Microvascularización de los tumores cerebrales y factor angiogénico en el líquido cefalorraquídeo tumoral

Utilizando el método de tinción de la bencidina se realizó un estudio sobre las características morfológicas de la microvascularización de los tumores cerebrales; paralelamente, en la membrana corioalantoidea de embriones de pollo, se estudió la capacidad angiogénica del LCR de pacientes con tumores. La densidad vascular se observó reducida en astrocitomas benignos, oligodendrogliomas y craneo-faringiomas, ligeramente aumentada en astrocitomas de grado I I y meduloblastomas. Los astrocitomas malignos, glioblastomas y metástasis mostraron patrones vasculares muy aumentados. Los meningiomas están intensamente vascularizados y menos los neurinomas. Los LCR de pacientes con tumores primitivos del SNC o a distancia mostraron actividad angiogénica en el 93% de los casos. El 27% de los LCR controles fueron positivos observándose correlación con la edad

African climate warming advances spring arrival of the Common Quail Coturnix coturnix

La fecha de la primera llegada de la Codorniz se ha avanzado bruscamente entre 1983 y 2004 en el noreste de España. Estos cambios fenológicos se correlacionaron significativamente con las temperaturas registradas durante los meses previos en la franja subsahariana pero sólo en su parte más occidental. Esto indica que ésta podría ser el área de invernada para algunas poblaciones ibéricas. El fuerte efecto del tiempo atmosférico sobre la fenología de los movimientos migratorios en esta especie beneficia su conservación, ya que la respuesta encontrada es adecuada y coherente con el avance del ciclo de la vegetación en la Península Ibérica

A Randomized Trial of Cardiopulmonary Resuscitation Training for Medical Students: Voice Advisory Mannequin Compared to Guidance Provided by an Instructor

Current European Resuscitation Guidelines 2010 recommend the use of prompt/feedback devices when training for cardiopulmonary resuscitation (CPR). We aimed to assess the quality of CPR training among second-year medical students with a voice advisory mannequin (VAM) compared to guidance provided by an instructor. Forty-three students received a theoretical reminder about CPR followed by a 2-minute pretest on CPR (compressions/ventilations cycle) with Resusci Anne SkillReporter (Laerdal Medical). They were then randomized into a control group (n = 22), trained by an instructor for 4 minutes per student, and an intervention group (n = 21) trained individually with VAM CPR mannequin for 4 minutes. After training, the students performed a 2-minute posttest, with the same method as the pretest. Participants in the intervention group (VAM) performed more correct hand position (73% vs. 37%; P = 0.014) and tended to display better compression rate (124 min vs. 135 min; P = 0.089). In a stratified analyses by sex we found that only among women trained with VAM was there a significant improvement in compression depth before and after training (36 mm vs. 46 mm, P = 0.018) and in the percentage of insufficient compressions before and after training (56% vs. 15%; P = 0.021). In comparison to the traditional training method involving an instructor, training medical students in CPR with VAM improves the quality of chest compressions in hand position and in compression rate applied to mannequins. Only among women was VAM shown to be superior in compression depth training. This technology reduces costs in 14% in our setup and might potentially release instructors' time for other activities.1.593 JCR (2013) Q3, 48/85 Health care sciences & ServicesUE

African climate warming advances spring arrival of the Common Quail Coturnix coturnix

La fecha de la primera llegada de la Codorniz se ha avanzado bruscamente entre 1983 y 2004 en el noreste de España. Estos cambios fenológicos se correlacionaron significativamente con las temperaturas registradas durante los meses previos en la franja subsahariana pero sólo en su parte más occidental. Esto indica que ésta podría ser el área de invernada para algunas poblaciones ibéricas. El fuerte efecto del tiempo atmosférico sobre la fenología de los movimientos migratorios en esta especie beneficia su conservación, ya que la respuesta encontrada es adecuada y coherente con el avance del ciclo de la vegetación en la Península Ibérica

African climate warming advances spring arrival of the Common Quail Coturnix coturnix

La fecha de la primera llegada de la Codorniz se ha avanzado bruscamente entre 1983 y 2004 en el noreste de España. Estos cambios fenológicos se correlacionaron significativamente con las temperaturas registradas durante los meses previos en la franja subsahariana pero sólo en su parte más occidental. Esto indica que ésta podría ser el área de invernada para algunas poblaciones ibéricas. El fuerte efecto del tiempo atmosférico sobre la fenología de los movimientos migratorios en esta especie beneficia su conservación, ya que la respuesta encontrada es adecuada y coherente con el avance del ciclo de la vegetación en la Península Ibérica

High prognostic value of measurable residual disease detection by flow cytometry in chronic lymphocytic leukemia patients treated with front-line fludarabine, cyclophosphamide, and rituximab, followed by three years of rituximab maintenance

© 2019 Ferrata Storti Foundation.It has been postulated that monitoring measurable residual disease (MRD) could be used as a surrogate marker of progression-free survival (PFS) in chronic lymphocytic leukemia (CLL) patients after treatment with immunochemotherapy regimens. In this study, we analyzed the outcome of 84 patients at 3 years of follow-up after first-line treatment with fludarabine, cyclophosphamide and rituximab (FCR) induction followed by 36 months of rituximab maintenance thearpy. MRD was assessed by a quantitative four-color flow cytometry panel with a sensitivity level of 10-4. Eighty out of 84 evaluable patients (95.2%) achieved at least a partial response or better at the end of induction. After clinical evaluation, 74 patients went into rituximab maintenance and the primary endpoint was assessed in the final analysis at 3 years of follow-up. Bone marrow (BM) MRD analysis was performed after the last planned induction course and every 6 months in cases with detectable residual disease during the 36 months of maintenance therapy. Thirty-seven patients (44%) did not have detectable residual disease in the BM prior to maintenance therapy. Interestingly, 29 patients with detectable residual disease in the BM after induction no longer had detectable disease in the BM following maintenance therapy. After a median followup of 6.30 years, the median overall survival (OS) and PFS had not been reached in patients with either undetectable or detectable residual disease in the BM, who had achieved a complete response at the time of starting maintenance therapy. Interestingly, univariate analysis showed that after rituximab maintenance OS was not affected by IGHV status (mutated vs. unmutated OS: 85.7% alive at 7.2 years vs. 79.6% alive at 7.3 years, respectively). As per protocol, 15 patients (17.8%), who achieved a complete response and undetectable peripheral blood and BM residual disease after four courses of induction, were allowed to stop fludarabine and cyclophosphamide and complete two additional courses of rituximab and continue with maintenance therapy for 18 cycles. Surprisingly, the outcome in this population was similar to that observed in patients who received the full six cycles of the induction regimen. These data show that, compared to historic controls, patients treated with FCR followed by rituximab maintenance have high-quality responses with fewer relapses and improved OS. The tolerability of this regime is favorable. Furthermore, attaining an early undetectable residual disease status could shorten the duration of chemoimmunotherapy, reducing toxicities and preventing long-term side effects. The analysis of BM MRD after fludarabine-based induction could be a powerful predictor of post-maintenance outcomes in patients with CLL undergoing rituximab maintenance and could be a valuable tool to identify patients at high risk of relapse, influencing further treatment strategies.This work was funded by Roche Farma, S.A., Madrid, Spai

High prognostic value of measurable residual disease detection by flow cytometry in chronic lymphocytic leukemia patients treated with front-line fludarabine, cyclophosphamide, and rituximab, followed by three years of rituximab maintenance.

It has been postulated that monitoring measurable residual disease (MRD) could be used as a surrogate marker of progression-free survival (PFS) in chronic lymphocytic leukemia (CLL) patients after treatment with immunochemotherapy regimens. In this study, we analyzed the outcome of 84 patients at 3 years of follow-up after first-line treatment with fludarabine, cyclophosphamide and rituximab (FCR) induction followed by 36 months of rituximab maintenance thearpy. MRD was assessed by a quantitative four-color flow cytometry panel with a sensitivity level of 10-4 Eighty out of 84 evaluable patients (95.2%) achieved at least a partial response or better at the end of induction. After clinical evaluation, 74 patients went into rituximab maintenance and the primary endpoint was assessed in the final analysis at 3 years of follow-up. Bone marrow (BM) MRD analysis was performed after the last planned induction course and every 6 months in cases with detectable residual disease during the 36 months of maintenance therapy. Thirty-seven patients (44%) did not have detectable residual disease in the BM prior to maintenance therapy. Interestingly, 29 patients with detectable residual disease in the BM after induction no longer had detectable disease in the BM following maintenance therapy. After a median followup of 6.30 years, the median overall survival (OS) and PFS had not been reached in patients with either undetectable or detectable residual disease in the BM, who had achieved a complete response at the time of starting maintenance therapy. Interestingly, univariate analysis showed that after rituximab maintenance OS was not affected by IGHV status (mutated vs unmutated OS: 85.7% alive at 7.2 years vs 79.6% alive at 7.3 years, respectively). As per protocol, 15 patients (17.8%), who achieved a complete response and undetectable peripheral blood and BM residual disease after four courses of induction, were allowed to stop fludarabine and cyclophosphamide and complete two additional courses of rituximab and continue with maintenance therapy for 18 cycles. Surprisingly, the outcome in this population was similar to that observed in patients who received the full six cycles of the induction regimen. These data show that, compared to historic controls, patients treated with FCR followed by rituximab maintenance have high-quality responses with fewer relapses and improved OS. The tolerability of this regime is favorable. Furthermore, attaining an early undetectable residual disease status could shorten the duration of chemoimmunotherapy, reducing toxicities and preventing long-term side effects. The analysis of BM MRD after fludarabine-based induction could be a powerful predictor of post-maintenance outcomes in patients with CLL undergoing rituximab maintenance and could be a valuable tool to identify patients at high risk of relapse, influencing further treatment strategies. This trial is registered with EudraCT n. 2007-002733-36 and ClinicalTrials.gov Identifier: NCT00545714