Pattern of use of radiotherapy for lung cancer: a descriptive study.

BACKGROUND Lung cancer remains one of the most prevalent forms of cancer. Radiotherapy, with or without other therapeutic modalities, is an effective treatment. Our objective was to report on the use of radiotherapy for lung cancer, its variability in our region, and to compare our results with the previous study done in 2004 (VARA-I) in our region and with other published data. METHODS We reviewed the clinical records and radiotherapy treatment sheets of all patients undergoing radiotherapy for lung cancer during 2007 in the 12 public hospitals in Andalusia, an autonomous region of Spain. Data were gathered on hospital, patient type and histological type, radiotherapy treatment characteristics, and tumor stage. RESULTS 610 patients underwent initial radiotherapy. 37% of cases had stage III squamous cell lung cancer and were treated with radical therapy. 81% of patients with non-small and small cell lung cancer were treated with concomitant chemo-radiotherapy and the administered total dose was ≥60 Gy and ≥45 Gy respectively. The most common regimen for patients treated with palliative intent (44.6%) was 30 Gy. The total irradiation rate was 19.6% with significant differences among provinces (range, 8.5-25.6%; p<0.001). These differences were significantly correlated with the geographical distribution of radiation oncologists (r=0.78; p=0.02). Our results were similar to other published data and previous study VARA-I. CONCLUSIONS Our results shows no differences according to the other published data and data gathered in the study VARA-I. There is still wide variability in the application of radiotherapy for lung cancer in our setting that significantly correlates with the geographical distribution of radiation oncologists.

Acute abdomen secondary to complete tubular colonic duplication.

We report the case of a 6-month-old infant who presented with a complete duplication of the large intestine, debuting clinically with acute abdomen and severe metabolic disorders. We discuss the pathogenesis and morphology of the lesions, diagnostic difficulties and peculiarities of surgical treatment.

Cost-effectiveness of an exercise intervention program in perimenopausal women: the Fitness League Against MENopause COst (FLAMENCO) randomized controlled trial.

BACKGROUND The high prevalence of women that do not reach the recommended level of physical activity is worrisome. A sedentary lifestyle has negative consequences on health status and increases health care costs. The main objective of this project is to assess the cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. METHODS/DESIGN The present study is a Randomized Controlled Trial. A total of 150 eligible women will be recruited and randomly assigned to either a 16-week exercise intervention (3 sessions/week), or to usual care (control) group. The primary outcome measure is the incremental cost-effectiveness ratio. The secondary outcome measures are: i) socio-demographic and clinical information; ii) body composition; iii) dietary patterns; iv) glycaemic and lipid profile; v) physical fitness; vi) physical activity and sedentary behaviour; vii) sleep quality; viii) quality of life, mental health and positive health; ix) menopause symptoms. All outcomes will be assessed at baseline and post intervention. The data will be analysed on an intention-to-treat basis and per protocol. In addition, we will conduct a cost effectiveness analysis from a health system perspective. DISCUSSION The intervention designed is feasible and if it proves to be clinically and cost effective, it can be easily transferred to other similar contexts. Consequently, the findings of this project might help the Health Systems to identify strategies for primary prevention and health promotion as well as to reduce health care requirements and costs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02358109 . Date of registration: 05/02/2015.

Rituximab in treatment-resistant CIDP with antibodies against paranodal proteins.

OBJECTIVE To describe the response to rituximab in patients with treatment-resistant chronic inflammatory demyelinating polyneuropathy (CIDP) with antibodies against paranodal proteins and correlate the response with autoantibody titers. METHODS Patients with CIDP and IgG4 anti-contactin-1 (CNTN1) or anti-neurofascin-155 (NF155) antibodies who were resistant to IV immunoglobulin and corticosteroids were treated with rituximab and followed prospectively. Immunocytochemistry was used to detect anti-CNTN1 and anti-NF155 antibodies and ELISA with human recombinant CNTN1 and NF155 proteins was used to determine antibody titers. RESULTS Two patients had a marked improvement; another patient improved slightly after 10 years of stable, severe disease; and the fourth patient had an ischemic stroke unrelated to treatment and was lost to follow-up. Autoantibodies decreased in all patients after rituximab treatment. CONCLUSIONS Rituximab treatment is an option for patients with CIDP with IgG4 anti-CNTN1/NF155 antibodies who are resistant to conventional therapies. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that rituximab is effective for patients with treatment-resistant CIDP with IgG4 anti-CNTN1 or anti-NF155 antibodies.

Prognostic role of genetic biomarkers in clinical progression of prostate cancer.

The aim of this study was to analyze the use of 12 single-nucleotide polymorphisms in genes ELAC2, RNASEL and MSR1 as biomarkers for prostate cancer (PCa) detection and progression, as well as perform a genetic classification of high-risk patients. A cohort of 451 men (235 patients and 216 controls) was studied. We calculated means of regression analysis using clinical values (stage, prostate-specific antigen, Gleason score and progression) in patients and controls at the basal stage and after a follow-up of 72 months. Significantly different allele frequencies between patients and controls were observed for rs1904577 and rs918 (MSR1 gene) and for rs17552022 and rs5030739 (ELAC2). We found evidence of increased risk for PCa in rs486907 and rs2127565 in variants AA and CC, respectively. In addition, rs627928 (TT-GT), rs486907 (AG) and rs3747531 (CG-CC) were associated with low tumor aggressiveness. Some had a weak linkage, such as rs1904577 and rs2127565, rs4792311 and rs17552022, and rs1904577 and rs918. Our study provides the proof-of-principle that some of the genetic variants (such as rs486907, rs627928 and rs2127565) in genes RNASEL, MSR1 and ELAC2 can be used as predictors of aggressiveness and progression of PCa. In the future, clinical use of these biomarkers, in combination with current ones, could potentially reduce the rate of unnecessary biopsies and specific treatments.

Evaluation of the speed-oligo direct Mycobacterium tuberculosis assay for molecular detection of mycobacteria in clinical respiratory specimens.

We present the first evaluation of a novel molecular assay, the Speed-oligo Direct Mycobacterium tuberculosis (SO-DMT) assay, which is based on PCR combined with a dipstick for the detection of mycobacteria and the specific identification of M. tuberculosis complex (MTC) in respiratory specimens. A blind evaluation was carried out in two stages: first, under experimental conditions on convenience samples comprising 20 negative specimens, 44 smear- and culture-positive respiratory specimens, and 11 sputa inoculated with various mycobacterium-related organisms; and second, in the routine workflow of 566 fresh respiratory specimens (4.9% acid-fast bacillus [AFB] smear positives, 7.6% MTC positives, and 1.8% nontuberculous mycobacteria [NTM] culture positives) from two Mycobacterium laboratories. SO-DMT assay showed no reactivity in any of the mycobacterium-free specimens or in those with mycobacterium-related organisms. Compared to culture, the sensitivity in the selected smear-positive specimens was 0.91 (0.92 for MTC and 0.90 for NTM), and there was no molecular detection of NTM in a tuberculosis case or vice versa. With respect to culture and clinical data, the sensitivity, specificity, and positive and negative predictive values for the SO-DMT system in routine specimens were 0.76 (0.93 in smear positives [1.0 for MTC and 0.5 for NTM] and 0.56 in smear negatives [0.68 for MTC and 0.16 for NTM]), 0.99, 0.85 (1.00 in smear positives and 0.68 in smear negatives), and 0.97, respectively. Molecular misidentification of NTM cases occurred when testing 2 gastric aspirates from two children with clinically but not microbiologically confirmed lung tuberculosis. The SO-DMT assay appears to be a fast and easy alternative for detecting mycobacteria and differentiating MTC from NTM in smear-positive respiratory specimens.

Plan de Gestión de la red de senderos ecoturísticos de la Sierra de San Javier, Tucumán- Argentina

El “Parque Sierra de San Javier” és un espai natural al costat d’ un gran nucli urbà, San Miguel de Tucumán (Argentina). A la Sierra es troba la comuna de San Javier, on s’ ha creat el CIC (Centre Integrador Comunitari). És a partir del CIC que s’ elabora un pla integral que inclou el projecte d’ ecoturisme. Aquest projecte es basa en una gestió de la xarxa de camins existents a la Sierra. Es fa un inventari de cadascun dels camins de la xarxa i s’ analitza cadascun d’ ells amb uns índexs de potencial paisatgístic i interpretatiu i es valora també la seva conservació. A partir d’ aquests valors es planteja un pla d’ actuació de recuperació i manteniment, i un pla d’ actuació turística en el que es millora l’ estat del camí; s’ intal•len panells informatius i senyalització. El projecte conté les fitxes d’ informació de cadascun dels itineraris amb un mapa i amb d’ altres informacions d’ interès pels usuaris dels senders

Cambios biológicos observados en los principales recursos pelágicos durante otoño de 1998 en el mar peruano. Crucero BIC José Olaya Balandra 9805-06 de Tacna a Máncora

En el periodo abril 1997-junio 1998 se realizaron cuatro cruceros de evaluación de recursos pelágicos en la costa peruana que permitieron observar cambios en la distribución, estructura por tamaños, estructura de la biomasa de los recursos pelágicos, que han incidido en la variación de las capturas, pansando de una pesquería monoespecífica a una pesquería multiespecífica.

Caracteristicas biológicas de la principales especies demersales acompañantes de la meluza en el área Puerto Pizarro a Huarmey. Crucero BIC José Olaya Balandra 9806-07

Resultados de los análisis de las características biológicas de las especies de peces demersales acompañantes de la merluza, durante el crucero de evaluación del recurso merluza BIC José Olaya 9806-07, en el comienzo del invierno 1998, entre Puerto Pizarro (3°29 'S) y Huarmey (10°5 'S), del 27 de junio al 13 de julio de 1998. De acuerdo a la composición de las capturas, las especies demersales que más destacaron después de Merluccius gayi peruanus (merluza), fueron: Prionotus stephanophrys (falso volador), Larimus pacificus (bereche), Paralabrax humeralis (cabrilla), Paralonchurus peruanus (coco o suco), Sciaena deliciosa (lorna) y Cynoscion analis (cachema), además de las especies pelágicas: Trachurus picturatus murphyi (jurel) y Scomber japonicus (caballa) que en conjunto, incluyendo a la merluza, representaron el 95,7% del total de la captura. Fue evidente observar en la mayoría de estos recursos un gradiente de estratificación latitudinal por tallas

Biomasa planctónica como alimento disponible durante el crucero BIC Humboldt y BIC Jose Olaya Balandra 9808-09 de Paita a los Palos (Tacna)

Distribución del plancton según tamaño de partículas y la biomasa planctónica (g/m3) en superficie como alimento disponible para los recursos pesqueros del Perú durante el Cr. de Evaluación Hidroacústica de Recursos Pelágicos 9808-09. La biomasa planctónica tuvo un valor promedio de 2,0018 g/m3 en donde el valor mínimo fue de 0,0160 g/m3 y el máximo de 63,622 g/m3 (Matarani). Las células pequeñas (75 µm), fueron localizadas en la franja costera entre Atico-Mollendo, destacando Skeletonema costatum en pequeños parches. Las especies mayores de 150 y 300 µm estuvieron distribuidas en casi toda el área de estudio.

Características oceanográficas durante el crucero pelágico BIC Humboldt y BIC Jose Olaya Balandra 9808-09 de Paita a los Palos (Tacna)

La temperatura de la superficie del mar entre el 20 de agosto al 18 de setiembre de 1998, presentó valores próximos a los promedios de los meses mencionados. Sólo por fuera de las 60 mn entre Salaverry y Huamey se presentaron anomalías mayores a 2°C por encima del patrón, en las áreas ocupadas por las Aguas Subtropicales Superficiales (ASS), registrándose los máximos valores. Las altas concentraciones de salinidad de las ASS entre los 05-12°S, que llegaron alcanzar profundidades mayores de 150 m y valores de hasta 35,98 ups, frente a Pimentel, así como la influencia que vienen ejerciendo las Aguas Templadas de la Subantártica (ATSA) al sur de los 12°S (bajas temperaturas y salinidades), han sido factores limitantes para la concentración de la anchoveta en el área de estudio.

Distribución de los recursos pesqueros de mayor abundancia a fines del invierno 1998. Crucero BIC Humboldt y BIC Jose Olaya Balandra 9808-09 de Paita a Tacna

Describe la distribución de abundancia de diversos recursos pelágicos y demersales: anchoveta (Engraulis ringens), sardina (Sardinops sagax), jurel (Trachurus picturatus murphyi), caballa (Scomber japonicus peruanus), samasa (Anchoa nasus), Vinciguerria lucetia, falso volador (Prionotus stephanophrys), bagre (Galeichthys peruvianus), pez cinta (Trichiurus lepturus) y múnida (Pleuroncodes monodon). Como plataformas de muestreo en el Cr. 9808-09, se utilizaron: para la zona Paita al Callao: el BIC Humboldt y la lancha IMARPE IV; y para la zona Los Palos (Tacna) al Callao, el BIC José Olaya Balandra y la lancha IMARPE V. Para la distribución de abundancia se utilizaron las ecosondas científicas SIMRAD EK 500 con frecuencias de 38 y 120 kHz de ambos buques, en un rango de detección de 3,5 a 400 m de profundidad, distribuidos en nueve capas de integración. Para el muestreo acústico se utilizó una grilla sistemática paralela con una separación de 12 mn entre cada transecto; se realizaron en total 352 laces de pesca. Las áreas de distribución de cada recurso se determinaron mediante un programa de software de interpolación de datos.

Biomasa de recursos pesqueros a finales del invierno 1998. Crucero BIC Humboldt y BIC Jose Olaya Balandra 9808-09, de Paita a Tacna.

Se estimó la biomasa de las especies: anchoveta, Engraulis ringens; sardina, Sardinops sagax sagax; jurel, Trachurus picturatus murphyi; caballa, Scomber japonicus peruanus; samasa, Anchoa nasus; vinciguerria, falso volador, Prionotus stephanophrys y bagre, Galeichthys peruvianus; mediante técnicas hidroacústicas durante el crucero realizado entre el 20 de agosto y el 18 de septiembre de 1998, a bordo del BIC Humboldt, del BIC José Olaya Balandra y las lanchas IMARPE IV e IMARPE V. El diseño para la obtención de datos fue el sistemático paralelo con transectos perpendiculares a la costa con una separación entre ellos de 14 mn. El equipo utilizado fue la ecosonda científica EK-500 Simrad a frecuencias de 38 y 120 kHz, en un rango de detección de 3,5 a 400 m de profundidad. Las calibraciones hidroacústicas se realizaron en la Isla San Lorenzo (Callao). La obtención de la biomasa se determinó por el método de estratificación por rectángulos constituidos en áreas isoparalitorales de 10 x 30 mn.