Role of executive functions in the relations of state- and trait-math anxiety with math performance.

The detrimental effect of math anxiety on math performance is thought to be mediated by executive functions. Previous studies have primarily focused on trait-math anxiety rather than state-math anxiety and have typically examined a single executive function rather than comprehensively evaluating all of them. Here, we used a structural equation modeling approach to concurrently determine the potential mediating roles of different executive functions (i.e., inhibition, switching, and updating) in the relationships between both state- and trait-math anxiety and math performance. A battery of computer-based tasks and questionnaires were administered to 205 university students. Two relevant results emerged. First, confirmatory factor analysis suggests that math anxiety encompassed both trait and state dimensions and, although they share substantial variance, trait-math anxiety predicted math performance over and above state-math anxiety. Second, working memory updating was the only executive function that mediated the relationship between math anxiety and math performance; neither inhibition nor switching played mediating roles. This calls into question whether some general proposals about the relationship between anxiety and executive functions can be extended specifically to math anxiety. We also raise the possibility that working memory updating or general cognitive difficulties might precede individual differences in math anxiety.

Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population.

Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice.

Psychometric Properties, Factor Structure, and Gender and Educational Level Invariance of the Abbreviated Math Anxiety Scale (AMAS) in Spanish Children and Adolescents.

The present study aimed to investigate the factor structure and degree of measurement invariance of a Spanish adaptation of the Abbreviated Math Anxiety Scale (AMAS) in primary and secondary school students (N = 1,504 students, 46.08% males, 7-19 years of age). The results of confirmatory factor analysis corroborated the original two-factor structure, although a modified two-factor model with one item loading simultaneously on both factors was better supported. Full measurement invariance was observed across gender, and partial measurement invariance was achieved across educational levels (primary and secondary education). The AMAS showed reasonable internal consistency, test-retest reliability, and convergent validity. These results highlight the utility of the AMAS as a measure of math anxiety in primary and secondary school students whose scores can be compared by gender and educational level.

Latin American consensus on the quality indicators for comprehensive care clinics for patients with inflammatory bowel disease: PANCCO-GETECCU.

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic and incurable entity. The aim of the Pan American Crohn's and Colitis Organisation (PANCCO) is to create awareness of IBD, with special emphasis on Latin America, and the primary objective of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU, the Spanish acronym) is to obtain the accreditation of the clinical and therapeutic criteria for the diagnosis and treatment of IBD. AIM: To carry out a consensus for evaluating the approval criteria that a Comprehensive Care Clinic for Latin American IBD patients must meet, to be considered a center of excellence. MATERIALS AND METHODS: Fourteen clinical experts participated in the consensus. They were made up of specialists in gastroenterology, with broad clinical experience, spanning several years, in managing the care of a large number of patients with IBD, as well as advanced specialists in IBD. Thirteen of the participants came from 11 Latin American countries (Argentina, Brazil, Colombia, Dominican Republic, Ecuador, Guatemala, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela) that have IBD clinics. An expert from Spain, representing the GETECCU, provided the methodologic support. The consensus consisted of 52 statements divided into three sections: 1) Structure indicators, 2) Process indicators, and 3) Result indicators. The Delphi panel method was applied. RESULTS: The present Latin American consensus describes the quality indicators that a Comprehensive Care Clinic for IBD patients must meet, to be considered a center of excellence, taking into account the needs of our region. CONCLUSIONS: This is the first Latin American consensus, jointly carried out by the PANCCO and GETECCU, to present accreditation standards for centers of excellence in the care of patients with IBD.

[Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy]. / Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.

INTRODUCTION: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. AIM: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. PATIENTS AND METHODS: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. RESULTS: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. CONCLUSION: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.

TITLE: Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.Introducción. El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual son escasos. Objetivo. Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual. Pacientes y métodos. Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos. Resultados. Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global. Conclusión. La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.

Characterization of inflammatory bowel disease in Colombia: Results of a national register. / Caracterización de la enfermedad inflamatoria intestinal en Colombia: resultados de un registro nacional.

AIM: To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register. METHODS: A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted. RESULTS: A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000). CONCLUSION: In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis.

Math Anxiety and Working Memory Updating: Difficulties in Retrieving Numerical Information From Working Memory.

This study aimed to determine whether math anxiety was related to working memory (WM) updating performance and, specifically, to the retrieval and substitution components of updating. A set of WM updating (WMU) tasks that involve different retrieval and substitution requirements were administered to 114 university students. In addition, participants completed a math anxiety assessment on two occasions: 1-2 weeks before and immediately prior to task administration to increase the likelihood of observing the relationship between math anxiety and updating performance. The results showed a relationship between math anxiety scores and updating performance. Math anxious individuals took longer and made more errors, especially on tasks that required retrieving information from WM. These results suggest that math anxious individuals are less efficient when it comes to accessing numerical information in WM. Consequently, they may struggle with math-related tasks that involve retrieving numerical information from WM.

Proteomic insights into the immune response of the Colorado potato beetle larvae challenged with Bacillus thuringiensis.

Bacillus thuringiensis (Bt) toxins constitute effective, environmentally safe biopesticides. Nevertheless, insects' tolerance to Bt is influenced by environmental factors affecting immunity. To understand larval immune response in the devastating coleopteran insect pest Colorado potato beetle (CPB), we undertook a proteomic analysis of hemolymph of non-treated control larvae and larvae consuming non-lethal doses of spore-crystal mixtures containing the coleopteran-active Cry3Aa toxin. Results revealed lower amount of proteins involved in insect growth and higher amount of immune response-related proteins in challenged insects, sustaining the larval weight loss observed. Additionally, we found a potential regulatory role of the evolutionary conserved miR-8 in the insect's immune response relying on antimicrobial peptides (AMPs) production. Upon toxin challenge, different patterns of hemolymph AMPs expression and phenoloxidase activity were observed in CPB larvae reared on different Solanaceae plants. This suggests that diet and diet-associated insect midgut microbiota might modulate this insects' tolerance to non-lethal doses of Bt.

Prostatectomía inmediata versus demorada en pacientes que progresan a una enfermedad de mayor riesgo en vigilancia activa / Immediate versus delayed prostatectomy and the fate of patients who progress to a higher risk disease on active surveillance

Introducción: Se debaten los resultados oncológicos de la prostatectomía radical (PR) en pacientes que progresan en vigilancia activa (VA). Comparamos los resultados de los pacientes elegibles para VA sometidos a PR inmediatamente después del diagnóstico con aquellos que lo hacían después de un retraso o progresión de la enfermedad en VA. Métodos: Entre 2000 y 2014, 961 pacientes fueron elegibles para VA según los criterios de la EAU. Se comparó la PR a los 6 meses del diagnóstico (PRI) o más allá (PRT), PR sin VA (PRTa) y pacientes en VA que progresan a PR (PRTb). Se registró PSA inicial, características clínicas y de biopsia. Los resultados oncológicos incluyeron patología adversa (PA) en la muestra de PR y recurrencia bioquímica (RBQ). Se realizó un análisis de pares emparejados entre los pacientes con PRTb y GS7 sometidos a PR inmediata (GS7PRI). Resultados: PRI, PRT, PRTa y PRTb tuvieron 820 (85%), 141 (15%), 118 (12,24%) y 23 (2,7%) pacientes respectivamente. PRI, PRTa y PRTb se sometieron a PR a una mediana de 3, 9 y 19 meses después del diagnóstico, respectivamente. Las características basales fueron comparables. PRT vs. PRI tuvieron una mediana de tiempo más temprana (31 vs. 43 meses; p < 0,001) y una mayor tasa de progresión a RBQ (7,6 vs. 3,9%; p = 0,045). PRTb mostró RBQ más alta (19 frente a 5%; p = 0,021) con una mediana de tiempo más temprana a RBQ, en comparación con PRI y PRTa (p = 0,038). No hubo diferencias en las tasas de PA y RBQ, pero el tiempo hasta RBQ fue significativamente menor en PRTb (49 frente a 6 meses; p<0,001), en comparación con GS7PRI. Conclusiones: Los pacientes que progresaron en VA tuvieron los peores resultados oncológicos. PR para progresión de GS7 y par coincidente de pacientes con GS7 tuvieron resultados similares. Peores resultados oncológicos en los progresores de VA no pueden explicarse por una mera demora en PR

Introduction: Oncological outcomes of radical prostatectomy (RP) in patients progressing on active surveillance (AS) are debated. We compared outcomes of AS eligible patients undergoing RP immediately after diagnosis with those doing so after delay or disease progression on AS. Methods: Between 2000 and 2014, 961 patients were AS eligible as per EAU criteria. RP within 6 months of diagnosis (IRP) or beyond (DRP), RP without AS (DRPa) and AS patients progressing to RP (DRPb) were compared. Baseline PSA, clinical and biopsy characteristics were noted. Oncological outcomes included adverse pathology in RP specimen and biochemical recurrence (BCR). Matched pair analysis was done between DRPb and GS7 patients undergoing immediate RP (GS7IRP). Results: IRP, DRP, DRPa and DRPb had 820 (85%), 141 (15%), 118 (12.24%) and 23 (2.7%) patients respectively. IRP, DRPa and DRPb underwent RP at a median of 3, 9 and 19 months after diagnosis respectively. Baseline characteristics were comparable. DRP vs. IRP had earlier median time (31 vs. 43 months; p < 0.001) and higher rate of progression to BCR (7.6 vs. 3.9%; p = 0.045). DRPb showed higher BCR (19 vs. 5%; p = 0.021) with earlier median time to BCR, compared to IRP and DRPa (p = 0.038). There was no difference in adverse pathology and BCR rates, but time to BCR was significantly lesser in DRPb (49 vs. 6 months; p < 0.001), compared to GS7IRP. Conclusions: Patients progressing on AS had worst oncological outcomes. RP for GS7 progression and matched pair of GS7 patients had similar outcomes. Worse oncological outcomes in AS progressors cannot be explained by a mere delay in RP

Resultados oncológicos y características patológicas de la sobrestadificación de cT1 a carcinoma de células renales pT3a en comparación con los tumores pT3a de novo / Oncological outcomes and pathological characteristics of cT1 upstaging to pT3a renal cell carcinoma compared with de novo pT3a tumors

Introducción: La importancia de la sobrestadificación de tumores renales cT1 a pT3a no está clara. Evaluamos la incidencia de la sobrestadificación, identificamos factores predictivos y analizamos los resultados oncológicos de estos pacientes frente a aquellos que no sobrestadificaron. También comparamos los resultados oncológicos de la sobrestadificación de cT1 a pT3a con tumores renales pT3a de novo. Métodos: De una base de datos de 1.021 tumores renales con datos de seguimiento completos disponibles, 517 pacientes tenían cT1. Los pacientes que sobrestadificaron a pT3a se compararon con aquellos que no lo hicieron. Se analizaron los resultados de las características clínicas, perioperatorias, histopatológicas y oncológicas iniciales. Resultados: De 517 pacientes con cT1, 105 (20,3%) sobrestadificaron a pT3a y 412 (79,7%) no lo hicieron. La proporción de pacientes en cada grupo tratados mediante nefrectomía parcial y radical, el tamaño del tumor postoperatorio, la histología, el estado de los márgenes, y la afectación de ganglios linfáticos fueron similares. Entre los que sobrestadificaron, 9 pacientes (8,6%) desarrollaron la primera recurrencia en comparación con solo 3 (0,7%) en aquellos que no sobrestadificaron (p < 0,001). La mediana del tiempo hasta la recurrencia (57 frente a 107 meses; p < 0,001) fue menor en los tumores renales pT3a de novo. Conclusiones: La sobrestadificación patológica de cT1 a pT3a y la necrosis en la histopatología se asociaron con la recurrencia. La edad avanzada, el tabaquismo, la necrosis en la histopatología, la histología de células claras y grados más altos de Fuhrman contribuyeron a la sobrestadificación patológica de los tumores cT1. El CCR pT3a de novo tuvo una supervivencia peor cuando se comparó con los pacientes con cT1 que sobrestadificaron a CCR pT3a

Introduction: The significance of upstaging of cT1 renal tumors to pT3a is not clear. We evaluate the incidence of upstaging, identify predictors and analyze oncological outcomes of these patients versus those who did not upstage. We also compared the oncological outcomes of cT1 upstaging to pT3a with de novo pT3a renal tumors. Methods: From a database of 1021 renal tumors with complete available follow-up data, 517 patients had cT1. Patients upstaging to pT3a were compared to those who did not. Baseline clinical, perioperative, histopathologic features and oncological outcomes were analysed. Results: Out of 517 cT1 patients, 105 (20.3%) upstaged to pT3a and 412 (79.7%) did not. Proportion of patients in each group undergoing partial and radical nephrectomy, postoperative tumor size, histology, margin status and lymph node involvement were similar. Among upstaged, 9 patients (8.6%) developed first recurrence as compared to only 3 (0.7%) in those not upstaging (P < 0.001). The median time to recurrence (57 vs. 107 months; P < 0.001) was lesser in de novo pT3a renal tumors. Conclusions: Pathological upstaging from cT1 to pT3a and necrosis on histopathology were associated with recurrence. Advanced age, smoking, necrosis on histopathology, clear cell histology and higher Fuhrman grades contributed to pathological upstaging of cT1 tumors. De novo pT3a RCC had worse survival when compared to cT1 patients upstaging to pT3a RCC

Immediate versus delayed prostatectomy and the fate of patients who progress to a higher risk disease on active surveillance. / Prostatectomía inmediata versus demorada en pacientes que progresan a una enfermedad de mayor riesgo en vigilancia activa.

INTRODUCTION: Oncological outcomes of radical prostatectomy (RP) in patients progressing on active surveillance (AS) are debated. We compared outcomes of AS eligible patients undergoing RP immediately after diagnosis with those doing so after delay or disease progression on AS. METHODS: Between 2000 and 2014, 961 patients were AS eligible as per EAU criteria. RP within 6 months of diagnosis (IRP) or beyond (DRP), RP without AS (DRPa) and AS patients progressing to RP (DRPb) were compared. Baseline PSA, clinical and biopsy characteristics were noted. Oncological outcomes included adverse pathology in RP specimen and biochemical recurrence (BCR). Matched pair analysis was done between DRPb and GS7 patients undergoing immediate RP (GS7IRP). RESULTS: IRP, DRP, DRPa and DRPb had 820 (85%), 141 (15%), 118 (12.24%) and 23 (2.7%) patients respectively. IRP, DRPa and DRPb underwent RP at a median of 3, 9 and 19 months after diagnosis respectively. Baseline characteristics were comparable. DRP vs. IRP had earlier median time (31 vs. 43 months; p<.001) and higher rate of progression to BCR (7.6 vs. 3.9%;p=.045). DRPb showed higher BCR (19 vs. 5%;p=.021) with earlier median time to BCR, compared to IRP and DRPa (p=.038). There was no difference in adverse pathology and BCR rates, but time to BCR was significantly lesser in DRPb (49 vs. 6 months;p<.001), compared to GS7IRP. CONCLUSIONS: Patients progressing on AS had worst oncological outcomes. RP for GS7 progression and matched pair of GS7 patients had similar outcomes. Worse oncological outcomes in AS progressors cannot be explained by a mere delay in RP.

Oncological outcomes and pathological characteristics of cT1 upstaging to pT3a renal cell carcinoma compared with de novo pT3a tumors. / Resultados oncológicos y características patológicas de la sobrestadificación de cT1 a carcinoma de células renales pT3a en comparación con los tumores pT3a de novo.

INTRODUCTION: The significance of upstaging of cT1 renal tumors to pT3a is not clear. We evaluate the incidence of upstaging, identify predictors and analyze oncological outcomes of these patients versus those who did not upstage. We also compared the oncological outcomes of cT1 upstaging to pT3a with de novo pT3a renal tumors. METHODS: From a database of 1021 renal tumors with complete available follow-up data, 517 patients had cT1. Patients upstaging to pT3a were compared to those who did not. Baseline clinical, perioperative, histopathologic features and oncological outcomes were analysed. RESULTS: Out of 517 cT1 patients, 105 (20.3%) upstaged to pT3a and 412 (79.7%) did not. Proportion of patients in each group undergoing partial and radical nephrectomy, postoperative tumor size, histology, margin status and lymph node involvement were similar. Among upstaged, 9 patients (8.6%) developed first recurrence as compared to only 3 (0.7%) in those not upstaging (P <0.001). The median time to recurrence (57 vs. 107 months; P <0.001) was lesser in de novo pT3a renal tumors. CONCLUSIONS: Pathological upstaging from cT1 to pT3a and necrosis on histopathology were associated with recurrence. Advanced age, smoking, necrosis on histopathology, clear cell histology and higher Fuhrman grades contributed to pathological upstaging of cT1 tumors. De novo pT3a RCC had worse survival when compared to cT1 patients upstaging to pT3a RCC.

Factores predictivos de recidiva bioquímica temprana, intermedia y tardía tras prostatectomía radical mínimamente invasiva en una cohorte unicéntrica con seguimiento medio de 8 años / Predictors of early, intermediate and late biochemical recurrence after minimally invasive radical prostatectomy in a single-centre cohort with a mean follow-up of 8 years

Objetivo: Determinar factores predictivos de recidiva bioquímica (RB) temprana, intermedia y tardía después de prostatectomía radical mínimamente invasiva en pacientes con cáncer de próstata localizado. Material y métodos: Se incluyeron 6.195 pacientes con cáncer de próstata cT1-3N0M0 intervenidos mediante prostatectomía radical laparoscópica (PRL) y robótica en nuestra institución entre 2000 y 2016. Ninguno recibió tratamiento adyuvante. La RB se definió como PSA ≥ 0,2 ng/dl. El tiempo hasta RB se dividió en terciles para identificar variables asociadas con recidiva temprana (< 12 meses), intermedia (12-36 meses) y tardía (> 36 meses). Se utilizaron modelos de regresión logística para determinar los factores de riesgo asociados en cada intervalo. Resultados: Se identificaron 1.148 (18,3%) pacientes con RB. La mediana de tiempo hasta la RB fue de 24 meses (RIQ: 0,98-53,18). El análisis multivariable mostró que el PSA preoperatorio, la invasión ganglionar, los márgenes positivos y la PRL se asociaron con recidiva precoz (todos p ≤ 0,029). La cirugía laparoscópica fue el único predictor de recidiva intermedia (p = 0,001). Los predictores de recidiva tardía incluyeron un score de Gleason patológico ≥7, estadio ≥pT3, márgenes positivos y PRL (todos con p ≤ 0,02). Conclusiones: Los pacientes con cáncer de próstata de alto riesgo pueden desarrollar recurrencia tardía y precisar un seguimiento a largo plazo. La identificación de pacientes con mayor PSA e invasión ganglionar tiene un importante papel predictivo en el primer año tras la cirugía. La asociación entre PRL y RB merece una evaluación adicional

Objective: To determine the predictors of early, intermediate and late biochemical recurrence (BR) following minimally invasive radical prostatectomy in patients with localised prostate cancer (PC). Material and methods: We included 6195 patients with cT1-3N0M0 prostate cancer treated using radical laparoscopic prostatectomy (RLP) and radical robot-assisted prostatectomy at our institution between 2000 and 2016. None of the patients underwent adjuvant therapy. BR is defined as PSA levels ≥0.2 ng/dL. The time to BR is divided into terciles to identify the variables associated with early (< 12 months), intermediate (12-36 months) and late (> 36 months) recurrence. We employed logistic regression models to determine the risk factors associated with each interval. Results: We identified 1148 (18.3%) patients with BR. The mdian time to BR was 24 months (IQR, 0.98-53.18). The multivariate analysis showed that preoperative PSA levels, lymph node invasion, positive margins and RLP are associated with early recurrence (P≤ .029 for all). Laparoscopic surgery was the only predictor of intermediate recurrence (P = .001). The predictors of late recurrence included a pathological Gleason score ≥ 7, stage ≥ pT3, positive margins and RLP (P≤.02 for all). Conclusions: The patients with high-risk prostate cancer can develop late recurrence and require long-term follow-up. Identifying patients with higher PSA levels and lymph node invasion has an important predictive role in the first year after surgery. The association between RLP and BR warrants further assessment

Predictive factors and the important role of detectable prostate-specific antigen for detection of clinical recurrence and cancer-specific mortality following robot-assisted radical prostatectomy

Purpose: To evaluate predictive factors associated with detectable prostate-specific antigen (PSA) and describe clinical recurrence (CR) and cancer-specific mortality (CSM) after robot-assisted radical prostatectomy (RARP). Methods: The study included 2500 patients who were treated with RARP at a single institution between 2000 and 2016. All patients had clinically localized PCa. Patients were divided into two groups according to PSA value at 6 weeks after surgery: undetectable (n = 2271; PSA < 0.1 ng/dl) and persistently elevated (n = 229; PSA ≥ 0.1 ng/dl). The association between various covariates and: (1) detectable PSA and (2) CR was evaluated. Kaplan-Meier analyses estimated CR and CSM rates according to PSA persistence. Results: Inside the group of detectable PSA, 146 men (63.75%) received adjuvant treatments, 44 patients (19.21%) salvages therapies and 38 men (16.5%) experienced CR. Factors associated with aggressive disease predicted PSA persistence. Within patients with detectable PSA, pathologic stage ≥ pT3a (HR 2.71; p < 0.029) and to received adjuvant androgen deprivation therapy (ADT) due to bad prognosis tumors (HR 13.36; p < 0.001) were associated with CR. Overall 14 (0.56%) died of PCa. 5 and 10-year CSM rates were higher for patients with CR (9.6 and 23.7%, p < 0.001), and Gleason ≥ 8 (5.7 and 6.9%, p = 0.003). Conclusions: A detectable PSA is affected by factors associated with aggressive prostate cancer. Within men with persistent PSA, those with higher pathologic stage and who received adjuvant ADT are more likely to have CR. Patients with CR, Gleason ≥ 8, and those who received adjuvant ADT must have a close monitoring due to the high rate of mortality

No disponible

Predictors of early, intermediate and late biochemical recurrence after minimally invasive radical prostatectomy in a single-centre cohort with a mean follow-up of 8 years. / Factores predictivos de recidiva bioquímica temprana, intermedia y tardía tras prostatectomía radical mínimamente invasiva en una cohorte unicéntrica con seguimiento medio de 8 años.

OBJECTIVE: To determine the predictors of early, intermediate and late biochemical recurrence (BR) following minimally invasive radical prostatectomy in patients with localised prostate cancer (PC). MATERIAL AND METHODS: We included 6195 patients with cT1-3N0M0 prostate cancer treated using radical laparoscopic prostatectomy (RLP) and radical robot-assisted prostatectomy at our institution between 2000 and 2016. None of the patients underwent adjuvant therapy. BR is defined as PSA levels ≥0.2 ng/dL. The time to BR is divided into terciles to identify the variables associated with early (<12 months), intermediate (12-36 months) and late (>36 months) recurrence. We employed logistic regression models to determine the risk factors associated with each interval. RESULTS: We identified 1148 (18.3%) patients with BR. The median time to BR was 24 months (IQR, 0.98-53.18). The multivariate analysis showed that preoperative PSA levels, lymph node invasion, positive margins and RLP are associated with early recurrence (P≤.029 for all). Laparoscopic surgery was the only predictor of intermediate recurrence (P=.001). The predictors of late recurrence included a pathological Gleason score ≥7, stage ≥pT3, positive margins and RLP (P≤.02 for all). CONCLUSIONS: The patients with high-risk prostate cancer can develop late recurrence and require long-term follow-up. Identifying patients with higher PSA levels and lymph node invasion has an important predictive role in the first year after surgery. The association between RLP and BR warrants further assessment.

Predictive factors and the important role of detectable prostate-specific antigen for detection of clinical recurrence and cancer-specific mortality following robot-assisted radical prostatectomy.

PURPOSE: To evaluate predictive factors associated with detectable prostate-specific antigen (PSA) and describe clinical recurrence (CR) and cancer-specific mortality (CSM) after robot-assisted radical prostatectomy (RARP). METHODS: The study included 2500 patients who were treated with RARP at a single institution between 2000 and 2016. All patients had clinically localized PCa. Patients were divided into two groups according to PSA value at 6 weeks after surgery: undetectable (n = 2271; PSA < 0.1 ng/dl) and persistently elevated (n = 229; PSA ≥ 0.1 ng/dl). The association between various covariates and: (1) detectable PSA and (2) CR was evaluated. Kaplan-Meier analyses estimated CR and CSM rates according to PSA persistence. RESULTS: Inside the group of detectable PSA, 146 men (63.75%) received adjuvant treatments, 44 patients (19.21%) salvages therapies and 38 men (16.5%) experienced CR. Factors associated with aggressive disease predicted PSA persistence. Within patients with detectable PSA, pathologic stage ≥ pT3a (HR 2.71; p < 0.029) and to received adjuvant androgen deprivation therapy (ADT) due to bad prognosis tumors (HR 13.36; p < 0.001) were associated with CR. Overall 14 (0.56%) died of PCa. 5 and 10-year CSM rates were higher for patients with CR (9.6 and 23.7%, p < 0.001), and Gleason ≥ 8 (5.7 and 6.9%, p = 0.003). CONCLUSIONS: A detectable PSA is affected by factors associated with aggressive prostate cancer. Within men with persistent PSA, those with higher pathologic stage and who received adjuvant ADT are more likely to have CR. Patients with CR, Gleason ≥ 8, and those who received adjuvant ADT must have a close monitoring due to the high rate of mortality.

[Management of ablative therapies in prostate cancer]. / Traitements ablatifs pour cancer de prostate : modalités de prise en charge.

OBJECTIVES: To describe the specific modalities of ablative therapies management in prostate cancer. MATERIALS AND METHODS: A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 61 articles were analysed. RESULTS: Development of innovations such as ablative therapies in prostate cancer induces specific modalities in their management, during pre-, per- and post-procedure. More than for classical and well-known treatments, the decision to propose an ablative therapy requires analysis and consensus of medical staff and patient's agreement. Patient's specificities and economical aspects must also be considered. Procedures and follow-up must be realized by referents actors. CONCLUSION: Indication, procedure and follow-up of ablative therapies in prostate cancer require specific modalities. They must be respected in order to optimize the results and to obtain a precise and objective evaluation for defining future indications.

Revisión sistemática de resultados perioperatorios y complicaciones después de cistectomía radical abierta, laparoscópica y asistida por robot / Systematic review of perioperative outcomes and complications after open, laparoscopic and robot-assisted radical cystectomy

La cistectomía radical y disección de los ganglios linfáticos regionales es el tratamiento estándar para el cáncer vesical músculo invasivo localizado y no músculo-invasivo de alto riesgo, y representa uno de los principales procedimientos quirúrgicos urológicos. El abordaje quirúrgico abierto es todavía ampliamente adoptado, aunque en las últimas 2 décadas se han hecho esfuerzos con el fin de evaluar si los procedimientos mínimamente invasivos, ya sean laparoscópicos o asistidos por robot, podrían mostrar un beneficio en comparación con la técnica estándar. La cistectomía radical abierta se asocia con una alta tasa de complicaciones, pero los datos de la serie quirúrgica laparoscópica y robótica no lograron demostrar una clara reducción en las tasas de complicaciones postoperatorias en comparación con la serie quirúrgica abierta. La cistectomía radical laparoscópica y robótica muestran una reducción en la pérdida de sangre, las tasas de estancia hospitalaria y de transfusión, pero un mayor tiempo operatorio, mientras que la cistectomía radical abierta se asocia típicamente con un tiempo operatorio más corto, pero con un ingreso más largo en el hospital y, posiblemente, una mayor tasa complicaciones de alto grado

Radical cystectomy and regional lymph node dissection is the standard treatment for localized muscle-invasive and for high-risk non-muscle-invasive bladder cancer, and represents one of the main surgical urologic procedures. The open surgical approach is still widely adopted, even if in the last two decades efforts have been made in order to evaluate if minimally invasive procedures, either laparoscopic or robot-assisted, might show a benefit compared to the standard technique. Open radical cystectomy is associated with a high complication rate, but data from the laparoscopic and robotic surgical series failed to demonstrate a clear reduction in post-operative complication rates compared to the open surgical series. Laparoscopic and robotic radical cystectomy show a reduction in blood loss, in-hospital stay and transfusion rates but a longer operative time, while open radical cystectomy is typically associated with a shorter operative time but with a longer in-hospital admission and possibly a higher rate of high grade complications

Oxylipin mediated stress response of a miraculin-like protease inhibitor in Hexanoic acid primed eggplant plants infested by Colorado potato beetle.

Insect-plant interactions are governed by a complex equilibrium between the mechanisms through which plant recognize insect attack and orchestrate downstream signaling events that trigger plant defense responses, and the mechanisms by which insects overcome plant defenses. Due to this tight and dynamic interplay, insight into the nature of the plant defense response can be gained by analyzing changes in the insect herbivores digestive system upon plant feeding. In this work we have identified a Solanum melongena miraculin-like protease inhibitor in the midgut juice of Colorado potato larvae feeding on eggplant plants treated with the natural inducer of plant defenses hexanoic acid. We analyzed the corresponding gene expression by qRT-PCR and our results showed that this eggplant miraculin-like gene enhanced induction contributes to the hexanoic acid priming effect in this Solanaceae species. Moreover, our data evidencing that OPDA might be involved in this gene regulation highlights its potential as biomarker in eggplant plant responses to stress mediated this oxylipin signaling pathway.

Math anxiety and math performance in children: The mediating roles of working memory and math self-concept.

BACKGROUND: Numerous studies, most of them involving adolescents and adults, have evidenced a moderate negative relationship between math anxiety and math performance. There are, however, a limited number of studies that have addressed the mechanisms underlying this relation. AIMS: This study aimed to investigate the role of two possible mediational mechanisms between math anxiety and math performance. Specifically, we sought to test the simultaneous mediating role of working memory and math self-concept. SAMPLE: A total of 167 children aged 8-12 years participated in this study. METHODS: Children completed a set of questionnaires used to assess math and trait anxiety, math self-concept as well as measures of math fluency and math problem-solving. Teachers were asked to rate each student's math achievement. As measures of working memory, two backward span tasks were administered to the children. RESULTS: A series of multiple mediation analyses were conducted. Results indicated that both mediators (working memory and math self-concept) contributed to explaining the relationship between math anxiety and math achievement. CONCLUSIONS: Results suggest that working memory and self-concept could be worth considering when designing interventions aimed at helping students with math anxiety. Longitudinal designs could also be used to better understand the mediational mechanisms that may explain the relationship between math anxiety and math performance.