Oesophageal Atresia: Prevalence in the Valencian Region (Spain) and Associated Anomalies.

The objective was to determine the prevalence of oesophageal atresia (OA) and describe the characteristics of OA cases diagnosed before the first year of life, born between 2007 and 2019, and residents in the Valencian Region (VR), Spain. Live births (LB), stillbirths (SB), and termination of pregnancy for fetal anomaly (TOPFA) diagnosed with OA were selected from the Congenital Anomalies population-based Registry of VR (RPAC-CV). The prevalence of OA per 10,000 births with 95% confidence interval was calculated, and socio-demographic and clinical variables were analyzed. A total of 146 OA cases were identified. The overall prevalence was 2.4/10,000 births, and prevalence by type of pregnancy ending was 2.3 in LB and 0.03 in both SB and TOPFA. A mortality rate of 0.03/1000 LB was observed. A relationship was found between case mortality and birth weight (p-value < 0.05). OA was primarily diagnosed at birth (58.2%) and 71.2% of the cases were associated with another congenital anomaly, mainly congenital heart defects. Significant variations in the prevalence of OA in the VR were detected throughout the study period. In conclusion, a lower prevalence in SB and TOPFA was identified compared to EUROCAT data. As several studies have identified, an association between OA cases and birth weight was found.

Chile: Acceptability of a Training Program for Depression Management in Primary Care.

BACKGROUND: In Chile, there are inconsistencies in the management of depression in primary care settings, and the National Depression Program, currently in effect, was implemented without a standardized training program. The objective of this study is to evaluate the acceptability of a training program on the management of depression for primary care health teams. METHODS: The study was a randomized controlled trial, and two primary centers from the Metropolitan Region of Santiago were randomly selected to carry out the intervention training program. Pre-post surveys were applied, to evaluate expectations and satisfaction with the intervention, respectively. Descriptive and content analysis was carried out. RESULT: The sample consisted of 41 health professionals, 56.1% of who reported that their expectations for the intervention were met. All of the training activities were evaluated with scores higher than 6.4 (on a 1-7 scale). The trainers, the methodology, and the learning environment were considered strengths and facilitators of the program, while the limited duration of the training, the logistical problems faced during part of the program, and the lack of educational material were viewed as weaknesses. CONCLUSION: The intervention was well accepted by primary health care teams. However, the clinical impact in patients still has to be evaluated.

Trastornos mentales comunes y uso de servicios de salud en población inmigrante / Mental disorders among immigrants in Chile

Background: Chile is receiving immigrant populations coming from other Latin-American countries. Aim: To determine the prevalence of Common Mental Disorders (CMD) among immigrants who live in Independencia, a quarter in Santiago, Chile. Material and Methods: A cross sectional study was carried out in the primary health care clinic and in the state-funded school of Independencia. A representative sample of 282 adults and 341 children were interviewed. Mental disorders were diagnosed using CIS-R and MINI structured interviews. Results: The interviewed immigrants came mostly from Peru. The prevalence of mental disorders in the adult population was 17.8 percent and among children, it was 29.3 percent. Conclusions: The adult immigrants have a lower prevalence of mental disorders than the Chilean population but it increases among children. Barriers of access to health services, that should be solved, were detected.

[Mental disorders among immigrants in Chile]. / Trastornos mentales comunes y uso de servicios de salud en población inmigrante.

BACKGROUND: Chile is receiving immigrant populations coming from other Latin-American countries. AIM: To determine the prevalence of Common Mental Disorders (CMD) among immigrants who live in Independencia, a quarter in Santiago, Chile. MATERIAL AND METHODS: A cross sectional study was carried out in the primary health care clinic and in the state-funded school of Independencia. A representative sample of 282 adults and 341 children were interviewed. Mental disorders were diagnosed using CIS-R and MINI structured interviews. RESULTS: The interviewed immigrants came mostly from Peru. The prevalence of mental disorders in the adult population was 17.8% and among children, it was 29.3%. CONCLUSIONS: The adult immigrants have a lower prevalence of mental disorders than the Chilean population but it increases among children. Barriers of access to health services, that should be solved, were detected.

Proteomic approach to ETV5 during endometrial carcinoma invasion reveals a link to oxidative stress.

Endometrial cancer, the most common gynecological malignancy in western countries, is characterized by a favorable prognosis. Nonetheless, deep myometrial invasion correlates with more undifferentiated tumors, lymph-vascular invasion, node involvement and decreased global survival. We have described previously the Ets family member ERM/ETV5 specifically upregulated in endometrial endometrioid carcinoma (EEC) associated with myometrial infiltration. To understand the role of this transcription factor during myometrial infiltration, we analyzed by two-dimension differential gel electrophoresis (2D-DIGE) technology those proteins whose expression was altered in endometrial cell lines stably overexpressing ERM/ETV5. Pathway analysis pointed to actin regulation and transforming growth factor beta and progesterone signaling as processes regulated by ERM/ETV5. In addition, we characterized the specific upregulation of the nuclear dehydrogenase/reductase Hep27 as well as its ERM/ETV5-dependent mitochondrial localization. Further functional studies demonstrated a protective role of Hep 27 against apoptosis induced by oxidative stress. Overall, the ETV5-related proteomic approach performed in the Hec-1A cell line reinforces a role of this transcription factor in the regulation of the migratory and invasive tumor behavior and points to a modulated response to oxidative stress associated with the promotion of invasion in endometrial cancer. Unraveling the molecular events in EEC associated with the initiation of tumor invasion would represent an obvious improvement in the pursuit of rational targets for the onset of metastasis. This knowledge would also be a valuable tool for the molecular stratification of patients since myometrial affectation determines an increase in the rate of recurrence after a first surgical treatment and a decrease in 5 year survival.

An orthotopic endometrial cancer mouse model demonstrates a role for RUNX1 in distant metastasis.

Endometrial carcinoma is the most common malignancy of the female genital tract in industrialized countries. Metastasis is the major cause of endometrial cancer deaths. Therefore, there is a vital need for clinically relevant in vivo models allowing the elucidation of the molecular and cellular mechanisms underlying metastatic behavior. In this study, we describe an innovative experimental orthotopic model of human endometrial carcinoma. Implantation in the bifurcation of the uterine horns resulted in tumors integrated into the myometrial compartment, which can be used and further exploited for the study of in vivo angiogenesis, myometrial invasion, and the metastatic capacity of endometrial cancer cells. This orthotopic model also represents a suitable tool to analyze how tumorigenesis and distant metastasis of endometrial cancer might be influenced by gene alteration, by modulating its expression in the original cancer cell line. One of the candidate genes implicated in endometrial cancer is the transcription factor RUNX1. The over-expression of RUNX1 in the endometrial cancer cell line HEC1A and the transplantation of these cells to the uterus of nude mice were associated specifically with distant metastasis in the lung. RUNX1 plays a role in the establishment of metastases in endometrial cancer. Translated to the clinics, these models would be equivalent to an advanced undifferentiated carcinoma with node affectation (stage IIIC) and distant metastasis (stage IVB). These patients would be candidates for adjuvant therapy, not efficient until today, and therefore, our models are actually suitable for the design and evaluation of experimental therapies.

Total laparoscopic radical hysterectomy (type II-III) with pelvic lymphadenectomy in early invasive cervical cancer.

STUDY OBJECTIVE: To describe the feasibility and outcome of total laparoscopic radical hysterectomy with pelvic lymphadenectomy in early cervical cancer. DESIGN: Retrospective, nonrandomized study (Canadian Task Force classification II-2). SETTING: Acute-care, teaching hospital. PATIENTS: Twenty-seven nonconsecutive patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA2 (n = 4) or IB1 (n = 23) cancer of the cervix. INTERVENTION: Laparoscopic type II (n = 9) or type III (n = 18) hysterectomy with systematic bilateral pelvic lymphadenectomy. Monopolar coagulation, vascular clips, and harmonic scalpel were used. Resection of the cardinal and uterosacral ligaments was performed with Endo GIA stapling and the harmonic scalpel. MEASUREMENTS AND MAIN RESULTS: Histopathologically, there were 20 cases of squamous carcinoma, 6 adenocarcinomas, and 1 adenosquamous carcinoma. The operation was performed entirely by laparoscopy in 26 patients. One patient underwent laparotomy because of equipment failure. The patients' mean age was 45.1 years (95% CI 41.7-48.4), with a median body mass index of 26.0 kg/m2. The mean number of resected pelvic nodes was 19.1 (95% CI 17.02-21.2). Three patients had microscopic metastatic nodal disease. The surgical margins were free of disease in all cases. The median blood loss was 400 mL (range 250-700 mL). The median length of stay was 5 days. Major intraoperative complications did not occur. All patients are free of disease after a median follow-up of 32 months (range 4-52 months). CONCLUSION: Radical hysterectomy can be successfully completed by laparoscopy in patients with early cervical cancer. This procedure may reduce the morbidity associated with abdominal or transvaginal radical hysterectomy.

Estudio de captopril versus tratamientos convencionales en dependientes alcohólicos / Captopril study versus conventional treatment in alcoholic dependants

En este estudio doble ciego, controlado con placebo, participaron 11 dependientes al alcohol que reunian los criterios de DSM-III-R. Durante 15 meses, el primer grupo (n=6) recibió captopril 150 mg/dia y el segundo (n=5) recibió los tratamientos convencionales; los dos grupos recibieron además psicoterapia de apoyo. Cuando se comparó con los valores basales, los pacientes de ambos grupos mostraron una mejoría notable que se tradujo en una reducción de alrededor del 90 porciento de la cantidad de tragos standard consumidos y de los días de embriaguez a la semana y en un aumento significativo de los dias de abstinencia. También se observó una dismunución de cerca del 80 porciento en el número de días con apetito y más o menos del 50 porciento de la intensidad de éste. La calidad de vida mejoró significativamente en ambos grupos. Sin embargo, no hubo diferencias significativas cuando se compararon estos resultados con los obtenidos con el placebo ni cuando se compararon los efectos de captopril versus tratamientos convencionales entre sí

La CIE-10 y los trastornos del humor / The ICD-10 and the mood disorders

Se evalúan 30 pacientes afectivos por une quipo de Salud Mental siguiendo criterios diagnósticos CIE-10 y DSM-III-R. Se comparan los resultados. Se analizan aspectos significativos de la CIE-10 y diferencias entre ambas clasificaciones en esta área

La CIE-10 y los trastornos del humor / The ICD-10 and the mood disorders

Se evalúan 30 pacientes afectivos por une quipo de Salud Mental siguiendo criterios diagnósticos CIE-10 y DSM-III-R. Se comparan los resultados. Se analizan aspectos significativos de la CIE-10 y diferencias entre ambas clasificaciones en esta área (AU)

Evolución de un grupo de pacientes alcohólicos después de diez años / Evolution after 10 years of a group of alcoholic patients

Se estudia la evolución a 10 años plazo de un grupo de 26 pacientes alcohólicos, hospitalizados en 1978, en la Clínica Psiquiátrica Universitaria. En el transcurso del tiempo se perfilaron dos grupos, uno de buena y otro de mala evolución. Fueron similares en cuanto a: edad promedio, estado civil, cuadro clínico y tratamiento recibido. Encontramos que el grupo de mala evolución era claramente mayoritario y estaba formado principalmente por varones inactivos o jubilados y tenían mejor nivel educacional. Finalmente el hecho más inquietante fue mortalidad encontrada, que alcanzó al 38,5% de los sujetos y con edad promedio de 53 años, datos que ilustran la gravedad de la enfermedad

Conciencia de enfermedad y abstnencia absoluta en un grupo de alcohólicos en rehabilitación / Conscience of disease and absolute abstinence in an alcoholic group in rehabilitation

Se describe la evolución de la Conciencia de Enfermedad y la permanencia en abstinencia absoluta de un grupo de 12 alcohólicos hombres en rehabilitación. Se describe también las vivencias de las cónyuges. Se efectuó un seguimiento de 2 años