The role of matrix metalloproteinase MMP-9 and TIMP-2 tissue inhibitor of metalloproteinasas as serum markers of bladder cancer

1.148 JCR (2013) Q4, 57/75 Urology & nephrolog

Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer.

Introducción: Investigamos en nuestro entorno la utilidad de optimizar el cribado de cáncer de próstata (CaP) mediante determinación de PSA basal en varones entre 40-49 años. Material y método: Estudio retrospectivo que analiza el PSA basal en la quinta década y su capacidad para predecir desarrollo de CaP en una población de Madrid (España). Se realiza curva ROC y se propone un punto de corte. Se compara la evolución del PSA desde basal en pacientes con determinaciones consecutivas mediante el test de Friedman. Se establecen rangos de PSA basal con diferente riesgo de desarrollo de cáncer y se evalúa la utilidad diagnóstica de la velocidad de PSA (VPSA) anual en esta población. Resultados: Un total de 4.304 varones de 40-49 años fueron sometidos a cribado oportunista a lo largo de 17 años, con al menos una determinación sérica de PSA (6.001 determinaciones) y con seguimiento medio de 57,1 ± 36,8 meses. A 768 se les practicó biopsia de algún órgano y a 104 biopsia prostática. Catorce pacientes (0,33%) fueron diagnosticados de cáncer de próstata. La mediana de PSA basal fue 0,74 ng/ml (0,01-58,5) para pacientes sin CaP y 4,21 ng/ml (0,76-47,4) con CaP. La mediana de tiempo desde la determinación hasta el diagnóstico fue 26,8 meses (1,5-143,8). El punto de corte óptimo para detectar CaP fue 1,9 ng/ml (sensibilidad 92,86%, especificidad 92,54%, VPP 3,9%, VPN 99,97%) y el área bajo la curva 92,8%. Respecto a las determinaciones repetidas, la evolución del PSA no mostró diferencias estadísticamente significativas entre pacientes sin cáncer (p = 0,56) o con cáncer (p = 0,64); pero un valor de VPSA > 0,3 ng/ml/año revela elevada especificidad para detectar cáncer en esta población. Conclusiones: Un PSA basal ≥ 1,9 ng/ml en varones españoles de 40-49 años predice el desarrollo de CaP, por lo que podría resultar de utilidad para el cribado oportunista en edad temprana. Se necesita definir un seguimiento apropiado adaptado al riesgo en esta población, pero una VPSA anual ≥ 0,3 ng/ml/año parece de utilidad para conseguir un diagnóstico temprano.INTRODUCTION: We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. MATERIAL AND METHOD: A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. RESULTS: Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. CONCLUSIONS: A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis.Sin financiación0.964 JCR (2015) Q4, 63/77 Urology & NephrologyUE

Department of Computer Architecture C. Tecnologico . PO Box 4114 . E-29080 Malaga . Spain

As a consequence of the needs to solve expensive simulations that include time dependent partial differential equations solutions (PDEs) in short time intervals, laser/tissue interaction modelling has a high, implicit and natural computational demand. Another kind of demand that must be considered is for graphical representation and exploratory analysis of the results. For the first problem, we have used the simulation case of light generation on a semiconductor laser, to derive a novel scheme to solve the computational problem using parallel computers. The solution gets high efficiency and scales well in a message-passing parallel architecture. For graphical demands and in order to make the modelling task easier and less expensive, we have developed a library of functions that can be used to build high quality graphical interfaces. 1. INTRODUCTION Extensive use of laser as a medical and surgical tool has lead to a growing interest in modelling the interactions between laser irradiat..

Prediction of the time constant of small-scale concentrated solar CHP plants

The operation of a power plant based on solar energy can vary significantly with time because of the intrinsic intermittency of the energy resource. Hence, a smart management is required to deal with the complex dynamic variations of the different subsystems. In order to do that, different control logics can be implemented but their effectiveness strictly depends on the temporal evolution of the parameters considered. For a given plant configuration, their exact estimation can be obtained through experimental tests during the commissioning of the plant. However, any change in the design parameters of the plant reflects in a different time constant, whose preliminary knowledge may be of support in tuning the control logic of the plant during the design stage. Therefore, based on the configuration of a small-scale concentrated solar combined heat and power plant as designed and built under the EU funded project Innova MicroSolar by several universities and companies, in this study a prediction of the time constant of several plant configurations with varying solar multiple and size of the storage tank is performed. By making use of the dynamic simulator previously developed by some of the authors, an estimation of such characteristic is assessed in case of potential redesign of the plant, providing also useful suggestions into the design of the control logic

Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?

ObjectivesEarly, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary. The guidelines are intended to support radiologists in their decision-making and contribute to interdisciplinary tumor board discussions.Materials and methodsA validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements were scored online by level of agreement (0 to 10) during two iterative rounds. Either “group consensus,” “group agreement,” or “lack of agreement” was achieved.ResultsEight sections were defined that finally contained 145 statements with comments. Overall, group consensus was reached in 95.9%, and group agreement in 4.1%. This communication contains the first part consisting of the imaging algorithm for suspected soft tissue tumors, methods for local imaging, and the role of tumor centers.ConclusionUltrasound represents the initial triage imaging modality for accessible and small tumors. MRI is the modality of choice for the characterization and local staging of most soft tissue tumors. CT is indicated in special situations. In suspicious or likely malignant tumors, a specialist tumor center should be contacted for referral or teleradiologic second opinion. This should be done before performing a biopsy, without exception.Radiolog

When Risk Management Systems ‘Fail’: On Criminal Negligence and the Limits of Scientists’ Responsibility

This chapter consists of a brief discussion on some legal aspects concerning scientists’ responsibility in risk prevention processes. After proposing some introductory considerations on scientists’ responsibility as such, the author deals with the L’Aquila earthquake crisis of 2009, when a strong quake destroyed significant parts of L’Aquila (Italy) and surrounding villages, killing more than 300 people. The chapter focuses on the relations between scientific knowledge, normative expectations, decision-making and criminal negligence for ‘failed’ risk assessment and management, paying particular attention to the role of ‘regulatory science’ in constructing the ‘reasonable person’ normative standard of care in the theory of criminal negligence. This allows explaining why the first judgement in the L’Aquila trial (2012) is not convincing, having misunderstood how policy-relevant science should participate in prevention processes and the construction of normative standards. In his conclusions, the author suggests some reasons for the recent tendency to blame experts when natural or technological disasters occur