Detecting soil water redistribution in subsurface drip irrigated processing tomatoes using electrical resistivity tomography, proximal sensing and hydrological modelling.

In this study, multiple soil-plant-atmosphere continuum (SPAC) monitoring methodologies, including electrical resistivity tomography (ERT), proximal thermal sensing techniques, and micrometeorological data, were combined with two-dimensional (2-D) soil hydrological modelling using HYDRUS 2-D to explore the soil water redistribution, and infer the relative crop water status in a subsurface drip irrigated (SDI) processing tomato field located in California (Yolo County, USA). Specifically, time-lapse ERT surveys were performed at two transects distributed parallel and perpendicular, respectively, to the SDI line, during an irrigation event. The ERT results were compared to HYDRUS 2-D outputs and the relative differences were explained in the form of local heterogeneities in electrical resistivity (ER) changes, as a proxy for soil water content (SWC) variations. Concurrent simultaneous soil wetting and root water uptake during the last irrigation event of the season caused negligible changes in ER in the active root zone. Slight differences in ER were observed in the top 20 cm along the dripline, confirming that the emitter spacing is small enough to create a wetted strip along the processing tomato bed. These changes were also compared to SWC values measured with time domain reflectometry soil moisture sensors. A comparison between HYDRUS 2-D and ERT confirmed negligible changes in ER during irrigation due to simultaneous wetting and root water uptake processes. In addition, a good correlation was observed between the proximal sensed and the ERT results. Finally, the findings of this study underscore the necessity of using multiple methods for improving our knowledge of the SPAC system under real field conditions.

Ulnar nerve mononeuropathy in a patient with Hansen's disease: Clinical and radiological features.

Leprosy is a chronic infection caused by bacteria called Mycobacterium leprae. This is a prevalent disease in low-income countries, and it has not been completely eradicated. We present the case of a 29-year-old man with a previous diagnosis of Hansen's disease, who consulted for pain in the left elbow and wrist, associated with fever with preserved mobility and pain on palpation. Diagnosis of mononeuropathy of the ulnar nerve was made by MRI of the elbow and forearm. This entity corresponds to an infrequent complication of this infection with few cases reported in the literature. Our added value with this case is to show and explain the clinical imaging correlation, which is vital to understand the presentation of symptoms and to carry out a comprehensive and rapid approach to establish adequate and timely treatment.

Hepatic levels of S-adenosylmethionine regulate the adaptive response to fasting.

There has been an intense focus to uncover the molecular mechanisms by which fasting triggers the adaptive cellular responses in the major organs of the body. Here, we show that in mice, hepatic S-adenosylmethionine (SAMe)-the principal methyl donor-acts as a metabolic sensor of nutrition to fine-tune the catabolic-fasting response by modulating phosphatidylethanolamine N-methyltransferase (PEMT) activity, endoplasmic reticulum-mitochondria contacts, ß-oxidation, and ATP production in the liver, together with FGF21-mediated lipolysis and thermogenesis in adipose tissues. Notably, we show that glucagon induces the expression of the hepatic SAMe-synthesizing enzyme methionine adenosyltransferase α1 (MAT1A), which translocates to mitochondria-associated membranes. This leads to the production of this metabolite at these sites, which acts as a brake to prevent excessive ß-oxidation and mitochondrial ATP synthesis and thereby endoplasmic reticulum stress and liver injury. This work provides important insights into the previously undescribed function of SAMe as a new arm of the metabolic adaptation to fasting.

Infrared optical signature reveals the source-dependency and along-transport evolution of dust mineralogy as shown by laboratory study.

Advancing knowledge of the mineralogical composition of dust is key for understanding and predicting its climate and environmental impacts. The variability of dust mineralogy from one source to another and its evolution during atmospheric transport is not measured at large scale. In this study we use laboratory measurements to demonstrate that the extinction signature of suspended dust aerosols in the 740 - 1250 cm-1 atmospheric window can be used to derive dust mineralogy in terms of the main infrared - active minerals, namely quartz, clays, feldspars and calcite. Various spectral signatures in dust extinction enable to distinguish between multiple global sources with changing composition, whereas modifications of the dust extinction spectra with time inform on size - dependent particles mineralogy changes during transport. The present study confirms that spectral and hyperspectral infrared remote sensing observations offer great potential for elucidating the size - segregated mineralogy of airborne dust at regional and global scales.

Sacral schwannoma: case report and review of the literature.

Schwannomas are tumors of the macroglia cells, most frequently localized to the brain, in the pontocerebellar angle. We present the case of a 53 year-old female patient who presented multiple times with diffuse abdominal pain and was initially diagnosed as having a complex right adnexal mass. Exploratory laparotomy found a retroperitoneal mass and later on, the presence of a sacral schwannoma was found, suspected initially on contrast magnetic resonance imaging of the abdomen and pelvis, and confirmed by means of lesional biopsy and histopathology. This is a rare and unusual presentation accounting for only 5% of this tumor location and poses a challenge for imaging diagnosis, directly impacting the approach to the patient and any future interventions. There are few reports in the literature about giant sacral schwannomas, but these tumors have been found to extend within the spinal space towards the vertebral space, even occupying part of the abdomen. Hence, the importance of recognizing the presence of this tumor as well as its imaging features.

Incidental finding of left vertebral artery agenesis: Case report.

Vertebral artery agenesis is a rare congenital malformation, with few reported cases in the literature and no epidemiological data in the world at this point in time. The importance of diagnosis lies in identifying a potential risk factor for future ischemic events of the posterior circulation, in particular in the young population. It is also important to determine the etiology of chronic headache of unexplained cause that could be attributed to this entity. The present case describes this finding in a 27-year-old female patient with no pathological history, with multiple stab wounds was brought to the emergency room of our hospital .During the study of whether the wounds caused had been penetrating to the neck, a CT angiography was performed. The CT documented an incidental finding of absent left transverse foramen of the cervical vertebrae, absence of the left vertebral artery from its origin in the ipsilateral subclavian artery and a single dolichoectatic right vertebral artery crossing the midline at the entrance to the foramen magnum.

Cribado de cáncer de pulmón: Supervivencia en un amplio programa de detección precoz en España (I-ELCAP) / Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP)

Introducción y objetivo: El cáncer de pulmón (CP) se diagnostica habitualmente en estadios avanzados con una supervivencia media a cinco años del 12%. Ensayos como el National Lung Screening Trial (NLST) y el NEderlands Leuvens longkanker Screenings ONderzoek (NELSON) demuestran una reducción de la mortalidad que justifican la implantación del cribado en población de riesgo. Nuestro objetivo es presentar los resultados de supervivencia del programa de cribado de CP más amplio de España con tomografía computarizada de baja dosis (TCBD). Métodos: Se analizaron los datos del programa Internacional de Detección Precoz de CP (IELCAP) en Valencia, España. Este programa reclutó fumadores o exfumadores con una edad entre 40- 80 años. Se comparan los resultados con otros programas de similar tamaño. Resultados: Un total de 8.278 participantes fueron reclutados con al menos dos rondas de seguimiento, hasta noviembre de 2020 (62,8% varones), realizando una media de seis rondas de cribado por individuo. Diagnosticamos 239 tumores en 12 años de seguimiento. El adenocarcinoma fue el tumor más frecuente con un 61,3% en estadio I. Las tasas de prevalencia e incidencia fueron de 1,5% y 1,4%, respectivamente, con una tasa de detección anual de 0,17. Las tasas de supervivencia cáncer específica a cinco años fueron del 90 y del 80,1% a 10 años. La adherencia fue de 96,84%. Conclusión: La experiencia del programa más amplio de España demuestra que la supervivencia se mejora cuando se realiza en equipos multidisciplinares con experiencia en CP y es similar a programas similares. (AU)

Introduction: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). Methods: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. Results: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. Conclusion: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs. (AU)

[Translated article] Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP) / Cribado de cáncer de pulmón: supervivencia en un amplio programa de detección precoz en España (I-ELCAP)

Introduction: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). Methods: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. Results: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. Conclusion: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs. (AU)

Introducción y objetivo: El cáncer de pulmón (CP) se diagnostica habitualmente en estadios avanzados con una supervivencia media a cinco años del 12%. Ensayos como el National Lung Screening Trial (NLST) y el NEderlands Leuvens longkanker Screenings ONderzoek (NELSON) demuestran una reducción de la mortalidad que justifican la implantación del cribado en población de riesgo. Nuestro objetivo es presentar los resultados de supervivencia del programa de cribado de CP más amplio de España con tomografía computarizada de baja dosis (TCBD). Métodos: Se analizaron los datos del programa Internacional de Detección Precoz de CP (IELCAP) en Valencia, España. Este programa reclutó fumadores o exfumadores con una edad entre 40- 80 años. Se comparan los resultados con otros programas de similar tamaño. Resultados: Un total de 8.278 participantes fueron reclutados con al menos dos rondas de seguimiento, hasta noviembre de 2020 (62,8% varones), realizando una media de seis rondas de cribado por individuo. Diagnosticamos 239 tumores en 12 años de seguimiento. El adenocarcinoma fue el tumor más frecuente con un 61,3% en estadio I. Las tasas de prevalencia e incidencia fueron de 1,5% y 1,4%, respectivamente, con una tasa de detección anual de 0,17. Las tasas de supervivencia cáncer específica a cinco años fueron del 90 y del 80,1% a 10 años. La adherencia fue de 96,84%. Conclusión: La experiencia del programa más amplio de España demuestra que la supervivencia se mejora cuando se realiza en equipos multidisciplinares con experiencia en CP y es similar a programas similares. (AU)

Tumor filoides maligno con diferenciación angiosarcomatosa / Malignant phyllodes tumor with angiosarcomatous

Resumen Los tumores filoides (TF) malignos son infrecuentes. Poco se ha descrito en la literatura sobre la diferenciación angiosarcomatosa de un TF maligno (1). Presentamos el caso de una mujer de 25 años con TF maligno de alto grado con diferenciación angiosarcomatosa y compromiso axilar. Manejada con mastectomía radical modificada y adyuvancia con radioterapia (RT). Se hace una discusión del caso y revisión de la literatura.

Abstract Malignant phyllodes tumors (TF) are rare. Little has been described in the literature on angiosarcomatous differentiation of a malignant TF. We report the case of a 25 years old woman with a malignant phyllodes tumor of high grade with angiosarcomatous differentiation and axillary involvement. She was managed with modified radical mastectomy and adjuvant radiotherapy. A discussion of the case and review of the literature was made.

Uncertainty in climate change impact studies for irrigated maize cropping systems in southern Spain.

This study investigates the main drivers of uncertainties in simulated irrigated maize yield under historical conditions as well as scenarios of increased temperatures and altered irrigation water availability. Using APSIM, MONICA, and SIMPLACE crop models, we quantified the relative contributions of three irrigation water allocation strategies, three sowing dates, and three maize cultivars to the uncertainty in simulated yields. The water allocation strategies were derived from historical records of farmer's allocation patterns in drip-irrigation scheme of the Genil-Cabra region, Spain (2014-2017). By considering combinations of allocation strategies, the adjusted R2 values (showing the degree of agreement between simulated and observed yields) increased by 29% compared to unrealistic assumptions of considering only near optimal or deficit irrigation scheduling. The factor decomposition analysis based on historic climate showed that irrigation strategies was the main driver of uncertainty in simulated yields (66%). However, under temperature increase scenarios, the contribution of crop model and cultivar choice to uncertainty in simulated yields were as important as irrigation strategy. This was partially due to different model structure in processes related to the temperature responses. Our study calls for including information on irrigation strategies conducted by farmers to reduce the uncertainty in simulated yields at field scale.

Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP). / Cribado de cáncer de pulmón: Supervivencia en un amplio programa de detección precoz en España (I-ELCAP).

INTRODUCTION: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). METHODS: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. RESULTS: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. CONCLUSION: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs.

Spanish Lung Cancer Group SCAT trial: surgical audit to lymph node assessment based on IASLC recommendations.

BACKGROUND: The Spanish Customized Adjuvant Therapy (SCAT) trial assessed the role of individualized adjuvant therapy in clinical N0 incidental pN1 and/or N2 non-small cell lung cancer (NSCLC) completely resected. We assessed surgical topics with an in-depth analysis of quality of lymphadenectomy based on International Association for the Study of Lung Cancer (IASLC) recommendations. METHODS: Patients with information about lymphadenectomy available were included (N=451). Prospectively collected data about tumor, type of resection, and postoperative morbidity and quality of lymph node dissection (LND) were retrospectively evaluated. Role of lymph node assessment on survival was analyzed using Kaplan-Meier curves, using regression models to identify prognostic factors. RESULTS: In 33.7%, 17.7% and 49.9% of cases, regions 7, 10 and 11 respectively were not assessed. In 21.1% of patients, less than three lymph node regions were biopsied, while in 19.6% of patients less than six lymph nodes were assessed. In 53,4% of patients only one N1 region was evaluated. From patients with positive N2, 8.9% had no N1 regions biopsied. Twenty-nine percent of patients with at least one N2 lymph node resected shown the highest region involved. Thirty-day postoperative mortality was unknown. Five-year overall survival (OS) was 61.7% (95% CI: 55.4-67.4%), 51.5% (95% CI: 39.2-62.4%) and 42.3% (95% CI: 32.1-52.2%) for patients with N1, N2 and N1+N2 disease, respectively (P<0.01). Both number of lymph nodes resected and number of lymph nodes involved by tumor were significantly related to prognosis. CONCLUSIONS: IASLC recommendations for surgical resections were not followed in a high proportion of surgical procedures. Hilar and mediastinal lymph node assessment and involvement showed to impact prognosis. Surgical issues such as postoperative mortality could not be evaluated owing to trial design.

Relation between cumulative damage in systemic lupus erythematosus and recognised disability by the National Social Security Institute of Spain (INSS) / Relación entre el daño acumulado en el lupus eritematoso sistémico y la discapacidad reconocida por el Instituto Nacional de la Seguridad Social de España

Introduction: Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disease that particularly affects young women during their second and third decades. Events attributed to SLE itself and others related to the disease may impact negatively on the quality of life, employment and disability. However, there are not many studies focused on the impact that the disease may have on patients regarding those aspects. In Spain, the evaluation of disability and the assignation of a pension is given by the National Social Security Institute of Spain, INSS (“Instituto Nacional de la Seguridad Social”). Objective: To assess the relationship between cumulative damage regarding the affected organ and the percentage of disability recognised by the National Social Security Institute of Spain (INSS) in SLE patients. Methods: Cross-sectional prospective study of SLE patients according to the SLICC-2012 criteria, from the Rheumatology Service of two Spanish hospitals. We collected clinical and demographic data through personal interview and the SLICC/ACR questionnaire, and classified patients regarding a recognised disability or not. Results: 142 patients were evaluated; 30% had some percentage of official disability. We found a positive correlation between percentage of recognised disability and the SLICC/ACR index score. Musculoskeletal system is the most affected system, without differences between both groups; but we found a higher proportion of damage in nervous system, renal and vasculitis in patients with a recognised disability. Conclusion: There is a positive correlation between percentage of recognised disability in Spain and the cumulative damage in SLE.(AU)

Introducción: El lupus eritematoso sistémico (LES) es una enfermedad multisistémica autoinmune que afecta especialmente a las mujeres jóvenes durante su segunda y tercera décadas. Los eventos atribuidos al propio LES y otros relacionados con la enfermedad pueden tener un impacto negativo en la calidad de vida, el empleo y la discapacidad. Sin embargo, existen pocos datos publicados al respecto. En España, la evaluación de la discapacidad y la asignación de una pensión corresponden al Instituto Nacional de Seguridad Social de España (INSS). Objetivo: Evaluar la relación entre el daño acumulado relacionado con el órgano afectado y el porcentaje de discapacidad reconocido por el INSS en pacientes con LES. Métodos: Estudio prospectivo transversal de pacientes con LES según los criterios SLICC-2012, del servicio de reumatología de 2 hospitales de España. Recopilamos datos clínicos y demográficos mediante entrevista personal y el cuestionario SLICC/ACR, y clasificamos a los pacientes con respecto a una discapacidad reconocida o no. Resultados: Se evaluaron 142 pacientes; el 30% tenía algún porcentaje de discapacidad oficial. Encontramos una correlación positiva entre el porcentaje de discapacidad reconocida y la puntuación del índice SLICC/ACR. El sistema musculoesquelético es el sistema más afectado, sin diferencias entre ambos grupos; pero encontramos una mayor proporción de daño en el sistema nervioso, renal y vasculitis en pacientes con una discapacidad reconocida.(AU)ConclusiónExiste una correlación positiva entre el porcentaje de discapacidad reconocida en España y el daño acumulado en el LES.(AU)

Relation between cumulative damage in systemic lupus erythematosus and recognised disability by the National Social Security Institute of Spain (INSS).

INTRODUCTION: Systemic Lupus Erythematosus (SLE) is a multisystemic autoimmune disease that particularly affects young women during their second and third decades. Events attributed to SLE itself and others related to the disease may impact negatively on the quality of life, employment and disability. However, there are not many studies focused on the impact that the disease may have on patients regarding those aspects. In Spain, the evaluation of disability and the assignation of a pension is given by the National Social Security Institute of Spain, INSS ("Instituto Nacional de la Seguridad Social"). OBJECTIVE: To assess the relationship between cumulative damage regarding the affected organ and the percentage of disability recognised by the National Social Security Institute of Spain (INSS) in SLE patients. METHODS: Cross-sectional prospective study of SLE patients according to the SLICC-2012 criteria, from the Rheumatology Service of two Spanish hospitals. We collected clinical and demographic data through personal interview and the SLICC/ACR questionnaire, and classified patients regarding a recognised disability or not. RESULTS: 142 patients were evaluated; 30% had some percentage of official disability. We found a positive correlation between percentage of recognised disability and the SLICC/ACR index score. Musculoskeletal system is the most affected system, without differences between both groups; but we found a higher proportion of damage in nervous system, renal and vasculitis in patients with a recognised disability. CONCLUSION: There is a positive correlation between percentage of recognised disability in Spain and the cumulative damage in SLE.

Diagnóstico precoz del cáncer de pulmón: utilidad de la tomografía computarizada de baja dosis de radiación / Lung Cancer Screening: Use of Low-Dose Computed Tomography

Introducción: El pronóstico del cáncer de pulmón (CP) está relacionado directamente con el estadio de la enfermedad al diagnóstico. Material y métodos: Realizamos TC de baja dosis (TCBD) a personas asintomáticas ≥ 50 años, fumadores o exfumadores de ≥ 10 paquetes-año, sin antecedentes oncológicos. Seguimos un algoritmo de evaluación según el tamaño y la morfología de los nódulos. En los CP diagnosticados se estableció el tratamiento adecuado y el seguimiento fue de 5 años. Resultados: Estudiamos 4.951 personas (65,4% varones) con una media de edad de 56,89 ± 5,26 años; 550 presentaron nódulos. De 3.891 nódulos detectados, 692 (19,57%) fueron considerados positivos, hallando 38 tumores (36 CP). En el estudio anual, 224 sujetos mostraban algún nódulo, siendo 288 (7,91%) positivos (13 CP). En el 80% el control se realizó con TCBD y se indicó biopsia en el 5,8% (basal) y 7,6% (anual) de los nódulos positivos. La prevalencia fue del 0,89 y la incidencia del 0,1%. La sensibilidad, la especificidad, el VPP y el VPN en el estudio basal fueron del 92,31, del 89,54, del 6,55 y del 99,93%, respectivamente, y en el anual, del 76,92, del 95,7, del 4,52 y del 99,94%, respectivamente. Se detectaron 52 tumores (49 CP), 25 (52,08%) en estadio I. La supervivencia global de los CP fue del 58,5% a los 5 años, y la supervivencia cáncer específica, del 67,1% (75,8% en los pacientes quirúrgicos). Conclusiones: La TCBD integrada en un programa elaborado de detección y evaluación de nódulos es una herramienta útil para diagnosticar CP en estadio precoz

Introduction: The prognosis of lung cancer (LC) correlates directly with the stage of the disease at the time of diagnosis. Material and methods: We performed low-dose CT (LDCT) in asymptomatic individuals ≥ 50 years old, smokers or former smokers of ≥ 10 pack-years, with no history of cancer. We followed an evaluation algorithm, according to the size and morphology of the nodules. The appropriate treatment for the LC diagnosis was given and patients were followed up for 5 years. Results: We studied 4,951 individuals (65.4% males) with an average age of 56.89 ± 5.26 years; 550 presented nodules. Of the 3,891 nodules detected, 692 (19.57%) were considered positive, and 38 tumors (36 LC) were identified. In the annual follow-up, nodules were found in 224 subjects, 288 (7.91%) of which were positive (13 LC). In 80%, the study was performed with LDCT, and biopsy was indicated in 5.8% (baseline) and in 7.6% (annual) of the positive nodules. Prevalence was 0.89 and incidence was 0.1%. The sensitivity, specificity, PPV and NPV in the baseline study were 92.31, 89.54, 6.55 and 99.93%, respectively, and in the annual study, they were 76.92, 95.7, 4.52 and 99.94%, respectively. A total of 52 tumors were detected (49 LC), 25 (52.08%) in stage I. The 5-year overall survival rate for LC was 58.5% and cancer-specific survival was 67.1% (75.8% in surgical patients). Conclusion: LDCT integrated into an elaborate nodule detection and evaluation program is a useful tool for diagnosing early-stage LC

Aumento de las concentraciones de interferón-1alpha, interleucina-10 y BLyS como biomarcadores de actividad clínica en el lupus eritematoso sistémico / Increased interferon-1alpha, interleukin-10 and BLyS concentrations as clinical activity biomarkers in systemic lupus erythematosus

Fundamento y objetivo: Analizar la asociación entre concentraciones de interferón-1alpha (INF1alpha), interleucina 10 (IL-10) y BLyS con la actividad clínica en el lupus eritematoso sistémico (LES). Pacientes y métodos: Estudio observacional transversal de 142 pacientes con LES y 34 controles sanos mediante analítica de sangre y orina y revisión de la historia clínica. La concentración sérica de citocinas se determinó mediante métodos colorimétricos. El análisis bioestadístico se realizó con R (3.3.2). Resultados: El 69% de pacientes mostraron al menos una citocina aumentada. Las tres citocinas están más elevadas en pacientes que en controles (p<0,001, p=0,005 y p=0,043), siendo INF1alpha el más frecuente. Los pacientes fueron categorizados según las concentraciones de las tres citocinas. Encontramos una asociación significativa entre concentraciones elevadas de IL-10/INF1alpha y una mayor actividad clínica según SELENA-SLEDAI (p<0,0001) y, en menor medida, con concentraciones aumentadas de INF1alpha/IL-10/BLyS. Concentraciones elevadas de IL-10/INF1alpha e INF1alpha/IL-10/BLyS se relacionaron con un mayor consumo de C3-C4 (p<0,001 y p=0,001) y títulos elevados de anti-dsDNA (p=0,001 y p=0,002). Concentraciones elevadas de INF1alpha/BLyS se relacionaron con títulos más altos de anti-dsDNA (p=0,004) y positividad ENA (p<0,001). Concentraciones altas de INF1alpha/IL-10/BLyS se relacionaron con la positividad de ANA (p<0,001) y anticuerpos antifosfolípidos (p=0,004). Conclusiones: INF1alpha, IL-10 y BLyS están más elevados en pacientes con LES que en controles sanos. El aumento de IL-10, asociado o no a aumento de BLyS y/o INF1alpha, es la citocina que mejor se ajusta a la actividad clínica del LES medida con métodos clásicos

Background and objective: to analyse the association between interferon-1alpha (INF1alpha), interleukin-10 (IL-10) and BLyS concentrations and clinical activity in systemic lupus erythematosus (SLE). Patients and methods: A cross-sectional, observational study of 142 SLE patients and 34 healthy controls was performed, through a complete blood and urine test and review of their medical history. Serum concentration of INF1alpha, IL-10 and BLyS was determined by colorimetric methods. A biostatistical analysis was performed with R (3.3.2.). Results: 69% of our SLE patients showed at least one cytokine increased. INF1alpha, IL-10 and BLyS are higher in SLE patients than in healthy controls (P<.001, P=.005 and P=.043, respectively), being INF1alpha the most frequent. Patients were categorised according to low or high concentrations of the three cytokines. We found a significant association between increased IL-10/INF1alpha concentrations and a higher clinical activity measured by SELENA-SLEDAI (P<.0001) and, to a lesser extent, an association with increased INF1alpha/IL-10/BLyS concentrations. Elevated levels of IL-10/INF1alpha and INF1alpha/IL-10/BLyS related to increased C3-C4 consumption (P<.001 and P=.001 respectively) and anti-dsDNA titres (P=.001 and P=.002 respectively). Elevated INF1alpha/BLyS related to higher anti-dsDNA titres (P=.004) and ENA positivity (P<.001). Increased levels of INF1alpha/IL-10/BLyS related to positivity of ANAs (P<.001) and APL (P=.004). Conclusions: INF1alpha, IL-10 and BLyS are higher in SLE patients than in healthy controls. Increased IL-10 levels, regardless of whether or not there were also increased levels of BLyS and/or INF1alpha, was the cytokine that best fit with clinical activity in SLE measured with classic methods

Metástasis en tejido celular subcutáneo de glioblastoma multiforme: caso clínico y revisión de la literatura / Subcutaneous tissue metastasis from glioblastoma multiforme: A case report and review of the literature

El glioblastoma multiforme es la neoplasia maligna cerebral primaria más frecuente, y a pesar de su curso agresivo, menos del 2% de los pacientes desarrollan metástasis extraneurales. Presentamos el caso de un varón de 72 años con diagnóstico de glioblastoma multiforme temporal derecho por clínica de cefalea. El paciente se intervino con resección macroscópicamente completa y se administró terapia adyuvante. Cinco meses después, reingresa por dolor trigeminal observándose en la RM una masa extracraneal infratemporal que infiltraba el espacio masticador, estructuras óseas, musculatura temporal y ganglios linfáticos cervicales superiores y parotídeos. El paciente se reintervino, alcanzándose la resección parcial de la lesión temporal, tras los cual presentaba persistencia del dolor trigeminal invalidante. Dada la mala situación funcional del paciente y el fracaso del tratamiento se decidió limitar esfuerzo terapéutico, produciéndose el exitus del paciente a las 3 semanas del diagnóstico de la afectación extracraneal

Glioblastoma multiforme is the most common primary brain tumor, despite an aggressive clinical course, less than 2% of patients develop extraneural metastasis. We present a 72-year-old male diagnosed with a right temporal glioblastoma due to headache. He underwent total gross resection surgery and after that the patient was treated with adyuvant therapy. Five months after the patient returned with trigeminal neuralgia, and MRI showed an infratemporal cranial mass which infiltrates masticator space, the surrounding bone, the temporal muscle and superior cervical and parotid lymph nodes. The patient underwent a new surgery reaching partial resection of the temporal lesion. After that the patient continued suffering from disabling trigeminal neuralgia, that's why because of the bad clinical situation and the treatment failure we decided to restrict therapeutic efforts. The patient died 3 weeks after the diagnosis of extracranial metastasis

Lung Cancer Screening: Use of Low-Dose Computed Tomography. / Diagnóstico precoz del cáncer de pulmón: utilidad de la tomografía computarizada de baja dosis de radiación.

INTRODUCTION: The prognosis of lung cancer (LC) correlates directly with the stage of the disease at the time of diagnosis. MATERIAL AND METHODS: We performed low-dose CT (LDCT) in asymptomatic individuals ≥50years old, smokers or former smokers of ≥10 pack-years, with no history of cancer. We followed an evaluation algorithm, according to the size and morphology of the nodules. The appropriate treatment for the LC diagnosis was given and patients were followed up for 5years. RESULTS: We studied 4,951 individuals (65.4% males) with an average age of 56.89±5.26years; 550 presented nodules. Of the 3,891 nodules detected, 692 (19.57%) were considered positive, and 38 tumors (36LC) were identified. In the annual follow-up, nodules were found in 224 subjects, 288 (7.91%) of which were positive (13LC). In 80%, the study was performed with LDCT, and biopsy was indicated in 5.8% (baseline) and in 7.6% (annual) of the positive nodules. Prevalence was 0.89 and incidence was 0.1%. The sensitivity, specificity, PPV and NPV in the baseline study were 92.31, 89.54, 6.55 and 99.93%, respectively, and in the annual study, they were 76.92, 95.7, 4.52 and 99.94%, respectively. A total of 52 tumors were detected (49LC), 25 (52.08%) in stageI. The 5-year overall survival rate for LC was 58.5% and cancer-specific survival was 67.1% (75.8% in surgical patients). CONCLUSION: LDCT integrated into an elaborate nodule detection and evaluation program is a useful tool for diagnosing early-stage LC.

Evolución morfométrica de descompresión obtenida tras corpectomía. Dirigiéndonos hacia abordajes posteriores / Morphometrical evaluation of decompression obtained through corpectomy. Heading towards to posterior approaches

Introducción: Hemos analizado la descompresión obtenida mediante corpectomía dorsal o dorsolumbar medida a través del ángulo de Cobb y el área del canal medular antes y después de la cirugía. Además, se ha comparado la evolución de la técnica entre los primeros 5 años del estudio y los 5 posteriores. Material y método: Se realizó un estudio retrospectivo de los pacientes operados entre 2005-2015 en nuestro centro mediante abordajes anteriores y posteriores. Resultados: Se intervinieron 24 pacientes y observamos una mejoría significativa entre los valores preoperatorios y postoperatorios en el análisis morfométrico (corrección de 4,18° de cifosis y un aumento del área del canal medular de 130,8mm2 con una significación de p<0,001 en ambos casos) y mejoría clínica (45,8% de los pacientes presentaron mejoría en la escala ASIA y una mejoría media de 13 puntos en el Karnofsky, p<0,001). Sin embargo, no se observa correlación entre los parámetros clínicos y morfométricos. También hemos observado que en los últimos 5 años del estudio los abordajes posteriores se utilizaron con mayor frecuencia y con buenos resultados. Conclusiones: La corpectomía dorsal permite una descompresión espinal significativa, con mejoría de la función neurológica sin que se correlacione con las mediciones de la descompresión. Gracias a las mejoras técnicas, las técnicas mínimamente invasivas (abordajes posteriores y técnicas MISS) permiten unos buenos resultados funcionales que son similares a los obtenidos con técnicas anteriores

Introduction: We analysed the decompression obtained by dorsal or dorsolumbar corpectomy measured by Cobb angle and the spinal area prior to and after surgery and compared the evolution of the technique over the last five years of the study. Material and method: A retrospective review of patients operated between 2005 and 2015 through anterior or posterior approaches was performed. Results: 24 patients were studied and a significant improvement was observed between the preoperative and postoperative morphometrical measurement (4.18° correction of the kyphosis and an increase of 130.8mm2 in the spinal canal, p<.001 in both cases) and in clinical parameters (45.8% of patients improved in ASIA, and Karnofsky showed 13 points of improvement, p<.001 in both cases). However, there was no correlation between clinical and morphological parameters. We also observed that in the last five years of the study posterior approaches were more frequently used with good results. Conclusions: Dorsal corpectomy allows significant spinal decompression, with neurological improvement but this does not correlate with the measurement of decompression. Thanks to technical improvements, less invasive techniques (posterior approaches and MISS) allow good clinical results, which are similar to those obtained by anterior techniques

Increased interferon-1α, interleukin-10 and BLyS concentrations as clinical activity biomarkers in systemic lupus erythematosus. / Aumento de las concentraciones de interferón-1α, interleucina-10 y BLyS como biomarcadores de actividad clínica en el lupus eritematoso sistémico.

BACKGROUND AND OBJECTIVE: to analyse the association between interferon-1α (INF1α), interleukin-10 (IL-10) and BLyS concentrations and clinical activity in systemic lupus erythematosus (SLE). PATIENTS AND METHODS: A cross-sectional, observational study of 142 SLE patients and 34 healthy controls was performed, through a complete blood and urine test and review of their medical history. Serum concentration of INF1α, IL-10 and BLyS was determined by colorimetric methods. A biostatistical analysis was performed with R (3.3.2.). RESULTS: 69% of our SLE patients showed at least one cytokine increased. INF1α, IL-10 and BLyS are higher in SLE patients than in healthy controls (P<.001, P=.005 and P=.043, respectively), being INF1α the most frequent. Patients were categorised according to low or high concentrations of the three cytokines. We found a significant association between increased IL-10/INF1α concentrations and a higher clinical activity measured by SELENA-SLEDAI (P<.0001) and, to a lesser extent, an association with increased INF1α/IL-10/BLyS concentrations. Elevated levels of IL-10/INF1α and INF1α/IL-10/BLyS related to increased C3-C4 consumption (P<.001 and P=.001 respectively) and anti-dsDNA titres (P=.001 and P=.002 respectively). Elevated INF1α/BLyS related to higher anti-dsDNA titres (P=.004) and ENA positivity (P<.001). Increased levels of INF1α/IL-10/BLyS related to positivity of ANAs (P<.001) and APL (P=.004). CONCLUSIONS: INF1α, IL-10 and BLyS are higher in SLE patients than in healthy controls. Increased IL-10 levels, regardless of whether or not there were also increased levels of BLyS and/or INF1α, was the cytokine that best fit with clinical activity in SLE measured with classic methods.