Small particle-size talc is associated with poor outcome and increased inflammation in thoracoscopic pleurodesis

Rationale: Talc is very effective for pleurodesis, but there is concern about complications, especially acute respiratory distress syndrome. Objectives: It was the aim of this study to investigate if talc with a high concentration of small particles induces greater production of cytokines, and if pleural tumor burden has any influence on the local production and spillover of cytokines to the systemic circulation and eventual complications. Methods: We investigated 227 consecutive patients with malignant effusion submitted to talc pleurodesis. One hundred and three patients received 'small-particle talc' (ST; containing about 50% particles <10 ¿m) and 124 received 'large-particle talc' (with <20% particles <10 ¿m). Serial samples of both pleural fluid and blood were taken before and 3, 24, 48 and 72 h after thoracoscopy. Also, mesothelial cells were stimulated with both types of talc in vitro. Measurements and Results: Interleukin-8, tumor necrosis factor-¿, vascular endothelial growth factor, basic fibroblast growth factor and thrombin-antithrombin complex were measured in all samples. Early death (<7 days after talc) occurred in 8 of 103 patients in the ST and in 1 of 124 in the 'large-particle talc' group (p = 0.007). Patients who received ST had significantly higher proinflammatory cytokines in pleural fluid and serum after talc application, and also in supernatants of the in vitro study. Pleural tumor burden correlated positively with proinflammatory cytokines in serum, suggesting that advanced tumor states induce stronger systemic reactions after talc application. Conclusions: ST provokes a strong inflammatory reaction in both pleural space and serum, which is associated with a higher rate of early deaths observed in patients receiving it.Instituto de Salud Carlos III FIS 04/028

Tracheal self-expandable metallic stents: A comparative study of three different stents in a rabbit model

Introduction: The objective of this study was to assess tracheal reactivity after the deployment of different self-expandable metal stents (SEMS). Material and methods: Forty female New Zealand rabbits were divided into four groups. Three groups received three different SEMS: steel (ST), nitinol (NiTi), or nitinol drug-eluting stent (DES); the fourth group was the control group (no stent). Stents were deployed percutaneously under fluoroscopic guidance. Animals were assessed by multislice, computed tomography (CT) scans, and tracheas were collected for anatomical pathology (AP) study. Data from CT and AP were statistically analyzed and correlated. Results: The DES group had the longest stenosis (20.51±14.08 mm vs 5.84±12.43 and 6.57±6.54 mm in NiTi and ST, respectively, day 30; P<.05), and higher granuloma formation on CT (50% of cases). The NiTi group showed the lowest grade of stenosis (2.86±6.91% vs 11.28±13.98 and 15.54±25.95% in DES and ST, respectively; P<.05). The AP study revealed that the ST group developed intense proliferative reactivity compared to the other groups. In the DES group, a destructive response was observed in 70% of the animals, while the NiTi was the least reactive stent. CT was more effective in detecting wall thickening (positive correlation of 68.9%; P<.001) than granuloma (not significant). Conclusions: The ST group developed granulomas and significant stenosis. NiTi was the least reactive stent, while DES caused significant lesions that may be related to drug dosage. This type of DES stent is therefore not recommended for the treatment of tracheobronchial stenosis. Introducción: El objetivo de este estudio es evaluar la reactividad traqueal tras la implantación de distintos stents metálicos autoexpandibles (SMAE). Material y métodos: Se utilizaron 40 conejos hembra de raza neozelandesa, que se dividieron en 4 grupos. En 3 grupos se implantaron SMAE: de acero (SA), de nitinol (NiTi) o stents liberadores de nitinol (SLF). El cuarto grupo fue el grupo de control (sin stent). Los stents se implantaron por vía percutánea bajo control fluoroscópico. Los animales se evaluaron mediante tomografía axial computarizada (TAC) multicorte y las tráqueas se extirparon para su estudio anatomopatológico (EAP). Los datos de la TAC y el EAP se analizaron estadísticamente y se correlacionaron Resultados: El grupo que recibió SLF presentaba la mayor longitud de estenosis (20,51±14,08 mm frente a 5,84±12,43 y 6,57±6,54 mm en los grupos NiTi y SA, día 30; p < 0,05) y el mayor índice de formación de granulomas evidenciados mediante TAC (50% de los casos). El grupo al que se implantaron stents NiTi mostró el menor grado de estenosis (2,86±6,91% frente a 11,28±13,98 y 15,54±25,95% en los grupos SLF y SA; p < 0,05). En el estudio AP, el grupo SA presentó reactividad proliferativa intensa en comparación con los otros 2 grupos. En el grupo SLF se observó una respuesta destructiva en el 70% de animales, mientras que el stent NiTi fue el que menos reacción provocó. La TAC resultó ser superior para detectar el engrosamiento (correlación positiva de un 68,9%; p < 0,001) que para la observación de granulomas (n.s.). Conclusiones: El grupo SA desarrolló granulomas y estenosis significativas. El stent NiTi fue el que menos reacción indujo, mientras que el SLN provocó lesiones importantes que podrían estar relacionadas con la dosis de fármaco. Por consiguiente, este tipo de SLF no se recomienda para el tratamiento de la estenosis traqueobronquial

Aprendizaje cooperativo. Un recurso indispensable en la formación universitaria

El Libro “Aprendizaje cooperativo Un recurso indispensable en la formación universitaria”, se enmarca dentro del Proyecto de Innovación docente Finestra Oberta UV_ SFPIE GER 15-314671, bajo la dirección de la Profesora María Elena Cobas Cobiella, del Departamento de Derecho Civil, de la Facultad de Derecho de la Universidad de Valencia. Este libro contiene 19 artículos inéditos de un grupo importante de profesores y especialistas en la temática nacionales e internacionales, así como con la intervención como colaboradores de estudiantes de Grado en Derecho, de la doble titulación Derecho- ADE de la Universidad de Valencia, y de Universidades internacionales. También han intervenido en el mismo estudiantes del Master de Mediación y Arbitraje y solución de conflictos en Derecho Privado 2015/2016 y del Proyecto Unisocietat L’Eliana Curso 2015 – 2016. Constituye una obra que eleva la práctica del aula a la teoría. Altamente recomendable para aquellos que incursionen en el camino de la docencia.The Book "Cooperative learning: an indispensable resource in university education" is part of the Project for teaching innovation "Finestra Oberta,UV_ SFPIE GER 15-314671", under the direction of Professor Maria Elena Cobas Cobiella, from Civil Law department of the Faculty of Law of the University of Valencia. This book contains 19 new articles of a large group of professors and specialists in national and international topics, as well as with the intervention as collaborators of Law degree students from the double degree Law-Business Administration from the University of Valencia, and also from international universities. They have also intervened in the book some students from the Master of Mediation, Arbitration and resolution of conflicts in Private Law 2015/2016 and from the Unisocietat L'Eliana project 2015/2016. It is a work that elevates the classroom practice towards the theory. Highly recommended for those who want to progress in the way of teaching.Los siguientes estudiantes han colaborado en la Parte Especial del Libro, con los resúmenes de sus trabajos de mapas conceptuales y los prezi:Ylenia Martínez, María Gómez Escrivá,Julieta Campora Espí, Blanca Giner Zarranz, Mario Zúñiga Martínez, Alicia Martínez Ruiz, Sandra Gimeno Bascuñana, Héctor Martínez Soler, Amparo García Navarro,Joan De la Haba Herrera,Alberto José Fourrat Calatayud, Juan Ortega Talamantes, Vicente Vila Subiela, Cristina Blázquez Sánchez, Sara Monsalve Alemany, Paula Navarro Román, Carlos Reyes Hernández,Jesús Sanz Carnero,José Guillermo Gil, Aroa Gimeno, José Manuel Aznar, Teresa Pérez, Antonio Fernández, Cristina Martin, Rodrigo Climent, José Ángel Molina Sánchez, Daniel Cabanes Ferrando, David Escobar Haro, Diego Martínez Amor, Mari Carmen Arnau Gil, Raquel Jiménez Gago, Daniel March Quevedo, Laura Alapont Vidal, Gema Canós Ferrandis, Mónica Costa Isabel, Jesús Sanmartín Viturro, Eduardo José Tobio García, Pau Viñuelas LLoria, María del Mar Figueroa Hernández, Minerva Llagunes Picazo, Lucía Olmos, José Olmedo, Brynn De Houwer, Enrique Pla Marcos, Héctor Tabernero Más, Laura Payá González, Blanca Martínez Pons,Alejandro Grima Margarit, Belén Català, Mariam Pérez, David Sánchez, Jorge Seguí ,Sara Tamarit,Fernando Aparisi Escriba, Analía Carballo Quispe,José Luis Moreno Miguel,Candy Priscilla Rojas Campoverde, Ademar Lledó Monfort, Irene Belles Rubio, Clara Calomarde Esteban, Marta Marín de la Dueña, Sergio Pinel Castillo,Maria Simo Martin, Daniel Rocher Camps, Sandra Nicolás Mascarell, Teresa Bartret García, Maria Amparo Monasort Pérez,Joan Vicente Torres Moreno, Belén Cuñat Salavert, Carmen Rodríguez Bertos, Aníbal Sánchez Gómez, Sofía Morant Muñoz, Pedro Ballester Martínez,Akbar Khawar, David Ortíz Soler, Jonathan Pérez Gutiérrez.Jorge Amat Andrés, M.ª Antonia García Juncos, Jenny Maritza González Vergara,Juan José Tocón Torres,Pau Zurita Varela, Manuel Calvo Pereiro, Carolina Luis Tamarit,Beatriz Muñoz Moncholí,Marta Conejero Sarrió, Guillermo Juarez Ginestar, Carolina Más Trullás,Ramón Fernández Pares, Carlos Hervás García,Carolina Tamarit García, Jose Belloch Ortí,Danilo Terán Taborga,Manuel Castillo Martínez, Isabel Martínez Salas, Carlos Javier Castello Domenech, Silvia Juste Frechina, Cristina Barrado Franco, Noemi De Miguel Domingo, Elena Masegosa Laurí, Maryana Seniv, Paula Sanz Perez, Liney Paola Peiró Soriano, José Manuel Zahonero Ferrer,Paula Pons Guillem,Andrea Oviedo Millán,Arnaud Wustefeld, Alba Ruiz-Santa Quiteria Lara,Lydia García Céspedes,Antonio Gomar López,Eva Piqueras García, Claudia Salvador Pérez, Joel David Alvarez Remy, Sheila Jorge Muñoz,Virginia Mendoza Leal,David Benavides Arenas, Mario Perera Sánchez, Vladimir Sarmiento Paizán,Javier Mustelier Armiñán,Diamela Salina Ocaña, Edel Morales Salazar,Fortunato Dong Oñaña,María del Carmen Carvajal Balagué,María del Carmen Daries Coll, Catalina Olmo Brazales,Mª Teresa Sánchez, Julia Serra Figuerola,Mª Nieves Valdearcos Quintín,Carmen Moraga Martín,María José Moragues, Salvador Lluch,Maribel Moreno,José Luis Coello,José Cebriá,Matilde Argente,Consuelo Martínez,Rosi Hernández,Susi García,Graciela Garibotti,Susana Bianchi,Judith Steffan,Susan Humphreys,Jesús Castellano,Ana Preus,Mª José Figueroa,Mª Teresa Carbonell,Lola Lombrera,Luisa Martínez Gordillo,Roberto Soler,Pilar Bezares Martínez, Ramón González Ferrer,Raquel González Sainz,Sacra Martínez Alarcón, Emetério Mirálles Ribot, Ramón Pubill Rocaort,Conchin Ruiz Leal, Isabel Sucarrat Bermejo,Pepa San Román Moñino,InmaTarín Arfella, Maise Tarín Arfella, Pedro Montalban,Carmen Kroebel, Lydia González, Carlos Gómez, Amparo Cuellar,Pilar Navarro,Luisa Vallejo, Encarna Monzó,Carmen Conca,Pilar Alegría, Sonia Almonacil, Inma Fernández, María José García Marcelo,Clara Olivert Pavia, Ana Herrero Martínez, Rosana Crespo Martínez, Carmen Vidal Casañ,José Ramón Villagrasa Tort,Juan Carlos López Cubero,Paco Velayos Sánchez,María de la O Pérez,Carles Montagut Alvarez, José Leopoldo Rodríguez Pla, Amanda Bernat Tinoco,Marta García Montañana, Ioana Roxana Moraru, Jenifer Perujo Plumed,María Ribera Cebolla,Amparo Esteve Cervera, Iris Pla Sempere,Juan Rafael Aranda Perozo,Jesús Collado Mas, Cristina Grimalt Molina,Isabel Rojo Lora, María Teresa Peirats Casanova,Rosana Marin Rausell, Ricardo Mejía Hidalgo,Pablo Pastor Aguilera,Daniel Trujillo Villalba,Yolanda Fuster Llidó, Lucas Lamarca Pedemonte, Gabriel Rosa Felipe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Estadios radiológicos y lavado broncoalveolar en la sarcoidosis

Objetivo: La sarcoidosis es una enfermedad inflamatoria granulomatosa multisistémica de causa desconocida que afecta principalmente al pulmón y a los ganglios linfáticos. La utilidad del lavado broncoalveolar (LBA) en el diagnóstico es conocida, pero su valor como marcador pronóstico es controvertido. El objetivo de nuestro estudio es evaluar si existe un patrón característico en la celularidad del LBA según el estadio radiológico de presentación y determinar si el LBA aporta información sobre la evolución de la enfermedad. Pacientes y métodos: Se incluyó en el estudio a 34 pacientes con sarcoidosis no tratados. Se recogieron las siguientes variables: edad, sexo, hábito tabáquico, tipo de tratamiento, estadio radiológico, exploración funcional respiratoria, parámetros serológicos y análisis celular del LBA. Se clasificó a los pacientes en 3 grupos según la evolución funcional y radiológica a los 12 meses. Resultados: No se encontraron diferencias entre la edad, el sexo y el hábito tabáquico ni entre los estadios radiológicos ni entre los grupos según evolución. En el estadio radiológico I el recuento porcentual de linfocitos del LBA fue mayor que en los estadios II y III, pero las diferencias no fueron estadísticamente significativas. Las diferencias en el LBA por grupos evolutivos no fueron estadísticamente significativas. Conclusiones: Al analizar las características del LBA según estadios radiológicos no se encontraron diferencias. El recuento diferencial de células en el LBA no parece predecir el curso de la sarcoidosis durante los primeros 12 mese

Determination of inflammatory biomarkers in patients with COPD: a comparison of different assays

Abstract Background Chronic obstructive pulmonary disease (COPD) is an inflammatory pulmonary disorder with systemic inflammatory manifestations that are mediated by circulating acute-phase reactants. This study compared an enzyme-linked immunosorbent assay (ELISA) to a nephelometric technique for the measurement of serum C-reactive protein (CRP) and serum amyloid A (SAA) and investigated how the choice of assay influenced the estimation of inflammation in patients with stable COPD. Methods CRP and SAA concentrations measured by ELISA and nephelometry in 88 patients with COPD and 45 control subjects were used to evaluate the performance of these methods in a clinical setting. Results With both assays, the concentrations of CRP and SAA were higher in COPD patients than in controls after adjustment for age and sex. There was a moderate correlation between the values measured by ELISA and those measured by nephelometry (logCRP: r = 0.55, p Conclusion Although the serum CRP and SAA concentrations measured by ELISA and nephelometry correlated well in COPD patients, the ELISA values tended to be lower for CRP and SAA when compared with nephelometric measurements. International standardization of commercial kits is required before the predictive validity of inflammatory markers for patients with COPD can be effectively assessed in clinical practice.</p

Plasmatic Membrane Expression of Adhesion Molecules in Human Cardiac Progenitor/Stem Cells Might Explain Their Superior Cell Engraftment after Cell Transplantation

© 2020 Imelda Ontoria-Oviedo et al.Human bone marrow mesenchymal stem cells (BM-MSCs) and cardiac progenitor/stem cells (CPCs) have been extensively studied as a potential therapeutic treatment for myocardial infarction (MI). Previous reports suggest that lower doses of CPCs are needed to improve cardiac function relative to their bone marrow counterparts. Here, we confirmed this observations and investigated the surface protein expression profile that might explain this effect. Myocardial infarction was performed in nude rats by permanent ligation of the left coronary artery. Cardiac function and infarct size before and after cell transplantation were evaluated by echocardiography and morphometry, respectively. The CPC and BM-MSC receptome were analyzed by proteomic analysis of biotin-labeled surface proteins. Rats transplanted with CPCs showed a greater improvement in cardiac function after MI than those transplanted with BM-MSCs, and this was associated with a smaller infarct size. Analysis of the receptome of CPCs and BM-MSCs showed that gene ontology biological processes and KEGG pathways associated with adhesion mechanisms were upregulated in CPCs compared with BM-MSCs. Moreover, the membrane protein interactome in CPCs showed a strong relationship with biological processes related to cell adhesion whereas the BM-MSCs interactome was more related to immune regulation processes. We conclude that the stronger capacity of CPCs over BM-MSCs to engraft in the infarcted area is likely linked to a more pronounced cell adhesion expression program.The proteomic studies were carried out at the University of Valencia Proteomics Unit, a member of the ISCIII ProteoRed Proteomics Platform. Imelda Ontoria-Oviedo acknowledges a post-doctoral contract from for the PlaGenT, Generalitat Valenciana (CDPT-01/20-A). We thank Dr. Kenneth McCreath for constructive comments on the manuscript. This work was supported by grants PI16/0107, PI19/00245, and RETICS Program (RD16/0011/0004) from Instituto de Salud Carlos III cofunded by FEDER “una manera de hacer Europa.