Multi-source datasets acquired over Toulouse (France) in 2021 for urban microclimate studies during the CAMCATT/AI4GEO field campaign.

The CAMCATT-AI4GEO extensive field experiment took place in Toulouse, a city in the southwest of France, from 14th to 25th June 2021 (with complementary measurements performed on the 6 September 2021). Its main objective was the acquisition of a new reference dataset on an urban site to support the development and validation of data products from the future thermal infrared (TIR) satellite missions such as TRISHNA (CNES/ISRO), LSTM (ESA) and SBG (NASA). With their high spatial (between 30-60m) and temporal (2-3 days) resolutions, the future TIR satellite data will allow a better investigation of the urban climate at the neighbourhood scale. However, in order to validate the future products of these missions such as LST, air temperature, comfort index and Urban Heat Island (UHI), there is a need to accurately characterise the organisation of the city in terms of 3D geometry, spectral optical properties and both land surface temperature and emissivity (LST and LSE) at several scales. In this context, the CAMCATT-AI4GEO field campaign provides a set of airborne VISNIR-SWIR (Visible Near InfraRed - ShortWave InfraRed) hyperspectral imagery, multispectral thermal infrared (TIR) imagery and 3D LiDAR acquisitions, together with a variety of ground data collected, for some of them, simultaneously to the flight. The ground dataset includes surface reflectance measured spectrally with ASD spectroradiometers and in six spectral bands spreading from shortwave to thermal infrared and for two viewing angles with a SOC410-DHR handheld reflectometer. It is completed with LST and LSE retrieved from thermal infrared radiance acquired in six spectral bands with CIMEL radiometers. It also includes meteorological data coming from four radio soundings (one of which was taken during the flight), data routinely collected at the Blagnac airport reference station as well as air temperature and humidity acquired using instrumented cars following two different itineraries. In addition, a link is provided to access the data routinely collected by the network of weather stations set up by Toulouse Metropole in the city and its surroundings. This data paper describes this new reference urban dataset which can be useful for many applications such as calibration/validation of at-surface radiance, LST and LSE data products as well as higher level products such as air temperature or comfort index. It also provides valuable opportunities for other applications in urban climate studies, such as supporting the validation of microclimate models.

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

Enfermedad periodontal y diabetes mellitus gestacional: estudio caso-control / Periodontal disease and gestational diabetes mellitus: a case-control study

Antecedentes: Los estudios que relacionan la enfermedad periodontal (EP) y la diabetes mellitus gestacional (DMG) no son concordantes. Nuestro objetivo principal es evaluar la posible asociación entre la EP y la DMG. Además, analizamos los factores de riesgo para la DMG en nuestra muestra. Métodos: Participaron 180 gestantes, 90 con DMG y 90 controles, del Hospital La Fe de Valencia. Se pasó un cuestionario y realizo un examen periodontal, valorándose los siguientes parámetros: número de dientes, índices de placa y sangrado al sondaje, profundidad de sondaje (PS) y nivel de inserción de clínica (NIC). La periodontitis se definió según criterios de la CDC-AAP. Resultados: Las DMG tuvieron mayor valor promedio de PS (p = 0,001) y NIC (p = 0,028). Un 74,4% de las pacientes con DMG presentaron inflamación gingival vs. 57,8% de las no diabéticas. La periodontitis fue más prevalente en las pacientes con DMG (p < 0,05). La edad materna, el nivel de estudios y la presencia de periodontitis son factores independientes de riesgo para la DMG (OR = 1,16, IC 95% 1,07 a 1,25, p < 0,001), (OR = 0,37, IC 95% 0,19 a 0,72, p < 0,005) y (OR = 2,79, IC 95% 1,40 a 5,59, p < 0,005), respectivamente. Conclusiones: Los resultados sugieren que las embarazadas con diabetes gestacional asocian más enfermedad periodontal que aquellas sin dicha enfermedad gestacional. En nuestra muestra el riesgo de DMG puede estimarse a partir de la periodontitis, la edad y el nivel de estudios.(AU)

Background: Studies linking periodontal disease (PD) and gestational diabetes mellitus (GDM) are not consistent. Our main objective is to evaluate the possible association between PD and GDM. We also analysed the risk factors for GDM in our sample. Methods: 180 pregnant women participated, 90 with GDM and 90 controls, from Valencia's Hospital La Fe. A questionnaire was completed and a periodontal examination was performed, assessing the following parameters: number of teeth, plaque and bleeding on probing indices, probing depth (PD) and clinical attachment level (CAL). Periodontitis was defined according to the criteria of CDC-AAP. Results: The GDM group had a higher mean value of PD (p = .001) and CAL (p = .028). Of the patients with GDM, 74.4% had gingival inflammation compared to 57.8% of the non-diabetic patients. Periodontitis was more prevalent in patients with GDM (p < .05). Maternal age, educational level and periodontitis are independent risk factors for GDM (OR = 1.16, 95% CI 1.07 to 1.25, p < .001), (OR = .37, 95% CI .19 to .72, p < .005) and (OR = 2.79, 95% CI 1.40 to 5.59, p < .005) respectively. Conclusions: The results suggest that pregnant women with gestational diabetes have more associated periodontal disease than those without gestational diabetes. In our sample, the risk for GDM can be estimated from periodontitis, age, and educational level.(AU)

[Effectiveness, adherence and usability of a teleneurorehabilitation programme to ensure continuity of care for patients with acquired brain injury during the COVID-19 pandemic]. / Efectividad, adhesión y usabilidad de un programa de teleneurorrehabilitación para garantizar la continuidad de cuidados en pacientes con daño cerebral adquirido durante la pandemia originada por la COVID-19.

INTRODUCTION: The health pandemic brought about by SARS-CoV-2 (COVID-19) has limited access to neurorehabilitation programmes for many patients who have suffered stroke, traumatic brain injury or acquired brain damage due to some other cause. As telerehabilitation allows for the provision of care in situations of social distancing, it may mitigate the negative effects of confinement. The aim of this study was to determine the efficacy, adherence and usability of a teleneurorehabilitation intervention for patients with acquired brain injury. PATIENTS AND METHODS: All patients included in a face-to-face neurorehabilitation programme at the time of the declaration of the state of alarm in Spain due to COVID-19 and who agreed to participate in the study were included in a teleneurorehabilitation programme. The effectiveness of the programme, understood as an improvement in independence, was quantified with the Barthel index. Adherence to the programme and usability of the tool were explored through questionnaires. RESULTS: Altogether, 46 patients, accounting for 70.6% of the total, participated in the study. Participants significantly improved their independence and showed an improvement in the Barthel index between the start (77.3 ± 28.6) and the end of the programme (82.3 ± 26). Adherence to the intervention was very high (8.1 ± 2.2 out of 10) and the online sessions were the most highly rated content. The tool used showed a high usability (50.1 ± 9.9 out of 60) and could be used without assistance by more than half the participants. CONCLUSION: The teleneurorehabilitation intervention was found to be effective in improving patients' independence, and promoted a high degree of adherence and usability.

TITLE: Efectividad, adhesión y usabilidad de un programa de teleneurorrehabilitación para garantizar la continuidad de cuidados en pacientes con daño cerebral adquirido durante la pandemia originada por la COVID-19.Introducción. La pandemia sanitaria originada por el SARS-CoV-2 (COVID-19) ha limitado el acceso a programas de neurorrehabilitación de muchos pacientes que han sufrido ictus, traumatismos craneoencefálicos o un daño cerebral adquirido por otra causa. Dado que la telerrehabilitación permite la provisión de cuidados en situaciones de distanciamiento social, podría atenuar los efectos negativos del confinamiento. El objetivo de este estudio fue determinar la eficacia, la adhesión y la usabilidad de una intervención de teleneurorrehabilitación dirigida a pacientes con daño cerebral adquirido. Pacientes y métodos. Todos los pacientes incluidos en un programa de neurorrehabilitación presencial en el momento de la declaración del estado de alarma en España con motivo de la COVID-19 y que aceptaron participar en el estudio fueron incluidos en un programa de teleneurorrehabilitación. La eficacia del programa, entendida como una mejora en la independencia, se cuantificó con el índice de Barthel. La adhesión al programa y la usabilidad de la herramienta se investigaron mediante cuestionarios. Resultados. Un total de 146 pacientes, el 70,6% del total, participó en el estudio. Los participantes mejoraron significativamente su independencia y mostraron una mejoría en el índice de Barthel entre el inicio (77,3 ± 28,6) y el fin del programa (82,3 ± 26). La intervención tuvo una gran adhesión (8,1 ± 2,2 sobre 10) y las sesiones en línea fueron el contenido mejor valorado. La herramienta utilizada mostró una elevada usabilidad (50,1 ± 9,9 sobre 60) y pudo ser utilizada sin ayuda por más de la mitad de los participantes. Conclusión. La intervención de teleneurorrehabilitación resultó ser eficaz para mejorar la independencia de los pacientes, y promovió una elevada adhesión y usabilidad.

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy. / Guía anestésico-quirúrgica en el tratamiento de la cirugía de aorta ascendente y del arco aórtico. Documento de consenso de la Sociedad Española de Cirugía Cardiovascular y Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

RETRACTED: Anesthesic and surgical guideline for the treatment of the thoraco-abdominal aorta. Consensus Document of the Spanish Societies of Anesthesia and Cardiovascular Surgery. / Guía anestésico-quirúrgica en el tratamiento de la patología de aorta toracoabdominal. Documento de Consenso de la Sociedad Española de Cirugía Cardiovascular Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Este artículo ha sido retirado por indicación del Editor Jefe de la revista, después de constatar que parte de su contenido había sido plagiado, sin mencionar la fuente original: European Heart Journal (2014) 35, 2873 926.: https://academic.oup.com/eurheartj/article/35/41/2873/407693#89325738 El autor de correspondencia ha sido informado de la decisión y está de acuerdo con la retirada del artículo. El Comité Editorial lamenta las molestias que esta decisión pueda ocasionar. Puede consultar la política de Elsevier sobre la retirada de artículos en https://www.elsevier.com/about/our-business/policies/article-withdrawal

Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP). / Vía clínica de recuperación intensificada en cirugía cardiaca. Documento de consenso de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR), la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) y la Asociación Española de Perfusionistas (AEP).

The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.

Cirugía de Bentall: supervivencia a medio y largo plazo de 109 pacientes / Bentall procedure: long and midterm results in 109 patients

INTRODUCCIÓN: La cirugía de sustitución de raíz de aorta con implante de prótesis mecánica o biológica es un procedimiento ampliamente utilizado. El objetivo de nuestro estudio es evaluar los resultados de morbimortalidad a corto y largo plazo de la cirugía de Bentall, e identificar predictores de mortalidad durante el seguimiento. MATERIAL Y MÉTODOS: Entre 1983 y 2020 un total de 109 pacientes (edad media 56,8 ± 7,1) fueron sometidos a procedimiento de Bentall en nuestro centro de forma programada, con seguimiento medio de 12 ± 5,1 años. En el 88% de los casos se implantó un conducto valvulado mecánico y en el 12% se realizó procedimiento de Biobentall. En 22 pacientes (20,2%) se realizaron procedimientos concomitantes, siendo los más frecuentes la cirugía coronaria y mitral. RESULTADOS: La mortalidad intrahospitalaria fue del 1,83%, y la supervivencia fue del 88,9% a los 5 años y del 77,9% a los 15 años. Cuatro pacientes (3,7%) precisaron reintervención, la tasa de accidente cerebrovascular fue del 5,5% y tres pacientes (2,8%) desarrollaron endocarditis. El análisis de regresión multivariante de Cox reveló la presencia de procedimientos concomitantes como predictor independiente de mortalidad a largo plazo. CONCLUSIÓN: Nuestro estudio muestra que el procedimiento de Bentall presenta excelentes resultados a largo plazo, siendo una técnica segura con bajas tasas de morbilidad y mortalidad. La presencia de procedimientos concomitantes es el factor de riesgo de mayor impacto de cara a disminución de la supervivencia durante el seguimiento de estos enfermos

INTRODUCCIÓN: Aortic root replacement with a mechanical or biological valve prosthesis is a a classical technique used worldwide. The study aim was to evaluate short-term and long-term clinical outcomes of the modified Bentall procedure and to identify predictors of long-term mortality. METHODS: Between 1983 and 2020, a total of 109 patients (mean age 56,8 ± 7,1 years) underwent a Bentall procedure at the authors' institution. Concomitant procedures were performed in 22 patients (20,2%). The mean follow up was 11 ± 6.2 years and was 100% complete. Eighty-eight percent had a mechanical valve Bentall prosthesis and in 12% a biologic valve was implanted. Only data from scheduled procedures were collected. RESULTS: Operative mortality was 1,83% and long-term survival was 88,9% after 5 years and 77,9% after 10 years. Actuarial freedom from thromboembolism was 94,5% at 15 years. Four patients (3,7%) required reoperation, stroke rate was 5,5% and three patients (2,8%) developed endocarditis . Multivariate analysis revealed concomitant procedures (OR 2,58; CI 95%, [1,12- 5,9], p = 0,025 ) as independent predictors of long-term mortality. CONCLUSION: Our study shows that the Bentall procedure has excellent long-term results and can be performed safely with low mortality and acceptable morbidity. The presence of concomitant procedures is the strongest independent risk factor of long-term mortality

Validez actual del diagnóstico de «estado vegetativo permanente»: estudio longitudinal en una muestra clínica de pacientes en estados alterados de conciencia / Current validity of diagnosis of permanent vegetative state: A longitudinal study in a sample of patients with altered states of consciousness

INTRODUCCIÓN: Los estados alterados de conciencia han sido considerados tradicionalmente como cuadros clínicos de pronóstico infausto. En la actualidad, sabemos que dichos estados engloban distintas entidades clínicas cuyo perfil diferencial empieza a reconocerse. MÉTODO: Se incluyeron 37 pacientes con el diagnóstico de estado vegetativo o síndrome de vigilia sin respuesta (SVSR) y 43 en estado de mínima conciencia (EMC) de acuerdo con la Coma Recovery Scale-Revised (CRS-R). Todos los pacientes fueron evaluados mensualmente con la CRS-R durante al menos 6 meses. Se evaluó el momento de superar cada estado considerando los puntos de corte de «irreversibilidad» (12 meses para los casos de origen traumático y 3 para los no traumáticos), tradicionalmente establecidos por la Multi-Society-Task-Force. Se empleó un modelo de regresión logística para determinar las variables predictoras de superar el EMC. RESULTADOS: Un total de 23 pacientes en SVSR superaron este estado, pero solo 9superaron el EMC. De los 43 pacientes en EMC al ingreso, 26 lograron superarlo. Ocho de los 23 (34,7%) pacientes que superaron el SVSR y 17 de los 35 (48,6%) que superaron el EMC lo hicieron más allá del punto de «irreversibilidad». La etiología (p < 0,01), la cronicidad (p = 0,01) y la puntuación en la CRS-R (p < 0,001) predijeron la salida de EMC en el modelo multivariante con un 77,5% de acierto. CONCLUSIONES: Tanto el SVRS como el EMC son entidades clínicamente diferenciadas en términos diagnósticos y pronósticos. Algunos criterios clásicos relacionados con el mal pronóstico de estos estados en términos de tiempo y posibilidades de recuperación deben ser reevaluados

INTRODUCTION: Altered states of consciousness have traditionally been associated with poor prognosis. At present, clinical differences between these entities are beginning to be established. METHOD: Our study included 37 patients diagnosed with vegetative state/unresponsive wakefulness syndrome (UWS) and 43 in a minimally conscious state (MCS) according to the Coma Recovery Scale-Revised (CRS-R). All patients were followed up each month for at least 6 months using the CRS-R. We recorded the time points when vegetative state progressed from 'persistent' to 'permanent' based on the cut-off points established by the Multi-Society-Task-Force: 12 months in patients with traumatic injury and 3 months in those with non-traumatic injury. A logistic regression model was used to determine the factors potentially predicting which patients will emerge from MCS. RESULTS: In the UWS group, 23 patients emerged from UWS but only 9 emerged from MCS. Of the 43 patients in the MCS group, 26 patients emerged from that state during follow-up. Eight of the 23 patients (34.7%) who emerged from UWS and 17 of the 35 (48.6%) who emerged from MCS recovered after the time points proposed by the Multi-Society-Task-Force. According to the multivariate regression analysis, aetiology (P < .01), chronicity (P = .01), and CRS-R scores at admission (P < .001) correctly predicted emergence from MCS in 77.5% of the cases. CONCLUSIONS: UWS and MCS are different clinical entities in terms of diagnosis and outcomes. Some of the factors traditionally associated with poor prognosis, such as time from injury and likelihood of recovery, should be revaluated

Current validity of diagnosis of permanent vegetative state: A longitudinal study in a sample of patients with altered states of consciousness. / Validez actual del diagnóstico de «estado vegetativo permanente¼: estudio longitudinal en una muestra clínica de pacientes en estados alterados de conciencia.

INTRODUCTION: Altered states of consciousness have traditionally been associated with poor prognosis. At present, clinical differences between these entities are beginning to be established. METHOD: Our study included 37 patients diagnosed with vegetative state/unresponsive wakefulness syndrome (UWS) and 43 in a minimally conscious state (MCS) according to the Coma Recovery Scale-Revised (CRS-R). All patients were followed up each month for at least 6 months using the CRS-R. We recorded the time points when vegetative state progressed from 'persistent' to 'permanent' based on the cut-off points established by the Multi-Society-Task-Force: 12 months in patients with traumatic injury and 3 months in those with non-traumatic injury. A logistic regression model was used to determine the factors potentially predicting which patients will emerge from MCS. RESULTS: In the UWS group, 23 patients emerged from UWS but only 9 emerged from MCS. Of the 43 patients in the MCS group, 26 patients emerged from that state during follow-up. Eight of the 23 patients (34.7%) who emerged from UWS and 17 of the 35 (48.6%) who emerged from MCS recovered after the time points proposed by the Multi-Society-Task-Force. According to the multivariate regression analysis, aetiology (P<.01), chronicity (P=.01), and CRS-R scores at admission (P<.001) correctly predicted emergence from MCS in 77.5% of the cases. CONCLUSIONS: UWS and MCS are different clinical entities in terms of diagnosis and outcomes. Some of the factors traditionally associated with poor prognosis, such as time from injury and likelihood of recovery, should be revaluated.

Optimización de los criterios metabólicos en la valoración pronóstica de los pacientes con linfoma. Estudio multicéntrico / Optimisation of metabolic criteria in the prognostic assessment in patients with lymphoma. A multicentre study

Objetivo: Comparar sensibilidad, especificidad y valor pronóstico de Deauville score (DS) versus ΔSUVmax, tanto en «interim» PET (iPET) como en «end» PET (ePET), en pacientes con linfoma difuso de células grandes B (LDCGB), linfoma de Hodgkin (LH), linfoma folicular (LF). Método: Estudio multicéntrico retrospectivo longitudinal en 138 pacientes (46 LDCGB, 46 LH, 46 LF). Se realizaron 3 18F-FDG PET/TC: basal, iPET y ePET. En iPET y ePET se utilizaron 2 criterios de interpretación: visual (DS) y semicuantitativo (ΔSUVmax). Se estableció el valor pronóstico en relación con el intervalo libre de enfermedad. Resultados: Análisis estadístico. Del iPET por subtipos histológicos (LDCGB, LH y LF): 1) DS obtuvo sensibilidad 76,92/83,33/61,53%; especificidad 78,78/85/81,81%, respectivamente; 2) ΔSUVmax obtuvo una sensibilidad del 53,84/83,33/61,53%; especificidad del 87,87/87,50/78,78%. Del ePET por subtipos histológicos: 1) DS obtuvo sensibilidad del 61,53/83,33/69,23%; especificidad del 90,90/85/87,87%; 2) ΔSUVmax obtuvo sensibilidad del 69,23/83,33/69,23%; especificidad del 90,90/87,5/84,84%. Evaluación pronóstica. Estudio iPET: en LDCGB el DS obtuvo que 10,3% con iPET negativo recidivó durante el intervalo libre de enfermedad y 17,1% con ΔSUVmax; en LH ambos métodos obtuvieron que 2,8% con iPET negativo recidivó; en LF el DS obtuvo que 15,6% con iPET negativo recidivó, con ΔSUVmax 16,1%, sin significación estadística para este método. Estudio ePET: en LDCGB el DS obtuvo que 14,3% con ePET negativo recidivó durante el intervalo libre de enfermedad, respecto al 11,8% con ΔSUVmax; en LH y LF ambos métodos obtuvieron que 2,8 y 12,5%, respectivamente, con ePET negativo recidivó. Conclusión: DS y ΔSUVmax no muestran diferencias significativas en LDCGB, LH, LF. El valor pronóstico del DS y ΔSUVmax no muestra diferencias significativas en LH y LF; en LDCGB el DS es superior en iPET y el ΔSUVmax en ePET (AU)

Objective: To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL). Method: Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 18F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval. Results: Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted in 14.3% recurrence of negative ePET, and 11.8% in ΔSUVmax at disease-free interval; in HL and FL, both methods showed 2.8 and 12.5% recurrence in negative ePET, respectively. Conclusion: DS and ΔSUVmax did not show significant differences in DLBCL, HL and FL. Their predictive value also did not show significant differences in HL and FL. In DLBCL, DS was higher in iPET, and ΔSUVmax in ePET (AU)

Optimisation of metabolic criteria in the prognostic assessment in patients with lymphoma. A multicentre study. / Optimización de los criterios metabólicos en la valoración pronóstica de los pacientes con linfoma. Estudio multicéntrico.

OBJECTIVE: To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL). METHOD: Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 18F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval. RESULTS: Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted in 14.3% recurrence of negative ePET, and 11.8% in ΔSUVmax at disease-free interval; in HL and FL, both methods showed 2.8 and 12.5% recurrence in negative ePET, respectively. CONCLUSION: DS and ΔSUVmax did not show significant differences in DLBCL, HL and FL. Their predictive value also did not show significant differences in HL and FL. In DLBCL, DS was higher in iPET, and ΔSUVmax in ePET.

[Disability after stroke: a longitudinal study in moderate and severe stroke patients included in a multidisciplinary rehabilitation program]. / Ictus y discapacidad: estudio longitudinal en pacientes con discapacidad moderada-grave tras un ictus incluidos en un programa de rehabilitacion multidisciplinar.

INTRODUCTION: Stroke is a recognized cause of disability among adults. However the impact that the deficits that occur after a moderate/severe stroke have on long-term disability, as well as the response of the resultant deficits to rehabilitation, are not completely understood. PATIENTS AND METHODS: A total of 396 patients with a modified Rankin score >= 3 after an ischemic (n = 221) or hemorrhagic (n = 175) stroke were included in this study. All patients were assessed with cognitive, behavior, emotional, motor and functional domains. All patients were assessed at baseline and six months after inclusion in a multidisciplinary rehabilitation program. RESULTS: Risk of falling (Berg Balance Scale < 45 in 83.1% of the sample at baseline and 49.5% at follow-up) and functional problems (82.8% with a Barthel Index < 75 at baseline and 53% at follow-up) were the most prevalent deficits. Emotional disturbances were those that most improved while behavioral problems were those that did less. Although global disability improved during treatment among most patients, only 11% of our patients, especially those with preserved cognitive function at baseline, could be classified as patients with mild disability at follow-up. CONCLUSIONS: Stroke consequences are multidimensional. The symptoms that the stroke can cause in multiple domains, as well as the pattern of recovery are widely diverse, with prevalence of behavioral long-term disturbances.

TITLE: Ictus y discapacidad: estudio longitudinal en pacientes con discapacidad moderada-grave tras un ictus incluidos en un programa de rehabilitacion multidisciplinar.Introduccion. Los ictus son causa frecuente de discapacidad en el adulto; sin embargo, la repercusion que los deficits que acontecen tras un ictus moderado-grave tiene sobre el grado de discapacidad final, asi como la respuesta de estos a programas de rehabilitacion, no se ha estudiado por completo. Pacientes y metodos. Se incluyeron 396 pacientes con Rankin modificado >= 3 despues de un ictus isquemico (n = 221) o hemorragico (n = 175). En todos los pacientes se evaluo su situacion cognitiva, conductual, emocional, motora y funcional. Todos los pacientes fueron incluidos en un programa de rehabilitacion multidisciplinar y reevaluados tras seis meses de tratamiento. Resultados. El riesgo de caida (escala de equilibrio de Berg < 45 en el 83,1% de la muestra) y los deficits funcionales (indice de Barthel < 75 en el 82,8% de la muestra) fueron los problemas mas prevalentes en el momento del ingreso, mientras que los conductuales lo fueron en el del alta (55,1% de la muestra). Los problemas emocionales fueron los que mas mejoraron, mientras que los conductuales fueron los que menos lo hicieron. El nivel de discapacidad global mejoro tras el tratamiento, aunque solo un 11% de los pacientes, especialmente los que tenian buena situacion cognitiva en el ingreso, lograron alcanzar una discapacidad leve. Conclusiones. Las consecuencias del ictus son multidimensionales. La afectacion de las distintas esferas y el patron de recuperacion son diferenciales, con predominio a largo plazo de los problemas conductuales.

BioTrak: análisis de efectividad y satisfacción de un sistema de realidad virtual para la rehabilitación del equilibrio en pacientes con daño cerebral / BioTrak virtual reality system: effectiveness and satisfaction analysis for balance rehabilitation in patients with brain injury

Objetivo: Estudio de efectividad y satisfacción de un sistema de realidad virtual (BioTrak) para la rehabilitación del equilibrio en pacientes con da˜no cerebral adquirido (DCA). Material y métodos: Diez pacientes con una hemiparesia crónica (> 6 meses) como secuela de un DCA participaron en un programa de 20 sesiones con el módulo de equilibrio mediante alcances del sistema BioTrak. Todos los pacientes fueron valorados al inicio, al final del tratamiento y un mes después de finalizar el mismo con la Berg Balance Scale (BBS) y la Tinetti Performance-Oriented Mobility Assessment (POMA), así como mediante la posturografía dinamométrica computarizada NedSVE/IBV. El estudio posturográfico incluyó el análisis de índices sensoriales, del desplazamiento rítmico del peso, así como de los límites de estabilidad. El estudio de usabilidad se realizó mediante un cuestionario elaborado ad hoc. Resultados: Un ANOVA de medidas repetidas mostró una mejora significativa en BBS (p < 0,01), POMA (p < 0,01), índice vestibular (p < 0,05), control rítmico antero-posterior (p < 0,05) y una tendencia a la significación en el control medio-lateral (p = 0,059). El análisis post hoc reveló mejoras significativas entre la valoración inicial y final en la BBS, la POMA y en control antero-posterior, que se mantuvieron al mes de completar el tratamiento. El sistema mostró un alto grado de usabilidad, tanto en aspectos positivos (presencia, inmersión, facilidad de uso) como por la ausencia de efectos adversos. Conclusión: Nuestros resultados confirman la validez de los sistemas de realidad virtual para la rehabilitación del equilibrio en esta población. Las características de usabilidad del sistema BioTrak permite la generalización del sistema a un alto número de pacientes y entornos (AU)

Objective: To study effectiveness of and satisfaction with a virtual reality-based balance rehabilitation system (BioTrak) for patients with acquired brain injury (ABI). Material and methods: Ten patients with chronic hemiparesis (chronicity > 6 months) following an ABI completed a 20-session programme using the balance reaching-task module of the BioTrak system. All patients were assessed at baseline, at the end of treatment, and one month later with the Berg Balance Scale (BBS), the Tinetti Performance-Oriented Mobility Assessment (POMA), and the computerised posturography tool NedSVE/IBV. The posturography study included analysis of sensory indexes, limits of stability, and rhythmic weight shift. The usability study was conducted using an ad hoc questionnaire. Results: Repeated measures ANOVA showed a significant improvement in BBS (P < .01), TBS (P < .01), vestibular index (P < .05), and anterior-posterior weight shift (P < .05); a trend in the same direction was also found for medial lateral weight shift (P = .059). The post-hoc analysis revealed significant improvement between the initial and final assessments for BBS, POMA and anterior-posterior weight shift control; gains remained a month after completing the programme. The system showed a high degree of usability in terms of presence, immersion and user-friendliness, and there was a significant absence of adverse effects. Conclusion: Our results confirm the utility of virtual reality systems for balance rehabilitation in this population. Usability data suggest that BioTrak could be adapted for use in multiple rehabilitation settings by a high number of patients (AU)

BioTrak virtual reality system: effectiveness and satisfaction analysis for balance rehabilitation in patients with brain injury.

OBJECTIVE: To study effectiveness of and satisfaction with a virtual reality-based balance rehabilitation system (BioTrak) for patients with acquired brain injury (ABI). MATERIAL AND METHODS: Ten patients with chronic hemiparesis (chronicity>6 months) following an ABI completed a 20-session programme using the balance reaching-task module of the BioTrak system. All patients were assessed at baseline, at the end of treatment, and one month later with the Berg Balance Scale (BBS), the Tinetti Performance-Oriented Mobility Assessment (POMA), and the computerised posturography tool NedSVE/IBV. The posturography study included analysis of sensory indexes, limits of stability, and rhythmic weight shift. The usability study was conducted using an ad hoc questionnaire. RESULTS: Repeated measures ANOVA showed a significant improvement in BBS (P<.01), TBS (P<.01), vestibular index (P<.05), and anterior-posterior weight shift (P<.05); a trend in the same direction was also found for medial lateral weight shift (P=.059). The post-hoc analysis revealed significant improvement between the initial and final assessments for BBS, POMA and anterior-posterior weight shift control; gains remained a month after completing the programme. The system showed a high degree of usability in terms of presence, immersion and user-friendliness, and there was a significant absence of adverse effects. CONCLUSION: Our results confirm the utility of virtual reality systems for balance rehabilitation in this population. Usability data suggest that BioTrak could be adapted for use in multiple rehabilitation settings by a high number of patients.

Cross-suppression of EGFR ligands amphiregulin and epiregulin and de-repression of FGFR3 signalling contribute to cetuximab resistance in wild-type KRAS tumour cells.

BACKGROUND: In addition to the mutational status of KRAS, the epidermal growth factor receptor (EGFR) ligands amphiregulin (AREG) and epiregulin (EREG) might function as bona fide biomarkers of cetuximab (Ctx) sensitivity for most EGFR-driven carcinomas. METHODS: Lentivirus-delivered small hairpin RNAs were employed to specifically reduce AREG or EREG gene expression in wild-type KRAS A431 squamous cell carcinoma cells. Colony-forming assays were used to monitor the impact of AREG and EREG knockdown on Ctx efficacy. Amphiregulin and EREG protein expression levels were assessed by quantitative ELISA in parental A431 cells and in pooled populations of A431 cells adapted to grow in the presence of Ctx. A phosphoproteomic platform was used to measure the relative level of phosphorylation of 42 distinct receptor tyrosine kinases before and after the acquisition of resistance to Ctx. RESULTS: Stable gene silencing of either ligand was found to notably reduce the expression of the other ligand. Parental A431 cells with normal expression levels of AREG/EREG exhibited significantly increased growth inhibition in response to Ctx, compared with derivatives that are engineered to produce minimal AREG/EREG. The parental A431 cells acutely treated with Ctx exhibited reduced basal expression levels of AREG/EREG. Pooled populations of Ctx-resistant A431 cells expressed significantly lower levels of AREG/EREG and were insensitive to the downregulatory effects of Ctx. Phosphoproteomic screen identified a remarkable hyperactivation of FGFR3 in Ctx-resistant A431 cells, which gained sensitivity to the cytotoxic and apoptotic effects of the FGFR3 TK inhibitor PD173074. The A431 parental cells acutely treated with Ctx rapidly activated FGFR3 and their concomitant exposure to Ctx and PD173074 resulted in synergistic apoptosis. CONCLUSION: Cross-suppression of AREG/EREG expression may explain the tight co-expression of AREG and EREG, as well as their tendency to be more highly expressed than other EGFR ligands to determine Ctx efficacy. The positive selection for Ctx-resistant tumour cells exhibiting AREG/EREG cross-suppression may have an important role in the emergence of Ctx resistance. As de-repression of FGFR3 activity rapidly replaces the loss of EGFR-ligand signalling in terms of cell proliferation and survival, combinations of Ctx and FGFR3-targeted drugs may be a valuable strategy to enhance the efficacy of single Ctx while preventing or delaying acquired resistance to Ctx.