ALTA GRACIA ES EL MUNDO

19/04/2025

19/04/2025

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19/04/2025

A 65-year-old male presents with high-grade fever, productive cough with purulent sputum, dyspnea, and left-sided chest discomfort. He has a history of smoking and type 2 diabetes. Chest exam reveals decreased breath sounds and dullness to percussion over the left hemithorax.

19/04/2025

A previously healthy 3-year-old boy was brought to the emergency department with a 6-week history of painless bumps and ulcers on his left leg. He initially had itchy insect bites on his foot and then bumps and ulcers had developed slowly on his leg. The boy had recently immigrated from Venezuela after a months-long journey by land with his family. On physical examination, ulcerated plaques with rolled borders and satellite papules were observed on the left lower leg, buttocks, and back. Three biopsy samples were obtained from one of the lesions. Histopathological analysis was notable for severe lymphohistiocytic infiltration with no organisms identified by routine microbiologic stains. What is the most likely diagnosis? https://nej.md/IC04172025

19/04/2025

19/04/2025

𝐆𝐞𝐧𝐨𝐦𝐞 𝐢𝐧𝐬𝐭𝐚𝐛𝐢𝐥𝐢𝐭𝐲 is a hallmark of cancer development and progression characterized by the accumulation of DNA damage; genome instability manifests as increased genetic alteration across the genome, including chromosomal translocations, structural variants, extrachromosomal DNAs, and aneuploidy. Replication stress, frequently observed in rapidly dividing cells, and exogenous factors, such as ultraviolet and ionizing radiation, to***co smoke, and certain chemicals, can result in genome instability. Early genetic events in the life of cancer cells, such as changes in the maintenance of telomeric length, or the activation of an oncogene can lead to genome instability. Loss-of-function variants in genes encoding tumor suppressor proteins, such as those that mediate DNA repair and cell-cycle checkpoints, can also contribute to an unstable genome.