Primary Neuroendocrine Carcinoma of the Cerebellopontine Angle: A Case Report and Literature Review.

Primary intracranial neuroendocrine tumors are extremely rare malignancies with very few cases reported in the world literature. We describe a primary neuroendocrine carcinoma arising from the right cerebellopontine angle, the second case that has been described in this location. The possible origin in this place and treatment are described. A 29-year-old male patient, diagnosed with schwannoma of the right cerebellopontine angle, and treated with radiosurgery at another institution, came to our hospital six months later, The patient presented with a history of rapid progression of numbness on the right side of the face, diplopia, dizziness, vomiting, and facial palsy. On examination, the right cranial nerves V, VI, VII, VIII, and IX were affected. The MRI showed tumor growth occupying the right cerebellopontine angle, with compression of the brain stem and cerebellum. A right retromastoid craniectomy removed the tumor partially and the histopathological examination revealed a high-grade neuroendocrine carcinoma. We describe a primary neuroendocrine tumor of the brain that, despite its rarity, must be considered in the differential diagnosis. There are currently no guidelines for the management of these tumors. According to previously reported cases, surgery is the first line of treatment, followed by radiotherapy or chemotherapy. We consider that such a rare case is needed to be reported for a better understanding of the disease and its neurobiology.

Metastatic colorectal micropapillary carcinoma presenting as lymphangitic lung carcinomatosis.

Pulmonary lymphangitic carcinomatosis denotes the infiltration of tumor cells into the lung parenchymal lymphatic channels. Breast, lung, stomach, and colon adenocarcinoma are the most common origin of this invasion pattern. The micropapillary variant of colorectal adenocarcinoma has a high rate of lymph node metastases and poor overall survival. A 49 year-old man with a 6 months history of persistent cough and a relevant occupational chemical exposure had a computed tomography that showed bilateral interstitial lung infiltrates. The lung biopsy demonstrated a micropapillary adenocarcinoma with diffusely obstruction of the lung parenchymal lymphatics. The immunohistochemistry confirmed a colorectal origin. The colonoscopy evidenced a mass with identical morphology. Colorectal micropapillary carcinoma with metastatic lung lymphangitic carcinomatosis can occur, as a persistent cough, as presenting symptom in extraordinarily rare cases. To the best of our knowledge, this is the first case of an alive patient with colorectal metastatic micropapillary carcinoma presenting with lymphangitic lung carcinomatosis.

Percepciones de los profesores sobre de la deshonestidad en estudiantes de Medicina: prevalencia, motivaciones e implicaciones / Faculty perceptions of dishonesty on medical students: Prevalence, motivations and implications

INTRODUCCIÓN: La deshonestidad académica son actitudes y acciones que toma el estudiante con la finalidad de obtener beneficio. Poco se conoce sobre el efecto de los profesores en este fenómeno. El objetivo de esta investigación fue conocer la percepción de los docentes sobre la prevalencia, motivación e implicaciones de la deshonestidad académica, así como analizar su rol en la incidencia de estas conductas. Métodos y materiales: Fue un estudio cuantitativo, descriptivo y transversal para el que se aplicó un cuestionario de 39 ítems que valora el modelo que explica la deshonestidad en los factores de prevalencia, motivación e implicaciones. Se analizaron las medias considerando como factores para la prueba ANOVA los años de experiencia y la etapa de la carrera en la que participa. RESULTADOS: Los profesores indican que las conductas más frecuentes son que el alumno obtenga crédito en trabajos en los que no participó, y plagio en actividades y tareas, con una media de 2,13 y 2,18, respectivamente. De los motivadores, los más implicados son la obtención de mayores calificaciones y las facilidades que ofrecen las nuevas tecnologías, con una media de 3,91 y 3,82, respectivamente. Sobre las implicaciones, aunque los profesores aseguran que alguna vez han sido testigos de la deshonestidad, solo un 48,2% ha abierto la conversación con los estudiantes durante su clase. DISCUSIÓN: Es necesario fortalecer las políticas institucionales que faciliten los métodos de reporte y seguimiento a situaciones de riesgo. En particular, un punto de interés es el de desvincular de los profesores la documentación de evidencia y la responsabilidad del proceso

INTRODUCTION: Academic dishonesty are attitudes and actions taken by the student in order to obtain benefits. Little is known about the effect of teachers on this phenomenon. The objective of this research was to study the perception of teachers about the prevalence, motivation and implications of academic dishonesty on students, as well as to analyze their role in the incidence of these behaviors. METHODS AND MATERIALS: The study was quantitative, descriptive and cross-sectional. A questionnaire of 39 items that assesses the model that explains the dishonesty in the factors of prevalence, motivation and implications. The means were analyzed considering as factors for the ANOVA test: the years of experience and the stage of the career in which the faculty participates. RESULTS: The faculty members indicate that the most frequent behaviors are: the student that obtains credit for work where he / she did not participate, and plagiarism in activities and tasks, with an average of 2.13 and 2.18 respectively. Of the motivators, the most involved are: obtaining higher grades, and the easiness offered by new technologies, with an average of 3.91 and 3.82 respectively. On the implications, although the professors claim that they have witnessed dishonesty, only 48.2% have opened the conversation with the students during their class. DISCUSSION: It is necessary to strengthen the institutional policies that enable the methods of reporting and monitoring risk situations. Particularly, a point of interest is removing the responsibility of faculty about the documentation of evidence and the responsibility of the process itself

En nuestra escuela esto no pasa: percepciones sobre la deshonestidad académica con estudiantes de medicina / This does not happen at our school: Perceptions about academic dishonesty with medical students

INTRODUCCIÓN: La deshonestidad académica se refiere a copiar en una prueba, plagiar, falsificar resultados de una investigación o conseguir anticipadamente resultados de actividades o exámenes; sin embargo, algunas conductas parecen no ser consideradas como deshonestas por los estudiantes. Se sabe que prevalecen dentro de muchos niveles y áreas del conocimiento, pero no se conocen las percepciones de estudiantes respecto al impacto en su aprendizaje. El objetivo del estudio fue evaluar la percepción que los estudiantes tienen sobre la deshonestidad académica observable cuando comparten el contenido de los casos y actividades de un curso con compañeros de generaciones posteriores. MATERIAL Y MÉTODO: El diseño fue cuantitativo y descriptivo, utilizando encuestas aplicadas a 3 generaciones (2014, 2016 y 2017) dentro de un curso de patología. Se incluyó ítems relacionados con deshonestidad académica y su impacto en la resolución de los casos. Para el análisis se utilizó una escala que determina las tendencias en las aseveraciones como honestos +1 y deshonestos como -1. RESULTADOS: La participación fue del 84%, 99% y 50%, respectivamente. A pesar de que la mayoría (40%) refirió no obtener beneficio en el aprendizaje al compartir el material, las generaciones más recientes demuestran una tendencia hacia el polo de conductas deshonestas (-0,124, -0,509 y -0,562). CONCLUSIONES: La intención de los alumnos al compartir las actividades fue disminuir el tiempo que sus compañeros invierten en buscar información del caso al comparar sus respuestas; sin embargo, refieren que el aprendizaje total del tema no aumenta como resultado de sus prácticas. Futuras intervenciones son necesarias para realizar difusión de ejemplos concretos relacionados con el concepto, para que interioricen los resultados sobre el beneficio en su aprendizaje y el significado de la integridad académica

INTRODUCTION: Academic dishonesty includes copying, plagiarising, or falsifying the results of an investigation, or obtaining the correct answers for activities or exams from peers that have already answered them. However, some of these behaviours do not appear to be considered as dishonest by students. Although it is known that this prevails within many levels and areas of knowledge, students' perceptions of the impact of this on their learning process are not known. The aim of this study was to evaluate the perception that students have about academic dishonesty when sharing course material with other students. MATERIAL AND METHOD: The design was quantitative and descriptive using questionnaires applied to students of 3 different years (2014, 2016 and 2017) during a pathology course. These included items related to academic dishonesty and its impact on the resolving of cases. A scale was used to classify the honest results as+1 and the dishonest ones as -1. RESULTS: Participation was 84%, 99% and 50%, respectively. Although the majority (40%) reported not benefiting from learning by sharing material, more recent generations show a greater tendency towards dishonesty (-0.124, -0.509, and -0.562). CONCLUSION: The intention of the students when sharing activities was to reduce the time that their classmates invest in looking for information by comparing their answers. However, they report that the total learning of the subject does not increase. Future interventions are necessary to transmit clear examples related to the concept so that they can internalise the results regarding the benefit to their learning, and the meaning of academic integrity

Primeros encuentros clínicos con pacientes: un estudio de la neurofobia y empatía en estudiantes de medicina / First clinical encounters with patients: A study of neurophobia and empathy in medical students

INTRODUCCIÓN: El temor hacia las neurociencias y a la neurología clínica por parte de los estudiantes, mejor conocido como neurofobia, dificulta la relación médico-paciente. La ansiedad creada en los encuentros clínicos obstaculiza el manejo efectivo y la creación de lazos como la empatía. El objetivo de este estudio fue evaluar los niveles de neurofobia y empatía que los estudiantes de medicina demuestran hacia los pacientes en el servicio de neurología. MATERIAL Y MÉTODOS: El diseño de la investigación fue cuantitativo, descriptivo y transeccional, con una muestra de 98 estudiantes del programa de medicina de una universidad privada. Se adaptó un instrumento y se utilizaron 19 ítems con posterioridad al encuentro clínico. RESULTADOS: Se encontró evidencia de neurofobia, siendo esta de mayor grado en mujeres. También se observaron altos niveles de empatía en los alumnos, los hombres presentaron un nivel de empatía significativamente menor. DISCUSIÓN: Los estudiantes presentaron evidente preocupación sobre su capacidad de manejar pacientes con enfermedad neurológica de forma autodirigida. Los resultados sobre empatía fueron más favorables que en otros estudios. Futuros trabajos pudieran adentrarse en el análisis de si estos niveles son sostenibles a largo plazo

INTRODUCTION: Fear of neurosciences and clinical neurology of students, best known as neurophobia, affects the doctor-patient relationship. The anxiety of clinical encounters interferes with effective management and the creation of inter-personal bonding, such as empathy towards patients. The objective of this study was to assess the levels of neurophobia and empathy that medical students show towards patients in the Neurology Department. MATERIAL AND METHODS: A quantitative, descriptive and cross-sectional study was conducted on a sample of 98 students of a private university. A clinical encounter evaluation tool was adapted and 19 items were then used to assess it afterwards. RESULTS: There was evidence of neurophobia, existing in a greater degree in female students. High levels of empathy were observed, although there were significantly lower levels shown by males. DISCUSSION: The students have an obvious concern as regards their ability to manage patients with neurological disease in a self-directed manner. The results regarding empathy were more favourable than previous studies. Future research must analyse these levels further, questioning if these could be preserved in the long-term

Her-2 positive mucinous carcinoma breast cancer, case report.

INTRODUCTION: Mucinous carcinoma is a variant of invasive breast carcinomas that accounts for 2% of them and has a better prognosis in contrast to the non-specific invasive carcinoma. They regularly are positive for estrogen and progesterone receptors and, generally, they do not overexpress HER2. When HER2 is positive, the first line treatment is trastuzumab; although the resistance is 52-89% for the non-specific carcinoma, it has been described just once in mucinous carcinoma. CASE SUMMARY: A 48-year-old female presented with a lump in her right breast and after a biopsy, it was diagnosed as mucinous carcinoma in the core biopsy and surgical resection, with positive hormone receptors and HER2 positive (3+) in 100% of the tumor cells. She was treated with neoadjuvant chemotherapy based on trastuzumab and pertuzumab with no pathological response. DISCUSSION: There are few pure mucinous carcinomas positive for HER2. Mucinous carcinomas are positive for HER2 account for less than 5% of invasive ductal carcinoma. Furthermore, our case was resistance to chemotherapy. Most mucinous carcinomas test negative for HER2, so they usually would not be treated with trastuzumab, in this case because the expression of HER2 in the biopsies we initiated it. CONCLUSION: It's important to know that cases of mucinous carcinoma positive for HER2 exist and to be aware of the clinical problems that they may present: resistance to trastuzumab. Also, we need to understand the responsible mechanisms of this resistance and use immunohistochemistry for MUC which may predict it.