A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia.

BACKGROUND: Convalescent plasma is frequently administered to patients with Covid-19 and has been reported, largely on the basis of observational data, to improve clinical outcomes. Minimal data are available from adequately powered randomized, controlled trials. METHODS: We randomly assigned hospitalized adult patients with severe Covid-19 pneumonia in a 2:1 ratio to receive convalescent plasma or placebo. The primary outcome was the patient's clinical status 30 days after the intervention, as measured on a six-point ordinal scale ranging from total recovery to death. RESULTS: A total of 228 patients were assigned to receive convalescent plasma and 105 to receive placebo. The median time from the onset of symptoms to enrollment in the trial was 8 days (interquartile range, 5 to 10), and hypoxemia was the most frequent severity criterion for enrollment. The infused convalescent plasma had a median titer of 1:3200 of total SARS-CoV-2 antibodies (interquartile range, 1:800 to 1:3200). No patients were lost to follow-up. At day 30 day, no significant difference was noted between the convalescent plasma group and the placebo group in the distribution of clinical outcomes according to the ordinal scale (odds ratio, 0.83; 95% confidence interval [CI], 0.52 to 1.35; P = 0.46). Overall mortality was 10.96% in the convalescent plasma group and 11.43% in the placebo group, for a risk difference of -0.46 percentage points (95% CI, -7.8 to 6.8). Total SARS-CoV-2 antibody titers tended to be higher in the convalescent plasma group at day 2 after the intervention. Adverse events and serious adverse events were similar in the two groups. CONCLUSIONS: No significant differences were observed in clinical status or overall mortality between patients treated with convalescent plasma and those who received placebo. (PlasmAr ClinicalTrials.gov number, NCT04383535.).

Effects of a Pilates programme in spinal curvatures and hamstring extensibility in adolescents with thoracic hyperkyphosis: a randomised controlled trial.

AIM: To evaluate the effects of a 9-month Pilates exercise programme on the sagittal spinal posture and hamstring extensibility of adolescents with thoracic hyperkyphosis. DESIGN: Randomised controlled trial with blinded examiner. PATIENTS: One-hundred and three adolescents with thoracic hyperkyphosis. INTERVENTIONS: Participants were randomly placed into an experimental group which participated in a Pilates exercise programme implemented for a total of 38 weeks (two sessions/week, 15 min/session) (Pilates group (PG), sample = 49, or control group (CG), sample = 48). MAIN OUTCOME MEASURES: The outcome measures were the thoracic curve in sagittal spinal curvature in relaxed standing, sagittal spinal curvatures and pelvic tilt in relaxed standing and sit-and-reach positions, and hamstring extensibility. RESULTS: There was a significant adjusted mean difference between groups in favour of the PG in the thoracic curve in relaxed standing position (-5.6°, p = 0.003), pelvic tilt (-2.9°, p = 0.03) and all straight leg tests (p<0.001). The PG showed a significant change in thoracic curve (-5.9, p<0.001) and in lumbar angle (4.0, p = 0.001) in relaxed standing position and in all straight leg raise tests (+6.4 to +15°, p<0.0001). CONCLUSIONS: The adolescents with thoracic hyperkyphosis from the PG had a decreased thoracic kyphosis in relaxed standing position, and improved hamstring extensibility as compared with the CG. More than 50% of the participants obtained kyphosis values inside normality, showing an adjusted mean difference between groups in the thoracic curve of about 73% of the baseline mean, resulting in a large improvement and high clinical importance. TRIAL REGISTRATION NUMBER: NCT03831867.

Splenic rupture after colonoscopy for colorectal cancer screening.

Colonoscopy is a frequently used procedure in our environment for the diagnosis, treatment and even prevention of colorectal cancer. Despite being a routine procedure, it is not exempt from possible complications. Bleeding and perforation are the main ones, with splenic rupture being extremely infrequent as well as one of the most serious complications derived from performing a colonoscopy. We present a patient with splenic rupture secondary to colorectal cancer screening colonoscopy who required urgent surgery for acute hemorrhagic shock.

COVID-19 and Social Isolation: A Case for Why Home-Based Resistance Training Is Needed to Maintain Musculoskeletal and Psychosocial Health for Older Adults.

The coronavirus disease outbreak in China has become the world's leading health headline and is causing major panic and public concerns. Public health guidelines in many countries are suggesting that people stay at home to avoid human-to-human transmission of the virus, which may lead to reduced physical activity and greater feelings of isolation. Such effects may be particularly problematic in older adults due to their reduced physical capacities and their potential for increased mental health issues, such as anxiety and depression. A potential way to minimize many of these side effects of stay-at-home guidelines may be progressive home-based resistance training. A simple way to provide progressive overload in home-based resistance training may involve elastic resistance, which has been demonstrated to provide similar benefits to traditional resistance training equipment typically found in gymnasiums. Recommendations on how older adults can safely and effectively perform elastic resistance training at home are provided.

Fin type and flutter technique: a study to optimise the oxygen consumption in divers.

The purpose of this research was to assess the variability of the oxygen consumption (VO2) depending on fin type and the flutter technique used for the different divers' profile. Twenty-three SCUBA divers took part in four 2.5 hour sessions to evaluate a total of six fin models and two flutter techniques. The flutter routines lasted 30 minutes per fin and per technique. Measurements of VO2 significantly decreased on Jet (20.42 ml*min-1*kg-1) and XShot fin (20.87 ml*min-1*kg-1) compared to Twin Jet fin (22.81 ml, p < 0.05). In addition, the VO2 was in all cases higher in certified divers than in professional divers (23.87 and 19.00 ml*min-1*kg-1, p = 0.00). These differences were significant between divers' profile and flutter technique (p < 0.05). Similarly, measurements of VO2 were higher in frog kick technique than crawl kick technique (22.97 ml*min-1*kg-1 and 19.96 ml*min-1*kg-1, p = 0.00). These differences were significant between fin type and flutter technique in all fins (p = 0.03). Practitioner summary: This study investigated the impact of fin type, flutter technique and divers' profile on VO2 during diving. Results of this research suggest that combination a diving different factors significantly impacts the divers' VO2, thus providing new perspective for election of fin type and flutter technique according to the divers' profile.

Enantioselective Synthesis of 5-Trifluoromethyl-2-oxazolines under Dual Silver/Organocatalysis.

The first enantioselective formal [3 + 2] cycloaddition between α-isocyanoesters and trifluoromethylketones to give 5-trifluoromethyl-2-oxazolines bearing two contiguous stereogenic centers, one of them being a quaternary stereocenter substituted with a CF3 group, has been developed. The reaction is based upon a multicatalytic approach that combines a bifunctional Brønsted base-squaramide organocatalyst and Ag+ as Lewis acid. The reaction could be achieved with a range of aryl and heteroaryl trifluoromethyl ketones, and the resulting oxazolines were obtained with good to excellent diastereo- and enantioselectivity.

Mediterranean Diet in Older Irish Adults: Prevalence, Patterns, Predictors and Pertinence.

The Mediterranean diet (MD) shows the strongest evidence in support of healthy aging and prevention of age-related diseases. It is associated with a decreased risk of chronic disease, such as cardiovascular disease, obesity, hypertension, diabetes mellitus and cognitive disease. Given the health-promoting aspects of this diet, we conducted a secondary analysis of data from the LifeAge study ("Promoting the shift: sedentary Lifestyle towards active Ageing-LifeAge" Project No 603121-EPP-1-2018-1-ES-SPO-SCP) with the primary aim to determine the proportion of older Irish adults adhering to the MD and to examine the association between adherence to the MD (assessed using the Mediterranean Diet Adherence Screener (MEDAS) scoring tool) and anthropometric risk factors of non-communicable diseases. Of the 131 eligible participants (71.8% female, n = 94) (medically well, aged > 50 years and physically independent) (mean age = 66.2 ± 6.5 years), the mean cumulative MD score across the cohort was 5.8 ± 2.2, with 41% classified as moderate-to-high MD adherers (scoring > 7 MEDAS). Females had a significantly higher score compared to males (female 6.24 ± 1.98; male 4.86 ± 2.53; p = 0.002). Age (y), waist circumference (cm) and waist-hip ratio (WHR) each had a significant (p < 0.05) weak and negative correlation with MD score (r = -0.193, -0.240, -0.284, respectively). Visceral fat level had a significant (p < 0.05) moderate and negative correlation with MD score (r = -0.327). This analysis is the first to assess adherence to the MD in older Irish adults. MD adherence was lower in the Irish older cohort than that reported in older adults in Mediterranean regions and was adhered to more by females and those with a more favourable anthropometric profile. The health-promoting aspects of the diet are evident in non-Mediterranean regions as is demonstrated by the lesser incidence of some non-communicable diseases in moderate-to-high adherers. With the evidence of the protective effects of the MD, external to Mediterranean regions, it would be helpful to establish limitations to adherence, especially in aging populations living in non-Mediterranean regions.

Synthesis of Benzoic Acids from Electrochemically Reduced CO2 Using Heterogeneous Catalysts.

A method for the synthesis of benzoic acids from aryl iodides using two of the most abundant and sustainable feedstocks, carbon dioxide (CO2) and water, is disclosed. Central to this method is an effective and selective electrochemical reduction of CO2 to CO, which mitigates unwanted dehalogenation reactions occurring when H2 is produced via the hydrogen evolution reaction (HER). In a 3-compartment set-up, CO2 was reduced to CO electrochemically by using a surface-modified silver electrode in aqueous electrolyte. The ex-situ generated CO further underwent hydroxycarbonylation of aryl iodides by MOF-supported palladium catalyst in excellent yields at room temperature. The method avoids the direct handling of hazardous CO gas and gives a wide range of benzoic acid derivatives. Both components of the tandem system can be recycled for several consecutive runs while keeping a high catalytic activity.

The Effect of Resistance Training with Outdoor Fitness Equipment on the Body Composition, Physical Fitness, and Physical Health of Middle-Aged and Older Adults: A Randomized Controlled Trial.

This study examined the effect of outdoor-fitness-equipment-based resistance training on the health parameters of middle-aged and older adults, as well as analyzing the effect of age on the results found. A total of 149 volunteers were randomly assigned to the training (TG) and control (CG) groups. The TG performed two weekly sessions of resistance training for 8 weeks using outdoor fitness equipment, while the CG continued with their regular daily activities. Body composition was measured using DXA, and the maximal isometric voluntary contraction in knee extension, elbow flexion, and hand grip were assessed, along with the 4 m walk test, the Timed Up and Go Test, and the Short Form 36 Health Survey Questionnaire. The TG showed a significant increase in the lean mass index (p = 0.002) and maximal isometric voluntary contraction in both legs (p < 0.001) and arms (p < 0.001), as well as in physical functioning (p < 0.001) and the role physical dimension (p = 0.006) of the Short Form 36 Health Survey Questionnaire, compared to the CG, which showed a decrease in all these variables. In addition, the TG showed a greater decrease in fat mass (p < 0.001), fat mass index (p = 0.003), and the Timed Up and Go Test (p < 0.001) than the CG. Age conditioned the evolution of most of the variables analyzed (p < 0.05). In conclusion, resistance training with outdoor fitness equipment may be useful for improving the health of middle-aged and older adults, although age is a factor that could influence the adaptations found.

Brain functional training: a perspective article.

Introduction: Physical exercise (PE) positively affects the nervous system, impacting morphology and physiology. It increases brain gray and white matter, improves cerebral blood flow, and stimulates neurogenesis, synaptogenesis, and angiogenesis, promoting brain function. Although exercise already affects cognition, some training modalities place greater demands on the cognitive aspects of physical exercise, such as perceptual-motor and visual-motor training. This type of approach aims to emphasize the cognitive adaptations that occur chronically. Specifically for older people, functional training, a multi-component approach, is a promising exercise modality that stimulates functionality using multi-joint, multi-planar exercises mirroring daily activities. However, applying a greater focus on cognitive adaptations in line with the functional training proposal for maximal benefits remains underexplored. Aim: Thus, this perspective article initially explores different exercise approaches emphasizing cognitive adaptations and proposes Brain Functional Training to improve older adult's functionality. Methods: Furthermore, we explain how brain functional training can be explored to emphasize cognitive aspects based on increasing complexity to stimulate the executive function and its subdomains. Conclusion: This proposal is one alternative to combining motor and cognitive stimuli to promote autonomy and health in older people.

Sarcopenic obesity does not impair lower limb strength and physical performance in sufficiently active older adults: a cross-sectional study.

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study.

OBJECTIVE: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. METHOD: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. RESULTS: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. CONCLUSION: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Low handgrip strength is associated with falls after the age of 50: findings from the Brazilian longitudinal study of aging (ELSI-Brazil).

AIM: This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. METHODS: This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. RESULTS: A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables. CONCLUSIONS: Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s.

Evaluation of the effects of a gamified, fully immersive and stroke-specific virtual reality intervention for improving disability and quality of life in patients with stroke in the subacute phase: study protocol of the RESET randomised trial.

Stroke is the leading cause of disability and the second cause of death worldwide. The increasing burden of stroke underscores the importance of optimising rehabilitation protocols. Virtual reality (VR) can improve poststroke prognosis. A VR software combining gamification, full immersion and stroke specificity (ie, the Development and validation of a novel viRtual rEality software for improving diSability and quality of lifE in patients with sTroke (RESET) software) might substantially improve disability and quality of life (QoL). However, this technology is still very scarce. The RESET trial aims to assess the effects of an early 10-week gamified, fully immersive and stroke-specific VR intervention (ie, starting at week 3 poststroke) on disability and QoL in people with stroke in the subacute phase. People with ischaemic or haemorrhagic stroke (n=94) aged ≥ 18 years will be randomised to receive (1) usual care (UC), (2) commercial VR or (3) gamified, fully immersive and stroke-specific VR (RESET). The three groups will receive UC (ie, three sessions/week of 90 min of standard rehabilitation). The VR groups will additionally receive three VR sessions of 20 min per week. The outcome measures will be assessed at baseline (week 2 from stroke occurrence), week 13 (approximately 90 days from the event) and week 26 (approximately 6 months from the event). The primary outcome is disability measured with the Barthel Index. Secondary outcomes include QoL, upper-extremity and lower-extremity motor function, gross manual dexterity, handgrip strength and cognitive function. This study will unravel the effects of a gamified, fully immersive and stroke-specific VR software on disability and QoL in patients with stroke in the early subacute phase.Trial registration number: NCT06132399.

Optimizing outdoor fitness equipment training for older adults: Benefits and future directions for healthy aging.

Regular physical activity is vital for the health and disease prevention of older adults. Outdoor fitness equipment has gained popularity for natural exercise spaces among middle-aged and older individuals. This narrative review demonstrates that these programs have the potential to improve cardiovascular health, muscle strength, flexibility, balance, and reduce falls, while also enhancing quality of life, alleviating depression and anxiety, and boosting self-esteem. However, our understanding is hindered by limited rigorous experimental studies. Future directions include implementing standardized measurements, conducting long-term studies, and addressing equipment limitations to enable better adjustment of training intensity and promote correct postures on machines. New, more rigorous research is needed to comprehensively understand the psychophysiological and social effects on health. Additionally, suggested modifications could render the machines more effective and safer. The primary objective is to enhance this type of machinery to encourage its use in outdoor spaces, thus aiding adults and older individuals in achieving overall health and enjoying a healthy aging process.

Synthesis of α,α-Diaryl-α-amino Acid Precursors by Reaction of Isocyanoacetate Esters with o-Quinone Diimides.

A novel procedure for the synthesis of α,α-diaryl-α-amino acid derivatives has been developed. Silver oxide catalyzes the conjugate addition of α-aryl isocyanoacetates to o-quinone diimide, affording the corresponding α,α-diarylisocyano esters in excellent yields and regioselectivities in short reaction times. Acid hydrolysis of the isocyano group provides the corresponding amino acids bearing a diarylated tetrasubstituted carbon atom. The reaction is also amenable to the synthesis of α-alkyl-α-arylisocyano esters, while the reaction with 3-hydroxy o-quinone diimides provides 4H-benzo[e][1,3]oxazines via a conjugate addition/cyclization process.

GDLAM and SPPB batteries for screening sarcopenia in community-dwelling Spanish older adults: Healthy-age network study.

OBJECTIVES: To determine the diagnostic ability of GDLAM and SPPB batteries to classify people with sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP19). STUDY DESIGN: This cross-sectional study recruited 584 participants (240 men, 65.33 ± 8.68 years old). The diagnostic criteria of the EWGSOP19 for probable, confirmed and severe sarcopenia were used as the standard. Then, the Latin American Group for Maturity battery-GDLAM- and the short physical performance battery-SPPB- were measured. The ability as screening methods of these two batteries were determined by specific indicators including sensitivity, specificity, receiver operating characteristic (ROC) curve, and area under the ROC curves (AUC). MAIN OUTCOME MEASURES: Anthropometric variables (Body mass, height, triceps, thigh and calf skinfolds and relaxed arm, middle-thigh and calf girths), handgrip strength (HG), chair stand, 4 m walk, and timed-up-and-go-tests (TUG) as well as the Latin American Group for Maturity battery (GDLAM) and the short physical performance battery (SPPB) were performed. RESULTS: The GDLAM battery shows a sensitivity from moderate to high (60.1-72.2 %), and specificity from moderate (57.6 %) to very high (90.7 %) to identify sarcopenia categories (probable, confirmed and severe). However, the SPPB battery shows a lack of classification ability for probable sarcopenia (AUC = 0.436; p = 0.123), confirmed sarcopenia (AUC = 0.499; p = 0.959) and severe sarcopenia (AUC = 0.484; p = 0.532). Those participants classified as probable sarcopenia or confirmed sarcopenia measured by GDLAM battery according to the cut-off points obtained in the ROC curve showed a higher probability to be in the probable sarcopenia (OR = 2.8; p = 0.001) or confirmed sarcopenia categories (OR = 10; p = 0.002), respectively, based on EWGSOP19 criteria. CONCLUSIONS: The GDLAM screening battery showed improved properties in terms of distinguishing individuals at risk for sarcopenia from those who were not.

Physical and psychological effects of outdoor fitness equipment training on middle-aged and older adults: study protocol of a randomised controlled trial.

This project will investigate the effectiveness of an 8-week outdoor fitness equipment (OFE) programme on health parameters in healthy community-dwelling middle and older adults, corresponding to the present paper to the study protocol, which follows a single-blind randomised controlled trial design. The training intervention will involve participation in an OFE programme implemented over 8 weeks, two sessions/week. Rating of perceived exertion, heart rate, training volume and adherence to the exercise programme will be registered each session. The control group will not receive any structured exercise programme. Blinded examiners will evaluate before and after the training programme muscle strength with both maximum knee extension and elbow flexion isometric tests, handgrip strength test and five time sit-to-stand test; cardiovascular fitness with 400-metre walking test; postural stability with the balance tests of the short physical performance battery (SPPB) battery; dynamic balance with Timed Up and Go (TUG) test; body composition with dual-energy X-ray absorptiometry; functional performance by gait speed, TUG and SPPB battery; blood pressure; and sagittal spine disposition and pelvic tilt. Information will also be collected about demographic characteristics, health-related quality of life, satisfaction with life and adherence to the Mediterranean diet questionnaires. After that, sarcopenia, osteoporosis and fracture risk will be calculated. The results derived from this research will increase the knowledge of the effectiveness of OFE training for improving the health of healthy community-dwelling middle and older adults.

Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations.

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO. Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency. Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions. Not all studies reported how the exercise selection, repetition cadence, and rest interval were made. Conclusion: The characteristics of RT protocols and their variables prescribed in the literature for older adults with SO were mapped. The lack of detail on some training variables (i.e., exercise selection, repetition cadence, and rest interval) was identified. RT protocols are heterogeneous and described only partially among studies. The recommendations for RT prescription details in older adults with SO are provided for future studies. Systematic review registration: https://osf.io/wzk3d/.

Predictive factors for response to treatment in patients with advanced renal cell carcinoma.

INTRODUCTION: The analysis of predictive factors of response may aid in predicting which patients with advanced renal cell carcinoma (RCC) would be good candidates for systemic treatments. MATERIALS AND METHODS: The expression of several biomarkers was retrospectively analyzed using immunohistochemistry (IHC), as well as 2 analytical variables in 135 patients with advanced RCC treated with cytokines (CK) and/or new targeted drugs (NTD). RESULTS: 67 patients were treated solely with NTD and 68 with CK (23 also received NTD). Univariate analysis: HIF1α did not correlate significantly with response to these drugs. Overexpression of CAIX was associated with more responses (%) to NTD (64.7 vs. 21.1; p = 0.004) and CK (22.6 vs. 0; p = 0.038). PTEN demonstrated predictive value of response to sunitinib (70.8 vs. 34.1; p = 0.005). p21 was associated with a lower response to sunitinib (35.9 vs. 65.4; p = 0.025). Thrombocytosis was not significantly associated with response to NTD, although it was with CK (0 vs. 20; p = 0.017). Neutrophilia correlated with a lower response to NTD (29.6 vs. 57.5; p = 0.045), although not with CK. Multivariate analysis: Overexpression of CAIX was an independent predictor of significantly higher response to NTD and CK; OR = 8.773 (p < 0.001). CONCLUSIONS: Our findings highlight the usefulness of CAIX in selecting patients with advanced RCC as candidates for systemic treatment. PTEN and p21 may be important in predicting response to sunitinib. Thrombocytosis and neutrophilia correlate well with response to CK and NTD, respectively.