Primary renal lymphoma: report of three new cases and literature review.

OBJECTIVES We report the cases of three patients with primary renal lymphoma. Diagnosis and subsequent treatment are discussed. METHODS The literature on the origin, epidemiology, clinical presentation, diagnosis, treatment and prognosis of primary renal lymphoma was reviewed. RESULTS The first patient was diagnosed after radical nephrectomy and subsequently was given six cycles of CVP (cyclophosphamide, vincristine, prednisone). The diagnosis of the second patient was established by renal biopsy, and the patient received six cycles of CHOP (cyclophosphamide, adriamycin, vincristine and predisone). The last patient had a lymphoma, secondary to immunosuppression, in a transplanted kidney. In this case transplant nephrectomy sufficed to cure the patient's lymphoma. All patients had B-cell non-Hodgkin lymphoma (an extrarenal origin was ruled out by bone marrow biopsy), and were disease-free 15 months, 7 months, and 6.5 years after diagnosis, respectively. CONCLUSIONS Primary renal lymphoma is rare. Diagnosis is established by renal biopsy, although it often presents as a mass simulating renal cell cancer and diagnosis is obtained after radical nephrectomy. Treatment consists of chemotherapy (CHOP). associated with rituximab.

La construcció del coneixement pràctic. Una anàlisi integrada des dels plans social i individual

La tesi doctoral aborda la relació entre coneixement i pràctica en l’àmbit de la pràctica professional dels mestres. Aquest problema s’aborda des de la psicologia històrico-cultural, la qual implica un trencament amb la “racionalitat tècnica” des de la que s’ha abordat el problema tradicionalment. Aquest nou abordatge de la problemàtica implica una considerable elaboració teòrica, que en la tesi es vehicula mitjançant dos constructes fonamentals: la situació i els conceptes pràctics. Les dades de la tesi consisteixen en les converses face-to-face i on-line entre un estudiant de Mestre en pràcticum i el seu tutor en el centre de pràctiques. L’estudi analitza dos casos d’uns quatre mesos de duració cadascun. L’anàlisi es porta a terme mitjançant anàlisi de discurs, utilitzant diverses unitats d’anàlisi i diverses dimensions, les quals fan possible una anàlisi integrada que permeti considerar de manera relacionada l’activitat conjunta (pla social) i l’ús individual de conceptes (pla individual). Els resultats preliminars suggereixen una especificitat estructural i genètica dels conceptes pràctics (en contrast amb els espontanis i científics), i l’existència de mecanismes d’activitat conjunta que potencien especialment el desenvolupament d’aquests conceptes.

Mosaico mediterráneo. El Arte como herramienta de diálogo intercultural

El presente trabajo de investigación doctoral reflexiona sobre el aporte de las prácticas artísticas contemporáneas en los procesos de diálogo entre culturas en el Mediterráneo. En las dinámicas de percepción, acercamiento y (re)conocimiento del otro y de las culturas otras, todos los medios informativos y de comunicación pueden ser, por un lado, válidos y efectivos como, por otro, pueden desviar de la verdad y difundir fácilmente numerosos prejuicios. Frente a la “síntesis” operada por los medios de comunicación tradicionales, donde “el Otro” es a menudo objeto de representaciones estereotipadas, las prácticas artísticas, en su sentido más amplio, contraponen un “análisis” que puede permitir, en diferentes casos, la eliminación de las barreras y un mayor acercamiento a la cultura otra. En la presente investigación se quiere trazar un itinerario teórico que parte de las hipótesis orientalistas, pasa por las filosofías del encuentro con el otro; los estudios sobre la participación; las actuales reflexiones sobre la estética relacional; las definiciones históricas y socio-políticas del Mediterráneo; hasta llegar a reconocer en el arte, en la creación artística, el medio de comunicación más eficaz y penetrante a la hora de refinar el conocimiento y (re)descubrir los diferentes aspectos de las culturas de los países y de los pueblos del Mediterráneo. En el espacio plural del Mediterráneo las prácticas artísticas y creativas actuales actúan como un campo de experimentación y un territorio de debate valioso e importante para el desarrollo del discurso intercultural.

Prevalence of human papillomavirus and Epstein-Barr virus DNA in penile cancer cases from Brazil

Penile cancer is a potentially mutilating disease. Although its occurrence is relatively rare worldwide, penile cancer rates can be high in developing countries. A few studies have been conducted on the involvement of human papillomavirus (HPV) in penile carcinoma, which have found HPV present in 30-70% of penile malignant lesions, with a higher prevalence of HPV 16 and 18. It has been assumed that cofactors, such as Epstein-Barr virus (EBV) infections, may play a role in the progression of penile neoplasia. The aim of this study was to determine HPV and EBV prevalence in 135 penile malignant lesions from Brazilian men through the use of MY09/11 polymerase chain reaction (PCR), type-specific PCR and restriction fragment length polymorphism analysis. HPV prevalence among the men tested was 60.7%. Of the men who tested positive, 27 presented with HPV 16 (29.7%), five with HPV 18 (5.5%), 21 with HPV 45 (23.1%) and nine with HPV 6 (9.9%). Seven mixed infections were detected (9.2%), while 11 cases remained untyped (13.4%). Regarding EBV positivity, 46.7% of the samples contained EBV DNA with EBV-1 as the most prevalent type (74.6%). More than 23% of the men were co-infected with both HPV and EBV, while 35% presented exclusively with HPV DNA and 20% presented only with EBV DNA. Penile carcinoma aetiology has not been fully elucidated and the role of HPV and EBV infections individually or synergistically is still controversial. Hence, more studies are needed to determine their possible role in carcinogenesis.

2013, declarado año del aire

Boletín semanal para profesionales sanitarios de la Secretaría General de Salud Pública, Inclusión y Calidad de Vida de la Consejería de Salud y Bienestar Social

Caracterització estadística dels pics de correlació a GPS

Aquest projecte es centra a donar una caracterització estadística del valor que tenen els pics de correlació sota diferents escenaris d’adquisició a un receptor GPS. En primer lloc, s’ha volgut donar una visió general de tots els fonaments del sistema GPS per tal de poder entendre el seu funcionament. A continuació, s’ha passat a analitzar el bloc d’adquisició d’un receptor GPS. Primer, hem estudiat quines operacions es realitzen en aquest bloc i quines són les diferents formes d’implementar-lo. Seguidament, sota un escenari d’adquisició per cerca de fase de codi en paral·lel i utilitzant integracions coherents, s’han estudiat les distribucions estadístiques de les pdf’s obtingudes pels pics de correlació de senyal+soroll i pels pics de correlació de només soroll, i s’ha vist com aquestes fan modificar la corba ROC del receptor . Les simulacions s’han realitzat amb MATLAB i en diferents escenaris d’adquisició per tal de poder comparar com varien les estadístiques obtingudes en casos diferents.

Applications of stochastic analysis in finance and statistical inference

First: A continuous-time version of Kyle's model (Kyle 1985), known as the Back's model (Back 1992), of asset pricing with asymmetric information, is studied. A larger class of price processes and of noise traders' processes are studied. The price process, as in Kyle's model, is allowed to depend on the path of the market order. The process of the noise traders' is an inhomogeneous Lévy process. Solutions are found by the Hamilton-Jacobi-Bellman equations. With the insider being risk-neutral, the price pressure is constant, and there is no equilibirium in the presence of jumps. If the insider is risk-averse, there is no equilibirium in the presence of either jumps or drifts. Also, it is analised when the release time is unknown. A general relation is established between the problem of finding an equilibrium and of enlargement of filtrations. Random announcement time is random is also considered. In such a case the market is not fully efficient and there exists equilibrium if the sensitivity of prices with respect to the global demand is time decreasing according with the distribution of the random time. Second: Power variations. it is considered, the asymptotic behavior of the power variation of processes of the form _integral_0^t u(s-)dS(s), where S_ is an alpha-stable process with index of stability 0&alpha&2 and the integral is an Itô integral. Stable convergence of corresponding fluctuations is established. These results provide statistical tools to infer the process u from discrete observations. Third: A bond market is studied where short rates r(t) evolve as an integral of g(t-s)sigma(s) with respect to W(ds), where g and sigma are deterministic and W is the stochastic Wiener measure. Processes of this type are particular cases of ambit processes. These processes are in general not of the semimartingale kind.

Phaeohyphomycosis: a clinical-epidemiological and diagnostic study of eighteen cases in Rio Grande do Sul, Brazil

The goal of this study was to review 18 cases of phaeohyphomycosis in Rio Grande do Sul. The records of all of the patients with a diagnosis of phaeohyphomycosis between 1995-2010 were reviewed. Twelve of the 18 patients (66.6%) were male. The average age of the patients was 50 years old (range: 16-74 years). Eleven patients (61%) presented with subcutaneous lesions. Seven patients (38.8%) had received a solid organ transplant. In all of the cases, the presence of melanin in the fungal cells was determined by Fontana-Masson staining of tissue sections and documented. Among the 18 patients, a total of 11 different fungal species were isolated. The causative organisms included Exophiala jeanselmei, Alternaria, Curvularia, Cladophialophora and Colletotrichum gloeosporioides. To our knowledge, this review reports the first case of subcutaneous phaeohyphomycosis caused by C. gloeosporioides in a lung transplant patient. The number of reported cases of phaeohyphomycosis has increased in the last decade. In a number of cases, this increased incidence may be primarily attributed to iatrogenic immunodeficiency.

Microdiàlisis cerebral aplicada a l'estudi del metabolisme energètic i a la resposta neuroinflamatòria dels pacients amb traumatisme cranioencefàlic

La tècnica de la microdiàlisis cerebral (MDC) és un instrument que proporciona informació rellevant en la monitorització del metabolisme cerebral en els pacients neurocrítics. El lactat i l’índex lactat-piruvat (ILP) són dos marcadors utilitzats per a la detecció de la hipòxia cerebral en pacients que han patit un traumatisme cranioencefàlic (TCE). Aquests dos marcadors poden estar anormalment elevats en circumstàncies que no cursen amb hipòxia tissular. Per una altra banda la recent aparició dels catèters de MDC amb porus de major mida denominats d’”alta resolució”, permet ampliar el rang de molècules que es poden detectar en el dialitzat. Objectius: 1) descriure les característiques del metabolisme energètic cerebral que s’observa en la fase aguda dels pacients que han patit un TCE en base als dos indicadors del metabolisme anaeròbic: lactat i ILP, i 2) determinar la recuperació relativa (RR) de les molècules implicades en la resposta neuroinflamatòria: de IL-1β, IL- 6, IL-8 i IL-10. Material i mètodes: Es van seleccionar 46 pacients d’una cohort de pacients amb TCE moderat o greu ingressats a la Unitat de Cures Intensives de l’Hospital Universitari de la Vall d’Hebron i monitoritzats amb MDC. Es van analitzar els nivells de lactat i ILP i es va correlacionar amb els nivells de PtiO2. Es van realitzar experiments in vitro per estudiar la recuperació de les membranes de 100 KDa per tal de poder interpretar posteriorment els nivells reals de les molècules estudiades en l’espai extracel•lular del teixit cerebral. Resultats: La concordança entre el lactat i l’índex LP per a determinar episodis de disfunció metabòlica va ser dèbil (índex de kappa = 0,36, IC 95%: 0,34-0,39). Més del 80% dels casos en què el lactat i l’índex LP es trobaven incrementats, els valors de la PtiO2 es van trobar dins els rangs de normalitat (PtiO2&15mmHg). La recuperació de les citoquines a través de la membrana de microdiàlisis va ser menor de l’esperat tenint en compte la mida dels porus de la membrana. Conclusions: el lactat i l’índex LP elevats va ser una troballa freqüent després d’un TCE i no es va relacionar, en la majoria de casos, amb episodis d’hipòxia tissular. Per un altra part la mida del porus de la membrana no és l’únic paràmetre indicador de la RR de macromolècules.

Characteristics of leprosy diagnosed through the surveillance of contacts: a comparison with index cases in Rio de Janeiro, 1987-2010

Contact surveillance is an important strategy to ensure effective early diagnosis and control of leprosy; passive detection may not be as efficient because it is directly tied to the ready availability of heath care services and health education campaigns. The aim of this study was to reinforce that contact surveillance is the most effective strategy for the control of leprosy. The analysed data were obtained from a cohort of contacts and cases diagnosed through a national referral service for leprosy. We analysed data from patients diagnosed between 1987-2010 at the Souza Araújo Ambulatory in Rio de Janeiro. Epidemiological characteristics of leprosy cases diagnosed through contact surveillance and characteristics of passively detected index cases were compared using a conditional logistic regression model. Cases diagnosed by contact surveillance were found earlier in the progression of the disease, resulting in less severe clinical presentations, lower levels of initial and final disability grades, lower initial and final bacterial indices and a lower prevalence of disease reaction. In this respect, contact surveillance proved to be an effective tertiary prevention strategy, indicating that active surveillance is especially important in areas of high endemicity, such as Brazil.

Molecular identification of Rickettsia parkeri infecting Amblyomma triste ticks in an area of Argentina where cases of rickettsiosis were diagnosed

Specimens of the hard tick Amblyomma triste were found infected with Rickettsia parkeri in an area of Argentina (General Lavalle, Buenos Aires Province) where cases of human illness attributed to this microorganism have been reported. Molecular detection of R. parkeri was based on polymerase chain reactions that amplify a ca. 400-bp fragment of the 23S-5S intergenic spacer and a ca. 500-bp fragment of the gene encoding a 190-kDa outer membrane protein. Three (6.97%) of 43 A. triste ticks were determined to be positive for R. parkeri. These results provide strong evidence that A. triste is the vector of R. parkeri in the study area. The findings of this work have epidemiological relevance because human parasitism by A. triste ticks has been frequently recorded in some riparian areas of Argentina and Uruguay and new cases of R. parkeri rickettsiosis might arise in the South American localities where humans are exposed to the bites of this tick species.

The right to appeal in cases of forensic autopsies. [Le droit de recours en matière d'autopsies médico-légales.]

The decision to carry out forensic autopsies is frequently made to determine the reasons of the death, especially in cases of non-natural death. In Switzerland, the judge strictly controls the authorisation to conduct forensic autopsies and the possibility to appeal against such a decision remains limited. This article aims to analyse the legal framework that enables appeals against a decision to conduct a forensic autopsy, taking into account the jurisprudence from the High Court of Switzerland (Tribunal Fédéral) and the European Court of Human Rights. La décision de pratiquer des autopsies médico-légales est très fréquente pour déterminer les causes de décès, notamment lorsque ceux-ci semblent avoir des causes non naturelles. En Suisse, l'autorisation de procéder à des autopsies médico-légales est strictement encadrée sur le plan légal et la faculté de s'opposer à une telle autorisation reste très limitée. L'article s'attache à analyser les conditions qui permettent de recourir contre une décision d'autopsie médico-légale, à la lumière notamment des décisions du Tribunal Fédéral et de la Cour européenne des droits de l'homme.

The association between dietary energy density and type 2 diabetes in Europe: results from the EPIC-InterAct Study

BACKGROUND Observational studies implicate higher dietary energy density (DED) as a potential risk factor for weight gain and obesity. It has been hypothesized that DED may also be associated with risk of type 2 diabetes (T2D), but limited evidence exists. Therefore, we investigated the association between DED and risk of T2D in a large prospective study with heterogeneity of dietary intake. METHODOLOGY/PRINCIPAL FINDINGS A case-cohort study was nested within the European Prospective Investigation into Cancer (EPIC) study of 340,234 participants contributing 3.99 million person years of follow-up, identifying 12,403 incident diabetes cases and a random subcohort of 16,835 individuals from 8 European countries. DED was calculated as energy (kcal) from foods (except beverages) divided by the weight (gram) of foods estimated from dietary questionnaires. Prentice-weighted Cox proportional hazard regression models were fitted by country. Risk estimates were pooled by random effects meta-analysis and heterogeneity was evaluated. Estimated mean (sd) DED was 1.5 (0.3) kcal/g among cases and subcohort members, varying across countries (range 1.4-1.7 kcal/g). After adjustment for age, sex, smoking, physical activity, alcohol intake, energy intake from beverages and misreporting of dietary intake, no association was observed between DED and T2D (HR 1.02 (95% CI: 0.93-1.13), which was consistent across countries (I(2) = 2.9%). CONCLUSIONS/SIGNIFICANCE In this large European case-cohort study no association between DED of solid and semi-solid foods and risk of T2D was observed. However, despite the fact that there currently is no conclusive evidence for an association between DED and T2DM risk, choosing low energy dense foods should be promoted as they support current WHO recommendations to prevent chronic diseases.

Skin infection caused by Scedosporium apiospermum in immunocompromised patients. Report of two cases.

Scedosporium apiospermum is a filamentous fungus that can cause cutaneous or extracutaneous disease. A large number of cases have been published over the last decades, mainly in patients immunocompromised as a result of their disease or treatment. These kinds of infections can progress rapidly and become disseminated, leading to very serious or even fatal complications. We report two new cases of skin infection by Scedosporium apiospermum from our hospital.

4-7-19, stade Pershing, saut [en] hauteur avec élan [Robert Lyman "Dink" Templeton sautant, et Carl Rice en attente à gauche de l'aire de saut, Jeux interalliés] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 54707