Update on adrenal cortical neoplasia

The adrenal cortex gives rise to a biologically heterogenous group of neoplasms, each with a distinct morphology, antigen expression and molecular profile. Adrenal cortical adenomas have excellent prognosis and are usually cured by surgical resection alone, while adrenal cortical carcinomas are very aggressive tumors with a poor prognosis regardless of therapy. These tumors are rare and often challenging for a pathologist to diagnose, as significant overlap exists between benign and malignant lesions in some cases. In this review, we attempt to summarize most important histologic and clinical features of adrenal cortical adenomas and carcinomas, clarify the use of different grading systems, the use of special stains and the differential diagnosis for practicing pathologists. Most relevant hereditary syndromes associated with adrenal cortical tumors are listed. Updates in molecular alterations in adrenal cortical neoplasms and hyperplastic diseases as well as their clinical significance and potential therapeutic implications are also discussed.     

X-ray diffraction and electrochemical impedance spectroscopy study of zinc coated LiNi0.5Mn1.5O4 electrodes

Coating and doping with zinc have been used to modify LiNi_0.5Mn_1.5O₄ powders prepared at 700 and 800 °C. As previously found in the literature, surface treatment with zinc leads to a net improvement of the electrochemical performance of the 5-V electrode in lithium cells. X-ray diffraction reveals the occurrence of surface ZnO, which disappears after heating at 500 °C. This indicates that ZnO forms a coating, although zinc can also be incorporated in the LiNi_0.5Mn_1.5O₄ framework. The electrochemical oxidation of both bare LiNi_0.5Mn_1.5O₄ and zinc treated products has been followed by ex situ X-ray diffraction of charged electrodes. For both materials a decrease in the cubic unit cell parameter and the formation of two cubic phases during lithium extraction has been found. Lattice contraction is significantly larger in the sample modified with zinc. EIS measurements give direct evidence of the better stabilization of the electrode surface in the coated material.     

Valoración del paciente que solicita muerte asistida

Resumen El equipo médico debe estar preparado para evaluar a los pacientes que solicitan muerte asistida. En esta revisión hemos recopilado de la literatura internacional los criterios médicos y psicológicos para evaluar a los pacientes que solicitan muerte asistida con la finalidad de aliviar las necesidades fisicas, psicológicas y sociales de los pacientes y sus familias. Se realizó un estudio de tipo exploratorio seleccionando los artículos que propusieran protocolos de valoración psicológica y médica de los pacientes que solicitan muerte asistida. Se analizó qué aspectos son los que se evalúan con mayor frecuencia en la literatura internacional. Se identificaron dos posturas generales para la valoración del paciente: por un lado la valoración de su competencia para la toma de decisiones y por otro la valoración del sufrimiento físico, seguido por el sufrimiento psicológico, social, existencial/espiritual, la relación médico-paciente y la relación médico-familiares. Finalmente se enumeran una serie de principios que pueden guiar al clínico ante la petición de muerte asistida.      

Arbovirus surveillance from 1990 to 1995 in the Barkedji area (Ferlo) of Senegal, a possible natural focus of Rift Valley fever virus

Surveillance for mosquito-borne viruses was conducted in Barkedji area from 1990 to 1995, following an outbreak of Rift Valley fever (RVF) virus in southern Mauritania. Mosquitoes, sand flies, and midges were collected from human bait and trapped by solid-state U.S. Army battery-powered CDC miniature light traps baited with dry ice or animals (sheep or chickens) at four ponds. Overall, 237,091 male and female mosquitoes representing 52 species in eight genera, 214,967 Phlebotomine sand flies, and 2,527 Culicoides were collected, identified, and tested for arboviruses in 9,490 pools (7,050 pools of female and 331 of male mosquitoes, 2,059 pools of sand flies and 50 pools of Culicoides). Viruses isolated included one Alphavirus, Babanki (BBK); six Flaviviruses, Bagaza (BAG), Ar D 65239, Wesselsbron (WSL), West Nile (WN), Koutango (KOU), Saboya (SAB); two Bunyavirus, Bunyamwera (BUN) and Ngari (NRI); two Phleboviruses, Rift Valley fever (RVF) and Gabek Forest (GF); one Orbivirus, Ar D 66707 (Sanar); one Rhabdovirus, Chandipura (CHP); and one unclassified virus, Ar D 95537. Based on repeated isolations, high field infection rates and abundance, Culex appeared to be the vectors of BAG, BBK, Ar D 65239 (BAG-like), and WN viruses, Ae. vexans and Ae. ochraceus of RVF virus, Mansonia of WN and BAG viruses, Mimomyia of WN and BAG viruses, and Phlebotomine of SAB, CHP, Ar D 95537, and GF viruses. Our data indicate that RVF virus circulated repeatedly in the Barkedji area.