Experiencia de elastografía strain en 2 casos de lesiones subcutáneas sospechosas de malignidad / Our Experience With Strain Elastography in 2 Cases of Suspected Malignant Subcutaneous Lesions

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Concentration-dependent effects of acute and chronic neonicotinoid exposure on the behaviour and development of the nematode Caenorhabditis elegans.

BACKGROUND: Neonicotinoid insecticides are under review owing to emerging toxicity to non-target species. Interest has focused on biological pollinators while their effects on other organisms that are key contributors to the ecosystem remain largely unknown. To advance this, we have tested the effects of representatives of three major classes of neonicotinoids, thiacloprid, clothianidin and nitenpyram, on the free-living nematode Caenorhabditis elegans (C. elegans), as a representative of the Nematoda, an ecologically important phylum contributing to biomass. RESULTS: Concentrations that are several-fold higher than those with effects against target species had limited impact on locomotor function. However, increased potency was observed in a mutant with a hyperpermeable cuticle, which shows that drug access limits the effects of the neonicotinoids in C. elegans. Thiacloprid was most potent (EC50 714 µm). In addition, it selectively delayed larval development in wild-type worms at 1 mm. CONCLUSION: C. elegans is less susceptible to neonicotinoids than target species of pest insect. We discuss an approach in which this defined low sensitivity may be exploited by heterologous expression of insect nicotinic acetylcholine receptors from both pest and beneficial insects in transgenic C. elegans with increased cuticle permeability to provide a whole organism assay for species-dependent neonicotinoid effects. © 2017 Society of Chemical Industry.

Tumor fibroso solitario en la región temporal: a propósito de un caso / Solitary fibrous tumour in the temporal region: Presentation of a case

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El sistema cutáneo, nuevo capítulo en el baremo médico / The Skin, a new chapter in the Medical Scale

En el baremo médico contenido en el Real Decreto 8/2004 no se contemplan las alteraciones en el sistema cutáneo como responsables de menoscabo físico; se valora el menoscabo estético que produce en los lesionados. La inclusión de este capítulo en el nuevo baremo médico de autos viene determinada por la importancia de la piel, como sistema corporal, primordialmente por su función, reguladora de múltiples procesos en el individuo, y por su extensión. La valoración de las alteraciones del sistema cutáneo se realizará principalmente en quemaduras profundas y extensas, así como en lesiones que produzcan trastornos dermatológicos, teniendo en cuenta el porcentaje de superficie corporal afectada y el modo de reparación. La puntuación se puede complementar con las alteraciones funcionales en otros sistemas si las hubiera, así como con el perjuicio estético producido. El resto de las lesiones en la piel que no ocasionan menoscabo funcional, fundamentalmente cicatrices no patológicas, se valoran exclusivamente en el capítulo del perjuicio estético (AU)

The Medical Scale contained in the Real Decreto 8/2004 did not consider the skin alterations as the cause of the physical impairment, it only contemplated the aesthetic impairment which produce in the injuried person. Including this new chapter is determined by the importance of the skin as a essential body system due to its function as a regulatory system for a wide range of processes and its large area. The skin assesment will be mainly done in deep and extensive burns, as well as injuries which produce dermalotogic disorders, taking into acount the body surface percentage afected and the way it can be repared. The score can be supplemented with the functional disorders in other systems in case they exist, as well as the aesthetic damage suffered. The other skin injuries which do not cause functional impairment, essentialy no pathologic scars, will be assesed exclusively in the aesthetic damage chapter (AU)

[Body's integumentary restoration after autopsy: legislative, technical and ethical issues]. / Restauration des corps après autopsies : aspects législatifs, techniques et éthiques.

In France, families of the deceased raised concerns as regards to the conditions of restoration of body. If scientists hospital autopsies are organized by the Bioethics Law of August 6, 2004, the forensic autopsies were so far not provided with such a legal framework. The legislator has proposed the creation of a new chapter in the Code of Criminal Procedure institutionalizing forensic activities. This legislative evolution allows the harmonization of practices; forensic pathologists must be involved in these changes by bringing their scientific expertise, notably through improving their autopsy techniques.

Fluazuron-induced morphophysiological changes in the cuticle formation and midgut of Rhipicephalus sanguineus Latreille, 1806 (Acari: Ixodidae) nymphs.

The present study demonstrated the effects of the arthropod growth regulator, fluazuron (Acatak®), in the formation of the integument and digestive processes of Rhipicephalus sanguineus nymphs fed on rabbits treated with different doses of this chemical acaricide. For this, three different doses of fluazuron (20, 40, or 80 mg/kg) were applied "pour on" to the hosts (groups II, III, and IV), as well as distilled water to the control group. On the first day after treatment (24 h), the hosts were artificially infested with R. sanguineus nymphs. After full engorgement (7 days), the nymphs were removed, placed on labeled Petri dishes, and kept in biochemical oxygen demand incubator for 7 days. The engorged nymphs were then taken for morphological, histochemical, and histological analyses. The results showed the occurrence of cytological, morphohistological, and histochemical alterations in the integument and midgut of nymphs from all the different treated groups. These alterations occurred at cuticular level in the subdivisions of the cuticle, related to the size of the digestive cells, amount of accumulated blood elements, and digestive residues, as well as the presence of vacuoles in the cytoplasm of the digestive cells. Thus, this study demonstrated that fluazuron acts on the integument and midgut cells of R. sanguineus nymphs fed on treated rabbits and pointed out the possibility of the use of this chemical-which is more specific, less toxic, and less harmful to the environment and nontarget organisms-in the control of R. sanguineus, at least in the nymphal stage of its biological cycle.

Termómetros de mercurio, aún tóxicos aún presentes / Mercury thermometers, still toxic, still present

Los termómetros de mercurio han sido y son, a pesar de la prohibición de su fabricación, una de las principales fuentes de exposición en la edad pediátrica al mercurio (Hg) elemental en nuestro medio. La toxicidad producida por el Hg elemental depende de la vía de exposición y de la duración de la misma. La exposición a través del tracto digestivo no produce prácticamente toxicidad, pero la inoculación subcutánea o endovenosa y la inhalación puede producir lesiones a nivel local o sistémico. Presentamos el caso clínico de una niña, que presentó inoculación de mercurio líquido en tejido subcutáneo tras la rotura de un termómetro de cristal, produciéndose daño a nivel local con este atonecrosis del tejido. El diagnóstico se realizó mediante estudio radiológico y precisó intervención quirúrgica urgente con escisión en cuña de piel y tejido subcutáneo, guiada con radioscopia. Se descartó la extensión a nivel sistémico, comprobándose la normalidad de los niveles de mercurio en sangre y orina(AU)

Mercury thermometers are and have been, despite their manufacture being banned, one of the main sources of exposure at the paediatric age to elementary mercury (Hg) in our environment. The toxicityproduced by elementary Hg depends on the exposure channel and its length. Exposure through the digestive tract produces hardly any toxicity, but subcutaneous or intravenous inoculation and inhalation of mercury may produce damages at a local or system level. We present the case of a child who showed inoculation of liquid mercury in subcutaneous tissue after a liquid-in-glass thermometer broke. This provoked damages at a local level with steatonecrosis of the tissue. The diagnosis was decided through a radiological test and required urgent surgery with excision of skin and subcutaneous tissue, guided by radioscopy. Any spread at a system level was discarded. The levels of mercury in the bloodstream and in the urine were regular (AU)

Hamartoma fibroso de la infancia Fibrous hamartoma of infancy

El hamartoma fibroso de la infancia (HFI) es un tumor mesenquimal benigno infrecuente, que cursa como un nódulo subcutáneo único en niños menores de 2 años. Tiene una anatomía patológica característica, con un patrón organoide trifásico, y el tratamiento de elección es quirúrgico. Presentamos un caso con los hallazgos característicos de HFI, así como con cambios cutáneos (dilatación de las glándulas ecrinas) y un amplio estudiode inmunohistoquímica. Finalmente comentamos el diagnóstico diferencial de los tumores fibrosos de la infancia (AU)

Fibrous hamartoma of infancy (HFI) is a rare benign mesenchymal tumor. It is presented as a single subcutaneous tumor in children in the first two years of life. The lesion has a characteristic morphology with a triphasic organoid growth pattern, and the treatment of choice is local excision. We report a case with the distinctive histologic appearance of HFI and cutaneous changes (dilatation of eccrine glands) and a extensive immunohistochemestry study. Finally, differential diagnosis of fibrous tumors of infancy are discussed (AU)

Clinical observations of black disease in fairy shrimps, Streptocephalus sirindhornae and Branchinella thailandensis, from Thailand and pathogen verification.

In this study, black disease infecting fairy shrimps, Streptocephalus sirindhornae Sanoamuang, Murugan, Weekers & Dumont, and Branchinella thailandensis Sanoamuang, Saengphan & Murugan, in Thailand, was investigated. The typical signs of the disease are the appearance of black spots on the cuticle, located mainly on the dorsal side and thoracopods. A number of rod-shaped bacteria aggregated in the black spots and were visualized by scanning electron microscopy. The histopathological results showed that a haemocytic response to the infection resulted in a dense melanized core of bacteria. In addition, generalized septicaemia by rod-shaped bacteria was also observed in the infected tissue. Of the 31 isolates, Aeromonas spp. were predominantly isolated and six strains were selected for the experimental infections. The most pathogenic strain was identified molecularly as A. hydrophila. When fairy shrimp were infected at bacterial concentrations of 10(4) and 10(6) cfu mL(-1) , the overall infection levels were 73.33 ± 6.67% and 93.33 ± 6.67%, respectively. The experimentally infected fairy shrimp showed abnormal swimming and died within 24-48 h after the appearance of the dark pigment.

Effect of cuticular abrasion and recovery on water loss rates in queens of the desert harvester ant Messor pergandei.

Factors that affect water loss rates (WLRs) are poorly known for organisms in natural habitats. Seed-harvester ant queens provide an ideal system for examining such factors because WLRs for mated queens excavated from their incipient nests are twofold to threefold higher than those of alate queens. Indirect data suggest that this increase results from soil particles abrading the cuticle during nest excavation. This study provides direct support for the cuticle abrasion hypothesis by measuring total mass-specific WLRs, cuticular abrasion, cuticular transpiration, respiratory water loss and metabolic rate for queens of the ant Messor pergandei at three stages: unmated alate queens, newly mated dealate queens (undug foundresses) and mated queens excavated from their incipient nest (dug foundresses); in addition we examined these processes in artificially abraded alate queens. Alate queens had low WLRs and low levels of cuticle abrasion, whereas dug foundresses had high WLRs and high levels of cuticle abrasion. Total WLR and cuticular transpiration were lowest for alate queens, intermediate for undug foundresses and highest for dug foundresses. Respiratory water loss contributed ~10% of the total WLR and was lower for alate queens and undug foundresses than for dug foundresses. Metabolic rate did not vary across stages. Total WLR and cuticular transpiration of artificially abraded alate queens increased, whereas respiratory water loss and metabolic rate were unaffected. Overall, increased cuticular transpiration accounted for essentially all the increased total water loss in undug and dug foundresses and artificially abraded queens. Artificially abraded queens and dug foundresses showed partial recovery after 14 days.

Ulcerative disease outbreak in crayfish Orconectes propinquus linked to Saprolegnia australis in big Muskellunge Lake, Wisconsin.

Crayfish populations in the area of the North Temperate Lakes Long Term Ecological Research (LTER) project, Wisconsin, USA, have been monitored for >25 yr. In 2005, native crayfish Orconectes propinquus from Big Muskellunge Lake were found with ulcerated lesions in the cuticle. In 2006, lesions occurred in 9.5% of sampled crayfish from the lake (n=3146). Ulcers generally occurred on the appendages of affected individuals but varied in location and severity. The prevalence of ulcers varied widely among sites, sample depths, and sampling dates, ranging from < 2% to >20%. The prevalence of ulcers in crayfish increased from a minimum in early June to a maximum in late July and August. In aquarium trials, healthy crayfish representing either O. propinquus or O. rusticus co-housed with ulcerated crayfish did not develop ulcers within 4 wk of exposure. Gross and histopathologic analyses of ulcerated crayfish revealed the presence of filamentous hyphae in the lesions while hemocytic infiltrates, melanotic reactions and silver-stained sections indicated that the ulcers had an oomycete etiology. Excised samples of ulcerated crayfish cuticle grown in culture developed an oomycete that was identified as Saprolegnia australis by PCR amplification and sequence analysis of 2 different DNA fragments. This is the first report of the occurrence of ulcers in wild crayfish associated with S. australis infection in the U.S.A. The advent of the outbreak and its underlying ecological causes are still under investigation.

Molt stage and cuticle damage influence white spot syndrome virus immersion infection in penaeid shrimp.

Transmission of white spot syndrome virus (WSSV) in shrimp has been reported to occur by feeding and immersion. In the present study, the impact of the molt process and artificial lesions in the cuticle on shrimp susceptibility to WSSV was examined using intramuscular and immersion routes. For the intramuscular route, Penaeus (Litopenaeus) vannamei shrimp (n=450) were injected with 10(-2.3) up to 10(2.7) shrimp infectious dose 50% end point (SID(50)) of WSSV in early and late post-molt, inter-molt, early and late pre-molt; resp. A-, B-, C-, D1- and D2-stage. The resulting infection titers demonstrated that no difference (p>0.05) in susceptibility existed between different molt stages when virus was injected. For the waterborne route, shrimp in different molt stages were immersed in seawater containing 10(4)SID(50)ml(-1) of WSSV. In a first study, P. vannamei (n=125) incubated in cell culture flasks, became infected with WSSV mostly in post-molt stages. In a second study, 2 groups of P. vannamei (n=100) and P. monodon (n=100) were transferred into plastic bags to prevent damage to the cuticle; and in 1 group a pleopod was cut off prior to incubation. Induction of damage increased infection significantly (p<0.05) in A-stage from 0-40% to 60-100%, in B-stage from 0-20% to 40-60%, in C-stage from 0-20 to 20-60%, while infection was 0% in D-stages with both immersion methods. This study proved that shrimp are more susceptible to WSSV infection via immersion after molting than in the period before molting and wounding facilitates infection.

Effects of epizootic shell disease in American lobster Homarus americanus determined using a quantitative disease index.

The incidence of epizootic shell disease in American lobster Homarus americanus has increased in southern New England, U.S.A., in the last decade, but few longitudinal studies have followed the disease progress in individual lobsters or demonstrated direct effects on mortality or growth. Diseased lobsters were held in the laboratory for 1 yr, and the progression of disease and its effects on molting, mortality, and growth were monitored. A quantitative disease index (QDI) was developed by measuring disease lesions in digital images of the carapace and expressing the result as a proportion of shell area. Some lobsters died due to high temperatures, but at least 13 of 55 lobsters (24%) died as a direct result of disease-related problems, mostly during molting, and there was a significant relationship between mortality and high values of the QDI. Lobsters that molted successfully were free of disease lesions, but many had exoskeletal deformities. There was no relationship between pre-molt size and disease severity, but molt increment was significantly correlated with premolt carapace length (CL) and negatively correlated with QDI. However, percentage growth was negatively correlated with QDI, but not with pre-molt CL. These significant lethal and sublethal effects of epizootic shell disease should be considered in lobster management.

CD34-reactive tumors of the skin. An updated review of an ever-growing list of lesions.

Over the past few years, a growing number of cutaneous tumors expressing CD34 is being reported. The list contains benign and malignant neoplasms as well as reactive and hamartomatous lesions of diverse lineages of differentiation, including fibroblastic, myofibroblastic, fibrohistiocytic, vascular, neural, adipocytic, smooth muscle, hematopoietic, melanocytic and epithelial. The more frequent diagnostic difficulties are found in spindle cell proliferations, mainly in those of the fibrocytic lineage. In part, this is because of the fact that in this area are, aside to well-defined entities, histologically and clinically diverse, recently reported cutaneous CD34-reactive lesions, whose definitions, limits and relationships are not completely established. The CD34 expression plays a key role in the differential diagnosis of some tumors, such as dermatofibrosarcoma protuberans, epithelioid sarcoma (ES) or pleomorphic hyalinizing angiectatic tumor of soft parts, with important therapeutic consequences. In others, as in desmoplastic trichilemmoma, it can help to resolve diagnostic problems in concrete cases. Finally, in many of the CD34-positive lesions, the diagnosis with the hematoxylin and eosin stain is straightforward. However, in all of them, the knowledge of the immunohistochemical profile contributes to our understanding of the cutaneous pathology.

The problem of subepidermal blisters in neoformed integuments.

The present paper is a review of articles on the onset of subepidermal blisters in neoformed integuments. Considering the discrepancy between the literature data and our clinical experience concerning spontaneous onset of subepidermal blisters in neoformed integuments, we decided to conduct an extensive review of the literature. The main finding arising from it was the lack of characterization of the neoformed integument where the blisters were formed. These were normally referred to only by clinical descriptions such as "spontaneously healed burn", "grafted site", "donor site", "epidermal graft". Anatomical and clinical pathology aspects such as the formation mechanism of these integuments and the respective tissues that comprise them were not considered. We concluded that by adopting more precise criteria to classify neoformed integuments we would realize that split thickness grafts are not susceptible to blister formation.

Early post-larval development of the endoparasitic platyhelminth Mesocestoides corti: trypsin provokes reversible tegumental damage leading to serum-induced cell proliferation and growth.

Mesocestoides corti is a suitable in vitro model for studying the development of human endoparasitic platyhelminthes. Treatment with trypsin, supplemented with fetal bovine serum (FBS), induces M. corti development from larvae (tetrathyridia) to segmented adult worm; however, the role of this protease and of FBS in post-larval development induction remains unknown. To characterize the participation of trypsin enzymatic activity and of FBS in the induction of tetrathyridia growth and development, both stimuli were added to the larvae either together or sequentially. Additionally, specific inhibition of trypsin activity was also monitored. Finally, the effect of the enzyme on the parasite tegument as well as the proliferative activity and location of proliferating cells after induction of tetrathyridia development were also studied. We conclude that trypsin-induced tetrathyridia development to adult worm is FBS-dependent and that the effect of serum factors is dependent upon a previous trypsin-induced reversible damage to the larva tegument. In dividing and non-dividing tetrathyridia, proliferative activity of cells is mainly located within the apical massif in the anterior region and nerve cords of larvae, respectively. In tetrathyridia stimulated to develop to adult worms, an intense proliferative activity is evident along the nerve cords. Our results suggest that in natural infections the tetrathyridia tegument is temporally made permeable to growth factors by proteolytic enzyme activity in the intestine juice of the definitive host, thus leading to development to adult worms.

Servicio enfermero ofertado en una unidad de hospitalización de Nefrología / Nursing services offered in a hospital unit for nephrology

La aportación de la disciplina enfermera se concreta en la prestación de cuidados, y el proceso de enfermería permite reconocer la aportación de las enfermeras a los resultados de salud del paciente. En el Servicio Vasco de Salud (Osakidetza) se trabaja con el programa informático Zaineri, que recoge bajo soporte informático todos los cuidados y actividades que la enfermera realiza en la práctica diaria. Es fundamental que en las unidades se analice qué servicio estamos ofertando a nuestros clientes. Por ello el objetivo de este trabajo es describir el trabajo que realizan las enfermeras de Nefrología, a través del análisis de las necesidades alteradas de los pacientes ingresados y de los diagnósticos de enfermería planteados durante el año 2002. Material y método: estudio descriptivo de los planes de cuidados de los pacientes ingresados en la unidad entre el 1 de Enero de 2002 y el 31 de Diciembre de 2002. Resultados: del total de necesidades planteadas, el 65,30% pertenecen al área independiente de Enfermería mientras un 34,70% pertenecen al área interdependiente. Los diagnósticos derivados de Necesidades Humanas corresponden al 56,63% sobre el total, mientras aquellos diagnósticos (complicaciones) derivados de los sistemas, tienen un porcentaje del 43,37% (AU)

Nursing skills are offering a number of services to the patient, including its care. Nursing processes allow the identification of results on the patient´s health. In the Vasc Service of Health (Osakidetza) we work with the programme Zaineri that collects all processes done by nurses in their daily activities. Is is important to analyze what kind of service we are offering to our clients, therefore, the aim of this work is to describe the work done by nurses of nephrology through the analysis of the patient´s needs and nursing diagnosis during 2002. Material and methods: descriptive study of the care plan for patients from Jan 1st 2002 to Dec 31st 2002. Results: from all needs analyze, 65% belong to the nurse independent area, while 34% belong to the interdependent area. Diagnosis obtained from human needs are 57% while those obtained from systems are 43% (AU)

Morpho-regulation of ectodermal organs: integument pathology and phenotypic variations in K14-Noggin engineered mice through modulation of bone morphogenic protein pathway.

Ectodermal organs are composed of keratinocytes organized in different ways during induction, morphogenesis, differentiation, and regenerative stages. We hypothesize that an imbalance of fundamental signaling pathways should affect multiple ectodermal organs in a spatio-temporal-dependent manner. We produced a K14-Noggin transgenic mouse to modulate bone morphogenic protein (BMP) activity and test the extent of this hypothesis. We observed thickened skin epidermis, increased hair density, altered hair types, faster anagen re-entry, and formation of compound vibrissa follicles. The eyelid opening was smaller and ectopic cilia formed at the expense of Meibomian glands. In the distal limb, there were agenesis and hyperpigmentation of claws, interdigital webbing, reduced footpads, and trans-differentiation of sweat glands into hairs. The size of external genitalia increased in both sexes, but they remained fertile. We conclude that modulation of BMP activity can affect the number of ectodermal organs by acting during induction stages, influence the size and shape by acting during morphogenesis stages, change phenotypes by acting during differentiation stages, and facilitate new growth by acting during regeneration stages. Therefore during organogenesis, BMP antagonists can produce a spectrum of phenotypes in a stage-dependent manner by adjusting the level of BMP activity. The distinction between phenotypic variations and pathological changes is discussed.