La radioterapia en las enfermedades no malignas del aparato locomotor

Los autores hacen una revisión de las indicaciones y resultados obtenidos mediante la radioterapia en enfermedades del aparato locomotor, excluyendo las enfermedades proliferativas malignas. En el ámbito de los procesos inflamatorios siguen existiendo dudas a su eficacia en el tratamiento de bursitis y tendinitis, por el contrario, tanto en el tratamiento sistémico inmunosupresor de la artritis reumatoide como en la formación heterotópica de hueso, su utilidad está probada. En el campo de los procesos proliferativos no malignos, el papel de la radioterapia es indudable. Los tumores desmoides o fibromatosis agresiva, el ameloblastoma, los quistes óseos aneurismáticos, los hemangiomas óseos en general y vertebrales en particular, así como en la sinovitis vellonodular pigmentada, la radioterapia, administra tras la cirugía o como tratamiento exclusivo en los enfermos inoperables o antes una recidiva es el tratamiento de elección. En el trabajo se exponen las posibles áreas de colaboración entre radioterapeutas y reumatólogo, ortopedas, traumatólogos y rehabilitadores.The Authors present a critical review of the indications and results of radiotherapy in the treatment of non-malignant diseases of the musculoskeletal system. In inflamatory disorders, there are still controversias in the treatment of bursitis and tendinitis, whereas for immunosuppression in rheumatoid arthritis and heterotopic ossification alter total hip replacemente, the indications of radiotherapy are well established. In non-malignant proliferative diseases, the role of ionizing radiation is clear. Aggressive fibromatosis, ameblastoma, aneurystmal bone cyst, haemangiomas, and pigmented villonodular synovitis, radiotherapy, associated with surgical procedures or as an exclusive treatment in inoperable or relapsed patient, is the treatment of choice

Site specific and localized structural displacements in open structured multimetallic oxides

The structures of solids can locally differ from the macroscopic picture obtained by structural averaging techniques. This difference significantly influences the performance of any functional material. Measurements of these local structures are challenging. Thus, the description of defects is often disregarded. However, in order to understand the functionality, such irregularities have to be investigated. Here, we present a high resolution scanning transmission electron microscopic (STEM) study revealing local structural irregularities in open structured oxides using catalytically active orthorhombic (Mo,V,Te,Nb)Ox as a complex example. Detailed analysis of annular dark field- and annular bright field-STEM images reveal site specific local structural displacements of individual framework and channel sites in the picometer range. These experimental observables can be considered as an important structural addendum for theoretical modelling and should be implemented into the existing data in order to quantify site specific potential energies and stresses. This information can further be used to describe the impact of the structure on the catalytic performance in greater detail

Low dose anti-inflammatory radiotherapy for the treatment of pneumonia by covid-19 : A proposal for a multi-centric prospective trial

COVID-19 is a highly contagious viral infection with high morbidity that is draining health resources. The biggest complication is pneumonia, which has a serious inflammatory component, with no standardized treatment. Low-dose radiation therapy (LD-RT) is non-invasive and has anti-inflammatory effects that can interfere with the inflammatory cascade, thus reducing the severity of associated cytokine release and might be useful in the treatment of respiratory complications caused by COVID-19. This multicentric prospective clinical trial seeks to evaluate the efficacy of bilateral lung LD-RT therapy as a treatment for interstitial pneumonia in patients with COVID-19 for improving respiratory function. This prospective study will have 2 phases: I) an exploratory phase enrolling 10 patients, which will assess the feasibility and efficacy of low-dose lung irradiation, evaluated according to an increase in the PaO2/FiO2 ratio of at least 20% at 48-72 h with respect to the pre-irradiation value. If a minimum efficiency of 30% of the patients is not achieved, the study will not be continued. II) Non-randomized comparative phase in two groups: a control group, which will only receive pharmacological treatment, and an experimental arm with pharmacological treatment and LD-RT. It will include 96 patients, the allocation will be 1: 2, that is, 32 in the control arm and 64 in the experimental arm. The primary end-point will be the efficacy of LD-RT in patients with COVID-19 pneumonia according to an improvement in PaO2/FiO2. Secondary objectives will include the safety of bilateral lung LD-RT, an improvement in the radiology image, overall mortality rates at 15 and 30 days after irradiation and characterizing anti-inflammatory mechanisms of LD-RT by measuring the level of expression of adhesion molecules, anti-inflammatory cytokines and oxidative stress mediators. Trial registration: ClinicalTrial.gov NCT-04380818

A review of bioactive factors in human breastmilk: A focus on prematurity

Preterm birth is an increasing worldwide problem. Prematurity is the second most common cause of death in children under 5 years of age. It is associated with a higher risk of several pathologies in the perinatal period and adulthood. Maternal milk, a complex fluid with several bioactive factors, is the best option for the newborn. Its dynamic composition is influenced by diverse factors such as maternal age, lactation period, and health status. The aim of the present review is to summarize the current knowledge regarding some bioactive factors present in breastmilk, namely antioxidants, growth factors, adipokines, and cytokines, paying specific attention to prematurity. The revised literature reveals that the highest levels of these bioactive factors are found in the colostrum and they decrease along the lactation period; bioactive factors are found in higher levels in preterm as compared to full-term milk, they are lacking in formula milk, and decreased in donated milk. However, there are still some gaps and inconclusive data, and further research in this field is needed. Given the fact that many preterm mothers are unable to complete breastfeeding, new information could be important to develop infant supplements that best match preterm human milkThis work was supported by Ministerio de Economia y Competitividad (grant number FEM2015-63631-R) to SMA and the Ministerio de Ciencia, Innovación y Universidades (Spain) (grant number RTI2018-097504-B-100) to SMA and MAM-C. Both grants were co-financed with FEDER fund

Infrastructure and equipment for radiation oncology in the spanish national health system: analysis of external beam radiotherapy 2015-2020.

PURPOSE Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS). MATERIAL AND METHODS The Sociedad Española de Oncología Radioterápica (SEOR) performed a cross-sectional survey of all Spanish radiation oncology services (ROS) in 2015. We collected data on SNHS radiotherapy units, recording the year of installation, specific features of linear accelerators (LINACs) and other treatment units, and radiotherapeutic techniques implemented by region. Any machine over 10 years old or lacking a multileaf collimator or portal imaging system was considered obsolete. We performed a k-means clustering analysis using the Hartigan-Wong method to test associations between the gross domestic regional product (GDRP), the number of LINACs per million population and the percentage of LINACs over 10 years old. RESULTS The SNHS controls 72 (61%) of the 118 Spanish ROS and has 180 LINACs, or 72.5% of the total public and private resources. The mean rate of LINACs per million population is 3.9 for public ROS, and 42% (n=75) of the public accelerators were obsolete in 2015: 61 due to age and 14 due to technological capability. There was considerable regional variation in terms of the number and technological capacity of radiotherapy units; correlation between GRDP and resource availability was moderate. CONCLUSION Despite improvements, new investments are still needed to replace obsolete units and increase access to modern radiotherapy. Regular analysis of ROS in each Spanish region is the only strategy for monitoring progress in radiotherapy capacity.pre-print1471 K

The CD85j+ NK Cell Subset Potently Controls HIV-1 Replication in Autologous Dendritic Cells

Natural killer (NK) cells and dendritic cells (DC) are thought to play critical roles in the first phases of HIV infection. In this study, we examined changes in the NK cell repertoire and functions occurring in response to early interaction with HIV-infected DC, using an autologous in vitro NK/DC coculture system. We show that NK cell interaction with HIV-1-infected autologous monocyte-derived DC (MDDC) modulates NK receptor expression. In particular, expression of the CD85j receptor on NK cells was strongly down-regulated upon coculture with HIV-1-infected MDDC. We demonstrate that CD85j+ NK cells exert potent control of HIV-1 replication in single-round and productively HIV-1-infected MDDC, whereas CD85j− NK cells induce a modest and transient decrease of HIV-1 replication. HIV-1 suppression in MDCC by CD85j+ NK cells required cell-to-cell contact and did not appear mediated by cytotoxicity or by soluble factors. HIV-1 inhibition was abolished when NK-MDDC interaction through the CD85j receptor was blocked with a recombinant CD85j molecule, whereas inhibition was only slightly counteracted by blocking HLA class I molecules, which are known CD85j ligands. After masking HLA class I molecules with specific antibodies, a fraction of HIV-1 infected MDDC was still strongly stained by a recombinant CD85j protein. These results suggest that CD85j+ NK cell inhibition of HIV-1 replication in MDDC is mainly mediated by CD85j interaction with an unknown ligand (distinct from HLA class I molecules) preferentially expressed on HIV-1-infected MDDC

Impact of non-adherence to radiotherapy on 1-year survival in cancer patients in Catalonia, Spain

This study aims to assess the effects of non-adherence to external beam radiation therapy in cancer patients receiving treatment with a curative. This retrospective cohort study collected health records data for all cancer patients treated with external beam radiotherapy with curative intent in 2016 in Catalonia, Spain. Adherence was defined as having received at least 90% of the total dose prescribed. A logistic regression model was used to assess factors related to non-adherence, and its association with one-year survival was evaluated using Cox regression. The final sample included 8721 patients (mean age 63.6 years): breast cancer was the most common tumour site (38.1%), followed by prostate and colon/rectum. Treatment interruptions prolonged the total duration of therapy in 70.7% of the patients, and 1.0% were non-adherent. Non-adherence was associated with advanced age, female gender, and some localization of primary tumour (head and neck, urinary bladder, and haematological cancers). The risk of death in non-adherent patients was higher than in adherent patients (hazard ratio [HR] 1.63, 95% confidence interval 0.97-2.74), after adjusting for the potential confounding effect of age, gender, tumour site and comorbidity. Non-adherence to radiotherapy, as measured by the received dose, is very low in our setting, and it may have an impact on one-year survival