Cannabinoid receptor CB2 ablation protects against TAU induced neurodegeneration.

Tauopathies are a group of neurodegenerative diseases characterized by the alteration/aggregation of TAU protein, for which there is still no effective treatment. Therefore, new pharmacological targets are being sought, such as elements of the endocannabinoid system (ECS). We analysed the occurrence of changes in the ECS in tauopathies and their implication in the pathogenesis. By integrating gene expression analysis, immunofluorescence, genetic and adeno-associated virus expressing TAU mouse models, we found a TAU-dependent increase in CB2 receptor expression in hippocampal neurons, that occurs as an early event in the pathology and was maintained until late stages. These changes were accompanied by alterations in the endocannabinoid metabolism. Remarkably, CB2 ablation in mice protects from neurodegeneration induced by hTAUP301L overexpression, corroborated at the level of cognitive behaviour, synaptic plasticity, and aggregates of insoluble TAU. At the level of neuroinflammation, the absence of CB2 did not produce significant changes in concordance with a possible neuronal location rather than its classic glial expression in these models. These findings were corroborated in post-mortem samples of patients with Alzheimer's disease, the most common tauopathy. Our results show that neurons with accumulated TAU induce the expression of the CB2 receptor, which enhances neurodegeneration. These results are important for our understanding of disease mechanisms, providing a novel therapeutic strategy to be investigated in tauopathies.

La enfermedad de Paget de la mama en nuestra área: revisión 1998-2012 / Paget disease of the breast in our setting: review 1998-2012

La enfermedad de Paget de la mama es una entidad poco frecuente y de buen pronóstico. El tratamiento clásico ha sido la mastectomía, pero es posible una cirugía conservadora de la mama, y hoy en día debe valorarse como primera opción siempre y cuando se aseguren márgenes libres con un resultado estético aceptable. Las pruebas de imagen son fundamentales para descartar un carcinoma subyacente y de cara a la planificación de una cirugía conservadora, así como para el futuro seguimiento de estas pacientes

Paget disease of the breast is a relatively rare entity with a favourable prognosis. Form any years, the gold standard treatment has been mastectomy. However, breast-conserving surgery is now feasible and should be evaluated as the first-line option whenever negative margins with acceptable cosmetic results can be achieved. Imaging techniques are essential to exclude an underlying carcinoma and play an important role in selecting candidates for breast-conserving treatment and in follow-up

Tumor filodes de la mama. A propósito de dos casos / Phyllodes tumor of the breast: apropos of two cases

El tumor filodes de mama constituye una neoplasia de tipo fibroepitelial de mama poco frecuente, pueden ser benignas, borderline y malignas, representando un 0,3 a 0,9% de todas las tumoraciones mamarias. El diagnóstico definitivo es anatomopatológico y la resección amplia, completa y con márgenes libres de la lesión, constituye el pilar fundamental del tratamiento de estas lesiones. Presentamos dos casos de dos pacientes de 33 y 38 años, respectivamente, diagnosticadas de tumor filodes de la mama y tratadas en nuestro servicio. Hemos estudiado los métodos diagnósticos y técnicas quirúrgicas utilizadas en su tratamiento así como su posterior evolución y lo hemos comparado con lo descrito en la bibliografía (AU)

Phyllodes tumour of the breast is a highly uncommon fibro epithelial tumour, representing 0.3 to 0.9% of all breast tumours. The definitive diagnosis is histological and the goal of treatment is wide and complete surgical excision of the tumour with disease-free margins. We report two patients, aged 33 and 38 years old, with phyllodes tumour of the breast diagnosed and treated in our center. We discuss the diagnostic techniques, surgical approaches, and follow-up in these patients and compare our experience with reports in the literature (AU)

Metabolic syndrome and coronary heart disease among Spanish male workers: a case-control study of MESYAS.

BACKGROUND AND AIMS: In Spain, the incidence of coronary heart disease is below that expected based on the burden of classic cardiovascular risk factors present in the population. Whether the risk associated with metabolic syndrome is lower in Spain deserves to be investigated. This study evaluates the association of incident clinical coronary heart disease with metabolic syndrome and each of its individual defining components in a sample of Spanish working males. METHODS AND RESULTS: Among the workers of a factory (MESYAS registry), 208 incident cases of coronary heart disease (between 1981 and 2005) were age-matched with 2080 healthy workers visited in 2004-2005. Metabolic syndrome was characterized using modified criteria of the joint consensus definition (2009). Metabolic syndrome was strongly associated with coronary heart disease (OR = 4.03; 95% CI: 2.98, 5.45) and the risk seemed to be fully explained by metabolic syndrome components (OR = 0.84, p = 0.54 after adjustment). Odds ratios for the independent effects of the diagnostic criteria were: hypertriglyceridemia (OR = 3.39, p < 0.001), hyperglycemia (OR = 2.70, p < 0.001), low HDL cholesterol (OR = 2.35, p < 0.001), hypertension (OR = 1.49, p = 0.016) and overweight (OR = 1.07, p = 0.678). Young workers showed a higher risk associated with metabolic syndrome. CONCLUSION: The risk associated with metabolic syndrome is fully explained by its components considered independently. The risk of coronary heart disease in a Spanish male working population is considerably increased among those with metabolic syndrome, by a factor similar to that described for other countries. Public health measures to prevent a rise in the prevalence of metabolic syndrome are advisable to minimize cardiovascular disease rate in Spain.

Improving mass transfer to soften tissues by pulsed electric fields: fundamentals and applications.

The mass transfer phenomenon occurs in many operations of the food industry with the purpose of obtaining a given substance of interest, removing water from foods, or introducing a given substance into the food matrix. Pretreatments that modify the permeability of the cell membranes, such as grinding, heating, or enzymatic treatment, enhance the mass transfer. However, these techniques may require a significant amount of energy and can cause losses of valuable food compounds. Pulsed electric field (PEF) technology is a nonthermal processing method that causes permeabilization of cell membranes using low energy requirements and minimizing quality deterioration of the food compounds. Many practical applications of PEF for enhancing mass transfer in the food industry have been investigated. The purpose of this chapter is to give an overview of the state of the art of application of PEF for improving mass transfer in the food industry.

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Spanish adaptation of the CEIPC 2008]. / Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación Española del Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC) 2008.

We present the Spanish adaptation made by the CEIPC of the European Guidelines on Cardiovascular Disease Prevention (CVD) in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD through the management of its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL<130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, to reach body mass index (BMI) guided and waist circumference objectives. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to transfer the recommendations established into the daily clinical practice.

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación Española del Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC) 2008 / European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. Spanish adaptation of the CEIPC 2008

Presentamos la adaptación española realizada por el CEIPC de la Guía Europea de Prevención de las Enfermedades Cardiovasculares (ECV) 2008. Esta guía recomienda el modelo SCORE de bajo riesgo para la valoración del riesgo cardiovascular. El objetivo es prevenir la mortalidad y morbilidad debidas a las ECV mediante el manejo de sus factores de riesgo en la práctica clínica. La guía hace énfasis en la prevención primaria y en el papel del médico y la enfermería de atención primaria en la promoción de un estilo de vida saludable, basado en el incremento de los niveles de actividad física, la adopción de una alimentación saludable y, en los fumadores, el abandono del tabaco. La meta terapéutica para la presión arterial es en general <140/90 mmHg; pero en pacientes con diabetes, enfermedad renal crónica o ECV el objetivo es 130/80 mmHg. El colesterol debe mantenerse por debajo de 200 mg/dl (cLDL<130 mg/dl); en los pacientes con ECV o diabetes el objetivo es cLDL<100 mg/dl (80 mg/dl si factible en sujetos de muy alto riesgo). En diabetes tipo 2 y en pacientes con síndrome metabólico se debe reducir el peso y aumentar la actividad física y en su caso utilizar los fármacos indicados, para alcanzar los objetivos de índice de masa corporal (IMC) y de perímetro de cintura. El objetivo en diabéticos tipo 2 debe ser alcanzar un nivel de hemoglobina glucosilada (HbA1c) <7%. La amplia difusión de las guías y el desarrollo de los programas destinados a favorecer su implantación, identificando barreras y buscando soluciones, son objetivos prioritarios del CEIPC, como uno de los medios fundamentales para trasladar las recomendaciones establecidas a la práctica clínica diaria (AU)

We present the Spanish adaptation made by the CEIPC of the European Guidelines on Cardiovascular Disease Prevention (CVD) in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD through the management of its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL<130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, to reach body mass index (BMI) guided and waist circumference objectives. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to transfer the recommendations established into the daily clinical practice (AU)

Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008 / European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. CEIPC 2008 Spanish Adaptation

Presentamos la adaptación española realizada por el Comité Español Interdisciplinario para la Prevención Cardiovascular (CEIPC) de la Guía Europea de Prevención de las Enfermedades Cardiovasculares 2008. Esta guía recomienda el modelo SCORE de riesgo bajo para valorar el riesgo cardiovascular. El objetivo es prevenir la mortalidad y la morbilidad debidas a las enfermedades cardiovasculares (ECV) mediante el tratamiento de sus factores de riesgo en la práctica clínica. La guía hace énfasis en la prevención primaria y en el papel del médico y el personal de enfermería de atención primaria en la promoción de un estilo de vida cardiosaludable, basado en el incremento de los grados de actividad física, la adopción de una alimentación saludable y, en los fumadores, el abandono del tabaco. La meta terapéutica para la presión arterial es en general < 140/90 mmHg; pero en pacientes con diabetes mellitus, enfermedad renal crónica o ECV el objetivo es 130/80 mmHg. El colesterol debe mantenerse por debajo de 200 mg/dl (colesterol unido a lipoproteínas de baja densidad [cLDL] < 130 mg/dl); en los pacientes con ECV o diabetes mellitus el objetivo es cLDL < 100 mg/dl (80 mg/dl si factible en individuos de riesgo muy alto). En pacientes con diabetes mellitus tipo 2 y en pacientes con síndrome metabólico se debe reducir el peso y aumentar la actividad física y, en su caso, utilizar los fármacos indicados, para alcanzar los objetivos del índice de masa corporal y de perímetro de cintura. El objetivo en pacientes con diabetes mellitus tipo 2 debe ser alcanzar una hemoglobina glucosilada < 7%. La amplia difusión de las guías y el desarrollo de los programas destinados a favorecer su implantación, en los que se identifiquen barreras y se busquen soluciones, son objetivos prioritarios del CEIPC, como uno de los medios fundamentales para trasladar las recomendaciones establecidas a la práctica clínica diaria(AU)

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is < 130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL < 130 mg/dl, although in patients with CVD or diabetes, the objective is < 100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin < 7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice(AU)

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. CEIPC 2008 Spanish adaptation]. / Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008.

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is < 130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL < 130 mg/dl, although in patients with CVD or diabetes, the objective is < 100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin < 7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

Guía Europea de Prevención Cardiovascular en la Práctica Clínica / European guidelines on Cardiovascular Disease Prevention in Clinical Practice

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Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008 / European Guideline of Cardiovascular Disease Prevention in the Clinical Practice. Spanish Adaptation of the CEIPC 2008

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[Primitive neuroectodermal tumor/extraosseus Ewing sarcoma of the temporal bone]. / Tumor neuroectodérmico primitivo periférico/sarcoma de Ewing extraóseo del hueso temporal.

The term primitive neuroectodermal tumor (PNET) should be included in the differential diagnosis of small round blue cell tumors, which come from the neural crest and explain their neuroectodermal character. This is one of the most indifferentiated histological types of malignant tumors. In the PNET family, we high light the Ewing's Sarcoma, that is frecuently located in bony sites and has a less frequent localization in soft tissues. We focus on one atypic case of PNET/Extraosseus Ewing's Sarcoma that involves the external auditory canal and infiltrates the temporal bone. Surgery followed by postoperative chemotherapy and radiation offers the best local control of the disease.

Tumor neuroectodérmico primitivo periférico/ sarcoma de Ewing extraóseo del hueso temporal / Primitive neuroectodermal tumor/Extraosseus Ewing Sarcoma of the temporal bone

El término tumor neuroectodérmico primitivo (PNET) se incluye dentro de un grupo de neoplasias formado por "células redondas azules de pequeño tamaño" que derivan de la cresta neural y de ahí su carácter neuroectodérmico. Es uno de los tipos histológicos más indiferenciados de tumores malignos. Dentro de esta familia de tumores destaca el Sarcoma de Ewing, que aparece fundamentalmente en estructuras óseas, disminuyendo su probabilidad en estructuras extraóseas. Presentamos un caso atípico de pPNET/Sarcoma de Ewing extraóseo que ocupaba el CAE e infiltraba el hueso temporal. Para el control de la enfermedad, el enfoque preferido es la cirugía más radioquimioterapia

The term primitive neuroectodermal tumor (PNET) should be included in the differential diagnosis of small round blue cell tumors, which come from the neural crest and explain their neuroectodermal character. This is one of the most indifferentiated histological types of malignant tumors. In the PNET family, we high light the Ewing´s Sarcoma, that is frecuently located in bony sites and has a less frequent localization in soft tissues. We focus on one atypic case of PNET/ Extraosseus Ewing´s Sarcoma that involves the external auditory canal and infiltrates the temporal bone. Surgery followed by postoperative chemotherapy and radiation offers the best local control of the disease

[Guidelines of the Spanish Society of Cardiology for clinical practice in exercise testing]. / Guías de práctica clínica de la Sociedad Española de Cardiología en pruebas de esfuerzo.

Most exercise testing is performed in adults with known or suspected ischemic heart disease. In the last few years cardiac imaging techniques have been applied in this field, improving the information obtained with the procedure. However, the exceptions to this rule are emerging rapidly not only in healthy people (asymptomatic individuals, athletes, handicapped people) but also in cardiac patients (advanced congestive heart failure, hypertension, rhythm disorders, congenital heart disease, etc.). All the-se issues justify the need for a multidisciplinary consensus document in Spain. This paper reviews and updates the methodological aspects of the stress test, including those related to oxygen consumption measurements. The main aim of this review was to determine the role of exercise testing in the evaluation of ischemic heart disease as well as the applications of imaging stress testing. The usefulness of this test in other non-ischemic cardiac disorders and in selected subsets of healthy people is also reviewed.

[A frequent problem in the laboratory control of heparinization: contamination of blood specimens with exogenous heparin]. / Ein häufiges Problem bei der Laborkontrolle der Heparinisierung: Kontamination der Blutproben mit exogenem Heparin.

If blood for monitoring of heparin therapy is collected through indwelling catheters it may be contaminated by exogenous heparin. A prospective study comparing thrombin times in plasma obtained by venipuncture and by collection through heparin perfused catheters showed that 26 out of 77 catheter samples were contaminated. In 16 of these 26 cases, overestimation of the heparin effect would have led to incorrect dosage recommendations. It is concluded that blood for laboratory monitoring of heparin treatment should be collected by venipuncture.