Inquilinus limosus isolated from a patient with chronic cystic fibrosis. First report in Mexico and evidence that co-infection with Pseudomonas aeruginosa promotes the accelerated and increased formation of extracellular neutrophil traps.

Cystic fibrosis is characterized by abnormal mucous secretions in the lungs that favor the proliferation of colonizing bacteria, with Pseudomonas aeruginosa and Staphylococcus aureus being the most isolated, however, other less known species could also have an impact on the health of the patient. Here we demonstrate the isolation and antibiotic resistance profiles of Inquilinus limosus, a rarely reported multidrug resistant bacterium, and compare them to a co-infectant strain of Pseudomonas aeruginosa. Likewise, we found that co-infection with both bacteria promotes increased formation of neutrophil extracellular traps, which can have an impact on the disease severity and make treatment difficult.

Técnica quirúrgica para la corrección simultánea del prolapso de órganos pélvicos y la incontinencia urinaria recidivada mediante laparoscopia / Combined laparoscopic surgery for the treatment of pelvic organ prolapse and recurrent urinary incontinence

INTRODUCCIÓN: La colposacropexia laparoscópica (CL) es el tratamiento gold standard del prolapso de órganos pélvicos (POP) apical. El esfínter urinario artificial (EUA) presenta elevada eficacia en el tratamiento de la incontinencia urinaria de esfuerzo recidivada (IUEr). OBJETIVO: Describir por primera vez la técnica de CL e implante laparoscópico de EUA mediante un abordaje vesicovaginal a la cara posterior del cuello vesical. MATERIAL Y MÉTODOS: La cirugía se realiza por un abordaje transperitoneal. Se crea el espacio rectovaginal y se fija la malla posterior. Se realiza la disección del espacio vesicovaginal con ayuda de una valva vaginal, se crean los espacios laterovesicales y se comunican ambos con el espacio vesicovaginal. Se fija la malla anterior. Se diseca la cara anterior del cuello y se coloca el manguito. Se fijan ambas mallas al promontorio. Se introduce el reservorio, se coloca el botón de activación en el labio mayor y se realizan las conexiones de forma habitual. Finalmente, se cierra el peritoneo. RESULTADOS: El tiempo quirúrgico fue de 180 minutos, la sonda vesical se retiró al quinto día y la estancia fue de cinco días. El EUA se activó a la sexta semana. No hubo complicaciones perioperatorias. Tras 12 meses, la paciente presenta continencia completa y curación objetiva y subjetiva del POP. CONCLUSIONES: La disección vesicovaginal es un paso común en esta técnica de CL y colocación de EUA. La visión directa del cuello vesical permitiría disminuir el riesgo de erosión. Recomendamos esta técnica en casos seleccionados de POP e IUEr

INTRODUCTION: Laparoscopic sacral colpopexy (LSC) is the gold standard treatment for apical pelvic organ prolapse (POP). Artificial urinary sphincter (AUS) has a high success rate in treating recurrent stress urinary incontinence (SUI). OBJECTIVE: To describe the first simultaneous LSC and AUS implantation through a vesicovaginal approach to the bladder neck. MATERIAL AND METHODS: Operation is performed through a transperitoneal approach. The rectovaginal space is created and the posterior mesh is fixed. The vesicovaginal and both laterovesical spaces are dissected. The vesicovaginal space is connected to both lateral spaces. This is main step of the procedure because it let us place the cuff around the bladder neck in a non-blind fashion. The anterior mesh is fixed to the vagina. The anterior side of the bladder neck is dissected and the cuff implanted. Both meshes are fixed to the promontory. Pressure-regulating balloon is inserted, the pump is placed in the labia majora and the components are connected. Peritoneum is closed. RESULTS: Surgical time was 180 minutes, bladder catheter was removed at 5th postoperative day, hospital stay was 5 days. The AUS was activated 6 weeks after surgery. No perioperative complications occurred. After 12 months the patient is pad-free and prolapse was objectively and subjectively cured. CONCLUSIONS: Vesicovaginal dissection is a shared step in this technique of LSC and AUS implantation. This approach could minimize the risk of bladder neck injury. We propose this technique in selected cases of prolapse and recurrent SUI

Increased thin-spine density in frontal cortex pyramidal neurons in a genetic rat model of schizophrenia-relevant features.

The cellular mechanisms altered during brain wiring leading to cognitive disturbances in neurodevelopmental disorders remain unknown. We have previously reported altered cortical expression of neurodevelopmentally regulated synaptic markers in a genetic animal model of schizophrenia-relevant behavioral features, the Roman-High Avoidance rat strain (RHA-I). To further explore this phenotype, we looked at dendritic spines in cortical pyramidal neurons, as changes in spine density and morphology are one of the main processes taking place during adolescence. An HSV-viral vector carrying green fluorescent protein (GFP) was injected into the frontal cortex (FC) of a group of 11 RHA-I and 12 Roman-Low Avoidance (RLA-I) male rats. GFP labeled dendrites from pyramidal cells were 3D reconstructed and number and types of spines quantified. We observed an increased spine density in the RHA-I, corresponding to a larger fraction of immature thin spines, with no differences in stubby and mushroom spines. Glia cells, parvalbumin (PV) and somatostatin (SST) interneurons and surrounding perineuronal net (PNN) density are known to participate in FC and pyramidal neuron dendritic spine maturation. We determined by stereological-based quantification a significantly higher number of GFAP-positive astrocytes in the FC of the RHA-I strain, with no difference in microglia (Iba1-positive cells). The number of inhibitory PV, SST interneurons or PNN density, on the contrary, was unchanged. Results support our belief that the RHA-I strain presents a more immature FC, with some structural features like those observed during adolescence, adding construct validity to this strain as a genetic behavioral model of neurodevelopmental disorders.

Avoiding the trap: Mechanisms developed by pathogens to escape neutrophil extracellular traps.

Neutrophils are the first cells of the innate immune system that respond to infection by arriving at sites when pathogens have exceeded physical barriers. Among their response mechanisms against pathogens is the release of neutrophil extracellular traps (NETs), which are composed of deoxyribonucleic acid and antimicrobial proteins such as neutrophil elastase, myeloperoxidase, antimicrobial peptides, and other proteins in neutrophil granules. The formation of extracellular traps is considered an effective strategy to capture and, in some cases, neutralize pathogenic bacteria, fungi, parasites, or viruses. However, it is also known that pathogens can respond to NETs by expressing some virulence factors, thus evading the antimicrobial effect of these structures. These include the secretion of proteins to degrade the deoxyribonucleic acid scaffold, the formation of biofilms that impede the effect of NETs, or the modification of its membrane structure to avoid interaction with NETs. In this review, we discuss these mechanisms and summarize the different pathogens that employ one or more mechanisms to evade the NET-mediated neutrophil response.

Combined laparoscopic surgery for the treatment of pelvic organ prolapse and recurrent urinary incontinence. / Técnica quirúrgica para la corrección simultánea del prolapso de órganos pélvicos y la incontinencia urinaria recidivada mediante laparoscopia.

INTRODUCTION: Laparoscopic sacral colpopexy (LSC) is the gold standard treatment for apical pelvic organ prolapse (POP). Artificial urinary sphincter (AUS) has a high success rate in treating recurrent stress urinary incontinence (SUI). OBJECTIVE: To describe the first simultaneous LSC and AUS implantation through a vesicovaginal approach to the bladder neck. MATERIAL AND METHODS: Operation is performed through a transperitoneal approach. The rectovaginal space is created and the posterior mesh is fixed. The vesicovaginal and both laterovesical spaces are dissected. The vesicovaginal space is connected to both lateral spaces. This is main step of the procedure because it let us place the cuff around the bladder neck in a non-blind fashion. The anterior mesh is fixed to the vagina. The anterior side of the bladder neck is dissected and the cuff implanted. Both meshes are fixed to the promontory. Pressure-regulating balloon is inserted, the pump is placed in the labia majora and the components are connected. Peritoneum is closed. RESULTS: Surgical time was 180 minutes, bladder catheter was removed at 5th postoperative day, hospital stay was 5 days. The AUS was activated 6 weeks after surgery. No perioperative complications occurred. After 12 months the patient is pad-free and prolapse was objectively and subjectively cured. CONCLUSIONS: Vesicovaginal dissection is a shared step in this technique of LSC and AUS implantation. This approach could minimize the risk of bladder neck injury. We propose this technique in selected cases of prolapse and recurrent SUI.

Pseudomonas aeruginosa isolates from cystic fibrosis patients induce neutrophil extracellular traps with different morphologies that could correlate with their disease severity.

Cystic fibrosis (CF) is a disease characterized by bacterial chronic infection of the respiratory tract and inflammation, which leads to a progressive decrease in lung function. Pseudomonas aeruginosa is commonly isolated from the sputum of patients and their presence is associated with a predominant airway inflammation with neutrophils, causing chronic colonization and higher mortality rates. Neutrophil extracellular traps (NETs) have been observed in response against Pseudomonas, however, these cannot eliminate the pathogen from the respiratory tract, so one possibility is that the bacteria could promote their production to use them as a scaffold to colonize the lungs and as a nutrient source, however, their overproduction could also lead to increased damage to the lungs. In this work, we evaluated NETs formation by Pseudomonas clinical isolates obtained from CF patients and found that these induced NETs formation with globular or spread morphologies, of note, we found that there is a trend by which the spread forms were induced mainly by isolates obtained from patients with severe disease, whereas, the globular morphologies were observed for isolates obtained from patients with mild/moderate disease. Finally, we screened for bacterial molecules implicated in NETs formation and found that Exotoxin S, pyocin S2 and pyoverdine could participate in the process.

Variation of δ18O in otoliths of Stellifer lanceolatus and Eucinostomus gula environmental change indicator in Terminos Lagoon, Mexico.

Environmental changes have been associated with natural climatic variability or human activity. Water resources management is, perhaps, the most drastic change observed in the coastal environment. However, external forcings such as the El Niño event have important implications in the global and regional hydrological balance. These environmental changes have an impact on the density and biomass of the ichthyofauna in the Terminos Lagoon (TL) for the past 30 years, presumably, associated with variations in the temperature and surface salinity of the sea. Therefore, in the present study, δ18O was quantified in otoliths of two important species due to their dominance: Stellifer lanceolatus and Eucinostomus gula, and to understand the environmental changes reflected in both species. The δ18O was analyzed in otoliths of these two species captured in 1998/1997, 2006/2007 and 2016/2017 and were compared with in situ temperature and salinity data. Sea surface temperature and salinity increased by 2 °C and 9, respectively, between 1997 and 2017. Stellifer lanceolatus δ18O values was in isotopic equilibrium with seawater calcite; while, E. gula is not in isotopic equilibrium. The δ18O of S. lanceolatus and E. gula varied significantly with the increase in salinity (R2 = 0.8987 and R2 = -0.2964) and not with the sea surface temperature. S. lanceolatus is an excellent bioindicator of changes in sea surface salinity in this region of the Gulf of Mexico.

Photoemission from non-polar aromatic molecules in the gas and liquid phase.

The photoelectron spectra of both liquid and gas phase aromatic molecules are reported. The spectra were obtained using a 34.1 eV source produced by high harmonic generation and analysed with the help of high-level ab initio simulations using the reflection principle combined with path integral molecular dynamics simulations accounting for nuclear quantum effects for the gas phase. We demonstrate the suitability of three trimethylbenzenes (1,3,5-trimethylbenzene, 1,2,3-trimethylbenzene and 1,2,4-trimethylbenzene) as a solvent for liquid photoelectron spectroscopy of solute species. We also discuss the electrokinetic charging of a non-polar liquid jet.

Dissociation between schizophrenia-relevant behavioral profiles and volumetric brain measures after long-lasting social isolation in Roman rats.

Social isolation rearing of rodents is an environmental manipulation known to induce or potentiate psychotic-like symptoms and attentional and cognitive impairments relevant for schizophrenia. When subjected to a 28-week isolation rearing treatment, the Roman high-avoidance (RHA-I) rats display the common behavioral social isolation syndrome, with prepulse inhibition (PPI) deficits, hyperactivity, increased anxiety responses and learning/memory impairments when compared to their low-avoidance (RLA-I) counterparts. These results add face validity to the RHA-I rats as an animal model for schizophrenia-relevant behavioral and cognitive profiles and confirm previous results. The aim here was to further investigate the neuroanatomical effects of the isolation rearing, estimated through volume differences in medial prefrontal cortex (mPFC), dorsal striatum (dSt) and hippocampus (HPC). Results showed a global increase in volume in the mPFC in the isolated rats of both strains, as well as strain effects (RLA > RHA) in the three brain regions. These unexpected but robust results, might have unveiled some kind of compensatory mechanisms due to the particularly long-lasting isolation rearing period, much longer than those commonly used in the literature (which usually range from 4 to 12 weeks).

Evidence of Extreme Ultraviolet Superfluorescence in Xenon.

We present a comprehensive experimental and theoretical study on superfluorescence in the extreme ultraviolet wavelength regime. Focusing a free-electron laser pulse in a cell filled with Xe gas, the medium is quasi-instantaneously population inverted by 4d-shell ionization on the giant resonance followed by Auger decay. On the timescale of ∼10 ps to ∼100 ps (depending on parameters) a macroscopic polarization builds up in the medium, resulting in superfluorescent emission of several Xe lines in the forward direction. As the number of emitters in the system is increased by either raising the pressure or the pump-pulse energy, the emission yield grows exponentially over four orders of magnitude and reaches saturation. With increasing yield, we observe line broadening, a manifestation of superfluorescence in the spectral domain. Our novel theoretical approach, based on a full quantum treatment of the atomic system and the irradiated field, shows quantitative agreement with the experiment and supports our interpretation.

Bebidas energéticas y estudiantes universitarios en España. Usos, efectos y asociaciones / Energy drinks and university students in Spain. Uses, effects and associations

INTRODUCCIÓN: Las bebidas energéticas (BE) son bebidas carbonatadas creadas y comercializadas con la intención de incrementar el rendimiento físico y mental. Sus ingredientes principales son la glucosa, cafeína, taurina, glucoronolactona y vitaminas del grupo B. OBJETIVOS: Conocer la frecuencia de consumo de BE en estudiantes universitarios, la finalidad, así como los factores asociados a su uso, su relación con el consumo de otras sustancias y los efectos experimentados. MATERIAL Y MÉTODOS: Estudio de corte transversal realizado a través de una encuesta online por medio de la plataforma "Formularios" de Google DocsR, lanzada entre marzo y agosto de 2014 dirigido a estudiantes universitarios de toda España. Los resultados se analizaron mediante el paquete estadístico SPSSR. RESULTADOS: De los 633 encuestados 221 fueron hombres (34.9 %) y 412 mujeres (65.1 %).384 (61 %) han probado las BE. El consumo es mayor en hombres ,70 %, frente a un 55% en mujeres. Dentro de sus efectos reportados están: el incremento rendimiento académico (23.7 %) taquicardia (34.9 %), el insomnio (33.6 %) y nerviosismo (45.1 %). Hemos encontrado asociación entre su consumo con: psicofármacos; de drogas en general; alcohol; tabaco y marihuana (OR=1.43; 1.28; 1.5; 1.25; 1.28, respectivamente). En época de exámenes observamos una asociación entre consumo de BE y el cambio de dieta (OR= 1.65). Finalmente, existe una asociación positiva ente la toma de BE con intención de mejorar el rendimiento académico y la sensación de obtenerlo (OR=2.72). CONCLUSIONES: Existe un alto consumo de BE entre los estudiantes universitarios, predominante en varones, asociado a la época de exámenes y su consumo junto a bebidas alcohólicas. Se encuentra una asociación con la toma separada de alcohol, tabaco, marihuana y psicofármacos. Es por ello que se cree conveniente llevar a cabo estudios que aborden posibles asociaciones de su consumo con alteraciones en la dieta

INTRODUCTION: Energy drinks are carbonated drinks which purpose is to increase physical and mental performance. Its main ingredients are glucose, caffeine, taurine, glucoronolactone and vitamine B. MAIN OBJECTIVE: We aim to asses the frequency of the use of energy drinks and its purpose, among a population of university students. We aim also to correlate it with the use of other substances and their effects. MATERIAL AND METHODS: Cross- sectional study designed throug an on line questionnaire launched in the Google DocsR platform, and answered by spanish university students between march and august of 2014. Statistical analysis was performed with statistical software SPSSR. RESULTS: Out of 633 participants 221 were male (34,9%) and 412 female (65,1%).384 (61%) had tried energetic drinks. Its use is higher in male (70%) than in female (55%). Between its effects we found the increase in academic performance (23,7%), tachycardia (34,9%), insomnia (33,6%), and anxiety (45,1%). We found an association between the intake of energy drinks and the use of psychoactive drugs, abuse drugs, alcohol, tobacco and marijuana (OR=1.43; 1.28; 1.5; 1.25; 1.28). During exams period we found an association between intake of energy drinks and change in feeding habits (OR= 1.65). Finally, there is an association between the intake of energy drinks with the purpose of increasing academic performance and the feeling of having achieved it (OR=2.72). CONCLUSIONS: There is a high prevalence of energy drinks intake between university students, specially in male, associated to exams period and in combination with alcoholic drinks. There is an association with the use of alcohol, tobacco, marijuana and psychoactive drugs. We suggest it woud be convenient to design tryals to find out the association between its use and change in diet habits

¿Se debe realizar como primera prueba de imagen una radiografía de tórax en inspiración o en espiración ante la sospecha de neumotórax? / Should we perform an inspiratory or an expiratory chest radiograph for the initial diagnosis of pneumothorax?

La radiografía de tórax para el despistaje de neumotórax es una prueba que se realiza frecuentemente en la práctica clínica. No obstante, existe controversia sobre cuál es la técnica de elección. La radiografía de tórax posteroanterior en espiración ha sido durante muchas décadas la técnica empleada, debido a que varios expertos en radiología torácica clásica, como Greene y Felson, la recomendaron. Sin embargo, la radiografía de tórax, con proyecciones posteroanterior y lateral, adquirida en inspiración, es la técnica recomendada para valorar inicialmente la patología torácica en su conjunto. En este trabajo hemos tratado de clarificar, basándonos en la mejor evidencia disponible, cuál es la técnica radiográfica inicial óptima ante la sospecha clínica de neumotórax

Chest radiography for pneumothorax screening is a frequently employed test. However, there is some controversy about which radiographic technique to choose. Posteroanterior chest radiography taken during expiration has been the technique used for many decades because several experts in classical thoracic radiology, such as Greene and Felson, recommended it. However, chest radiography, with posteroanterior and lateral projections, taken during deep breath is the appropriated technique to initially assess the whole thoracic pathology. In this review we have tried to establish, based on the best available evidence, which is the initial examination of choice to diagnose pneumothorax

Spatial and trophic preferences of jumbo squid Dosidicus gigas (D'Orbigny, 1835) in the central Gulf of California: ecological inferences using stable isotopes.

RATIONALE: The jumbo squid Dosidicus gigas is a fishery resource of considerable economic and ecological importance in the Mexican Pacific. Studies on its habitat preferences are needed to understand recent fluctuations in the abundance and availability of the species. Stable isotope analysis allows us to infer ecological aspects such as spatial distribution and trophic preferences. METHODS: We used an isotope ratio mass spectrometer, automated for carbonate analysis, and coupled to an elemental analyzer, to determine the isotopic composition of statoliths (δ18 O and δ13 C values) and beaks (δ13 C and δ15 N values) from 219 individuals caught over two fishing seasons (2007 and 2009) off the coast of Santa Rosalía, in the central Gulf of California. We used these isotopic ratios to assess variation in spatial and trophic preferences by sex, size, and fishing season. RESULTS: In the 2009 group, we observed significant differences in statolith δ13 C values and beak δ13 C and δ15 N values between males and females. Between size groups, we observed significant differences in statolith δ18 O and δ13 C values in 2007 and in beak δ13 C and δ15 N values during both seasons. Both seasons were characterized by high overlap in δ18 O and δ13 C values between sexes and in 2009 between size groups. We observed low trophic overlap between sexes in 2009 and between size groups during both seasons. CONCLUSIONS: The isotopic ratios from statoliths and beaks indicate that D. gigas has changed its spatial and trophic preferences, a shift that is probably related to changes in the species' diet. This intraspecific variation in preferences could be related to characteristics such as size, which may influence squid distribution preferences.

Should we perform an inspiratory or an expiratory chest radiograph for the initial diagnosis of pneumothorax? / ¿Se debe realizar como primera prueba de imagen una radiografía de tórax en inspiración o en espiración ante la sospecha de neumotórax?

Chest radiography for pneumothorax screening is a frequently employed test. However, there is some controversy about which radiographic technique to choose. Posteroanterior chest radiography taken during expiration has been the technique used for many decades because several experts in classical thoracic radiology, such as Greene and Felson, recommended it. However, chest radiography, with posteroanterior and lateral projections, taken during deep breath is the appropriated technique to initially assess the whole thoracic pathology. In this review we have tried to establish, based on the best available evidence, which is the initial examination of choice to diagnose pneumothorax.

Accurate prediction of X-ray pulse properties from a free-electron laser using machine learning.

Free-electron lasers providing ultra-short high-brightness pulses of X-ray radiation have great potential for a wide impact on science, and are a critical element for unravelling the structural dynamics of matter. To fully harness this potential, we must accurately know the X-ray properties: intensity, spectrum and temporal profile. Owing to the inherent fluctuations in free-electron lasers, this mandates a full characterization of the properties for each and every pulse. While diagnostics of these properties exist, they are often invasive and many cannot operate at a high-repetition rate. Here, we present a technique for circumventing this limitation. Employing a machine learning strategy, we can accurately predict X-ray properties for every shot using only parameters that are easily recorded at high-repetition rate, by training a model on a small set of fully diagnosed pulses. This opens the door to fully realizing the promise of next-generation high-repetition rate X-ray lasers.

Expresión de las proteínas FGFR3, PI3K, AKT, p21Waf1/Cip1 y ciclinas D1 y D3 en pacientes con tumores de vejiga T1: implicaciones clínicas y significado pronóstico / Expression of proteins FGFR3, PI3K, AKT, p21Waf1/Cip1 and cyclins D1 and D3 in patients with T1 bladder tumours: clinical implications and prognostic significance

Objetivo: Determinar la expresión proteica diferencial de los biomarcadores FGFR3, PI3K (subunidades PI3Kp110α, PI3KClassIII, PI3Kp85), AKT, p21Waf1/Cip1 y las ciclinas D1 y D3 en el cáncer de vejiga T1 versus tejido sano, así como estudiar su posible papel como marcadores de recidiva precoz. Material y método: Se trata de un estudio prospectivo en el que se utilizaron un total de 67 muestras de tejido (55 casos de tumores de vejiga T1 sometidos a resección transuretral y 12 casos de mucosa sana adyacente). Los niveles de expresión de las proteínas se evaluaron mediante Western blot, y las medias y los porcentajes fueron comparados utilizando el test «t» de Student y la prueba Chi cuadrado. El análisis de supervivencia se realizó mediante el método Kaplan-Meier y el test Log-rank. Resultados: Se detectó una mayor expresión proteica de FGFR3, PI3Kp110α, PI3KClassIII, ciclinas D1 y D3 y p21Waf1/Cip1 en tejido tumoral versus mucosa sana. Sin embargo, estas diferencias no fueron significativas para PI3Kp85 y AKT. Se observaron correlaciones estadísticamente significativas de PI3Kp110α, PI3KClassIII, PI3Kp85 y AKT con la recidiva temprana (p = 0,003, p = 0,045, p = 0,050 y p = 0,028 respectivamente), de ciclina D3 (p=0,001) con el tipo tumoral (primario versus recidivante), de FGFR3 (p = 0,035) con el tamaño tumoral y de ciclina D1 (p = 0,039) con la multifocalidad. El análisis de supervivencia seleccionó a FGFR3 (p = 0,024), PI3Kp110alfa (p = 0,014), PI3KClassIII (p = 0,042) y AKT (p= 0,008) como marcadores de supervivencia libre de recidiva precoz. Conclusiones: Existe un incremento de los niveles de expresión proteica en el tejido tumoral vesical, asimismo, la sobreexpresión de FGFR3, PI3Kp110α, PI3KClassIII y AKT se asocia con una mayor supervivencia libre de recidiva precoz en pacientes con tumores de vejiga T1

Objective: To determine the differential protein expression of biomarkers FGFR3, PI3K (subunits PI3Kp110α, PI3KClassIII, PI3Kp85), AKT, p21Waf1/Cip1 and cyclins D1 and D3 in T1 bladder cancer versus healthy tissue and to study their potential role as early recurrence markers. Material and method: This is a prospective study that employed a total of 67 tissue samples (55 cases of T1 bladder tumours that underwent transurethral resection and 12 cases of adjacent healthy mucosa). The protein expression levels were assessed using Western blot, and the means and percentages were compared using Student's t-test and the chi-squared test. The survival analysis was conducted using the Kaplan-Meier method and the log-rank test. Results: Greater protein expression was detected for FGFR3, PI3Kp110α, PI3KClassIII, cyclins D1 and D3 and p21Waf1/Cip1 in the tumour tissue than in the healthy mucosa. However, these differences were not significant for PI3Kp85 and AKT. We observed statistically significant correlations between early recurrence and PI3Kp110α, PI3KClassIII, PI3Kp85 and AKT (P = .003, P = .045, P = .050 and P = .028, respectively), between the tumour type (primary vs. recurrence) and cyclin D3 (P=.001), between the tumour size and FGFR3 (P = .035) and between multifocality and cyclin D1 (P = .039). The survival analysis selected FGFR3 (P = .024), PI3Kp110α (P = .014), PI3KClassIII (P = .042) and AKT (P = .008) as markers of early-recurrence-free survival. Conclusions:. There is an increase in protein expression levels in bladder tumour tissue. The overexpression of FGFR3, PI3Kp110α, PI3KClassIII and AKT is associated with increased early-recurrence-free survival for patients with T1 bladder tumours

Expression of proteins FGFR3, PI3K, AKT, p21Waf1/Cip1 and cyclins D1 and D3 in patients with T1 bladder tumours: clinical implications and prognostic significance. / Expresión de las proteínas FGFR3, PI3K, AKT, p21Waf1/Cip1 y ciclinas D1 y D3 en pacientes con tumores de vejiga T1: implicaciones clínicas y significado pronóstico.

OBJECTIVE: To determine the differential protein expression of biomarkers FGFR3, PI3K (subunits PI3Kp110α, PI3KClassIII, PI3Kp85), AKT, p21Waf1/Cip1 and cyclins D1 and D3 in T1 bladder cancer versus healthy tissue and to study their potential role as early recurrence markers. MATERIAL AND METHOD: This is a prospective study that employed a total of 67 tissue samples (55 cases of T1 bladder tumours that underwent transurethral resection and 12 cases of adjacent healthy mucosa). The protein expression levels were assessed using Western blot, and the means and percentages were compared using Student's t-test and the chi-squared test. The survival analysis was conducted using the Kaplan-Meier method and the log-rank test. RESULTS: Greater protein expression was detected for FGFR3, PI3Kp110α, PI3KClassIII, cyclins D1 and D3 and p21Waf1/Cip1 in the tumour tissue than in the healthy mucosa. However, these differences were not significant for PI3Kp85 and AKT. We observed statistically significant correlations between early recurrence and PI3Kp110α, PI3KClassIII, PI3Kp85 and AKT (P=.003, P=.045, P=.050 and P=.028, respectively), between the tumour type (primary vs. recurrence) and cyclin D3 (P=.001), between the tumour size and FGFR3 (P=.035) and between multifocality and cyclin D1 (P=.039). The survival analysis selected FGFR3 (P=.024), PI3Kp110α (P=.014), PI3KClassIII (P=.042) and AKT (P=.008) as markers of early-recurrence-free survival. CONCLUSIONS: There is an increase in protein expression levels in bladder tumour tissue. The overexpression of FGFR3, PI3Kp110α, PI3KClassIII and AKT is associated with increased early-recurrence-free survival for patients with T1 bladder tumours.

Graft Survival in Patients Who Received Second Allograft, Comparing Those With or Without Previous Failed Allograft Nephrectomy.

INTRODUCTION: Nowadays, the number of patients receiving a second graft is growing, and the management of failed grafts is still controversial. OBJECTIVE: Our objective was to analyze the influence of graft nephrectomy on graft and patient survival. MATERIALS AND METHODS: We retrospectively evaluated the demographic features and graft outcomes of 63 recipients who received second allografts between August 1985 and April 2013. They were divided into two groups: group A, those who underwent nephrectomy of failed graft (n = 21, 33.3%), and group B, those whose failed graft was retained (n = 42, 66.6%). χ2 and Mann-Whitney U tests were used to compare demographic characteristics and graft features in both groups. Kaplan-Meier test was used to analyze graft and patient survival. Finally, univariate and multivariate analysis was done using Cox regression. RESULTS: Demographic characteristics of donor and receptors were similar in both groups. Overall panel-reactive antibody (P = .040) showed statistically significant differences between groups (72.0 ± 25.3 in group A and 54.8 ± 30.0 in group B). Hemodialysis duration was longer in group A (P = .023, 112.2 ± 72.8 vs 70.9 ± 66.9 months). The percentage of patients who had delayed graft function was higher in group A (58.8% vs 27.3%, P = .029). Kaplan-Meier test found no differences between groups (P = .344); group A, 107.4 months (95% confidence interval [CI] 74.0 to 140.8) and group B, 82.7 months (95% CI 62.5 to 102.8). We found no differences in terms of patient survival (P = .798) with the Kaplan-Meier test. In group A, patient survival was 164.5 months (CI 137.7 to 191.31) and in group B, 152.0 months (95% CI 125.5 to 178.5). CONCLUSIONS: Failed graft nephrectomy did not show a negative impact on graft and patient survival.

Influence of Donor and Recipient Ages in Survival of Simultaneous Pancreas-Kidney Transplantation.

INTRODUCTION: Simultaneous pancreas-kidney transplantation (SPKT) is a well treatment for patients with insulin-dependent diabetes and end-stage renal disease. Donor age is a barrier to the acceptance of organs. Age matching has been extensively studied in kidney transplantation; however, there are no studies in graft survival after SPKT. We aimed to study the combined influence of the ages of the donors and recipients in graft survival after SPKT. MATERIAL AND METHODS: Donors and recipients are classified as younger (age <40 years) or older (age ≥40 years). There were four study groups (young-young, young-old, old-young, and old-old). They were evaluated retrospectively for demographic and clinical characteristics of donors and recipients and the long-term survival between 2001 and 2012 of kidney pancreas transplantation patients at our center. RESULTS: A total of 115 transplantations were performed. The four groups had 55 young-young, 40 young-old, 10 old-young, and 10 old-old patients. Serious complications occurred in 32%, 42%, 30%, and 40%, respectively, and deaths were 2%, 5%, 0%, and 20%, respectively, in the groups. Pancreas graft survival at 3 years for each group was 80%, 87, 5%, 90%, and 60%, respectively, and kidney graft survival was 92.7%, 90%, 90%, and 70%, respectively. Panel-reactive antibodies (PRAs) >30% were associated with poor graft survival, and serious postoperative complications associated with poor pancreas-kidney graft survival. CONCLUSIONS: In conclusion, both younger and older recipients show excellent long-term graft and patient survival after SPKTs from younger donors. We recommended that older-recipient SPKT be transplanted from younger donors because older recipients who have been transplanted from older donors had decreased survival.

Validation of the Pancreatic Donor Risk Index in Simultaneous Pancreas-Kidney Transplantation Performed in Córdoba Hospital From 2000 to 2015.

BACKGROUND: The Pancreatic Donor Risk Index (PDRI) was developed in 2010 in the United States to predict graft survival after pancreas transplantation, based on donor characteristics and logistical and technical conditions. The aim of the study was to validate the utility of PDRI as a pancreas allograft survival predictor in simultaneous pancreas-kidney transplantation (SPK) transplants performed in our hospital between 2000 and 2015. METHODS: This retrospective analysis of 126 SPK transplants was performed by the same surgical team from the years 2000 to 2015. Donor variables that are integrated in the PDRI were calculated (age, sex, race, creatinine serum levels, body mass index, height, cold ischemia time, cause of death, type of pancreas transplant). Pancreatic graft survival at 1 and 5 years was calculated by use of the Kaplan-Meier test. Comparison of survival curves between PDRI risk quartiles was calculated by use of the log-rank test. Association between graft survival and variables integrating the PDRI was calculated by use of univariate Cox regression analysis. RESULTS: Log-rank analysis found no statistically significant association between global graft survival and PDRI quartiles. Univariate Cox regression analysis showed a statistically significant association between graft survival and cold ischemia time (P < .05). CONCLUSIONS: PDRI was not a useful tool to predict pancreatic graft outcomes in a Spanish reference population.