Analysis of the execution of the plans for the renewal of coastal tourist destinations. The case of Puerto de la Cruz (Canary Islands, Spain)

La política turística implementa sus acciones a través de un conjunto de instrumentos cuya configuración y ejecución son esenciales en la acción del gobierno, convirtiéndose en un indicador fundamental para evaluar su enfoque y efectos. En lo que respecta a la renovación de los destinos turísticos, la política turística de Canarias ha diseñado los Planes de Modernización, Mejora e Incremento de la Competitividad entre sus instrumentos más importantes, concentrando en ellos un significativo conjunto de medidas. En este contexto, el presente trabajo se centra en cómo se ha configurado y ejecutado este instrumento, tomando como caso de estudio el plan implementado en Puerto de la Cruz. Los resultados evidencian la importancia de la renovación urbana y rehabilitación edificatoria en comparación con las operativas no urbanísticas, una mayor ejecutividad de las actuaciones privadas frente a las públicas y la trascendencia que ha adquirido el instrumento para la renovación del destino turístico. En cuanto al proceso metodológico implementado, se ha fundamentado en el análisis de contenido y en entrevistas no estructuradas con actores clave.Tourism policy implements its actions through a set of instruments whose configuration and execution are essential in government action, constituting a fundamental indicator to evaluate its approach and effects. Regarding the renewal of tourist destinations, the Canary Islands tourist policy has designed the Plans for Modernisation, Improvement and Increased Competitiveness among its most important instruments, which incorporate a significant series of measures. Within this context, this study focuses on how this instrument has been configured and executed, using the plan implemented in Puerto de la Cruz as a case study. The results show the importance of urban renewal and building rehabilitation in comparison with non-urban operations, the greater implementation of private actions compared to public ones and the transcendence that the instrument has acquired for the renewal of the tourist destination. The methodological process implemented has been based on content analysis and unstructured interviews with key actors.La publicación es resultado de un contrato de servicios en el ámbito de iniciativas investigadoras, transferencia de resultados y/o trabajos de carácter científico, técnico o artístico firmado con la Fundación General de la Universidad de La Laguna (FGULL) que tuvo como título “Estudio de evaluación de las actuaciones previstas en el Plan de Rehabilitación de las Infraestructuras Turísticas y desarrolladas en Plan de Modernización, Mejora e Incremento de la Competitividad de Puerto de la Cruz” [A21100006], siendo IP el Dr. Jesús Hernández Hernández

Liquid Biopsy as Novel Tool in Precision Medicine: Origins, Properties, Identification and Clinical Perspective of Cancer’s Biomarkers

Producción CientíficaIn recent years, there has been an increase in knowledge of cancer, accompanied by a technological development that gives rise to medical oncology. An instrument that allows the implementation of individualized therapeutic strategies is the liquid biopsy. Currently, it is the most innovative methodology in medical oncology. Its high potential as a tool for screening and early detection, the possibility of assessing the patient’s condition after diagnosis and relapse, as well as the effectiveness of real-time treatments in different types of cancer. Liquid biopsy is capable of overcoming the limitations of tissue biopsies. The elements that compose the liquid biopsy are circulating tumor cells, circulating tumor nucleic acids, free of cells or contained in exosomes, microvesicle and platelets. Liquid biopsy studies are performed on various biofluids extracted in a non-invasive way, and they can be performed both from the blood and in urine, saliva or cerebrospinal fluid. The development of genotyping techniques, using the elements that make up liquid biopsy, make it possible to detect mutations, intertumoral and intratumoral heterogeneity, and provide molecular information on cancer for application in medical oncology in an individualized way in different types of tumors. Therefore, liquid biopsy has the potential to change the way medical oncology could predict the course of the disease

Análisis de ejecución de los planes de renovación de destinos turísticos de litoral. El caso de Puerto de la Cruz (Canarias, España)

La política turística implementa sus acciones a través de un conjunto de instrumentos cuya configuración y ejecución son esenciales en la acción del gobierno, convirtiéndose en un indicador fundamental para evaluar su enfoque y efectos. En lo que respecta a la renovación de los destinos turísticos, la política turística de Canarias ha diseñado los Planes de Modernización, Mejora e Incremento de la Competitividad entre sus instrumentos más importantes, concentrando en ellos un significativo conjunto de medidas. En este contexto, el presente trabajo se centra en cómo se ha configurado y ejecutado este instrumento, tomando como caso de estudio el plan implementado en Puerto de la Cruz. El análisis se desarrolla sobre las acciones de renovación del espacio público y privado, llevando a cabo un proceso metodológico basado en el análisis de contenido y entrevistas no estructuradas con actores clave

Expresión proteica de p53 y proliferación celular en leucoplasias orales

Objetivos: Conocer la expresión proteica de las alteraciones genéticas que se producen en las etapas precoces de la cancerización del campo de cavidad oral en nuestro medio. Estudiar la proliferación celular mediante Ki-67 y la expresión de la proteína p53 para valorar si las alteraciones en la expresión proteica de estos marcadores suceden de forma secuencial a través de las distintas etapas en la cancerización del campo de la cavidad oral. Material y métodos: Se realizó un estudio mediante técnicas de inmunohistoquímica sobre 53 pacientes que presentaron lesiones de leucoplasia oral, atendidos por el Servicio de O.R.L del Hospital Universitario de Salamanca, desde 1.990 hasta 2000. Se incluyen en el estudio 11 muestras de epitelio normal, 15 displasias leves y moderadas, 15 carcinomas in situ, y 12 carcinomas microinvasores. Resultados: Encontramos la proliferación celular aumentada y sobreexpresión de p53 a medida que avanzamos en el grado de severidad histopatológica de las lesiones. Las alteraciones más precoces son el aumento significativo de la proliferación celular en displasias leves y moderadas y el aumento de expresión de p53. Conclusión: La leucoplasia oral es un estado precanceroso que constituye una lesión cancerizable debido a las alteraciones genéticas que intervienen en la evolución de la lesión. El estudio inmunohistoquímico y molecular de las lesiones es un medio rutinario que permite conocer la expresión proteica de las alteraciones genéticas, que puede ayudar en el diagnóstico precoz y tratamiento de esta patología, teniendo especial relevancia el estudio de Ki-67 en etapas iniciales y p53 en lesiones más avanzadas.OBJECTIVES: We intend to know the protein expression of genetic alterations that take place in the early stages in the field cancerization of oral cavity in our means as well as to study the cellular proliferation by means of Ki-67 and the protein product expression of p53 to value if the alterations in the protein products expression of these markers happen in a sequential pathway through the different stages in the field cancerization of oral cavity. MATERIALS AND METHODS: A study was made by immunohistochemistry on 53 patients that presented lesions of oral leukoplaquia, assisted by the ENT service at University Hospital of Salamanca, from 1.990 up to 2000. 11 samples of normal epithelium, 15 mild to moderate dysplasias, 15 in situ carcinomas and 12 microinvasive carcinomas are included in the study. RESULTS: we find an increased cellular proliferation and p53 over-expression as we advance in the grade of severity histopathologic of these lesions. The most early alterations are a significant increase of cell proliferation in mild and moderate dysplasias and an increased p53 over-expression. CONCLUSIONS: Oral leukoplaquia is a precancerous stage that constitutes a canzerisable lesion due to the genetic alterations that mediate in the evolution of lesion. Routine Immunohistochemical and molecular study of these lesions allow us to know the protein expression of genetic alterations that can help in the early diagnosis and treatment of this pathology, having special relevance the study of Ki-67 in early stages and p53 in advanced lesions

Clinical perspective and translational oncology of liquid biopsy

Producción CientíficaThe term liquid biopsy (LB) refers to the study of circulating tumor cells, circulating tumors nucleic acids free of cells or contained in exosomes, and information about platelets associated with tumors. LB can be performed in different biofluids and allows the limitations of tissue biopsy to be overcome offering possibilities of tumor identification reflecting in real time tumor heterogeneity. In addition, LB allows screening and early detection of cancer, real-time monitoring of therapy, stratification and therapeutic intervention, a therapeutic target and resistance mechanism, and a risk of metastatic relapse. Currently, LB has been shown to be effective for its application in different types of tumors including lung, colorectal, prostate, melanoma, breast and pancreatic cancer, by the determination and identification of biomarkers that with a high probability have the potential to change the way in which medical oncology could predict the course of the disease. These biomarkers make it possible to capture the heterogeneity of the cancer, monitor its clonal evolution, indicate new treatments or retreatments and evaluate the responses to different evolutionary and/or therapeutic pressures in the cancer disease

Study of chemotherapy-induced cognitive impairment in women with breast cancer

Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient’s quality of life. The studies reviewed showed that chemotherapy-related cognitive impairmentmight occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. Method: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprisedwomen newly diagnosedwith locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed—processing speed, attention, memory, and executive functions (subtests of theWechsler Intelligence Scale and the TrailMaking Test). Results: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. Conclusion: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied

Integrated analysis of mismatch repair system in malignant astrocytomas

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al.Malignant astrocytomas are the most aggressive primary brain tumors with a poor prognosis despite optimal treatment. Dysfunction of mismatch repair (MMR) system accelerates the accumulation of mutations throughout the genome causing uncontrolled cell growth. The aim of this study was to characterize the MMR system defects that could be involved in malignant astrocytoma pathogenesis. We analyzed protein expression and promoter methylation of MLH1, MSH2 and MSH6 as well as microsatellite instability (MSI) and MMR gene mutations in a set of 96 low- and high-grade astrocytomas. Forty-one astrocytomas failed to express at least one MMR protein. Loss of MSH2 expression was more frequent in low-grade astrocytomas. Loss of MLH1 expression was associated with MLH1 promoter hypermethylation and MLH1 -93G>A promoter polymorphism. However, MSI was not related with MMR protein expression and only 5% of tumors were MSI-High. Furthermore, the incidence of tumors carrying germline mutations in MMR genes was low and only one glioblastoma was associated with Lynch syndrome. Interestingly, survival analysis identified that tumors lacking MSH6 expression presented longer overall survival in high-grade astrocytoma patients treated only with radiotherapy while MSH6 expression did not modify the prognosis of those patients treated with both radiotherapy and chemotherapy. Our findings suggest that MMR system alterations are a frequent event in malignant astrocytomas and might help to define a subgroup of patients with different outcome.This work was supported by Fondo de Investigación Sanitaria (FIS PI 10/00219), Instituto de Estudios de Ciencias de la Salud de Castilla y León IECSCYL and Junta de Castilla y León y Fondo Social Europeo (Orden EDU/330/2008).Peer Reviewe

Indicators to evaluate quality of care in head and neck cancer in Spain.

Purpose This study aimed to develop a set of criteria and indicators to evaluate the quality of care of patients with head and neck cancer (HNC). Methods A systematic literature review was conducted to identify valuable criteria/indicators for the assessment of the quality of care in HNC. With the aid of a technical group, a scientific committee of oncologists specialised in HNC used selected criteria to propose indicators that were evaluated with a two-round Delphi method. Indicators on which consensus was achieved were then prioritised by the scientific committee to develop a final set of indicators. Results We proposed a list of 50 indicators used in the literature or developed by us to be evaluated with a Delphi method. There was consensus on the appropriateness of 47 indicators in the first round; the remaining 3 achieved consensus in the second round. The 50 indicators were scored to prioritise them, leading to a final selection of 29 indicators related to structure (3), process (22), or outcome (4) and covering diagnosis, treatment, follow-up, and health outcomes in patients with HNC. Easy-to-use index cards were developed for each indicator, with their criterion, definition, formula for use in real-world clinical practice, rationale, and acceptable level of attainment. Conclusions We have developed a set of 29 evidence-based and expert-supported indicators for evaluating the quality of care in HNC, covering diagnosis, treatment, follow-up, and health outcomes.post-print998 K

Estudio preliminar de la arácnofauna en la ribera del río Chinguiñoso, Huejutla de Reyes, Hidalgo, México

Las  arañas  comprenden  un  grupo  de  fauna  muy diverso  y ampliamente  distribuido  en  todos  los ecosistemas terrestres invadiendo incluso algunos ambientes dulceacuícolas. Se realizó un estudio sobre la arácnofauna en la ribera del río Chinguiñoso, Huejutla de Reyes, Hidalgo; México. Durante los meses de septiembre a noviembre del 2017. Se utilizó el método de colecta directa, trampas de caída y golpeo de ramas y arbustos, en un trayecto de dos kilómetros, distribuidos en cinco sitios cada uno con 200 metros de longitud, obteniendo 240 horas de esfuerzo de muestreo en jornadas diurnas. Se obtuvieron un total 190 individuos, distribuidos en 13 especies y siete familias (Araneidae, Oxyopidae, Pisauridae, Salticidae, Sytodidae, Sparissidae y Tetragnathidae). Se tomó como medida de la diversidad verdadera (especies efectivas) la exponencial del índice de equidad de Shannon (H’); a su vez dominancia de Simpson (D’), como un indicador para medir la diversidad. El mes de septiembre fue el más abundante, rico y diverso. Por otra parte, el análisis de similitud de Jaccard arroja un grupo que presenta un 80 % de similitud y otro en donde presenta especies que no se encontraron en los demás sitios. La riqueza y diversidad de arácnidos podría estar aunada a la riqueza de vegetación, debido a que aún existen zonas con gran altura y cobertura arbórea

Immune system disorders, cancer and viral infections: A new treatment opportunity for the immune checkpoint inhibitors

Producción CientíficaThe relationship between viral infections and cancer is well known and has been established for decades. Multiple tumours are generated from alterations secondary to viral infections 2 resulting from a dysregulation of the immune system in many cases. Certain causal relationships, such as that between the Epstein–Barr virus (EBV) in nasopharyngeal cancer or hepatitis C and B viruses in hepatocarcinoma, have been clearly established, and their implications for the prognosis and treatment of solid tumours are currently unknown. Multiple studies have evaluated the role that these infections may have in the treatment of solid tumours using immunotherapy. A possible relationship between viral infections and an increased response to immune checkpoint inhibitors (ICIs) has been established at a theoretical level in solid neoplasms, such as EBV-positive cavum cancer and human papillomavirus (HPV)-positive and oropharyngeal cancer. These could yield a greater response associated with the activation of the immune system secondary to viral infection, the consequence of which is an increase in survival in these patients. That is why the objective of this review is to assess the different studies or clinical trials carried out in patients with solid tumours secondary to viral infections and their relationship to the response to ICIs