7 research outputs found

    Laparoscopic Surgery in Genitourinary Cancer Treatment

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    Utilidad clínica de la expresión de marcadores inmunohistoquímicos en el tumor vesical urotelial papilar sin invasión de la muscular propia (pTa/pT1) grado 2

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    Introducción: El tumor vesical urotelial papilar sin invasión de la muscular propia (TVU NoMinv) es uno de los tumores urológicos más frecuentes. A pesar del tratamiento, presenta una elevada tasa de recidiva y progresión. El hallazgo de factores pronósticos que nos indiquen su comportamiento clínico es fundamental para estratificar riesgos y ayudar al diseño de una estrategia terapéutica. Las variables anatomoclínicas clásicamente utilizadas no son del todo precisas en la evaluación pronóstica. La nueva clasificación histológica de la OMS 2004 tampoco ha conseguido este objetivo, presentando una importante variabilidad interobservador. Por ello, está en auge el estudio de marcadores moleculares, que precisen el comportamiento clínico y biológico de estos tumores. El principal problema de los estudios que han evaluado su utilidad es la heterogeneidad en la metodología empleada, ya que no se centran en un tipo específico de tumor. Por otra parte, dentro de los TVU NoMinv el tumor de grado 2 (G2) (OMS 1973) es el paradigma de comportamiento clínico incierto. Objetivos: Conocer la utilidad pronóstica de una batería de marcadores inmunohistoquímicos en el TVU NoMinv G2 con respecto a los periodos libres de recidiva, progresión y mortalidad cáncer específica. Material y métodos: Estudio analítico, observacional y ambispectivo de 213 pacientes con tumor vesical primario no musculoinvasivo G2. Estudio transversal de las muestras procesadas en parafina de dicho tumor, determinando la expresión inmunohistoquímica de 26 marcadores moleculares correspondientes a las distintas rutas oncológicas. Se construyeron mapas tridimiensionales para su representación. Se realizó un análisis multidimensional de los datos mediante el uso de regresión logística penalizada ¿Least absolute shrinkage and selection operator¿ (LASSO) y bosques aleatorios de supervivencia ¿Random survival forest¿ (RSF). Se efectuó un análisis de supervivencia mediante curvas Kaplan-Meier (log Rank test). Se generaron grupos de riesgo con las variables seleccionadas, comparándolos con la probabilidad de recidiva y progresión calculadas según las tablas de la EORTC.. Resultados: La media de seguimiento y de la edad fue de 58 ± 33,5 meses y 69,5 ± 10,4 años. Los porcentajes de recidiva, progresión y mortalidad cáncer-específica (CaEsp) fueron del 54,5%, 17,4%, 11,3%, respectivamente. Un 61% de la muestra correspondió a tumores T1 y un 71% a un alto grado OMS 2004. Las variables seleccionadas por LASSO y RSF influyentes en la aparición de tiempos de supervivencia cortos fueron la siguientes. Tiempo libre (TL) de recidiva: número de tumores >1 , un aumento en la expresión nuclear de Ki67, VEGFR2 y Ciclina D1 y una débil expresión citoplasmática de CtIP y p16INK4a. TL de progresión: tumor multicéntrico, expresión de Ki 67 y Survivina nuclear. TL de mortalidad CaEsp: edad >=70 años, estadio T1, expresión nuclear de GAPDH, Survivina y p53. Los grupos de riesgo generados han sido más efectivos en cuanto al análisis de supervivencia que la estratificación según la EORTC o mediante la clasificación según estadio/grado (p<0,005). Conclusiones: La expresión inmunohistoquímica de varios marcadores moleculares influye en el pronóstico clínico de los pacientes con TVU NoMinv G2, siendo posible su uso en conjunto con variables anatomoclínicas para generar grupos de riesgo

    Wide-Geographic and Long-Term Analysis of the Role of Pathogens in the Decline of Pinna nobilis to Critically Endangered Species

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    A mass mortality event (MME) affecting the fan mussel Pinna nobilis was first detected in Spain in autumn 2016 and spread north- and eastward through the Mediterranean Sea. Various pathogens have been blamed for contributing to the MME, with emphasis in Haplosporidium pinnae, Mycobacterium sp. and Vibrio spp. In this study, samples from 762 fan mussels (necropsies from 263 individuals, mantle biopsies from 499) of various health conditions, with wide geographic and age range, taken before and during the MME spread from various environments along Mediterranean Sea, were used to assess the role of pathogens in the MME. The number of samples processed by both histological and molecular methods was 83. The most important factor playing a main role on the onset of the mass mortality of P. nobilis throughout the Mediterranean Sea was the infection by H. pinnae. It was the only non-detected pathogen before the MME while, during MME spreading, its prevalence was higher in sick and dead individuals than in asymptomatic ones, in MME-affected areas than in non-affected sites, and it was not associated with host size, infecting both juveniles and adults. Conversely, infection with mycobacteria was independent from the period (before or during MME), from the affection of the area by MME and from the host health condition, and it was associated with host size. Gram (-) bacteria neither appeared associated with MME.En prens

    Wide-Geographic and Long-Term Analysis of the Role of Pathogens in the Decline of Pinna nobilis to Critically Endangered Species

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    20 Pág.A mass mortality event (MME) affecting the fan mussel Pinna nobilis was first detected in Spain in autumn 2016 and spread north- and eastward through the Mediterranean Sea. Various pathogens have been blamed for contributing to the MME, with emphasis in Haplosporidium pinnae, Mycobacterium sp. and Vibrio spp. In this study, samples from 762 fan mussels (necropsies from 263 individuals, mantle biopsies from 499) of various health conditions, with wide geographic and age range, taken before and during the MME spread from various environments along Mediterranean Sea, were used to assess the role of pathogens in the MME. The number of samples processed by both histological and molecular methods was 83. The most important factor playing a main role on the onset of the mass mortality of P. nobilis throughout the Mediterranean Sea was the infection by H. pinnae. It was the only non-detected pathogen before the MME while, during MME spreading, its prevalence was higher in sick and dead individuals than in asymptomatic ones, in MME-affected areas than in non-affected sites, and it was not associated with host size, infecting both juveniles and adults. Conversely, infection with mycobacteria was independent from the period (before or during MME), from the affection of the area by MME and from the host health condition, and it was associated with host size. Gram (-) bacteria neither appeared associated with MME.This work was funded by: DG Pesca i Medi Mari (GOIB),EsMarEs (order IEO by MITECO, Spanish government), Life UFE IP-PAF INTEMARES (LIFE15 IPE ES 012) “Gestión integrada, innovadora y participativa de la Red Natura 2000 en el medio marino español,” the research project “Estado de conservación del bivalvo amenazado Pinna nobilis en el PNAC” (OAPN 024/2010), the project RECONNECT (MIS 5017160) of the Programme Interreg V-B “Balkan-Mediterranean 2014–2020.” MTES (French Government), DREAL (Direction Régionale Environnement Aménagement Logement) and Région Occitanie (France) for funding research and monitoring of Pinna.GC and PP were contracted under the INIA-CCAA cooperative research programme for postdoctoral incorporation from the Spanish National Institute for Agricultural and Food Research and Technology (INIA) (DOC INIA 8/2013 and 15/2015). MV-L was supported by a Juan de la Cierva-Incorporación postdoctoral contract (ICJI-2016-29329, MICIU Programme). ML-S and EÁ were supported by a Personal Técnico de Apoyo contract MINECO programme (PTA2015-11709-I and PTA2015-10829- I, respectively). CP and GS were supported by the project RECONNECT (MIS 5017160) financed by the Transnational Cooperation Programme Interreg V-B “Balkan-Mediterranean 2014–2020” and co-funded by the European Union and national funds of the participating countries. CP was supported by Sorbonne University.Peer reviewe

    S.O.S. Pinna nobilis: a mass mortality event in western Mediterranean Sea.

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    A mass mortality event (MME) impacting the bivalve Pinna nobilis was detected across a wide geographical area of the Spanish Mediterranean Sea (Western Mediterranean Sea) in early autumn 2016. Underwater visual censuses were conducted across several localities separated by hundreds of kilometers along the Spanish Mediterranean coasts and revealed worrying high mortality rates reaching up to 100% in the center and southernmost coasts of the Iberian Peninsula including Balearic Islands. Populations on the northern coasts of the Spanish Mediterranean Sea seemed to be unaffected (Catalonian region). Histological examination of affected individuals revealed the presence of a haplosporidan-like parasite within the digestive gland being probably the pathogen that causes this mortality. The present MME has spread rapidly, causing high mortality rates in infected populations. Taking into account the degree of impact, the geographic extent, and the high probability that the infection is still in a spreading phase, this might be considered the largest MME ever registered for P. nobilis up to date, forcing this emblematic bivalve into a critical viability status over hundreds of kilometers of coast

    Wide-Geographic and Long-Term Analysis of the Role of Pathogens in the Decline of Pinna nobilis to Critically Endangered Species

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    A mass mortality event (MME) affecting the fan mussel Pinna nobilis was first detected in Spain in autumn 2016 and spread north- and eastward through the Mediterranean Sea. Various pathogens have been blamed for contributing to the MME, with emphasis in Haplosporidium pinnae, Mycobacterium sp. and Vibrio spp. In this study, samples from 762 fan mussels (necropsies from 263 individuals, mantle biopsies from 499) of various health conditions, with wide geographic and age range, taken before and during the MME spread from various environments along Mediterranean Sea, were used to assess the role of pathogens in the MME. The number of samples processed by both histological and molecular methods was 83. The most important factor playing a main role on the onset of the mass mortality of P. nobilis throughout the Mediterranean Sea was the infection by H. pinnae. It was the only non-detected pathogen before the MME while, during MME spreading, its prevalence was higher in sick and dead individuals than in asymptomatic ones, in MME-affected areas than in non-affected sites, and it was not associated with host size, infecting both juveniles and adults. Conversely, infection with mycobacteria was independent from the period (before or during MME), from the affection of the area by MME and from the host health condition, and it was associated with host size. Gram (-) bacteria neither appeared associated with MME.info:eu-repo/semantics/publishedVersio
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