Special-point approach for optical absorption coefficient calculations on two-dimensional self-assemblies of type-II perovskite quantum dots.

All-inorganic perovskite quantum dots with the usual cubic shape have emerged as a successful and low-cost alternative to electronically functional nanomaterials motivating various fields of applications, including high-efficiency photovoltaics. Here, we present an efficient and almost analytic approach for optical absorption coefficient calculation on self-assembled perovskite quantum dot films with type-II band alignment. The approach takes advantage of the special point technique for integration over the two-dimensional Brillouin zone, which minimizes the computational cost. The set of special wave-vector points is generated using the Monkhorst and Pack method. The optical absorption spectrum for phenyl-C60-butyric acid methyl ester (PCBM)/CsPbI3quantum dot films is computed, in good agreement with the experiment assuming a homogeneous linewidth of 50 meV and considering a ten special-point set. We show that light absorption in these systems is a cooperative optoelectronic property resulting from the quantum-mechanical coupling between perovskite nanocubes, leading to extended system states. The generality of this approach makes it suitable for calculating the optical absorption coefficient in a broad class of perovskite quantum dot systems.

Monitorización neurofisiológica intraoperatoria en cirugía de columna / Neurophisiologic monitoring in spinal surgery

The most feared complication in spinal surgeries is damage to the spinal cord due to inadvertent compression or interference in the blood supply with the consequent motor and/or sensory déficit. Intraoperative physiological surveillance reduces the risk of generating direct damage or due to hypoxia, helping in the early detection of complications. Publications in the Pubmed database are reviewed.

La complicación más temida en las cirugías de columna es el daño de la médula espinal por una compresión inadvertida o interferencia en el aporte sanguíneo con el consiguiente déficit motor y/o sensitivo. La vigilancia fisiológica intra operatoria disminuye el riesgo de generar daño directo o por hipoxia, ayudando en la detección temprana de las complicaciones. Se revisan publicaciones en base de datos Pubmed.

[Autoimmune hemolytic anemia. Review of 43 cases]. / Anemia hemolítica autoinmune en Chile: un análisis retrospectivo de 43 pacientes.

BACKGROUND: Autoimmune hemolytic anemia (AIHA) is an uncommon disease. In its presentation, it can be severe and even lethal. There is only one clinical report concerning this pathology in Chile. OBJECTIVE: To describe the clinical characteristics and evolution of adult AIHA inpatients. MATERIALS AND METHODS: Retrospective review of clinical records of adult AIHA inpatients between January 2010 and June 2018 was done. Demographic, clinical, laboratory and therapeutic information was analyzed. A descriptive, analytical and survival analysis was performed. RESULTS: Forty-three adult patients diagnosed with AHIA were hospitalized in a period of 8 years. Median age was 63 years (range 22-86 years), mostly women (72%). Warm antibodies were detected in 36 cases (84%) and cold antibodies in seven. Seventy two percent of the patients had an underlying cause, and 58% were secondary to lymphoproliferative neoplasms. All patients except two, received steroids as initial treatment, with response in 37 (90%) of them. Three refractory patients received rituximab, with response in all of them, and relapse in one. Median follow-up was 38 months (range 2-98 months). Five year overall survival was 72%. CONCLUSION: AHIA in adults inpatients is a heterogeneous disease, mainly due to warm antibodies, and to secondary etiology.

[Treatment of Hodgkin lymphoma. Analysis of 915 patients]. / Evaluación del tratamiento de linfoma de Hodgkin con esquema ABVD en Chile.

BACKGROUND: Hodgkin lymphoma has a high rate of curability, even in advanced stages. AIM: To assess the results of Hodgkin lymphoma treatment using the ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy regimen. MATERIAL AND METHODS: Analysis of a database held by the Chilean Ministry of Health, including all patients treated at accredited cancer treatment centers. RESULTS: Data for 915 patients, median age 35 years (range 15-86 years) and followed for a median of 97 months (range 1-347 months) were analyzed. Forty-one percent had localized disease. Overall survival at five years for localized and advanced stages was 92% and 74%, respectively. The figures for progression free survival were 87% and 64%, respectively. Patients with relapse who received autologous stem cell transplantation (ASCT) had a five year overall survival of 92%, compared to 64% among those who did not undergo this procedure (p < 0.01). The Guarantees in Health Program set up by the Ministry of Health, was associated with earlier stage disease at diagnosis. CONCLUSIONS: The ABVD regimen achieves high rates of cure in localized stages of the disease but the results in advanced stages are not optimal. ASCT significantly improves survival in patients with relapse. The Guarantees in Health Program is associated with earlier diagnosis of the disease.

Anemia hemolítica autoinmune en Chile: un análisis retrospectivo de 43 pacientes / Autoimmune hemolytic anemia: review of 43 cases

Background: Autoimmune hemolytic anemia (AIHA) is an uncommon disease. In its presentation, it can be severe and even lethal. There is only one clinical report concerning this pathology in Chile. Objective: To describe the clinical characteristics and evolution of adult AIHA inpatients. Materials and Methods: Retrospective review of clinical records of adult AIHA inpatients between January 2010 and June 2018 was done. Demographic, clinical, laboratory and therapeutic information was analyzed. A descriptive, analytical and survival analysis was performed. Results: Forty-three adult patients diagnosed with AHIA were hospitalized in a period of 8 years. Median age was 63 years (range 22-86 years), mostly women (72%). Warm antibodies were detected in 36 cases (84%) and cold antibodies in seven. Seventy two percent of the patients had an underlying cause, and 58% were secondary to lymphoproliferative neoplasms. All patients except two, received steroids as initial treatment, with response in 37 (90%) of them. Three refractory patients received rituximab, with response in all of them, and relapse in one. Median follow-up was 38 months (range 2-98 months). Five year overall survival was 72%. Conclusion: AHIA in adults inpatients is a heterogeneous disease, mainly due to warm antibodies, and to secondary etiology.

Evaluación del tratamiento de linfoma de Hodgkin con esquema ABVD en Chile / Treatment of Hodgkin lymphoma: analysis of 915 patients

Background: Hodgkin lymphoma has a high rate of curability, even in advanced stages. Aim: To assess the results of Hodgkin lymphoma treatment using the ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy regimen. Material and Methods: Analysis of a database held by the Chilean Ministry of Health, including all patients treated at accredited cancer treatment centers. Results: Data for 915 patients, median age 35 years (range 15-86 years) and followed for a median of 97 months (range 1-347 months) were analyzed. Forty-one percent had localized disease. Overall survival at five years for localized and advanced stages was 92% and 74%, respectively. The figures for progression free survival were 87% and 64%, respectively. Patients with relapse who received autologous stem cell transplantation (ASCT) had a five year overall survival of 92%, compared to 64% among those who did not undergo this procedure (p < 0.01). The Guarantees in Health Program set up by the Ministry of Health, was associated with earlier stage disease at diagnosis. Conclusions: The ABVD regimen achieves high rates of cure in localized stages of the disease but the results in advanced stages are not optimal. ASCT significantly improves survival in patients with relapse. The Guarantees in Health Program is associated with earlier diagnosis of the disease.

Macrophage polarization as a novel weapon in conditioning tumor microenvironment for bladder cancer: can we turn demons into gods?

Macrophages are major components of the immune infiltration in cancer where they can affect tumor behavior. In the bladder, they play important roles during the resolution of infectious processes and they have been associated with a worse clinical prognosis in bladder cancer. The present review focused on the characteristics of these important immune cells, not only eliciting an innate immune surveillance, but also on their importance during the cancer immunoediting process. We further discuss the potential of targeting macrophages for anticancer therapy, the current strategies and the state of the art as well as the foreseen role on combined therapies on the near future. This review shows how a comprehensive understanding of macrophages within the tumor should translate to better clinical outcome and new therapeutic strategies focusing especially on bladder cancer.

Atención de las violencias de género: interfaces entre salud y justicia / Addressing gender violence: interfaces between health and justice

INTRODUCCIÓN Este estudio indaga los abordajes de las violencias de género (VG) en el campo de la salud. Trabaja la interfaz de la aplicación de la Ley Nacional 26485 y la Ley Nacional 26.657/10 Salud Mental. OBJETIVOS Analizar desde un enfoque interseccional la APS en casos de VG. Identificar interfaces entre las prácticas de los sistemas de salud, justicia y seguridad en la atención de las VG. Indagar los imaginarios sociales respecto de las VG en efectores de salud incluyendo los relativos a los aspectos legales de la atención en este campo. Identificar si la territorialidad pudiera resultar una estrategia de intervención para la resolución eficaz de las demandas de las VG. MÉTODOS Se realizó un estudio exploratorio-descriptivo de corte cualitativo con fuentes primarias y secundarias. Trabajó desde la Metodología de Problematización Recursiva (MPR) y tomó herramientas del enfoque de la territorialidad. RESULTADOS Se identificaron los obstáculos y facilitadores en un territorio de la atención en VG del primer nivel de atención en salud, en sus articulaciones con justicia y seguridad como así también las características de su abordaje en el campo de la Salud Mental en ese territorio y las estrategias desplegadas por las mujeres víctimas o "caminos espontáneos" para resolver su problemática. DISCUSIÓN S Se considera relevante focalizar el abordaje de la VG en la estrategia de APS, ya que en ella se encuentran actores y actrices principales del sector salud y fortalecer dispositivos post denuncia como estrategia intersectorial para el seguimiento y acompañamiento longitudinal de las mujeres víctimas de VG.

Miastenia gravis y su asociación con trastornos linfoproliferativos: casos clínicos / Myasthenia gravis and its association with lymphoproliferative disorders: a case series

Myasthenia gravis (MG) is a rare autoimmune disease of the neuromuscular junction. It is characterized by variable weakness and excessive fatigability of skeletal muscles. In the last few years, numerous reports have been published showing the association between autoimmune diseases, such as systemic erythematous lupus or rheumatoid arthritis, with lymphoid neoplasias. The association between MG and lymphoid neoplasia seems to be less frequent. To analyze this association we reviewed the MG patients in the Department of Neurology, Hospital Salvador of Santiago, Chile. During a three-year period we identified four patients who developed different lymphoproliferative disorders: two with B-cell lymphoma, one with chronic lymphocytic leukaemia and one plasmacytoma with an associated amyloidosis. The MG was generalized but mild, all cases classified as type IIa according to the definition proposed by the MG Foundation of America. The neoplasia appeared two to 36 years after the onset of MG. These cases provide additional evidence of the association between MG and lymphoproliferative disorders.

[Impact of the Chilean Explicit Guaranties Health System (GES) on breast cancer treatment]. / Resultados del tratamiento del cáncer de mama, Programa Nacional de Cáncer del Adulto.

Background Breast cancer is the most common malignant tumor in women in the world. In 2005, it was incorporated to the Explicit Guaranties Health System (GES) in Chile. Aim To describe the demographic and clinical characteristics of breast cancer patients and to determine the effect of incorporating these women to GES. Material and Methods Medical records of 5,119 women with breast cancer aged 59 ± 14 years, attended at six public hospitals between 2000 and 2010 were reviewed. Median follow up was 87 months (range 1-182). Mortality was assessed using death certificates obtained at the National Identification Registry. Results Sixty six percent of women were in stage I-II, 29% in stage III and 5% in stage IV. Surgery was performed in 4023/5119 cases (79%), adyuvant radiotherapy in 3627/4517 cases (80%), chemotherapy in 3,204/3,424 cases (94%) and hormone therapy in 1,695/2,375 cases (71%). Between 2000 and 2010, there was a significant increase in the proportion of cases in stage I, from 8% to 25%, (p < 0.01). Overall survival (OS) increased 1% per year, since the beginning of GES system (p = 0.024). Five year OS was 75.1%. The figures for Stage I, II, III and IV were 93, 84, 62 and 27% respectively (p < 0.01). Patients without lymph node involvement and who were not triple negative, had a significantly better OS. Conclusions There was a significant increase in stage I cases, and a 1% per year OS improvement after GES system started, compared with the previous period.

[Myasthenia gravis and its association with lymphoproliferative disorders: a case series]. / Miastenia gravis y su asociación con trastornos linfoproliferativos: casos clínicos.

Myasthenia gravis (MG) is a rare autoimmune disease of the neuromuscular junction. It is characterized by variable weakness and excessive fatigability of skeletal muscles. In the last few years, numerous reports have been published showing the association between autoimmune diseases, such as systemic erythematous lupus or rheumatoid arthritis, with lymphoid neoplasias. The association between MG and lymphoid neoplasia seems to be less frequent. To analyze this association we reviewed the MG patients in the Department of Neurology, Hospital Salvador of Santiago, Chile. During a three-year period we identified four patients who developed different lymphoproliferative disorders: two with B-cell lymphoma, one with chronic lymphocytic leukaemia and one plasmacytoma with an associated amyloidosis. The MG was generalized but mild, all cases classified as type IIa according to the definition proposed by the MG Foundation of America. The neoplasia appeared two to 36 years after the onset of MG. These cases provide additional evidence of the association between MG and lymphoproliferative disorders.

Positive influence of a dental anaesthesia simulation model on the perception of learning by Mexican dental students.

INTRODUCTION: This study evaluated the influence of three-repetition training with a dental anaesthesia simulation model (DASM) on the perception of learning by dental students. MATERIALS AND METHODS: Dental students who had never used a dental anaesthesia technique were randomly divided into two groups that were taught the anterior superior alveolar nerve infiltrative anaesthesia technique. Group 1 (G1; N = 10) followed a three-stage learning method: (i) theoretical lecture, (ii) clinical demonstration and (iii) DASM training, including three repetitions of the anaesthesia technique. Group 2 (G2; N = 10) followed only the 1st and 2nd stages. The students in both groups then performed the anaesthesia technique. The perception of the students was evaluated by four learning concepts. Each was evaluated with a 5-point Likert scale questionnaire. The average score of each item of the questionnaire for G1 was compared with that of G2. Statistically significant differences were identified with the Mann-Whitney test. The average working time of each group was timed and compared by Student's t-test to identify possible statistically significant differences. RESULTS: Students in G1 showed higher average scores of perception in controlling the handling of the dental syringe and confidence in performing the injection (P < 0.05) and showed an average working time shorter than that of the students in G2 (P < 0.05). CONCLUSION: The DASM positively influenced the perception learning of the dental students; it increased their confidence and syringe handling ability, as well as skills to perform the injection of anaesthesia more quickly.

Abandono del hábito tabáquico tras un primer ingreso en el Servicio de Neumología / Smoking cessation after first admission in a respiratory unit

Some authors suggest that hospitalization is an ideal moment to stop smoking. It is unknown the outcome of smokers admitted for the first time in the pulmonology department, which interventions are carried out to achieve smoking cessation and which are the dropout rates once they are discharged. The purpose of this study is to analyze the impact of a first hospital admission in a service of Pneumology on smokers. Epidemiological variables, smoking habit, specialized interventions carried out on these subjects and rate of withdrawal after discharge were studied. It is necessary to train specialists to diagnose and treat the patient in the process, so that on every hospitalized smoker a cessation intervention should be carried out.

Algunos autores defienden que el ingreso hospitalario constituye un marco ideal para dejar de fumar. Se desconoce lo que sucede con los fumadores que ingresan por primera vez en el Servicio de Neumología, sobre las intervenciones que en ellos se lleva a cabo, así como sus tasas de abandono una vez que son dados de alta. El objetivo de este estudio es analizar el impacto que tiene un primer ingreso hospitalario en el Servicio de Neumología en sujetos fumadores. Conocer sus variables epidemiológicas, el hábito de tabáquico, las intervenciones que el personal médico especializado realiza sobre estos sujetos y las tasas de abstinencia posteriores al alta. Es necesario formar a los especialistas para diagnosticar y tratar al paciente en dicho proceso, de tal forma que sobre todo sujeto fumador hospitalizado se realice alguna intervención.

Presentación atípica de meningioma de células claras en cauda equina sin implantación dural / Atipic presentation of nondura-based clear cell meningioma in cauda equina

Introducción: El Meningioma de Células Claras (MCC) es un raro subtipo de meningioma. Se han descrito más de 100 casos de MCC a nivel mundial, de ellos sólo se han publicado 17 con duramadre indemne, presentándose generalmente en mujeres jóvenes. El objetivo es presentar un caso clínico inusual y atípico, conociendo manejo y pronóstico. Presentación del caso: Se trata de un varón de 75 años con antecedentes de hipertensión arterial y leucemia linfoide crónica en tratamiento, que consultó por dolor polirradicular y paresia de extremidades inferiores con posterior compromiso esfinteriano. La resonancia nuclear magnética de columna evidenció un tumor intradural a nivel de L1-L3. Se realizó exéresis tumoral bajo neuromonitoreo, observándose un tumor amarillo-grisáceo adyacente al cono medular y a la cauda equina, sin afección de la duramadre. El estudio histológico e inmunohistoquímico demostraron MCC. El paciente evolucionó con regresión completa de su sintomatología preoperatoria. Discusión: En la cauda equina, incluso sin implantación dural, debe plantearse la posibilidad de un meningioma, enfatizando en la resección completa de la lesión a causa del fuerte factor predictor de recidiva.

Introduction: The Clear Cell Meningioma (CCM) is a rare subtype of meningioma. Have been reported more than 100 cases of CCM in the world, of which only 17 cases are nondura-based CCM, more frequently in young women. The aim is to present an unusual case knowing management and prognosis. Case report: This is a man of 75 years old with a history of hypertension and chronic lymphocytic leukemia in treatment, who consulted for polirradicular pain and paresis of lower extremities with subsequent sphincteric compromise. The magnetic resonance imaging showed spinal tumor in L1-L3. Tumor resection was per-formed under neuromonitoring and observed a nondura-based tumor adjacent to the medullary cone and the cauda equina. The histological and immunohistochemical study showed CCM. The patient developed complete regression of preoperative symptoms. Discussion: In horsetail, even without dural implantation, it should consider the possibility of a meningioma, emphasizing in the complete resection of the lesion given strong predictor factor of recurrence

Lesiones cutáneas en mieloma múltiple: Descripción de un caso y revisión de la literatura / Cutaneous involvement in multiple myeloma: Report of one case

Cutaneous involvement in multiple myeloma (MM) is extremely rare. It may correspond to plasmocytomas, secondary amyloidosis, paraneoplastic syndromes or drug reactions. We report a 75-year-old female with skin lesions, corresponding to extramedullary plasmacytomas (EPs), as a manifestation of MM progression. Most EPs appear in the upper airway and gastrointestinal tract, but have also been described in the genitourinary tract, lung, kidney, thyroid and in 2% of cases, in the skin. Cutaneous lesions are generally associated with terminal stages of the disease and a poor prognosis.

Tumor histological subtyping determined by hormone receptors and HER2 status defines different pathological complete response and outcome to dose-dense neoadjuvant chemotherapy in breast cancer patients.

PURPOSE: To assess the impact in pathological complete response (pCR) and outcome of two dose-dense neoadjuvant chemotherapy (DDNC) regimens among different histological subtypes determined by hormonal receptor (HR) and HER2 status in breast cancer patients. METHODS: A total of 127 breast cancer patients were treated with DDNC in two prospective studies. A: adriamycin 40 mg/m(2) on day (d) 1 plus paclitaxel 150 mg/m(2) and gemcitabine 2,000 mg/m(2) on d2 for six cycles (n = 54). B: epirubicin 90 mg/m(2), cyclophosphamide 600 mg/m(2) on d1 for three cycles, followed by paclitaxel 150 mg/m(2) and gemcitabine 2,500 mg/m(2) on d1 ± trastuzumab according to HER2 status (n = 73). Histological subtypes of breast cancer were 49 % HR+/HER2-, 17.5 % HR+/HER2+, 13.5 % HR-/HER2+ and 20 % HR-/HER2-. RESULTS: pCR (absence of invasive cells in breast and lymph node) was achieved in 35 patients (28 %). The pCR rate was significantly different between histological subtypes: HR+/HER2- (9 %), HR+/HER2+ (23 %), HR-/HER2+ (50 %), HR-/HER2- (56 %) (p < 0.001). The median follow-up was 81 months (r: 15-150 months). HR-/HER2- tumor subtype had a significantly worse DFS compared to HR+/HER2- (p = 0.02), RH+/HER2+ (p = 0.04) and HR-/HER2+ tumor subtypes (p = 0.02). HR-/HER2- tumor subtype had a significantly shorter OS compared to HR+/HER2- (p = 0.007), RH+/HER2+ (p = 0.05), and HR-/HER2+ (p = 0.03) tumor subtypes. However, no significant difference was observed in DFS and OS among HR-/HER2- tumors that achieved a pCR. CONCLUSIONS: HR-/HER2- and HR-/HER2+ subtypes had a high pCR rate to DDNC. HR-/HER2- tumors had a worse outcome compared to other tumor subtypes but no significant difference was observed among HR-/HER2- tumors that achieved a pCR.