Tomografía por emisión de positrones (PET) con 18FDG en oncología clínica (Revisión Sistemática)

El objetivo de este informe es revisar la evidencia científica disponible sobre la contribución relativa de la PET-FDG al manejo de pacientes oncológicos. Se excluyen de esta revisión trabajos realizados con otros radiotrazadores PET menos habituales.Antecedentes, Aspectos técnicos, Distribución de la PET en España La PET en Oncología, Indicaciones clínicas, Revisiones anteriores Objetivos, Material y método, Búsqueda primaria, Búsqueda secundaria Estrategia de búsqueda utilizada en esta Revisión, Criterios de inclusión-exclusión, Tipos de participantes, Tipo de intervención Tipo de medidas de resultado, Métodos en la selección de las referencias, Calificación de los artículos seleccionados definitivamente siguiendo criterios de Medicina Basada en la Evidencia (MBE) para pruebas diagnósticas, Resultados definitivos de la búsqueda bibliográfica, Análisis del documento de indicaciones de la 18-FDG-PET coordinado por la AETS (Instituto de Salud Carlos III) y consensuado entre todas las AETS del Estado español en mayo de 2001, Manejo de los datos, Resultados, Resultados de algunas de las Revisiones analizadas Melanoma maligno, Medicare, Estudios seleccionados e incluidos en nuestra Revisión Sistemática que aportan datos primarios y que comparan los resultados de la FDG-PET con otras tecnologías diagnósticas. Discusión, Comentarios referentes a las Revisiones analizadas en cuanto a resultados en el capítulo IV, sección IV.a Comentarios referentes a la Revisión Sistemática holandesa sobre melanomas malignos de G. Sophie Mijnhout y colaboradores, del año 2001, analizada en cuanto a esultados en el capítulo IV, sección IV.b Comentarios referentes a los estudios incluidos en nuestra Revisión Sistemática, Conclusiones y recomendacion

Agreement Between 18F-FDG PET/CT and Whole-Body Magnetic Resonance Compared With Skeletal Survey for Initial Staging and Response at End-of-Treatment Evaluation of Patients With Multiple Myeloma

PURPOSE: To compare the agreement between whole-body (WB) magnetic resonance (MR) imaging, 18F-FDG PET/CT, and skeletal survey (SS) in patients with multiple myeloma (MM) for diagnosis, initial staging, response evaluation, and early detection of complications. METHODS: This is a retrospective cohort study including MM patients who were diagnosed, treated, and followed in 2 institutions. These patients were studied with SS, WB-MR, and/or 18F-FDG PET/CT. We studied bone lesions by anatomical locations and analyzed the concordance between SS and a tomographic technique (WB-MR or 18F-FDG PET/CT) and between both tomographic techniques (WB-MR and PET/CT). RESULTS: Forty-four MM patients with a mean age of 62.6 years (range, 38-85 years) were included from January 2012 to February 2016. Whole-body MR and 18F-FDG PET/CT found more lesions than SS in every location except in the skull. Concordance between WB-MR and 18F-FDG PET/CT was either good or excellent in most of the locations and in plasmacytoma studies. However, WB-MR was better than 18F-FDG PET/CT in the study of complications (medullar compression and vascular necrosis). CONCLUSIONS: Our results suggest the study of MM patients should include WB-MR and/or 18F-FDG PET/CT, whereas SS is only useful for the skull. Whole-body MR and 18F-FDG PET/CT are complementary techniques, because both of them show good concordance in almost every location. It is still necessary to individualize the indication of each technique according to patient characteristics.None declare

mRNA Detection in Anal Cytology: A Feasible Approach for Anal Cancer Screening in Men Who Have Sex with Men Living With HIV

There is growing interest in anal cancer screening strategies. However, cytological/molecular evaluation of anal samples is challenging. We aimed to determine the feasibility of detecting, in anal liquid-based cytologies, the expression of biomarkers involved in the cell cycle disturbance elicited by human papillomavirus (HPV). The accuracy of this approach in the identification of high-grade squamous intraepithelial lesions/anal intraepithelial neoplasia grade2-3 (HSIL/AIN2-3) was also evaluated. 215 anal cytologies from men having sex with men living with human immunodeficiency virus were evaluated. Patients showing concordant cytological and anoscopy-directed biopsy diagnosis were selected: 70 with negative cytology and HPV test, 70 with low-grade SIL (LSIL/AIN1) cytology and biopsy, and 75 with cytology and biopsy of HSIL/AIN2-3. CDKN2A/p16, MKI67 and TOP2A mRNA expression was analyzed. HPV detection was performed with Xpert HPV Assay (Cepheid, Sunnyvale, CA, USA). HSIL/AIN2-3 showed higher expression for the biomarkers than LSIL/AIN1 or negative samples. The specificity for HSIL/AIN2-3 detection for a sensitivity established at 70% was 44.7% (95%confidence interval [CI] 36.5-53.2) for TOP2A and MKI67 and 54.5% (95%CI 46.0-62.8%) for CDKN2A/p16. mRNA detection of cell biomarkers in anal liquid-based cytology is feasible. Further studies are warranted to confirm if strategies based on mRNA detection have any role in anal cancer screening

A structurally unique Fusobacterium nucleatumtannase provides detoxicant activity againstgallotannins and pathogen resistance

20 pags., 7 figs., 1 tab.Colorectal cancer pathogenesis and progression isassociated with the presence of Fusobacteriumnucleatum and the reduction of acetylated deriva-tives of spermidine, as well as dietary componentssuch as tannin-rich foods. We show that a new tan-nase orthologue of F. nucleatum (TanBFnn) has sig-nicant structural differences with its Lactobacillusplantarum counterpart affecting the ap covering theactive site and the accessibility of substrates. Crys-tallographic and molecular dynamics analysisrevealed binding of polyamines to a small cavity thatconnects the active site with the bulk solvent whichinteract with catalytically indispensable residues. Asa result, spermidine and its derivatives, particularlyN8-acetylated spermidine, inhibit the hydrolytic activ-ity of TanBFnnand increase the toxicity of gallotan-nins to F. nucleatum. Our results support a model inwhich the balance between the detoxicant activity ofTanBFnnand the presence of metabolic inhibitorscan dictate either conducive or unfavourable condi-tions for the survival of F. nucleatum.Supported by grants from the Spanish Ministry of Science and Innovation (MCI) cofinanced with FEDER funds (SAF2015‐65327‐R and RTI2018‐096494‐B‐100 to JA; AGL2017‐86757‐R to LA, SAF2015‐73549‐JIN to HR; RTI2018‐099592‐B‐C22 to GJO) and the Mizutani Foundation for Glycoscience (200077 to GJO). LA and GJO are supported by the Ramon y Cajal program (RYC‐2013‐13666 and RYC‐2013‐14706 respectively). JTC and AP are the recipients postdoctoral fellowships from the Basque Government. DB is the recipient of a MCI FPI fellowship. APC is the recipient of a fellowship from the University of the Basque Country. We thank the MCI for the Severo Ochoa Excellence accreditation (SEV‐2016‐0644) and the Basque Department of Industry, Tourism and Trade (Etortek and Elkartek programs). JMM thanks the ALBA synchrotron for providing access time to the BL‐13 XALOC beamline. This work is supported by grants from the Jesús de Gangoiti Barrera FoundationPeer reviewe

I Congreso Nacional: La Ciencia en la Educación Infantil y Primaria

Documento PDF de 236 páginas donde se resume las conferencias, ponencias, comunicaciones y carteles presentados en el I Congreso Nacional "La Ciencia en la Educación Infantil y Primaria" celebrado los días 5,6,7 y 8 de septiembre de 2001. La organización del congreso estuvo a cargo del Grupo de Extensión Científica del IMAFF del CSIC (El CSIC en la Escuela) y de la Real Sociedad Española de Física.Resumen de las ponencias, comunicaciones y posters del I Congreso Nacional "La Ciencia en la Educación Infantil y Primaria" celebrado en Granada en septiembre de 2001. El objetivo de este congreso es propiciar el acercamiento del mundo de la Ciencia al de la enseñanza en las primeras etapas. La enseñanza de la Ciencia, concebida como parte de la cultura, es un elemento fundamental de los contenidos con los que un niño tiene que contar para afrontar un mundo de creciente complejidad, en el que la Ciencia irrumpe como ingrediente cotidiano. Despertar su curiosidad y espíritu crítico, fomentar la creatividad y desarrollar destrezas y actitudes, a la vez que se transmiten contenidos científicos, son actividades esenciales para ayudarle a entender un mundo en el que el valor de la observación y la experimentación adquieren la categoría de requisito en el nuevo humanismo.Real Sociedad Española de Física. Consejo Superior de Investigaciones Científicas. Instituto de Matemáticas y Física Fundamental. Instituto de Historia. Universidad de Granada. Centro de Estudios Superiores Don Bosco. Centro de Apoyo al Profesorado de Vallecas. Parque de las Ciencias de Granada. Caja Duero. FECyTN

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care