Comparative response to PDT with methyl-aminolevulinate and temoporfin in cutaneous and oral squamous cell carcinoma cells.

Cutaneous and Head and Neck squamous cell carcinoma (CSCC, HNSCC) are among the most prevalent cancers. Both types of cancer can be treated with photodynamic therapy (PDT) by using the photosensitizer Temoporfin in HNSCC and the prodrug methyl-aminolevulinate (MAL) in CSCC. However, PDT is not always effective. Therefore, it is mandatory to correctly approach the therapy according to the characteristics of the tumour cells. For this reason, we have used cell lines of CSCC (A431 and SCC13) and HNSCC (HN5 and SCC9). The results obtained indicated that the better response to MAL-PDT was related to its localization in the plasma membrane (A431 and HN5 cells). However, with Temoporfin all cell lines showed lysosome localization, even the most sensitive ones (HN5). The expression of mesenchymal markers and migratory capacity was greater in HNSCC lines compared to CSCC, but no correlation with PDT response was observed. The translocation to the nucleus of ß-catenin and GSK3ß and the activation of NF-κß is related to the poor response to PDT in the HNSCC lines. Therefore, we propose that intracellular localization of GSK3ß could be a good marker of response to PDT in HNSCC. Although the molecular mechanism of response to PDT needs further elucidation, this work shows that the most MAL-resistant line of CSCC is more sensitive to Temoporfin.

Operational characteristics of ultrasound in the diagnosis of Sjögren's syndrome.

BACKGROUND AND OBJECTIVE: To determine the operational characteristics of salivary gland ultrasound (SGU) in the diagnosis of Sjögren's syndrome (SS) in a population of colombian patients with dry symptoms. MATERIALS AND METHODS: Study of diagnostic tests in patients with dry symptoms who consecutively attended the rheumatology consultation (2018-2020). Sociodemographic and clinical data were obtained through a survey, paraclinical and ophthalmological tests, minor salivary gland biopsy, unstimulated salivary flow and SGU (score 0-6 based on De Vita) were done. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values (Stata 15®) were calculated. The receiver operating characteristics (ROC) curve was developed. RESULTS: 102 patients were included (34 SS and 68 non-SS), mean age 55.69 (±11.93) years, 94% women. Positive ultrasound (score of 2 or more) was more frequent in the SS group, (70.6% vs. 22.1%, P<0.0001). The sensitivity was the same for grade 2 and 3 (70.59%), with a higher specificity (89.71%) for grade 3 (PPV 77.42% NPV 85.92). The ROC curve from the sum of the glands by means of ultrasound was better than those of the independent glands. The ROC curve of the ultrasound presented a greater area under the curve (0.72 [0.61-0.82]) than that of the histological analysis (focus score) (0.68 [0.59-0.78]), P=0.0252. CONCLUSION: Salivary gland ultrasound is a useful and reliable method for the classification of SS. Its use could be considered in the future within the SS classification criteria.

Características operativas de la ecografía en el diagnóstico del Síndrome de Sjögren / Operational characteristics of ultrasound in the diagnosis of Sjögren's syndrome

Antecedentes y objetivo: Determinar las características operativas de la ecografía de glándula salival (EGS) en el diagnóstico del síndrome de Sjögren (SS) en una población de pacientes colombianos con síntomas secos. Materiales y métodos: Estudio de pruebas diagnósticas en pacientes con síntomas secos que asistieron a la consulta de reumatología (2018-2020). Se obtuvieron datos sociodemográficos y clínicos a través de una encuesta, pruebas paraclínicas, oftalmológicas, biopsia de glándula salival menor, flujo salival no estimulado y EGS (puntuación 0-6 basada en De Vita). Se calcularon la sensibilidad, la especificidad y los valores predictivos positivo (VPP) y negativo (VPN) (Stata 15®). Se desarrolló la curva de características operativas del receptor (COR). Resultados: Se incluyó a 102 pacientes (34 con SS y 68 sin SS), edad media ± desviación estándar de 55,69 ± 11,93 años, 94% mujeres. La ecografía positiva (puntuación de 2 o más) fue más frecuente en el grupo de SS, (70,6% vs. 22,1%, p < 0,0001). La sensibilidad fue igual para el grado 2 y 3 (70,59%), con una especificidad mayor (89,71%) para el grado 3 (VPP 77,42% VPN 85,92). La curva COR a partir de la sumatoria de las glándulas por medio de ecografía, fue mejor que las de las glándulas independientes. La curva COR de la ecografía presentó una mayor área bajo la curva (0,72 [0,61-0,82]) que la del análisis histológico (puntuación por focos) (0,68 [0,59-0,78]), p = 0,0252. Conclusión: La EGS es un método útil y confiable para la clasificación del SS. Se podría plantear su uso futuro dentro de los criterios clasificatorios del SS.(AU)

Background and objective: To determine the operational characteristics of salivary gland ultrasound (SGU) in the diagnosis of Sjögren's syndrome (SS) in a population of colombian patients with dry symptoms. Materials and methods: Study of diagnostic tests in patients with dry symptoms who consecutively attended the rheumatology consultation (2018-2020). Sociodemographic and clinical data were obtained through a survey, paraclinical and ophthalmological tests, minor salivary gland biopsy, unstimulated salivary flow and SGU (score 0-6 based on De Vita) were done. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values (Stata 15®) were calculated. The receiver operating characteristics (ROC) curve was developed. Results: 102 patients were included (34 SS and 68 non-SS), mean age 55.69 (± 11.93) years, 94% women. Positive ultrasound (score of 2 or more) was more frequent in the SS group, (70.6% vs. 22.1%, P<.0001). The sensitivity was the same for grade 2 and 3 (70.59%), with a higher specificity (89.71%) for grade 3 (PPV 77.42% NPV 85.92). The ROC curve from the sum of the glands by means of ultrasound was better than those of the independent glands. The ROC curve of the ultrasound presented a greater area under the curve (0.72 [0.61-0.82]) than that of the histological analysis (focus score) (0.68 [0.59-0.78]), P=.0252. Conclusion: Salivary gland ultrasound is a useful and reliable method for the classification of SS. Its use could be considered in the future within the SS classification criteria.

Neumatización detenida del seno esfenoidal: una condición benigna que simula lesiones patológicas / Arrested pneumatization of the sphenoid sinus: a benign condition that simulates pathological lesions

Resumen La neumatización detenida de los senos paranasales es una condición benigna poco conocida, que consiste en una variación de la neumatización normal, permaneciendo médula ósea grasa dentro de la cavidad, siendo más frecuente en el seno esfenoidal. Es generalmente asintomática y su diagnóstico suele ser incidental en el contexto de la realización de imágenes por otras causas, existiendo criterios imagenológicos definidos para esta condición. Su manejo es expectante y es esencial su distinción de otros diagnósticos diferenciales, con objeto de evitar procedimientos y tratamientos invasivos que solo aporten morbilidad. Presentamos dos casos de pacientes, de 15 y 16 años que, en estudio imagenológico por otra causa, se observan lesiones esfenoidales heterogéneas con focos de baja señal sugerentes de calcificaciones, con características compatibles con neumatización detenida del seno esfenoidal.

Abstract Arrested pneumatization of the paranasal sinuses is an under-recognized benign condition, which consists of a variation of the normal pneumatization, with fatty bone marrow remaining within the cavity, more frequent in the sphenoid sinus. It is generally asymptomatic, and its diagnosis is usually incidental in the context of imaging for other causes, with defined imaging criteria for this condition. Its management is expectant and its distinction from other differential diagnoses is essential, in order to avoid invasive procedures and treatments that only contribute morbidity. We present two cases of 15- and 16-year-old patients who, on imaging for another reason, show heterogeneous sphenoid lesions with low-signal foci suggestive of calcifications, with characteristics compatible with arrested pneumatization of the sphenoid sinus.

Abordaje prelagrimal del seno maxilar: experiencia del Hospital Clínico de la Universidad de Chile

Resumen Introducción: La patología del seno maxilar es frecuente en la práctica del otorrinolaringólogo. El abordaje prelagrimal permite un amplio acceso al seno maxilar, preservando el cornete inferior y ducto nasolagrimal. Objetivo: describir y analizar las características de los pacientes sometidos a abordaje prelagrimal del seno maxilar, en el Servicio de Otorrinolaringología del Hospital Clínico de la Universidad de Chile (HCUCh). Material y Método: Estudio retrospectivo, descriptivo, incluyendo los pacientes con patología otorrinolaringológica sometidos a abordaje prelagrimal del seno maxilar, entre los años 2015 y 2019 en HCUCh. Se analizaron variables epidemiológicas, clínicas, resultados y complicaciones. Resultados: La serie está constituida por 11 pacientes, con edad promedio de 46,8 años; 6 hombres y 5 mujeres. Los diagnósticos más frecuentes que motivaron esta intervención fueron papiloma invertido y pólipo antrocoanal recidivado. Todos los pacientes fueron estudiados con endoscopía nasal e imágenes, siendo de elección la tomografía computada. No se reportaron complicaciones postoperatorias mayores. En el período de seguimiento, ningún paciente ha requerido reintervención del seno maxilar. Conclusión: El abordaje prelagrimal del seno maxilar es una alternativa para abordar esta cavidad, en pacientes adecuadamente seleccionados. En nuestra experiencia, la tasa de complicaciones es baja y no hemos presentado casos de recidiva.

Abstract Introduction: Maxillary sinus disease is frequent in otorhinolaryngology clinical practice. The pre-lacrimal approach allows a wide access to the maxillary sinus, preserving the inferior turbinate and the nasolacrimal duct. Aim: To describe and analyze the characte- ristics of patients undergoing endoscopic sinus surgery (ESS) with pre-lacrimal approach to the maxillary sinus at University of Chile Clinical Hospital. Material and Method: Retrospective, descriptive study of all patients who underwent ESS for the treatment of any otorhinolaryngological pathology with pre-lacrimal approach, between 2015 and 2019. Variables analyzed include demographics, signs and symptoms and surgical complications. Results: This series includes 11 patients, with a mean age of 46.8 years at the time of sur- gery; 6 men and 5 women. The main diagnoses included inverted papilloma and recurrent antrochoanal polyp. All the patients were studied with nasal endoscopy and images, with computed tomography being the modality of choice. No major complications were observed at follow-up. Conclusion: The pre-lacrimal approach to the maxillary sinus is an alterna- tive to access this cavity, especially in well-selected patients. In our experience, the compli- cation rate is low. We report no recurrences so far.

Tumores fibroóseos de cavidades paranasales: experiencia en el Hospital Clínico de la Universidad de Chile y revisión de la literatura / Fibro-osseous tumors of paranasal cavities: experience in the Hospital Clínico de la Universidad de Chile and review of the literature

Los tumores de cavidades paranasales presentan una baja frecuencia. Dentro de éstos, entre los benignos destacan las lesiones fibroóseas que se caracterizan por el reemplazo de hueso normal por estroma celular fibroso. Dentro de estas lesiones se describen osteoma, displasia fibrosa y fibroma osificante. Se revisan 3 casos de pacientes del Hospital Clínico de la Universidad de Chile y se presenta una revisión bibliográfica en cuanto a las lesiones fibroóseas, su clínica, diagnóstico, imagenología y tratamiento.

The tumors of paranasal cavities present a low frequency. Among the benign tumors are fibro-osseous lesions characterized by the replacement of normal bone by fibrous cell stroma. Osteoma, fibrous dysplasia, and ossifying fibroma are described within these lesions. Three cases of patients from the Hospital Clínico de la Universidad de Chile are reviewed and a bibliographic review is presented regarding the fibro-osseous lesions, their clinical features, diagnosis, imaging and treatment.

Trauma laríngeo externo y fractura de cartílago tiroides: revisión de la literatura / External laryngeal trauma and thyroid cartilage fracture: a literature review

RESUMEN El trauma laríngeo constituye un grupo de lesiones infrecuentes, pero de gran importancia clínica dada su alta morbimortalidad. Requiere un alto nivel de sospecha, puesto que muchas de estas lesiones pueden pasar desapercibidas en la evaluación inicial. Se debe sospechar en todo paciente que se presenta con traumatismo cervical y síntomas que van desde la disfonía y el dolor cervical anterior, a la disnea e incluso el compromiso respiratorio severo por obstrucción de la vía aérea. El abordaje de estos pacientes debe iniciar con la evaluación de la vía aérea y asegurar su estabilidad, para luego enfocarse en el diagnóstico y manejo específico de las lesiones. Presentamos a continuación una revisión bibliográfica en cuanto a los mecanismos de trauma, presentación clínica, diagnóstico, clasificación y manejo.

ABSTRACT The laryngeal trauma constitutes a group of infrequent lesions, but with great clinical importance, given its high morbidity and mortality. It requires a high level of suspicion, since many of these injuries may go unnoticed at the initial evaluation. It should be suspected in every patient presenting with cervical trauma and symptoms ranging from dysphonia and anterior cervical pain, to dyspnea or even severe respiratory distress, due to obstruction of the airway. The approach of these patients should begin with the evaluation of the airway and ensure its stability, to then focus on the diagnosis and specific management of the lesions. We present an updated literature review regarding the mechanisms of trauma, clinical presentation, diagnosis, classification and management.

Rinosinusitis fúngica invasiva aguda: actualización en pacientes adultos y pediátricos / Acute invasive fungal rhinosinusitis: update in adults and pediatric patients

RESUMEN La rinosinusitis fúngica invasiva aguda (RSFIA) es una enfermedad poco frecuente caracterizada por una infiltración fúngica de la submucosa y vasos sanguíneos de las cavidades nasal y paranasal. Afecta a pacientes con grados variables de inmunosupresión, destacando entre estas patologías subyacentes la diabetes mellitus y las neoplasias malignas hematológicas. Presenta una alta tasa de mortalidad, pudiendo reducirse significativamente si el diagnóstico y el tratamiento se realizan precozmente. Este artículo tiene por objetivo presentar una revisión actualizada de la literatura respecto a la presentación clínica, microbiología, factores de riesgos, métodos diagnósticos, tratamiento y pronóstico de la RSFIA, tanto en adultos como en niños.

ABSTRACT Acute invasive fungal rhinosinusitis (AIFS) is a rare disease characterized by fungal infiltration of the submucosa and blood vessels of the nasal y paranasal cavities. It affects almost exclusively patients with different degrees of immunosuppression, with underlying pathologies such as diabetes mellitus and hematological malignancies. AIFS has a high mortality rate, but it can be significantly reduced if the diagnosis and treatment are carried out early in the course of disease. This article aims to present an updated literature review regarding clinical presentation, microbiology, risk factors, diagnostic methods, treatment and prognosis of AIFS, both in adults and children.

Rinosinusitis crónica: una revisión de su etiopatogenia / Chronic rhinosinusitis: a review of its etiopathogenesis

RESUMEN La rinosinusitis crónica (RSC) se define como una inflamación sintomática de las cavidades nasales y paranasales. Es una enfermedad altamente prevalente, que conlleva una gran carga económica asociada y cuyo tratamiento médico actual consigue un alivio sintomático en aproximadamente 50% de los pacientes. Tradicionalmente se ha clasificado de acuerdo a la presencia o ausencia de pólipos nasales, sin embargo, no se conoce con total claridad los mecanismos que llevan a la diferenciación de ambos fenotipos. Se estima que existirían tanto factores exógenos como endógenos involucrados que configurarían un origen multifactorial de la enfermedad. La RSC es motivo de intensa investigación científica actual dado su impacto y prevalencia, de manera de determinar con mejor precisión los objetivos de un eventual tratamiento de mayor efectividad. Es por ello que presentamos una revisión actualizada en relación a los mecanismos fisiopatológicos subyacentes en RSC.

ABSTRACT Chronic rhinosinusitis (CRS) is defined as a symptomatic inflammation of the nasal and paranasal cavities. It is a highly prevalent disease carrying a large associated economic burden, and its current medical treatment achieves symptomatic relief in approximately 50% of patients. Traditionally, it has been classified according to the presence or absence of nasal polyps. However, the mechanisms that lead to the differentiation of both phenotypes are not fully understood. It has been estimated that there are both exogenous and endogenous factors involved that would configure a multifactorial origin of the disease. Given its impact and prevalence, CRS is currently a subject of intense scientific research, in order to accurately determine the targets for a more effective treatment. For this reason, we present an updated review in relation to the underlying pathophysiological mechanisms in CRS.

In vivo evidence of mitochondrial dysfunction and altered redox homeostasis in a genetic mouse model of propionic acidemia: Implications for the pathophysiology of this disorder.

Accumulation of toxic metabolites has been described to inhibit mitochondrial enzymes, thereby inducing oxidative stress in propionic acidemia (PA), an autosomal recessive metabolic disorder caused by the deficiency of mitochondrial propionyl-CoA carboxylase. PA patients exhibit neurological deficits and multiorgan complications including cardiomyopathy. To investigate the role of mitochondrial dysfunction in the development of these alterations we have used a hypomorphic mouse model of PA that mimics the biochemical and clinical hallmarks of the disease. We have studied the tissue-specific bioenergetic signature by Reverse Phase Protein Microarrays and analysed OXPHOS complex activities, mtDNA copy number, oxidative damage, superoxide anion and hydrogen peroxide levels. The results show decreased levels and/or activity of several OXPHOS complexes in different tissues of PA mice. An increase in mitochondrial mass and OXPHOS complexes was observed in brain, possibly reflecting a compensatory mechanism including metabolic reprogramming. mtDNA depletion was present in most tissues analysed. Antioxidant enzymes were also found altered. Lipid peroxidation was present along with an increase in hydrogen peroxide and superoxide anion production. These data support the hypothesis that oxidative damage may contribute to the pathophysiology of PA, opening new avenues in the identification of therapeutic targets and paving the way for in vivo evaluation of compounds targeting mitochondrial biogenesis or reactive oxygen species production.

Factores ambientales relacionados con la duración de la lactancia: estudio de seguimiento a 1 año / Environmental factors related with breastfeeding duration: a one year follow-up study

Objetivo: Estudiar los factores protectores y de riesgo relacionados con la duración de la lactancia materna completa (LMC) y total (LMT) en la Región de Murcia. Material y métodos: Estudio de seguimiento desde el nacimiento hasta el año de vida de 327 recién nacidos y sus familias entre 2009 y 2010. Estudio descriptivo, de supervivencia de la lactancia y regresión de Cox. Resultados: La duración media de la LMC fue de 82 días y la prevalencia a los 6 meses del 15%. La prevalencia de la LMT a los 12 meses fue del 20%. El riesgo relativo (RR) para la LMC a los 6 meses variaba según las diferentes situaciones: madre fumadora (1,79; intervalo de confianza [IC] del 95%: 1,35-2,38), ausencia de «contacto precoz» (1,18; IC del 95%: 1,08-1,28), ingesta de alcohol -al menos una bebida/semana- (1,57; IC del 95%: 1,12-2,21), arrastrar trazas de tóxicos del trabajo a casa -en ropa o zapatos- durante el embarazo (1,43; IC del 95%:1,10-1,87), estudios maternos universitarios (0,48; IC del 95%: 0,33-0,70) y duración de la baja maternal (días) (0,99, IC del 95%: 0,98-0,99). El RR para la LMT a los 12 meses también difería según el tabaquismo materno (cigarros/semana) (1,01; IC del 95%: 1,01-1,02), la duración de las experiencias previas de lactancia materna (semanas) (0,98; IC del 95%: 0,97-0,99) y el tiempo de baja maternal (días) (0,99; IC del 95%: 0,98-0,99). Conclusiones: Los programas enfocados a conseguir una lactancia materna prolongada deberían contemplar un abordaje integral que ayude a crear ambientes más saludables desde la etapa periconcepcional, que incluya eliminar la exposición a drogas legales e ilegales, disminuir la contaminación química del trabajo hacia el hogar, fortalecer el contacto precoz en el paritorio, dedicar más recursos a las mujeres con menos estudios y contemplar mecanismos legales que prolonguen la baja por maternidad (AU)

Objective: To study the risk and protective factors related for the length of breastfeeding and full breastfeeding (FB) in the Region of Murcia, Spain. Methods: Follow-up study from birth until the first year of 327 newborns and their families between 2009 and 2010. We present the descriptive study, survival analysis of breastfeeding and Cox regression model. Results: The median duration of FB was 82 days and 6 months with a prevalence of 15%. The prevalence of breastfeeding at 12 months was 20%. Relative risk (RR) for FB at 6 months: mother smoking (1.79; 95%CI: 1.35-2.38), absence of 'early skin-to-skin contact' -after the first hour- (1.18; 95%CI: 1.08-1.28), alcohol intake (at least one drink/week) (1.57; 95%CI: 1.12-2.21), take-homes exposures (chemicals from the work can come home on clothing and shoes) during pregnancy (1.43; 95%CI: 1.10-1.87), maternal university studies (0.48; 95%CI: 0.33-0.70) and maternity leave length (days) (0.99; 95%CI: 0.98-0.99). The RR for breastfeeding at 12 months: maternal smoking (cigarettes/wk) (1.01; 95%CI: 1.01-1.02), duration of previous breastfeeding experiences (weeks) (0.98; 95%CI: 0.97-0.99) and maternity leave length (days) (0.99; 95%CI: 0.98-0.99). Conclusions: A comprehensive approach that helps create healthier environments from the periconcepcional stage must be considered in the development of programs focused on achieving sustained breastfeeding. Factors to consider in program development include: the elimination of exposure to legal and illegal drugs, reduction of take-homes (para-occupational) exposures, expedite early mother-newborn contact in the delivery room, devote more resources to less educated women, and contemplate legal reforms to extend maternity leave (AU)

Total ammoniacal nitrogen biofiltration of wastewaters from aquaculture systems using Macrocystis spp.

The results of total ammoniacal nitrogen (NH(3) + NH(4) (+)) removal in aquaculture systems using two experimental sets, aquatic seedlings produced in laboratory controlled conditions and wild seaweed (Macrocystis spp.) in reproductive state, are shown in this work. Biofiltration assays were carried out using a load of total ammoniacal nitrogen (TAN) of 1 mg/L. Absorption rates were measured taking into account a previous surface characterization, which gave values of 44 ± 14 cm(2)/g and 18 ± 6 cm(2)/g for aquatic seedlings and wild algae, respectively. The following parameters were measured during the experimental runs: temperature, pH, O(2), illuminance or light intensity, salinity and total solids. TAN removals of 61% and 70% were achieved for the seedlings and Macrocystis spp., respectively, after 17 h of treatment. The TAN absorption results were expressed as a function of surface and mass achieving the following values: 3.0 nmol N cm(-2) h(-1) and 111 nmol N g(-1) h(-1) for the seedlings, and 6.9 nmol N cm(-2) h(-1) and 122.4 nmol N g(-1) h(-1) for the macroalgae. In the light of these biofiltration processes, the initial TAN concentration decreased by 90% for the seedlings and wild algae over approximately 110 and 41 h, respectively. In addition, TAN removals achieved with Macrocystis spp. were always higher than those obtained with aquatic seedlings for the same operating periods.

Tumour VEGF/non tumour VEGF protein expression ratio as a biomarker for survival in colorectal cancer patients.

AIMS: Vascular endothelial growth factor (VEGF) over-expression is frequently considered as a marker of both, a poor prognosis and of an aggressive tumour phenotype. Colorectal carcinoma is still one of the most lethal malignancies. Thus, our purpose was to study the expression of VEGF in tumour tissue (VEGF(t)) and in the tissue surrounding tumours (VEGF(nt)) and analyse its correlation with clinico-pathological features and overall survival. METHODS: The study was designed to determine the concentration of vascular endothelial growth factor in tumour (n = 87) and non-tumour tissue (n = 230) obtained form the colorectal cancer patients. Accordingly, VEGF expression was studied in tissue homogenates by a quantitative sandwich ELISA method. RESULTS: The study was performed on 317 colorectal samples from 87 colorectal cancer patients. VEGF expression was higher in the tumour than in the non-tumour area (P < 0.0005). In areas of 5-10 cm around the tumours, VEGF expression was higher than the expression obtained in proximal or distal edge of the resection. VEGF(t) expression was lower in patients with stage I than in patients with stage II, III, or IV. However, a shorter overall survival time was evident when the ratio obtained between VEGF expression in the tumour and mean VEGF expression in the non-tumour areas of the same patient (VEGF(t)/VEGF(nt) ratio) was ≤2 (P = 0.019). CONCLUSIONS: VEGF expression in colorectal cancer tissue was higher in tumour than in non-tumour areas. VEGF(t) expression was lower in initial clinical stages. Indeed, patients who presented a VEGF(t)/VEGF(nt) ratio >2 survived longer. This is the first report showing that the clinical outcome could be related to the VEGF(nt) over-expression in colorectal cancer patients.

[The intercontinental schizophrenia outpatient health outcomes study (IC-SOHO): initial 6 month findings of the sample in Latin America]. / Estudio observacional intercontinental de los resultados de salud en pacientes ambulatorios con esquizofrenia (IC-SOHO): hallazgos iniciales de 6 meses de la muestra en Latinoamérica.

The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression-Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the ICSOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p<0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p<0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other studies in different samples, where it was found that olanzapine was more effective and better tolerated than risperidone or conventional antipsychotics.

Estudio observacional intercontinental de los resultados de salud en pacientes ambulatorios con esquizofrenia (IC-SOHO): hallazgos iniciales de 6 meses de la muestra en Latinoamérica / The intercontinental schizophrenia outpatient health outcomes study (IC-SOHO): initial 6 month findings of the sample in Latin America

El estudio IC-SOHO se diseñó para aportar información sobre los tratamientos antipsicóticos en la práctica clínica real mediante la evaluación de una población de muestra grande y diversa con esquizofrenia. Este documento describe los hallazgos de los primeros 6 meses del IC-SOHO en Latinoamérica. A la fecha éste es el estudio observacional más grande de su tipo en esta región. En este estudio observacional y prospectivo se ingresaron aquellos pacientes ambulatorios con esquizofrenia que requirieron un cambio o un inicio de medicación antipsicótica. La efectividad se evaluó utilizando la escala de Calificación de Impresión Clínica Global-Gravedad (CGI-S). La tolerabilidad se evaluó mediante cuestionarios de efectos adversos y mediciones de peso. Se presentan aquí las comparaciones entre olanzapina (monoterapia), risperidona (monoterapia) y antipsicóticos convencionales (monoterapia y terapia combinada). En conjunto, participaron 7.658 pacientes en el IC-SOHO; n=2.671 provenientes de 11 países de Latinoamérica se incluyeron en este informe. A los 6 meses la proporción de pacientes que respondieron a la olanzapina fue significativamente mayor que los que respondieron a la risperidona o los antipsicóticos convencionales (p < 0,001). Los pacientes del grupo de olanzapina tuvieron mejorías mayores en todos los dominios de síntomas, incluyendo los síntomas generales, positivos, negativos, depresivos y cognoscitivos, en comparación con la risperidona (p<0,05) o los antipsicóticos convencionales (p<0,001). Los síntomas extrapiramidales (SEP) y la discinesia tardía (DT) disminuyeron desde la línea basal en los grupos tratados con olanzapina y risperidona, pero aumentaron en el grupo convencional. Los efectos adversos relacionados con la función sexual fueron más prominentes en el grupo convencional. Se observó ganancia de peso en cada grupo de tratamiento, aunque los pacientes del grupo de olanzapina aumentaron más de peso, seguidos por los de risperidona y después por los de antipsicóticos convencionales. Nuestros hallazgos en esta población de muestra latinoamericana emulan los resultados de otros estudios en muestras diferentes, donde se encontró que la olanzapina fue más efectiva y mejor tolerada que la risperidona o los antipsicóticos convencionales

The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression- Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the ICSOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p<0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p<0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other studies in different samples, where it was found that olanzapine was more effective and better tolerated than risperidone or conventional antipsychotics

Barbara McClintock and the transposition concept.

Barbara McClintock was awarded Nobel Prize in Physiology or Medicine in 1983 for the discovery and characterization of jumping genes or transposons. In 1948 she described for the first time maize controlling elements. She proposed 'transposition' as a mechanism that relates phenotypic characteristics with the presence of unstable genes. This discovery was 'ignored' even though she was recognized as a brilliant cytogeneticist. In this paper I approach the matter of the maize research groups within which McClintock developed all of her work, and the problem of variegation in relation to unstable genes and transposition.

[Hepatic adenoma and focal nodular hyperplasia: difficult differential diagnosis. Presentation of a case of focal nodular hyperplasia]. / Adenoma hepático e hiperplasia nodular focal: difícil diagnóstico diferencial. Presentación de un caso de hiperplasia nodular focal.

Hepatic adenoma and focal nodular hyperplasia are unfrequent benign lesions of the liver with individual histologic characteristics, but not always clinically distinguishable. The main difference is the intratumoral or intraperitoneal bleeding risk (high in adenoma and virtually zero in focal nodular hyperplasia). Surgery is the elective treatment for the first, while a more conservative attitude is allowed for the second. We present the case of a woman with an hepatic mass that clinically and radiologically seemed to be an adenoma. An atypical hepatectomy was done uneventfully. The examination of the specimen showed shaw focal nodular hyperplasia. We review the diagnostic and therapeutic controversy between these entities, because only the histologic examination of the entire surgical specimen could demonstrate the real nature of the lesion.