex) from 26 Spanish universities completed a validated questionnaire about general anti-doping knowledge. The questionnaire is an adapted version of the Play True Quiz of the World Anti-Doping Agency and contains 37 multiple-choice questions. The score obtained in the questionnaire was transformed into a 0−100-point scale. The questionnaire was distributed among students within each university by a faculty member and it was filled out online. Students obtained a score of 65.8 ± 10.10 points (range = 32−92 points). There was an effect of the course in the score obtained (p < 0.001). Students of the first course (63.6 ± 9.5 points) had lower scores than the remaining courses (p < 0.037) while the students of the fourth course obtained the highest scores (68.7 ± 9.5 points; p < 0.019). The students with an itinerary on sports performance were the respondents with the highest anti-doping knowledge (67.2 ± 10.2) points, followed by the students with an itinerary on health (66.7 ± 9.5 points). The knowledge of basic anti-doping rules and doping prevention strategies of the bachelor students in sports sciences in Spain was suboptimal. Increasing doping prevention information in the syllabus of the bachelor's degree in sports sciences is essential as these future professionals will directly work with populations at risk of doping.

[Mucinous tubular and spindle cell renal cell carcinoma: two novel cases and a literature review.] / Carcinoma mucinoso tubular y de células fusiformes renal: aportación de 2 nuevos casos y revisión de la literatura.

INTRODUCTION: Mucinous tubularand spindle cell carcinomas (MTSC) are a relativelyrare subtype of renal cell carcinoma (RCC) . Thesetumors are composed by tubular and spindle cellareas within a mucinous stroma. They are generallylow-grade nuclei tumors and limited to the kidney, sothey usually have a favorable prognosis. We report twonew cases of MTSC treated at our institution. MATERIALS AND METHODS: We reviewed therenal tumors surgery database of our hospital from2008 to 2019, selecting patients diagnosed with CMTF.We evaluated clinicopathological data and evolution ofthe patients. We also reviewed the published literatureto compare it with our findings. RESULTS: Two patients were included in the study,a 50-year-old male (case 1) and a 55-year-old female(case 2). The diagnosis was made by ultrasound asan incidental fi nding in case 1 and during the studyof fl ank pain in case 2. Treatment was surgical withpartial and radical nephrectomy respectively. After amean follow-up of 70 months, both patients are aliveand disease-free. CONCLUSION: Mucinous tubular and spindle cellcarcinomas (MTSC) is a rare renal tumor, approximatelytwo hundred cases have been published. Thereare questions yet to be answered about their diagnosisand behaviour so it is of utmost importance to reportnew cases in order to increase our knowledge and improvepatient care.

INTRODUCCIÓN: Los carcinomasmucinosos tubulares y de células fusiformes (CMTF)son un subtipo relativamente infrecuente de carcinomarenal (CCR). Están compuestos por célulastubulares y fusiformes con un estroma mucinoso.Generalmente son tumores de bajo grado y estánlimitados al riñón, por lo que habitualmente tienenbuen pronóstico. Reportamos dos nuevos casos deCMTF tratados en nuestra institución. MATERIAL Y MÉTODOS: Se realizó una revisiónde todos los tumores renales intervenidos en nuestrohospital desde el año 2008 has ta el año 2019, seleccionandolos pacientes diagnosticados de CMTF.Se evaluaron las características clinicopatológicasy la evolución de los pacientes. Así mismo, se realizóuna revisión exhaustiva de la literatura publicadapara comparar los hallazgos descritos con los denuestros casos. RESULTADOS: Dos pacientes fueron incluidos enel estudio, un varón de 50 años ( caso 1) y una mujer de55 años ( caso 2). El diagnóstico fue ecográfico, de forma incidental en el caso 1 y a partir del estudio de undolor en flanco, en el caso 2. El tratamiento fue quirúrgicomediante nefrectomía parcial y radical respectivamente.Tras un seguimiento medio de 70 meses ambospacientes están vivos y libres de enfermedad. CONCLUSIÓN: El carcinoma mucinoso tubular yde células fusiformes (CMTF) es un tumor renal infrecuente,habiéndose publicado aproximadamente doscentenares de casos. Aún hay incógnitas que resolversobre su diagnóstico y comportamiento, de ahí la importanciade reportar nuevos casos que nos permitanaumentar su conocimiento y mejorar el manejo denuestros pacientes.