Tratamiento en primera línea de mieloma múltiple no candidato a trasplante: experiencia y evolución en 5 años de un hospital terciario

PO-011 Introducción: El avance en tratamiento del mieloma múltiple en las últimas décadas ha supuesto mejoría en las tasas de supervivencia y en las posibilidades de manejo en pacientes de edad avanzada o con comorbilidad. Estudios realizados han demostrado la eficacia de nuevos esquemas de tratamiento con lenalidomida o bortezomib asociados o no al tratamiento clásico con melfalán. Objetivos: Describir los esquemas de tratamiento utilizados en pacientes con reciente diagnóstico de mieloma sintomático en primera línea en la práctica clínica habitual en pacientes no candidatos a trasplante. Observar la tendencia en los últimos cinco años y asociarla con las guías de práctica clínica. Analizar la supervivencia libre de progresión en primera línea. Métodos: estudio observacional, descriptivo y retrospectivo realizado en el H. U. Miguel Servet de Zaragoza desde abril 2014 hasta abril 2019. Se incluyeron pacientes con nuevo diagnóstico de mieloma múltiple sintomático no candidatos a trasplante en primera línea (según criterios de IMWG). Los criterios de exclusión fueron: haber recibido tratamiento previo y no disponibilidad de datos determinantes para el estudio. ..

Multiplicity dependence of jet-like two-particle correlations in p-Pb collisions at sNN\sqrt{s_{NN}} = 5.02 TeV

Two-particle angular correlations between unidentified charged trigger and associated particles are measured by the ALICE detector in p-Pb collisions at a nucleon-nucleon centre-of-mass energy of 5.02 TeV. The transverse-momentum range 0.7 $< p_{\rm{T}, assoc} < p_{\rm{T}, trig} <$ 5.0 GeV/$c$ is examined, to include correlations induced by jets originating from low momen\-tum-transfer scatterings (minijets). The correlations expressed as associated yield per trigger particle are obtained in the pseudorapidity range $|\eta|<0.9$. The near-side long-range pseudorapidity correlations observed in high-multiplicity p-Pb collisions are subtracted from both near-side short-range and away-side correlations in order to remove the non-jet-like components. The yields in the jet-like peaks are found to be invariant with event multiplicity with the exception of events with low multiplicity. This invariance is consistent with the particles being produced via the incoherent fragmentation of multiple parton--parton scatterings, while the yield related to the previously observed ridge structures is not jet-related. The number of uncorrelated sources of particle production is found to increase linearly with multiplicity, suggesting no saturation of the number of multi-parton interactions even in the highest multiplicity p-Pb collisions. Further, the number scales in the intermediate multiplicity region with the number of binary nucleon-nucleon collisions estimated with a Glauber Monte-Carlo simulation.Comment: 23 pages, 6 captioned figures, 1 table, authors from page 17, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/161

Multi-particle azimuthal correlations in p-Pb and Pb-Pb collisions at the CERN Large Hadron Collider

Measurements of multi-particle azimuthal correlations (cumulants) for charged particles in p-Pb and Pb-Pb collisions are presented. They help address the question of whether there is evidence for global, flow-like, azimuthal correlations in the p-Pb system. Comparisons are made to measurements from the larger Pb-Pb system, where such evidence is established. In particular, the second harmonic two-particle cumulants are found to decrease with multiplicity, characteristic of a dominance of few-particle correlations in p-Pb collisions. However, when a $|\Delta \eta|$ gap is placed to suppress such correlations, the two-particle cumulants begin to rise at high-multiplicity, indicating the presence of global azimuthal correlations. The Pb-Pb values are higher than the p-Pb values at similar multiplicities. In both systems, the second harmonic four-particle cumulants exhibit a transition from positive to negative values when the multiplicity increases. The negative values allow for a measurement of $v_{2}\{4\}$ to be made, which is found to be higher in Pb-Pb collisions at similar multiplicities. The second harmonic six-particle cumulants are also found to be higher in Pb-Pb collisions. In Pb-Pb collisions, we generally find $v_{2}\{4\} \simeq v_{2}\{6\}\neq 0$ which is indicative of a Bessel-Gaussian function for the $v_{2}$ distribution. For very high-multiplicity Pb-Pb collisions, we observe that the four- and six-particle cumulants become consistent with 0. Finally, third harmonic two-particle cumulants in p-Pb and Pb-Pb are measured. These are found to be similar for overlapping multiplicities, when a $|\Delta\eta| > 1.4$ gap is placed.Comment: 25 pages, 11 captioned figures, 3 tables, authors from page 20, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/87

A note on comonotonicity and positivity of the control components of decoupled quadratic FBSDE

In this small note we are concerned with the solution of Forward-Backward Stochastic Differential Equations (FBSDE) with drivers that grow quadratically in the control component (quadratic growth FBSDE or qgFBSDE). The main theorem is a comparison result that allows comparing componentwise the signs of the control processes of two different qgFBSDE. As a byproduct one obtains conditions that allow establishing the positivity of the control process.Comment: accepted for publicatio

Mieloma múltiple extra-óseo, un caso con mala evolución ¿es lo usual?

PB-021 Introducción: El mieloma extramedular (MEM) se presenta al diagnóstico en 3-18% de los casos y otro 10-30% lo padecerá en algún en la evolución. Esta presentación de MM se asocia a morfología inmadura, Cg de alto riesgo, escape de cadenas ligeras, disminución en la expresión de CD56y aumento en la expresión de CD44 y CXCR4; con peor pronóstico pese a los avances en el tratamiento. Metodologia: Presentamos el caso de un paciente con diagnóstico de MM IgA K extra óseo con una evolución desfavorable. Diagnóstico inicial en Febrero 2014 ISS I, con plasmocitoma en V, VIII y IX arco costal, recibió tratamiento con VD por 6 ciclos alcanzando RC y posteriormente TASPE y consolidación con Velcade por 6 ciclos. Primer recaída en Ago 2016 con masa en pared torácica sin contacto óseo; escape a CLL K, tratamiento con VRD por 6 ciclos logrando RC y segundo TASPE y mantenimiento con R. Segunda recaída en Mayo 2018 con derrame pleural y ascitis maligna, tratamiento con DVd por 1 ciclo y progresión intratratamiento; cambio a Pomalidomida-Claritromicina- Dexametasona sin respuesta, desarrollo de insuficiencia respiratoria, fallo renal y hepático culminando en su fallecimiento en Agosto 2018. Conclusiones: Acorde a lo reportado, la supervivencia de la paciente fue menor a lo esperado por escalas de riesgo (ER) habitual (ISS) y el grado de respuesta alcanzado con el tratamiento, la SG fue de 54 meses con SLP 31 meses, la supervivencia después de la segunda recaída fue de 3 meses, similar a lo ya descrito (6 meses). Acorde a un estudio realizado por Weinstock el MEM solo 1, 32% de los MEM se manifestaron con enfermedad pleural y derrame, y 0, 62% en peritoneo y ascitis (como en el caso). Al igual que lo reportado, la enfermedad de la paciente presentó liberación de cadenas ligeras. Si bien existe evidencia y ..

Effective Rheology of Bubbles Moving in a Capillary Tube

We calculate the average volumetric flux versus pressure drop of bubbles moving in a single capillary tube with varying diameter, finding a square-root relation from mapping the flow equations onto that of a driven overdamped pendulum. The calculation is based on a derivation of the equation of motion of a bubble train from considering the capillary forces and the entropy production associated with the viscous flow. We also calculate the configurational probability of the positions of the bubbles.Comment: 4 pages, 1 figur

The 'PUCE CAFE' Project: the First 15K Coffee Microarray, a New Tool for Discovering Candidate Genes correlated to Agronomic and Quality Traits

Background: Understanding the genetic elements that contribute to key aspects of coffee biology will have an impact on future agronomical improvements for this economically important tree. During the past years, EST collections were generated in Coffee, opening the possibility to create new tools for functional genomics. Results: The "PUCE CAFE" Project, organized by the scientific consortium NESTLE/IRD/CIRAD, has developed an oligo-based microarray using 15,721 unigenes derived from published coffee EST sequences mostly obtained from different stages of fruit development and leaves in Coffea Canephora (Robusta). Hybridizations for two independent experiments served to compare global gene expression profiles in three types of tissue matter (mature beans, leaves and flowers) in C. canephora as well as in the leaves of three different coffee species (C. canephora, C. eugenoides and C. arabica). Microarray construction, statistical analyses and validation by Q-PCR analysis are presented in this study. Conclusion: We have generated the first 15 K coffee array during this PUCE CAFE project, granted by Genoplante (the French consortium for plant genomics). This new tool will help study functional genomics in a wide range of experiments on various plant tissues, such as analyzing bean maturation or resistance to pathogens or drought. Furthermore, the use of this array has proven to be valid in different coffee species (diploid or tetraploid), drastically enlarging its impact for high-throughput gene expression in the community of coffee research

Secuencia de tratamiento óptima para el tratamiento del mieloma múltiple en España un modelo secuencial

PO-014 Introducción: El mieloma múltiple (MM) se sigue considerando una enfermedad incurable. Sin embargo, con la disponibilidad de nuevos fármacos, las opciones de tratamiento para pacientes de MM han incrementado drásticamente, aumentando a su vez su supervivencia. Esto hace que sea necesario evaluar la secuencia de tratamiento más apropiada, en lugar de los regímenes de manera aislada. Junto con la seguridad y la eficacia, la evaluación económica se está convirtiendo en una herramienta cada vez más útil y necesaria en la toma de decisiones. Objetivos: El estudio tiene como objetivo estimar los beneficios y costes de las secuencias de tratamiento en el MM más comunes para establecer un umbral de eficiencia y determinar la ratio coste-eficacia incremental (ICER) entre las secuencias. Métodos: Se diseñó un modelo de Markov con 5 estados de salud que representan líneas de tratamiento (1ª, 2ª, 3ª y posteriores) y muerte, con 3 subestados relacionados con la respuesta (respuesta completa [CR], respuesta parcial [PR] y no respuesta [NR]) para simular la transición de pacientes (cada 4 semanas) a lo largo del curso de la enfermedad. Un consejo de hematólogos definió veinte posibles secuencias de tratamiento, como las más utilizadas en la práctica clínica en España. Una revisión de la literatura permitió la identificación de los estudios para estimar las tasas de respuesta específica de cada terapia y los eventos adversos (EA), junto con el tiempo de progresión dependiente de la respuesta requerido para modelar la transición entre las líneas terapéuticas sucesivas y los valores de utilidad necesarios para evaluar la calidad de vida de los pacientes para poder estimar la variable principal del estudio ..

Foraging patterns of acorn woodpeckers (Melanerpes formicivorus) on valley oak (Quercus lobata Née) in two California oak savanna-woodlands

Landscape characteristics and social behavior can affect the foraging patterns of seed-dependent animals. We examine the movement of acorns from valley oak (Quercus lobata) trees to granaries maintained by acorn woodpeckers (Melanerpes formicivorus) in two California oak savanna-woodlands differing in the distribution of Q. lobata within each site. In 2004, we sampled Q. lobata acorns from 16 granaries at Sedgwick Reserve in Santa Barbara County and 18 granaries at Hastings Reserve in Monterey County. Sedgwick has lower site-wide density of Q. lobata than Hastings as well as different frequencies of other Quercus species common to both sites. We found acorn woodpeckers foraged from fewer Q. lobata seed source trees (Kg = 4.1 ± 0.5) at Sedgwick than at Hastings (Kg = 7.6 ± 0.6) and from fewer effective seed sources (Nem* = 2.00 and 5.78, respectively). The differences between sites are due to a greater number of incidental seed sources used per granary at Hastings than at Sedgwick. We also found very low levels of seed source sharing between adjacent granaries, indicating that territoriality is strong at both sites and that each social group forages on its own subset of trees. We discovered an interesting spatial pattern in the location of granaries. At Sedgwick, acorn woodpeckers situated their granaries within areas of higher-than-average tree density, while at Hastings, they placed them within areas of lower-than-average tree density, with the outcome that granaries at the two sites were located in areas of similar valley oak density. Our results illustrate that landscape characteristics might influence the number of trees visited by acorn woodpeckers and the locations of territories, while woodpecker social behavior, such as territoriality, shapes which trees are visited and whether they are shared with other social groups