Prospective phase II trial of extended treatment with rituximab in patients with B-cell post-transplant lymphoproliferative disease.

BACKGROUND AND OBJECTIVES The elective treatment of patients with post-transplant lymphoproliferative disorders is controversial. The purpose of this trial was to evaluate the efficacy of treatment with extended doses of rituximab adapted to the response in patients with post-transplant lymphoproliferative disorders after solid organ transplantation. DESIGN AND METHODS This was a prospective, multicenter, phase II trial. Patients were treated with reduction of immunosuppression and four weekly infusions of rituximab. Those patients who did not achieve complete remission (CR) received a second course of four rituximab infusions. The primary end-point of the study was the CR rate. RESULTS Thirty-eight patients were assesable. One episode of grade 4 neutropenia was the only severe adverse event observed. After the first course of rituximab, 13 (34.2%) patients achieved CR, 8 patients did not respond, and 17 patients achieved partial remission. Among those 17 patients, 12 could be treated with a second course of rituximab, and 10 (83.3%) achieved CR, yielding an intention-to-treat CR rate of 60.5%. Eight patients excluded from the trial because of absence of CR were treated with rituximab combined with chemotherapy, and six (75%) achieved CR. Event-free survival was 42% and overall survival was 47% at 27.5 months. Fourteen patients died, ten of progression of their post-transplant lymphoproliferative disorder. INTERPRETATION AND CONCLUSIONS These results confirm that extended treatment with rituximab can obtain a high rate of CR in patients with post-transplant lymphoproliferative disorders after solid organ transplantation without increasing toxicity, and should be recommended as initial therapy for these patients.

Arqueología de la producción agrícola. Aplicación de técnicas de análisis estadístico y geocomputacional a un caso de estudio del IV-II milenio ANE en la Cuenca del Río Grande (Perú)

Muchas investigaciones arqueobotánicas, desde un enfoque cualitativo-descriptivo, limitan el propio campo de estudio a los análisis de presencia/ausencia y/o de frecuencia de taxones a partir de su recuento en los conjuntos vegetales. De esa manera, los datos proporcionados resultan ser inconcluyentes y no fiables para la reconstrucción del paleoambiente, la determinación de la dieta alimenticia y de la práctica económica realizada (recolección VS agricultura), y totalmente insuficientes para determinar los cambios históricos ocurridos en los procesos productivos. Por lo que concierne el Perú, desde los primeros estudios con referencia a restos vegetales recuperados en yacimientos arqueológicos, principalmente de la costa, se documenta el importante papel que han desarrollado las especies vegetales en la vida de las comunidades pre-hispánicas. No obstante la excepcional abundancia y óptima preservación de este tipo de material (botánico) en muchos de los yacimientos arqueológicos de esta región, gracias a las extremas condiciones climáticas y ambientales sobre todo de sus áridas zonas costeras, los estudios arqueobotánicos desarrollados hasta el momento son muy escasos y las limitaciones análiticas que presentan en su mayoría reflejan la poca importancia dada a las investigaciones arqueobotánicas. En el presente trabajo desarrollamos y aplicamos una metodología analítica de tipo cuantitativa para el estudio de los macrorestos vegetales procedentes de un yacimiento de la Costa sur del Perú. Con ello pretendemos obtener datos representativos y objetivos de los conjuntos analizados, cuyo procesado lleve a una exhaustiva y correcta interpretación de la información.

Prácticum II : Psicología de la educación

El tema elegido para la realización del Prácticum II es la elaboración de un programa de modificación de conductas para un alumno de 3º de la ESO con Síndrome de Down. Con el programa de modificación de conductas lo que realmente se ha querido conseguir es poder ayudar al alumno en su día a día, beneficiarle para obtener mejores relaciones con su entorno y ello le conduzca a una mejor integración tanto con los profesores como con el resto de compañeros y pueda extrapolarse a su vida personal, redundando en un mejor aprendizaje desde una posición más positiva.

Efeito da calagem e sulfato de amônio no algodão: II - Concentração de cátions e ânions na solução do solo e absorção de nutrientes pelas plantas

No sistema de semeadura direta, o calcário tem sido aplicado superficialmente para evitar o revolvimento do solo. Os ânions adicionados via adubação nitrogenada podem aumentar a solubilização de sais de cátions básicos do solo graças à formação de pares iônicos. O objetivo deste trabalho foi estudar a dinâmica dos ânions NO3- e SO4(2-) e dos cátions NH4+, Ca2+, Mg2+ e K+ da solução do solo, bem como a absorção de nutrientes pelo algodoeiro submetido a distintas formas de aplicação de calcário e diferentes doses de sulfato de amônio em cobertura, cultivado com a presença de palha na superfície do solo. Utilizou-se um Latossolo Vermelho distroférrico de textura média que foi acomodado em vasos com 15,71 dm³. Plantas de algodão (Gossypium hirsutum) foram cultivadas por 60 dias nas condições de calagem superficial sobre a palha, calagem incorporada a 0-20 cm de profundidade e ausência de correção do solo, com a aplicação de doses de sulfato de amônio equivalentes a 0, 50, 100 e 150 kg ha-1 de N em cobertura. Cápsulas porosas foram instaladas para amostragem e quantificação de nutrientes da solução do solo. A concentração de SO4(2-) da solução do solo foi incrementada pela adubação nitrogenada, independentemente da forma de aplicação do calcário. A curto prazo, a nitrificação do NH4+ aplicado foi favorecida somente com a calagem incorporada, apesar de o N nítrico da solução do solo ter aumentado no final do cultivo do algodão até mesmo no solo não corrigido. As concentrações de Ca, Mg e K da solução do solo foram incrementadas pela adubação de cobertura. O ânion SO4(2-) apresentou maior afinidade do que o NO3- na formação de pares iônicos com os cátions básicos da solução do solo. A adubação nitrogenada proporcionou maior eficiência na absorção de Ca e Mg pelo algodoeiro na condição de calagem incorporada.

Revegetação de cava de extração de argila com Acacia mangium: II - caracterização química da humina

Este trabalho foi realizado com o objetivo de caracterizar a natureza química dos compostos da humina extraída em solo de área degradada pela extração de argila, com vegetação espontânea de Brachiaria mutica (Forsk.) Stapf e revegetada com Acacia mangium Willd. Após extração e purificação, a humina foi submetida à transesterificação com metanol trifluorato de B (BF3-MeOH), obtendo-se as subfrações alifáticas e aromáticas. Essas subfrações foram submetidas à cromatografia gasosa (Shimadzu GC-17A) combinada com a espectrometria de massa (Shimadzu GC/MS-qp5050A). Na subfração alifática obtida da cobertura com A. mangium, os compostos identificados foram: hexadecanoato de metila, octadecanoato de metila, heptadecano e 2-hidroxidodecanoato de metila; já na área com B. mutica os compostos foram: 14-metilpentadecanoato de metila e nonadecanoato de metila. Na subfração aromática, os compostos identificados na cobertura com A. mangium foram os mesmos obtidos naquela com B. mutica, sendo eles: 14-metilpentadecanoato de metila, 1,2 benzenodioato de 2 etilexila e butila. A leguminosa arbórea A. mangium proporcionou mudanças na fração mais recalcitrante das substâncias húmicas (humina), extraída da cava de extração de argila, preservando maior diversidade de compostos alifáticos.

Towards a theory of the credit-risk balance sheet (II). The evolution of its structure

This article has an immediate predecessor, upon which it is based and with which readers must necessarily be familiar: Towards a Theory of the Credit-Risk Balance Sheet (Vallverdú, Somoza and Moya, 2006). The Balance Sheet is conceptualised on the basis of the duality of a credit-based transaction; it deals with its theoretical foundations, providing evidence of a causal credit-risk duality, that is, a true causal relationship; its characteristics, properties and its static and dynamic characteristics are analyzed. This article, which provides a logical continuation to the previous one, studies the evolution of the structure of the Credit-Risk Balance Sheet as a consequence of a business¿s dynamics in the credit area. Given the Credit-Risk Balance Sheet of a company at any given time, it attempts to estimate, by means of sequential analysis, its structural evolution, showing its usefulness in the management and control of credit and risk. To do this, it bases itself, with the necessary adaptations, on the by-now classic works of Palomba and Cutolo. The establishment of the corresponding transformation matrices allows one to move from an initial balance sheet structure to a final, future one, to understand its credit-risk situation trends, as well as to make possible its monitoring and control, basic elements in providing support for risk management.

Turfeiras da Serra do Espinhaço Meridional - MG: II - influência da drenagem na composição elementar e substâncias húmicas

As turfeiras são Organossolos que resultam de condições ecológicas ideais ao acúmulo de material orgânico, controladas pelos sistemas geomorfológicos e processos geológicos e climáticos globais. Sua constituição física, química e biológica é pouco conhecida. No presente trabalho foi realizado um estudo sobre as turfeiras da Serra do Espinhaço Meridional (SdEM) - MG, por meio da descrição e coleta de amostras em três perfis situados a 1.250 m (P1), 1.350 m (P4) e 1.800 m (P2) de altitude. Os três perfis foram caracterizados morfologicamente e, nas amostras coletadas, foram realizadas análises químicas e fracionamento da matéria orgânica em ácidos húmicos, ácidos fúlvicos e humina. A matéria orgânica dos perfis de Turfeiras da SdEM apresentou marcantes diferenças entre si em relação à sua composição química e ao teor das substâncias húmicas e à composição química dos ácidos húmicos. A variação das condições de drenagem foi preponderante para a diferenciação qualitativa e quantitativa da matéria orgânica. A turfeira P1, com moderadas condições de drenagem, apresentou matéria orgânica com maiores relações C/N e O/C, predomínio de ácidos fúlvicos entre as substâncias húmicas e ácidos húmicos e elevada relação C/N. Nas turfeiras P2 e P4, com muito más condições de drenagem, as relações C/N e O/C da matéria orgânica foram mais baixas, a humina predominou amplamente entre as substâncias húmicas e os ácidos húmicos apresentaram a mais baixa relação C/N.

Towards a theory of the credit-risk balance sheet (II). The evolution of its structure

This article has an immediate predecessor, upon which it is based and with which readers must necessarily be familiar: Towards a Theory of the Credit-Risk Balance Sheet (Vallverdú, Somoza and Moya, 2006). The Balance Sheet is conceptualised on the basis of the duality of a credit-based transaction; it deals with its theoretical foundations, providing evidence of a causal credit-risk duality, that is, a true causal relationship; its characteristics, properties and its static and dynamic characteristics are analyzed. This article, which provides a logical continuation to the previous one, studies the evolution of the structure of the Credit-Risk Balance Sheet as a consequence of a business¿s dynamics in the credit area. Given the Credit-Risk Balance Sheet of a company at any given time, it attempts to estimate, by means of sequential analysis, its structural evolution, showing its usefulness in the management and control of credit and risk. To do this, it bases itself, with the necessary adaptations, on the by-now classic works of Palomba and Cutolo. The establishment of the corresponding transformation matrices allows one to move from an initial balance sheet structure to a final, future one, to understand its credit-risk situation trends, as well as to make possible its monitoring and control, basic elements in providing support for risk management.

Concurrent or Sequential Adjuvant Hormonoradiotherapy after Conservative Surgery for Early-Stage Breast Cancer: Clinical Results of the CO-HO-RT Phase II Randomized Trial.

Purpose: Letrozole (LET) has recently been shown to be superior to tamoxifen for postmenopausal patients (pts). In addition, LET radiosensitizes breast cancer cells in vitro. We conducted a phase II randomized study to evaluate concurrent and sequential radiotherapy (RT)-LET in the adjuvant setting. We present here clinical results with a minimum follow-up of 24 months. Patients and Methods: Postmenopausal pts with early-stage breast cancer were randomized after conservative surgery to either: A) concurrent RT-LET (LET started 3 weeks before the first day of RT) or B) sequential RT-LET (LET started 3 weeks after the end of RT). Whole breast RT was delivered to a total dose of 50 Gy. A 10-16 Gy boost was allowed according to age and pathological prognostic factors. Pts were stratified by center, adjuvant chemotherapy, boost, and radiation-induced CD8 apoptosis (RILA). RILA was performed before RT as previously published (Ozsahin et al. Clin Cancer Res, 2005). An independent monitoring committee reviewed individual safety data. Skin toxicities were evaluated by two different clinicians at each medical visit (CTCAE v3.0). Lung CT-scan and functional pulmonary tests were performed regularly. DNA samples were screened for SNPs in candidate genes as recently published (Azria et al., Clin Cancer Res, 2008). Results: A total of 150 pts were randomized between 01/05 and 02/07. Median follow-up is 26 months (range, 3-40 months). No statistical differences were identified between the two arms in terms of mean age; initial TNM; median surgical bed volume; post surgical breast volume. Chemotherapy and RT boost were delivered in 19% and 38% of pts, respectively. Nodes received 50 Gy in 23% of patients without differences between both arms. During RT and within the first 6 weeks after RT, 10 patients (6.7%) presented grade 3 acute skin dermatitis during RT but no differences were observed between both arms (4 and 6 patients in arm A and B, respectively). At 26 month of follow-up, grade 2 and more radiation-induced subcutaneous fibrosis (RISCF) was present in 4 patients (3%) without any difference between arm A (n = 2) and B (n = 2), p=0.93. In both arms, all patients that presented a RICSF had a RILA lower than 16%. Sensitivity and specificity were 100% and 39%, respectively.No acute lung toxicities were observed and quality of life was good to excellent for all patients.SNPs analyses are still on-going (Pr Rosenstein, NY). Conclusion: Acute and early late grade 2 dermatitis were similar in both arms. The only factor that influenced RISCF was a low radiation-induced lymphocyte apoptosis yield. We confirmed prospectively the capacity of RILA for identifying hypersensitive patients to radiation. Indeed, patients with RILA superior to 16% did not present late effects to radiation and confirmed the first prospective trial we published in 2005 (Ozsahin et al., Clin Cancer Res).

Organic Matter Fractions and Quality of the Surface Layer of a Constructed and Vegetated Soil After Coal Mining. II - Physical Compartments and Carbon Management Index

Soils constructed after mining often have low carbon (C) stocks and low quality of organic matter (OM). Cover crops are decisive for the recovery process of these stocks, improving the quality of constructed soils. Therefore, the goal of this study was to evaluate the effect of cover crops on total organic C (TOC) stocks, C distribution in physical fractions of OM and the C management index (CMI) of a soil constructed after coal mining. The experiment was initiated in 2003 with six treatments: Hemarthria altissima (T1), Paspalum notatum (T2), Cynodon dactylon (T3), Urochloa brizantha (T4), bare constructed soil (T5), and natural soil (T6). Soil samples were collected in 2009 from the 0.00-0.03 m layer, and the TOC and C stocks in the physical particle size fractions (carbon in the coarse fraction - CCF, and mineral-associated carbon - MAC) and density fractions (free light fraction - FLF; occluded light fraction - OLF, and heavy fraction - HF) of OM were determined. The CMI components: carbon pool index (CPI), lability (L) and lability index (LI) were estimated by both fractionation methods. No differences were observed between TOC, CCF and MAC stocks. The lowest C stocks in FLF and OLF fractions were presented by T2, 0.86 and 0.61 Mg ha-1, respectively. The values of TOC stock, C stock in physical fractions and CMI were intermediate, greater than T5 and lower than T6 in all treatments, indicating the partial recovery of soil quality. As a result of the better adaptation of the species Hemarthria and Brizantha, resulting in greater accumulation of labile organic material, the CPI, L, LI and CMI values were higher in these treatments, suggesting a greater potential of these species for recovery of constructed soils.

HLA class II antigens (DR, DQ LOCI) and peripheral arthritis in ankylosing spondylitis.

Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DQ antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cw1, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigenic frequencies were observed in patients having peripheral arthritis and patients with only axial involvement. Seven out of nine patients (78%) with an erosive peripheral arthritis were DR7 positive, suggesting that DR7 or genes closely linked could be related with a more aggressive peripheral joint involvement in patients with AS.

LUGARESI, Leonardo, Il teatro di Dio. Il problema degli spettacoli nel cristianesimo antico (II-IV secolo), ed. Morcelliana, Brescia, 2008, 895 p., ISBN: 978-88-372-2257-4

La relación del cristianismo con los espectáculos de la tradición romano-pagana, y muy especialmente las críticas que los Padres de la Iglesia dirigieron a todo tipo de manifestación lúdica, constituye un tema complejo y lleno de interés que desde hace unos cuarenta años ha generado la publicación de importantes monografías consagradas a este sujeto. Sin duda, un momento de inflexión fue la aparición, en 1972, del célebre libro de Werner Weismann, Kirche und Schauspiele. Die Schauspiele im Urteil der lateinischen Kirchenväter unter besonderer Berücksichtigung vom Augustin. Posteriormente han visto la luz nuevos trabajos dedicados a examinar esta cuestión.

IFN-gamma-dependent transcription of MHC class II IA is impaired in macrophages from aged mice

To determine the effect of aging on IFN-gamma-induced MHC class II antigen expression, we produced bone marrow¿derived macrophages in vitro. In these conditions, we analyzed the effect of aging on the genomic expression of macrophages without the influence of other cell types that may be affected by aging. Although macrophages from young and aged mice showed an identical degree of differentiation, after incubation with IFN-gamma, the expression at the cell surface of the IA complex and the levels of IAbeta protein and mRNA were lower in aged macrophages. Moreover, the transcription of the IAbeta gene was impaired in aged macrophages. The amount of transcription factors that bound to the W and X, but not to the Y, boxes of the IAbeta promoter gene was lower in aged macrophages. Similar levels of CIITA mRNA were found after IFN-gamma treatment of both young and aged macrophages. This shows that neither the initial cascade that starts after the interaction of IFN-gamma with the receptor nor the second signals involved in the expression of CIITA are impaired in aged macrophages. These data indicate that aging is associated with low levels of MHC class II gene induction by IFN-gamma because of impaired transcription.

IFN-gamma-dependent transcription of MHC class II IA is impaired in macrophages from aged mice

To determine the effect of aging on IFN-gamma-induced MHC class II antigen expression, we produced bone marrow¿derived macrophages in vitro. In these conditions, we analyzed the effect of aging on the genomic expression of macrophages without the influence of other cell types that may be affected by aging. Although macrophages from young and aged mice showed an identical degree of differentiation, after incubation with IFN-gamma, the expression at the cell surface of the IA complex and the levels of IAbeta protein and mRNA were lower in aged macrophages. Moreover, the transcription of the IAbeta gene was impaired in aged macrophages. The amount of transcription factors that bound to the W and X, but not to the Y, boxes of the IAbeta promoter gene was lower in aged macrophages. Similar levels of CIITA mRNA were found after IFN-gamma treatment of both young and aged macrophages. This shows that neither the initial cascade that starts after the interaction of IFN-gamma with the receptor nor the second signals involved in the expression of CIITA are impaired in aged macrophages. These data indicate that aging is associated with low levels of MHC class II gene induction by IFN-gamma because of impaired transcription.