“Displasia ósea florida: signos imagenológicos reportados en artículos odontológicos publicados entre el 2012 y 2021” / Florid bone dysplasia: imaging signs reported in dental articles published between 2012 and 2021

Introducción: Identificar los signos imagenológicos característicos de la displasia ósea florida reportados en artículos publicados en revistas odontológicas indexadas en la principal fuente de información de salud (Medline) entre el año 2012 al 2021. Materiales y métodos: Se llevó a cabo un estudio observacional, transversal y retrospectivo evaluando las principales revistas odontológicas encontradas en publicaciones entre los años 2012 al 2021 mediante la búsqueda electrónica en la base de datos de Medline vía PubMed, usando los términos (cemento-osseus displasia) AND (radiology), luego se procedió a depurar la muestra siguiendo los criterios de selección estipulados. Resultados: Se evaluó un total de 7 artículos que cumplieron con los criterios de selección en donde se recopiló la información de 363 casos de displasia ósea florida. Encontrándose en promedio esta lesión a los 51.88 años según la edad con predominio en el sexo femenino, en promedio 49.51 frente a 2.34 para el masculino. Según la ubicación de la lesión, los artículos muestran que es más frecuente en mandíbula con un promedio de 28 casos, seguido de ambos maxilares con 23.29 casos y muy raro en la maxila con 0.57 casos. Imagenológicamente los artículos describen lesiones radiolúcidas o hipodensas en promedio 2.29 casos, mixtas 36.57 casos y radiopacas o hiperdensas en promedio 20.29 casos. Conclusiones: De acuerdo a lo descrito en la literatura, la displasia ósea florida suele presentarse con mayor frecuencia en mujeres adultas, a partir de la quinta década de vida, disminuyendo su incidencia de la sexta década en adelante. Su localización más frecuente es en la mandíbula, en segundo lugar, en ambos maxilares y muy raramente solo en la maxila. Imagenológicamente se presentan con mayor incidencia con un patrón mixto. (AU)

Introduction: Identify the characteristic imaging signs of florid bone dysplasia reported in articles published in dental journals indexed in the main source of health information (Medline) between 2012 and 2021. Materials and methods: An observational, cross-sectional and retrospective study was carried out evaluating the main dental journals found in publications between the years 2012 and 2021 through the electronic search in the Medline database via PubMed. Using the terms (cemento-osseus dysplasia) AND (radiology), we then proceeded to refine the sample following the stipulated selection criteria. Results: A total of 7 articles that met the selection criteria were evaluated, where information from 363 cases of florid bone dysplasia was collected. Finding this lesion on average at 51.88 years according to age, with a predominance in the female sex, on average 49.51 compared to 2.34 for the male. Depending on the location of the lesion, the articles show that it is more frequent in the mandible with an average of 28 cases, followed by both maxillae with 23.29 cases and very rare in the maxilla with 0.57 cases. Imagingly, the articles describe radiolucent or hypodense lesions in an average of 2.29 cases, mixed 36.57 cases, and radiopaque or hyperdense lesions in an average of 20.29 cases. Conclusions: According to what has been described in the literature, florid bone dysplasia tends to occur more frequently in adult women, starting in the fifth decade of life, decreasing its incidence from the sixth decade onwards. Its most frequent location is in the mandible, secondly, in both jaws and very rarely only in the maxilla. Imaging, they present with a higher incidence with a mixed pattern. (AU)

Controlled Ovarian Stimulation Initiated at Different Phases of the Menstrual Cycle for Fertility Preservation in Oncological Patients: a Retrospective Study.

The purpose of this study is to compare conventional start in early follicular phase (EFP) with late follicular phase (LFP) and luteal phase (LP) in controlled ovarian stimulation (COS) for fertility preservation (FP) to assess differences in clinical outcomes. Retrospective study of the first cycles of COS for FP in oncological patients between 2012 and 2020 in a tertiary hospital. Two-hundred forty-eight cycles were classified into 3 groups: 176 cycles in EFP, 8 cycles in LFP, and 52 cycles in LP. Comparing LFP to EFP, there were no differences in number of oocytes (10.0 [6.3-16.0] vs 12.0 [8.0-18.0]; p = 0.253) or number of metaphase II (MII) obtained (7.0 [2.3-13.3] vs 9.0 [6.0-13.0]; p = 0.229). Total number of days needed was higher in LFP (14.5 [12.5-16.0] vs 3.0 vs 10.0 [8.3-11.0 p = 0.000) but without significant differences in number of days of usage of gonadotropins (11.5 [8.3-12.8] vs 10.0 [8.3-11.0] p = 0.308). No differences were found between LP and EFP in number of oocytes (14.5 [9.0-20.0] p = 0.151) or MII (11.5 [7.0-16.0] p = 0.084). Number of days of gonadotropins (11.0 [10.0-12.0] p = 0.00) and total dosing (3000.0 [2475.0-3600.0] p = 0.013) were significantly higher in LP. FORT and FOI were similar in all groups. COS with a random start in fertility preservation has similar outcomes to EFP start. Therefore, we can initiate COS at any phase of the menstrual cycle with optimal results. However, LP may need more days of stimulation.

Protocolo de optimización de uso de medicamentos biológicos en enfermedades inflamatorias inmunomediadas / Protocol for optimization of the use of biological drugs in immune-mediated inflammatory diseases

Objetivo: La artritis reumatoide (AR), espondilitis anquilosante, psoriasis (Ps), artritis psoriásica (APs) están mediadas por factor de necrosis tumoral (TNF). El objetivo es el diseño multidisciplinar de un protocolo personalizado de agentes biológicos en enfermedades reumáticas y dermatológicas. Métodos: Se seleccionaron pacientes con AR, APs, espondiloartritis y Ps que recibían etanercept o adalimumab durante al menos 6 meses ininterrumpidamente. La monitorización terapéutica consideró criterios bioquímicos y criterios clínicos. Rangos terapéuticos óptimos de adalimumab: 5-8 μg/mL para AR y APs, 3.2-7 μg/mL para Ps y 4.6-12 μg/mL para espondiloartritis. Rangos óptimos de etanercept fueron: 2-3 μg/mL para AR y espondiloartritis, y 2-7 μg/mL para Ps y APs. Resultados: Se realizaron propuestas de optimización del tratamiento en pacientes con adecuada respuesta clínica y niveles de fármaco biológico superiores al rango terapéutico óptimo. Si la propuesta de optimización fue aceptada por facultativo, se valoró percepción de la enfermedad del paciente al primer y tercer mes. Los pacientes con niveles plasmáticos de fármaco inferiores al rango terapéutico óptimo, ausencia de anticuerpos anti-fármaco y adecuada respuesta clínica fueron propuestos a optimización de tratamiento mediante discontinuación o espaciamiento de administración. Los pacientes con niveles plasmáticos de fármaco inferiores al rango óptimo y anticuerpos anti-fármaco fueron propuestos a cambio de tratamiento o discontinuación, si se pudiera alcanzar control de enfermedad. Conclusiones: Este protocolo permite la personalización terapéutica de etanercept y adalimumab para enfermedades inflamatorias inmunomediadas en áreas de dermatología y reumatología. La implantación del protocolo podría mejorar la eficacia, seguridad, conveniencia y eficiencia de etanercept y adalimumab. (AU)

Objective: Rheumatoid arthritis (RA), ankylosing spondylitis, psoriasis (Ps), psoriatic arthritis (PAs) are mediated by tumor necrosis factor (TNF). The objective is the multidisciplinary design of a personalized protocol of biological agents in rheumatic and dermatological diseases. Methods: Patients with RA, PAs, spondyloarthritis and Ps receiving etanercept or adalimumab for at least 6 months uninterruptedly were selected. Therapeutic monitoring considered biochemical criteria and clinical criteria. Optimal therapeutic ranges of adalimumab were: 5-8 μg/mL for RA and APs, 3.2-7 μg/mL for Ps and 4.6-12 μg/mL for spondyloarthritis. Optimal ranges of etanercept were: 2-3 μg/mL for RA and spondyloarthritis, and 2-7 μg/mL for Ps and APs. Results: Proposals were elaborated to optimize treatment in patients with adequate clinical response and levels of biological drug higher than the optimal therapeutic range. If the optimization proposal was accepted by the physician, the patient’s perception of disease was evaluated at the first and third months. Patients with plasma drug levels below the optimal therapeutic range, absence of anti-drug antibodies and adequate clinical response were proposed for treatment optimization by discontinuation or spacing of administration. Patients with plasma drug levels below the optimal range and anti-drug antibodies were proposed in exchange for treatment or discontinuation -if disease control could be achieved-. Conclusions: This protocol allows the therapeutic personalization of etanercept and adalimumab for immune-mediated inflammatory diseases in areas of dermatology and rheumatology. Implementation of the protocol could improve the efficacy, safety, convenience and efficiency of etanercept and adalimumab. (AU)

Evaluación de los comparadores empleados en los estudios pivotales de nuevos medicamentos e indicaciones / Assessment of comparators used in pivotal studies of new medicines and indications

Objetivo: En algunos casos, los estudios pivotales para aprobar nuevos medicamentos no emplean el comparador más adecuado. El objetivo es cuantificar este problema analizando los Informes de Posicionamiento Terapéutico (IPT) publicados por el Ministerio de Sanidad español.Métodos: El comparador se clasificó en seis categorías según la adecuación del tratamiento, es decir, si coincidía con el estándar de tratamiento al ser autorizado: A-“inicialmente adecuado”, B-“sin comparador por causa ética”, C-“sin comparador excluyendo los clasificados en B”, D-“inadecuado” y E-“parcialmente subóptimo” (cuando era estándar solo para parte de los pacientes).La variable principal fue la proporción de nuevos fármacos/indicaciones con comparación suficiente (categorías A, B y C) o deficiente (el resto). La información sobre comparadores y tratamiento estándar se extrajo del IPT. Resultados: Se analizaron aleatoriamente 186 IPT con nuevos medicamentos/indicaciones, publicados entre 2013 y 2022. La comparación se consideró suficiente en un 73,7% (IC95 66,9-79,5) de los casos. El 26,3% restante (IC95 20,5-33,1) presentaba comparaciones deficientes en el ensayo pivotal, ya fuera por comparador inadecuado (11,3%), parcialmente subóptimo (5,4%) o ausencia de un estudio comparativo (9,7%). No hubo diferencias en relación con el año de aprobación.Conclusiones: Aproximadamente uno de cada cuatro nuevos medicamentos o indicaciones carece de una comparación suficiente en el momento de empezar a ser utilizado en la práctica clínica. La proporción no mejora a lo largo de los últimos 10 años. Las agencias reguladoras deben ser más exigentes en la selección del comparador para los ensayos clínicos pivotales, por cuestiones éticas y sanitarias. (AU)

Objective: Pivotal studies to approve new medicines often do not use the most appropriate comparator. The objective is to quantify this problem by analysing the Therapeutic Positioning Reports (IPT for its acronym in Spanish) published by the Spanish Health Ministry.Methods: The comparator was classified into six categories, based on the appropriateness of the treatment, i.e. whether it matched the standard of treatment when authorised: A-«initially adequate» (at the start of the study), B-«no comparator for ethical reasons», C-«no comparator -excluding B-«, D-«inadequate» and E-«partially suboptimal» (when it was standard for part of the included patients but not for all of them).The primary endpoint was the proportion of new drugs/indications with sufficient (categories A, B and C) or poor comparator (the rest). Information on comparators and standard treatment was extracted from the IPT. Results: We randomly analysed 186 IPTs with new drugs or indications, published between 2013 and March 2022. Comparability was assessed as sufficient in 73.7% (95%CI 66.9-79.5) of cases. The remaining 26.3% (95%CI 20.5-33.1) had poor comparisons in the pivotal trial, either due to inadequate comparator (11.3%), partially suboptimal (5.4%) or absence of a comparative study excluding ethical justification (9.7%). Conclusions: Approximately one in four new medicines or indications lacks sufficient comparability at the time of entry into clinical practice. The proportion has not improved over the last 10 years. Regulatory agencies need to be more stringent in comparator selection for pivotal clinical trials, for ethical and health reasons. (AU)

How and when to use clozapine.

OBJECTIVE: Clozapine is the only approved strategy for treatment-resistant schizophrenia, although it is highly underutilized. We aim to generate practical and actionable evidence-based recommendations for the use of this drug considering prescription barriers. METHOD: Narrative review. RESULTS: A consistent body of evidence supports the efficacy of clozapine reducing morbidity and mortality in schizophrenia. The main obstacles to its use are the lack of experience by prescribers and perceived treatment burden. Systematic screening of eligibility, utilization of available resources for consultation, developing a professional network with other stakeholders, as well as optimizing how clozapine is presented to patients is discussed. Furthermore, specific evidence-based recommendations for initiation, maintenance, and safety monitoring with clozapine are provided. CONCLUSION: Clozapine prescription is one of the areas in psychiatry with the greatest mismatch between efficacy and utilization in clinical practice. Although multiple barriers to the use of clozapine exist, some of these may be overcome by updates of routine clinical practice.

Vivax malaria in a blood donor in Spain, relapse or a new infection in a malaria non-endemic country?

Malaria is a vectorborne disease caused by protozoan of the genus Plasmodium, which can also be transmitted by the transfusion of infected red blood cells. One year after return from a travel to Honduras, a Spanish traveller developed vivax malaria. Prior to the onset of symptoms, the donor made a donation that tested non-reactive using an immunological test for malaria. Samples from the donor taken before donation and tested by serological and molecular methods were negative but positive at the time of hospital admission. The possible sources of the donors' infection, imported versus locally acquired, are discussed.

New graphic AUC-based method to estimate overall survival benefit: pomalidomide reanalysis.

WHAT IS KNOWN AND OBJECTIVE: Difference in median survival is an erratic measure and sometimes does not provide a good assessment of survival benefit. The aim of this study was to reanalyse the overall survival benefit of pomalidomide from pivotal clinical trial using a new area under curve (AUC)-based method. COMMENT: In the pivotal trial, pomalidomide plus low-dose dexamethasone showed a significant survival benefit over high-dose dexamethasone, with a difference between medians of 4.6 months. The new AUC method applied to the survival curves, obtained an overall survival benefit of 2.6 months for the pomalidomide treatment. This average difference in OS was calculated for the 61.5% of patients for whom the time to event is reliable enough. WHAT IS NEW AND CONCLUSION: This 2-month differential would have major clinical and pharmacoeconomic implications, on both cost-effectiveness studies and on the willingness of the healthcare systems to pay for this treatment.

A novel nested multiplex PCR for the simultaneous detection and differentiation of Cryptosporidium spp., Enterocytozoon bieneusi and Encephalitozoon intestinalis.

Cryptosporidium spp. and microsporidia are opportunistic parasites affecting a wide range of hosts in which they can be potentially life threatening in immunocompromised individuals. Diagnosis usually relies on the identification of the stained Cryptosporidium oocyst or microsporidial spores, but these methods lack sensitivity and require highly trained technicians to perform and interpret the results. Molecular diagnosis offers an alternative with both superior sensitivity and specificity as compared to microscopy. Although replacing microscopy with nucleic acid based methods is hampered by the higher costs, in particular in developing countries, multiplexing the detection of more than one parasite in a single test has been found to be very effective and would decrease the cost of the test without the need for new equipment, as it would be the case for quantitative PCR. The method shown in this report for the simultaneous detection of Cryptosporidium spp., Enterocytozoon bieneusi and Encephalitozoon intestinalis by multiplex nested PCR, has proved to have several advantages versus microscopy such as higher sensitivity and specificity, low subjectivity and a minimal need for specialist's training to interpret the results. The present multiplex assay can fill an important gap to identify other possible causative agents of several diarrheal diseases which until present remain undiagnosed and can improve the epidemiology of the disease with a more reliable detection method.

Direct and indirect comparison of the efficacy and safety of adalimumab, etanercept, infliximab and golimumab in psoriatic arthritis.

WHAT IS KNOWN AND OBJECTIVE: Psoriatic arthritis is an autoimmune disease characterized by chronic inflammation of the skin and joints. Anti-TNF drugs reduce the severity of the disease in the long term. This study compares the efficacy and safety of adalimumab, etanercept, infliximab and golimumab in patients with psoriatic arthritis. METHODS: Direct comparison was based on a literature search of drug comparison studies, whereas indirect treatment comparison was based on phase III clinical trials with biological agents, involving similar populations and durations, and with the same outcome. ACR50 was taken as primary outcome for comparison, whereas ACR20 and ACR70 were used as secondary outcomes. Indirect comparisons were made using infliximab as the reference drug and the Bucher method. In calculating δ (the maximum acceptable difference as a clinical criterion of equivalence), use was made of half of the absolute risk reduction obtained in the meta-analysis of the clinical trials included in the indirect comparison (ARR 32%; δ: 16%). The four anti-TNF drugs were also compared in relation to the secondary outcomes and adverse effects. RESULTS AND DISCUSSION: Reported direct and indirect comparisons of the four drugs did not include golimumab, and did not yield conclusive results. Four clinical trials - one for each drug studied - were identified. The estimated differences for the primary outcome, ACR50, between infliximab and the other drugs were adalimumab (ARR 4%, 95% CI -9·5 to 17·5), etanercept (ARR 4%, 95% CI -10·5 to 18·5) and golimumab (ARR 9%, 95% CI -5·4 to 23·4). Likewise, there were no relevant differences between the drugs in relation to the secondary efficacy outcomes, except for etanercept, which was less effective in ACR70 response. For adverse reactions, there were also no significant differences except for injection site, reactions which were more frequent with etanercept, with a mean difference of 26% relative to infliximab. WHAT IS NEW AND CONCLUSION: No significant differences were found in ACR50 responses to the four drugs after 24 weeks. Injection-site reactions were more common with etanercept, but this was insufficient to invalidate the inference that clinically the four drugs can be regarded as clinically equivalent for the treatment of psoriatic arthritis.

Implicaciones clínicas de la determinación histológica de los micrornas en el cáncer colorrectal / Clinical implication of histological determination of micrornas in colorectal cancer

Los microRNAs son estructuras moleculares con actividad post-transcripcional que están implicados en la regulación de la expresión genética. Diversos estudios ponen de manifiesto la participación de los microRNAs con distintas funciones fisiológicas, así como con el proceso de la oncogénesis. La expresión de los microRNAs puede verse alterada en las neoplasias por su interacción bien con los genes supresores de tumores, bien con los oncogenes. Se ha llevado a cabo una revisión bibliográfica en PubMed acerca de la evidencia publicada sobre la determinación histológica de los microRNAs y la relación existente con el diagnóstico y el pronóstico del cáncer colorrectal. A pesar de ser preciso nuevos estudios clínicos que especifiquen la relación de los microRNAs con el cáncer colorrectal, se ha evidenciado una relación de estas estructuras con el diagnóstico y pronóstico de esta neoplasia (AU)

MicroRNAs are short non-coding RNA molecules involved in the regulation of gene expression. Several studies demonstrate the involvement of microRNAs with different physiological functions and oncogenesis. The expression of microRNAs may be altered in tumors by their interaction with tumor suppressor genes or with oncogenes. A literature review in PubMed was made about the evidence on the histological determination of microRNAs and the relationship with the diagnosis and prognosis of colorectal cancer. Although further clinical studies focusing on serum microRNAs are required to determine the relationship of microRNAs in colorectal cancer, the relationship of these structures with the diagnosis and prognosis of this neoplasm has been shown (AU)

[Temporomandibular joint dysfunction, disability and oral health in a community-dwelling elderly population]. / Disfunción temporomandibular, discapacidad y salud oral en una población geriátrica semi-institucionalizada.

INTRODUCTION: Temporomandibular joint dysfunction (TMD) is involved in important activities of the stomatognathic system for nutrition, such as chewing or swallowing. If the physiological tolerance of its components is exceeded, it can trigger symptoms of temporomandibular dysfunction (TMD). OBJECTIVES: To assess and relate the symptoms of TMD, functional limitations and estimates of self-perceived oral health and general geriatric population in a communitydwelling elderly population. METHODS: An observational study was performed. Ninetyfour persons belonging to units of Granada Geriatric Day were assessed symptoms of TMD (Helkimo Simplified Index), pain (VAS scale), functional limitation of stomatognathic system (research diagnostic criteria for temporomandibular disorders CDI/TTM), jaw opening index, general health index (1-5) and oral health (geriatric oral health assessment). RESULTS: In the total sample, 42.7% had at least one symptom of TMD. The most common symptoms were muscular fatigue (26.6%), noise (21.3%) and TMD pain (14.9%). The most common non-specific symptoms in the symptomatic group were neck pain and nervousness. A 48.9% of the sample had functional limitation in orofacial activities. Also, there was a statistically significant association (p<0.05) between the jaw opening index and symptomatic and asymptomatic groups with TMD. CONCLUSIONS: In the group with symptoms of TMD were more common temporomandibular joint departures and pain, and they presented lower values in oral and general health self-perception.

Identification of a novel Assemblage B subgenotype and a zoonotic Assemblage C in human isolates of Giardia intestinalis in Egypt.

Giardia intestinalis (G. intestinalis) is a flagellate parasite which has been considered the most common protozoan infecting human. Molecular techniques are of great value in studying the taxonomy, the zoonotic potential of animal isolates and the correlation between the genetic variability of the parasite and the range of clinical symptoms observed in humans. The present work aims at genotyping G. intestinalis isolates from Egypt using molecular techniques. PCR targeting the ß-giardin locus, RFLP and sequencing were applied to 12 microscopically positive and 3 microscopically negative samples (which were positive by real time PCR targeting SSUr DNA). Two other loci, triose phosphate isomerase (TPI) gene and glutamate dehydrogenase (GDH) gene PCR and RFLP were also applied to all study isolates. The most frequent genotype was Assemblage B (13 out of 15), while Assemblage A and C were present in one sample each. This is the first report on zoonotic transmission of Assemblage C (dog genotype) to human in Egypt. Sequencing of the Assemblage B isolates revealed new subgenotypes with consistent mutations at specific positions, some of which were not characterized previously. The results shed light on the possibility that G. intestinalis can infect humans through a zoonotic route and open the door to wider investigations using different genetic loci to genotype Giardia isolates.

Criopreservación ovárica en niñas con cáncer: nuevos retos / Ovarian cryopreservation in girls with cancer: new challenges

Objetivos. La criopreservación de la corteza ovárica (CCO) para futuro autotrasplante permitirá hacer frente al fallo ovárico precoz y a las alteraciones de la capacidad reproductiva que afectan a algunas delas supervivientes de cáncer pediátrico. Material y métodos. En el Programa de Preservación de Fertilidad en Oncología Pediátrica se incluyen pacientes con alto riesgogonadotóxico: las que vayan a recibir radioterapia pélvica, trasplante de precursores hematopoyéticos, altas dosis de radioterapia craneal o agentes alquilantes, o aquéllas con patología ovárica bilateral. Antes del tratamiento oncológico y coincidiendo con otros procedimientos invasivos, se recoge el tejido ovárico por vía laparoscópica. Una vez descartada la malignidad en la muestra y confirmada la presencia de folículos primordiales, el equipo multidisciplinar de oncólogo, cirujano y especialista en fertilidad coordina la manipulación y envío de la corteza ovárica al Banco de Tejidos de la Comunidad Valenciana. Resultados. De julio de 2008 hasta mayo de 2010 se incluyeron en el programa a 8 pacientes, entre 8 y 18 años, con diagnóstico de: linfoma de Hodgkin (n= 2), leucemia aguda linfoide y mieloide (n= 2),sarcoma de Ewing pélvico, teratoma ovárico bilateral y meduloblastoma. Cinco pacientes recibieron quimioterapia no gonadotóxica previa a la CCO. De forma adicional, se practicaron 6 procedimientos en el mismo acto anestésico. Se realizó o oforectomía parcial en la mitad delos casos y total en el resto, asociando pexia ovárica en 1 ocasión. Todas las muestras fueron válidas. Conclusiones. La CCO de los casos seleccionados se realizó de forma segura, sin complicaciones ni demora del tratamiento oncológico. Podemos afi rmar que la primera experiencia nacional en este tipo de abordaje ha sido satisfactoria (AU)

Background. Ovarian cortex cryopreservation (OCC) for future autotransplant represents a treatment alternative for those paediatriccancer survivors affected of ovarian failure and fertility disorders. Methods. Patients with high gonadotoxic risk are included in the Oncology Paediatric Fertility Preservation Programme: those receiving pelvic radiotherapy, bone marrow transplantation, high doses of cranial radiotherapy or alquilating agents, or those with bilateral ovarian pathology. Prior to the oncological treatment, the ovarian tissue is harvested laparoscopically. At the same time, other invasive procedures are done. Once malignancy is ruled out of the specimen and the presence of primordial follicles is confirmed, the multidisciplinary team of oncologist, paediatric surgeon and fertility specialist coordinate the processing and delivery of the ovarian cortex to the Comunidad ValencianaTissue Bank. Results. From July 2008 to May 2010 eight patients have been included in the programme, aged between 8-18 years old and with diagnosis of: Hodgkin’s lymphoma (n= 2), Acute Myeloblastic and Lymphoblasticleukaemia (n= 2), pelvic Ewing’s sarcoma, bilateral ovarian Teratoma and Meduloblastoma. Five patients underwent non gonadotoxicchemo therapy before OCC. Six additional procedures were doneusing the same anaesthetic event. Partial oophorectomy was performed in half the cases, total oophorectomy in the rest of them, and an ovarianpexia was once associated. All taken samples were found to be valid. Conclusions. OCC of selected patients was performed safely, with neither postoperative complications nor delay of the oncological treatment. Therefore, the fi rst national experience in this procedure has been satisfactorily achieved (AU)

Microrna-21 y cáncer colorrectal / Microrna - 21 and colorectal cancer

Introducción. Los microRNAs son estructuras moleculares con actividad post-transcripcional que están implicados en la regulación de la expresión genética. Diversos estudios ponen de manifiesto la participación de los microRNAs con distintas funciones fisiológicas, así como con el proceso de la oncogénesis. La expresión de los microRNAs puede verse alterada en las neoplasias por su interacción bien con los genes supresores de tumores, bien con los oncogenes. Discusión. Llevamos a cabo una revisión de la literatura sobre el microRNA-21, poniendo de manifiesto la evidencia existenteentre el microRNA-21 y la enfermedad neoplásica, de forma especial con el cáncer colorrectal. Conclusiones. El estado actual de los microRNAs hace necesario continuar con la investigación existente entre la etiopatogenia de las neoplasias y los microRNAs. El conocimiento de la verdadera implicación de los microRNAs en la fisiopatología de la enfermedad neoplásica, permitirá ampliar las supuestas aplicaciones clínicas del miR-21 no sólo a la determinación del pronóstico del cáncer colorrectal, sino también desde el punto de vista diagnóstico al poder diferenciar las lesiones de la mucosa colónica (AU)

Introduction. MicroRNAs are molecular structures with post-transcriptional activity, involved in the gene expression regulation. Several studies have demonstrated the involvement of microRNAs in different physiological functions, as well as in the oncogenesis process. The expression of microRNAs may be altered in the tumors by either interaction with tumor suppressor genes or oncogenes. Discussion. A review of the medical literature on microRNA-21 has been conducted, showing the evidence between microRNA-21 and neoplastic disease, specially with colorectal cancer. Conclusion. The current status of microRNAs makes necessary to continue the investigation of the pathogenesis of cancer and microRNAs. The knowledge of the involvement of microRNAs in the pathophysiology of neoplastic disease, will allow to extend the supposed clinical applications of miR-21 not only to the determination of the prognosis of colorectal cancer, but also for the differential diagnosis of processes of colonic mucosae (AU)

[Ovarian cryopreservation in girls with cancer: new challenges]. / Criopreservación ovárica en niñas con cáncer: nuevos retos.

BACKGROUND: Ovarian cortex cryopreservation (OCC) for future autotransplant represents a treatment alternative for those paediatric cancer survivors affected of ovarian failure and fertility disorders. METHODS: Patients with high gonadotoxic risk are included in the Oncology Paediatric Fertility Preservation Programme: those receiving pelvic radiotherapy, bone marrow transplantation, high doses of cranial radiotherapy or alquilating agents, or those with bilateral ovarian pathology. Prior to the oncological treatment, the ovarian tissue is harvested laparoscopically. At the same time, other invasive procedures are done. Once malignancy is ruled out of the specimen and the presence of primordial follicles is confirmed, the multidisciplinary team of oncologist, paediatric surgeon and fertility specialist coordinate the processing and delivery of the ovarian cortex to the Comunidad Valenciana Tissue Bank. RESULTS: From July 2008 to May 2010 eight patients have been included in the programme, aged between 8-18 years old and with diagnosis of: Hodgkin's lymphoma (n= 2), Acute Myeloblastic and Lymphoblastic leukaemia (n= 2), pelvic Ewing's sarcoma, bilateral ovarian Teratoma and Meduloblastoma. Five patients underwent non gonadotoxic chemotherapy before OCC. Six additional procedures were done using the same anaesthetic event. Partial oophorectomy was performed in half the cases, total oophorectomy in the rest of them, and an ovarian pexia was once associated. All taken samples were found to be valid. CONCLUSIONS: OCC of selected patients was performed safely, with neither postoperative complications nor delay of the oncological treatment. Therefore, the first national experience in this procedure has been satisfactorily achieved.

Complicaciones del aumento mamario con Macrolane®. A propósito de un caso / No disponible

El aumento mamario estético es un procedimiento popular y en alza. Gran variedad de materiales se han propuesto y utilizado, siendo el último comercializado el ácido hialurónico o Macrolane®. Se describe el caso de una paciente que 2 años antes se sometió a una implantación de Macrolane en ambas mamas con finalidad estética y que presenta complicaciones como encapsulamiento del material, dificultad para el diagnóstico por la imagen y un pobre resultado cosmético(AU)

The aesthetic breast augmentation is a popular and increasing surgical technique. There are a lot of possible materials for this use, but the latest authorized is the hyaluronic acid or Macrolane®. We present a case of a woman with a history of injection of Macrolane® for aesthetic augmentation two years ago. She developed adverse effects like capsular contracture, difficulty for interpretation of radiological studies and poor cosmetic result(AU)