2023 GEIS Guidelines for gastrointestinal stromal tumors

Avapritinib; Gastrointestinal stromal tumor; SurgeryAvapritinib; Tumor estromal gastrointestinal; CirurgiaAvapritinib; Tumor estromal gastrointestinal; CirugíaGastrointestinal stromal tumor (GIST) is the most common malignant neoplasm of mesenchymal origin. GIST spans a wide clinical spectrum that ranges from tumors with essentially no metastatic potential to malignant and life-threatening spread diseases. Gain-of-function mutations in KIT or PDGFRA receptor tyrosine kinases are the crucial drivers of most GISTs, responsible for tumor initiation and evolution throughout the entire course of the disease. The introduction of tyrosine kinase inhibitors targeting these receptors has substantially improved the outcomes in this formerly chemoresistant cancer. As of today, five agents hold regulatory approval for the treatment of GIST: imatinib, sunitinib, regorafenib, ripretinib, and avapritinib. This, in turn, represents a success for a rare neoplasm. During the past two decades, GIST has become a paradigmatic model in cancer for multidisciplinary work, given the disease-specific particularities regarding tumor biology and tumor evolution. Herein, we review currently available evidence for the management of GIST. This clinical practice guideline has been developed by a multidisciplinary expert panel (oncologist, pathologist, surgeon, molecular biologist, radiologist, and representative of patients’ advocacy groups) from the Spanish Group for Sarcoma Research, and it is conceived to provide, from a critical perspective, the standard approach for diagnosis, treatment, and follow-up.This work was supported in part by AECC (CLSEN20004SERR) and the Fero Foundation, both to CS

Propuesta metodológica para incorporar variables socioeconómicas, culturales e institucionales en la caracterización de humedales a partir del enfoque de sistemas socioecológicos.

Este producto es elaborado en el marco del convenio 005 (13-014) entre el Instituto Humboldt y el Fondo Adaptación, este documento se presenta un conjunto de variables que deben considerarse en la identificación y delimitación de estos sistemas, basados en un enfoque conceptual de sistemas socioecológicos y considerando de manera explícita aspectos socioeconómicos, culturales e institucionales.Bogotá, ColombiaSubdirección de Servicios Científicos y Proyectos Especiale

Dinámica de crecimiento y curvas de extracción de nutrientes de Pennisetum sp. (Maralfalfa)

El crecimiento de una especie, así como la concentración y extracción de nutrientes en el forraje, se pueden conocer a través de modelos matemáticos. Se utilizaron las ecuaciones de Gompertz y Logistic para estudiar el crecimiento, un modelo potencial negativo para las curvas de dilución NPK y la extracción máxima a través de polinomios de segundo orden. Se calculó la Extracción Unitaria (EU) y Eficiencia de Recuperación del Nutriente (ERN) NPK. La bondad de ajuste de los modelos fue comparada bajo un diseño completamente al azar con arreglo factorial 2×2, factor A: dos modelos y factor B: fertilización y testigo con 16 repeticiones. La concentración de nutrientes se optimizó por algoritmo de Levenberg-Marquart.  Los resultados indicaron que el ajuste del modelo fue similar para las parcelas en estudio; sin embargo, Gompertz mostró   una mejor representación de la realidad biológica. La máxima tasa de crecimiento se alcanzó a los 21 días en parcelas testigo y 56 días en parcelas fertilizadas, el punto de inflexión a los 30 y 31 días, respectivamente. La concentración de nutrientes en el pasto, disminuyó a través de los cortes en ambos tratamientos y las parcelas fertilizadas además presentaron la mayor producción de materia seca. La EU se mostró casi de manera homogénea para parcelas fertilizadas y no fertilizadas.  La ERN fue de 48 % para nitrógeno, 39 % para fósforo y 104 % para potasio, lo cual sugiere un suministro excedido de N y P con la dosis suministrada y un consumo de lujo para K

Efecto de la mineria en macroinvertebrados acuáticos de la ciénaga plaza seca, Atrato, Chocó

The wetland ecosystems of the middle Atrato basin have been affected by factors such as mining, which interrupt the natural ecological dynamics of these aquatic communities, including the assemblage of aquatic macroinvertebrates. The effect of gold mining contamination in the Pla-za Seca marsh, Middle Atrato basin, Chocó, Colombia, was determined. The structure and dynamics were analyzed. Macroinvertebrate specimens were collected from substrates such as macrophytes, sediment and riparian vegetation, fixed with 70% alcohol; physicochemical and hydrological parameters were measured. A total of 175 organisms were collected, distributed in 2 classes, 7 orders, 22 families and 27 genera. The order Odonata was the most representative (34%), followed by Coleoptera (28%). The Shannon-Wiener diversity index showed low values (1.92 bits/ind). The physicochemical variables were influenced by mining activity in the areas surrounding the marsh.Los ecosistemas de humedales de la cuenca media del Atrato se han visto afectados por factores como la minería, que interrumpen la dinámica ecológica natural de estas comunidades acuáticas entre ellas el ensamblaje de macroinvertebrados acuáticos. Se determinó el efecto de la contaminación minera aurífera en la ciénaga Plaza Seca, cuenca Media del Atrato, Chocó, Colombia. Se analizó la estructura y dinámica. Los ejemplares de macroinvertebrados se colectaron en sustratos como las macrófitas, sedimento y vegetación de ribera, se fijaron con alcohol al 70%; se midieron parámetros fisicoquímicos e hidrológicos. Se colectaron un total de 175 organismos, distribuidos en 2 clases, 7 órdenes, 22 familias y 27 géneros. El orden Odonata fue el más representativo (34%), seguido de Coleóptera (28%). El índice de diversidad de Shannon-Wiener arrojó bajos valores (1,92 bits/ind). Las variables fisicoquímicas se vieron influenciadas por la actividad minera que se desarrolla en las áreas aledañas a la ciénaga. The wetland ecosystems of the middle Atrato basin have been affected by factors such as mining, which interrupt the natural ecological dynamics of these aquatic communities, including the assemblage of aquatic macroinvertebrates. The effect of gold mining contamination in the Pla-za Seca marsh, Middle Atrato basin, Chocó, Colombia, was determined. The structure and dynamics were analyzed. Macroinvertebrate specimens were collected from substrates such as macrophytes, sediment and riparian vegetation, fixed with 70% alcohol; physicochemical and hydrological parameters were measured. A total of 175 organisms were collected, distributed in 2 classes, 7 orders, 22 families and 27 genera. The order Odonata was the most representative (34%), followed by Coleoptera (28%). The Shannon-Wiener diversity index showed low values (1.92 bits/ind). The physicochemical variables were influenced by mining activity in the areas surrounding the marsh

In Vitro and In Vivo Evaluation of a Folate-Targeted Copolymeric Submicrohydrogel Based on N-Isopropylacrylamide as 5-Fluorouracil Delivery System

Folate-targeted poly[(p-nitrophenyl acrylate)-co-(N-isopropylacrylamide)] nanohydrogel (F-SubMG) was loaded with 5-fluorouracil (5-FU) to obtain low (16.3 ± 1.9 μg 5-FU/mg F-SubMG) and high (46.8 ± 3.8 μg 5-FU/mg F-SubMG) load 5-FU-loaded F-SubMGs. The complete in vitro drug release took place in 8 h. The cytotoxicity of unloaded F-SubMGs in MCF7 and HeLa cells was low; although it increased for high F-SubMG concentration. The administration of 10 μM 5-FU by 5-FU-loaded F-SubMGs was effective on both cellular types. Cell uptake of F-SubMGs took place in both cell types, but it was higher in HeLa cells because they are folate receptor positive. After subcutaneous administration (28 mg 5-FU/kg b.w.) in Wistar rats, F-SubMGs were detected at the site of injection under the skin. Histological studies indicated that the F-SubMGs were surrounded by connective tissue, without any signs of rejections, even 60 days after injection. Pharmacokinetic study showed an increase in MRT (mean residence time) of 5-FU when the drug was administered by drug-loaded F-SubMGs

Investigaciones paleobotánicas en la cuenca central del Duero

El objetivo del trabajo es dar a conocer el estado actual de conocimientos científicos sobre el pasado del paisaje vegetal (Cuaternario final) en los territorios interiores no montanos de la depresión del Duero. Se recogen todos los yacimientos cuyo estudio ya ha concluido así como los que se encuentran en fase de investigación o prospección. Se precisa el tipo de informador en cada caso (polen, carbones, maderas, otros macrorrestos), el rango cronológico conocido hasta el momento así como el grado o proporción de trabajo realizado en cada yacimiento en relación con las previsiones efectuadas. Se aporta una síntesis-resumen de los principales resultados obtenidos hasta el momento y de los aspectos más concluyentes de los mismos en relación con la elaboración de modelos de evolución del paisaje vegetal posteriores al último máximo glacial en la Meseta norte. A nuestro juicio debe destacarse, como uno de los resultados más relevantes, el conocimiento ya afianzado de que los pinares de meseta han sido el elemento más significativo en amplios sectores del sur y este de la cuenca a lo largo de todo o gran parte del Holoceno, circunstancia que contrasta con todas las propuestas de paisaje pretérito (preantrópico) existentes antes de la realización de las prospecciones paleobotánicas

Can scenario-planning support community-based natural resource management? Experiences from three countries in latin america

Community Based Natural Resource Management (CBNRM) is a concept critical to managing socio-ecological systems, but whose implementation needs strengthening. Scenario-planning is one approach that may offer benefits relevant to CBNRM, but whose potential is not yet well understood. We therefore designed, trialled and evaluated a scenario-planning method intended to support CBNRM at three cases, located in Colombia, Mexico and Argentina. Implementing scenario-planning was judged as worthwhile in all three cases, although aspects of it could be challenging to facilitate. The benefits generated were relevant to strengthening CBNRM: encouraging the participation of local people and using their knowledge; enhanced consideration and adaption of future change; and supporting the development of systems thinking. Tracing exactly when and how these benefits arise is challenging, but two elements of the method seemed particularly useful. Firstly, using a systematic approach to discuss how drivers of change may affect local socio-ecological systems helped to foster systems thinking and identify connections between issues. Secondly, explicitly focusing on how to use and respond to scenarios helped identify specific practical activities ('response options') that would support CBNRM despite the pressures of future change. Discussions about response options also highlighted the need for support by other actors (e.g. policy groups): this raises the question of when and how other actors and other sources of knowledge should be involved in scenario-planning, so as to encourage their buy-in to actions identified by the process. We suggest other CBNRM initiatives may benefit from adapting and applying scenario-planning. However, these initiatives should be carefully monitored since further research is required to understand how and when scenario-planning methods may produce benefits, and their strengths and weaknesses versus other methods

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND: Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVE: We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS: We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 ± 19.2 years) recruited from 29 international centers. RESULTS: At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% ± 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of ≤35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS: MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation