Using the Synergy between HPLC-MS and MALDI-MS Imaging to Explore the Lipidomics of Clear Cell Renal Cell Carcinoma.

Lipid imaging mass spectrometry (LIMS) has been tested in several pathological contexts, demonstrating its ability to segregate and isolate lipid signatures in complex tissues, thanks to the technique's spatial resolution. However, it cannot yet compete with the superior identification power of high-performance liquid chromatography coupled to mass spectrometry (HPLC-MS), and therefore, very often, the latter is used to refine the assignment of the species detected by LIMS. Also, it is not clear if the differences in sensitivity and spatial resolution between the two techniques lead to a similar panel of biomarkers for a given disease. Here, we explore the capabilities of LIMS and HPLC-MS to produce a panel of lipid biomarkers to screen nephrectomy samples from 40 clear cell renal cell carcinoma patients. The same set of samples was explored by both techniques, and despite the important differences between them in terms of the number of detected and identified species (148 by LIMS and 344 by HPLC-MS in negative-ion mode) and the presence/absence of image capabilities, similar conclusions were reached: using the lipid fingerprint, it is possible to set up classifiers that correctly identify the samples as either healthy or tumor samples. The spatial resolution of LIMS enables extraction of additional information, such as the existence of necrotic areas or the existence of different tumor cell populations, but such information does not seem determinant for the correct classification of the samples, or it may be somehow compensated by the higher analytical power of HPLC-MS. Similar conclusions were reached with two very different techniques, validating their use for the discovery of lipid biomarkers.

[Elevation of Ca 125 in a patient with giant congenital hydronephrosis].

OBJECTIVE: To report a new case with elevation of Ca 125 and hydronephrotic kidney without neoplastic disease, having special reference to clinical aspects. METHOD: The clinical history, anatomopathological and immunohistochemical findings are described. We performed a bibliographic review. We report the case of a 27 year-old female with the diagnosis of giant hydronephrosis and Ca125 elevation (313 u/ml hydronephrotic kidney urine and 112.3 u/ml serum). RESULT: She underwent a radical nephrectomy and Ca125 levels decreased. After 9 years the patient did not have any neoplastic disease and Ca125 levels are normal. CONCLUSIONS: The Ca125 rise with hydronephrotic kidney may be usual although there are not enough studies. We think that in patients with hydronephrotic kidney and malignant neoplasm the Ca125 antigen can lose sensitivity for the early diagnosis, staging and follow up of the malignant diseases.

[Multidisciplinary pelvic floor team: 5 year experience.] / Unidad funcional multidisciplinar de suelo pélvico: experiencia de 5 años.

INTRODUCTION: Pelvic floor dysfunction (PFD) is expressed by many different symptoms that can affect pelvic floor organs. These symptoms can appear alone or associated. The involvement of different organs and the wide variety of symptoms we have to deal with, has become teamwork essential for diagnosis and treatment of PFD. Currently, multidisciplinary pelvic floor teams are essential when dealing with PFD. OBJECTIVE: The main objective of the article is to analyze characteristics and pathologies of the patients discussed during these multidisciplinary meetings. MATERIAL AND METHODS: This is a descriptive study. Patients followed in the multidisciplinary pelvic floorteam at Galdakao-Usansolo Hospital were recruited. We analyzed the patients discussed at the meetings from January 2014 until March 2019. RESULTS: We recruited 55 patients. 89.09% were female and the mean age of the analyzed patients was 55.36 years. The most frequent reasons for medicalconsultation were pelvic floor prolapses in female (22.45%) and pelvic floor pain in male (33.33%). Association between symptoms occur in 78.18% of the patients.41.82% of patients were referred to more than 2 specialists and 21.82% needed associated treatments. CONCLUSIONS: Pelvic floor dysfunction is manifested by a combination of  symptoms which need different specialists, not only for diagnosis, but also for treatment. This is why multidisciplinary teams have become important for the management of pelvic floor disfunction.

INTRODUCCIÓN: La disfunción del suelo pélvico se presenta de múltiples formas y se manifiesta con síntomas que afectan a diferentes órganos del suelo pélvico. Estos síntomas pueden aparecer aislados o asociados entre sí, implicando así a diferentes especialidades a la hora del diagnóstico y tratamiento. Los comités multidisciplinares se han convertido en una herramienta imprescindible en el manejo de la patología del suelo pélvico. OBJETIVO: El objetivo principal es estudiar las características de la patología que presentan los pacientes abordados en el Comité Funcional Multidisciplinar de Suelo Pélvico (CFMSP).MATERIAL Y MÉTODOS: Estudio descriptivo transversal de los pacientes abordados en el CFMSP del Hospital de Galdakao-Usansolo desde 2014 hasta marzo de 2019. RESULTADOS: En el comité se abordaron 55 pacientes, de las cuales el 89,09% fueron mujeres. La edad media fue de 55,36 años. El motivo de consulta másfrecuente fue el prolapso de órganos pélvicos (22,45%) en la población femenina y el dolor (33,33%) en la población masculina. El 78,18% presentaba más de unsíntoma asociado. Los pacientes que requirieron ser derivados a más de 2 especialidades supuso el 41,82% y el 21,82% de los pacientes precisaron más de una modalidad de tratamiento. CONCLUSIONES: La patología del suelo pélvico se manifiesta como asociación de síntomas que requieren la implicación de diferentes especialistas para el diagnóstico y tratamiento. Es el motivo por el que las unidades multidisciplinares son cada vez más necesarias en el abordaje integral de la patología del suelo pélvico.