ΔNp73 and its effector targets promote colorectal peritoneal carcinosis and predict survival.

Peritoneal metastasis of colorectal origin appears in ~10-15% of patients at the time of diagnosis and in 30-40% of cases with disease progression. Locoregional spread through the peritoneum is considered stage IVc and is associated with a poor prognosis. The development of a regional therapeutic strategy based on cytoreductive surgery, and hyperthermic intra-abdominal chemotherapy has significantly altered the course of the disease. Although recent evidence supports the benefits of cytoreductive surgery, the benefits of hyperthermic intra-abdominal chemotherapy are, however, still a matter of debate. Understanding the molecular alterations underlying the disease is crucial for developing new therapeutic strategies. Here, we evaluated the involvement in peritoneal dissemination of the oncogenic isoform of TP73, ΔNp73, and its effector targets in in vitro and mouse models, and in 30 patients diagnosed with colorectal peritoneal metastasis. In an orthotopic mouse model, we observed that tumor cells overexpressing ΔNp73 present a higher avidity for the peritoneum and that extracellular vesicles secreted by ΔNp73-upregulating tumor cells enhance their dissemination. In addition, we identified that tumor cells overexpressing ΔNp73 present with dysregulation of genes associated with an epithelial/mesothelial-to-mesenchymal transition (MMT) and that mesothelial cells exposed to the conditioned medium of tumor cells with upregulated ΔNp73 present a mesenchymal phenotype. Lastly, ΔNp73 and its effector target RNAs were dysregulated in our patient series, there were positive correlations between ΔNp73 and its effector targets, and MSN and ITGB4 (ΔNp73 effectors) predicted patient survival. In conclusion, ΔNp73 and its effector targets are involved in the peritoneal dissemination of colorectal cancer and predict patient survival. The promotion of the EMT/MMT and modulation of the adhesion capacity in colorectal cancer cells might be the mechanisms triggered by ΔNp73. Remarkably, ΔNp73 protein is a druggable protein and should be the focus of future studies. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Arthrocnemum Moq.: Unlocking Opportunities for Biosaline Agriculture and Improved Human Nutrition.

(1) Background: This study provides novel insights into the elemental content and biomineralization processes of two halophytic species of the genus Arthrocnemum Moq. (A. macrostachyum and A. meridionale). (2) Methods: Elemental content was analyzed using ICP-MS, while biominerals were detected through electron microscopy (SEM and TEM) and X-ray diffraction. (3) Results: The elemental content showed significant concentrations of macronutrients (sodium, potassium, magnesium, and calcium) and micronutrients, especially iron. Iron was consistently found as ferritin in A. macrostachyum chloroplasts. Notably, A. macrostachyum populations from the Center of the Iberian Peninsula exhibited exceptionally high magnesium content, with values that exceeded 40,000 mg/kg d.w. Succulent stems showed elemental content consistent with the minerals identified through X-ray diffraction analysis (halite, sylvite, natroxalate, and glushinskite). Seed analysis revealed elevated levels of macro- and micronutrients and the absence of heavy metals. Additionally, the presence of reduced sodium chloride crystals in the seed edges suggested a mechanism to mitigate potential sodium toxicity. (4) Conclusions: These findings highlight the potential of Arthrocnemum species as emerging edible halophytes with nutritional properties, particularly in Western European Mediterranean territories and North Africa. They offer promising prospects for biosaline agriculture and biotechnology applications.

Towards single-cell bioprinting: micropatterning tools for organ-on-chip development.

Organs-on-chips (OoCs) hold promise to engineer progressively more human-relevant in vitro models for pharmaceutical purposes. Recent developments have delivered increasingly sophisticated designs, yet OoCs still lack in reproducing the inner tissue physiology required to fully resemble the native human body. This review emphasizes the need to include microarchitectural and microstructural features, and discusses promising avenues to incorporate well-defined microarchitectures down to the single-cell level. We highlight how their integration will significantly contribute to the advancement of the field towards highly organized structural and hierarchical tissues-on-chip. We discuss the combination of state-of-the-art micropatterning technologies to achieve OoCs resembling human-intrinsic complexity. It is anticipated that these innovations will yield significant advances in realization of the next generation of OoC models.

Atroposelective Synthesis of Axially Chiral Naphthylpyrroles by a Catalytic Asymmetric 1,3-Dipolar Cycloaddition/Aromatization Sequence.

A straightforward methodology for the enantioselective preparation of axially chiral 2-naphthylpyrroles has been developed. This protocol is based on a CuI/Fesulphos-catalyzed highly enantioselective 1,3-dipolar cycloaddition of an azomethine ylide followed by pyrrolidine alkylation and pyrrolidine to pyrrole oxidation. The mild conditions employed in the DDQ/blue light-mediated aromatization process facilitate an effective central-to-axial chirality transfer affording the corresponding pyrroles with high atroposelectivity.

Lack of variations in the salamander chytrid fungus, Batrachochytrium salamandrivorans, at its alleged origin: Updating its Japanese distribution with new evidence.

The chytrid fungus Batrachochytrium salamandrivorans [Bsal] is causing declines in the amphibian populations. After a decade of mapping the pathogen in Europe, where it is causing dramatic outbreaks, and North America, where its arrival would affect to the salamander's biodiversity hotspot, little is known about its current status in Asia, from presumably is native. Japan has several species considered as potential carriers, but no regulation is implemented against Bsal spreading. Previous Bsal known presence detected various cases on the Okinawa Island, southwestern Japan. Previous studies on its sister species, B. dendrobatidis presented a high genomic variation in this area and particularly on Cynops ensicauda. Here, we have done the largest monitoring to date in Japan on the Cynops genus, focusing on Okinawa Island and updating its distribution and providing more information to unravel the still unknown origin of Bsal. Interestingly, we have provided revealing facts about different detectability depending on the used molecular techniques and changes in its Japanese distribution. All in all, the Bsal presence in Japan, together with its low variability in the sequenced amplicons, and the lack of apparent mortalities, may indicate that this part of Asia has a high diversity of chytrids.

Association of Acidotolerant Cyanobacteria to Microbial Mats below pH 1 in Acidic Mineral Precipitates in Río Tinto River in Spain.

This report describes acidic microbial mats containing cyanobacteria that are strongly associated to precipitated minerals in the source area of Río Tinto. Río Tinto (Huelva, Southwestern Spain) is an extreme acidic environment where iron and sulfur cycles play a fundamental role in sustaining the extremely low pH and the high concentration of heavy metals, while maintaining a high level of microbial diversity. These multi-layered mineral deposits are stable all year round and are characterized by a succession of thick greenish-blue and brownish layers mainly composed of natrojarosite. The temperature and absorbance above and below the mineral precipitates were followed and stable conditions were detected inside the mineral precipitates. Different methodologies, scanning and transmission electron microscopy, immunological detection, fluorescence in situ hybridization, and metagenomic analysis were used to describe the biodiversity existing in these microbial mats, demonstrating, for the first time, the existence of acid-tolerant cyanobacteria in a hyperacidic environment of below pH 1. Up to 0.46% of the classified sequences belong to cyanobacterial microorganisms, and 1.47% of the aligned DNA reads belong to the Cyanobacteria clade.

GOECP/SEOR radiotheraphy guidelines for non-small-cell lung cancer

Non-small cell lung cancer (NSCLC) is a heterogeneous disease accounting for approximately 85% of all lung cancers. Only 17% of patients are diagnosed at an early stage. Treatment is multidisciplinary and radiotherapy plays a key role in all stages of the disease. More than 50% of patients with NSCLC are treated with radiotherapy (curative-intent or palliative). Technological advances-including highly conformal radiotherapy techniques, new immobilization and respiratory control systems, and precision image verification systems-allow clinicians to individualize treatment to maximize tumor control while minimizing treatment-related toxicity. Novel therapeutic regimens such as moderate hypofractionation and advanced techniques such as stereotactic body radiotherapy (SBRT) have reduced the number of radiotherapy sessions. The integration of SBRT into routine clinical practice has radically altered treatment of early-stage disease. SBRT also plays an increasingly important role in oligometastatic disease. The aim of the present guidelines is to review the role of radiotherapy in the treatment of localized, locally-advanced, and metastatic NSCLC. We review the main radiotherapy techniques and clarify the role of radiotherapy in routine clinical practice. These guidelines are based on the best available evidence. The level and grade of evidence supporting each recommendation is provided.

Valoración de la efectividad de un protocolo de estimulación sensorial de la mano hemiparésica para la rehabilitación del control postural en pacientes con ictus crónico. Estudio piloto / Evaluation of the effectiveness of a hemiparesis hand sensory stimulation protocol for postural control rehabilitation in patients with chronic stroke. Pilot study

Introducción. Uno de los objetivos principales de la neurorrehablitación en pacientes con ictus es el reentrenamiento del equilibrio. Se ha estudiado la influencia de la función motora del miembro superior en el control postural, pero desconocemos si la estimulación somatosensorial de la mano afecta puede influirlo. Objetivo. Estudiar si un protocolo de estimulación somatosensorial de la mano afecta, podía modificar, en pacientes con ictus crónico, la posición del centro de masa y su desplazamiento en bipedestación. Pacientes y métodos. 5 pacientes con ictus crónico con capacidad de bipedestación autónoma completaron este estudio piloto prospectivo y longitudinal, con valoración pretratamiento, post-primer tratamiento y post-intervención final. La intervención consistió en estimulación somatosensorial de la mano afecta, de 20 minutos de duración durante 5 días consecutivos. Se midieron Timed Up and GO Test (TUG), Performance Oriented Mobility Assessment (POMA), Limits Of Stability (LOS) y Modified Clinical Test of Sensory Interaction on Balance (mCTSIB). Resultados. Se observaron cambios estadísticamente significativos en TUG (p=0,043), en mCTSIB en los máximos desplazamientos del centro de presiones para la condición ojos abiertos (p=0,043) y en LOS para el tiempo de reacción en la diagonal posterior afecta(p꞊0,043), máximas excursiones en las diagonales anterior menos afecta, afecta y posterior afecta (p=0,043) y el control direccional en la anterior menos afecta y anterior afecta. Conclusiones. La estimulación somatosensensorial propuesta puede ser positiva para el reentrenamiento del equilibrio a la luz de los resultados obtenidos. Son necesarias investigaciones a este nivel a gran escala y a largo plazo con muestras más grandes.

Introduction. One of the main objectives of neurorehablitation in stroke patients is balance retraining. The influence of upper limb motor function on postural control has been studied, but we do not know whether somatosensory stimulation of the affected hand can influence it. Objective. To study whether a protocol of somatosensory stimulation of the affected hand could modify, in patients with chronic stroke, the position of the center of mass and its displacement in standing. Patients and methods. Five patients with chronic stroke who were able to stand independently completed this prospective and longitudinal pilot study, with pre-treatment, post-first treatment and final post-intervention assessment. The intervention consisted of somatosensory stimulation of the affected hand, lasting 20 minutes for 5 consecutive days. Timed Up and GO Test (TUG), Performance Oriented Mobility Assessment (POMA), Limits Of Stability (LOS) and Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) were measured. Results. Statistically significant changes were observed in TUG (p=0.043), in mCTSIB for maximum center of pressures displacements for the eyes open condition (p=0.043) and in LOS for reaction time in the posterior diagonal affect(p꞊0.043), maximum excursions in the anterior least affect, affect and posterior affect diagonals (p=0.043) and directional control in the anterior least affect and anterior affect. Conclusions. The proposed somatosensory stimulation may be positive for balance retraining in light of the results obtained. Large-scale and long-term investigations at this level with larger samples are necessary.

Diagnosis and locoregional treatment of patients with breast cancer during the COVID-19 pandemic / Diagnostico y tratamiento locorregional de las pacientes con cancer de mama durante la pandemia de la COVID-19

We are facing a pandemic that is going to affect a significant part of the population. At the end of April in the world there are about 3,000,000 cases, with 205,000 deaths and 860,000 patients recovered. The response to this pandemic has in many cases led to a significant change in the daily work of caring for cancer patients, the good results of which depend largely on time-adjusted protocols and multidisciplinary treatments. We present a review of local, surgical and radiotherapy treatment together with authors' recommendations made from personal experience on ways to act in the diagnosis and surgical treatment of breast cancer during the COVID-19 pandemic. The multidisciplinary Breast Committees must continue to meet weekly in videoconference format. All surgical actions and irradiations must be carried out with maximum safety for both the patients and the participating teams. Hypofractionation in radiation therapy should be the standard treatment. Sometimes it is recommended to apply a primary systemic treatment or even a primary irradiation. Great coordination between the surgical and oncology teams, both medical and radiotherapeutic, is essential

Nos enfrentamos a una pandemia que afecta a una parte importante de la población.  A finales de abril de 2020, en el mundo hay cerca de 3.000.000 de casos, con 205.000 muertes y 860.000 pacientes recuperados. La respuesta a esta pandemia en muchos casos ha supuesto modificaciones importantes en el cuidado diario de las pacientes con cáncer, dependiendo el buen resultado en buena parte del ajuste de los protocolos a las circunstancias especiales y a los tratamientos multidisciplinarios. Presentamos una revisión del tratamiento quirúrgico y radioterapia junto con las recomendaciones de los autores basadas en su experiencia personal a la hora del diagnóstico y tratamiento locorregional del cáncer de mama durante la pandemia del COVID-19. Los comités multidisciplinarios deben seguir reuniéndose semanalmente en formato de videoconferencia. Todos las intervenciones quirúrgicas e irradiaciones deben ser llevadas a cabo con la máxima seguridad tanto para las pacientes como para el personal sanitario que participa. El hipofraccionamiento debe ser el tratamiento radioterápico estándar. En algunos casos se utilizará tratamiento sistémico primario o incluso radioterapa preoperatoria. Es esencial una coordinación importante entre los equipos quirúrgicos y los oncológicos, tanto radioterápicos como médicos

Actividad in-vitro de fosfomicina, sola o en combinaciones, frente a aislamientos clínicos de Pseudomonas aeruginosa resistentes a carbapenémicos / In vitro activity of fosfomycin, alone or in combination, against clinical isolates of carbapenem resistant Pseudomonas aeruginosa

INTRODUCCIÓN: En la actualidad asistimos a un progresivo aumento de aislamientos de microorganismos con patrones de multirresistencia y aun de panresistencia. Fosfomicina (FO) es un antimicrobiano activo frente a una gran variedad de microorganismos, incluyendo cepas de Pseudomonas aeruginosa (P. aeruginosa), que es susceptible de actuar sinérgicamente con otras moléculas. MÉTODOS: El objetivo de este estudio consiste en evaluar la actividad in-vitro de FO frente a 120 cepas de P. aeruginosa resistentes a carbapenémicos, utilizando un método de dilución en agar y otro de difusión en gradiente y, además, explorar, mediante el método de E-test y curvas de muerte, la posible sinergia de FO/amikacina y FO/ciprofloxacino, asociaciones potencialmente eficaces frente a P. aeruginosa resistentes a carbapenémicos. RESULTADOS: Para FO, partiendo de los valores de corte epidemiológicos (ECOFF) que publica European Committee on Antimicrobial Susceptibility Testing (EUCAST), más de las 3 cuartas partes de las cepas serían susceptibles de poder ser tratadas con este antimicrobiano, especialmente en combinación con otro agente. La asociación FO/ciprofloxacino presentó un efecto sinérgico en casi la mitad de los aislamientos (40%), mientras que la asociación FO/amikacina solo alcanzó este efecto sinérgico en el 12% de los casos. CONCLUSIÓN: La aparición de cepas de P. aeruginosa resistentes a carbapenémicos hace necesaria la valoración de tratamientos combinados. Este trabajo sugiere que la combinación FO/ciprofloxacino puede ser útil, presentando un efecto sinérgico en el 40% de los aislamientos estudiados

INTRODUCTION: The increase in microorganisms showing patterns of multi-drug resistance or even pan-drug resistance is of growing concern. Fosfomycin (FO) is well known to be active against a wide variety of microorganisms, including highly resistant strains of Pseudomonas aeruginosa (P. aeruginosa), and can also synergistically act with other molecules. METHODS: This study examines the in vitro activity shown by FO against 120 strains of carbapenem-resistant P. aeruginosa using an agar dilution and a gradient diffusion test. Possible synergistic effects of the combinations of FO/amikacin and FO/ciprofloxacin were also examined using E-test and time-kill techniques. RESULTS: According to the epidemiological cut-off value (ECOFF) issued by the European Committee on Antimicrobial Susceptibility Testing (EUCAST), our results indicate that over three-quarters of the strains tested would be susceptible to FO treatment, especially if combined with another antimicrobial. The FO/ciprofloxacin combination had a synergistic effect on 40% of the clinical isolates, while for FO/amikacin this effect was only observed in 12% of the isolates. CONCLUSION: The appearance of carbapenem-resistant P. aeruginosa strains requires the evaluation by combination therapy. This report suggests that the FO/ciprofloxacin combination can be useful, showing a synergistic effect in 40% of the isolates

Cutaneous abscess due to Gordonia bronchialis: case report and literature review / Absceso cutáneo por Gordonia bronchialis: descripción de un caso y revisión de la literatura

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Estrategias para incrementar la motivación de las enfermeras asistenciales hacia la investigación / Strategies to increase motivation for research among practice nurses

OBJETIVO: identificar estrategias de intervención que sean de utilidad para potenciar la motivación de las enfermeras hacia la investigación. MÉTODO: el estudio se desarrolló en el contexto del máster universitario de Liderazgo y Gestión de Enfermería 2018/2019 de la Universidad de Barcelona. Se aplicó un diseño cualitativo mediante análisis interpretativo de contenido. Los datos se obtuvieron a través de la elaboración de un plan de acción donde cada participante, a partir de unos objetivos, planteó unas estrategias de intervención para incrementar su motivación hacia la investigación. Para el análisis se agruparon las diferentes estrategias por dimensiones, estableciendo dos subcategorías: intervenciones autoaplicadas dirigidas hacia uno mismo, e intervenciones institucionales dirigidas a la institución. RESULTADOS: prevalecieron las intervenciones dirigidas a la organización de la vida personal. Las propuestas más habituales de intervenciones autoaplicadas se relacionaron con aumentar el tiempo de dedicación a la investigación intentando optimizar el tiempo personal, incrementar la formación específica en investigación, el conocimiento de lengua inglesa y medidas destinadas a aumentar la motivación intrínseca. Mientras que las propuestas de intervenciones institucionales estuvieron enfocadas a disponer de tiempo para investigar dentro de la jornada laboral y tener acceso a los recursos necesarios. CONCLUSIONES: los resultados obtenidos pueden ayudar a generar planes estratégicos de intervención en los que se potencie la investigación enfermera a partir de un modelo de implantación, elaborado por las propias enfermeras, tanto de intervenciones autoaplicadas como a desarrollar por la institución

OBJECTIVE: to identify intervention strategies that will be useful in order to boost motivation for research among nurses. METHOD: the study was conducted in the setting of the University Master Degree for Nursing Leadership and Management 2018/2019 in the University of Barcelona. A qualitative design was applied through interpretive content analysis. Data were collected through the preparation of a plan of action where each participant, based on some objectives, presented intervention strategies in order to increase their motivation towards research. The different strategies were grouped by dimensions for their analysis, determining two subcategories: self-applied interventions targeted to oneself, and institutional interventions targeted to the institution. RESULTS: there was a prevalence of interventions targeted to personal life management. The most usual proposals for self-applied interventions were associated with increasing the time devoted to research, trying to optimize personal time, to increase the specific training on research, knowledge of English, and measures targeted to increase intrinsic motivation. On the other hand, the proposals for institutional interventions were focused on having time for research within the working day, and having access to the resources required. CONCLUSIONS: the results obtained can help to generate strategic plans of intervention that will boost nursing research based on a model of implementation, prepared by nurses, both for self-applied interventions and for those to be conducted by the institution

Conocimiento y valoración de las voluntades anticipadas del personal sanitario de unidades de hospitalización a domicilio, oncología médica, hospitales de día y servicios de urgencias / Knowledge and assessment of living wills by health professionals at home hospitalization units, medical oncology departments, daytime hospital services and emergency romos

OBJETIVO: Describir el conocimiento del personal sanitario de servicios implicados en el manejo de enfermos paliativos en situación avanzada, sobre el Documento de Voluntades Anticipadas (DVA) y su Registro Nacional. Conocer cómo valoran su uso y si lo consultan habitualmente. MATERIAL Y MÉTODO: Estudio multicéntrico, transversal descriptivo, mediante cuestionario anónimo cumplimentado por personal médico y de enfermería en tres centros hospitalarios. Se recogieron un total de 160 cuestionarios correspondientes a 58 médicos y 102 enfermeros, pertenecientes a Servicios de Urgencias (SU), Oncología, Unidades de Hospitalización a Domicilio (HaD) y Hospital de Día. El cuestionario constaba de 14 preguntas tipo test de respuesta única, además de las variables demográficas y laborales pertinentes para el estudio. RESULTADOS: Las medias de edad de la muestra fueron de 42 ± 9 años, y la experiencia profesional de 17 ± 9,3 años. El 83,1 % de los encuestados afirmaron conocer el DVA y el 53,7 % que sabrían cumplimentarlo, pero solo un 8,1 % de ellos contestaron correctamente a la pregunta de dónde localizar dicho documento. El 92,5 % de los encuestados no lo consultan nunca. Los dos encuestados que afirmaban consultarlo habitualmente, no supieron localizarlo. CONCLUSIONES: Existe un desconocimiento generalizado del DVA, siendo este independiente tanto de la categoría profesional como de los años de experiencia o del servicio en el que se trabaja. Incluso en los casos que dicen conocerlo, sus respuestas no corroboran tal afirmación

OBJECTIVE: To describe the knowledge healthcare providers at the units involved in the management of advanced palliatiave care patients have of the advance directives document (ADD). To find out how do they value its use, and whether they check it out regularly. MATERIAL AND METHODS: A multicenter, cross-sectional, descriptive study using an anonymous questionnaire to be completed by doctors and nurses in three hospitals. A total of 160 questionnaires were collected from 58 doctors and 102 nurses working at emergency rooms (ERs), oncology departments, home hospitalization units (HHUs), and day hospital services. Questionnaires included 14 multiple choice questions with only one valid option, and also collected the demographic and labor variables required by the study. RESULTS: Mean age in the sample was 42 ± 9 years, and professional experience was 17 ± 9.3 years. Among responders, 83.1 % claimed knowledge of the ADD, and 53.7 % said they could complete it, but only 8.1 % knew where to find it; 92.5 % of respondents never consult it. The two respondents who claimed they usually checked it out were eventually unable to locate it. CONCLUSIONS: Lack of knowledge about ADDs and their related National Registry is widespread, and occurs regardless of professional category or years of experience. Even in providers who claim awareness of this document the answers provided belie it

Irradiación parcial acelerada en cáncer de mama: revisión de las diferentes técnicas / Accelerated partial irradiation in breast cancer: a review of distinct techniques

El tratamiento conservador es el de elección en el cáncer de mama en estadios iniciales. La irradiación parcial acelerada de la mama es una estrategia que permite tratar únicamente el lecho quirúrgico con 1-2 cm de margen, en contraposición al tratamiento clásico, que consiste en irradiar toda la mama. La reducción del volumen a irradiar nos permite aumentar la dosis/fracción administrada, acortando la duración total del tratamiento. El interés creciente por este esquema terapéutico ha motivado la realización de ensayos fase I-III, que evalúan esta modalidad terapéutica mediante diferentes técnicas: braquiterapia intersticial multicatéter, braquiterapia intracavitaria mediante balón, radioterapia externa conformada y radioterapia intraoperatoria. La braquiterapia mediante balón incluye MammoSite, Axxent y Contura, y dispositivos híbridos como SAVI y ClearPath. Este artículo revisa las diferentes técnicas, reflejando las ventajas e inconvenientes de cada una de ellas. Aunque estamos a la espera de los resultados a largo plazo de los ensayos fase III, parece evidente que la irradiación parcial acelerada de la mama tendrá un papel importante en el manejo de un grupo seleccionado de pacientes con cáncer de mama precoz

Breast conservation therapy is the procedure of choice of early-stage breast cancer. Accelerated partial breast irradiation is an approach that treats only the lumpectomy bed plus a 1-2 cm margin, rather than the whole breast. Because of the small volume of irradiation, a higher dose can be delivered, thus reducing the total length of treatment. Growing interest in accelerated partial breast irradiation has prompted the development of phase I-III clinical studies evaluating distinct techniques within this therapeutic modality; these techniques include multicatheter interstitial brachytherapy, balloon-catheter brachytherapy, conformal external beam radiation therapy, and intraoperative radiation therapy. Balloon-based brachytherapy approaches include MammoSite, Axxent and Contura electronic brachytherapy. Hybrid brachytherapy devices include SAVI and ClearPath. This article reviews the different techniques, identifying the weaknesses and strengths of each approach, and proposes a direction for future research and development. Although further follow-up and mature phase III data are needed, it seems evident that accelerated partial breast irradiation will play a role in the management of a selected group of patients with early-stage breast cancer

Primer aislamiento de Corynebacterium mucifaciens en una úlcera corneal / First case of a corneal ulcer associated with Corynebacterium mucifaciens

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Contrasting morphology and training background in waterpolo teams of different competitive levels / Comparação de indicadores morfológicos e do tempo de treino semanal em equipes de pólo aquático de diferentes níveis competitivos / Comparación de indicadores morfológicos y de tiempo de entrenamiento semanal en equipos de waterpolo de diferentes niveles competitivos

We aimed to describe and compare the general morphological, somatotype and training background characteristics of Iberian waterpolo players (22 Portuguese and 22 Spanish National Teams players) considering their playing positions. The International Working Group of Kinanthropometry guidelines was herein followed, and a somatochart was obtained through specific software (Somatotype, Calculation and Analysis. (c)2001 SWEAT technologies). Spanish players train more hours per week (22.8 ±9.5 vs.12.2 ±5.6), are taller (187.4 cm ±6.6 vs.180.3 cm ±5.1), heavier (89.2 kg ±11.6 vs.79.1 kg ±10.0), show higher arm span (195.7 cm ±8.5 vs.185.2 cm ±7.4) and muscle mass percentage (49.0% ± 1.8 vs.46.0% ±6.0), and tend to be more mesomorphic (5.19 ±1.27 vs.4.26 ±1.32) than the Portuguese players. Concerning field positions, Spanish center forward players train more hours per week than the Portuguese (20.2 ±9.1 vs.12.2 ±3.8) and show higher arm span (204.4 cm ±7.3 vs.184.0 cm ±6.5). Spanish goal keepers and outside players show higher muscle mass percentage (49.8% ±1.5 vs.42.2% ±5.2 and 49.4% ±1.5 vs.45.5% ±4.6, respectively) than the Portuguese players. These evidences should be taken into account for the improvement of waterpolo sport...

"Comparação de indicadores morfológicos e do tempo de treino semanal em equipes de pólo aquático de diferentes níveis competitivos." O presente estudo objetivou descrever e comparar a morfologia geral, o somatótipo e horas de treino de jogadores Ibéricos de selecções nacionais de polo aquático (22 portugueses e 22 espanhóis) e compará-los quanto às posições de jogo. Utilizou-se um software específico para o desenho da somatocarta (Somatotype, Calculation and Analysis,(c)2001 SWEAT technologies). Os jogadores espanhóis, quando comparados com os portugueses, treinam mais horas por semana (22,8 ±9,5 vs.12,2 ±5,6), são mais altos (187,4 cm ±6,6 vs.180,3 cm ±5,1), mais pesados (89,2 kg ±11,6 vs.79,1 kg ±10,0), apresentam maior envergadura (195,7 cm ±8,5 vs. 185,2 cm ±7,4), percentagem de massa muscular (49,0% ±1,8 vs. 46,0% ±6,0) e tendem a ser mais mesomorfos (5,19 ±1,27 vs. 4,26 ±1,32) do que os jogadores portugueses. Quanto às posições de jogo, os pivôs espanhóis treinam mais horas por semana (20,2 ±9,1 vs.12,2 ±3,8) e apresentam maior envergadura (204,4 cm ±7,3 vs.184,0 cm ±6,5) que os portugueses. Ainda, respectivamente, os goleiros e os jogadores laterais espanhóis apresentam percentagens mais elevadas de massa muscular (49,8% ±1,5 vs.42,2% ±5,2 e 49,4% ±1,5 vs.45,5% ±4,6) do que os portugueses. Estas evidências devem ser consideradas para a melhoria do polo aquático...

"Comparación de indicadores morfológicos y de tiempo de entrenamiento semanal en equipos de waterpolo de diferentes niveles competitivos" El objetivo del estudio fue describir y comparar la morfología general, somatotipo y horas de entrenamiento de jugadores Ibéricos de selecciones nacionales de waterpolo (22 portugueses y 22 españoles) y comparar sus diferencias entre posiciones de juego. Los parámetros evaluados fueron seleccionados en la literatura. La somatocarta fue construida con un software específico (Somatotype, Calculation and Analysis, (c)2001 SWEAT technologies). Los jugadores españoles entrenan más horas por semana (22,8 ±9,5 vs.12,2 ±5,6), tienen más altura (187,4cm ± 6,6 vs.180,3 cm ±5.1), más peso (89,2 kg ±11,6 vs.79,1 kg ±10,0), más envergadura (195,7 cm ±8,5 vs. 185,2 cm ±7,4), porcentaje de masa muscular (49,0% ±1,8 vs. 46,0% ±6,0) y tienden a presentar valores más altos de mesomorfia (5,19 ±1,27 vs. 4,26 ±1,32) que los jugadores portugueses. Con respecto a las posiciones de juego, los boyas Españoles superan los portugueses en las horas de entrenamiento semanal (20,2 ±9,1 vs.12,2 ±3,8) y presentan más envergadura (204,4 cm ±7,3 vs.184,0 cm ±6,5). Los porteros y jugadores periféricos españoles tienen más masa muscular que los jugadores portugueses (49,8% ±1,5 vs. 42,2% ±5,2 e 49,4% ±1,5 vs.45,5% ±4,6), respectivamente. Estas evidencias deberán ser consideradas para la mejora del waterpolo...

Aplicación del análisis de riesgo en la preparación de soluciones para producción de Quimi-Hib® / Risk assessment tools in the preparation of the solutions used in the production of Quimi-Hib®

Entre las técnicas avanzadas de administración de riesgo se encuentran las herramientas de soporte estadístico, así como los histogramas y gráficos de frecuencia acumulada, los cuales sirven de base para la acumulación de datos. Se realizó un análisis de los mismos y se evaluó la influencia de diferentes parámetros sobre un proceso determinado para la toma de decisiones. Los resultados obtenidos demostraron que existe riesgo de contaminación de las soluciones en una cabina de flujo laminar. Todos los tampones evaluados cumplieron satisfactoriamente con los límites establecidos para el contenido de endotoxinas y límite microbiano. Los valores de carga microbiana, determinados por diferentes métodos en el ambiente de trabajo, estuvieron dentro de los límites, acorde con la clasificación de las áreas. La higienización de los tanques de preparación demostró que los procedimientos empleados garantizaron una adecuada remoción de los contaminantes. Se concluyó que los riesgos y escenarios evaluados fueron aceptables para alcanzar la calidad del producto(AU)

Among the advanced techniques of risk management are the tools of statistical support, such as histograms and cumulative frequency plots, which are the basis for the accumulation of data. An analysis of these and evaluated the influe.nce of different parameters on a particular process for making decisions. The results showed that a risk contamination of the solutions named in a laminar flow cabinet in which filtered. All buffers tested satisfactorily complied with the limits for the content of endotoxin and microbial limit. The microbial load values determined by different methods in the workplace gave values within the limits, according to the classification of areas. The sanitizing preparation tanks showed that the procedures ensured adequate removal of contaminants. It was concluded that the risks and scenarios evaluated to achieve acceptable product quality(AU)

Staphylococcus coagulasa negativos resistentes al linezolid: características fenotípicas, genotípicas y sensibilidad a combinaciones de antibióticos / Linezolid resistant coagulase-negative Staphylococcus: Phenotypical and genotypical characteristics and sensitivity to antibiotic combinations

Objetivo Recuperamos 22 aislados de estafilococos coagulasa negativos resistentes al linezolid de nuestro hospital para su identificación, sensibilidad, perfil epidemiológico, mecanismos de la resistencia al linezolid y posibles combinaciones antibióticas sinérgicas. Métodos La identificación de los aislados fue realizada mediante espectrometría de masas (Vitek-MS, BioMérieux). La sensibilidad se realizó con el sistema Vitek-2 (bioMérieux) y el método de microdilución en caldo según las recomendaciones del CLSI. Se realizó electroforesis en gel de campo pulsado (PFGE) para estudiar la relación genética de los aislados. Los mecanismos de la resistencia al linezolid fueron evaluados por PCR/secuenciación: presencia del gen cfr, mutaciones puntuales en el dominio V del ARN ribosomal 23S y mutaciones ribosomales adicionales (en los genes rplC, rplD y rplV). La actividad in vitro del linezolid fue estudiada por separado y en combinación con otros 3 antibióticos utilizando tiras de E-test. Resultados Veinte aislados fueron identificados como Staphylococcus epidermidis y 2 como Staphylococcus hominis. La PFGE demostró que los aislados pertenecían a diferentes clones: 21 de los aislados presentaron mutaciones en la región del dominio V del ARNr 23S y en el 54,5% fue encontrado el gen cfr. La administración previa de linezolid fue documentada en la mayor parte de casos. El linezolid en combinación con gentamicina mostró una actividad sinérgica en el 45,5% de los aislados. Conclusiones Staphylococcus epidermidis fue la especie de estafilococos coagulasa negativos resistentes al linezolid más frecuentes. Los valores de CMI fueron además elevados para otros antiestafilocócicos. Todas las cepas presentaron varios mecanismos de resistencia al linezolid. Nuestros datos sugieren que linezolid más gentamicina podría ser una combinación sinérgica frente a los estafilococos coagulasa negativos resistentes al linezolid(AU)

Objective We recovered 22 coagulase-negative staphylococci isolates in our hospital to study their identity, susceptibility, epidemiological profile, linezolid resistance mechanisms, and the possibilities of different antibiotic combinations. Methods Isolate identification was performed using mass spectrometry (Vitek-MS, bioMérieux). Susceptibility testing was carried out with the Vitek-2 system and the broth microdilution method according to CLSI guidelines. Pulsed-field gel electrophoresis (PFGE) was performed to analyze the genetic relationship between isolates. Linezolid resistance mechanisms were evaluated by PCR/sequencing: presence of cfr gene, point mutations in domain V of 23S ribosomal RNA and additional ribosomal mutations (in the rplC, rplD and rplV genes). The in vitro activity of linezolid was investigated alone and in combination with another three antibiotics acting on different cellular targets, using E-test strips. Results Twenty isolates were identified as Staphylococcus epidermidis, and 2 as Staphylococcus hominis. PFGE showed that isolates belonged to diverse clones, 21 of them presented mutations in the domain V region of 23S rRNA and the cfr gene was found in 54.5%. Prior administration of linezolid was documented in most of cases. Linezolid in combination with gentamicin showed a synergistic activity in 45.5% of isolates. Conclusions Staphylococcus epidermidis was the most prevalent linezolid-resistant coagulase-negative staphylococci. All isolates showed increased MIC values compared to other anti-staphylococcal drugs and several linezolid resistance mechanisms. Our data suggest that linezolid plus gentamicin could be a synergistic combination against linezolid-resistant coagulase-negative staphylococci(AU)

Irradiación completa de la mama y sobreimpresión del lecho tumoral hipofraccionadas en el cáncer de mama: valoración de la toxicidad / Whole-breast and tumor boost hypofractionated irradiation in breast carcinoma: toxicity results

Introducción. Presentamos los resultados de tolerancia de la adición de sobreimpresión hipofraccionada después de irradiación global hipofraccionada de la mama. Material y método. Se incluyeron pacientes con cirugía conservadora y tratadas mediante hipofraccionamiento de 2,67Gy/día hasta 40Gy sobre la mama. La sobreimpresión del lecho tumoral se realizó a dosis de 16 o 8Gy según los criterios de riesgo para recaída local: tamaño tumoral, grado, márgenes o presencia de carcinoma ductal in situ, o nada en ausencia de dichos factores. Resultados. Se trataron 110 pacientes. Los grupos de riesgo se distribuyeron en alto, medio o bajo, con 51, 54 y 5 pacientes, respectivamente. Un 4,5% no presentaron toxicidad aguda. Las pacientes presentaron dermitis grado i o ii en el 38,2 y 47,3% de los casos, respectivamente. No se observaron diferencias en la toxicidad aguda dependiendo de la dosis de sobreimpresión. Tras un seguimiento medio de 2 años, en 79 casos (71,8%) no hubo cambios cutáneos crónicos. Apareció fibrosis leve en 24 pacientes (21,8%) y de grado ii en 7 pacientes. Conclusiones. La sobreimpresión hipofraccionada parece bien tolerada y las toxicidades aguda y crónica son leves. No parece haber impacto de la dosis total acumulada en la incidencia de fibrosis(AU)

Introduction. We present the results of adding a hypofractionated boost after whole-breast hypofractionated radiotherapy and report patient tolerance of this procedure. Material and method. Patients were included after conservative surgery and underwent adjuvant therapy. The whole breast was treated at 2.67Gy per fraction up to 40Gy. The boost was performed at different dose levels (16 or 8Gy) according to the presence of risk factors for local recurrence (tumor size, histologic grade, margin status or the presence of carcinoma in situ) or nothing in case of their absence. Results. A total of 110 patients were treated. The distribution into high-, middle- and low-risk groups was 51, 54 and 5 patients, respectively. There was no toxicity in 4.5% of the patients. Grade i or ii dermatitis was found in 38.2 and 47.3%, respectively. No differences were observed in acute dermatitis depending on boost doses. After a follow-up of 2 years, there were no chronic skin or subcutaneous changes in 79 patients (71.8%). Mild fibrosis occurred in 24 patients (21.8%) and grade ii fibrosis occurred in 7 patients. Conclusions. Hypofractionated boost seems to be well tolerated. Acute and chronic toxicities are mild. The cumulative dose does not seem to increase the incidence of fibrosis at the boost area compared with the whole breast(AU)

Precisión del método E-test para el estudio de la sensibilidad de Campylobacter spp. a eritromicina, ciprofloxacino y tetraciclina / Accuracy of Etest method to study Campylobacter spp. susceptibility to erythromycin, ciprofloxacin and tetracycline

Introducción. En los países industrializados el enteropatógeno bacteriano más frecuentemente aislado de las heces de pacientes con gastroenteritis es Campylobacter jejuni. Evaluamos la precisión del Etest para categorizar la susceptibilidad de Campylobacter spp. frente a eritromicina, ciprofloxacino y tetraciclina. Métodos. Estudiamos 90 cepas. El Etest® se realizó en placas comerciales de Mueller Hinton con sangre siguiendo las instrucciones del fabricante. Los puntos de corte fueron los recomendados por el Clinical Laboratory Standards Institute (CLSI) para microdilución en caldo. El método de referencia fue el de microdilución en caldo descrito por el CLSI. Resultados. La concordancia del Etest con el método de referencia fue 100%, 97% y 98% para eritromicina, ciprofloxacino y tetraciclina respectivamente. No hubo errores graves ni muy graves. Conclusiones. Con Etest se obtienen resultados equivalentes a los del método de referencia por lo que es válido para categorizar las cepas clasificadas como no resistentes a eritromicina y ciprofloxacino mediante el método de difusión y determinar la susceptibilidad frente a tetraciclina(AU)

Introduction. In industrialized countries Campylobacter jejuni is the enteropathogen most frequently isolated from the feces of patients with gastroenteritis. The Etest accuracy to categorize Campylobacter spp. susceptibility to erythromycin, ciprofloxacin and tetracycline was evaluated. Methods. Ninety strains were studied. The Etest® was performed following the manufacturer’s instructions on commercial plates of Mueller-Hinton blood. The breakpoints were those recommended by the Clinical Laboratory Standards Institute (CLSI) for broth microdilution. The gold standard was the broth microdilution method as recommended by CLSI. Results. The Etest agreement with the reference method was 100%, 97% and 98% for erythromycin, ciprofloxacin and tetracycline, respectively. No major or very major errors were found. Conclusions. The Etest results are equivalent to those obtained using the gold standard. The Etest is a valid method to determine susceptibility to tetracycline. It is also a suitable method to categorize strains classified as non-resistant to erythromycin and ciprofloxacin by the diffusion method(AU)