1,456 research outputs found
SEOM clinical guideline for treatment of kidney cancer (2017)
The goal of this article is to provide recommendations about the management of kidney cancer. Based on pathologic and molecular features, several kidney cancer variants were described. Nephron-sparing techniques are the gold standard of localized disease. After a randomized trial, sunitinib could be considered in adjuvant treatment in high-risk patients. Patients with advanced disease constitute a heterogeneous population. Prognostic classification should be considered. Both sunitinib and pazopanib are the standard options for first-line systemic therapy in advanced renal cell carcinoma. Based on the results of two randomized trials, both nivolumab and cabozantinib should be considered the standard for second and further lines of therapy. Response evaluation for present therapies is a challenge
A biological tool to assess flow connectivity in reference temporary streams from the Mediterranean Basin
Many streams in the Mediterranean Basin have temporary flow regimes. While timing for seasonal drought is predictable, they undergo strong inter-annual variability in flow intensity. This high hydrological variability and associated ecological responses challenge the ecological status assessment of temporary streams, particularly when setting reference conditions. This study examined the effects of flow connectivity in aquatic macroinvertebrates from seven reference temporary streams across the Mediterranean Basin where hydrological variability and flow conditions are well studied. We tested for the effect of flow cessation on two streamflow indices and on community composition, and, by performing random forest and classification tree analyses we identified important biological predictors for classifying the aquatic state either as flowing or disconnected pools. Flow cessation was critical for one of the streamflow indices studied and for community composition. Macroinvertebrate families found to be important for classifying the aquatic state were Hydrophilidae, Simuliidae, Hydropsychidae, Planorbiidae, Heptageniidae and Gerridae. For biological traits, trait categories associated to feeding habits, food, locomotion and substrate relation were the most important and provided more accurate predictions compared to taxonomy. A combination of selected metrics and associated thresholds based on the most important biological predictors (i.e. Bio-AS Tool) were proposed in order to assess the aquatic state in reference temporary streams, especially in the absence of hydrological data. Although further development is needed, the tool can be of particular interest for monitoring, restoration, and conservation purposes, representing an important step towards an adequate management of temporary rivers not only in the Mediterranean Basin but also in other regions vulnerable to the effects of climate change
Home enteral nutrition in Spain: NADYA registry 2010
Objetivos: Describir los resultados del registro de
nutriciĂłn enteral domiciliaria (NED) del grupo NADYASENPE
del año 2010.
Material y métodos: Se recopilaron los datos introducidos
en el registro desde el 1 de enero al 31 de diciembre de
2010.
Resultados: Se registraron 6.591 pacientes (51% varones)
con 6.688 episodios de NED, procedentes de 32 hospitales.
La edad media en los menores de 14 años (4%) fue
de 1 ± 2 años (m ± DS) y de 69,9 ± 17,8 en los mayores de
14 años. El 76% de los pacientes recibieron la NED por un
tiempo superior a 2 años. La patologĂa mĂĄs prevalente fue
la neurolĂłgica 42%, seguida de la neoplasia 28% (en su
mayorĂa cĂĄncer de cabeza y cuello 18%). La informaciĂłn
referente a la vĂa de acceso sĂłlo se recogiĂł en 626 casos
(9,4%), el 51% de los pacientes utilizaron sonda nasogĂĄstrica,
27% gastrostomĂas, 10% vĂa oral y 3% yeyunostomĂas.
Sólo 251 episodios finalizaron a lo largo del año,
siendo el motivo mĂĄs frecuente el fallecimiento del
paciente en el 57% de los casos y el paso a la alimentaciĂłn
oral en el 14%. El 29% de los pacientes presentaban una
actividad limitada y el 39% estaba confinado en cama/
sillĂłn. El 68% de los adultos requerĂan ayuda total o parcial.
El suministro del producto se realizĂł desde el hospital
o la farmacia de referencia en el 63% y 34%, respectivamente.
El suministro del material fungible se realizĂł
desde el hospital o atenciĂłn primaria en el 83% y 16%,
respectivamente.
Conclusiones: Los resultados obtenidos en el registro
de NED del año 2010 muestran caracterĂsticas muy similares
a las recogidas en los años previos en cuanto al
nĂșmero y caracterĂsticas de los pacientes registrados.
Seguimos encontrando problemas en la recogida de datos
relativos a la vĂa de acceso y finalizaciĂłn de los episodiosObjective: To describe the results of the home enteral
nutrition (HEN) registry of the NADYA-SENPE group in
2010.
Material and methods: We retrieved the data of the
patients recorded from January 1st to December 31st
2010.
Results: We registered 6,591 patients (51% males) with
6,688 episodes of HEN, from 32 hospitals. Mean age in
those younger than 14 yr (4%) was 1 ± 2 yrs (m ± SD) and
69,9 ± 17,8 yrs in those older than 14 yr. The length of
HEN was longer than 2 yrs in 76% of the patients. The
most frequent underlying disease was neurological disorders
42%, followed by cancer 28% (mostly head and neck
cancer 18%). We had information related to the enteral
access route in only 626 cases (9,4%), 51% of them used
nasogastric tubes, 27% gastrostomies, 10% oral route
and 3% jejunostomies. Only 251 episodes were closed
during the year, mostly due to patient death 57% and
progress to oral diet 14%. The activity level was limited in
29% of the patients and 39% of them were bed- or chairridden.
Total or partial help was needed by 68% of the
patients. The hospitals and the private pharmacies delivered
the enteral formula in 63% and 34% of the cases,
respectively. The hospitals and the primary care centres
delivered the disposables in 83% and16% of the cases,
respectively.
Conclusions: The results of the 2010 HEN registry are
similar to those published in previous years regarding the
number and characteristics of the patients. We continue
finding problems in the entrance of data referred to the
enteral access route and the closing of the episode
Search for CP violation in D+âÏÏ+ and D+sâK0SÏ+ decays
A search for CP violation in D + â ÏÏ + decays is performed using data collected in 2011 by the LHCb experiment corresponding to an integrated luminosity of 1.0 fbâ1 at a centre of mass energy of 7 TeV. The CP -violating asymmetry is measured to be (â0.04 ± 0.14 ± 0.14)% for candidates with K â K + mass within 20 MeV/c 2 of the Ï meson mass. A search for a CP -violating asymmetry that varies across the Ï mass region of the D + â K â K + Ï + Dalitz plot is also performed, and no evidence for CP violation is found. In addition, the CP asymmetry in the D+sâK0SÏ+ decay is measured to be (0.61 ± 0.83 ± 0.14)%
Early atmospheric metal pollution provides evidence for Chalcolithic/Bronze Age mining and metallurgy in Southwestern Europe
Although archaeological research suggests that mining/metallurgy already started in the Chalcolithic (3rd millennium BC), the earliest atmospheric metal pollution in SW Europe has thus far been dated to ~ 3500â3200 cal. yr. BP in paleo-environmental archives. A low intensity, non-extensive mining/metallurgy and the lack of appropriately located archives may be responsible for this mismatch. We have analysed the older section (> 2100 cal. yr. BP) of a peat record from La Molina (Asturias, Spain), a mire located in the proximity (35â100 km) of mines which were exploited in the Chalcolithic/Bronze Age, with the aim of assessing evidence of this early mining/metallurgy. Analyses included the determination of C as a proxy for organic matter content, lithogenic elements (Si, Al, Ti) as markers of mineral matter, and trace metals (Cr, Cu, Zn, Pb) and stable Pb isotopes as tracers of atmospheric metal pollutionThis work was funded by the projects CGL2010-20672 and HAR2008-06477-C03-03/HIST (Plan Nacional I + D + i, Spanish Ministerio de EconomĂa y Competitividad), 10PXIB200182PR (General Directorate of I + D, Xunta de Galicia), and CDS-TCP (CSD2007-00058, Programa Consolider-Ingenio 2010). We are grateful to JosĂ© Antonio LĂłpez-SĂĄez, Fernando Gil Sendino, Carmen FernĂĄndez Ochoa and Roberto Zapico for their collaboration and assistance during the fieldwork, to JosĂ© RodrĂguez Racedo for helping with the geochemical analyses, and to Suzanne Leroy for perceptive comments on an earlier draftS
Observation of two new baryon resonances
Two structures are observed close to the kinematic threshold in the mass spectrum in a sample of proton-proton collision data, corresponding
to an integrated luminosity of 3.0 fb recorded by the LHCb experiment.
In the quark model, two baryonic resonances with quark content are
expected in this mass region: the spin-parity and
states, denoted and .
Interpreting the structures as these resonances, we measure the mass
differences and the width of the heavier state to be
MeV,
MeV,
MeV, where the first and second
uncertainties are statistical and systematic, respectively. The width of the
lighter state is consistent with zero, and we place an upper limit of
MeV at 95% confidence level. Relative
production rates of these states are also reported.Comment: 17 pages, 2 figure
Differential branching fraction and angular analysis of the decay B0âKâ0ÎŒ+ÎŒâ
The angular distribution and differential branching fraction of the decay B 0â K â0 ÎŒ + ÎŒ â are studied using a data sample, collected by the LHCb experiment in pp collisions at sâ=7 TeV, corresponding to an integrated luminosity of 1.0 fbâ1. Several angular observables are measured in bins of the dimuon invariant mass squared, q 2. A first measurement of the zero-crossing point of the forward-backward asymmetry of the dimuon system is also presented. The zero-crossing point is measured to be q20=4.9±0.9GeV2/c4 , where the uncertainty is the sum of statistical and systematic uncertainties. The results are consistent with the Standard Model predictions
Observation of associated production of a boson with a meson in the~forward region
A search for associated production of a boson with an open charm meson is
presented using a data sample, corresponding to an integrated luminosity of
of proton--proton collisions at a centre-of-mass energy
of 7\,TeV, collected by the LHCb experiment. %% Seven candidate events for
associated production of a boson with a meson and four candidate
events for a boson with a meson are observed with a combined
significance of 5.1standard deviations. The production cross-sections in the
forward region are measured to be where the first uncertainty is statistical and the
second systematic.Comment: 18 pages, 2 figure
Model-independent search for CP violation in D0âKâK+ÏâÏ+ and D0âÏâÏ+Ï+Ïâ decays
A search for CP violation in the phase-space structures of D0 and View the MathML source decays to the final states KâK+ÏâÏ+ and ÏâÏ+Ï+Ïâ is presented. The search is carried out with a data set corresponding to an integrated luminosity of 1.0 fbâ1 collected in 2011 by the LHCb experiment in pp collisions at a centre-of-mass energy of 7 TeV. For the KâK+ÏâÏ+ final state, the four-body phase space is divided into 32 bins, each bin with approximately 1800 decays. The p-value under the hypothesis of no CP violation is 9.1%, and in no bin is a CP asymmetry greater than 6.5% observed. The phase space of the ÏâÏ+Ï+Ïâ final state is partitioned into 128 bins, each bin with approximately 2500 decays. The p-value under the hypothesis of no CP violation is 41%, and in no bin is a CP asymmetry greater than 5.5% observed. All results are consistent with the hypothesis of no CP violation at the current sensitivity
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