Search

Background: Medulloblastomas (MB) are the most common malignant brain tumors in the pediatric age. In 2021, WHO categorized medulloblastomas into two groups: molecularly defined and histologically defined medulloblastomas. Molecularly defined medulloblastomas are divided into WNTactivated medulloblastoma, SHH-activated and TP53-wildtype medulloblastoma, SHH-activated, and TP53-mutant and non-WNT/non-SHH medulloblastoma, which include Group 3 (MYC) and Group 4 (CDK6 and MYCN). In this paper, we will focus on molecularly defined medulloblastomas. Objective: This paper aims to review the literature in order to describe the molecular structure of the medulloblastoma groups and to emphasize the importance of genetic predictors in medulloblastoma that can be used in clinical practice, either as a prognostic tool or as a therapeutic target in the future. Results: Each molecular subtype of medulloblastoma presents a different prognosis, and the molecular subtype with the best prognosis is medulloblastoma-activated WNT. It has even been observed that a reduction in the intensity of the combined treatment does not modify the prognosis of the patients, resulting in even fewer adverse effects due to the treatment. On the other hand, it was observed that the subtypes with the worst prognosis are medulloblastomas with activated MYC and medulloblastomas with activated SHH and mutated TP53, due to their high capacity to metastasize or to their radio-resistance. However, a new target therapy has emerged that could help improve the prognosis in these patients. Conclusion: The deeper knowledge of the molecular pathways involved in the appearance and progression of medulloblastomas will allow us to offer a prognosis at the time of diagnosis and more specific treatments through the development of the targeted therapy.

BACKGROUND: Changes in neutrophil to lymphocyte ratio (ΔNLR) have been used as a clinical tool for stratification and prognosis of patients with solid tumors, there is scarce evidence of their clinical relevance in patients with tumors of the central nervous system who have also undergone surgical resection. OBJECTIVE: Determine if (ΔNLR) are associated with poor response to treatment and worse prognosis in pediatric patients with central nervous system tumors (CNST) who underwent surgical resection. METHODS: We performed a retrospective cohort study; demographic, clinical, and hematological variables were evaluated, Kaplan-Meier survival curves and Cox proportional hazards regression model were performed to evaluate prognosis. RESULTS: The ΔNLR cutoff value obtained through the third interquartile range was 4.30; The probability of survival and complete response to treatment was different between patients with high ΔNLR when compared to patients with low ΔNLR (p= 0.013, p=≪ 0.001, respectively). A high ΔNLR behaved as an independent predictor of worse Overall Survival (HR 2,297; 95% CI: 1,075–4.908, p= 0.032). CONCLUSION: An elevated ΔNLR was a predictor of poor response to treatment and a prognostic factor for worse Overall Survival in pediatric patients with CNST undergoing surgical resection.

Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impairment, psychopathology, and personality pathology in a sample of 161 young adults. Consistent with past studies, positive, negative, and disorganized schizotypy had distinct and hypothesized associations with symptoms and impairment. Positive schizotypy was associated with prodromal symptoms and schizotypal, paranoid, and borderline personality traits. Negative schizotypy was associated with impaired functioning, negative symptoms, and schizoid, schizotypal, and paranoid traits, as well as any broad personality disorder diagnosis; it was also associated with never having dated. Disorganized schizotypy was associated with impaired functioning, disorganized schizotypic experiences, attentional deficits, and schizotypal, paranoid, borderline, and avoidant personality traits, as well as depression. Overall, we successfully replicated findings from five previous schizotypy interview studies, supporting the construct validity of the multidimensional model of schizotypy and the Multidimensional Schizotypy Scale. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Resumen Objetivo: describir factores de riesgo y características clínicas, electrocardiográficas y angiográficas de pacientes jóvenes que sufren síndromes coronarios agudos y son llevados a arteriografía coronaria a causa de este diagnóstico. Métodos: estudio retrospectivo, de corte transversal. Se revisaron historias clínicas de pacientes entre 18 y 50 años, con síndrome coronario agudo en una institución de Cardiología Intervencionista en Bucaramanga. Resultados y conclusiones: se identificaron 128 casos, con una mediana de edad de 45 años, y predominancia del género masculino (80,4%). La mediana de tiempo a la consulta fue de 7 horas. El factor de riesgo más frecuente fue el exceso de peso (71,3% de los casos). La mayoría de los casos correspondió a infarto con elevación del segmento ST (44% de los casos). En el 60,9% de los casos se identificó enfermedad coronaria, con 55,1% de enfermedad coronaria multivaso. La intervención de reperfusión más frecuente fue la intervención coronaria percutánea mediante angioplastia coronaria con implantación de stent coronario convencional (60,25% de los casos). La mortalidad intrahospitalaria fue del 2,34%. El exceso de peso como principal factor de riesgo observado plantea la importancia de intervenciones poblacionales dirigidas a controlar su prevalencia. La elevada frecuencia de infartos con elevación del segmento ST y de enfermedad coronaria multivaso llama la atención sobre el riesgo de estos pacientes y la importancia de su atención temprana y diligente. Abstract Objective: To describe the risk factors and clinical, electrocardiographic, and angiographic characteristics of young adults that suffer from acute coronary syndromes and have been subjected to a coronary angiography due to this diagnosis. Methods: A retrospective, cross-sectional study was performed by reviewing the clinical records of patients between 18 and 50 years-old with an acute coronary syndrome in a Interventional Cardiology institution in Bucaramanga, Colombia. Results and conclusions: A total of 128 cases were identified, with a median age of 45 years, and the large majority (80.4%) male. The median time in the clinic was 7 hours. The most frequent risk factor was overweight (71.3% of cases). The majority of cases corresponded to an infarction with elevated ST segment (44% of cases). Coronary disease was identified in 60.9% of cases, and 55.1% with multiple vessel coronary disease. The most frequent reperfusion treatment was percutaneous coronary intervention by means of coronary angioplasty with the implantation of a conventional coronary stent (60.25% of cases). The in-hospital mortality was 2.34%. The excess weight as the main risk factor observed, shows the importance of population interventions directed at controlling its prevalence. The increased frequency of infarctions with elevated ST segment and multiple vessel coronary disease highlights the risk of these patients, and the importance of their early and rapid care.

SARS-CoV-2 is a member of the family of coronaviruses associated with severe outbreaks of respiratory diseases in recent decades and is the causative agent of the COVID-19 pandemic. The recognition by and activation of the innate immune response recruits neutrophils, which, through their different mechanisms of action, form extracellular neutrophil traps, playing a role in infection control and trapping viral, bacterial, and fungal etiological agents. However, in patients with COVID-19, activation at the vascular level, combined with other cells and inflammatory mediators, leads to thrombotic events and disseminated intravascular coagulation, thus leading to a series of clinical manifestations in cerebrovascular, cardiac, pulmonary, and kidney disease while promoting severe disease and mortality. Previous studies of hospitalized patients with COVID-19 have shown that elevated levels of markers specific for NETs, such as free DNA, MPO, and H3Cit, are strongly associated with the total neutrophil count; with acute phase reactants that include CRP, D-dimer, lactate dehydrogenase, and interleukin secretion; and with an increased risk of severe COVID-19. This study analyzed the interactions between NETs and the activation pathways involved in immunothrombotic processes in patients with COVID-19.

The aim of the study is to determine the distribution of trace and major elements in the water and in the sediments of the south part of the Bacalar Lagoon and to identify the sources of the trace elements and their changes over time. The western part of the lagoon water column is characterised by high concentrations of Ca2+, HCO3– and Sr2+, derived from groundwater input. In contrast, the eastern part of the lagoon is characterised by high concentrations of Mg2+, Na+ and Cl–. The lagoon is not affected by present-day seawater intrusion. Water column and sediment geochemical analyses performed in Bacalar Lagoon show clear spatial distribution of different parameters. The saturation index of the water column indicates three main groups: (1) a zone oversaturated with regard to aragonite, calcite and dolomite; (2) an undersaturated area where all three minerals are dissolving; and (3) an area with calcite equilibrium and undersaturation with regard to the other minerals. Herein we present the first measurements of trace element (Ba2+, Mn2+, K+, Ni2+, Zn2+) concentrations in carbonates obtained from sediments in Bacalar Lagoon. In order to evaluate whether the trace elements are derived from natural or anthropogenic sources, four pollution indices were calculated. The results confirmed that Bacalar Lagoon sediments are not contaminated with Ni2+, K+, Mn2+ and Ba2+, and that the Zn2+ seems to have a predominantly anthropogenic origin.

The chemical characteristics and hydrogeochemical processes that govern the groundwater in the sinkholes ring of the Yucatan Peninsula were assessed. The groundwater of the area studied is of the Ca–Mg–HCO3 type. Local geology (abundance of dolomite) determines Mg2+ enrichment relative to Ca2+. The absence of seawater intrusion was established. Sinkhole water chemistry is controlled by carbonate rock dissolution, with dominance of Ca2+, Mg2+ and HCO3–. The dynamic and controlling factors of trace elements were determined in sediments of the southern part of Mexico. The order of mean concentrations of trace elements in sediments is Sr>Pb>Cu>Zn>Cr>> Cd. With regard to the sequential extraction procedure, the potential importance of fractions in sediments is in the order residual>organic matter>carbonates>exchangeable>water soluble, confirming that sinkhole sediments works as a sink of trace elements, and that no anthropogenic pressure exists in the groundwater of the hydrogeological reserve area. Trace element stability in sediments decreased as follow: Cd>Pb>Zn>Cr>Cu>Sr. The study results describe the groundwater and sediment condition of the hydrogeological reserve area, and provide insights for stakeholders and authorities. Growing population and economic activities may be major threats to the groundwater in coming decades.