Severe childhood trauma and clinical and neurocognitive features in schizotypal personality disorder.

OBJECTIVE: Literature suggests that childhood trauma increases vulnerability for schizophrenia-spectrum disorders, including schizotypal personality disorder (SPD). Yet, it remains unexplored whether childhood trauma predicts symptom load and the level of neurocognitive functioning in SPD. METHOD: We included 225 individuals with SPD and 127 healthy controls. Childhood trauma was evaluated using the Childhood Trauma Questionnaire, and schizotypal traits were assessed using the Schizotypal Personality Questionnaire. Standard neurocognitive assessments covered six cognitive domains. RESULTS: All types of reported childhood trauma were significantly associated with SPD, in a linear fashion. Severe sexual abuse showed the greatest magnitude of association with higher cognitive-perceptual load (e.g., ideas of reference, odd belief or magical thinking); severe emotional neglect was associated with interpersonal scores (e.g., excessive social anxiety, constricted affect) within the SPD group. SPD individuals who reported severe trauma showed worse cognitive functioning (i.e., working memory, verbal/visual learning and memory, as well as verbal fluency). CONCLUSIONS: Particular severe childhood trauma types were associated with higher cognitive-perceptual and interpersonal symptoms in SPD, along with worse cognitive functioning. These findings highlight the need for clinicians to enquire about childhood trauma in SPD patients, since unaddressed early adverse experiences may carry long-term negative consequences.

The Effects of Aquatic Plyometric Training on Repeated Jumps, Drop Jumps and Muscle Damage.

The purpose of this study was to compare the effects of land- vs. aquatic based plyometric training programs on the drop jump, repeated jump performance and muscle damage. Sixty-five male students were randomly assigned to one of 3 groups: aquatic plyometric training group (APT), plyometric training group (PT) and control group (CG). Both experimental groups trained twice a week for 10 weeks performing the same number of sets and total jumps. The following variables were measured prior to, halfway through and after the training programs: creatine kinase (CK) concentration, maximal height during a drop jump from the height of 30 (DJ30) and 50 cm (DJ50), and mean height during a repeated vertical jump test (RJ). The training program resulted in a significant increase (P<0.01-0.001) in RJ, DJ30, and DJ50 for PT, whereas neither APT nor CG reached any significant improvement APT showed likely/possibly improvements on DJ30 and DJ50, respectively. Greater intra-group Effect Size in CK was found for PT when compared to APT. In conclusion, although APT seems to be a safe alternative method for reducing the stress produced on the musculoskeletal system by plyometric training, PT produced greater gains on reactive jumps performance than APT.

Effects of velocity loss during resistance training on athletic performance, strength gains and muscle adaptations.

We compared the effects of two resistance training (RT) programs only differing in the repetition velocity loss allowed in each set: 20% (VL20) vs 40% (VL40) on muscle structural and functional adaptations. Twenty-two young males were randomly assigned to a VL20 (n = 12) or VL40 (n = 10) group. Subjects followed an 8-week velocity-based RT program using the squat exercise while monitoring repetition velocity. Pre- and post-training assessments included: magnetic resonance imaging, vastus lateralis biopsies for muscle cross-sectional area (CSA) and fiber type analyses, one-repetition maximum strength and full load-velocity squat profile, countermovement jump (CMJ), and 20-m sprint running. VL20 resulted in similar squat strength gains than VL40 and greater improvements in CMJ (9.5% vs 3.5%, P < 0.05), despite VL20 performing 40% fewer repetitions. Although both groups increased mean fiber CSA and whole quadriceps muscle volume, VL40 training elicited a greater hypertrophy of vastus lateralis and intermedius than VL20. Training resulted in a reduction of myosin heavy chain IIX percentage in VL40, whereas it was preserved in VL20. In conclusion, the progressive accumulation of muscle fatigue as indicated by a more pronounced repetition velocity loss appears as an important variable in the configuration of the resistance exercise stimulus as it influences functional and structural neuromuscular adaptations.

Effect of Low- vs. Moderate-Load Squat Training on Strength, Jump and Sprint Performance in Physically Active Women.

This study aimed to analyze the effects of resistance training (RT) load on neuromuscular performance. Twenty-seven physically active women were randomly distributed into 3 groups: a low-load group (LLG); a moderate-load group (MLG); and a control group (CG). The RT consisted of full squat exercise with a low load (40-60% 1RM, LLG) or a moderate load (65-80% 1RM, MLG). Sprint times (T10, T20, and T10-20), countermovement jump (CMJ), estimated one-repetition maximum (1RMest) and velocity attained against the first (FMPV) and the last load (LMPV) common to both tests were assessed pre- and post-test. Both experimental groups showed significant (P<0.05-0.001) improvements in all variables, except MLG for T10-20 and FMPV. The LLG achieved significantly (P<0.05-0.001) greater percent changes than CG in all variables except in T10 and T10-20, while MLG presented significantly (P<0.05-0.001) higher improvements than CG in T10, 1RMest and LMPV. The LLG presented a possibly better effect than MLG in T10-20, T20 and1RMest. In addition, LLG obtained a higher degree of transfer than MLG in all variables except in T10. These results suggest that a low-load training program produces similar or more beneficial effects on neuromuscular performance than moderate-load training.

Short-term Recovery Following Resistance Exercise Leading or not to Failure.

This study analyzed the time course of recovery following 2 resistance exercise protocols differing in level of effort: maximum (to failure) vs. half-maximum number of repetitions per set. 9 males performed 3 sets of 4 vs. 8 repetitions with their 80% 1RM load, 3×4(8) vs. 3×8(8), in the bench press and squat. Several time-points from 24 h pre- to 48 h post-exercise were established to assess the mechanical (countermovement jump height, CMJ; velocity against the 1 m·s(-1) load, V1-load), biochemical (testosterone, cortisol, GH, prolactin, IGF-1, CK) and heart rate variability (HRV) and complexity (HRC) response to exercise. 3×8(8) resulted in greater neuromuscular fatigue (higher reductions in repetition velocity and velocity against V1-load) than 3×4(8). CMJ remained reduced up to 48 h post-exercise following 3×8(8), whereas it was recovered after 6 h for 3×4(8). Significantly greater prolactin and IGF-1 levels were found for 3×8(8) vs. 3×4(8). Significant reductions in HRV and HRC were observed for 3×8(8) vs. 3×4(8) in the immediate recovery. Performing a half-maximum number of repetitions per set resulted in: 1) a stimulus of faster mean repetition velocities; 2) lower impairment of neuromuscular performance and faster recovery; 3) reduced hormonal response and muscle damage; and 4) lower reduction in HRV and HRC following exercise.

Effects of Combined Resistance Training and Plyometrics on Physical Performance in Young Soccer Players.

This study aimed to determine the effects of combined resistance training and plyometrics on physical performance in under-15 soccer players. One team (n=20) followed a 6-week resistance training program combined with plyometrics plus a soccer training program (STG), whereas another team (n=18) followed only the soccer training (CG). Strength training consisted of full squats with low load (45-60% 1RM) and low-volume (2-3 sets and 4-8 repetitions per set) combined with jumps and sprints twice a week. Sprint time in 10 and 20 m (T10, T20, T10-20), CMJ height, estimated one-repetition maximum (1RMest), average velocity attained against all loads common to pre- and post-tests (AV) and velocity developed against different absolute loads (MPV20, 30, 40 and 50) in full squat were selected as testing variables to evaluate the effects of the training program. STG experienced greater gains (P<0.05) in T20, CMJ, 1RMest, AV and MPV20, 30, 40 and 50 than CG. In addition, STG showed likely greater effects in T10 and T10-20 compared to CG. These results indicate that only 6 weeks of resistance training combined with plyometrics in addition to soccer training produce greater gains in physical performance than typical soccer training alone in young soccer players.

Effect of movement velocity during resistance training on neuromuscular performance.

This study aimed to compare the effect on neuromuscular performance of 2 isoinertial resistance training programs that differed only in actual repetition velocity: maximal intended (MaxV) vs. half-maximal (HalfV) concentric velocity. 21 resistance-trained young men were randomly assigned to a MaxV (n=10) or HalfV (n=11) group and trained for 6 weeks using the full squat exercise. A complementary study (n=8) described the acute metabolic and mechanical response to the protocols used. MaxV training resulted in a likely more beneficial effect than HalfV on squat performance: maximum strength (ES: 0.94 vs. 0.54), velocity developed against all (ES: 1.76 vs. 0.88), light (ES: 1.76 vs. 0.75) and heavy (ES: 2.03 vs. 1.64) loads common to pre- and post-tests, and CMJ height (ES: 0.63 vs. 0.15). The effect on 20-m sprint was unclear, however. Both groups attained the greatest improvements in squat performance at their training velocities. Movement velocity seemed to be of greater importance than time under tension for inducing strength adaptations. Slightly higher metabolic stress (blood lactate and ammonia) and CMJ height loss were found for MaxV vs. HalfV, while metabolite levels were low to moderate for both conditions. MaxV may provide a superior stimulus for inducing adaptations directed towards improving athletic performance.

Health questionnaire analysis and development of satisfaction questionnaire for patients treated with extracorporeal shock wave lithotripsy (SATISLIT). / Análisis de cuestionario de salud y desarrollo de cuestionario de satisfacción en pacientes tratados con litotricia extracorpórea por ondas de choque (SATISLIT).

INTRODUCTION: Due to the absence of specific instruments to study the psychosocial sphere of patients undergoing extracorporeal shock wave lithotripsy (SWL), the objective of this study is to develop a satisfaction questionnaire regarding the SWL treatment from a health questionnaire which was already designed and had been previously validated. MATERIAL AND METHODS: The design of the satisfaction questionnaire was carried out in 5 phases, based on a previously validated health scale in patients treated with SWL (ESPTL), including a total cohort of 135 patients treated at our center who received a phone interview. Phase 1: descriptive analysis of the series and scores of the 8 items of ESPTL. Phase 2: U-Mann Whitney comparison of ESPTL based on the patients' sex. Phase 3: study of ESPTL correlation with age using Spearman's Rho. Phase 4: grouping by factors of ESPTL, comparison by sex and correlation with age, as performed in phases 2 and 3 with the global score. Phase 5: obtaining the satisfaction subscale -SATISLIT-, descriptive analysis, comparison according to sex, correlation with age and linear regression model of SATISLIT with respect to ESPTL. RESULTS: 135 patients, 85(63%) men, 50(37%) women. Median (minimum-maximum) age 56 (27-79) and ESPTL score 31 (8-39). Differences in global ESPTL score between men and women (p <.001), as well as in items 1 (p =.029), 3 (p =.002), 6 (p =.006), 7 (p =.005) and 8 (p =.025). Non-significant correlation of ESPTL regarding age. Significant correlation in items 2, 4, 5 and 8 but, very weak (<0.2). 4 factors, each one with 2 items, with statistically significant differences regarding sex in F2 (p =.001), F3 (p =.007) and F4 (p =.001). Significant correlation with age only in F1 and F3, but very weak (<0.2). Median (minimum-maximum) SATISLIT 18 (4-20). Statistically significant differences regarding patients' sex (p =.001). Non- significant correlation with age (p =.836). Significant linear regression of SATISLIT with respect to ESPTL (p <.001). CONCLUSIONS: Based on validated health questionnaire, the present work has provided a new instrument called SATISLIT for assessing patients' satisfaction after treatment with SWL. Future studies with external and temporal validation will be necessary to contrast its real clinical usefulness.

Predicting the effectiveness of extracorporeal shock wave lithotripsy on urinary tract stones. Risk groups for accurate retreatment. / Predicción de efectividad de litotricia extracorpórea por ondas de choque en cálculos del tracto urinario. Grupos de riesgo para precisar retratamiento.

INTRODUCTION: Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive, safe and effective treatment for urinary tract lithiasis. Its effectiveness varies depending on the location and size of the stones as well as other factors; several sessions are occasionally required. The objective is to attempt to predict its success or failure, when the influential variables are known beforehand. MATERIAL AND METHODS: We analysed 211 patients who had had previous CT scans and were treated with ESWL between 2010 and 2014. The influential variables in requiring retreatment were studied using binary logistic regression models (univariate and multivariate analysis): maximum density, maximum diameter, area, location, disintegration and distance from the adipose panniculus. With the influential variables, a risk model was designed by assessing all possible combinations with logistic regression (version 20.0 IBM SPSS). RESULTS: The independent influential variables on the need for retreatment are: maximum density >864HU, maximum diameter >7.5mm and pyelocaliceal location. Using these variables, the best model includes 3risk groups with a probability of requiring significantly different retreatment: group 1-low risk (0 variables) with 20.2%; group 2-intermediate risk (1-2 variables) with 49.2%; and group 3-high risk (3 variables) with 62.5%. CONCLUSIONS: The density, maximum diameter and pyelocaliceal location of the stones are determinant factors in terms of the effectiveness of treatment with ESWL. Using these variables, which can be obtained in advance of deciding on a treatment, the designed risk model provides a precise approach in choosing the most appropriate treatment for each particular case.

Widespread expression of rat collapsin response-mediated protein 4 in the telencephalon and other areas of the adult rat central nervous system.

The rat collapsin response-mediated protein 4 (rCRMP-4) is a member of a family of proteins that are involved in axonal growth. It is found transiently in postmitotic neurons, such as those that are generated in the adult hippocampus. The authors used immunocytochemistry to investigate whether areas of the rat central nervous system (CNS) that retain postnatal neurogenesis express this protein. They found pronounced rCRMP-4 immunoreactivity in recently generated cells in the dentate granular layer, the subventricular zone, the olfactory bulbs, and the rostral migratory stream, four areas in which the production or migration of neurons occurs in adulthood. However, rCRMP-4 immunoreactivity also is expressed in many other regions of the rat brain in which there is no record of adult neurogenesis or neuronal migration, e.g., in the olfactory glomeruli and in neurons of the cerebral cortex. In the hypothalamus, intensely rCRMP-4-labeled neurons populated the supraoptic, paraventricular, and periventricular nuclei as well as the median eminence and the arcuate nucleus. Immunoreactivity for rCRMP-4 also was present in certain neurons of the interpeduncular nucleus, median raphe, superior colliculus, and scattered granule cerebellar neurons. Many of these regions are known to display axonal outgrowth and/or synaptic rearrangement in adulthood and to coexpress the polysialylated form of the neural cell adhesion molecule. Thus, the results of this study suggest that rCRMP-4 expression in the CNS is associated with cells that are migrating or are undergoing axonal growth. Nevertheless, small, rCRMP-4-immunoreactive cells were seen throughout the brain. These cells did not express neuronal, astroglial, or microglial markers, although some of them also were immunoreactive for rip antibody, suggesting an oligodendroglial lineage.

Spatiotemporal distribution of gp130 cytokines and their receptors after status epilepticus: comparison with neuronal degeneration and microglial activation.

Although numerous studies have demonstrated the neurotrophic capacity of gp130 cytokines, it remains unclear whether endogenously expressed cytokines actually function in a direct neuromodulatory manner. Therefore, using the lithium-pilocarpine status epilepticus model, we performed a detailed in situ hybridization time-course study of five gp130 cytokines (interleukin [IL]-6, leukemia inhibitory factor [LIF], IL-11, oncostatin-m [OSM], and ciliary neurotrophic factor), gp130, and the receptors of the cytokines we found to be induced (IL-6 receptor [IL-6R], LIF receptor [LIF-R], and IL-11 receptor [IL-11R]). Additionally, to further understand the regulation of these cytokines, we compared their expression with the pattern of neuronal degeneration and microglial activation. Under control conditions, all cytokines, except LIF, exhibited faint to moderate expression in hippocampal principal layers. After seizure, IL-6, LIF, and IL-11 exhibited a rapid, robust, and transient upregulation in non-principal cells. LIF also exhibited a remarkably early and transient induction in the granule cell layer of the dentate gyrus. OSM exhibited only a mild and inconsistent induction. All receptors examined were strongly expressed only in hippocampal principal layers under control conditions. A mild and late induction of the IL-6R, LIF-R, and IL-11R occurred after seizure with a scattered distribution. A progressive and chronic induction of gp130 was observed in cells that appeared to be associated with blood vessels. Degeneration of hilar interneurons and CA1 pyramidal cells was early and progressive. Granule neurons of the dentate gyrus, however, exhibited a delayed and precipitous pattern of degeneration, specifically in the lateral portion of the superior blade. Microglial activation was maximal 24-48 h post-seizure. We speculate that gp130 cytokines play a paracrine, neuromodulatory role in the hippocampus since both before and after seizure, principal cells appear to be the major cell type expressing the receptors for these cytokines. Furthermore, we suggest that activity-dependent mechanisms may be involved in the regulation of cytokines expressed early, and that relatively late occurring cytokine expression may be elicited by injury-related stimuli.

Differential expression of suppressors of cytokine signaling-1, -2, and -3 in the rat hippocampus after seizure: implications for neuromodulation by gp130 cytokines.

Numerous studies have investigated the expression of various cytokine families in the CNS after brain injury. The gp130 or interleukin (IL)-6-type cytokines have received a great deal of focus, and it is clear that they exhibit an acute and robust upregulation in various brain injury models. We are interested to determine, however, whether endogenously expressed cytokines in the CNS act in a direct neuromodulatory manner. In an accompanying study, we examined the expression of five gp130 cytokines and their receptors in the lithium-pilocarpine model of status epilepticus. We follow up that study here by trying to determine if gp130 signal transduction occurs in hippocampal principal neurons after seizure. Therefore, using the expression of suppressors of cytokine signaling (SOCS)-1 and -3 as indices of gp130 signal transduction, we performed a detailed in situ hybridization seizure time-course study in the adult rat hippocampus. For comparison, we also examined SOCS-2, which is involved in insulin-like growth factor signaling. We found that while SOCS-1 and -3 were faintly expressed under basal conditions, only SOCS-3 exhibited a rapid, robust, and transient induction. This occurred first in non-principal cells, which appeared to be glial, peaking at approximately 12 h post-seizure. Subsequently, a robust induction of SOCS-3 occurred in pyramidal and granule neurons, peaking at approximately 24 h. SOCS-2 displayed a relatively higher level of basal expression, particularly in CA3, and a mild and transient downregulation by 24 h. These findings corroborate the hypothesis that seizure-induced gp130 cytokines play a direct neuromodulatory role in the hippocampus. Since in our previous study we did not detect cytokine receptor expression in non-principal cells, it is unclear what elicits SOCS-3 expression in this population.

Region specific increases in oxidative stress and superoxide dismutase in the hippocampus of diabetic rats subjected to stress.

Oxidative stress and modulation of anti-oxidant enzymes may contribute to the deleterious consequences of diabetes mellitus and to the effects of chronic (i.e. 21 day) stress in the CNS. We therefore compared the effects of short- and long-term exposure to diabetes-induced hyperglycemia, restraint stress and the combined effects of restraint stress and diabetes upon parameters of oxidative stress in the rat hippocampus. Whereas 7 days of restraint stress or hyperglycemia, or the combination, produced similar increases in oxidative stress markers 4-hydroxy-2-nonenal (HNE) and malondialdehyde (MDA) throughout the hippocampus, 21 days of stress or hyperglycemia did not increase these markers in the dentate gyrus. In contrast, Ammon's horn still showed elevated levels of these lipid peroxidation products, especially in diabetic rats subjected to 21 days of restraint stress. The expression of two anti-oxidant enzymes, copper/zinc superoxide dismutase (Cu/Zn-SOD) and manganese SOD, was also differentially regulated by stress and hyperglycemia in a time- and region-specific manner in the rat hippocampus. Although long-term stress decreased both SOD isoforms, diabetes increased Cu/Zn-SOD expression in DG with or without 21 days of repeated stress. These increases may account for the finding that protein-conjugated HNE and MDA levels returned to control levels between 7 days and 21 days of hyperglycemia or the combination of diabetes and stress. These results suggest that while other anti-oxidant pathways may account for decreases in oxidative stress in the long-term stress paradigm, increases in Cu/Zn-SOD expression may contribute to the region-specific attenuation of oxidative stress in the diabetic rat hippocampus.

Expression of adrenomedullin and proadrenomedullin N-terminal 20 peptide in human and rat prostate.

Adrenomedullin (AM) and proadrenomedullin N-terminal 20 peptide (PAMP) are two recently discovered hypotensive peptides translated from the same message transcript (preproAM mRNA). In this article we report the presence of AM, PAMP, and their mRNA in human and rat prostate and of AM receptor mRNA in rat prostate. PreproAM mRNA was found in the epithelium of normal human and rat prostate glands by in situ hybridization. In humans, it was mainly expressed in the basal cells. In rat, its expression was higher in the ducts than in the acini of all the prostate lobes. Immunocytochemistry identified a similar distribution pattern for AM compared with its mRNA but showed different locations for AM and PAMP immunoreactivity. The former was widespread in the epithelia, whereas the latter was almost exclusively found in neuroendocrine cells. In rat, Western blot analysis confirmed the presence of high levels of AM peptide in the ventral lobe and of its precursor in the ventral and dorsolateral lobes. Immunoreactivity for serotonin, chromogranin A, PAMP, and AM defined four subpopulations of prostate neuroendocrine-like cells in rat, a cell type that has not been previously described.

Phylogenetic Relationships within the Excavating Hadromerida (Porifera), with a Systematic Revision.

This study was performed to ascertain the relationships among clionid and spirastrellid species from the Mediterranean Sea, based on phylogenetic criteria. A matrix of 34 taxa and 20 characters was analysed. Cladistic analysis using PAUP produced 12 equally parsimonious trees of 54 steps (CI=0.648, RI=0.865). Resolution was high in all parts of the strict consensus tree except in those which involved relationships among the most characteristic clionid species: those having only tylostyles as megascleres and, if microscleres are present, these being spirasters. Six monophyletic groups, three of them represented by monospecific clades, appear in the totally resolved part of the trees, which supports their separation into different genera. On the basis of the results obtained, the species at present within the genus Cliona have been allocated to five different genera:Scantilletta, Pione, Volzia, Bernatia and Cliona, while Dotona and Cliothosa are maintained as separate genera.Scantilletta and Pione are genera erected by de Laubenfels (1936 Pap. Tortugas Lab. 30, 1-225) and Gray (1867 Proc. Zool. Soc. Lond. XXXII , 492-558) respectively, and whose diagnoses are amended here.Volzia and Bernatia are proposed as new genera to include Cliona albicans and Cliona rovignensis, and Cliona vermifera, respectively. Thus, the genus Cliona clearly appears in our analysis as a polyphyletic group. It is only maintained provisionally to harbour species whose position cannot be clearly ascertained from the information at hand. Skeletal characters such as spicule types and skeletal arrangement have proven to be useful in discriminating some genera and families but they do not completely resolve the phylogeny of this group of species. Biochemical, genetic, cytological or reproductive information, when available, may help in the resolution of the phylogenetic tree.

[Urologic complications in 237 recipients of cadaveric kidney transplantation]. / Complicaciones urológicas en 237 receptores de trasplante renal cadavérico.

We describe the urological complications occurred in 237 patients undergoing cadaveric renal transplant in 13 years. Two techniques of extravesical ureterocystoneostomy were used. Thirty patients (13%) presented 35 (15%) urological complications: 23 (9.7%) urinary fistula and 12 (5.1%) ureteral stenosis. The vast majority (80%) were early complications (before 90 days): 82% fistulas and 18% stenosis. All early complications were identified as technical deficiencies; all late complications were obstructive in nature. A new ureteral reimplant was performed in 15 patients, with successful results in 14. Six patients underwent nephrectomy and pyelostomy, 2 of these required a second operation. Seven patients underwent endo-urological procedures with good results. Three patients undergoing conservative treatment for urinary fistula required surgical drainage of an infected urinoma. No statistical difference was observed in the survival rates of both the grafts and the patients presenting or not urinary complications.

[Prognostic value of the tissue expression of human chorionic gonadotropin (beta-HCG) in infiltrating transitional carcinoma of the bladder]. / Valor pronóstico de la expresión tisular de gonadotrofina coriónica humana (beta-HCG) en el carcinoma transicional infiltrante de vejiga.

Study of the ectopic secretion of Human Chorionic Gonadotrophin (beta-HCG) in the tumoral tissue of 62 patients diagnosed with infiltrant transitional carcinoma of the bladder. The inmunohistochemical tests showed specific stains in 15/62 patients. Bi-varied analysis showed that vesical tumours with beta-HCG ectopic expression present associated nodular disease with a significantly higher prevalence (p = 0.02). Survival of patients with beta-HCG+ tumours was overall lower that of patients with beta-HCG-tumours, but this difference did not reach statistical significance. Multivariate analysis of survival showed no prognostic value for the tissue expression of beta-HCG, when it is considered as an isolated variable. Complete local response was seen in 5/6 beta-HCG+ patients treated with pre-operative chemo and radiotherapy and in 1/4 patients treated with pre-operative radiotherapy. Tissular expression of beta-HCG is a poor prognostic factor due to its relationship with another 2 variables of larger predictive capability: the presence of metastatic nodular disease and the infiltration of venous and/or lymphatic structures of the vesical wall.

[Multivariate analysis of local response to preoperative treatment in patients with infiltrating carcinoma of the bladder]. / Análisis multivariado de la respuesta local al tratamiento preoperatorio en pacientes con carcinoma infiltrante de vejiga.

The article presents a multivariate study carried out by means of a logistic regression of local responses (reduction to stage p0, p1 or p 'in situ') in 82 patients with transitional infiltrant carcinoma of the bladder, undergoing 3 different types of radical therapy: 25 patients treated with TUR and radical cystectomy; 33 patients treated with TUR, pre-operative radiotherapy (45-60 Gy) and radical cystectomy; and 24 patients treated with TUR, intra-operative radiotherapy (15 Gy), external radiotherapy (46 Gy), neo-adjuvant chemotherapy and radical cystectomy. Local response increased with the intensity of pre-operative therapy, there being a better relationship with this approach than with the initial clinical stage of the tumour. The factors which better explain the prospect of an objective local response are the use of radiotherapy associated to chemotherapy and the absence of metastatic lymphatic nodes. These 2 variables can adequately predict the local response in 87% of patients.

[Shockwave cytotoxicity on neoplastic and non-neoplastic cells]. / Evaluación de la citotoxicidad de las ondas de choque sobre células tumorales y no tumorales.

Since initial application of high-energy shockwaves to treat renal lithiasis, their usefulness has been extended within both the clinical and experimental fields. Shockwaves cytotoxic action is determined by means of cell viability methods of vital staining exclusion and nucleoside uptake. Application of shockwaves on cell cultures is carried out by means of an electromagnetic lithotripter. High-energy shockwaves have had cytotoxic action both on non-tumoral and tumoral cells, during "in vitro" experiments. The cytotoxicity produced by the shockwaves, however, is different in tumoral and non-tumoral cells, the viability inhibition being higher in tumoral cells.

[Inhibition of tumor cell growth by the action of high-energy sources]. / Inhibición del crecimento celular tumoral por acción de las fuentes de alta energía.

In vitro comparison of the cytotoxic action of high-energy shockwave and megavoltage radiotherapy on tumoral cells. The inhibitory action these two therapeutic approaches have on cell viability is determined both singly and jointly, through life staining exclusion and nucleoside uptake tests. High energy shockwaves have a cytotoxic action significantly greater than low- and medium-energy levels of megavoltage radiation. The cytotoxic effect from megavoltage radiation is significantly greater than that resulting from high levels of high-energy shockwave as shown by the life staining exclusion tests. However, the nucleoside uptake test shows that cytotoxicity from either type of energy is no significantly different. When measuring the cumulative cytotoxic action of high energy shockwaves plus megavoltage radiation, the level of cytotoxicity is greater than the individual inhibitory actions on cell viability, but the degree of cytotoxicity induced cannot be comparable to that produced by higher energy levels from both sources separately.