Chronic hyperglycemia and intracranial meningiomas.

Meningiomas are among the most common primary tumors of the central nervous system. Previous research into the meningioma histological appearance, genetic markers, transcriptome and epigenetic landscape has revealed that benign meningiomas significantly differ in their glucose metabolism compared to aggressive lesions. However, a correlation between the systemic glucose metabolism and the metabolism of the tumor hasn't yet been found. We hypothesized that chronic levels of glycaemia (approximated with glycated hemoglobin (HbA1c)) are different in patients with aggressive and benign meningiomas. The study encompassed 71 patients with de novo intracranial meningiomas, operated on in three European hospitals, two in Croatia and one in Spain. Our results show that patients with WHO grade 2 meningiomas had significantly higher HbA1c values compared to patients with grade 1 lesions (P = 0.0290). We also found a significant number of patients (19/71; 26.7%) being hyperglycemic, harboring all the risks that such a condition entails. Finally, we found a significant correlation between our patients' age and their preoperative HbA1c levels (P = 0.0008, ρ(rho) = 0.388), suggesting that older meningioma patients are at a higher risk of having their glycaemia severely dysregulated. These findings are especially important considering the current routine and wide-spread use of corticosteroids as anti-edematous treatment. Further research in this area could lead to better understanding of meningiomas and have immediate clinical impact.

Accelerated ageing experiments with crosslinked and conventional ultra-high molecular weight polyethylene (UHMW-PE) stabilised with alpha-tocopherol for total joint arthroplasty.

Samples of untreated ultra-high molecular weight polyethylene (UHMW-PE), UHMW-PE sterilized with gamma-rays in nitrogen atmosphere (conventional UHMW-PE, widely used for articulating surfaces in endoprostheses) and UHMW-PE, which has been crosslinked by electron beam irradiation and annealed subsequently, were stabilized with alpha-tocopherol and aged in air at 120 degrees C as well as in 10% aqueous hydrogenperoxide with 0.04 mg/ml FeCl3 as catalyst at 50 degrees C. The oxidative degradation was monitored with the help of infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), solubility measurements and size exclusion chromatography (SEC) and were compared to unstabilized samples. When aged in air at 120 degrees C, the crosslinked UHMW-PE showed a slightly slower increase of the carbonyl (CO)-number (according to DIN 53383) in FTIR than conventional UHMW-PE. A stabilisation with 0.4% w/w alpha-tocopherol resulted in an increase of lifetime by a factor of approx. 40 for all samples. Ageing in 10% aqueous H2O2 at 50 degrees C yielded similar results for all three unstabilised samples. The addition of the natural antioxidant alpha-tocopherol led to a prolongation of lifetime by a factor of approx. 2.5. A linear loss of alpha-tocopherol was detected during ageing. An increase of crystallinity as well as lamella thickness during ageing was observed with the help of DSC. The two-phase structure of crosslinked UHMW-PE with two melting endotherms at 114 degrees C and 137 degrees C was replaced very quickly by a single melting point at 130 degrees C. This effect was delayed with the stabilized samples. In the solubility and SEC measurements, a severe molecular degradation and drop of molar mass of all materials could be observed after ageing in H2O2, leading to a complete destruction and, in case of crosslinked UHMW-PE, to a serious damage of the molecular network, respectively.

Histeroscopia en hiperplasia y cáncer de endometrio / Hysteroscopy in hyperplasia and endometrial cancer

La histeroscopia permite observar directamente el interior del útero, La hiperplasia endometrial definida como una proliferación de glándulas, de forma y tamaño irregular, no presenta patrón histeroscópico determinado para cada tipo de hiperplasia. Cuando valoramos eficacia y correlación del diagnostico clínico con el histológico, la eficacia diagnóstica para hiperplasia oscila entre el 56 y el 83%, La normalidad de imagen histeroscópica no excluye la posibilidad de patología. La sensibilidad es del 98% con una especificidad del 99.9% en determinados grupos especialmente entrenados, entre los que nos encontramos, en el adenocarcinoma endometrial hacen a la histeroscopia herramienta imprescindible. La afectación cervical es diagnosticada con una sensibilidad que oscila entre el 64-100%, especificidad 73-98%. El VPN es de 100% y un VPP entre el 38.4 y 93.3%. La histeroscopia es el método de elección en el diagnostico y manejo de la patología maligna endometrial, favoreciendo el hallazgo temprano y el estadiaje del cáncer endometrial. Precisa entrenamiento y aprendizaje para la obtención de su mejor rendimiento diagnostico. Con una elevada sensibilidad, especificidad

The hysteroscopy allows to observe the interior of the uterus directly. The endometrial hyperplasia defined as a proliferation of glands, of form and irregular size, it doesn’t present hysteroscopic patron certain for each hyperplasia type. When we value effectiveness and correlation of the diagnose clinical with the histology, the effectiveness diagnostic for hyperplasia oscillates between the 56 and 83%. The normality of image hysteroscopic doesn’t exclude the pathology possibility. The sensibility is of 98% with a specificity of 99.9% in certain specially trained groups, in those that we find ourselves , the carcinoma endometrial makes to the hysteroscopy indispensable tool. The cervical affectation is diagnosed with a sensibility that oscillates between 64-100%, specificity 73-98%. The VPN is of 100% and a VPP between the 38.4 and 93.3%. The hysteroscopy is the election method in the diagnose and manage of the pathology wicked endometrial, favoring the early discovery and the stage of the endometrial cancer. It is necessary a training and a learning for the obtainig of their best yield diagnose. With a high sensibility, specificity