[Did the staging of renal neoplasm improve with time? Retrospective study on a cohort of 2000 patients]. / La stadiazione della neoplasia renale è migliorata nel tempo? Studio retrospettivo su una coorte contemporanea di 2000 pazienti.

OBJECTIVES: During the last 3 decades ultrasonographic and cross-sectional imaging techniques have been widely adopted in the pre-operative staging of renal masses with a progressive technological refinement. The aim of this study is to evaluate if, according to such a change, the accuracy of pre-operative staging is getting better. MATERIALS AND METHODS: A retrospective analysis of 1935 patients, surgically treated at our Institute since 1983 for a renal neoplasm, has been carried out. Dividing the experience in 2 periods, before and after the year 2000, the diagnostic tools adopted during pre-operative staging and their accuracy have been evaluated by a comparison with the post-operative data (accuracy=true positive+true negative/total number of cases), also taking into account each single aspect of staging (dimension of tumor, local extension, venous invasion, lymphnodal and distant metastasis). RESULTS AND DISCUSSION: 994 patients have been treated before 2000, and 941 afterwards. During time, a progressive reduction in the use of urography and, on the other hand, a diffusion of chest CT have been observed, whereas NMR maintained a similar and limited field of application in both periods. During time, the overall accuracy of staging has not significantly improved (69.5% vs 72.3%, p=0.18), but a slightly better staging of distant (93.9% vs 96.7%, p=0.01) and lymphnodal metastasis (90.9% vs 94.8%, p=0.01) can be found. CONCLUSIONS: The pre-operative staging of renal cancer has not really improved during the last 3 decades, in spite of the availability of more precise radiological tools. Anyway, due to the diffusion of CT scan, a slightly better definition of lymphnodal and distant metastasis can be observed. This fact could play a role in indicating a targeted therapy for advanced disease, especially in the light of a neo-adjuvant setting.

Investigaciones sobre las encefalitis equinas en Colombia, 1995-2000: Programa de Salud Pública Veterinaria División de Prevención y Control de Enfermedades / Encephalomyelitis equine in Colombia, 1995-2000: Veterinary Public Health Programme. Division of Control and Prevention Diseases

RESULTADOS OBTENIDOS: 1) Identificación del ciclo de transmisión de EEV en el Magdalena Medio colombiano. 2) Primeras evidencias de existencia de ciclos de transmisión aún sin caracterizar, que posiblemente involucran virus epizoóticos EEV en ciclos enzoóticos en la región del Casanare. 3) Se refuerzan los hallazgos que los virus epizoóticos IAB y IC evolucionan periódicamente a partir de progenitores EEV enzoóticos subtipo ID, los cuales circularían continua y silenciosamente en bosques húmedos de Colombia y Venezuela. 4) Ubicación preliminar de bosques con circulación activa del virus EEV enzoótica subtipo ID con ayuda de imágenes de satélite y Geographic Information System (GIS) en Colombia y Venezuela. 5) Demostración de transmisión continua de virus EEV ernzoótico en la región del Magdalena Medio por más de 30 años sin generar actividad epidémica o epizoótica "in situ". 6) Evidencia de anticuerpos para virus EEV en bovinos sin inmunización previa, en la proximidad de un bosque con ciclo enzoótico del Magdalena Medio (San Miguel). 7) Diferenciación de aislamientos de virus EEV mediante la técnica Single Strand Conformational Polymorphism (SSCP)