Umbilical cord blood transplantation from unrelated donors in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.

There are very few disease-specific studies focusing on outcomes of umbilical cord blood transplantation for Philadelphia chromosome-positive acute lymphoblastic leukemia. We report the outcome of 45 patients with Philadelphia chromosome-positive acute lymphoblastic leukemia who underwent myeloablative single unit cord blood transplantation from unrelated donors within the GETH/GITMO cooperative group. Conditioning regimens were based on combinations of thiotepa, busulfan, cyclophospamide or fludarabine, and antithymocyte globulin. At the time of transplantation, 35 patients (78%) were in first complete remission, four (8%) in second complete remission and six (14%) in third or subsequent response. The cumulative incidence of myeloid engraftment was 96% at a median time of 20 days and significantly better for patients receiving higher doses of CD34(+) cells. The incidence of acute grade II-IV graft-versus-host disease was 31%, while that of overall chronic graft-versus-host disease was 53%. Treatment-related mortality was 17% at day +100 and 31% at 5 years. The 5-year relapse, event-free survival and overall survival rates were 31%, 36% and 44%, respectively. Although the event-free and overall survival rates in patients without BCR/ABL transcripts detectable at time of transplant were better than those in whom BCR/ABL transcripts were detected (46% versus 24% and 60% versus 30%, respectively) these differences were not statistically significant in the univariate analysis (P=0.07). These results demonstrate that umbilical cord blood transplantation from unrelated donors can be a curative treatment for a substantial number of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia.

Adipose tissue concentrations of persistent organic pollutants and total cancer risk in an adult cohort from Southern Spain: preliminary data from year 9 of the follow-up.

There is an increasing trend in the incidence of cancer worldwide, and it has been accepted that environmental factors account for an important proportion of the global burden. The present paper reports preliminary findings on the influence of the historical exposure to a group of persistent organic pollutants on total cancer risk, at year 9 in the follow-up of a cohort from Southern Spain. A cohort of 368 participants (median age 51 years) was recruited in 2003. Their historical exposure was estimated by analyzing residues of persistent organic pollutants in adipose tissue. Estimation of cancer incidence was based on data from a population-based cancer registry. Statistical analyses were performed using multivariable Cox-regression models. In males, PCB 153 concentrations were positively associated with total cancer risk, with an adjusted hazard ratio (95% confidence interval) of 1.20 (1.01-1.41) for an increment of 100 ng/g lipid. Our preliminary findings suggest a potential relationship between the historical exposure to persistent organic pollutants and the risk of cancer in men. However, these results should be interpreted with caution and require verification during the future follow-up of this cohort.

Análisis multidisciplinar del fenómeno sismo-volcánico de El Hierro (julio 2011)

La erupción volcánica submarina de La Restinga (10 de octubre) ha permitido, por primera vez, poner en marcha el Plan Especial de Protección Civil y Atención de Emergencias por Riesgo Volcánico en la Comunidad Autónoma de Canarias. En este proyecto se ha realizado un análisis multidisciplinar de los principales elementos que han estado involucrados en la gestión de la crisis y sus repercusiones sociales, económicas y ambientales. Los resultados indican que, hoy en día, se cuenta con los medios necesarios para realizar la detección temprana y el seguimiento de procesos similares que tengan lugar en el Archipiélago pero, no obstante, sería necesario actualizar el presente Plan PEVOLCA, debido a las deficiencias detectadas. Estas deficiencias, además de afectar a la gestión del fenómeno sismo-volcánico, han provocado que se tomasen medidas de protección civil que han generado grandes repercusiones sociales y económicas en la Isla. Respecto a las consecuencias ambientales en la Reserva Marina de Punta La Restinga-Mar de Las Calmas se prevé una recuperación a corto plazo, siempre que se apliquen las medidas necesarias.

La Política europea de España 2006-2007

El presente working paper es la versión española del capítulo escrito por la autora sobre la política europea de España para un anuario alemán sobre construcción europea (W. Weidenfeld y W. Wessels (Hrsg.). Jahrbuch der Europäischen Integration 2006/07, Institut fur Europäische Politik. Europa Union Verlag, en prensa). La autora escribe dicho capítulo para el Jahrbuch regularmente desde el año 1990. Producto de dichos textos es el libro de la autora que lleva por título La política europea de España, Barcelona, Ariel, 1999. En dicho libro se recogen aspectos conceptuales y de análisis en profundidad que sirven de marco al presente texto, cuyas características responden al objetivo de la publicación (alemana) en la que apareció: un anuario de seguimiento de la construcción europea de carácter coyuntural.

La Política europea de España 2004- 2005

El presente working paper es la versión española del capítulo escrito por la autora sobre la política europea de España para un anuario alemán sobre construcción europea (W. Weidenfeld y W. Wessels (Hrsg.). Jahrbuch der Europäischen Integration 2004/05, Institut fur Europäische Politik. Europa Union Verlag, en prensa). La autora escribe dicho capítulo para el Jahrbuch regularmente desde el año 1990. Producto de dichos textos es el libro de la autora que lleva por título La política europea de España, Barcelona, Ariel, 1999. En dicho libro se recogen aspectos conceptuales y de análisis en profundidad que sirven de marco al presente texto, cuyas características responden al objetivo de la publicación (alemana) en la que apareció: un anuario de seguimiento de la construcción europea de carácter coyuntural.

La Política europea de España 2003-2004

El presente working paper es la versión española del capítulo escrito por la autora sobre la política europea de España para un anuario alemán sobre construcción europea (W. Weidenfeld y W. Wessels (Hrsg.). Jahrbuch der Europäischen Integration 2003/04, Institut fur Europäische Politik. Europa Union Verlag, en prensa). La autora escribe dicho capítulo para el Jahrbuch regularmente desde el año 1990. Producto de dichos textos es el libro de la autora que lleva por título La política europea de España, Barcelona, Ariel, 1999. En dicho libro se recogen aspectos conceptuales y de análisis en profundidad que sirven de marco al presente texto, cuyas características responden al objetivo de la publicación (alemana) en la que apareció: un anuario de seguimiento de la construcción europea de carácter coyuntural.

La Política europea de España 2002-2003

El presente working paper es la versión española del capítulo escrito por la autora sobre la política europea de España para un anuario alemán sobre construcción europea (W. Weidenfeld y W. Wessels (Hrsg.). Jahrbuch der Europäischen Integration 2002/03, Institut fur Europäische Politik. Europa Union Verlag, en prensa). La autora escribe dicho capítulo para el Jahrbuch regularmente desde el año 1990. Producto de dichos textos es el libro de la autora que lleva por título La política europea de España, Barcelona, Ariel, 1999. En dicho libro se recogen aspectos conceptuales y de análisis en profundidad que sirven de marco al presente texto, cuyas características responden al objetivo de la publicación (alemana) en la que apareció: un anuario de seguimiento de la construcción europea de carácter coyuntural.

Acupuncture and rehabilitation of the painful shoulder: study protocol of an ongoing multicentre randomised controlled clinical trial [ISRCTN28687220]

BACKGROUND Although the painful shoulder is one of the most common dysfunctions of the locomotor apparatus, and is frequently treated both at primary healthcare centres and by specialists, little evidence has been reported to support or refute the effectiveness of the treatments most commonly applied. According to the bibliography reviewed, physiotherapy, which is the most common action taken to alleviate this problem, has not yet been proven to be effective, because of the small size of sample groups and the lack of methodological rigor in the papers published on the subject. No reviews have been made to assess the effectiveness of acupuncture in treating this complaint, but in recent years controlled randomised studies have been made and these demonstrate an increasing use of acupuncture to treat pathologies of the soft tissues of the shoulder. In this study, we seek to evaluate the effectiveness of physiotherapy applied jointly with acupuncture, compared with physiotherapy applied with a TENS-placebo, in the treatment of painful shoulder caused by subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). METHODS/DESIGN Randomised controlled multicentre study with blind evaluation by an independent observer and blind, independent analysis. A study will be made of 465 patients referred to the rehabilitation services at participating healthcare centres, belonging to the regional public health systems of Andalusia and Murcia, these patients presenting symptoms of painful shoulder and a diagnosis of subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). The patients will be randomised into two groups: 1) experimental (acupuncture + physiotherapy); 2) control (TENS-placebo + physiotherapy); the administration of rescue medication will also be allowed. The treatment period will have a duration of three weeks. The main result variable will be the change produced on Constant's Shoulder Function Assessment (SFA) Scale; as secondary variables, we will record the changes in diurnal pain intensity on a visual analogue scale (VAS), nocturnal pain intensity on the VAS, doses of non-steroid anti-inflammatory drugs (NSAIDs) taken during the study period, credibility scale for the treatment, degree of improvement perceived by the patient and degree of improvement perceived by the evaluator. A follow up examination will be made at 3, 6 and 12 months after the study period has ended. Two types of population will be considered for analysis: per protocol and per intention to treat. DISCUSSION The discussion will take into account the limitations of the study, together with considerations such as the choice of a simple, safe method to treat this shoulder complaint, the choice of the control group, and the blinding of the patients, evaluators and those responsible for carrying out the final analysis.

Edge vascular response after polymer-free vs. polymer-based paclitaxel-eluting stent implantation.

BACKGROUND It is unknown if lack of polymer can provoke a different edge response in drug-eluting stents. The aim of this study was to compare edge vascular response between polymer-free paclitaxel-eluting stent (PF-PES) and polymer-based paclitaxel-eluting stents (PB-PES). METHODS AND RESULTS: A total of 165 eligible patients undergoing percutaneous coronary intervention were prospectively randomized 1:1 to receive either PF-PES or PB-PES. Those patients with paired intravascular ultrasound (IVUS) after procedure and at 9-month follow-up were included in this analysis.Seventy-six patients with 84 lesions, divided into PB-PES (38 patients, 41 lesions) and PF-PES groups (38 patients, 43 lesions) had paired post-procedure and 9-month follow-up IVUS and were therefore included in this substudy. There was a significant lumen decrease at the proximal edge of PF-PES (from 9.02±3.06 mm(2)to 8.47±3.05 mm(2); P=0.040), and a significant plaque increase at the distal edges of PF-PES (from 4.39±2.73 mm(2)to 4.78±2.63 mm(2); P=0.004). At the distal edge there was a significant plaque increase in the PF-PES compared to PB-PES (+8.0% vs. -0.6%, respectively; P=0.015) with subsequent lumen reduction (-5.2% vs. +6.0%, respectively; P=0.024). CONCLUSIONS PF-PES had significant plaque increase and lumen reduction at the distal edge as compared to PB-PES, probably due to difference in polymer-based drug-release kinetics between the 2 platforms.

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.

La Política europea de España 2001-2002

Aquest working paper és la versió espanyola del capítol escrit per l'autora sobre la política europea d'Espanya per a un anuari alemany sobre construcció europea (W. Weidenfeld i W. Wessels (Hrsg.). Jahrbuch der Europäischen Integration 2001/02, Institut fur Europäische Politik. Europa Union Verlag, en premsa). L'autora escriu aquest capítol per al Jahrbuch regularment des de l'any 1990. Producte d'aquests textos és el llibre de l'autora que porta per títol La política europea d'Espanya, Barcelona, Ariel, 1999. En aquest llibre es recullen aspectes conceptuals i d'anàlisi en profunditat que serveixen de marc a aquest text, les característiques responen a l'objectiu de la publicació (alemanya) en què va aparèixer: un anuari de seguiment de la construcció europea de caràcter conjuntural.

Thyroid metastasis as initial presentation of clear cell renal carcinoma.

INTRODUCTION Metastatic tumors account for 1.4-2.5% of thyroid malignancies. About 25-30% of patients with clear cell renal carcinoma (CCRC) have distant metastasis at the time of diagnosis, being the thyroid gland a rare localization [5%]. PRESENTATION OF THE CASE A 62-year woman who underwent a cervical ultrasonography and a PAAF biopsy reporting atypical follicular proliferation with a few intranuclear vacuoles "suggestive" of thyroid papillary cancer in the context of a multinodular goiter was reported. A total thyroidectomy was performed and the histology of a clear cell renal carcinoma (CCRC) was described in four nodules of the thyroid gland. A CT scan was performed and a renal giant right tumor was found. The patient underwent an eventful radical right nephrectomy and the diagnosis of CCRC was confirmed. DISCUSSION Thyroid metastasis (TM) from CCRC are usually apparent in a metachronic context during the follow-up of a treated primary (even many years after) but may sometimes be present at the same time than the primary renal tumor. Our case is exceptional because the TM was the first evidence of the CCRC, which was subsequently diagnosed and treated. CONCLUSION The possibility of finding of an incidental metastatic tumor in the thyroid gland from a previous unknown and non-diganosed primary (as CCRC in our case was) is rare and account only for less than 1% of malignancies. Nonetheless, the thyroid gland is a frequent site of metastasis and the presence of "de novo" thyroid nodules in oncologic patients must be always considered and studied.

Comparativa del mòdul de gestió de la planificació i producció del programari ERP lliure OpenERP i Apache OFBiz

El present document dóna resposta a una proposta de l'empresa NewBourg Consultors SL per determinar la capacitat del mòdul de producció del programari lliure OpenBravo o d'un altre programari lliure per donar resposta a les necessitats de planificació, seguiment i control de la producció d'una empresa tèxtil pilot, industrial o manufacturera, de menys de 50 treballadors. Els principals objectius d'aquest treball són: analitzar el programari ERP lliure disponible actualment al mercat, valorar i seleccionar un o dos programaris adients per una empresa de fabricació, realitzar un estudi de viabilitat i anàlisi del sistema, i comprovar amb dades fictícies si el programa s'ajusta als requeriments de planificació i producció presentant un informe final.

Caracterización de los pacientes trasplantados por Cirrosis Criptogénica. Estudio comparativo de la evolución post-trasplante hepático de las Cirrosis secundarias a EHDG y las Cirrosis Enólicas.

Nuestro objetivo es comparar la evolución post-trasplante hepático de los pacientes con cirrosis por una enfermedad hepática por depósito de grasa (EHDG) y los pacientes trasplantados por cirrosis enólica desde el punto de vista de supervivencia y complicaciones metabólicas y desarrollo de complicaciones cardiovascular con un seguimiento post-trasplante a medio plazo. Se estudiaron retrospectivamente los pacientes sometidos a TH por Cirrosis Criptogénica en nuestro centro, desde el 1 de enero de 1997 hasta el 31 de diciembre de 2006 (caracterizando aquellos con fenotipo de EHDG subyacente). La mayoría de pacientes trasplantados por CC en nuestro centro corresponden a una cirrosis secundaria a EHDG. La prevalencia de CHC es mayor en estos pacientes que en los TH por OH. El desarrollo de complicaciones metabólicas, enfermedad cardiovascular y supervivencia al 5º año post-TH fue similar a los pacientes trasplantados por cirrosis OH.