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1.
R Soc Open Sci ; 11(7): 240339, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39076370

RESUMEN

Globally, biogenic temperate reefs are among the most threatened habitats. In the North Sea in particular, large shellfish reefs were lost owing to fishing activities in the 1900s. The impact of offshore wind farms (OWFs) on marine wildlife is extensive, and it offers the possibility to reintroduce new hard substrate habitats that are protected from fisheries at a large scale. In addition to the submerged structures of OWFs, marine hard substrate habitat can be further enhanced by providing extra artificial reefs. In an operational OWF along the Dutch coast, four artificial reefs (two with a scour bed and two without) were deployed in the vicinity of a wind turbine. Acoustic telemetry was used to monitor the fine-scale movement of 64 Atlantic cod (Gadus morhua). The monitoring ran from July 2021 to January 2023. Detailed information on behaviour, area utilization and attraction to the structures was determined. Results showed strong attraction (high site fidelity and residency) to the artificial reef, with no significant difference between the two tested types of reefs, and only a few individuals staying over winter. Cod spent a large proportion of their time hiding in the artificial reefs, suggesting that adding pipes for shelter has a beneficiary effect.

2.
Pulmonology ; 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38614857

RESUMEN

INTRODUCTION AND OBJECTIVES: Adjuvant platinum-based chemotherapy for completely resected non-small cell lung cancer is associated with modest improvement in survival; nevertheless, no validated biomarker exists for predicting the benefit or harm of adjuvant platinum-based chemotherapy. MATERIALS AND METHODS: We simultaneously measured 27 cytokines in operative tumor specimens from a discovery cohort (n = 97) by multiplex immunoassay; half of the patients received adjuvant platinum-based chemotherapy, and the other half were observed. We tested possible prognostic and predictive factors in multivariate Cox models for overall survival (OS) and relapse-free survival (RFS), and a tree-based method was applied to detect predictive factors with respect to RFS. The results were validated in an independent validation cohort (n = 93). RESULTS: Fifty-two of 97 (54 %) patients in the discovery cohort and 50 of 93 (54 %) in the validation cohort received adjuvant chemotherapy; forty-four (85 %) patients in the discovery cohort and 37 (74 %) in the validation cohort received four cycles as planned. In patients with low IL-1ß-expressing tumors, RFS and OS were worse after adjuvant chemotherapy than after observation. The limited effect of adjuvant chemotherapy for patients with low IL-1ß-expressing tumors was confirmed in the validation cohort. Additionally, RFS and OS were prolonged by adjuvant chemotherapy only in patients with high IL-1ß-expressing tumors in the validation cohort. CONCLUSIONS: This study identified and validated low tumor IL-1ß expression as a potential biomarker of a limited response to adjuvant platinum-based chemotherapy after complete resection of pulmonary adenocarcinoma. This finding has the potential to inform adjuvant treatment decisions.

3.
Ann R Coll Surg Engl ; 106(4): 321-328, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38555869

RESUMEN

Genomics is a crucial part of managing surgical disease. This review focuses on some of the genomic advances that are available now and looks to the future of their application in surgical practice. Whole-genome sequencing enables unbiased coverage across the entire human genome of approximately three billion base pairs. Newer technologies, such as those that permit long-read sequence analysis, provide additional information in longer phased fragment and base pair epigenomic (methylomic) data. Whole-genome sequencing is currently available in England for cancers in children, teenagers and young adults, central nervous system tumours, sarcoma and haematological malignancies. Circulating tumour DNA (ctDNA), immunotherapy and pharmacogenomics have emerged as groundbreaking approaches in the field of cancer treatment. These are now revolutionising the way oncologists and surgeons approach curative cancer surgery. Cancer vaccines offer an innovative approach to reducing recurrence after surgery by priming the immune system to trigger an immune response. The Cancer Vaccine Launch Pad project facilitates cancer vaccine studies in England. The BNT122-01 trial is recruiting patients with ctDNA-positive high-risk colorectal cancer after surgery to assess the impact of cancer vaccines. The evolving landscape of cancer treatment demands a dynamic and integrated approach from the surgical multidisciplinary team. Immunotherapy, ctDNA, pharmacogenomics, vaccines, mainstreaming and whole-genome sequencing are just some of the innovations that have the potential to redefine the standards of care. The continued exploration of these innovative diagnostics and therapies, the genomic pathway evolution and their application in diverse cancer types highlights the transformative impact of precision medicine in surgery.


Asunto(s)
Vacunas contra el Cáncer , ADN Tumoral Circulante , Neoplasias , Cirujanos , Niño , Humanos , Adolescente , ADN Tumoral Circulante/genética , Genómica
4.
Mov Ecol ; 12(1): 15, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38374086

RESUMEN

Diadromous fish such as the European eel (Anguilla anguilla L.) are hampered by a high density of barriers in estuaries and freshwater systems. Modified and fragmented waterbodies lack tidal flows, and habitat may be less accessible and underutilized compared to free-flowing rivers and estuaries. With rising sea levels and increased occurrence of droughts, the number of barriers may further increase, implying that the need to study migration in such areas may even become more urgent worldwide. To study glass eel migration and behaviour in such highly modified water systems, a mark-recapture study was carried out in the North Sea Canal (NSC) basin, which drains into the North Sea via a large sluice complex. In total, eight uniquely tagged groups (3,797 glass eels) were released near the sluice complex, and 11 groups (2,663 glass eels) were released at inland barriers upstream over a 28 km long stretch in the NSC in spring 2018. The sluice complex attracted 10.3 million glass eel and did not block or delay their immigration. The large and diurnally intensively used coastal ship locks and allowings some saltwater intrusion, efficiently facilitated glass eel migration. Once in the NSC, water outlets from adjacent polders attracted glass eels relative proportional to the discharge of pumping stations. In the NSC, average migration speeds of 0.7 km/day (max. 1.8 km/day) were measured, and this increased with higher temperatures. Redistribution of glass eel from accumulations at inland barriers to other outlet locations was observed in both upstream and downstream directions in the NSC. Passage success and residence time ('delays' of 4.1-13.7 days) varied between the different inland barriers. Most of the glass eel, however, appears to settle in the easily accessible habitats within the brackish NSC catchment. This study combined an integral assessment of successive bottlenecks in a modified inland water system.

6.
Clin Pharmacokinet ; 62(3): 399-434, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36940039

RESUMEN

INTRODUCTION: Understanding the pharmacokinetics (PK) of antimicrobial drugs in pregnant women is crucial to provide effective and safe treatment. This study is part of a series that systematically reviews literature on the PK and analyzes if, based on the changed PK, evidence-based dosing regimens have been developed for adequate target attainment in pregnant women. This part focusses on antimicrobials other than penicillins and cephalosporins. METHODS: A literature search was conducted in PubMed according to the PRISMA guidelines. Search strategy, study selection, and data extraction were independently performed by two investigators. Studies were labeled as relevant when information on the PK of antimicrobial drugs in pregnant women was available. Extracted parameters included bioavailability for oral drugs, volume of distribution (Vd) and clearance (CL), trough and peak drug concentrations, time of maximum concentration, area under the curve and half-life, probability of target attainment, and minimal inhibitory concentration (MIC). In addition, if developed, evidence-based dosing regimens were also extracted. RESULTS: Of the 62 antimicrobials included in the search strategy, concentrations or PK data during pregnancy of 18 drugs were reported. Twenty-nine studies were included, of which three discussed aminoglycosides, one carbapenem, six quinolones, four glycopeptides, two rifamycines, one sulfonamide, five tuberculostatic drugs, and six others. Eleven out of 29 studies included information on both Vd and CL. For linezolid, gentamicin, tobramycin, and moxifloxacin, altered PK throughout pregnancy, especially in second and third trimester, has been reported. However, no target attainment was studied and no evidence-based dosing developed. On the other hand, the ability to reach adequate targets was assessed for vancomycin, clindamycin, rifampicin, rifapentine, ethambutol, pyrazinamide, and isoniazid. For the first six mentioned drugs, no dosage adaptations during pregnancy seem to be needed. Studies on isoniazid provide contradictory results. CONCLUSION: This systematic literature review shows that a very limited number of studies have been performed on the PK of antimicrobials drugs-other than cephalosporins and penicillins-in pregnant women.


Asunto(s)
Cefalosporinas , Penicilinas , Femenino , Humanos , Embarazo , Isoniazida/farmacocinética , Antibacterianos/farmacocinética , Clindamicina
7.
Clin Pharmacokinet ; 62(2): 221-247, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36662480

RESUMEN

BACKGROUND AND OBJECTIVE: Pharmacokinetics (PK) are severely altered in pregnant women due to changes in volume of distribution (Vd) and/or drug clearance (CL), affecting target attainment of antibiotics in pregnant women. This review is part of a series that reviews literature on the description of PK and target attainment of antibiotics in pregnant women with specific focus on penicillins. METHODS: A systematic literature search was carried out in PubMed. Articles were labelled as relevant when information on PK of penicillins in pregnant women was available. RESULTS: Thirty-two relevant articles were included, 8 of which discussed amoxicillin (with and without clavulanic acid), 15 ampicillin, 4 benzylpenicillin, 1 phenoxymethylpenicillin, and 4 piperacillin (with and without tazobactam). No studies were found on pheneticillin and flucloxacillin in pregnant women. Ten out of 32 articles included information on both Vd and CL. During the second and third trimester of pregnancy, a higher CL and larger Vd was reported than in non-pregnant women and in pregnant women during first trimester. Reduced target attainment was described in second and third trimester pregnant women. Only 7 studies reported dosing advice, 4 of which were for amoxicillin. CONCLUSION: The larger Vd and higher CL in second and third trimester pregnant women might warrant a higher dosage or shortening of the dosing interval of penicillins to increase target attainment. Studies frequently fail to provide dosing advice for pregnant women, even if the necessary PK information was available.


Asunto(s)
Antibacterianos , Penicilinas , Embarazo , Femenino , Humanos , Penicilinas/farmacocinética , Antibacterianos/farmacocinética , Amoxicilina , Ampicilina , Piperacilina
8.
ESMO Open ; 6(5): 100254, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34481329

RESUMEN

BACKGROUND: The advanced lung cancer inflammation index [ALI: body mass index × serum albumin/neutrophil-to-lymphocyte ratio (NLR)] reflects systemic host inflammation, and is easily reproducible. We hypothesized that ALI could assist guidance of non-small-cell lung cancer (NSCLC) treatment with immune checkpoint inhibitors (ICIs). PATIENTS AND METHODS: This retrospective study included 672 stage IV NSCLC patients treated with programmed death-ligand 1 (PD-L1) inhibitors alone or in combination with chemotherapy in 25 centers in Greece and Germany, and a control cohort of 444 stage IV NSCLC patients treated with platinum-based chemotherapy without subsequent targeted or immunotherapy drugs. The association of clinical outcomes with biomarkers was analyzed with Cox regression models, including cross-validation by calculation of the Harrell's C-index. RESULTS: High ALI values (>18) were significantly associated with longer overall survival (OS) for patients receiving ICI monotherapy [hazard ratio (HR) = 0.402, P < 0.0001, n = 460], but not chemo-immunotherapy (HR = 0.624, P = 0.111, n = 212). Similar positive correlations for ALI were observed for objective response rate (36% versus 24%, P = 0.008) and time-on-treatment (HR = 0.52, P < 0.001), in case of ICI monotherapy only. In the control cohort of chemotherapy, the association between ALI and OS was weaker (HR = 0.694, P = 0.0002), and showed a significant interaction with the type of treatment (ICI monotherapy versus chemotherapy, P < 0.0001) upon combined analysis of the two cohorts. In multivariate analysis, ALI had a stronger predictive effect than NLR, PD-L1 tumor proportion score, lung immune prognostic index, and EPSILoN scores. Among patients with PD-L1 tumor proportion score ≥50% receiving first-line ICI monotherapy, a high ALI score >18 identified a subset with longer OS and time-on-treatment (median 35 and 16 months, respectively), similar to these under chemo-immunotherapy. CONCLUSIONS: The ALI score is a powerful prognostic and predictive biomarker for patients with advanced NSCLC treated with PD-L1 inhibitors alone, but not in combination with chemotherapy. Its association with outcomes appears to be stronger than that of other widely used parameters. For PD-L1-high patients, an ALI score >18 could assist the selection of cases that do not need addition of chemotherapy.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Humanos , Inhibidores de Puntos de Control Inmunológico , Inflamación , Neoplasias Pulmonares/tratamiento farmacológico , Estudios Retrospectivos
9.
ESMO Open ; 6(5): 100253, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34487971

RESUMEN

BACKGROUND: Targeted therapies have improved survival and quality of life for patients with non-small-cell lung cancer with actionable driver mutations. However, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 gene (HER2, also known as ERBB2) exon 20 insertions (Ex20mut) are characterized by a poor response to currently approved tyrosine kinase inhibitors and immunotherapies. The underlying immune biology is not well understood. MATERIALS AND METHODS: We carried out messenger RNA expression profiling of lung adenocarcinomas (ADCs) with ERBB2 (n = 19) and EGFR exon 20-insertion mutations (n = 13) and compared these to tumors with classical EGFR mutations (n = 40, affecting EGFR exons 18, 19 or 21) and EGFR/ERBB2 mutation-negative lung ADC (EGFR/ERBB2wt, n = 26) focusing on immunologically relevant transcripts. Tumor-infiltrating immune cells were estimated from gene expression profiles. RESULTS: Cytotoxic cells were significantly lower in EGFR-mutated tumors regardless of the affected exon, while Th1 cells were significantly lower in EGFR-Ex20mut compared to EGFR/ERBB2wt tumors. We assessed the differentially expressed genes of ERBB2-Ex20mut and EGFR-Ex20mut tumors compared to EGFR-Ex18/19/21mut and EGFR/ERBB2wt tumors. Of these, the genes GUSB, HDAC11, IFNGR2, PUM1, RASGRF1 and RBL2 were up-regulated, while a lower expression of CBLC, GBP1, GBP2, GBP4 and MYC was observed in all three comparison groups. The omnibus test revealed 185 significantly (FDR = 5%) differentially expressed genes and we found these four most significant gene expression changes in the study cohort: VHL and JAK1 were overexpressed in ERBB2-Ex20mut and EGFR-Ex20mut tumors compared to both EGFR-Ex18/19/21mut and EGFR/ERBB2wt tumors. RIPK1 and STK11IP showed the highest expression in ERBB2-Ex20mut tumors. CONCLUSIONS: Targeted gene expression profiling is a promising tool to read out the characteristics of the tumor microenvironment from routine diagnostic lung cancer biopsies. Significant immune reactivity and specific immunosuppressive characteristics in ERBB2-Ex20mut and EGFR-Ex20mut lung ADC with at least some degree of immune infiltration support further clinical evaluation of immune-modulators as partners of immune checkpoint inhibitors in such tumors.


Asunto(s)
Adenocarcinoma del Pulmón , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Adenocarcinoma del Pulmón/genética , Receptores ErbB/genética , Histona Desacetilasas , Humanos , Neoplasias Pulmonares/genética , Calidad de Vida , Proteínas de Unión al ARN , Receptor ErbB-2/genética , Microambiente Tumoral/genética
11.
Rofo ; 193(3): 276-288, 2021 Mar.
Artículo en Inglés, Alemán | MEDLINE | ID: mdl-33242898

RESUMEN

PURPOSE: The DRG-ÖRG IRP (Deutsche Röntgengesellschaft-Österreichische Röntgengesellschaft international radiomics platform) represents a web-/cloud-based radiomics platform based on a public-private partnership. It offers the possibility of data sharing, annotation, validation and certification in the field of artificial intelligence, radiomics analysis, and integrated diagnostics. In a first proof-of-concept study, automated myocardial segmentation and automated myocardial late gadolinum enhancement (LGE) detection using radiomic image features will be evaluated for myocarditis data sets. MATERIALS AND METHODS: The DRG-ÖRP IRP can be used to create quality-assured, structured image data in combination with clinical data and subsequent integrated data analysis and is characterized by the following performance criteria: Possibility of using multicentric networked data, automatically calculated quality parameters, processing of annotation tasks, contour recognition using conventional and artificial intelligence methods and the possibility of targeted integration of algorithms. In a first study, a neural network pre-trained using cardiac CINE data sets was evaluated for segmentation of PSIR data sets. In a second step, radiomic features were applied for segmental detection of LGE of the same data sets, which were provided multicenter via the IRP. RESULTS: First results show the advantages (data transparency, reliability, broad involvement of all members, continuous evolution as well as validation and certification) of this platform-based approach. In the proof-of-concept study, the neural network demonstrated a Dice coefficient of 0.813 compared to the expert's segmentation of the myocardium. In the segment-based myocardial LGE detection, the AUC was 0.73 and 0.79 after exclusion of segments with uncertain annotation.The evaluation and provision of the data takes place at the IRP, taking into account the FAT (fairness, accountability, transparency) and FAIR (findable, accessible, interoperable, reusable) criteria. CONCLUSION: It could be shown that the DRG-ÖRP IRP can be used as a crystallization point for the generation of further individual and joint projects. The execution of quantitative analyses with artificial intelligence methods is greatly facilitated by the platform approach of the DRG-ÖRP IRP, since pre-trained neural networks can be integrated and scientific groups can be networked.In a first proof-of-concept study on automated segmentation of the myocardium and automated myocardial LGE detection, these advantages were successfully applied.Our study shows that with the DRG-ÖRP IRP, strategic goals can be implemented in an interdisciplinary way, that concrete proof-of-concept examples can be demonstrated, and that a large number of individual and joint projects can be realized in a participatory way involving all groups. KEY POINTS: · The DRG-ÖRG IRP is a web/cloud-based radiomics platform based on a public-private partnership.. · The DRG-ÖRG IRP can be used for the creation of quality-assured, structured image data in combination with clinical data and subsequent integrated data analysis.. · First results show the applicability of left ventricular myocardial segmentation using a neural network and segment-based LGE detection using radiomic image features.. · The DRG-ÖRG IRP offers the possibility of integrating pre-trained neural networks and networking of scientific groups.. CITATION FORMAT: · Overhoff D, Kohlmann P, Frydrychowicz A et al. The International Radiomics Platform - An Initiative of the German and Austrian Radiological Societies. Fortschr Röntgenstr 2021; 193: 276 - 287.


Asunto(s)
Corazón , Procesamiento de Imagen Asistido por Computador , Radiología , Inteligencia Artificial , Austria , Nube Computacional , Alemania , Corazón/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Acceso a Internet , Radiología/métodos , Reproducibilidad de los Resultados , Sociedades
12.
Br Poult Sci ; 61(5): 508-517, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32316746

RESUMEN

1. The objective of this study was to characterise the regulation of the pathways that synthesise long-chain polyunsaturated fatty acids (PUFA) on developing adipose deposits in broiler embryos and chicks. Subcutaneous adipose depots were harvested from embryos and embryonic d E13, E15 and E17. Subcutaneous, abdominal and crop (neck) adipose, as well as liver, were collected at 7 and 14 d post-hatch. 2. Targeted RNA sequencing was used to quantify expression of 6 elongation of very long-chain fatty acid (ELOVL) genes, two isoforms of stearoyl-CoA desaturase (SCD and SCD5), and three fatty acid desaturases (FADS1, FADS2, and FADS6) in each depot and in the liver. Expression levels of marker genes for fatty acid oxidation and adipogenesis (peroxisome proliferator-activated receptor gamma (PPARG)) were quantified. Fatty acid composition of subcutaneous adipose was analysed using gas chromatograph-mass spectrometry (GC/MS). 3. Genes in the PUFA synthetic pathway were differentially expressed across developmental ages and between depots. These include elongase and desaturase genes, that have not previously been characterised in chicken. Correlation analyses identified subsets of co-regulated genes and fatty acids and highlighted relationships that may influence adipose metabolism and development. 4. It was concluded that PUFA synthesis is an active and dynamically regulated pathway in developing adipose deposits in the broiler chick. These data highlighted potential novel roles for specific elongase and desaturase genes in adipose deposition and metabolism.


Asunto(s)
Adipogénesis , Pollos , Animales , Pollos/genética , Ácido Graso Desaturasas/genética , Ácidos Grasos , Ácidos Grasos Insaturados
13.
Behav Processes ; 170: 103992, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31704307

RESUMEN

Anthropogenic sources increasingly contribute to the underwater soundscape and this may negatively impact aquatic life, including fish. Anthropogenic sound may mask relevant sound, alter behaviour, physiology, and may lead to physical injury. Behavioural effect studies are often seen as critical to evaluate individual and population-level impact. However, behavioural responsiveness likely depends on context and characteristics of sound stimuli. We pose that ambient sound levels, signal-to-noise ratio (SNR), and pulse rate interval (PRI), could affect the behavioural response of fish. To study this, we experimentally exposed groups of tagged European seabass (Dicentrarchus labrax) to different impulsive sound treatments that varied in pulse level, elevated background level, SNR, and PRI. Upon sound exposure, the seabass increased their swimming depth. The variation in the increase in swimming depth could not be attributed to pulse level, background level, SNR or PRI. It may be that the current range of sound levels or PRIs was too narrow to find such effects.


Asunto(s)
Estimulación Acústica/psicología , Lubina/fisiología , Conducta Animal/fisiología , Sonido , Animales , Problema de Conducta , Relación Señal-Ruido , Natación/psicología
14.
Lung Cancer ; 138: 95-101, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31678832

RESUMEN

OBJECTIVE: Lymph node (LN) metastases predict survival in patients with non-small cell lung cancer (NSCLC) treated with curative surgery. Nevertheless, prognostic differences within the same nodal (N) status have been reported. Consequently, the International Association for the Study of Lung Cancer (IASLC) proposed to stratify patients with limited nodal disease (pN1) from low (pN1a) to high (pN1b) nodal tumor burden. This study aimed to validate the IASLC proposal in a large single-center surgical cohort of patients with pN1 NSCLC. MATERIAL AND METHODS: Data from 317 patients with pN1 NSCLC treated between January 2012 and December 2016, were retrospectively analyzed. Associations between distribution of LN metastases and survival were analyzed for different classification models-toward nodal extension (pN1a: one station involved; pN1b: multiple stations involved) and toward location (pN1 in the hilar [LN#10/11] or peripheral zone [LN#12-14]). RESULTS: Tumor-specific survival (TSS) in the entire pN1 cohort was 67.1% at five years. Five-year TSS rates for pN1a and pN1b patients were comparable (67.6% vs. 66.5%, p = 0.623). Significant survival differences from pN1a to pN1b were observed only in patients with adenocarcinoma histology and completed adjuvant chemotherapy (5-year TSS: pN1a, 80.4% vs. pN1b, 49.6%; p = 0.005). TSS for LN metastases in the hilar zone/peripheral zone or in both zones was 68.2% and 59.9%, respectively (p = 0.068). In multivariate analysis, adjuvant chemotherapy, squamous cell histology, and nodal disease limited to one zone nodal disease were identified as independent beneficial prognostic factors (p < 0.05). CONCLUSION: pN1 in only one region (hilar or lobar) was associated with better outcome than metastatic affection of both regions after surgery and adjuvant therapy. A stratification towards single (pN1a) and multiple (pN1b) N1-metastases was found of prognostic relevance only in adenocarcinoma. Prospective multicenter analysis of prognostic subgroups in N1 NSCLC is required to evaluate its clinical impact for consideration in future TNM classification.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Neoplasias Pulmonares/patología , Ganglios Linfáticos/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Femenino , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/cirugía , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias/métodos , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia , Carga Tumoral
15.
Chirurg ; 90(9): 697-703, 2019 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-31161248

RESUMEN

BACKGROUND: Interventional bronchoscopy is an indispensable option to manage bronchopleural and tracheopleural fistulas in patients in a poor general condition and at high risk for developing postoperative complications. METHODS: This article is based on a search in the PubMed database for relevant publications and own experiences as surgeons and pneumologists. RESULTS: Various interventional techniques can be used for the treatment of bronchopleural and tracheopleural fistulas. Currently, the insertion of stents or endobronchial valves is the most frequently used treatment. Ideally, the attending anesthesiologist will have experience with high frequency jet ventilation and the attending surgeon will have experience with rigid bronchoscopy, flexible bronchoscopy, and interventional bronchoscopy. DISCUSSION: Due to a lack of standardized treatment recommendations, individual treatment plans must be decided according to the location of the bronchopleural or tracheopleural fistula and taking existing comorbidities into account.


Asunto(s)
Fístula Bronquial , Enfermedades Pleurales , Fístula Bronquial/cirugía , Broncoscopía , Humanos , Enfermedades Pleurales/cirugía , Neumonectomía , Complicaciones Posoperatorias , Stents , Resultado del Tratamiento
16.
J Antimicrob Chemother ; 73(10): 2687-2690, 2018 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29982676

RESUMEN

Objectives: In this study we assess the antibiotic resistance genes in three metronidazole-resistant Prevotella bivia clinical isolates. Methods: Strains were whole-genome sequenced. De novo assembly was performed and genes were annotated in RAST. Manual adjustments were made, when required, to the annotation and length of the genes. Results: In all three strains a novel nim gene, nimK, was encountered located on a mobile genetic element (MGE). The nimK gene was associated with an IS1380 family transposase. On the same MGE, genes encoding an efflux small MDR (SMR) transporter were present and were associated with a crp/fnr regulator. Conclusions: This is the first description of the presence of a novel nim gene in metronidazole-resistant P. bivia clinical isolates. This gene is co-located with an efflux SMR transporter on an MGE, which has been named Tn6456 (MG827401). The identification of these resistance genes on an MGE is worrisome, since this indicates the horizontal gene transfer of antibiotic and/or biocide resistance from one strain to the other.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana/genética , Secuencias Repetitivas Esparcidas , Proteínas de Transporte de Membrana/genética , Metronidazol/farmacología , Prevotella/efectos de los fármacos , Prevotella/genética , Infecciones por Bacteroidaceae/microbiología , ADN Bacteriano/genética , Genes Bacterianos , Genoma Bacteriano , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Secuenciación Completa del Genoma
17.
Stud Mycol ; 89: 95-104, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29910516

RESUMEN

This study aims at characterizing the diversity and temporal changes of species richness and composition of fungi in an ecotone of a forest border and a meadow in the Taunus mountain range in Germany. All macroscopically visible, epigeous fungi and vascular plants were sampled monthly over three years, together with climatic variables like humidity and temperature that influence fungal diversity and composition as shown by previous studies. In this mosaic landscape, a total of 855 fungal species were collected and identified based on morphological features, the majority of which belonged to Ascomycota (51 %) and Basidiomycota (45 %). Records of fungal species and plant species (218) for this area yielded a fungus to plant species ratio of 4:1, with a plant species accumulation curve that reached saturation. The three years of monitoring, however, were not sufficient to reveal the total fungal species richness and estimation factors showed that a fungus to plant species ratio of 6:1 may be reached by further sampling efforts. The effect of climatic conditions on fungal species richness differed depending on the taxonomic and ecological group, with temporal patterns of occurrence of Basidiomycota and mycorrhizal fungi being strongly associated with temperature and humidity, whereas the other fungal groups were only weakly related to abiotic conditions. In conclusion, long-term, monthly surveys over several years yield a higher diversity of macroscopically visible fungi than standard samplings of fungi in autumn. The association of environmental variables with the occurrence of specific fungal guilds may help to improve estimators of fungal richness in temperate regions.

18.
HLA ; 2018 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-29888557

RESUMEN

The impact of de novo donor-specific anti-HLA antibodies (DSA) on outcomes in lung transplantation is still a matter of debate. We hypothesize that differentiating DSA by persistent and transient appearance may offer an additional risk assessment. The clinical relevance of HLA-antibodies was investigated prospectively in 72 recipients with a median follow-up period of 21 months. The presence of HLA-antibodies was analysed by single antigen bead assay prior to and after (3 weeks, 3, 6, 12 and 18 months) transplantation. In 23 patients (32%) de novo DSA were detected. In 10 of these patients (44%) DSA persisted throughout the follow-up period whereas 13 of these patients (56%) had transient DSA. There was a trend towards lower one-year-survival in DSA positive compared to DSA negative patients (83% versus 94%; p=0.199). Remarkably, patients with persistent DSA had significantly reduced survival (one-year survival 60%) compared with both patients without DSA and those with transient DSA (p=0.005). Persistent DSA represented an independent prognostic factor for reduced overall survival in multivariate analysis (HR 8.3, 95% CI 1.8-37.0; p=0.006). Persistence of DSA during the first year after transplantation seems to be more harmful for lung allograft function than transiently detected DSA at an early stage. This article is protected by copyright. All rights reserved.

19.
Environ Pollut ; 239: 367-374, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-29674215

RESUMEN

Aquatic animals live in an acoustic world, prone to pollution by globally increasing noise levels. Noisy human activities at sea have become widespread and continue day and night. The potential effects of this anthropogenic noise may be context-dependent and vary with the time of the day, depending on diel cycles in animal physiology and behaviour. Most studies to date have investigated behavioural changes within a single sound exposure session while the effects of, and habituation to, repeated exposures remain largely unknown. Here, we exposed groups of European seabass (Dicentrarchus labrax) in an outdoor pen to a series of eight repeated impulsive sound exposures over the course of two days at variable times of day/night. The baseline behaviour before sound exposure was different between day and night; with slower swimming and looser group cohesion observed at night. In response to sound exposures, groups increased their swimming speed, depth, and cohesion; with a greater effect during the night. Furthermore, groups also showed inter-trial habituation with respect to swimming depth. Our findings suggest that the impact of impulsive anthropogenic noise may be stronger at night than during the day for some fishes. Moreover, our results also suggest that habituation should be taken into account for sound impact assessments and potential mitigating measures.


Asunto(s)
Lubina/fisiología , Conducta Animal/fisiología , Exposición a Riesgos Ambientales , Ruido , Acústica , Animales , Sonido , Trastornos Relacionados con Sustancias , Natación
20.
Lung Cancer ; 118: 76-82, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29572007

RESUMEN

OBJECTIVES: Large cell neuroendocrine carcinoma of the lung (LCNEC) is associated with an unfavorable prognosis and only few patients are eligible for surgery. In most patients, chemotherapy is recommended alone or in addition to resection. Novel immunotherapies blocking the PD-L1 pathway have been introduced into therapeutic regimens for NSCLC with great success. In order to evaluate a possible efficacy of an anti-PD-L1 therapy, we analyzed the frequency of PD-L1 expression in LCNEC. MATERIAL AND METHODS: We retrospectively reviewed data from 76 patients with LCNEC treated in our institution between 1998 and 2010. The expression of PD-L1 was examined on the tumor cells and the tumor surrounding tissue by immunohistochemistry. An expression of >1% was considered as positive. Statistical analysis was performed to determine significant predictors for survival. RESULTS: 56 of 76 patients with LCNEC were treated with a potentially therapeutic surgical approach. Tumor-specific survival (TSS) of the entire cohort was 29% at five years. 17 patients (22.3%) had PD-L1 positive tumors and 12 of these had no additional PD-L1 expression in the adjacent immune cell infiltrate. Tumor-flanking immune cells were found PD-L1 positive 28 patients; 16 of these had no additional expression on the tumor cells. The most considerable difference in survival was found when comparing patients with isolated PD-L1 expression on tumor cells and PD-L1 negative immune cell infiltrate to their counterpart (positive immune-cell infiltrate and PD-L1 negative tumor cell surface; 5-year TSS: 0% vs. 60%; p < 0.017). CONCLUSION: PD-L1 expression in LCNEC was associated with poorer survival whereas PD-L1 expression in the tumor microenvironment seemed to have a beneficial effect. Therapeutic approaches have to be evaluated in future.


Asunto(s)
Antígeno B7-H1/metabolismo , Carcinoma Neuroendocrino/metabolismo , Neoplasias Pulmonares/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Neuroendocrino/diagnóstico , Carcinoma Neuroendocrino/mortalidad , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Análisis de Supervivencia , Microambiente Tumoral
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