This is a call to oncologists for action

Cancer cases are growing in an exponential way, likewise the prices of new cancer drugs. Continuing in this way, in the near future, it will be impossible to provide optimum care for all cancer patients. Therefore, it is important to establish mechanisms that enable the National Health Systems to provide the best options of treatment, either through the elaboration of decision-binding frameworks or through other initiatives that guarantee the best quality care for all oncology patients to overcome, in the best possible way, this difficult illness. Here, we review current proposals that have been established by different cancer organizations worldwide, their similarities, their differences and whether they are helpful in a real clinical setting. Facing present reality and despite these organizations’ huge efforts, these proposals are not being implemented at all and it does not seem feasible that they will in the short run. In the same way, we support and argue why oncologists should have a crucial and a preponderant role to establish the best way of guaranteeing an equal access to the latest oncology care

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This is a call to oncologists for action.

Cancer cases are growing in an exponential way, likewise the prices of new cancer drugs. Continuing in this way, in the near future, it will be impossible to provide optimum care for all cancer patients. Therefore, it is important to establish mechanisms that enable the National Health Systems to provide the best options of treatment, either through the elaboration of decision-binding frameworks or through other initiatives that guarantee the best quality care for all oncology patients to overcome, in the best possible way, this difficult illness. Here, we review current proposals that have been established by different cancer organizations worldwide, their similarities, their differences and whether they are helpful in a real clinical setting. Facing present reality and despite these organizations' huge efforts, these proposals are not being implemented at all and it does not seem feasible that they will in the short run. In the same way, we support and argue why oncologists should have a crucial and a preponderant role to establish the best way of guaranteeing an equal access to the latest oncology care.

Diagnostic features of the cycloid psychoses in a first psychotic episode sample.

INTRODUCTION: The cycloid psychoses have not been included in the modern classifications-what makes scientific research difficult. The aim of the present study is to investigate the presence and specific characteristics of the cycloid psychoses in a broad sample of first psychotic episodes. METHODS: Seventy patients diagnosed with one-year first schizophrenia episode, schizophreniform disorder, or schizoaffective disorder were studied (mean age, 27.9 years old; SD±6.34). The detection of the possible cases of cycloid psychosis was done according to the Perris and Brockington operational criteria. Two groups of "cycloid" (n=11) and "non cycloid" (n=59) patients were compared according to demographic and clinical variables, and possible diagnostic variables were evaluated by the ROC curves. RESULTS: Significant differences were found between cycloid and non cycloid groups for a number of clinical variables: prodromic symptoms (p<0.001), PANSS total score (p=0.003), PANSS-P (p=0.009), PANSS-GP (p=0.001), total score for mania by EVMAC (p=0.001), and CDSS for depression (p=0.004). ROC curves were significant for PANSS-GP (AUC=0.791, p=0.002), EVMAC (AUC=0.938, p=0.001), and CDSS (AUC=0.770, p=0.005). A sensitivity/specificity study demonstrated a negative predictive value for PANSS-GP (93.88%), EVMAC (96.30%), and CDSS (93.88%). CONCLUSIONS: According to these results, cycloid psychoses might represent differentiated and well-defined clinical entity.

Predicting molybdenum toxicity to higher plants: influence of soil properties.

The effect of soil properties on the toxicity of molybdenum (Mo) to four plant species was investigated. Soil organic carbon or ammonium-oxalate extractable Fe oxides were found to be the best predictors of the 50% effective dose (ED50) of Mo in different soils, explaining>65% of the variance in ED50 for four species except for ryegrass (26-38%). Molybdenum concentrations in soil solution and consequently plant uptake were increased when soil pH was artificially raised because sorption of Mo to amorphous oxides is greatly reduced at high pH. The addition of sulphate significantly decreased Mo uptake by oilseed rape. For risk assessment, we suggest that Mo toxicity values for plants should be normalised using soil amorphous iron oxide concentrations.

Predicting molybdenum toxicity to higher plants: estimation of toxicity threshold values.

Four plant species (oilseed rape, Brassica napus L.; red clover, Trifolium pratense L.; ryegrass, Lolium perenne L.; and tomato, Lycopersicon esculentum L.) were tested on ten soils varying widely in soil properties to assess molybdenum (Mo) toxicity. A larger range (66-fold-609-fold) of added Mo concentrations resulting in 50% inhibition of yield (ED50) was found among soils than among plant species (2-fold-38-fold), which illustrated that the soils differed widely in the expression of Mo toxicity. Toxicity thresholds based on soil solution Mo narrowed the variation among soils compared to thresholds based on added Mo concentrations. We conclude that plant bioavailability of Mo in soil depends on Mo solubility, but this alone did not decrease the variability in observed toxicity enough to be used in risk assessment and that other soil properties influencing Mo toxicity to plants need to be considered.

[Neuropsychological dysfunctions in personality borderline disorder: detection strategies]. / Alteraciones neuropsicológicas en el trastorno límite de la personalidad: estrategias de detección.

INTRODUCTION: Borderline personality disorder (BPD) is characterized by emotional instability and impulsivity. However, there is evidence that neurocognitive alterations have a relevant role in the clinical features of these patients. The present study investigates cognitive function in BPD in order to search for a specific profile of neuropsychological alterations. METHODS: Based on previous research and cognitive complaints reported by patients, a neuropsychological assessment protocol focused on prefrontal functioning was applied. The applied neuropsychological battery included tests assessing the following cognitive domains: memory (fixation, consolidation and recovery processes) categorical evocation, cognitive flexibility, sustained attention, processing rate, inhibitory control and working memory. The patient sample was recruited from an outpatient BPD unit and was composed by 26 patients (14 women, 12 men) diagnosed of BPD. RESULTS: In comparison to the normative values, BPD patients have a deficit in the execution of most of the neuropsychological tests. This deficit was especially present in the following: recovery processes of the immediate and differed memory, working memory, sustained attention and processing rate, verbal fluency, impulse control, cognitive flexibility, abstraction and planning. CONCLUSIONS: BPD patients could present a pattern of neurocognitive alterations that suggests a specific impairment of the prefrontal areas and requires a more detailed study. The neuropsychological dysfunctions could partially explain the behavioral alterations in BPD patients.

[Neuropsychological rehabilitation in patients with borderline personality disorder: a case series]. / Rehabilitación neuropsicológica en pacientes con trastorno límite de personalidad: una serie de casos.

Recent research studies have been confirming the evidence that patients with personality borderline disorder (BPD) suffer significant neuropsychological disorders. Neurocognitive dysfunction of BPD seems to mainly affect the functions characteristic of the prefrontal areas that participate in information processing and management and in the regulation of complex behavioral responses. Neuropsychological disorders not only are seen in the specific tests but are also reflected and could play an important role in the clinical manifestations of borderline disorder, such as emotional dysregulation and impulsive behaviors. Neurocognitive rehabilitation therapy has been used successfully in psychiatric disorders such as schizophrenia, also characterized by the presence of neuropsychological dysfunctions. Thus, it can be expected that rehabilitation of the neurocognitive functions affected in BPD contributes to the patient's functional improvement. The present work describes a series of five patients with BPD who presented important neuropsychological dysfunctions and who were treated successfully with a specific program of neurocognitive rehabilitation. The results observed justify the performance of controlled clinical studies on the efficacy of this technique in the treatment of BPD.

Alteraciones neuropsicológicas en el trastorno límite de la personalidad: estrategias de detección / Neuropsychological dysfunctions in personality borderline disorder: detection strategies

Introducción. Los síntomas más característicos del trastorno límite o «borderline» de la personalidad (TLP) son la inestabilidad afectiva y la impulsividad. No obstante, existen indicios de que las alteraciones neurocognitivas podrían tener un papel relevante en la clínica de estos trastornos. El objetivo del presente estudio es investigar la función cognitiva en el TLP y buscar un patrón específico de alteraciones neuropsicólogicas. Metodología. Sobre la base de investigaciones anteriores y de las quejas cognitivas referidas por los pacientes, se ha aplicado un protocolo de evaluación neuropsicológica centrado en las funciones prefrontales. La batería neuropsicológica aplicada estaba compuesta por diferentes pruebas que evalúan los siguientes dominios cognitivos: memoria (procesos de fijación, consolidación y de recuperación), evocación categorial, flexibilidad cognitiva, atención sostenida, velocidad de procesamiento, control de inhibición y memoria de trabajo. Se han evaluado 26 pacientes diagnosticados de TLP, de los cuales 14 eran mujeres y 12 hombres, todos ellos pertenecientes al Servicio de Psiquiatría del Hospital Clínico San Carlos. Resultados. En comparación con los valores normativos, los pacientes con TLP presentan un déficit en la ejecución de la mayoría de las pruebas neuropsicológicas utilizadas, especialmente en los procesos de recuperación de memoria inmediata y diferida, memoria de trabajo, atención sostenida y velocidad de procesamiento, fluidez verbal, control de impulsos, flexibilidad cognitiva, abstracción y planificación. Conclusiones. El TLP podría presentar un patrón de alteraciones neurocognitivas que sugiere una afectación específica de áreas prefrontales y que precisa ser estudiado con mayor detalle. Las disfunciones neuropsicológicas podrían explicar parcialmente las alteraciones conductuales de estos pacientes (AU)

Introduction. Borderline personality disorder (BPD) is characterized by emotional instability and impulsivity. However, there is evidence that neurocognitive alterations have a relevant role in the clinical features of these patients. The present study investigates cognitive function in BPD in order to search for a specific profile of neuropsychological alterations. Methods. Based on previous research and cognitive complaints reported by patients, a neuropsychological assessment protocol focused on prefrontal functioning was applied. The applied neuropsychological battery included tests assessing the following cognitive domains: memory (fixation, consolidation and recovery processes) categorical evocation, cognitive flexibility, sustained attention, processing rate, inhibitory control and working memory. The patient sample was recruited from an outpatient BPD unit and was composed by 26 patients (14 women, 12 men) diagnosed of BPD. Results. In comparison to the normative values, BPD patients have a deficit in the execution of most of the neuropsychological tests. This deficit was especially present in the following: recovery processes of the immediate and differed memory, working memory, sustained attention and processing rate, verbal fluency, impulse control, cognitive flexibility, abstraction and planning. Conclusions. BPD patients could present a pattern of neurocognitive alterations that suggests a specific impairment of the prefrontal areas and requires a more detailed study. The neuropsychological dysfunctions could partially explain the behavioral alterations in BPD patients (AU)

Rehabilitación neuropsicológica en pacientes con trastorno límite de personalidad: una serie de casos / Neuropsychological rehabilitation in patients with borderline personality disorder: a case series

La evidencia de que los pacientes con trastorno límite de la personalidad (TLP) padecen alteraciones neurospicológicas significativas se ha ido confirmando en recientes estudios de investigación. La disfunción neurocognitiva del TLP parece afectar principalmente a funciones propias de las áreas prefrontales que participan en el procesamiento y manejo de la información y en la regulación de las respuestas conductuales complejas. Las alteraciones neuropsicológicas no sólo se evidencian en los tests específicos sino que se reflejan y podrían tener un papel importante en las manifestaciones clínicas del trastorno límite, como la disregulación emocional y las conductas impulsivas. La terapia de rehabilitación neurocogntiva ha sido utilizada con éxito en trastornos psiquiátricos como la esquizofrenia, caracterizada también por la presencia de disfunciones neuropsicológicas. Por ello es esperable que la rehabilitación de las funciones neurocognitivas afectadas en el TLP contribuya a la mejoría funcional de los pacientes. En el presente trabajo se describe una serie de cinco pacientes con TLP que presentaban disfunciones neuropsicológicas notables y que fueron tratados con éxito mediante un programa específico de rehabilitación neurocognitiva. Los resultados observados justifican la realización de estudios clínicos controlados de la eficacia de esta técnica en el tratamiento del TLP (AU)

Recent research studies have been confirming the evidence that patients with personality borderline disorder (BPD) suffer significant neuropsychological disorders. Neurocognitive dysfunction of BPD seems to mainly affect the functions characteristic of the prefrontal areas that participate in information processing and management and in the regulation of complex behavioral responses. Neuropsychological disorders not only are seen in the specific tests but are also reflected and could play an important role in the clinical manifestations of borderline disorder, such as emotional dyregulation and impulsive behaviors. Neurocognitive rehabilitation therapy has been used successfully in psychiatric disorders such as schizophrenia, also characterized by the presence of neuropsychological dysfunctions. Thus, it can be expected that rehabilitation of the neurocognitive functions affected in BPD contributes to the patient’s functional improvement. The present work describes a series of five patients with BPD who presented important neuropsychological dysfunctions and who were treated successfully with a specific program of neurocognitive rehabilitation. The results observed justify the performance of controlled clinical studies on the efficacy of this technique in the treatment of BPD (AU)

Use of Co speciation and soil properties to explain variation in Co toxicity to root growth of barley (Hordeum vulgare L.) in different soils.

The influence of soil properties on the bioavailability and toxicity of Co to barley (Hordeum vulgare L.) root elongation was investigated. Ten soils varying widely in soil properties were amended with seven doses of CoCl2. Soil properties greatly influenced the expression of Co toxicity. The effective concentration of added Co causing 50% inhibition (EC50) ranged from 45 to 863 mg kg(-1), representing almost 20-fold variation among soils. Furthermore, we investigated Co toxicity in relation to Co concentrations and free Co2+ activity in soil solution. The EC50 values showed variation among soils of 17- and 29-fold, based on the Co concentration in soil solution and free Co2+ activity, respectively. Single regressions were carried out between Co toxicity threshold values and selected soil properties. Models obtained showed that soil effective cation exchange capacity (eCEC) and exchangeable calcium were the most consistent single predictors of the EC50 values based on soil added Co.

Human platelet lysate allows expansion and clinical grade production of mesenchymal stromal cells from small samples of bone marrow aspirates or marrow filter washouts.

We compared two protocols for the expansion of human mesenchymal stromal cells (hMSCs) starting from diagnostic samples of BM aspirates (2-5 ml) or using the remnants in the bag and filter at the end of the BM infusions. The protocols differed in the presence of either 10% fetal bovine serum (FBS) or 5% platelet lysate (PL). We obtained a significantly (P=0.02) better expansion with PL, obtaining a median 1010-fold compared to 198-fold with a selected batch of FBS and in fewer days (29.8 in PL versus 41.4 in FBS). Overall, we recovered a variable number from 54.8 x 10(6) to 365 x 10(6) hMSCs in PL versus a variable number from 2.7 x 10(6) to 31 x 10(6) in FBS. No difference could be found in terms of gross morphology, differentiation potential, surface markers and immunological properties (inhibition of allogeneic PHA response and mixed lymphocyte reaction) of cells expanded with PL or FBS. The preparations were found within the range of acceptability for all the quality control criteria. Due to the clinical grade nature of the PL and the reproducibility of separate preparations, we propose this method to obtain hMSCs even from minute amounts of BM cells.

The histone deacetylase inhibitor ITF2357 has anti-leukemic activity in vitro and in vivo and inhibits IL-6 and VEGF production by stromal cells.

We have investigated the activity of ITF2357, a novel hydroxamate histone deacetylase inhibitor, on multiple myeloma (MM) and acute myelogenous leukemia (AML) cells in vitro and in vivo. ITF2357 induced apoptosis in 8/9 MM and 6/7 AML cell lines, as well as 4/4 MM and 18/20 AML freshly isolated cases, with a mean IC(50) of 0.2 microM. ITF2357 activated the intrinsic apoptotic pathway, upregulated p21 and downmodulated Bcl-2 and Mcl-1. The drug induced hyperacetylation of histone H3, H4 and tubulin. When studied in more physiological conditions, ITF2357 was still strongly cytotoxic for the interleukin-6 (IL-6)-dependent MM cell line CMA-03, or for AML samples maximally stimulated by co-culture on mesenchymal stromal cells (MSCs), but not for the MSCs themselves. Interestingly, ITF2357 inhibited the production of IL-6, vascular endothelial growth factor (VEGF) and interferon-gamma by MSCs by 80-95%. Finally, the drug significantly prolonged survival of severe combined immunodeficient mice inoculated with the AML-PS in vivo passaged cell line already at the 10 mg/kg oral dose. These data demonstrate that ITF2357 has potent anti-neoplastic activity in vitro and in vivo through direct induction of leukemic cell apoptosis. Furthermore, the drug inhibits production of growth and angiogenic factors by bone marrow stromal cells, in particular IL-6 and VEGF.

First Report of Iris yellow spot virus in Commercial Leek (Allium porrum) in Spain.

Iris yellow spot virus (IYSV; family Bunyaviridae, genus Tospovirus) has a wide host range, with onion (Allium cepa L.) being one of the most economically important hosts. The first report of IYSV in Spain was from Albacete in 2003 (1) followed by the Canary Islands in 2005. In November of 2006, disease symptoms suspected to be caused by IYSV were observed on the central and outer leaves of commercial leeks plants (cvs. Asthow, Edison, and Shelton) from Alicante, Spain. Symptoms consisted of dry, white-to-straw-colored, spindle-shaped, irregular chlorotic and necrotic lesions on the leaves. Tissue from symptomatic leaves was sampled and analyzed by a double-antibody sandwich (DAS)-ELISA with specific polyclonal antibodies against Onion yellow dwarf virus (OYDV), Leek yellow stripe virus (LYSV) (Biorad Phyto-Diagnostics, Marnes-La Coquette, France), IYSV, and Tomato spotted wilt virus (TSWV) (Loewe Biochemica, Sauerlach, Germany). Five of seven leek samples belonging to the three cultivars tested were positive for IYSV. All samples were negative for the other viruses tested. The presence of IYSV was verified in the positive samples by reverse transcription (RT)-PCR using primers derived from the nucleocapsid (N) gene of IYSV (1). RT-PCR gave a PCR amplicon of expected size (approximately 790 bp) from symptomatic leek plants. The product of one of the positive leek samples was purified and sequenced (GenBank Accession No. EF427447). Nucleotide sequence analysis confirmed the identity of the amplicon as that of the IYSV N gene. Sequence comparisons showed 99% identity with the sequence of the IYSV Spanish isolate available in GenBank (Accession No. EF419888). Thrips tabaci is the primary vector of IYSV. Although the vector is present in Spain, the efficiency of the Mediterranean ecotype in transmitting the virus is not known. Leek has been reported to be a host of IYSV in countries such as the Netherlands, Reunion Island, Australia, and the United States (2). To our knowledge, this is the first report of natural infection of leek with IYSV in Spain. References: (1) C. Córdoba-Sellés et al. Plant Dis. 89:1243, 2005. (2) H. F. Schwartz et al. Plant Dis. 91:113, 2007.

Assessing heavy metal sources in agricultural soils of an European Mediterranean area by multivariate analysis.

According to the European Thematic Strategy for Soil Protection, the characterization of the content and source of heavy metals in soils are necessary to establish quality standards on a regional level that allow the detection of sampling sites affected by pollution. In relation to this, the surface horizons of 54 agricultural soils under vegetable crops in the Alicante province (Spain), a representative area of the European Mediterranean region, were sampled to determine the content of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn. Analytical determinations were performed by atomic absorption spectroscopy after microwave sample digestion in acid solution. Results indicated that heavy metal levels were similar to those reported by authors working on agricultural soils from other parts of the Mediterranean region, with the exception of Cu and Pb in some samples. Multivariate analysis (principal component analysis and cluster analysis) was performed to identify a common source for heavy metals. Moreover, soil properties were determined in order to characterize agricultural soils and to analyze relationships between heavy metal contents and soil properties. The content of Co, Cr, Fe, Mn, Ni and Zn were associated with parent rocks and corresponded to the first principal component called the lithogenic component. A significant correlation was found between lithogenic metals and some soil properties such as soil organic matter, clay content, and carbonates, indicating an important interaction among them. On the other hand, elements such as Cd, Cu and Pb were related to anthropic activities and comprised the second (Cu and Pb) and third principal components (Cd), designated the anthropogenic components. Generally, Cd, Cu and Pb showed a lower correlation with soil properties due to the fact that they remain in available forms in these agricultural soils. Taking into account these results and other achieved in other parts of the European Mediterranean region, it can be concluded that soil quality standards are highly needed to declare soils affected by human induced pollution. This is particularly relevant for anthropogenic metals (Cd, Cu and Pb, and in some areas also Zn). Further research in other agricultural areas of the region would improve the basis for proposing such soil quality standards.