Valor pronóstico de ERG, PTEN, SPINK1, Ki-67, RA y C-MYC en la predicción de recidiva bioquímica tras prostatectomía radical en el cáncer prostático

El cáncer prostático (CAP) es de gran prevalencia en el mundo desarrollado, y produce un enorme impacto en morbimortalidad y costes de salud pública. Tras la PR con intención curativa el 25% de los pacientes sufrirán una recidiva bioquímica (RBQ), aunque solo la mitad de ellos tendrán progresión clínica. Poder estadificar a los pacientes correctamente según la extensión tumoral y el riesgo de recidiva o progresión permitiría evitar sobretratamientos con secuelas importantes, indicando más vigilancia activa y evitando tratamientos adyuvantes o de rescate innecesarios. Para ello se utilizan herramientas predictivas como los nomogramas y scores construidos con distintas variables clínico-patológicas, biomarcadores inmunohistoquímicos (IHQ), paneles multigenéticos o pruebas de imagen como la Resonancia magnética multiparamétrica (RMm). Objetivos: Valorar la capacidad pronóstica de RBQ de 7 biomarcadores estudiados mediante IHQ en una población de pacientes con CAP localizado sometidos a Prostatectomía radical (PR). Construir un score predictivo de RBQ basado en CAPRA-S junto a los biomarcadores que pueda mejorar de forma coste-efectiva a otros modelos que incorporan RMm o paneles multigenéticos comercializados (Decipher®). Validar el score en la población y comparar su C-index respecto a CAPRA-S y a otros modelos predictivos..

Cardiovascular safety in refractory incontinent patients with overactive bladder receiving add-on mirabegron therapy to solifenacin (BESIDE)

© 2017 John Wiley & Sons Ltd.Summary : Aims/objectives: : In the BESIDE study, combination therapy (antimuscarinic [solifenacin] and β3-adrenoceptor agonist [mirabegron]) improved efficacy over solifenacin monotherapy without exacerbating anticholinergic side effects in overactive bladder (OAB) patients; however, a potential synergistic effect on the cardiovascular (CV) system requires investigation. Methods: OAB patients remaining incontinent despite daily solifenacin 5 mg during 4-week single-blind run-in, were randomised 1:1:1 to double-blind daily combination (solifenacin 5 mg/mirabegron 25 mg, increasing to 50 mg after week 4), solifenacin 5 or 10 mg for 12 weeks. CV safety assessments included frequency of CV-related treatment-emergent adverse events (TEAEs), change from baseline in vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse rate) and electrocardiogram (ECG) parameters. Results: The frequency of hypertension, tachycardia and ECG QT prolongation, respectively, was low and comparable across combination (1.1%, 0.3%, 0.1%), solifenacin 5 mg (0.7%, 0.1%, 0.1%), and solifenacin 10 mg groups (0.8%, 0%, 0.1%). Adjusted mean (SE) change from baseline to end of treatment (EoT) in SBP, DBP, and pulse rate with combination (0.07 mm Hg [0.38], -0.35 mm Hg [0.26], 0.47 bpm [0.28]), solifenacin 5 mg (-0.93 mm Hg [0.38], -0.45 mm Hg [0.26], 0.43 bpm [0.28]) and solifenacin 10 mg (-1.28 mm Hg [0.38], -0.48 mm Hg [0.26], 0.27 bpm [0.28]) was generally comparable, with the exception of a mean treatment difference of ~1 mm Hg in SBP between combination and solifenacin monotherapy; SBP was unchanged with combination and decreased with solifenacin monotherapy. Mean changes from baseline to EoT in ECG parameters were generally similar across treatment groups, except for QT interval corrected using Fridericia's formula, which was higher with solifenacin 10 mg (3.30 mseconds) vs. combination (0.49 mseconds) and solifenacin 5 mg (0.77 mseconds). Conclusion: The comparable frequency of CV-related TEAEs, changes in vital signs and ECG parameters indicates no synergistic effect on CV safety outcomes when mirabegron and solifenacin are combined

A MASSIVE OPEN ONLINE COURSE (MOOC) FOR THE MULTIDISCIPLINARY DESIGN OF BRIDGES

In last years, the traditional blackboard teaching has been incrementally supplemented by visual aids like slide projectors and videos. The phenomenal growth of the Internet has brought in new teaching media, such as Massive Online Open Courses (MOOCs) that open the educational experience up to a broader and more distant set of students. This easy access to education can increase motivation and it is a useful commercial tool for universities. Unlike other disciplines (such as economics or psychology), the MOOCs are rarely used to spread Civil Engineering courses. To fill this gap, and to encourage the use of MOOCs among Civil Engineering Schools, this paper presents the experience of the MOOC for the multidisciplinary design of bridges created by the University of Castilla-La Mancha. This MOOC is based on the experiences learned from the contest on bridge construction with knex for undergraduate students organized by this university in 2015, 2016 and 2017

Stir Casting Routes for Processing Metal Matrix Syntactic Foams: A Scoping Review

Metal matrix syntactic foams (MMSFs) are advanced lightweight materials constituted by a metallic matrix and a dispersion of hollow/porous fillers. Physical and mechanical properties can be fitted regarding matrix and filler properties and processing parameters. Their properties make them potential materials for sectors where density is a limiting parameter, such as transport, marine, defense, aerospace, and engineering applications. MMSFs are mainly manufactured by powder metallurgy, infiltration, and stir casting techniques. This study focuses on the current stir casting approaches and on the advances and deficiencies, providing processing parameters and comparative analyses on porosity and mechanical properties. PRISMA approaches were followed to favor traceability and reproducibility of the study. Stir casting techniques are low-cost, industrially scalable approaches, but they exhibit critical limitations: buoyancy of fillers, corrosion of processing equipment, premature solidification of molten metal during mixing, cracking of fillers, heterogeneous distribution, and limited incorporation of fillers. Six different approaches were identified; four focus on limiting buoyancy, cracking, heterogeneous distribution of fillers, and excessive oxidation of sensitive matrix alloys to oxygen. These improvements favor reaching the maximum porosity of 54%, increasing the fillers’ size from a few microns to 4–5 mm, reducing residual porosity by ±4%, synthesizing bimodal MMSFs, and reaching maximum incorporation of 74 vol%

Cardiovascular safety in refractory incontinent patients with overactive bladder receiving add-on mirabegron therapy to solifenacin (BESIDE)

Aims/objectives: In the BESIDE study, combination therapy (antimuscarinic [solifenacin] and beta(3)-adrenoceptor agonist [mirabegron]) improved efficacy over solifenacin monotherapy without exacerbating anticholinergic side effects in overactive bladder (OAB) patients; however, a potential synergistic effect on the cardiovascular (CV) system requires investigation. Methods: OAB patients remaining incontinent despite daily solifenacin 5 mg during 4-week single-blind run-in, were randomised 1:1:1 to double-blind daily combination (solifenacin 5 mg/mirabegron 25 mg, increasing to 50 mg after week 4), solifenacin 5 or 10 mg for 12 weeks. CV safety assessments included frequency of CV-related treatment-emergent adverse events (TEAEs), change from baseline in vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse rate) and electrocardiogram (ECG) parameters. Results: The frequency of hypertension, tachycardia and ECG QT prolongation, respectively, was low and comparable across combination (1.1%, 0.3%, 0.1%), solifenacin 5 mg (0.7%, 0.1%, 0.1%), and solifenacin 10 mg groups (0.8%, 0%, 0.1%). Adjusted mean (SE) change from baseline to end of treatment (EoT) in SBP, DBP, and pulse rate with combination (0.07 mm Hg [0.38], -0.35 mm Hg [0.26], 0.47 bpm [0.28]), solifenacin 5 mg (-0.93 mm Hg [0.38], -0.45 mm Hg [0.26], 0.43 bpm [0.28]) and solifenacin 10 mg (-1.28 mm Hg [0.38], -0.48 mm Hg [0.26], 0.27 bpm [0.28]) was generally comparable, with the exception of a mean treatment difference of similar to 1 mm Hg in SBP between combination and solifenacin monotherapy; SBP was unchanged with combination and decreased with solifenacin monotherapy. Mean changes from baseline to EoT in ECG parameters were generally similar across treatment groups, except for QT interval corrected using Fridericia’s formula, which was higher with solifenacin 10 mg (3.30 mseconds) vs. combination (0.49 mseconds) and solifenacin 5 mg (0.77 mseconds). Conclusion: The comparable frequency of CV-related TEAEs, changes in vital signs and ECG parameters indicates no synergistic effect on CV safety outcomes when mirabegron and solifenacin are combined

Conocimientos del profesional sobre la sexualidad del ostomizado

Antecedentes: Una ostomía influye significativamente en la vida de la persona, alterando su esfera biopsicosocial y sexual, y afectando a sus relaciones interpersonales. Material y método: Estudio observacional, descriptivo y transversal. Mediante un cuestionario dirigido a profesionales de un área sanitaria de Madrid, se analizan variables sociodemográficas, conocimientos de los profesionales, derivación del paciente a un especialista según la valoración del profesional encuestado y sentimientos que produce en ellos el tema de estudio. Resultados: El 49% afirma tener conocimientos nulos sobre la sexualidad del paciente ostomizado. El 55.9% de los encuestados considera que el sanitario es quien debe introducir el tema de la sexualidad durante la entrevista clínica. El 48.5 y el 85.2% desconocen tratamientos para la disfunción sexual, masculina y femenina, respectivamente. Conclusión: Los datos demuestran que la formación impartida en los centros universitarios es insuficiente para tratar de forma efectiva este tema en la consulta. Los participantes en el estudio muestran nulo o mínimo conocimiento sobre la esfera sexualidad en el paciente ostomizado Se detectan deficiencias de conocimiento en relación con la sexualidad del ostomizado, dificultad para hablar de sexo con el paciente y valor que da el profesional a la esfera sexual en su paciente, entre otras