Search

Diffuse large B cell lymphoma (DLBCL) treatment with R-CHOP regimen produces 5-year progression-free survival and overall survival of around 60–70%. Our objective was to discover prognostic biomarkers allowing early detection of the remaining 30–40% with poor long-term outcome. For this purpose, we applied a novel strategy: from a cohort of DLBCL patients, treated with standard therapy, a discovery group of 12 patients with poor prognosis (advanced stage III–IV, R-IPI > 2) was formed, consisting of six chemoresistant (refractory/early relapse < 12 months) and six chemosensitive (complete remission > 3 years) subjects. By using microarray assays, the most differentially expressed miRNAs were defined as an initial set of prognostic miRNA candidates. Their expression was then analyzed in a validation cohort of 68 patients and the three miRNAs with the most significant impact on event-free and overall survival were selected. In the DLBCL cell line U-2932 the transfection with miR-1244 and miR-193b-5p, but not miR-1231, blocked the effect of CHOP on cell viability. A subsequent gene set enrichment analysis in patients revealed the implication of the first two miRNAs in cell cycle control and chemoresistance-related pathways, whereas the last one was involved in immunological processes. In conclusion, this novel strategy identified three promising prognostic markers for DLBCL patients at high risk of failure with standard therapy.

Introduction/Background* Radical parametrectomy (RP) and upper vaginectomy (UV) is a challenging operation indicated when an occult cervical cancer (CC) is diagnosed after hysterectomy for another medical reason. It’s a technically difficult procedure due to adhesions from the previous surgery and the absence of a uterus to assist dissection and achieve adequate negative margins. Methodology Result(s)* A 57-year-old woman, with no known medical comorbidities, was referred to our hospital from an outside private institution after having undergone a simple hysterectomy (SH) with the diagnosis of incidental squamous cervical carcinoma. The patient had initially presented with 4 weeks history of postmenopausal bleeding. No abnormalities were noted during a speculum examination, she had a negative smear test four months previously, and a normal pelvic ultrasound. Endometrial biopsy was inconclusive and the patient subsequently underwent a SH and bilateral salpingo-oophorectomy. Pathology revealed an incidentally well differentiated squamous CC, measuring 3.5 cm in diameter and 1 cm of deep invasion (IB1 FIGO 2018). There was extensive lymphovascular space invasion and the cervical margins were also affected. Postoperative staging scan (PET/TC), did not show any evidence of residual local or metastatic disease. A complete pelvic lymphadenectomy, with negative intraoperative result, RP and UV by laparoscopic-robotic surgery was performed. Due to the results of the LACC Trial, an open colpectomy was performed. The surgery lasted approximately 345 min and the patient was discharged 3 days after surgery. Two weeks later, she presented painful lymphoedema, and was diagnosed with bilateral pelvic lymphocysts, requiring drainage by interventional radiology. Parametrectomy pathology demonstrated a residual focus (4 mm) of squamous carcinoma at the vagina, and free margins. Subsequently, a metastasis was found in one left pelvic node – upstaging to FIGO IIIC1. Adjuvant chemoradiation with weekly cisplatin and whole pelvic radiation was planned. Conclusion* CC may be found incidentally after SH carried out for benign gynecologic conditions or preinvasive cervical lesions. SH is suboptimal procedure and associated with significantly inferior survival rates. Further treatment, such as radiotherapy (RT) or additional surgery, is warranted. PET-CT have false negative, so surgery allow re-staging with a prognostic value and condition subsequent complementary treatment.

Although the presence of pancreatic tissue outside of the usual anatomical location of the pancreas is not an uncommon incidental finding, the risk of malignancy is extremely low. We report a case of ductal adenocarcinoma arising within a focus of heterotopic pancreas, occurring in the jejunum of an 81 year old woman. The patient presented with a history of progressive gastrointestinal occlusive symptoms. Computerized tomography showed a mass in the jejunum, which was surgically removed. Histopathology revealed an invasive pancreatic ductal adenocarcinoma from pancreatic tissue with no connection with the original gland (Heinrich type II). At the 12-month follow-up, there were no signs of recurrence. Despite the low risk of malignancy in heterotopic pancreas, adenocarcinoma is the most frequent histological type, and the prognosis is still not clear. Lesions incidentally detected during surgery and in symptomatic patients need to be removed by conservative procedures in order to exclude malignant disease.

Varón de 70 años, con hipertensión arterial y esquizofrenia, que presenta síndrome constitucional y disnea. Ingresa para estudio y tratamiento de gran masa torácica izquierda y lesiones isquémicas en dedos de la mano. El paciente se negó a la realización de otros estudios complementarios. Desafortunadamente, presentó evolución desfavorable hasta el fallecimiento., A 70-years-old man with arterial hypertension and schizophrenia presented with constitutional syndrome and dyspnea. He was admitted for study and treatment of large left thoracic mass and fingers ischemic lesions. The patient refused to carry out other complementary studies. Unfortunately, he presented poor evolution until death.

Varón de 70 años, con hipertensión arterial y esquizofrenia, que presenta síndrome constitucional y disnea. Ingresa para estudio y tratamiento de gran masa torácica izquierda y lesiones isquémicas en dedos de la mano. El paciente se negó a la realización de otros estudios complementarios. Desafortunadamente, presentó evolución desfavorable hasta el fallecimiento. A 70-years-old man with arterial hypertension and schizophrenia presented with constitutional syndrome and dyspnea. He was admitted for study and treatment of large left thoracic mass and fingers ischemic lesions. The patient refused to carry out other complementary studies. Unfortunately, he presented poor evolution until death.

Varón de 73 años con infecciones respiratorias de repetición, pérdida de peso y lesiones cutáneas que presenta masa en mediastino anterior en radiología e hipogammaglobulinemia con linfopenia en analítica. Se realizó biopsia de la masa mediastínica que dio el diagnóstico. 73 years old male with story of recurrent pulmonary infections, weight loss and skin lessions presenting anterior mediastinal mass in CT, hypogammaglobulinaemia with lymphopenia in blood tests. The mass biopsy revealed the diagnosis.

Varón de 73 años con infecciones respiratorias de repetición, pérdida de peso y lesiones cutáneas que presenta masa en mediastino anterior en radiología e hipogammaglobulinemia con linfopenia en analítica. Se realizó biopsia de la masa mediastínica que dio el diagnóstico., 73 years old male with story of recurrent pulmonary infections, weight loss and skin lessions presenting anterior mediastinal mass in CT, hypogammaglobulinaemia with lymphopenia in blood tests. The mass biopsy revealed the diagnosis.

La publicidad es un mecanismo que influye en la adquisición de un producto o servicio para finalizar una transacción. En la actualidad los artistas reconocidos en el ámbito nacional e internacional influyen en la generación de credibilidad en la negociación entre el oferente y el consumidor. Estas celebridades muestran su imagen a través de productos de publicidad lo que garantiza el éxito de dicha negociación. En el artículo se presenta una propuesta para la medición de la efectividad de esta publicidad en el consumidor final basada en la escala de Ohanian (1990), considerando el caso de Shakira y James Rodríguez como personalidades que manejan su imagen a través de la publicidad y que influyen en la credibilidad de los productos o servicios que promocionan. Publicity is a mechanism that influences the purchase of a product or service to complete a transaction. Currently renowned artists in national and international fields influence the generation of credibility in the negotiation between the suppliers and the consumer. These celebrities show their image through advertising products which guarantees the success of negotiation. The article presents a proposal for the measurement of the effectiveness of this advertising in the consumer based on the scale ofOhanian (1990), considering the case of Shakira and James Rodríguez as personalities who manage its image through publicity and affecting the credibility of the products or services that they promote.

Facultad de Arquitectura. Investigación y restauración de sitios y monumentos The present research deals with the structure of the area of agricultural production that lies to the south of Lake Chapala in Western Mexico during the prehispanic period and the sixteenth century. This region had natural resources ideal for the development of agricultural activities and animal husbandry. Both activities were common during the period and shaped a productive system around the haciendas of Guaracha and Buenavista. The main purpose of the thesis is to explain the processes that led to the structure of the productive territory around Chapala that was based on the relations of kinship oligarchy of the Salceda Andrade family, a family that obtained positions of political direction and social resources because of its economic status. They also established negotiations with religious organisms, obtained large expanses of properties and implemented necessary hydraulic technology for their development and marketing. Once these relations were understood, their imprint on the territory was identified physically in order to observe the territorial structure in the physical space. In this research, territory is considered as a socially delimited space, inhabited and used by different social groups as consequence of the practice of temporality or of the field of power exercised on the space by the dominant groups. With the support of historical documents and specialized bibliography, geographical descriptions, historical and current cartography, original maps were drawn that became graphic reconstructions of the different structures identified in the territory in the pre- hispanic and early viceregal periods. En la presente investigación se aborda la estructura del territorio productivo de la zona sur de la Ciénega de Chapala generada en la época prehispánica y en el virreinato. Esta región contaba con los recursos naturales óptimos para el desarrollo de actividades agrícolas y ganaderas, por lo que el territorio fue utilizado y aprovechado hasta conformar un sistema productivo por medio de las haciendas Guaracha y Buenavista. El objetivo central del trabajo es explicar los procesos que llevaron a la estructuración del territorio productivo de la Ciénega de Chapala con base a las relaciones de parentesco de una familia oligárquica – Salceda Andrade – cuyo alto capital económico les permitió obtener puestos de dirección política y recursos sociales, establecer negociaciones con organismos religiosos, obtener grandes acumulaciones de propiedades e implementar la tecnología hidráulica necesaria para su explotación y comercialización. Una vez comprendidas estas relaciones se identificaron físicamente en el territorio para poder así observar la estructura territorial en el espacio físico. En esta investigación se considera al territorio un espacio social delimitado, habitado y aprovechado por diferentes grupos sociales como consecuencia de su práctica de la temporalidad o del campo de poder ejercido sobre el espacio por los grupos dominantes. Con el apoyo de documentos archivísticos y bibliográficos, descripciones geográficas, cartografía histórica y actual, se elaboraron mapas propios de trabajo donde se plasmaron las reconstrucciones gráficas de las diferentes estructuras identificadas en el territorio en la época prehispánica y en las etapas de la época virreinal.

Instituto Tecnológico y de Estudios Superiores de Monterrey ITESM Maestría