SEOM clinical guidelines to primary prevention of cancer (2018).

Cancer is the leading social and healthcare problem of the twenty-first century. The aim of primary prevention is to decrease the incidence of cancer by avoiding the known causes and risk factors. Nevertheless, it has been estimated that cancer diagnoses could be halved through primary prevention measures. A comprehensive review of the scientific evidence regarding the main carcinogens and risk factors and primary prevention recommendations have been put forth based on this evidence. The GRADE scale has been used to classify the grade of evidence. We present the scientific evidence and recommendations for primary prevention of the major modifiable risk factors: smoking, alcohol, diet, obesity, physical activity, occupational and environmental factors, ultraviolet radiation, infections, and socioeconomic factors. Primary prevention is a simple, effective means to lower the incidence of cancer. Preventive measures must be circulated in the fight against cancer.

Aplicación de un árbol de decisión difusa con clasificación de ambigüedad para determinar el exceso de peso en escolares / Application of a fuzzy decision tree with ambiguity classification to determine excess weight in schoolchildren

RESUMEN La técnica del árbol de decisiones en las ciencias de la salud sirve para comprender las correlaciones entre las descripciones de los pacientes y para clasificar de forma precisa en diversas categorías. El objetivo del estudio fue analizar la exactitud de la clasificación del exceso de peso de escolares mediante la aplicación de un árbol de decisión difusa, utilizando una base de datos de Itaupú, Paraná (Brasil). Se utilizó la base de datos de una muestra conformada por 5962 estudiantes (3024 del sexo femenino y 2938 del sexo masculino), con un rango de edad entre los 6 a 17 años de edad. Las variables consideradas fueron peso, estatura y el Índice de Masa Corporal (IMC). Para clasificar los datos antropométricos de los escolares se utilizó un árbol de decisión difusa. Los resultados del aprendizaje mostraron una clasificación correcta en el sexo femenino de 2688 y en el sexo masculino de 2471 registros respectivamente. En relación a la exactitud, se determinó 84% en el sexo masculino y 89% en el sexo femenino. El Área Bajo la curva mostró valores más altos en el método Difuso y en ambos sexos (0.965-0.983), mientras que en el método clásico, fueron inferiores (0.804-0.895). De acuerdo a los resultados calculados es posible aplicar el árbol de decisión difusa para la clasificación de escolares con exceso de peso con una exactitud aceptable, además se presenta como una técnica alternativa que puede ahorrar tiempo a la hora de analizar el estado nutricional, sin embargo, no se realizó otros cálculos estadísticos que tengan que ver con la precisión y exactitud a través de métodos estadísticos convencionales y comparar con la técnica de árboles difusos.

ABSTRACT The decision tree technique in the health sciences serves to understand the correlations between the descriptions of patients and to classify accurately in various categories. The aim of the study was to analyze the accuracy of the classification of excess weight of schoolchildren through the application of a fuzzy decision tree, using a database of Itaupú, Paraná (Brazil). We used the database of a sample consisting of 5962 students (3024 female and 2938 male), with an age range between 6 to 17 years of age. The variables considered were weight, height and the Body Mass Index (BMI). To classify the anthropometric data of the students, a diffuse decision tree was used. The learning results showed a correct classification in the female sex of 2688 and in the male sex of 2471 records respectively. In relation to accuracy, 84% was determined in the male sex and 89% in the female sex. The Area under the curve showed higher values in the Fuzzy method and in both sexes (0.965-0.983), while in the classical method, they were lower (0.804-0.895). According to the calculated results it is possible to apply the fuzzy decision tree for the classification of overweight students with an acceptable accuracy, and it is presented as an alternative technique that can save time when analyzing the nutritional status, however, no other statistical calculations were made that have to do with the precision and accuracy through conventional statistical methods and compare with the technique of fuzzy trees.

Recurrent non-functioning pituitary adenomas: a review on the new pathological classification, management guidelines and treatment options.

At least 50% of surgically resected non-functioning pituitary adenomas (NFPA) recur. Either early or late adjuvant radiotherapy is highly efficacious in controlling recurrent NFPA but associates potentially burdensome complications like hypopituitarism, vascular complications or secondary neoplasm. Reoperation is indicated in bulky tumor rests compressing the optic pathway. To date, no standardized medical therapy is available for recurrent NFPA although cabergoline and temozolomide show promising results. Guidelines on the management of recurrent NFPAs are now available. The new 2017 WHO pituitary tumor classification, based on immunohistochemistry and transcription factor assessment, identifies a group of aggressive NFPA variants that may benefit from earlier adjuvant therapy. Nevertheless, NFPA patients exhibit a reduced overall life expectancy largely due to hypopituitarism and treatment-related morbidity. The management of recurrent NFPA benefits from a multidisciplinary teamwork of surgeons, endocrinologists, radiation oncologists, ophthalmologists, pathologists and neuro-radiologists in order to provide individualized therapy and anticipate deterioration.

Second primary malignancies in patients with neuroendocrine tumors.

PURPOSE: An association between neuroendocrine tumors (NETs) and second primary malignancies (SPMs) has been reported. We have examined the incidence and etiology of SPMs in patients with NETs included in the Neuroendocrine Tumor Association of Andalusia (ATNEA) Registry. METHODS: Data on 111 patients were collected. Sex, age, NET site, chromogranin A levels, neuropeptide secretion and disease stage were compared between NETs with and without SPMs. RESULTS: SPMs were present in 21 patients (18.9 %): five colorectal tumors, four non-small-cell lung cancers, three gastric cancers, two tumors in the small intestine, one hepatocarcinoma, two ovarian tumors, one breast adenocarcinoma, one hypernephroma, one bladder cancer, and one neuroblastoma. SPMs were present in 18 % of patients with a gastrointestinal NET and 22 % of those with a non-gastrointestinal NET. SPMs were found in 23 % of patients with elevated levels of serum chromogranin A, compared to 17 % of patients with normal levels, and in 22 % of patients with functional tumors, compared to 11 % of those with non-functional tumors. Finally, SPMs were observed in 24 % of patients with a local or locoregional tumor but in only 13 % of those with a metastatic tumor. No other differences between patients with and without SPMs were observed. CONCLUSIONS: The percentage of patients with SPMs in the ATNEA Registry is similar to those reported in other series. In our registry, patients with functional NETs and local/locoregional tumors have higher probability of SPMs. The low number of patients, selection bias and other etiologic factors of SPMs may have influenced our results.

New species of Tetramorium Mayr (Hymenoptera: Formicidae) from Puebla State, Mexico.

Tetramorium notomelanum sp. n. is described from the Tehuacán Valley, state of Puebla, México. Its distribution and relation with other species of the tortuosum-group is discussed. The new species of Tetramonium is described from workers, and distinguished from others of the group by several characters: i) black coloration of the body; ii) size: T. notomelanum sp. n. is smaller than T. hispidum (Wheeler), T. mexicanum Bolton and T.spinosum (Pergande), but larger than T. bicolorum Vásquez-Bolaños and T. placidum Bolton; iii) length of the hairs of the dorsal of the head are equal to the diameter of eye; iv) the length of the hairs on the scape and tibiae less than the width of the appendage where they are located. This is the second species of the tortuosum group of Tetramorium found in the State of Puebla, and the fourth recorded in Mexico.

New species of Tetramorium Mayr (Hymenoptera: Formicidae) from Puebla State, Mexico

Tetramorium notomelanum sp. n. is described from the Tehuacán Valley, state of Puebla, México. Its distribution and relation with other species of the tortuosum-group is discussed. The new species of Tetramonium is described from workers, and distinguished from others of the group by several characters: i) black coloration of the body; ii) size: T. notomelanum sp. n. is smaller than T. hispidum (Wheeler), T. mexicanum Bolton and T.spinosum (Pergande), but larger than T. bicolorum Vásquez-Bolaños and T. placidum Bolton; iii) length of the hairs of the dorsal of the head are equal to the diameter of eye; iv) the length of the hairs on the scape and tibiae less than the width of the appendage where they are located. This is the second species of the tortuosum group of Tetramorium found in the State of Puebla, and the fourth recorded in Mexico.

Características epidemiológicas de la insuficiencia renal crónica (ICR) en pediatría / Epidemiological characteristics of chronic renal failure (CRF)in pediatrics

Introducción: La Insuficiencia renal crónica (IRC) es un síndrome clínico complejo que resulta de un deterioro progresivo de la función renal. Se caracteriza por su elevada morbimortalidad. Su etiología y su incidencia varían con la región geográfica. El objetivo del trabajo es determinar las características epidemilógicas de las IRC en pacientes pediátricos que consultaron en el Servicio de Neforlogía Infantil de un Hospital de cuarto nivel de atención. Material y Métodos: Estudio observacional descriptivo, longitudinal. Se analizaron los expediantes clínicos de los pacientes con IRC que consultaron a nuestro servicio en el período comprendido entre noviembre de 1990 a octubre de 2002. Se estudiaron: edad, sexo, precedencia, nivel socioeconómico, etiología, estadío de la IRC y tasa de mortalidad en el periodo. Los datos fueron analizados por el programa Epi 6.0. Resultados: Se han registrado un total de 60 casos de IRC. El promedio de la incidencia anual aumentó de 2.3 paciente/año en los 5 primeros a 5.8 al final del periodo: la mínima fue 3 casos/año (1992, 1993, 1994) y la máxima con 8 casos (1999 y 2000). La edad promedio fue de 6.4 años (DS. 4.4). La frecuencia fue mayor en el sexo masculino (ralación 3:2). Procedían principalmente de los Dptos. Central, Cordillera y Asunción, siendo mayoritariamente de nivel socieconómcio bajo. El 50 porcientos de los casos fueron referidos, el resto consultó en forma espontánea. La contrareferencia fue débil. La etiología más frecunte fue la Uropatía. En 53.3 porcientos de los pacientes ingresaron en estadío de IRC severa. La tasa de mortalidad en el periodo de estudio fue del 13 porcientos. Conclusiones: La incidencia de casos de IRC en niños/as se incremento en los últimos años. La frecuencia relativa de la IRC en nuestra población fue mayor en el sexo masculino. La principal causa de IRC es la Uropatía. La mayoría de los pacientes ingresaron en estadío severo.

Dentinogenesis imperfecta. Presentacion de un caso clinico. / Dentinogenesis imperfecta. Report of a clinical case

Se presenta un caso de dentinogenesis imperfecta en un paciente de 4 anos y medio y su rehabilitacion con coronas de acero cromado