Survival of women previously diagnosed of melanoma with subsequent pregnancy: a systematic review and meta-analysis and a single-center experience

Review[Abstract] Melanoma incidence has increased over the last few decades. How the prognosis of a previously diagnosed melanoma may be affected by a woman's subsequent pregnancy has been debated in the literature since the 1950s, and the outcomes are essential to women who are melanoma survivors in their childbearing years. The main objective of this systematic review is to improve the understanding of whether the course of melanoma in a woman may be altered by a subsequent pregnancy and to help clinicians' diagnosis. Eligible studies for the systematic review were clinical trials, observational cohort studies and case-control studies that compared prognosis outcomes for non-pregnant patients with melanoma, or pregnant before melanoma diagnosis, versus pregnant patients after a diagnosis of melanoma. The search strategy yielded 1101 articles, of which 4 met the inclusion criteria for the systematic review. All the studies were retrospective non-randomised cohorts with patients with melanomas diagnosed before pregnancy. According to our findings, a subsequent pregnancy was not a significant influence on the outcome of a previous melanoma. However, given the small number of identified studies and the heterogeneous data included, it is recommended to approach these patients with caution, and counselling should be given by known prognostic factors. We also reviewed the medical records of 84 patients of childbearing age (35.8 ± 6.3 years, range 21-45 years) who were diagnosed with cutaneous invasive melanoma in our hospital between 2008 and 2018 (N = 724). Of these, 11 (13.1%) had a pregnancy after melanoma diagnosis (age at pregnancy: 35.6 ± 6.3 years). No statistical differences in outcome were detected

Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis

[EN] Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020. Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, p < 0.001, multivariable HR 2.68 (1.58–4.55), p < 0.001). Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients.S

Internal and near nozzle measurements of Engine Combustion Network "Spray G" gasoline direct injectors

[EN] Gasoline direct injection (GDI) sprays are complex multiphase flows. When compared to multi-hole diesel sprays, the plumes are closely spaced, and the sprays are more likely to interact. The effects of multi-jet interaction on entrainment and spray targeting can be influenced by small variations in the mass fluxes from the holes, which in turn depend on transients in the needle movement and small-scale details of the internal geometry. In this paper, we present a comprehensive overview of a multi-institutional effort to experimentally characterize the internal geometry and near-nozzle flow of the Engine Combustion Network (ECN) Spray G gasoline injector. In order to develop a complete pictitre of the near-nozzle flow, a standardized setup was shared between facilities. A wide range of techniques were employed, including both X-ray and visible-light diagnostics. The novel aspects of this work include both new experimental measurements, and a comparison of the results across different techniques and facilities. The breadth and depth of the data reveal phenomena which were not apparent from analysis of the individual data sets. We show that plume-to-plume variations in the mass fluxes from the holes can cause large-scale asymmetries in the entrainment field and spray structure. Both internal flow transients and small-scale geometric features can have an effect on the external flow. The sharp turning angle of the flow into the holes also causes an inward vectoring of the plumes relative to the hole drill angle, which increases with time due to entrainment of gas into a low-pressure region between the plumes. These factors increase the likelihood of spray collapse with longer injection durations.The X-ray experiments were performed at the 7-BM and 32-ID beam lines of the APS at Argonne National Laboratory. Use of the APS is supported by the U.S. Department of Energy (DOE) under Contract No. DE-AC02-06CH11357. Research was also performed at the Combustion Research Facility, Sandia National Laboratories, Livermore, California. Sandia National Laboratories is managed and operated by National Technology and Engineering Solutions of Sandia LLC, a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy National Nuclear Security Administration under contract DE-NA-0003525.Duke, DJ.; Kastengren, AL.; Matusik, KE.; Swantek, AB.; Powell, CF.; Payri, R.; Vaquerizo, D.... (2017). Internal and near nozzle measurements of Engine Combustion Network "Spray G" gasoline direct injectors. Experimental Thermal and Fluid Science. 88:608-621. https://doi.org/10.1016/j.expthermflusci.2017.07.015S6086218

Survival of Women Previously Diagnosed of Melanoma with Subsequent Pregnancy: A Systematic Review and Meta-Analysis and a Single-Center Experience

Melanoma incidence has increased over the last few decades. How the prognosis of a previously diagnosed melanoma may be affected by a woman's subsequent pregnancy has been debated in the literature since the 1950s, and the outcomes are essential to women who are melanoma survivors in their childbearing years. The main objective of this systematic review is to improve the understanding of whether the course of melanoma in a woman may be altered by a subsequent pregnancy and to help clinicians' diagnosis. Eligible studies for the systematic review were clinical trials, observational cohort studies and case-control studies that compared prognosis outcomes for non-pregnant patients with melanoma, or pregnant before melanoma diagnosis, versus pregnant patients after a diagnosis of melanoma. The search strategy yielded 1101 articles, of which 4 met the inclusion criteria for the systematic review. All the studies were retrospective non-randomised cohorts with patients with melanomas diagnosed before pregnancy. According to our findings, a subsequent pregnancy was not a significant influence on the outcome of a previous melanoma. However, given the small number of identified studies and the heterogeneous data included, it is recommended to approach these patients with caution, and counselling should be given by known prognostic factors. We also reviewed the medical records of 84 patients of childbearing age (35.8 +/- 6.3 years, range 21-45 years) who were diagnosed with cutaneous invasive melanoma in our hospital between 2008 and 2018 (N = 724). Of these, 11 (13.1%) had a pregnancy after melanoma diagnosis (age at pregnancy: 35.6 +/- 6.3 years). No statistical differences in outcome were detected

Time Course and Pattern of Metastasis of Cutaneous Melanoma Differ between Men and Women

Background: This study identified sex differences in progression of cutaneous melanoma. Methodology/Principal Findings: Of 7,338 patients who were diagnosed as an invasive primary CM without clinically detectable metastases from 1976 to 2008 at the University of Tuebingen in Germany, 1,078 developed subsequent metastases during follow up. The metastatic pathways were defined in these patients and analyzed using the Kaplan-Meier method. Multivariate survival analysis was performed using Cox modeling. In 18.7 % of men and 29.2 % of women (P,0.001) the first metastasis following diagnosis of primary tumor was locoregional as satellite/in-transit metastasis. The majority of men (54.0%) and women (47.6%, P = 0.035) exhibited direct regional lymph node metastasis. Direct distant metastasis from the stage of the primary tumor was observed in 27.3 % of men and 23.2 % of women (P = 0.13). Site of first metastasis was the most important prognostic factor of survival after recurrence in multivariate analysis (HR:1.3; 95 % CI: 1.0–1.6 for metastasis to the regional lymph nodes vs. satellite/in-transit recurrence, and HR:5.5; 95 % CI: 4.2–7.1 for distant metastasis vs. satellite/ in-transit recurrence, P,0.001). Median time to distant metastasis was 40.5 months (IQR, 58.75) in women and 33 months (IQR, 44.25) in men (P = 0.002). Five-year survival after distant recurrence probability was 5.2 % (95 % CI: 1.4–2.5) for men compared with 15.3 % (95 % CI: 11.1–19.5; P = 0.008) for women. Conclusions/Significance: Both, the pattern of metastatic spread with more locoregional metastasis in women, and th

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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A new funerary road in Colonia Patricia (Córdoba). The sepulcretum of Llanos del Pretorio

Damos a conocer con este trabajo, en absoluta primicia, un nuevo sepulcretum romano excavado recientemente en la necrópolis septentrional de Córdoba (España); un espacio bien planificado desde el punto de vista topográfico, que se organiza en recintos pareados con módulo predominante de 12 x 12 pies romanos, abiertos a una o más vías funerarias, delimitados por cipos de piedra –dos de ellos con indicación de las mensurae sepulcri–, y, en ocasiones, cerrados mediante muros de mampostería, con puertas de acceso en su fachada y ustrinum en su interior. La necrópolis fue sellada por una riada, lo que ha permitido recuperar la mayor parte de los enterramientos –52 cremaciones y 11 inhumaciones infantiles– intactos e in situ, con cronologías centradas en los comedios del s. i d. C. Todos estos materiales, procedentes de un seguimiento arqueológico vinculado a la construcción de un nuevo edificio de viviendas, están siendo estudiados en el marco de un proyecto multidisciplinar con investigadores de diferentes universidades –numismática, vidrio, cerámica, antropología, epigrafía, paleopaisaje, fauna, etc.–, del que este artículo constituye un primer avance.In this paper we present a new Roman sepulcretum which has recently been dug out in the northern necropolis of Córdoba (Spain): a well-planned space from a topographic point of view, organised into paired enclosures with a predominant module of 12 x 12 Roman feet opened to more than one funeral routes delimited by milestones –two of them belonging to mensuare sepulcri– and sometimes closed through masonry walls with access doors in its facade and an ustrinum inside. The necropolis was sealed by a flood leading to recover the major part of the intact burials and in situ –52 cremations and 11 child burials–, with chronologies of the middle of the first century ad. All these materials, yielded by developer-led archaeology, are being studied within the framework of a multidisciplinary project with researchers from different universities –numismatic, glass, ceramic, anthropology, epigraphy, paleolandscape, fauna, etc.–. This work is just one of the first advances