Interventional oncology at the time of COVID-19 pandemic: Problems and solutions.

The COVID-19 pandemic has deeply impacted the activity of interventional oncology in hospitals and cancer centers. In this review based on official recommendations of different international societies, but also on local solutions found in different expert large-volume centers, we discuss the changes that need to be done for the organization, safety, and patient management in interventional oncology. A literature review of potential solutions in a context of scarce anesthesiologic resources, limited staff and limited access to hospital beds are proposed and discussed based on the literature data

NaroNet: Discovery of tumor microenvironment elements from highly multiplexed images

Many efforts have been made to discover tumor-specific microenvironment elements (TMEs) from immunostained tissue sections. However, the identification of yet unknown but relevant TMEs from multiplex immunostained tissues remains a challenge, due to the number of markers involved (tens) and the complexity of their spatial interactions. We present NaroNet, which uses machine learning to identify and annotate known as well as novel TMEs from self-supervised embeddings of cells, organized at different levels (local cell phenotypes and cellular neighborhoods). Then it uses the abundance of TMEs to classify patients based on biological or clinical features. We validate NaroNet using synthetic patient cohorts with adjustable incidence of different TMEs and two cancer patient datasets. In both synthetic and real datasets, NaroNet unsupervisedly identifies novel TMEs, relevant for the user-defined classification task. As NaroNet requires only patient-level information, it renders state-of-the-art computational methods accessible to a broad audience, accelerating the discovery of biomarker signatures.Comment: 37 pages, 4 figure

Tumour biology, metastatic sites and taxanes sensitivity as determinants of eribulin mesylate efficacy in breast cancer: results from the ERIBEX retrospective, international, multicenter study.

BACKGROUND: Our retrospective, international study aimed at evaluating the activity and safety of eribulin mesylate (EM) in pretreated metastatic breast cancer (MBC) in a routine clinical setting. METHODS: Patients treated with EM for a locally advanced or MBC between March 2011 and January 2014 were included in the study. Clinical and biological assessment of toxicity was performed at each visit. Tumour response was assessed every 3 cycles of treatment. A database was created to collect clinical, pathological and treatment data. RESULTS: Two hundred and fifty-eight patients were included in the study. Median age was 59 years old. Tumours were Hormone Receptor (HR)-positive (73.3 %) HER2-positive (10.2 %), and triple negative (TN, 22.5 %). 86.4 % of the patients presented with visceral metastases, mainly in the liver (67.4 %). Median previous metastatic chemotherapies number was 4 [1-9]. Previous treatments included anthracyclines and/or taxanes (100 %) and capecitabine (90.7 %). Median number of EM cycles was 5 [1-19]. The relative dose intensity was 0.917. At the time of analysis (median follow-up of 13.9 months), 42.3 % of the patients were still alive. The objective response rate was 25.2 % (95 %CI: 20-31) with a 36.1 % clinical benefit rate (CBR). Median time to progression (TTP) and overall survival were 3.97 (95 %CI: 3.25-4.3) and 11.2 (95 %CI: 9.3-12.1) months, respectively. One- and 2-year survival rates were 45.5 and 8.5 %, respectively. In multivariate analysis, HER2 positivity (HR = 0.29), the presence of lung metastases (HR = 2.49) and primary taxanes resistance (HR = 2.36) were the only three independent CBR predictive factors, while HR positivity (HR = 0.67), the presence of lung metastases (HR = 1.52) and primary taxanes resistance (HR = 1.50) were the only three TTP independent prognostic factors. Treatment was globally well tolerated. Most common grade 3-4 toxicities were neutropenia (20.9 %), peripheral neuropathy (3.9 %), anaemia (1.6 %), liver dysfunction (0.8 %) and thrombocytopenia (0.4 %). Thirteen patients (5 %) developed febrile neutropenia. CONCLUSION: EM is an effective new option in heavily pretreated MBC, with a favourable efficacy/safety ratio in a clinical practice setting. Our results comfort the use of this new molecule and pledge for the evaluation of EM-trastuzumab combination in this setting. Tumour biology, primary taxanes sensitivity and metastatic sites could represent useful predictive and prognostic factors

Endometrial carcinoma: molecular alterations involved in tumor development and progression

In the western world, endometrial carcinoma (EC) is the most common cancer of the female genital tract. The annual incidence has been estimated at 10-20 per 100 000 women. Two clinicopathological variants are recognized: the estrogen related (type I, endometrioid) and the non-estrogen related (type II, non-endometrioid).The clinicopathological differences are paralleled by specific genetic alterations, with type I showing microsatellite instability and mutations in phosphatase and tensin homologue deleted on chromosome 70, PIK3CA, K-RAS and CTNNB1 (beta-catenin), and type II exhibiting TP53 mutations and chromosomal instability. Some non-endometrioid carcinomas probably arise from pre-existing endometrioid carcinomas as a result of tumor progression and, not surprisingly, some tumors exhibit combined or mixed features at the clinical, pathological and molecular levels. In EC, apoptosis resistance may have a role in tumor progression. Understanding pathogenesis at the molecular level is essential in identifying biomarkers for successful targeted therapies. In this review, the genetic changes of endometrial carcinogenesis are discussed in the light of the morphological features of the tumors and their precursors

Los programas de Educación Emocional Happy 8-12 y Happy 12-16. Evaluación de su impacto en las emociones y el bienestar

Durante los últimos años se ha visto confirmada la importancia de las variables emocionales y de bienestar para un correcto desarrollo académico y personal del alumnado. Por este motivo ha existido un auge en las intervenciones y programas que trabajan estas variables. El objetivo de la presente investigación es conocer la diferencia existente entre las variables emocionales y de bienestar en alumnado de primaria y de secundaria después de haber participado en los programas de Educación Emocional Happy 8-12 y Happy 12-16 durante un curso escolar. Para el desarrollo del estudio se contó con la participación de un total de 574 alumnos de educación primaria y otros 903 de educación secundaria. El diseño de la investigación fue cuasiexperimental, pretest, postest con grupo control. Los instrumentos utilizados fueron los siguientes: CDE, CDE-SEC, STAIC, STAI y la media de las notas académicas. En cuanto a los resultados, se realizó un análisis de la varianza (ANOVA) con un factor intersujetos y un factor intrasujetos para cada una de las muestras. Se detectó una mejora en las escalas de competencias emocionales y ansiedad en las dos muestras, especialmente en primaria. También existió una importante mejoría en el rendimiento académico. Así pues, los resultados del presente estudio demuestran que el entrenamiento de las competencias emocionales en educación primaria mejora las competencias emocionales, disminuye la ansiedad y potencia el rendimiento académico, resultados que no se manifiestan de manera tan significativa en educación secundaria, aunque sí que muestran una tendencia muy parecida

The BTB-zinc finger transcription factor abrupt acts as an epithelial oncogene in drosophila melanogaster through maintaining a progenitor-like cell state

The capacity of tumour cells to maintain continual overgrowth potential has been linked to the commandeering of normal self-renewal pathways. Using an epithelial cancer model in Drosophila melanogaster, we carried out an overexpression screen for oncogenes capable of cooperating with the loss of the epithelial apico-basal cell polarity regulator, scribbled (scrib), and identified the cell fate regulator, Abrupt, a BTB-zinc finger protein. Abrupt overexpression alone is insufficient to transform cells, but in cooperation with scrib loss of function, Abrupt promotes the formation of massive tumours in the eye/antennal disc. The steroid hormone receptor coactivator, Taiman (a homologue of SRC3/AIB1), is known to associate with Abrupt, and Taiman overexpression also drives tumour formation in cooperation with the loss of Scrib. Expression arrays and ChIP-Seq indicates that Abrupt overexpression represses a large number of genes, including steroid hormone-response genes and multiple cell fate regulators, thereby maintaining cells within an epithelial progenitor-like state. The progenitor-like state is characterised by the failure to express the conserved Eyes absent/Dachshund regulatory complex in the eye disc, and in the antennal disc by the failure to express cell fate regulators that define the temporal elaboration of the appendage along the proximo-distal axis downstream of Distalless. Loss of scrib promotes cooperation with Abrupt through impaired Hippo signalling, which is required and sufficient for cooperative overgrowth with Abrupt, and JNK (Jun kinase) signalling, which is required for tumour cell migration/invasion but not overgrowth. These results thus identify a novel cooperating oncogene, identify mammalian family members of which are also known oncogenes, and demonstrate that epithelial tumours in Drosophila can be characterised by the maintenance of a progenitor-like state

Evaluación del programa de Educación Emocional ' Happy 8-12' para la resolución asertiva de conflictos entre iguales

[eng] Introduction. Coexistence in schools inevitably implies conflicts among peers, which can have a negative impact inboth the students’ well-being and their academic achievement. In this sense, the main objective of the present article is to introduce and describe the evaluation of the Training Program in Emotional Management Happy 8-12. This software focuses on the education of the pupils’ emotional competences in order to solve conflicts in an assertive way. The program consists of 25 conflicts which students need to solve according to the management program of emotions developed by the Psychopedagogic Orientation Group (GROP). Method. The sample of the study consisted of 574 students of 5th and 6th grade of primary education. 301 of the participants were boys (52.4%) and 273 were girls (47.6%). Average age was 10.53, with a standard deviation of .662. The design employed in the present work was a quasi experimental design with pretest and posttest with a control group. The instruments and techniques used for the evaluation were: QDE, STAIC, CES, playground climate, anecdotic registration of conflict behaviours and academic performance. Results. Our results indicated that Happy 8-12 significantly improved the emotional competences of the students, reduced anxiety levels, and ameliorated the atmosphere in both the playground and in the class, noticeably augmenting the academic success. Conclusion. The results of this study show that training the management of emotions improves students' well-being at the same time that it acts as a preventive strategy for more severe disruptive behaviours, such as bullying. It also optimises the coexistence in the educative centres.[spa] Introducción. La convivencia en los centros educativos conlleva inevitablemente conflictos interpersonales entre iguales, lo cual puede incidir negativamente en el bienestar y en el rendimiento de los alumnos. En este sentido, el objetivo de este estudio es presentar y describir la evaluación del Programa de Educación Emocional gamificado Happy 8-12. Este videojuego está enfocado a la educación de las competencias emocionales de los alumnos con el fin de poder resolver conflictos de manera más asertiva. El programa consta de 25 conflictos que los alumnos deben resolver siguiendo el proceso de regulación emocional basado en el marco teórico del Grupo de Investigación en Orientación Psicopedagógica (GROP). Método. La muestra del estudio está constituida por 574 alumnos de 5º y 6º curso de educación primaria. 301 de ellos eran niños (52.4%) y 273 eran niñas (47.6%). La media de edad fue de 10.53, con una desviación estándar de .662. Se ha seguido un diseño cuasi experimental pretest y postest con grupo control. Los instrumentos y técnicas utilizados han sido: QDE_9-13, STAIC, CESC; cuestionario de clima de pat io, registro anecdótico de conductas conflictivas y rendimiento académico. Resultados. Los resultados indican que Happy 8-12 mejora de manera significativa las competencias emocionales, disminuye los niveles de ansiedad, mejora el clima social de aula y el clima de patio, reduciendo el número de conflictos entre iguales y aumentando sensiblemente el rendimiento académico. Discusión y conclusión. Los resultados de este estudio demuestran que educar la gestión de las emociones mejora el bienestar de los alumnos y actúa como estrategia de prevención de conductas disruptivas graves, incluido el acoso escolar, beneficiando en gran medida la convivencia de los centros educativo

Placebo-controlled trial of nimodipine in the treatment of acute ischemic cerebral infarction

Nimodipine is a 1,4-dihydropyridine derivative that shows a preferential cerebrovascular activity in experimental animals. Clinical data suggest that nimodipine has a beneficial effect on the neurologic outcome of patients suffering an acute ischemic stroke. Our double-blind placebo-controlled multicenter trial was designed to assess the effects of oral nimodipine on the mortality rate and neurologic outcome of patients with an acute ischemic stroke. One hundred sixty-four patients were randomly allocated to receive either nimodipine tablets (30 mg q.i.d.) or identical placebo tablets for 28 days. Treatment was always started less than or equal to 48 hours after the acute event. The Mathew Scale, slightly modified by Gelmers et al, was used for neurologic assessment. Mortality rate and neurologic outcome after 28 days were used as evaluation criteria. We considered 123 patients to be valid for the analysis of efficacy. Mortality rates did not differ significantly between groups. Neurologic outcome after 28 days of therapy did not differ between groups. However, when only those patients most likely to benefit from any intervention (Mathew Scale sum score of less than or equal to 65 at baseline) were analyzed separately in post hoc-defined subgroups, the nimodipine-treated subgroups showed a significantly better neurologic outcome. This result suggests that some patients with acute ischemic stroke will benefit from treatment with nimodipine tablets

Spontaneous rupture of metastatic α-fetoprotein-producing gastric cancer of the liver

An 80-year-old man was admitted to our hospital because of the rupture of the liver. Laboratory data showed iron-deficiency anemia, although there was no liver dysfunction. A computed tomography scan showed large liver tumor with intraperitoneal hemorrhage, and since a serum level of α-fetoprotein (AFP) was extremely high, we initially suspected a rupture of hepatocellular carcinoma (HCC). Transarterial embolization was performed to stop bleeding from the tumor, followed by an endoscopic examination that revealed advanced gastric cancer. Histological analysis revealed that both the gastric and the hepatic tumors were moderately to poorly differentiated adenocarcinoma, as well as that both tumors were immunohistochemically positive for AFP. Finally, we diagnosed AFP-producing gastric cancer associated with liver metastasis. Rupture of metastatic liver cancer is rare, and accordingly, distinction from HCC is important, particularly for the cases of AFP-producing gastric cancer

The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial

Abstract Background: Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity. Objectives: To assess the effectiveness of a Primary Health Care (PHC) based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period. Research Design: Randomized controlled trial. Subjects: Three hundred and sixty-two (n = 362) inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD); 68.3 (8.8) years; 118 women) were randomly allocated to the physical activity program (IG). One hundred and seventy-nine patients (n = 179; 67.2 (9.1) years; 106 women) were allocated to the control group (CG). The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources. Measures: The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2) was assessed at baseline (month 0), at the end of the intervention (month 3), and at 12 months follow-up after the end of the intervention (month 15). Results: The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5). The CG remained about the same: 18.2 (11.1) (P = .002). Conclusions: Our findings indicate that a 3-month physical activity program linked to community resources is a shortduration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits. Trial Registration: ClinicalTrials.gov NCT0071483