Intravascular schwannoma as an extremely unusual cause of vein obstruction: a case report.

The blood vessel lumen is an extremely rare location for a benign peripheral nerve sheath tumor like schwannoma. Less than 10 cases have been previously reported. In this report, we present a case of a 68-year-old woman who had a soft tissue nodule at the posterior calf of her left leg during a physical examination. Pathological examination was performed after complete surgical excision. The patient underwent follow-up for 12 months after surgery without evidence of recurrence or any other complication. This is the first case of intravascular schwannoma reported as a cause of vein obstruction. Microscopically, the tumor was composed of Schwann spindle cells that were immunoreactive for S100 protein and SOX10. This tumor was surrounded by a well-defined vascular smooth muscle wall. Prospective series are required to improve the knowledge on the underlying mechanisms of intravascular schwannoma development.

Influence of type of household on prognosis at one year in patients ≥65 years attending hospital emergency departments in Spain. The EDEN-6 study.

OBJECTIVE: To investigate whether the type of household is associated with prognosis at one year in patients ≥65 years of age discharged after medical consultation requiring emergency department care. METHODS: Data from the Emergency Department and Elder Needs (EDEN) cohort were used. This retrospective cohort included all patients ≥65 years of age seen in 52 Spanish emergency departments over one week (April 1-7, 2019) in whom the type of household was recorded and categorized as living at home alone, with relatives, with professional caregivers, or in a nursing home. Patient demographic and other baseline characteristics and management during the index emergency department episode were recorded and used to adjust the following 1-year outcomes: all-cause mortality, hospitalization and emergency department revisit. Associations between type of household and outcomes are expressed as adjusted hazard ratios with 95% confidence intervals using living alone as the reference category. RESULTS: 13,442 patients with a median age of 79 years (interquartile range 72-86) were included; 56% were women, 12.2% of patients lived alone, 74.9% with relatives, 3.9% with a professional caregiver, and 9.1% in a nursing home. During the year following discharge, the mortality rate was 14.0%, the hospitalization rate 29.7%, and the emergency department revisit rate 59.3%. In the fully adjusted model, the risk of death was associated only with living in a nursing home (hazard ratio 1.366 (1.101-1.695)). On the other hand, the risk of hospitalization was lower in individuals living in nursing homes (hazard ratio 0.783 [0.676-0.907]) and at home with relatives (hazard ratio 0.897 [0.810-0.992]), while the risk of emergency department revisit was lower in individuals living in nursing homes (hazard ratio 0.826 [0.742-0.920]) or at home with caregivers (hazard ratio 0.856 [0.750-0.976]). CONCLUSION: The type of household was modestly associated with the one-year prognosis of patients ≥65 years of age discharged after attendance at an emergency department. Living in a nursing home is associated with an increased risk of death but a decreased risk of rehospitalization or emergency department revisit, while living at home with relatives or professional caregivers is associated only with a decreased risk of hospitalization and emergency department revisit, respectively.

Malignant solitary fibrous kidney tumor with peritoneal disease: a case report.

We report a case of a large malignant solitary fibrous kidney tumor. A complete surgical resection of the primary tumor and peritoneal disease was carried out, and a histological examination confirmed the initial diagnosis. We describe and discuss the characteristics of this rare kidney neoplasm.

Valor pronóstico de los receptores hormonales, receptor del factor de crecimiento epidérmico humano, ciclinas D1 y D2, B-Cell Lymphoma2 y ciclooxigenasa-2 en pacientes jóvenes con cáncer de mama / Prognostic value of hormone receptors, human epidermal growth factor receptor, cyclins D1 and D2, B-cell lymphoma 2 and cyclooxygenase-2 in young patients with breast cancer

Objetivo: Valor pronóstico de receptores hormonales (RRHH), expresión de HER-2, ciclinas D1 y D2, bcl-2 y ciclooxigenasa-2 (COX-2) en pacientes de 35 años o menores con cáncer de mama. Sujetos y método: En una serie de 71 pacientes jóvenes, cuya evolución se conocía, analizamos por segunda vez las piezas tumorales mediante inmunohistoquímica y tissue arrays. Evaluamos la influencia pronóstica de estos factores con el test de la chi al cuadrado y el método de Kaplan-Meier. Resultados: El 67% de las pacientes mostraban RRHH positivos y el 48,6% sobreexpresaba el HER- 2. Fueron ciclinas D1 y D2 positivos el 59,1% y 59,7%, respectivamente. El bcl-2 en el 62,5% de los casos, y la COX-2 en el 63,4% de los tumores. La positividad de RRHH y de COX-2 se relacionó significativamente con un mayor riesgo de recidiva local (OR = 4,6, p = 0,03 para RRHH y OR = 3,7, p = 0,02 para COX-2). Conclusiones: La sobreexpresión de RRHH y COX-2 desempeña un papel pronóstico en la progresión del cáncer de mama en mujeres muy jóvenes. La expresión de ciclinas D1 y D2, y bcl-2 no influyó en su evolución(AU)

Objetive: To investigate the value of hormone receptor (HR) status, HER-2, cyclins D1 and D2, bcl-2 and cyclooxygenase-2 (COX-2) in predicting the outcome of very young breast cancer patients (below 35 years). Subjects and method: In this study HR, HER-2, cyclins D1 and D2, bcl-2 and COX-2 were determined for a second time by immunohistochemistry and tissue arrays in a cohort of 71 patients aged less than 35 years with known outcome. The prognostic influence of these factors was evaluated by the chi-square test and Kaplan Meier method. Results: Expression of HR was detected in 67% of the patients, HER-2 in 48.6%, cyclins D1 and D2 in 59.1% and 59.7%, respectively, bcl-2 in 62.5% and COX-2 in 63.4% of breast tumors. HR and COX- 2 overexpression were significantly correlated with a major risk of local relapse (OR: 4.6, P=.03 for HR and OR: 3.7, P=.02 for COX-2). Conclusions: Increased expression of HR and COX-2 may play a role in the progression of primary breast carcinoma in very young patients. Overexpression of cyclins D1 and D2 and bcl-2 had no prognostic value(AU)

Application of FISH 7q in MDS patients without monosomy 7 or 7q deletion by conventional G-banding cytogenetics: does -7/7q- detection by FISH have prognostic value?

Chromosomal abnormalities are detected in 40-60% of patients with de novo myelodysplastic syndromes (MDS). This study used the FISH technique in 773 patients with de novo MDS without evidence of monosomy 7 (-7) or 7q deletion (7q-) by conventional G-banding cytogenetics (CC) to analyze their prognostic impact by FISH alone. FISH detected -7/7q- in 5.2% of patients. Presence of -7/7q- was associated with shorter overall survival than absence of such aberrations. Our results suggest that FISH 7q could be beneficial in patients with intermediate WHO morphologic risk stratification and no evidence of -7/7q- by CC.

Linfomas primarios de mama. Presentación de nuestra casuística y revisión de la literatura científica / Primary breast lymphoma. Presentation of our casuistics and literature review

Los linfomas primarios de mama (LPM) constituyen una entidad clínica muy poco frecuente; representan menos del 1% de los tumores malignos de mama. Debido a su baja frecuencia es rara su consideración en la evaluación preoperatoria de pacientes que presentan un tumor mamario. Habitualmente no presenta signos clínicos ni mamográficos que nos hagan pensar en esa entidad. El diagnóstico es fundamentalmente anatomopatológico y para su inclusión como linfoma primario de mama debe hacerse un exhaustivo estudio de extensión y cumplirse los criterios originalmente descritos por Wiseman y Liao. El manejo inicial es quirúrgico con fines diagnósticos, pues la extensión de la cirugía no influye en el control local de la enfermedad. El tratamiento de elección es radioterápico, con o sin quimioterapia asociada, según el fenotipo histológico del tumor. Como único factor pronóstico estadísticamente significativo se considera la estadificación de Ann-Arbor. Tomando como referencia la base de datos de la unidad de mama del Hospital 12 de Octubre, describimos 3 casos clínicos de linfomas primarios de mama diagnosticados entre los años 1990 y 2005, y realizamos una amplia revisión bibliográfica del tema

Less than 1% of all malignant breast tumors are due to primary lymphoma. Because the frequency of this type of tumor is low, primary lymphoma is often overlooked in the preoperative evaluation of patients with breast tumors. Furthermore, there are no specific radiological or clinical findings that would suggest this entity. Diagnosis is based on histopathology. Before a diagnosis of primary breast lymphoma can be made, extensive investigations must be performed to ascertain that the criteria defined by Wisemand and Liao are fulfilled. The treatment strategy is surgical for diagnostic purposes but the extent of the surgery does not influence local control of the disease. The treatment of choice is radiation therapy with or without chemotherapy, depending on the tumoral phenotype. The only statistically significant prognostic factor in this entity is the Ann-Arbor staging system. Using the 12 de Octubre Hospital's database as reference, we describe three cases of primary breast lymphoma diagnosed between 1990 and 2005. A comprehensive review of the literature is also provided

Ansiedad en familiares de esquizofrénicos: eficacia de un programa de intervención familiar / Anxiety in relatives of schizophrenic patients: efficiency of a family treatment programme

El objeto de este trabajo es estudiar la eficacia de un programa de intervención para familiares de esquizofrénicos sobre distintas facetas de la ansiedad, evaluadas mediante el STAI (Spielberg, Gorsuch y Lushene, 1982) y el ISRA (Miguel-tobal y Cano-Vindel, 1984) en una muestra de 25 familiares de personas con diagnóstico de esquizofrenia. Los resultados de este estudio revelan que mediante nuestro programa de intervención los familiares reducen sus niveles de ansiedad. Se discute acerca de los beneficios que esta mejora puede tener sobre los familiares con respecto al manejo del trastorno y a los resultados de la intervención (AU)