Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID)

Background: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. Methods: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. Results: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). Conclusions: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival. (C) 2021 The Authors. Published by Elsevier Ltd

Repeated pancreatic resection for pancreatic metastases from renal cell Carcinoma: A Spanish multicenter study (PANMEKID)

Background and objectives: Recurrent isolated pancreatic metastasis from Renal Cell Carcinoma (RCC) after pancreatic resection is rare. The purpose of our study is to describe a series of cases of relapse of pancreatic metastasis from renal cancer in the pancreatic remnant and its surgical treatment with a repeated pancreatic resection, and to analyse the results of both overall and disease -free survival. Methods: Multicenter retrospective study of patients undergoing pancreatic resection for RCC pancreatic metastases, from January 2010 to May 2020. Patients were grouped into two groups depending on whether they received a single pancreatic resection (SPS) or iterative pancreatic resection. Data on short and long-term outcome after pancreatic resection were collected. Results: The study included 131 pancreatic resections performed in 116 patients. Thus, iterative pancreatic surgery (IPS) was performed in 15 patients. The mean length of time between the first pancreatic surgery and the second was 48.9 months (95 % CI: 22.2-56.9). There were no differences in the rate of postoperative complications. The DFS rates at 1, 3 and 5 years were 86 %, 78 % and 78 % vs 75 %, 50 % and 37 % in the IPS and SPS group respectively (p = 0.179). OS rates at 1, 3, 5 and 7 years were 100 %, 100 %, 100 % and 75 % in the IPS group vs 95 %, 85 %, 80 % and 68 % in the SPS group (p = 0.895). Conclusion: Repeated pancreatic resection in case of relapse of pancreatic metastasis of RCC in the pancreatic remnant is justified, since it achieves OS results similar to those obtained after the first resection

Alimentación intravenosa en el recién nacido

Debido a que la alimentación intravenosa en el periodo Neonatal está en fase de experimentación y puede Presentar graves peligros se investigan las indicaciones E inconvenientes de esta terapéutica utilizando una Casuística de 103 neonatos. Se comprueba la indicación de Alimentación parenteral en la diarrea prolongada Enterocolitis necrotizante recién nacido con stress Quirúrgico recién nacido con distress respiratorio y Recién nacido de bajo peso. En relación a inconvenientes Se resalta el peligro de infección y la posibilidad de Aparición de patología hepática y pulmonar secundaria a La utilización de suspensiones grasas

Enriched stable isotopes and isotope pattern deconvolution for quantitative speciation of endogenous and exogenous selenium in rat urine by HPLC-ICP-MS

Interest in selenium metabolism and its role in health and disease continue to stimulate a lot of bioanalytical research. The use of enriched stable isotopes of Se and isotope pattern deconvolution (IPD) with an ICP-MS in lactating rats is approached here for total selenium distribution studies. A mathematical tool has been developed to calculate supplemented and endogenous total Se contents in urine and faeces by ICP-MS. Also, quantification of endogenous (natural) and exogenous seleno-species by HPLC-ICP-MS has been worked out. The proposed IPD methodology, for total determinations and for quantitative speciation, was applied to reference materials to validate total selenium quantification in faeces and quantitative selenium speciation in urine samples. Selenium apparent absorption and retention and natural and exogenous selenium distribution in urine samples were calculated. Interesting quantitative information about selenium bio-transformations and final catabolism can be obtained from careful examination of the results observed, using such analytical tools, of the urinary endogenous and exogenous selenium metabolites in urine of rats and their kinetics throughout the two weeks of selenium supplementation