To study the impact of neoadjuvant therapies on postoperative complications and mortality among non-small-cell lung cancer (NSCLC) patients subjected to anatomic lung resection and included in the ...Spanish cohort of the video-assisted thoracic surgery (GE-VATS) multicenter database.
The study included a total of 3085 patients from 33 centers between December 2016 and March 2018. We performed a comparative analysis of the complications and mortality in patients who received neoadjuvant therapies (n = 263) versus those who did not (n = 2822). A propensity score-matched analysis was used to adjust for potential confounders. Association between exposure in two groups and outcomes were estimated by logistic regression weighted by inverse of probability of receiving the treatment that actually received.
In the unadjusted analysis, the chemotherapy (CT) and chemoradiotherapy (CRT) group presented a higher frequency of ICU readmissions, reinterventions, empyema, cardiovascular complications, a greater frequency of atrial fibrillation, and an increased need for blood product transfusions. In the adjusted group, CT and CRT patients had a higher rate of cardiovascular complications (CT p = 0.002; OR 2.29; 95% CI 1.34–3.94 and CRT p = 0.001; OR 2.90; 95% CI 1.52-5-52), arrhythmias (CT p = 0.013; OR 2.23; 95% CI 1.18–4.20 and CRT p = 0.046; OR 2.22; 95% CI 1.01–4.90) and transfussions (CT p = 0.042; OR 2.95; 95% CI 1.04–8.35 and CRT p < 0.001; OR 7.74; 95% CI 3.01-19-92).
Based on our series, neoadjuvant CT and CRT were associated with a higher rate of cardiovascular complications, arrhythmias and transfussions in patients with NSCLC subjected to anatomic lung resection.
Molecular techniques can often reveal a broader range of pathogens in respiratory infections. We aim to investigate the prevalence and age pattern of viral co-infection in children hospitalized with ...lower tract acute respiratory infection (LT-ARI), using molecular techniques.
A nested polymerase chain reaction approach was used to detect Influenza (A, B), metapneumovirus, respiratory syncytial virus (RSV), parainfluenza (1-4), rhinovirus, adenovirus (A-F), bocavirus and coronaviruses (NL63, 229E, OC43) in respiratory samples of children with acute respiratory infection prospectively admitted to any of the GENDRES network hospitals between 2011-2013. The results were corroborated in an independent cohort collected in the UK.
A total of 204 and 97 nasopharyngeal samples were collected in the GENDRES and UK cohorts, respectively. In both cohorts, RSV was the most frequent pathogen (52.9% and 36.1% of the cohorts, respectively). Co-infection with multiple viruses was found in 92 samples (45.1%) and 29 samples (29.9%), respectively; this was most frequent in the 12-24 months age group. The most frequently observed co-infection patterns were RSV-Rhinovirus (23 patients, 11.3%, GENDRES cohort) and RSV-bocavirus / bocavirus-influenza (5 patients, 5.2%, UK cohort).
The presence of more than one virus in pediatric patients admitted to hospital with LT-ARI is very frequent and seems to peak at 12-24 months of age. The clinical significance of these findings is unclear but should warrant further analysis.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This paper reports a programmable 400 μm pitch neural spike recording channel, fabricated in a 130 nm standard CMOS technology, which implements amplification, filtering, digitization, analog spike ...detection plus feature extraction, and self-calibration functionalities. It can operate in two different output modes: 1) signal tracking, in which the neural signal is sampled and transmitted as raw data; and 2) feature extraction, in which the spikes of the neural signal are detected and encoded by piece-wise linear curves. Additionally, the channel offers a foreground calibration procedure in which the amplification gain and the passband of the embedded filter can be self-adjusted. The amplification stage obtains a noise efficiency factor of 2.16 and an input referred noise of 2.84 μV rms over a nominal bandwidth of 167 Hz-6.9 kHz. The channel includes a reconfigurable 8-bit analog-to-digital converter combined with a 3-bit controlled programmable gain amplifier for adjusting the input signal to the full scale range of the converter. This combined block achieves an overall energy consumption per conversion of 102 fJ at 90 kS/s. The energy consumed by the circuit elements which are strictly related to the digitization process is 14.12 fJ at the same conversion rate. The complete channel consumes 2.8 μW at 1.2 V voltage supply when operated in the signal tracking mode, and 3.1 μW when the feature extraction mode is enabled.
La estrategia diagnóstico-terapéutica en la hemorragia digestiva baja (HDB) grave varía según la situación clínica del paciente. Las guías de práctica clínica actuales proponen diferentes estrategias ...de manejo.
Conocer la toma de decisiones de los gastroenterólogos de distintos centros hospitalarios en el manejo de esta enfermedad.
Estudio observacional descriptivo mediante una encuesta on-line, dirigida a facultativos de aparato digestivo de España y Latinoamérica, en diciembre de 2021.
Se incluyeron 281 encuestas anónimas de facultativos de España y Latinoamérica. El manejo diagnóstico-terapéutico de la HDB grave fue heterogéneo entre los encuestados. Con respecto a los estudios iniciales mostraron variabilidad entre la solicitud de angiografía por tomografía computarizada (angio-TC) (44,5%), gastroscopia (33,1%), colonoscopia (20,6%) y arteriografía (1,1%). La decisión terapéutica tras angio-TC positiva variaba mayoritariamente entre la solicitud de arteriografía (38,1%) y colonoscopia (44,1%). Si la angio-TC era negativa se realizaba gastroscopia en la mayoría de los casos. Si el paciente ingresaba en una unidad de cuidados intensivos y precisaba colonoscopia, la mayor parte de los encuestados la realizaban urgente (<24h) (31% siempre, 43,4% en la mayoría de los casos); mientras que, si no requerían ingreso en intensivos este porcentaje se reducía (10% siempre, 33,8% en la mayoría de los casos). Reconocían tener dudas en el manejo de estos pacientes el 40,9% de los encuestados, y consideraban necesario la creación de un protocolo de actuación el 98,2% de los participantes.
Existe una gran variabilidad interhospitalaria en el manejo de la HDB grave entre los gastroenterólogos. Es necesario unificar la actuación diagnóstico-terapéutica en esta enfermedad.
The diagnostic and therapeutic strategy in severe lower gastrointestinal bleeding (LGIB) varies depending on the patient's clinical situation. Actual clinical practice guidelines propose different management strategies. We aim to know the attitude of the gastroenterologists from different hospitalary centers in the management of this entity.
Descriptive and observational study using an on-line questionnaire, addressed to gastroenterologists in Spain and Latin America, in December 2021.
We included 281 anonymous questionnaires of gastroenterologists from Spain and Latin America. Diagnostic and therapeutic management of severe LGIB was heterogeneous among the participants. Regarding to the first diagnostic modalities they showed variability between performing computed tomography angiography (CTA) (44.5%), gastroscopy (33.1%), colonoscopy (20.6%) and arteriography (1.1%). The therapeutic attitude after a positive CTA mostly varied between performing arteriography (38.1%) and colonoscopy (44.1%). If negative CTA, in the majority of cases a gastroscopy was performed. If the patient needed intensive critical unit (ICU) care and to undergo colonoscopy, most participants performed an urgent colonoscopy (<24h) (31% always, 43.4% in most cases); while if the patient did not require ICU admission this percentage was lower (10% always, 33.8% in most cases). The 40.9% of the participants admitted having doubts about the management of this patients and the 98.2% considered the need for a creation of an action protocol.
There is a high interhospitalary variability on the management of severe lower gastrointestinal bleeding among gastroenterologists. It is necessary to unify the diagnostic and therapeutic management of this pathology.
Objective: Several reports on the effects of zeolite (ZEO) inclusion in diets for feedlot lamb diets have indicated improvements in dietary energy efficiency and decreases in internal fat. Inclusion ...levels and the type of zeolite used have been the main focus of those reports. However, the possible effect of the zeolite particle size on the growth performance and carcass characteristics has not yet been investigated.
Material and Methods: Forty-eight male intact Pelibuey × Katahdin lambs were fed for 67 days with a high-energy diet supplemented with ZEO as follows: 1) basal diet 0% ZEO (control); 2) basal diet 3% ZEO particle size 250 μM (sieve 60); 3) basal diet 3% ZEO particle size 149 μM (sieve 100); and 4) basal diet 3% ZEO particle size 74 μM (sieve 200). ZEO replaced corn grain and soybean meal in equal parts. At the end of feeding, lambs were slaughtered, and variables such as carcass characteristics and visceral mass were evaluated.
Results: Particle size did not affect growth performance, carcass characteristics, or visceral mass. The inclusion of ZEO reduced 3.4% of dietary net energy in diets but did not affect dry matter intake or average daily gain, thus improving (p ≤ 0.05) dietary energy efficiency by 2.9%. Except for an 18.9% reduction (p = 0.02) in visceral mass fat, ZEO did not affect other carcass characteristics or visceral organ mass.
Conclusion: The particle size studied in the present experiment has not affected any of the vari¬ables of growth performance or carcass characteristics. ZEO inclusion could be a strategy to reduce the visceral fat in finishing lambs.
Abstract Background aims Cell therapy with autologous mesenchymal stromal cells (MSCs) in patients with spinal cord injury (SCI) is beginning, and the search for its better clinical application is an ...urgent need. Methods We present a phase 2 clinical trial in patients with chronic SCI who received three intrathecal administrations of 100 x 106 MSCs and were followed for 10 months from the first administration. Efficacy analysis was performed on nine patients, and safety analysis was performed on 11 patients. Clinical scales, urodynamic, neurophysiological and neuroimaging studies were performed previous to treatment and at the end of the follow-up. Results The treatment was well-tolerated, without any adverse event related to MSC administration. Patients showed variable clinical improvement in sensitivity, motor power, spasms, spasticity, neuropathic pain, sexual function or sphincter dysfunction, regardless of the level or degree of injury, age or time elapsed from the SCI. In the course of follow-up three patients, initially classified as ASIA A, B and C, changed to ASIA B, C and D, respectively. In urodynamic studies, at the end of follow-up, 66.6% of the patients showed decrease in postmicturition residue and improvement in bladder compliance. At this time, neurophysiological studies showed that 55.5% of patients improved in somatosensory or motor-evoked potentials, and that 44.4% of patients improved in voluntary muscle contraction together with infralesional active muscle reinnervation. Conclusions The present guideline for cell therapy is safe and shows efficacy in patients with SCI, mainly in recovery of sphincter dysfunction, neuropathic pain and sensitivity.
BACKGROUND:Senescent cardiomyocytes exhibit a mismatch between energy demand and supply that facilitates their transition toward failing cells. Altered calcium transfer from sarcoplasmic reticulum ...(SR) to mitochondria has been causally linked to the pathophysiology of aging and heart failure.
METHODS:Because advanced glycation-end products accumulate throughout life, we investigated whether intracellular glycation occurs in aged cardiomyocytes and its impact on SR and mitochondria.
RESULTS:Quantitative proteomics, Western blot and immunofluorescence demonstrated a significant increase in advanced glycation-end product–modified proteins in the myocardium of old mice (≥20months) compared with young ones (4-6months). Glyoxalase-1 activity (responsible for detoxification of dicarbonyl intermediates) and its cofactor glutathione were decreased in aged hearts. Immunolabeling and proximity ligation assay identified the ryanodine receptor (RyR2) in the SR as prominent target of glycation in aged mice, and the sites of glycation were characterized by quantitative mass spectrometry. RyR2 glycation was associated with more pronounced calcium leak, determined by confocal microscopy in cardiomyocytes and SR vesicles. Interfibrillar mitochondria—directly exposed to SR calcium release—from aged mice had increased calcium content compared with those from young ones. Higher levels of advanced glycation-end products and reduced glyoxalase-1 activity and glutathione were also present in atrial appendages from surgical patients ≥75 years as compared with the younger ones. Elderly patients also exhibited RyR2 hyperglycation and increased mitochondrial calcium content that was associated with reduced myocardial aerobic capacity (mitochondrial O2 consumption/g) attributable to less respiring mitochondria. In contracting HL-1 cardiomyocytes, pharmacological glyoxalase-1 inhibition recapitulated RyR2 glycation and defective SR-mitochondria calcium exchange of aging.
CONCLUSIONS:Mitochondria from aging hearts develop calcium overload secondary to SR calcium leak. Glycative damage of RyR2, favored by deficient dicarbonyl detoxification capacity, contributes to calcium leak and mitochondrial damage in the senescent myocardium.
Respiratory syncytial virus (RSV) is an important cause of serious lower respiratory tract disease in infants. Several studies have shown evidence pointing to the genome of the host as an important ...factor determining susceptibility to respiratory disease caused by RSV. We sequenced the complete exomes of 54 patients infected by RSV that needed hospitalization due to development of severe bronchiolitis. The Iberian sample (IBS) from The 1000 Genomes Project (1000G) was used as control group; all the association results were pseudo-replicated using other 1000G-European controls and Spanish controls. The study points to SNP rs199665292 in the olfactory receptor (OR) gene OR13C5 as the best candidate variant (P-value = 1.16 × 10
; OR = 5.56). Genetic variants at HLA genes (HLA-DQA1, HLA-DPB1), and in the mucin 4 gene (MUC4) also emerge as susceptibility candidates. By collapsing rare variants in genes and weighing by pathogenicity, we obtained confirmatory signals of association in the OR gene OR8U1/OR8U8, the taste receptor TAS2R19, and another mucin gene (MUC6). Overall, we identified new predisposition variants and genes related to RSV infection. Of special interest is the association of RSV to olfactory and taste receptors; this finding is in line with recent evidence pointing to their role in viral infectious diseases.
Cnidoscolus chayamansa Mc Vaugh (Euphorbiaceae) is commonly known as ‘chaya’ in Central America. In South East Mexico, because of its high nutritional values, is an important part of the diet of many ...indigenous communities. Chaya is also used as a traditional remedy for the treatment of diabetes, rheumatism, gastrointestinal disorders and inflammation-related diseases. Although Cnidoscolus chayamansa is one of most used and valued medicinal plants, only few studies on documenting its pharmacological properties can be found.
Dried leaves of Cnidoscolus chayamansa were subjected to a successive maceration using Hex, EtOAc and EtOH. The antioxidant activities of the extracts were tested using the DPPH radical scavenging, Ferric reducing/antioxidant power and total phenolic content assays. To determine the anti-inflammatory activity, the TPA-induced mouse ear edema and the carrageenan-induced mouse paw edema assays were used. The cardioprotective effects of the EtOH extract was determined using the ischemia/reperfusion (I/R) rat model. Finally, the acute toxicity was determined using Lorke's method.
The results showed a similar anti-inflammatory activity (≈30%) for all extracts but only the EtOAc extract showed relevant activity when applied intraperitoneally. When tested for their antioxidant activity none of the extracts showed a significant activity suggesting that the antinflammatory activity is not related to a direct free radical scavenging of the extracts. Additionally, the EtOH extract showed a strong cardioprotective effect at 500mg/kg when given orally. Both the EtOAc and the EtOH extract have a LD50 >5g/kg, confirming their safety in acute oral administration.
All these results are relevant for a better understanding of the therapeutic used of Cnidoscolus chayamansa in the Mexican traditional medicine and highlights its cardioprotective potential.
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