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Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of end-stage liver disease. The aim of this controlled cross-sectional study was to assess the association between NAFLD and hidradenitis suppurativa. NAFLD was assessed using hepatic ultrasound. A total of 125 patients with hidradenitis suppurativa and 120 patients without hidradenitis suppurativa were recruited, matched for age, sex and body mass index (< 25 or >= 25 kg/m(2)), a risk factor related to NAFLD. Both groups presented similar proportions of overweight or obesity (89.6% vs 90%). Patients with hidradenitis suppurativa presented significantly higher prevalence of NAFLD compared with those with non-hidradenitis suppurativa (57.6% vs 31.7%, p < 0.001). Multivariable analysis confirmed independent association between hidradenitis suppurativa and NAFLD (odds ratio 2.79, 95% confidence interval 1.48-5.25; p = 0.001) besides age, body mass index, hypertension and hypertransaminasaemia. Hidradenitis suppurativa is significantly associated with the development of NALFD regardless of the presence of classic metabolic risk factors.

Chilblain-like acral lesions have been identified in some coronavirus disease 2019 (COVID-19) patients. It has been suggested that these pseudo-chilblains could be a specific marker of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Most patients with these lesions have had negative polymerase chain reactions (PCRs), but some authors believe serology tests are likely to give positive results. We designed a prospective study including all patients with pseudo-chilblains treated in outpatient department in April and May 2020 and then performed SARS-CoV-2 PCR and serology tests on all available patients. We evaluated 59 patients, of whom 17 had undergone PCR before the study period, all with negative results. For the present study, we performed 20 additional PCRs, serology tests in 25 patients, and a parvovirus B19 antibody test in 15 patients. All results were negative. Our findings counter the hypothesis that serology is likely to reveal SARS-CoV-2 infection in patients with pseudo-chilblains. One hypothesis for our negative results is that the time period between symptom onset and antibody production is longer in these patients; another is that the lesions are caused by behavioral changes during lockdown rather than SARS-CoV-2 infection. We nevertheless maintain that COVID-19 should be ruled out in people presenting with chilblain-like lesions.

Recently, young COVID-19 patients have presented with erythematous and purpuric acral lesions similar to chilblains(1–3). Despite the scarcity of published cases, this topic has attracted significant mass media attention.(4) Dermatologists have noted that more people than would be expected at this time of year are seeking medical attention for these chilblain-like lesions. Some have suggested that people presenting with this manifestation should be tested and isolated(2). Determining the accuracy of this association is therefore crucial. To establish the real prevalence of COVID-19 in patients with acral skin lesions, we firstly evaluated all the cases of acral lesions presented in dermatology and paediatrics departments and family doctors’ offices in an eastern Spanish region over a three-week period. Then we prospectively performed a SARS-CoV-2 PCR on nasopharyngeal aspirates taken from all available patients to determine whether their cutaneous manifestations were predictive of a positive result. To put our findings into context, we reviewed all the articles published before May 2020 concerning COVID-19 patients with cutaneous lesions. We evaluated 58 patients, whose characteristics are summarized in Table 1. In most cases, lesions were chilblain-like. Fifteen patients had already been tested, and only one had a positive result: an 85-year-old man admitted for severe Covid-19 pneumonia. He had an ulcer on a toe that was finally determined to be vascular in nature. We performed prospective PCR testing in 24 patients. All test results were negative. In total, then, PCR was negative in 38 patients and positive in a single patient whose lesion was very unlikely to be due to COVID-19. Our bibliography search returned 97 articles and we found 2 more through cross-references. Nine of these articles dealt with acral lesions specifically. Their results are summarized in Table 2. Data published in the literature are heterogeneous, as are the methods employed to collect them. The first papers looked at cutaneous manifestations in patients with confirmed SARS-CoV-2 infection.(5–8) This approach cannot reveal whether this dermatologic manifestation is a specific marker of SARS-CoV-2 infection, since patients without COVID-19 are not included. The other approach, which we have followed, is to analyse all patients with acral lesions. This can be done retrospectively, reporting on patients in the sample who have already been tested, or prospectively, performing the test on all available patients, regardless of whether they have symptoms. The retrospective method has a significant risk of confounding bias: due to the scarcity of COVID-19 tests(8), they are usually reserved for patients with COVID-19-related symptoms, who are obviously more likely to test positive. All previous studies including only patients with cutaneous acral lesions (summarized in table 2) have been retrospective, and only a minority of patients were tested. In total, 12 out of at least 49 tested patients were positive (24.5%). Combined with our results, they total 13 positives out of 88 tests (14.8%). There are two possible explanations for the high proportion of negative results: I) A high number of false negatives. II) The lesions are not related to SARS-CoV-2 infection. The low prevalence of an infected contact in our sample, after three weeks of strict confinement in Spain, makes the possibility of being infected in our cohort less likely. The diffusion of this entity by the mass media may have caused patients who would not normally consult to do so.(9) . Other possible explanations include a concomitant parvovirus B19 outbreak(10) or trauma-induced lesions. Our study suggests that acral skin lesions are not a specific marker of SARS-CoV-2 infection. Although larger prospective studies are needed, current evidence indicates that acral skin lesions should not be regarded as a sign of COVID-19 in otherwise asymptomatic patients.

The purpose of this study was to develop a scale to measure patient adherence to physical therapist intervention and to report psychometric properties in patients with cystic fibrosis (CF).

Hector Beltran-Alacreu,1,2 Ibai López-de-Uralde-Villanueva,1,2 César Calvo-Lobo,3 Roy La Touche,1,2,4 Roberto Cano-de-la-Cuerda,5 Alfonso Gil-Martínez,1,2,4 David Fernández-Ayuso,6 Josué Fernández-Carnero2,4,5 1Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Spain; 2Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonóma de Madrid, Spain; 3Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain; 4Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; 5Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; 6“San Juan de Dios” School of Nursing and Physiotherapy, Pontifica de Comillas University, Madrid, Spain Purpose: The main aim of the study was to predict the health-related quality of life (HRQoL) based on physical, functional, and psychological measures in patients with different types of neck pain (NP). Materials and methods: This cross-sectional study included 202 patients from a primary health center and the physiotherapy outpatient department of a hospital. Patients were divided into four groups according to their NP characteristics: chronic (CNP), acute whiplash (WHIP), chronic NP associated with temporomandibular dysfunction (NP-TMD), or chronic NP associated with chronic primary headache (NP-PH). The following measures were performed: Short Form-12 Health Survey (SF-12), Neck Disability Index (NDI), visual analog scale (VAS), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BECK), and cervical range of movement (CROM). Results: The regression models based on the SF-12 total HRQoL for CNP and NP-TMD groups showed that only NDI was a significant predictor of the worst HRQoL (48.9% and 48.4% of the variance, respectively). In the WHIP group, the regression model showed that BECK was the only significant predictor variable for the worst HRQoL (31.7% of the variance). Finally, in the NP-PH group, the regression showed that the BECK, STAI, and VAS model predicted the worst HRQoL (75.1% of the variance). Conclusion: Chronic nonspecific NP and chronic NP associated with temporomandibular dysfunction were the main predictors of neck disability. In addition, depression, anxiety, and pain were the main predictors of WHIP or primary headache associated with CNP. Keywords: quality of life, neck pain, disability, depression, anxiety

Alfonso Gil-Martínez,1–3 Alba Paris-Alemany,1–4 Ibai López-de-Uralde-Villanueva,1–3 Roy La Touche1–4 1Department of Physiotherapy, 2Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 3Hospital La Paz Institute for Health Research, IdiPAZ, 4Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain Abstract: Thanks to advances in neuroscience, biopsychosocial models for diagnostics and treatment (including physical, psychological, and pharmacological therapies) currently have more clinical support and scientific growth. At present, a conservative treatment approach prevails over surgery, given it is less aggressive and usually results in satisfactory clinical outcomes in mild–moderate temporomandibular disorder (TMD). The aim of this review is to evaluate the recent evidence, identify challenges, and propose solutions from a clinical point of view for patients with craniofacial pain and TMD. The treatment we propose is structured in a multimodal approach based on a biobehavioral approach that includes medical, physiotherapeutic, psychological, and dental treatments. We also propose a new biobehavioral model regarding pain perception and motor behavior for the diagnosis and treatment of patients with painful TMD. Keywords: biobehavioral, review, temporomandibular disorders, biobehavioral orofacial pain, multimodal approach, motor behavior, disability

Resumen Introducción: El 50% de los tumores de pared torácica son malignos, dentro de los que destaca el plasmocitoma de costilla. Objetivo: Presentar un caso clínico que debutó inicialmente como un plasmocitoma de costilla, y que terminó presentándose como mieloma múltiple. Materiales y Método: Registro clínico de un paciente sometido a resección de tumor de parrilla costal. Resultados: Paciente masculino de 58 años, con un año de dolor costal, asociado a aumento de volumen a nivel de la octava costilla derecha en línea media axilar, indurada. TC de tórax que demuestra imagen sugerente de plasmocitoma de 79 × 44 mm. Se realiza resección quirúrgica, con instalación de malla de prolene en el defecto. Biopsia diferida con compromiso neoplásico por lesión monoclonal de células plasmáticas. Se complementa estudio con biopsia de médula ósea confirmando mieloma múltiple. Se inicia tratamiento con quimioterapia adyuvante. Conclusiones: El plasmocitoma óseo solitario es una entidad de baja frecuencia, que se asocia a la presencia de mieloma múltiple. Es por esto que al momento de la sospecha se hace necesario descartar su presencia, con el fin de mejorar el pronóstico del paciente.

Resumen Introducción: El 50% de los tumores de pared torácica son malignos, dentro de los que destaca el plasmocitoma de costilla. Objetivo: Presentar un caso clínico que debutó inicialmente como un plasmocitoma de costilla, y que terminó presentándose como mieloma múltiple. Materiales y Método: Registro clínico de un paciente sometido a resección de tumor de parrilla costal. Resultados: Paciente masculino de 58 años, con un año de dolor costal, asociado a aumento de volumen a nivel de la octava costilla derecha en línea media axilar, indurada. TC de tórax que demuestra imagen sugerente de plasmocitoma de 79 × 44 mm. Se realiza resección quirúrgica, con instalación de malla de prolene en el defecto. Biopsia diferida con compromiso neoplásico por lesión monoclonal de células plasmáticas. Se complementa estudio con biopsia de médula ósea confirmando mieloma múltiple. Se inicia tratamiento con quimioterapia adyuvante. Conclusiones: El plasmocitoma óseo solitario es una entidad de baja frecuencia, que se asocia a la presencia de mieloma múltiple. Es por esto que al momento de la sospecha se hace necesario descartar su presencia, con el fin de mejorar el pronóstico del paciente. Introduction: Up to 50% of chest wall tumors are malignant; among which rib plasmocytoma stand out. Aim: Showcase a clinical case that debuted as a rib plasmacytoma, and that ended up presenting as Multiple Myeloma. Materials and Method: Records of a patient with resection of chest wall tumor. Results: Male patient of 58 years, with one year of costal pain, associated with an indurated increase in volume at the level of the eighth right rib in the mid-axillary line. Chest CT scan demonstrated a suggestive image of plasmacytoma of 79 × 44 mm. Surgical resection was performed, with prolene mesh installation in the defect. Biopsy showed neoplastic compromise due to monoclonal lesion of plasma cells. Study is complemented with bone marrow biopsy confirming multiple myeloma. The patient was treated with adjuvant chemotherapy. Conclusions: Solitary bone plasmacytoma is a low frequency entity, which is associated with the presence of multiple myeloma. At the moment of suspicion, it is necessary to rule out their presence, in order to improve the patient's prognosis.

Ibai López-de-Uralde-Villanueva,1–4 Hector Beltran-Alacreu,1–3 Alba Paris-Alemany,1–4 Santiago Angulo-Díaz-Parreño,2,3,5 Roy La Touche1–4 1Department of Physiotherapy, Faculty of Health Science, 2Research Group on Movement and Behavioral Science and Study of Pain, The Center for Advanced Studies University La Salle, Universidad Autónoma de Madrid, Aravaca, Madrid, Spain; 3Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain; 4Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain; 5Faculty of Medicine, Universidad San Pablo CEU, Madrid, Spain Objectives: This cross-sectional correlation study explored the relationships between craniocervical posture and pain-related disability in patients with chronic cervico-craniofacial pain (CCFP). Moreover, we investigated the test–retest intrarater reliability of two craniocervical posture measurements: head posture (HP) and the sternomental distance (SMD). Methods: Fifty-three asymptomatic subjects and 60 CCFP patients were recruited. One rater measured HP and the SMD using a cervical range of motion device and a digital caliper, respectively. The Spanish versions of the neck disability index and the craniofacial pain and disability inventory were used to assess pain-related disability (neck disability and craniofacial disability, respectively). Results: We found no statistically significant correlations between craniocervical posture and pain-related disability variables (HP and neck disability [r=0.105; P>0.05]; HP and craniofacial disability [r=0.132; P>0.05]; SMD and neck disability [r=0.126; P>0.05]; SMD and craniofacial disability [r=0.195; P>0.05]). A moderate positive correlation was observed between HP and SMD for both groups (asymptomatic subjects, r=0.447; CCFP patients, r=0.52). Neck disability was strongly positively correlated with craniofacial disability (r=0.79; P>0.001). The test–retest intrarater reliability of the HP measurement was high for asymptomatic subjects and CCFP patients (intraclass correlation coefficients =0.93 and 0.81, respectively) and for SMD (intraclass correlation coefficient range between 0.76 and 0.99); the test–retest intrarater reliability remained high when evaluated 9 days later. The HP standard error of measurement range was 0.54–0.75 cm, and the minimal detectable change was 1.27–1.74 cm. The SMD standard error of measurement was 2.75–6.24 mm, and the minimal detectable change was 6.42–14.55 mm. Independent t-tests showed statistically significant differences between the asymptomatic individuals and CCFP patients for measures of craniocervical posture, but these differences were very small (mean difference =1.44 cm for HP; 6.24 mm for SMD). The effect sizes reached by these values were estimated to be small for SMD (d=0.38) and medium for HP (d=0.76). Conclusion: The results showed no statistically significant correlations between craniocervical posture and variables of pain-related disability, but a strong correlation between the two variables of disability was found. Our findings suggest that small differences between CCFP patients and asymptomatic subjects exist with respect to the two measurements used to assess craniocervical posture (HP and SMD), and these measures demonstrated high test–retest intrarater reliability for both CCFP patients and asymptomatic subjects. Keywords: measurement, neck pain, rehabilitation, reliability, reproducibility of results, temporomandibular disorders&nbsp

Introducción: Las tinciones cromógenas o "Black Stain" (BS) se han asociado a una baja experiencia de caries y un menor recuento de bacterias cariogénicas. El objetivo es determinar si existe diferencia en el número de pacientes que presenten un alto recuento de S. mutans (>10(5) UFC/ml saliva) entre niños con BS y sin ellas. Material y métodos: Estudio observacional analítico de corte transversal. Se incluyeron 158 escolares entre 6 y 12 años de establecimientos educacionales de la ciudad de Valdivia, Chile. Luego de un examen clínico se determinó la prevalencia de individuos con BS y se conformó un grupo con ausencia de tinciones para comparar el recuento de S. mutans. Se calculó la proporción del número de pacientes con valores >10(5) UFC/ml en ambos grupos para establecer los sujetos con alto riesgo cariogénico, evaluando si las diferencias fueron significativas (p10(5) UFC/ml de S. mutans entre los grupos. Discusión: La presencia de BS en pacientes de 6 a 12 años no se asocia a mayor o menor riesgo cariogénico. Introduction: Chromogenic staining or "Black Stain" (BS) has been associated with a low caries frequency and less cariogenic bacteria count. The aim of the study was to determine the difference in the number of patients who have a high count of S. mutans (>10(5) CFU/ml saliva) among children with BS and without them. Material and methods: Analytical observational cross-sectional study. In this study were included 158 children between 6 and 12 years old, from educational establishments in the city of Valdivia, Chile. After clinical examination, the prevalence of individuals with BS was determined and a group was formed with no stains to compare the count of S. mutans. We calculate the ratio of patients with values> 10(5) CFU/ml in the two groups to identify the patients with high cariogenic risk. Statistical differences were evaluated by Fisher's test (p 10(5) CFU/ml of S. mutans between groups. Discussion: The presence of BS in patients aged 6 to 12 years is not associated with cariogenic risk.

Introducción: Las tinciones cromógenas o "Black Stain" (BS) se han asociado a una baja experiencia de caries y un menor recuento de bacterias cariogénicas. El objetivo es determinar si existe diferencia en el número de pacientes que presenten un alto recuento de S. mutans (>10(5) UFC/ml saliva) entre niños con BS y sin ellas. Material y métodos: Estudio observacional analítico de corte transversal. Se incluyeron 158 escolares entre 6 y 12 años de establecimientos educacionales de la ciudad de Valdivia, Chile. Luego de un examen clínico se determinó la prevalencia de individuos con BS y se conformó un grupo con ausencia de tinciones para comparar el recuento de S. mutans. Se calculó la proporción del número de pacientes con valores >10(5) UFC/ml en ambos grupos para establecer los sujetos con alto riesgo cariogénico, evaluando si las diferencias fueron significativas (p10(5) UFC/ml de S. mutans entre los grupos. Discusión: La presencia de BS en pacientes de 6 a 12 años no se asocia a mayor o menor riesgo cariogénico.

Introducción: La gastrectomía vertical laparoscópica (GVL) es un procedimiento quirúrgico efectivo en el tratamiento de la obesidad. La obesidad está asociada con algunas comorbilidades como diabetes, dislipidemia y enfermedad cardiovascular, pero también se ha demostrado que tiene efectos potenciales sobre la gastritis y diversas enfermedades gastrointestinales. El objetivo de este estudio es determinar los hallazgos histológicos del segmento gástrico resecado durante la GVL realizada en una serie de pacientes obesos. Material y Método: Entre enero de 2006 y diciembre de 2008, 250 pacientes consecutivos a los que se realizó GVL, fueron incluídos en un protocolo prospectivo. La serie consistió en 189 mujeres (75,6%) y 61 hombres (24,4%), con edad promedio de 37,5 ± 12,1 años. El Índice de Masa Corporal (IMC) promedio fue 37,7 ± 3,1 kg/m². Resultados: Los resultados histológicos identificaron 220 casos (88%) con patología gástrica. Se diagnosticó gastritis crónica folicular en 117 pacientes (46,8%), gastritis crónica superficial en 76 (30,4%), gastritis crónica inespecífica en 38 (15,2%), metaplasia intestinal en 14% (5,6%) y en un caso (0,4%) adenocarcinoma in situ. Helicobacter pylori (HP) estuvo presente en 34 pacientes (13,6%). Conclusiones: Los hallazgos de este estudio, muestran una prevalencia incrementada de lesiones gástricas histopatológicas detectadas posterior a la GVL, reafirmando la necesidad de una detección de estas lesiones antes de la cirugía. Background: Laparoscopic sleeve gastrectomy (LSG) is used for the treatment of obesity and may provide gastric tissue for pathological studies. The association of obesity with dyslipidemias, diabetes and cardiovascular disease is of common knowledge. However its association with gastrointestinal diseases and gastritis is less well known. Aim: To analyze the pathological findings of the resected gastric segment during LSG. Material and Methods: Two hundred fifty patients aged 37 ± 12 years and with a body mass index of 37.7 ± 3.1 kg/m² (189 women), subjected to LSG, were included in a prospective protocol. Resected gastric segments were sent for a pathological study. Results: A gastric disease was identified in 220 (88%) cases. Chronic follicular gastritis was diagnosed in 117 patients (46.8%), chronic superficial gastritis in 76 (30.4%), chronic nonspecific gastritis in 38 (15.2%), intestinal metaplasia in 14% (5.6%) and in one case (0.4%) an early gastric carcinoma. Helicobacterpylori was present in 34 (13.6%) patients. Conclusions: This study shows a high prevalence of histopathological gastric lesions detected after the LSG, reaffirming the need for detection of these lesions before surgery.

Introuccion: Los cánceres peritoneales primarios son una patología de baja prevalencia, dentro de los cuales el carcinoma se­roso papilar primario de peritoneo es el más frecuente con una incidencia de 6,78 casos por millón de habitantes. Predomina en el sexo femenino y su principal diagnóstico diferencial es el carcinoma papilar seroso de ovario avanzado, para lo cual la inmunohistoquímica, junto a sus clasificaciones clínicas y anatomopatológicas son la forma de diferenciar en base a la clasificación de la Organización Mundial de la salud para lesiones tumorales. Objetivo: Describir los resultados inmuno-histoquímicos de una serie de casos estudiados en el Hospital Clinico de la Universidad de Chile y compararlos con la literatura médica. Material y Método: Estudio retrospectivo, descriptivo en base a análisis de 12 biopsias entre Enero 2010 y Marzo 2015 clasificándolos según edad, sexo y registro de biopsia. Se realizó técnica histológica rutinaria además de las tin­ciones inmunohistoquímicas para WT1, citoqueratinas y otros reactivos de acuerdo a los diagnósticos diferenciales. Resultados: La distribución etaria fue de 47 a los 75 años, media de 60 años, el 100% de los casos de sexo femenino. Los reactivos de Inmunohistoquímica predominantes fueron WT1 (53,8%), Citoqueratina-7 (38,5%). Conclusiones: Este carcinoma es una entidad poco común en la clínica, con similitudes al carcinoma seroso ovárico. Existe consenso sobre el diagnóstico de esta patología, el cual se debe orientar, según los criterios de la Gynecologic Oncology Group. Ante la sospecha clínica, el patólogo puede realizar el estudio inmunohistoquímico dirigido y así tener un diagnóstico preciso para determinar la conducta terapéutica del cirujano.

Treball de recerca realitzat per alumnes d’ensenyament secundari i guardonat amb un Premi CIRIT per fomentar l'esperit científic del Jovent l’any 2010. El treball te com objectiu reivindicar la complexitat de l'obra de Calders defugint la simplificació amb què és generalment percebuda. Calders va més enllà de l'humor amable i la llengua que utilitza és rica en recursos poètics. La ironia, més que un recurs, és el tot, el vehicle d'expressió de la cosmovisió de l'autor.

Los tumores de glándulas salivales representan el 3%-10% de las neoplasias de cabeza y cuello. La localización más común es en la glándula parótida, representando el 50%-85% de los casos, siendo 20%-30% de ellos malignos. Los siguientes son indicadores de malignidad: Crecimiento acelerado, masa dolorosa, parálisis facial asociada y linfoadenopatía. La mayoría de las neoplasias de parótida derivan de un único tipo histológico, pero eventualmente puede ocurrir el desarrollo de más de un tipo en la misma glándula. Este trabajo presenta un caso de una neoplasia en parótida con dos tipos histológicos diferentes, con una presentación clínica atípica. El paciente se presentó inicialmente con otalgia y otorrea, al examen destacaba un tumor en el canal auditorio externo. El estudio complementario evidenció una neoplasia de parótida y se realizó resección total de la glándula. La biopsia informó un carcinoma adenoideo-quístico con áreas basaloideas diferenciadas. Se administró radioquimioterapia adyuvante, y el control imagenológico con PET-TC mostró la ausencia de recurrencias o diseminación del tumor. Tumors of the salivary glands represent 33%-10% of head and neck neoplasms. The most common location is the parotid gland, accounting for 50%-85% of the cases, with 20%-30% of them being malignant. The following are known to be indicative of a malignant tumor: fast growing, painless mass, associated facial paralysis and lymphadenopathy. Most parotid neoplasm derive from a single histological type but eventually the development of more than one type on the same gland can occur. This paper presents a case of a parotid neoplasm with two different histological tumors, with uncharacteristic clinical presentation. The patient presented initially with ear pain and otorrhoea, in the clinical examination highlighted an external auditory canal tumor. The complementary study revealed a parotid neoplasm and a total resection of the gland was performed. The biopsy revealed an adenoid-cystic carcinoma with differentiated basaloid areas. Adjuvant radio-chemotherapy was administered, and the imaging control with PET-CT showed no evidence of recurrence or dissemination of the tumor.

Los tumores de glandulas salivales representan el 3%-10% de las neoplasias de cabeza y cuello. La localizacion mas comun es en la glandula parotida, representando el 50%-85% de los casos, siendo 20%-30% de ellos malignos. Los siguientes son indicadores de malignidad: Crecimiento acelerado, masa dolorosa, paralisis facial asociada y linfoadenopatia. La mayoria de las neoplasias de parotida derivan de un unico tipo histologico, pero eventualmente puede ocurrir el desarrollo de mas de un tipo en la misma glandula. Este trabajo presenta un caso de una neoplasia en parotida con dos tipos histologicos diferentes, con una presentacion clinica atipica. El paciente se presento inicialmente con otalgia y otorrea, al examen destacaba un tumor en el canal auditorio externo. El estudio complementario evidencio una neoplasia de parotida y se realizo reseccion total de la glandula. La biopsia informo un carcinoma adenoideo-quistico con areas basaloideas diferenciadas. Se administro radioquimioterapia adyuvante, y el control imagenologico con PET-TC mostro la ausencia de recurrencias o diseminacion del tumor.

The discrepancy method is widely used to find lower bounds for communication complexity of XOR games. It is well known that these bounds can be far from optimal. In this context Disjointness is usually mentioned as a case where the method fails to give good bounds, because the increment of the value of the game is linear (rather than exponential) in the number of communicated bits. We show in this paper the existence of XOR games where the discrepancy method yields bounds as poor as one desires. Indeed, we show the existence of such games with any previously prescribed value. To prove this result we apply the theory of p-summing operators, a central topic in Banach space theory. We show in the paper other applications of this theory to the study of the communication complexity of XOR games.

Over the past two decades, cephalopod molluscs have attracted increased attention from marine biologists and fishery scientists. Several species are important for European fisheries, as targets of small‐scale coastal fisheries and/or as bycatch in multispecies fisheries for demersal fish. The present report draws on a series of reviews prepared in 2005 for the CEPHSTOCK project (see Section 1). The taxonomy of the main resource species is reviewed (Section 2), and brief descriptions of each species are provided, along with information from studies of population genetics, habitat requirements of paralarvae and adults, and health and ecotoxicology (Section 3). The main fisheries are described, including illustration of gears used in specialized small‐scale fisheries and a discussion of the socio-economic importance of the fisheries. The current status of cephalopod aquaculture is reviewed, highlighting notable advances in commercial culture of octopus and cuttlefish (Section 4). Current fishery data collection and fishery management are described, noting that there is no setting of landings quotas and no routine assessment of stock status. Optns for stock assessment are discussed, drawing on one off assessments made during specific projects and current practice elsewhere in the world. The “live fast, die yong” lifehistory strategies of cephalopods present particular challenges, buparallels can be drawn with shortlived fish (Section 5). Finally, the report looks to the future, reviewing possible effects of climate change on cephalopods. It discusses the future development of aquaculture and fisheries for cephalopods, including prospects for fishery forecasting and fishery management - especially in relation to the small-scale directed fisheries. Various knowledge gaps are identified, and ideas for research to fill these gaps are presented, Sí

This paper describes benchmark testing of six two-dimensional (2D) hydraulic models (DIVAST, DIVASTTVD, TUFLOW, JFLOW, TRENT and LISFLOOD-FP) in terms of their ability to simulate surface flows in a densely urbanised area. The models are applied to a 1·0 km × 0·4 km urban catchment within the city of Glasgow, Scotland, UK, and are used to simulate a flood event that occurred at this site on 30 July 2002. An identical numerical grid describing the underlying topography is constructed for each model, using a combination of airborne laser altimetry (LiDAR) fused with digital map data, and used to run a benchmark simulation. Two numerical experiments were then conducted to test the response of each model to topographic error and uncertainty over friction parameterisation. While all the models tested produce plausible results, subtle differences between particular groups of codes give considerable insight into both the practice and science of urban hydraulic modelling. In particular, the results show that the terrain data available from modern LiDAR systems are sufficiently accurate and resolved for simulating urban flows, but such data need to be fused with digital map data of building topology and land use to gain maximum benefit from the information contained therein. When such terrain data are available, uncertainty in friction parameters becomes a more dominant factor than topographic error for typical problems. The simulations also show that flows in urban environments are characterised by numerous transitions to supercritical flow and numerical shocks. However, the effects of these are localised and they do not appear to affect overall wave propagation. In contrast, inertia terms are shown to be important in this particular case, but the specific characteristics of the test site may mean that this does not hold more generally.

This paper describes benchmark testing of six two-dimensional (2D) hydraulic models (DIVAST, DIVASTTVD, TUFLOW, JFLOW, TRENT and LISFLOOD-FP) in terms of their ability to simulate surface flows in a densely urbanised area. The models are applied to a 1·0 km × 0·4 km urban catchment within the city of Glasgow, Scotland, UK, and are used to simulate a flood event that occurred at this site on 30 July 2002. An identical numerical grid describing the underlying topography is constructed for each model, using a combination of airborne laser altimetry (LiDAR) fused with digital map data, and used to run a benchmark simulation. Two numerical experiments were then conducted to test the response of each model to topographic error and uncertainty over friction parameterisation. While all the models tested produce plausible results, subtle differences between particular groups of codes give considerable insight into both the practice and science of urban hydraulic modelling. In particular, the results show that the terrain data available from modern LiDAR systems are sufficiently accurate and resolved for simulating urban flows, but such data need to be fused with digital map data of building topology and land use to gain maximum benefit from the information contained therein. When such terrain data are available, uncertainty in friction parameters becomes a more dominant factor than topographic error for typical problems. The simulations also show that flows in urban environments are characterised by numerous transitions to supercritical flow and numerical shocks. However, the effects of these are localised and they do not appear to affect overall wave propagation. In contrast, inertia terms are shown to be important in this particular case, but the specific characteristics of the test site may mean that this does not hold more generally.

La displasia osteofibrosa es una patología ósea benigna e idiopática, poco frecuente en cabeza y cuello. Afecta principalmente el hueso maxilar mientras en fosa nasal su frecuencia es baja. Habitualmente aslntomática, puede ser agresiva por crecimiento local y eventual malignización. El tratamiento es quirúrgico cuando produce alteraciones en la estética facial, síntomas compresivos orbitarios, rinosinusales, vasculares, nerviosos o ante sospecha de malignización. Se presenta un caso de un paciente con obstrucción nasal persistente, en cuya evaluación se diagnostica un tumor óseo de cornete inferior, que es extirpado mediante técnica endoscópica, con resultado satisfactorio. El estudio histopatológico confirmó el diagnóstico de displasia osteofibrosa. Se discuten los problemas diagnósticos y terapéuticos, destacando la importancia del examen físico y el diagnóstico oportuno, pudiendo tratarse endoscópicamente sin inconvenientes cuando son pequeños

La displasia osteofibrosa es una patología ósea benigna e idiopática, poco frecuente en cabeza y cuello. Afecta principalmente el hueso maxilar mientras en fosa nasal su frecuencia es baja. Habitualmente aslntomática, puede ser agresiva por crecimiento local y eventual malignización. El tratamiento es quirúrgico cuando produce alteraciones en la estética facial, síntomas compresivos orbitarios, rinosinusales, vasculares, nerviosos o ante sospecha de malignización. Se presenta un caso de un paciente con obstrucción nasal persistente, en cuya evaluación se diagnostica un tumor óseo de cornete inferior, que es extirpado mediante técnica endoscópica, con resultado satisfactorio. El estudio histopatológico confirmó el diagnóstico de displasia osteofibrosa. Se discuten los problemas diagnósticos y terapéuticos, destacando la importancia del examen físico y el diagnóstico oportuno, pudiendo tratarse endoscópicamente sin inconvenientes cuando son pequeños Fibrous dysplasia is an idiopathic benign bone disease, infrequent in head and neck. It is mainly located in the maxillary bone, while its nasal cavity frequency is low. It is usually asymptomatic, but it can be aggressive due to local growth and malignant degeneration. Its treatment is surgical when the disease produces an important facial deformity, orbital, rhinosinusal or vascular-nervous compressive symptoms or when malignization is suspected. A case report of a patient with persistent nasal obstruction is presented. Upon evaluation, a bony tumor of the inferior turbinate was diagnosed. Excision was performed using endoscopic technique, with satisfactory clinical results. Histopathological examination confirmed the diagnosis of fibrous dysplasia. We emphasize the importance of the otolaryngology physical examination and the early diagnosis in order to offer the more adequate treatment when lesions are small, so as to be able to perform an endoscopic surgery without potential disadvantages

Aquest article és una presentació de les revistes de contingut adreçat a l'ensenyament de la geografia, així com d'algunes que no ho són en un sentit estricte però que solen dedicar-hi una especial atenció, totes formen part del fons hemerogràfic de la Biblioteca d'Humanitats de la Universitat Autònoma de Barcelona. Constitueixen una mostra àmplia del pensament i de la pràctica en l'ensenyament de la geografia en àmbits francòfons i anglosaxons i gairebé totes es reben en règim d'intercanvi amb Documents d'Anàlisi Geogràfica. Este artículo es una presentación de revistas de contenido dirigido a la enseñanza de la geografía, así como de algunas que, aún no siéndolo en sentido estricto, suelen dedicar a este tema una atención periódica. Todas ellas, mayoritariamente incorporadas en régimen de intercambio con Documents d'Anàlisi Geogràfica, pueden consultarse en la Biblioteca de Humanidades de la Universitat Autònoma de Barcelona y constituyen una amplia muestra del pensamiento y la práctica de la geografía en ámbitos francófonos y anglosajones. Cet article est une présentation des revues de contenu adressé à l'enseignement de la géographie, et d'autres qui, ne l'étant pas dans un sens strict, y dédient habituellement une attention spéciale. Celles-ci font partie du fonds de revues et journaux de la Bibliothèque d'Humanités de la Universitat Autònoma de Barcelona, où la plupart d'elles sont intégrées en régime d'échange avec Documents d'Anàlisi Geogràfica et constituent une vaste réprésentation de la pensée et de la pratique dans l'enseignement de la géographie dans les milieux francophone et anglo-saxon. This article provides information on the periodical publications related to the teaching of geography, together with others not strictly related but which regularly dedicate particular attention to the discipline, all of which are available in the periodicals section of the Humanities Library in the Universitat Autònoma de Barcelona. They constitute a wide sample of thought and practice in geography teaching in English -and French- speaking circles. The vast majority of these publications are received through exchange agreements with Documents d'Anàlisi Geogràfica.

Deux rencontres ayant pour but l'éducation environnementale ont eu lieu dans l'intervalle d'a peine un mois en automne 1991. La premiere, de protée nationale, s'est tenue a Burgos les 27, 28 et 29 septembre sous le titre Deuxiemes Joumées de Didactique de la Géographie et a été organisee par l'Association de Géographes Espagnols. La deuxiéme, qui s'est tenue a Sestri Levante les 25, 26 et 27 d'octobre sous le titre de «L'ambiente nella formazione del cittadino europea», a été organisée par le Centro di Iniziativa Democratica degli Insegnanti sous le patronnage de la XIème Direction Générale de la CEE et de I'UNESCO. Two seminars on the topic of environmental education were held within the space of one month during the autumn of 1991. The first took place in Burgos on 27th, 28th and 29th September, and was organized by the Association of Spanish Geographers under the title of I1 Jomadas de Didactica de la Geografia (IInd Seminar on Didactics in Geography). The second meeting was held at Sestri Levante on 25th, 26th and 27th October. The topic of the seminar was «L'ambiente nella formazione del cittadino europeo»«The environment in the education of the European citizen», and it was organized by the Centro di Iniziativa Democratica degli Insegnanti under the auspices of the General Direction XI of the EEC and UNESCO. Con solo un mes de intervalo, han tenido lugar dos iniciativas para tratar el tema de la educación medioarnbiental. La primera fue patrocinada por la Asociación de Geógrafos Españoles mediante las I1 Jomadas de Didáctica de la Geografia, y tuvo lugar 10s dias 27,28 y 29 de septiembre en Burgos. La segunda, «L'ambiente nella formazione del cittadino europeo», fue convocada por el Centro di Iniziativa Democratica degli Insegnanti bajo el patrocinio de la Dirección General XI de la CEE y la UNESCO, y tuvo lugar en Sestri Levante durante los dias 25,26 y 27 de octubre de 1991. Amb un mes d'interval han tingut lloc dues iniciatives per tractar el tema de l'educació medioambiental. La primera, d'abast estatal, tingué lloc a Burgos els dies 27, 28 i 29 de setembre de 1991, sota el títol de I1 Jomadas de Didáctica de la Geografia, i foren convocades per l'Asociación de Geógrafos Españoles. La segona, «L'ambiente nella formazione del cittadino europeo», que tingué lloc a Sestri Levante els dies 25,26 i 27 d'octubre de 1991, convoca representants de nombrosos paisos europeus i fou organitzada pel Centro di Iniziativa Democratica degli Insegnanti, la Direcció General XI de la CEE i la UNESCO.

Cet article, publié en 1885, est une excellente synthèse de la pensée de son auteur. Il y expose sa conception de la géographie comme science dans un moment de grand progres dans le domaine scientifique et, de facon particulière, la potentialité formative et pédagogique qu'elle peut mettre en oeuvre en tant que discipline scolaire. Kropotkin y propose un nouveau modele scolaire qui fait possible l'enseignement d'une géographie susceptible de faire la liaison entre la formation scientifique et la formation humaniste, tout en éveillant l'interêt pour l'étude des lois naturelles et en permettant aux jeunes de comprendre le monde pour qu'ils puissent le transformer en un lieu plus juste et plus égalitaire. This article, first published in 1885, could be considered an excellent synthesis of Kropotkin's thought. He defines, in a moment of a great uprise of natural sciences, his conception of geography as a science, stressing its educational and pedagogical potentiality as a subject in the school curriculum. Kropotkin stands up for a new educational system where geography could mean a link between scientific and humanistic learnings could awake the interest in the studv of natural laws and give yoGni people the instruments to understand the world where they live in order to change it into a more just and equalitarian one. Este articulo, publicado en 1885, es una excelente síntesis del pensamiento del autor. En él expone su concepción de la geografia como ciencia en un momento de grandes avances en el terreno científico y, muy especialmente, el potencial formativo y pedagógico que puede desempeñar como asignatura escolar. Kropotkin defiende un nuevo modelo escolar en el que pueda enseñarse una geografia capaz de enlazar la formación cientifica y la humanistica, que despierte el interés por el estudio de las leyes naturales y que permita a los jóvenes comprender el mundo en el que viven para poder transformarlo en un lugar más justo y más igualitario. Aquest article, publicat el 1885, és una síntesi excel·lent del pensament de l'autor. Kropotkin hi exposa la seva concepció de la geografia com a ciència, en un moment de grans avenços en el terreny científic i també, d'una manera especial, el potencial informatiu i pedagògic que pot exercir com a assignatura escolar. L'autor hi defensa un model escolar que possibiliti l'ensenyament d'una geografia capaç d'enllaqar la formació científica i la humanística, que desvetlli l'interès per l'estudi de les lleis naturals i que permeti als joves de comprendre el món on viuen per transformar-lo en un lloc més just i més igualitari.

eLife 12, e81916 (2023). doi:10.7554/eLife.81916, Background:Short-term forecasts of infectious disease burden can contribute to situational awareness and aid capacity planning. Based on best practice in other fields and recent insights in infectious disease epidemiology, one can maximise the predictive performance of such forecasts if multiple models are combined into an ensemble. Here, we report on the performance of ensembles in predicting COVID-19 cases and deaths across Europe between 08 March 2021 and 07 March 2022.Methods:We used open-source tools to develop a public European COVID-19 Forecast Hub. We invited groups globally to contribute weekly forecasts for COVID-19 cases and deaths reported by a standardised source for 32 countries over the next 1–4 weeks. Teams submitted forecasts from March 2021 using standardised quantiles of the predictive distribution. Each week we created an ensemble forecast, where each predictive quantile was calculated as the equally-weighted average (initially the mean and then from 26th July the median) of all individual models’ predictive quantiles. We measured the performance of each model using the relative Weighted Interval Score (WIS), comparing models’ forecast accuracy relative to all other models. We retrospectively explored alternative methods for ensemble forecasts, including weighted averages based on models’ past predictive performance.Results:Over 52 weeks, we collected forecasts from 48 unique models. We evaluated 29 models’ forecast scores in comparison to the ensemble model. We found a weekly ensemble had a consistently strong performance across countries over time. Across all horizons and locations, the ensemble performed better on relative WIS than 83% of participating models’ forecasts of incident cases (with a total N=886 predictions from 23 unique models), and 91% of participating models’ forecasts of deaths (N=763 predictions from 20 models). Across a 1–4 week time horizon, ensemble performance declined with longer forecast periods when forecasting cases, but remained stable over 4 weeks for incident death forecasts. In every forecast across 32 countries, the ensemble outperformed most contributing models when forecasting either cases or deaths, frequently outperforming all of its individual component models. Among several choices of ensemble methods we found that the most influential and best choice was to use a median average of models instead of using the mean, regardless of methods of weighting component forecast models.Conclusions:Our results support the use of combining forecasts from individual models into an ensemble in order to improve predictive performance across epidemiological targets and populations during infectious disease epidemics. Our findings further suggest that median ensemble methods yield better predictive performance more than ones based on means. Our findings also highlight that forecast consumers should place more weight on incident death forecasts than incident case forecasts at forecast horizons greater than 2 weeks., Published by eLife Sciences Publications, Cambridge

[eng] RAGE is a transmembrane protein of the immunoglobulin family highly expressed during embryonic development but rarely expressed in adult healthy tissues. However, under cellular stress RAGE is re-expressed and mediates inflammatory chronic diseases including diabetes, Alzheimer’s and cancer. RAGE is a multi-ligand receptor and its protein ligands, which are unconventionally secreted, are overexpressed under inflammatory conditions, activating RAGE-driven signaling pathways. The aim of this thesis is to study the involvement of RAGE in Triple Negative Breast Cancer (TNBC) progression. First, we show that breast cancer (BC) cells exposed to different microenvironmental stresses become more migratory and invasive. Under acute acidosis, the secretome of different BC cells is enriched with RAGE ligands. Moreover, acidosis induces an oligomerization of RAGE, which correlates with its signaling activation. In BC cells, ligand binding to RAGE activates NF-kB and/or ERK1/2 pathways promoting breast cancer cell migration and invasion. Both the ablation of RAGE expression and its inhibition using RAGE antagonists block RAGE- mediated signaling and cell migration and invasion in TNBC cells. Furthermore, blocking RAGE in mesenchymal TNBC cells induces a mesenchymal-to-epithelial transition (MET) by down-regulating SNAIL1 expression. TNBC mesenchymal cells under RAGE inhibition gain the expression of several epithelial markers, increase cell adhesions and become less invasive. Furthermore, in a TNBC in vivo model, we show that treatment with a RAGE antagonist reduces the incidence of metastasis and increases overall survival. Therefore, this study shows that RAGE drives EMT and tumor cell invasion in mesenchymal TNBC cells, and it shows that RAGE is a new candidate therapeutic target for breast cancer.