Infrastructure and equipment for radiation oncology in the Spanish National Health System: analysis of external beam radiotherapy 2015-2020.

PURPOSE: Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS). MATERIALS AND METHODS: The Sociedad Española de Oncología Radioterápica (SEOR) performed a cross-sectional survey of all Spanish radiation oncology services (ROS) in 2015. We collected data on SNHS radiotherapy units, recording the year of installation, specific features of linear accelerators (LINACs) and other treatment units, and radiotherapeutic techniques implemented by region. Any machine over 10 years old or lacking a multileaf collimator or portal imaging system was considered obsolete. We performed a k-means clustering analysis using the Hartigan-Wong method to test associations between the gross domestic regional product (GDRP), the number of LINACs per million population and the percentage of LINACs over 10 years old. RESULTS: The SNHS controls 72 (61%) of the 118 Spanish ROS and has 180 LINACs, or 72.5% of the total public and private resources. The mean rate of LINACs per million population is 3.9 for public ROS, and 42% (n = 75) of the public accelerators were obsolete in 2015: 61 due to age and 14 due to technological capability. There was considerable regional variation in terms of the number and technological capacity of radiotherapy units; correlation between GRDP and resource availability was moderate. CONCLUSION: Despite improvements, new investments are still needed to replace obsolete units and increase access to modern radiotherapy. Regular analysis of ROS in each Spanish region is the only strategy for monitoring progress in radiotherapy capacity.

Comparative study of in-situ cell death induced by the viruses of viral haemorrhagic septicaemia (VHS) and infectious pancreatic necrosis (IPN) in rainbow trout.

The causative viruses of two diseases of rainbow trout, viral haemorrhagic septicaemia (VHS) and infectious pancreatic necrosis (IPN), exert much of their cytopathogenic effect in cell culture through the induction of apoptosis. In the present study, the TUNEL procedure was used to investigate the presence of apoptotic cells in different organs of rainbow trout infected with the viruses of VHS and IPN. VHS viral infection resulted in massive apoptosis in renal lymphoid tissue, where viral antigens were also detected. Large numbers of viral particles were observed in close proximity to apoptotic cells. Apoptosis was not detected in excretory cells of the renal tubules or in infected muscle cells. IPN virus did not induce apoptosis in the pancreas. However, the DNA degradation associated with apoptotic nuclei was observed in muscle lesions. Taken together, these results indicated that induction of apoptosis in vivo was critically influenced by the species of virus and the cell type. Moreover, it would seem likely that apoptosis contributed to the nature of the two diseases and to mortality.

Pathogenesis of viral haemorrhagic septicaemia virus: cellular aspects.

Leucocyte populations from rainbow trout subjected to experimental viral haemorrhagic septicaemia virus (VHSV) infections under in vivo and in vitro conditions were analysed by flow cytometry. Quantitative analysis shows that only a low percentage of the leucocytes support viral replication. Lymphocytes, compared with monocytes granulocytes and macrophages, are the least susceptible sub-population. A decrease in the amount of the phagocytic activity was observed after the cells were infected with VHSV. Obvious modifications were observed through dot plot profiles in the composition of the cell sub-populations and in the cell morphology. In addition to a direct effect of VHSV on the macrophages, a systemic effect is produced. This could also be related to the stress induced by the experimental infection process.

Comparative development of two microsporidian species: Enterocytozoon bieneusi and Enterocytozoon salmonis, reported in AIDS patients and salmonid fish, respectively.

Enterocytozoon bieneusi and Enterocytozoon salmonis are reported in HIV-infected patients and in salmonid fish, respectively. Both species share the early development of the extrusion apparatus of the spores, which is completed prior to fission of the sporogonic syncytium into sporoblasts, and the early synthesis of polar tube constituents, but they differ in other developmental and sporogenetic processes. Enterocytozoon bieneusi develops in direct contact with the cytoplasm of epithelial cells whereas E. salmonis occurs only in the nucleus of leucocytes and epithelioid cells. Sporogonic nuclei, which are scattered throughout the sporont in E. bieneusi, are located in the periphery in E. salmonis. The multilamellar structures associated with the nuclear envelopes and the endoplasmic reticulum cisternae are specific for E. bieneusi. Additionally, the evolution of the polar tube precursors proceeds differently in the two parasites. In E. bieneusi, they transform into electron-dense bodies associated with a reticulum and polar tubes derive from these structures according to a process similar to that reported in other microsporidia. In E. salmonis, polar tube precursors fuse directly at their ends and the polar tubes appear to be formed by the assemblage of these fused precursors with a material previously synthesized in the vicinity of nuclei. In conclusion, both species appear to be less closely related than was supposed in earlier descriptions.