Using the Synergy between HPLC-MS and MALDI-MS Imaging to Explore the Lipidomics of Clear Cell Renal Cell Carcinoma.

Lipid imaging mass spectrometry (LIMS) has been tested in several pathological contexts, demonstrating its ability to segregate and isolate lipid signatures in complex tissues, thanks to the technique's spatial resolution. However, it cannot yet compete with the superior identification power of high-performance liquid chromatography coupled to mass spectrometry (HPLC-MS), and therefore, very often, the latter is used to refine the assignment of the species detected by LIMS. Also, it is not clear if the differences in sensitivity and spatial resolution between the two techniques lead to a similar panel of biomarkers for a given disease. Here, we explore the capabilities of LIMS and HPLC-MS to produce a panel of lipid biomarkers to screen nephrectomy samples from 40 clear cell renal cell carcinoma patients. The same set of samples was explored by both techniques, and despite the important differences between them in terms of the number of detected and identified species (148 by LIMS and 344 by HPLC-MS in negative-ion mode) and the presence/absence of image capabilities, similar conclusions were reached: using the lipid fingerprint, it is possible to set up classifiers that correctly identify the samples as either healthy or tumor samples. The spatial resolution of LIMS enables extraction of additional information, such as the existence of necrotic areas or the existence of different tumor cell populations, but such information does not seem determinant for the correct classification of the samples, or it may be somehow compensated by the higher analytical power of HPLC-MS. Similar conclusions were reached with two very different techniques, validating their use for the discovery of lipid biomarkers.

Unidad funcional multidisciplinar de suelo pélvico: experiencia de 5 años / Multidisciplinary functional pelvic floor unit: 5-year experience

Introducción: La disfunción del suelopélvico se presenta de múltiples formas y se manifiesta con síntomas que afectan a diferentes órganos delsuelo pélvico. Estos síntomas pueden aparecer aisladoso asociados entre sí, implicando así a diferentes especialidades a la hora del diagnóstico y tratamiento. Loscomités multidisciplinares se han convertido en una herramienta imprescindible en el manejo de la patologíadel suelo pélvico.Objetivo: El objetivo principal es estudiar las características de la patología que presentan los pacientesabordados en el Comité Funcional Multidisciplinar deSuelo Pélvico (CFMSP).Material y métodos: Estudio descriptivo transversalde los pacientes abordados en el CFMSP del Hospitalde Galdakao-Usansolo desde 2014 hasta marzo de2019. Resultados: En el comité se abordaron 55 pacientes, de las cuales el 89,09% fueron mujeres. La edadmedia fue de 55,36 años. El motivo de consulta másfrecuente fue el prolapso de órganos pélvicos (22,45%)en la población femenina y el dolor (33,33%) en lapoblación masculina. El 78,18% presentaba más de unsíntoma asociado. Los pacientes que requirieron ser derivados a más de 2 especialidades supuso el 41,82%y el 21,82% de los pacientes precisaron más de unamodalidad de tratamiento.Conclusiones: La patología del suelo pélvico semanifiesta como asociación de síntomas que requierenla implicación de diferentes especialistas para el diagnóstico y tratamiento. Es el motivo por el que las unidades multidisciplinares son cada vez más necesarias enel abordaje integral de la patología del suelo pélvico.(AU)

Introduction: Pelvic floor dysfunction (PFD) is expressed by many different symptoms thatcan affect pelvic floor organs. These symptoms can appear alone or associated. The involvement of differentorgans and the wide variety of symptoms we have todeal with, has become teamwork essential for diagnosisand treatment of PFD. Currently, multidisciplinary pelvicfloor teams are essential when dealing with PFD.Objetive: The main objective of the article is to analyze characteristics and pathologies of the patients discussed during these multidisciplinary meetings.Material and methods: This is a descriptive study.Patients followed in the multidisciplinary pelvic floor team at Galdakao-Usansolo Hospital were recruited.We analyzed the patients discussed at the meetingsfrom January 2014 until March 2019.Results: We recruited 55 patients. 89.09% werefemale and the mean age of the analyzed patientswas 55.36 years. The most frequent reasons for medical consultation were pelvic floor prolapses in female(22.45%) and pelvic floor pain in male (33.33%). Association between symptoms occur in 78.18% of the patients. 41.82% of patients were referred to more than 2specialists and 21.82% needed associated treatments.Conclusions: Pelvic floor dysfunction is manifestedby a combination of symptoms which need different specialists, not only for diagnosis, but also for treatment.This is why multidisciplinary teams have become important for the management of pelvic floor disfunction.(AU)

[Multidisciplinary pelvic floor team: 5 year experience.] / Unidad funcional multidisciplinar de suelo pélvico: experiencia de 5 años.

INTRODUCTION: Pelvic floor dysfunction (PFD) is expressed by many different symptoms that can affect pelvic floor organs. These symptoms can appear alone or associated. The involvement of different organs and the wide variety of symptoms we have to deal with, has become teamwork essential for diagnosis and treatment of PFD. Currently, multidisciplinary pelvic floor teams are essential when dealing with PFD. OBJECTIVE: The main objective of the article is to analyze characteristics and pathologies of the patients discussed during these multidisciplinary meetings. MATERIAL AND METHODS: This is a descriptive study. Patients followed in the multidisciplinary pelvic floorteam at Galdakao-Usansolo Hospital were recruited. We analyzed the patients discussed at the meetings from January 2014 until March 2019. RESULTS: We recruited 55 patients. 89.09% were female and the mean age of the analyzed patients was 55.36 years. The most frequent reasons for medicalconsultation were pelvic floor prolapses in female (22.45%) and pelvic floor pain in male (33.33%). Association between symptoms occur in 78.18% of the patients.41.82% of patients were referred to more than 2 specialists and 21.82% needed associated treatments. CONCLUSIONS: Pelvic floor dysfunction is manifested by a combination of  symptoms which need different specialists, not only for diagnosis, but also for treatment. This is why multidisciplinary teams have become important for the management of pelvic floor disfunction.

INTRODUCCIÓN: La disfunción del suelo pélvico se presenta de múltiples formas y se manifiesta con síntomas que afectan a diferentes órganos del suelo pélvico. Estos síntomas pueden aparecer aislados o asociados entre sí, implicando así a diferentes especialidades a la hora del diagnóstico y tratamiento. Los comités multidisciplinares se han convertido en una herramienta imprescindible en el manejo de la patología del suelo pélvico. OBJETIVO: El objetivo principal es estudiar las características de la patología que presentan los pacientes abordados en el Comité Funcional Multidisciplinar de Suelo Pélvico (CFMSP).MATERIAL Y MÉTODOS: Estudio descriptivo transversal de los pacientes abordados en el CFMSP del Hospital de Galdakao-Usansolo desde 2014 hasta marzo de 2019. RESULTADOS: En el comité se abordaron 55 pacientes, de las cuales el 89,09% fueron mujeres. La edad media fue de 55,36 años. El motivo de consulta másfrecuente fue el prolapso de órganos pélvicos (22,45%) en la población femenina y el dolor (33,33%) en la población masculina. El 78,18% presentaba más de unsíntoma asociado. Los pacientes que requirieron ser derivados a más de 2 especialidades supuso el 41,82% y el 21,82% de los pacientes precisaron más de una modalidad de tratamiento. CONCLUSIONES: La patología del suelo pélvico se manifiesta como asociación de síntomas que requieren la implicación de diferentes especialistas para el diagnóstico y tratamiento. Es el motivo por el que las unidades multidisciplinares son cada vez más necesarias en el abordaje integral de la patología del suelo pélvico.

[Elevation of Ca 125 in a patient with giant congenital hydronephrosis].

OBJECTIVE: To report a new case with elevation of Ca 125 and hydronephrotic kidney without neoplastic disease, having special reference to clinical aspects. METHOD: The clinical history, anatomopathological and immunohistochemical findings are described. We performed a bibliographic review. We report the case of a 27 year-old female with the diagnosis of giant hydronephrosis and Ca125 elevation (313 u/ml hydronephrotic kidney urine and 112.3 u/ml serum). RESULT: She underwent a radical nephrectomy and Ca125 levels decreased. After 9 years the patient did not have any neoplastic disease and Ca125 levels are normal. CONCLUSIONS: The Ca125 rise with hydronephrotic kidney may be usual although there are not enough studies. We think that in patients with hydronephrotic kidney and malignant neoplasm the Ca125 antigen can lose sensitivity for the early diagnosis, staging and follow up of the malignant diseases.

Elevación de Ca 125 en paciente con hidronefrosis gigante congénita / Elevation of Ca 125 in a patient with giant congenital hydronephrosis

OBJETIVO: Aportar un nuevo caso de elevación del Antígeno Ca 125 causado por hidronefrosis, haciendo referencia a sus implicaciones clínicas. MÉTODO: Descripción de la historia clínica, hallazgos histopatológicos e Inmunohistoquímicos. Revisión de la bibliografía. Mujer 27 años diagnosticada de hidronefrosis gigante y elevación del antígeno Ca 125 (313 u/ml orina riñón hidronefrótico y 112.3 u/ml suero). RESULTADO: La paciente fue sometida a nefrectomía con normalización de Ca 125. Después de 9 años la paciente no sufre ningún proceso neoplásico y presenta niveles normales de Ca 125. CONCLUSIONES: La elevación de Ca 125 e hidronefrosis puede ser un fenómeno habitual aunque no suficientemente estudiado actualmente. En pacientes con neoplasia maligna con elevación de Ca 125 e hidronefrosis este marcador puede perder sensibilidad para el diagnóstico temprano, estadiaje y seguimiento del proceso tumoral(AU)

OBJECTIVE: To report a new case with elevation of Ca 125 and hydronephrotic kidney without neoplastic disease, having special reference to clinical aspects. METHOD: The clinical history, anatomopathological and immunohistochemical findings are described. We performed a bibliographic review. We report the case of a 27 year-old female with the diagnosis of giant hydronephrosis and Ca125 elevation (313 u/ml hydronephrotic kidney urine and 112.3 u/ml serum). RESULT: She underwent a radical nephrectomy and Ca125 levels decreased. After 9 years the patient did not have any neoplastic disease and Ca125 levels are normal. CONCLUSIONS: The Ca125 rise with hydronephrotic kidney may be usual although there are not enough studies. We think that in patients with hydronephrotic kidney and malignant neoplasm the Ca125 antigen can lose sensitivity for the early diagnosis, staging and follow up of the malignant diseases(AU)