¿Tiene el tratamiento previo con inhibidores de la 5-alfa reductasa repercusión en la enucleación prostática con láser holmium? Resultados de un estudio prospectivo observacional y revisión de la literatura / Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate

Introducción y objetivos Los pacientes tratados con HoLEP frecuentemente han recibido tratamientos previos, incluyendo los inhibidores de la 5-alfa-reductasa (5ARI). Nuestro objetivo es evaluar el efecto del tratamiento previo con 5ARI en los parámetros perioperatorios y del postoperatorio immediato en pacientes tratados con HoLEP. Materiales y métodos Se ha llevado a cabo un estudio retrospectivo utilizando una base de datos recogida prospectivamente, de todos los pacientes tratados con HoLEP en nuestro centro entre enero de 2017 y enero de 2023. Se han analizado los gramos de resección, la eficiencia de enucleación y morcelación (gramos enucleados/tiempo de enucleación y gramos de morcelación/tiempo de morcelación), las complicaciones postoperatorias, el tiempo de hospitalización y el descenso de hemoglobina. Resultados Se han incluido 327 pacientes; 173 de ellos (52,9%) fueron tratados con 5ARI. Entre los parámetros perioperatorios estudiados para determinar la eficiencia no se encontraron diferencias. No se observaron diferencias en las complicaciones peri o postoperatorias, estancia hospitalaria o descenso de hemoglobina. Conclusiones El uso de 5ARI no tuvo repercusión en el postoperatorio immediato de los pacientes tratados con HoLEP. En nuestra cohorte el uso de 5ARI no ha demostrado alterar la eficiencia quirúrgica, ni en la enucleación ni en la morcelación. Futuros estudios multicéntricos serán necesarios para corroborar estos hallazgos. (AU)

Introduction and aim Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. Material and Methods A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. Results A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. Conclusions Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings. (AU)

Evaluating the effects of preoperative treatment with 5-alpha reductase inhibitors in holmium laser enucleation of the prostate.

INTRODUCTION AND AIM: Patients treated with HoLEP are frequently treated with previous treatments, including 5-alpha-reductase inhibitors (5-ARIs). We investigated the impact of pretreatment with 5-ARIs on perioperative and immediate postoperative parameters in patients treated with HoLEP. MATERIAL AND METHODS: A retrospective study was performed using a prospectively collected database including all patients treated with HoLEP at our center between January 2017 and January 2023. The resected tissue weight, enucleation and morcellation efficiency (enucleation weight/time and morcellation weight/ time), postoperative complications, hospital stay and hemoglobin drop have been analyzed. RESULTS: A total of 327 patients were included. Of these, 173 (52.9%) were treated with 5-ARIs. No differences were found among the perioperative parameters investigated to determine efficiency. No differences were observed in peri- or postoperative complications, hospital stay or hemoglobin drop. CONCLUSIONS: Therapy with 5-ARIs had no impact on the immediate postoperative outcomes of patients treated with HoLEP. In our cohort, we observed that the use of 5-ARIs did not affect surgical efficiency, enucleation or morcellation. Further multicenter studies will be necessary to validate these findings.

The environmental performance of different pork production scenarios: a life cycle assessment study.

In order to evaluate the environmental performance generated by a "semi-technified" pig farm, as well as the comparison of different pig production scenarios, pig feed and animal production subsystems were evaluated considering both: (a) origin of feed ingredients and (b) variations in pig weight. Life cycle assessment methodology was used to evaluate the environmental performance, establishing 1 market pig as the functional unit (FU). Three ingredient origin distances (400, 950, and 1800 km) and three slaughter weights (110, 100, and 90 kg) were considered for the simulation analysis and comparison. The feed production subsystem was the main generator of environmental impacts, mainly caused by the cultivation of sorghum and the production of fat. The origin of the inputs represented the main increase in environmental impact for the feed production subsystem, mainly in the Fossil Depletion category, with a fivefold increase by acquiring inputs from 900 km and a ninefold increase at a distance of 1800 km. Producing lighter pigs resulted in the best environmental alternative, given the resultant 11% reduction in environmental impact.

Embolización prostática como tratamiento para pacientes con hiperplasia benigna de próstata portadores de sonda vesical permanente no tributarios a cirugía desobstructiva / Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery

Introducción: La hiperplasia benigna de próstata se considera la causa más común de los síntomas del tracto urinario inferior. El sondaje vesical es el tratamiento urgente en pacientes con retención urinaria y la cirugía el de aquellos refractarios al tratamiento médico. Existe un grupo de personas con comorbilidades importantes no tributarias a cirugía. La embolización arterial prostática (EAP) podría presentarse como una alternativa segura y eficaz para conseguir el vaciamiento vesical y la micción espontánea, evitando así el sondaje vesical permanente en pacientes con comorbilidades importantes que contraindiquen la cirugía. En este estudio retrospectivo, evaluamos la eficacia de la EAP en pacientes portadores de sonda vesical permanente no tributarios de tratamiento quirúrgico.Material y métodosEstudio retrospectivo de 26 pacientes portadores de sonda vesical permanente a los que se les realizó una embolización prostática. Se revisaron los datos demográficos y clínicos (edad, uso de anticoagulación, volumen prostático, tiempo de ingreso, embolización unilateral o bilateral), la evaluación del índice de comorbilidad de Charlson y la clasificación de Clavien-Dindo para las complicaciones del procedimiento. Se analizó el éxito de la retirada de la sonda vesical permanente al mes del procedimiento.ResultadosUn total de 26 pacientes fueron incluidos en la revisión. La mediana de edad fue de 85 años, con un volumen prostático mediano de 90mL. El 88,5% de los sujetos puntuó más de 7 en la escala de comorbilidad de Charlson. Un único paciente presentó una complicación Clavien-Dindo III. De los 26 sujetos, 17 (65,4%) tuvieron una micción espontánea y un residuo posmiccional inferior a 100mL al mes del procedimiento. En total, se logró retirar la sonda vesical en 19 de los 26 sujetos (73,1%). (AU)

Introduction: Benign prostatic hyperplasia is considered the most frequent cause of lower urinary tract symptoms. Urinary catheterization is the emergency treatment for patients with urinary retention and surgery is indicated in patients refractory to medical treatment. There is a group of people with important comorbidities that make them ineligible for surgery. Prostatic arterial embolization (PAE) could be presented as a safe and effective alternative to achieve bladder emptying and spontaneous urination, thus avoiding permanent urinary catheterization in patients with significant comorbidities that represent a contraindication for surgery. In this retrospective study, we evaluated the efficacy of PAE in patients with permanent urinary catheterization who are ineligible for surgical treatment.Material and methodsRetrospective study of 26 patients with permanent urinary catheter who underwent prostatic embolization. Demographic and clinical data (age, use of anticoagulation, prostate volume, length of hospital stay, unilateral or bilateral embolization), Charlson comorbidity index evaluation and Clavien-Dindo classification for procedural complications were reviewed. Successful removal of permanent urinary catheter was analyzed at one month after the procedure.ResultsA total of 26 patients were included in the review. The median age was 85 years with a median prostate volume of 90mL. A Charlson comorbidity score above 7 was obtained in 88.5% of the subjects. Only one patient had one Clavien-Dindo III complication. Of the 26 subjects, 17 (65.4%) had spontaneous micturition and a postvoid residual lower than 100mL at one month post procedure. Overall, catheter removal was achieved in 19 out of 26 subjects (73.1%). (AU)

Prostatic artery embolization treatment for patients with benign prostatic hyperplasia who are permanent urinary catheter users ineligible for de-obstructive surgery.

INTRODUCTION: Benign prostatic hyperplasia is considered the most frequent cause of lower urinary tract symptoms. Urinary catheterization is the emergency treatment for patients with urinary retention and surgery is indicated in patients refractory to medical treatment. There is a group of people with important comorbidities that make them ineligible for surgery. Prostatic arterial embolization (PAE) could be presented as a safe and effective alternative to achieve bladder emptying and spontaneous urination, thus avoiding permanent urinary catheterization in patients with significant comorbidities that represent a contraindication for surgery. In this retrospective study, we evaluated the efficacy of PAE in patients with permanent urinary catheterization who are ineligible for surgical treatment. MATERIAL AND METHODS: Retrospective study of 26 patients with permanent urinary catheter who underwent prostatic embolization. Demographic and clinical data (age, use of anticoagulation, prostate volume, length of hospital stay, unilateral or bilateral embolization), Charlson comorbidity index evaluation and Clavien-Dindo classification for procedural complications were reviewed. Successful removal of permanent urinary catheter was analyzed at one month after the procedure. RESULTS: A total of 26 patients were included in the review. The median age was 85 years with a median prostate volume of 90 mL. A Charlson comorbidity score above 7 was obtained in 88.5% of the subjects. Only one patient had one Clavien-Dindo III complication. Of the 26 subjects, 17 (65.4%) had spontaneous micturition and a postvoid residual lower than 100 mL at one month post procedure. Overall, catheter removal was achieved in 19 out of 26 subjects (73.1%). CONCLUSION: PAE is a safe and effective treatment for patients with permanent urinary catheterization who are ineligible for surgical treatment.

Epidemic model on a network: Analysis and applications to COVID-19.

We analyze an epidemic model on a network consisting of susceptible-infected-recovered equations at the nodes coupled by diffusion using a graph Laplacian. We introduce an epidemic criterion and examine different isolation strategies: we prove that it is most effective to isolate a node of highest degree. The model is also useful to evaluate deconfinement scenarios and prevent a so-called second wave. The model has few parameters enabling fitting to the data and the essential ingredient of importation of infected; these features are particularly important for the current COVID-19 epidemic.

Análisis de las complicaciones en el aprendizaje del HoLEP: revisión sistemática / No disponible

ANTECEDENTES: La enucleación prostática con láser de holmio (HoLEP) podría mejorar los resultados y tener menores tasas de complicaciones que las técnicas tradicionales (resección transuretral y prostatectomía abierta) en la desobstrucción quirúrgica prostática. A pesar de esto, su uso no se ha extendido en la urología a nivel mundial. La alta tasa de complicaciones en su curva de aprendizaje (CAHo) podría ser una causa. OBJETIVO: Hacer una revisión sistemática para determinar las tasas de complicaciones en el aprendizaje de HoLEP y compararlas con las descritas en técnicas tradicionales. Adquisición de la evidencia: se realizó una búsqueda bibliográfica en MedLine y Embase con los términos «HoLEP» y «holmium laser enucleation». Se obtuvieron 680 registros y, siguiendo los criterios PRISMA, se seleccionaron 15 estudios. SÍNTESIS DE LA EVIDENCIA Se analizaron 1.705 casos en la curva de aprendizaje de 59 urólogos. La mayoría de los estudios no hacen un reporte estandarizado de las complicaciones. Las complicaciones intraoperatorias son bajas y, en general, no tienen repercusiones posteriores. Las tasas de complicaciones postoperatorias son bajas y mejoran con la experiencia. Las tasas de complicaciones en CAHo son iguales o menores que las reportadas en las técnicas tradicionales. CONCLUSIÓN: Las tasas de complicaciones en la CAHo no superan a las reportadas en las técnicas tradicionales. El aprendizaje de HoLEP no debe ser retrasado por temor a aumentar las complicaciones o su severidad

BACKGROUND: Holmium laser enucleation of the prostate (HoLEP) could have better outcomes with decreased complication rates if compared to traditional techniques (transurethral resection and open prostatectomy) for the surgical relief of bladder outlet obstruction. Despite this, its use has not been implemented in the urology community, probably due to the high complication rates of the HoLEP learning curve (HoLC). OBJECTIVE: To conduct a systematic review of the complication rates in HoLC and compare these with those of traditional techniques. EVIDENCE ADQUISITION: a systematic literature search was performed in MedLine and Embase using the search terms «HoLEP» and «holmium laser enucleation». We identified 680 records and selected 15 studies following PRISMA criteria. Evidence synthesis: 1705 cases in the learning curves of 59 surgeons were analyzed. Most of the studies do not report complications in a standardized way. Intraoperative complication rates are low and usually without long-term impact. Postoperative complication rates are limited and show improvement with practice. The complication rates in the HoLC are similar or lower to those reported by traditional techniques. CONCLUSIONS: Complication rates in HoLC are not higher than those reported by traditional techniques. HoLEP learning should not be delayed for fear of increasing complications or their severity

The complications of the HoLEP learning curve. A systematic review. / Análisis de las complicaciones en el aprendizaje del HoLEP: revisión sistemática.

BACKGROUND: Holmium laser enucleation of the prostate (HoLEP) could have better outcomes with decreased complication rates if compared to traditional techniques (transurethral resection and open prostatectomy) for the surgical relief of bladder outlet obstruction. Despite this, its use has not been implemented in the urology community, probably due to the high complication rates of the HoLEP learning curve (HoLC). OBJECTIVE: To conduct a systematic review of the complication rates in HoLC and compare these with those of traditional techniques. EVIDENCE ACQUISITION: a systematic literature search was performed in MedLine and Embase using the search terms «HoLEP¼ and «holmium laser enucleation¼. We identified 680 records and selected 15 studies following PRISMA criteria. EVIDENCE SYNTHESIS: 1705 cases in the learning curves of 59 surgeons were analyzed. Most of the studies do not report complications in a standardized way. Intraoperative complication rates are low and usually without long-term impact. Postoperative complication rates are limited and show improvement with practice. The complication rates in the HoLC are similar or lower to those reported by traditional techniques. CONCLUSION: Complication rates in HoLC are not higher than those reported by traditional techniques. HoLEP learning should not be delayed for fear of increasing complications or their severity.

Marcadores urinarios en la vigilancia del tumor vesical no músculo infiltrante. Revisión de la literatura / Urinary markers in the surveillance of non-muscle invasive bladder cancer. A literature review

Contexto: La vigilancia del tumor vesical no músculo infiltrante (TVNMI) se realiza habitualmente mediante cistoscopia y citologías urinarias seriadas. Hoy, no se utiliza ningún marcador urinario, suficientemente eficaz, para reducir la morbilidad y coste de este seguimiento. Objetivo: Describir el rendimiento de los marcadores urinarios en la vigilancia del TVNMI. Adquisición de la evidencia: el 1 de agosto de 2018 se realizó búsqueda bibliográfica en Pubmed, Embase y librería Cochrane, acotada a los últimos 10 años, con los términos: bladder cancer, recurrence, detection y urine marker. Se obtuvieron 973 registros y siguiendo las recomendaciones PRISMA se seleccionaron 27 publicaciones. Síntesis de la evidencia: Los valores predictivos negativos de varios ensayos permitirían reducir el número de cistoscopias en la vigilancia del TVNMI. Seis ensayos de factores de transcripción tuvieron un valor predictivo negativo superior al 90% y uno de ellos se puede realizar en el punto de control. Seis ensayos de factores de transcripción describen diagnóstico anticipado entre el 68% y 83% de sus «falsos positivos». Dos ensayos de factores de transcripción y uno de proteínas demuestran reducir entre el 23% y el 35% de las cistoscopias de vigilancia. Los ensayos celulares se restringen a pruebas reflejo ante citologías urinarias dudosas. Conclusión: Existen pocas publicaciones que permitan analizar la mejoría del protocolo de vigilancia del TVNMI. Los ensayos de factores de transcripción tienen la mejor precisión diagnóstica y algunos permiten diagnóstico anticipado. Hoy en día no hay análisis que comparen entre protocolos alternativos de vigilancia y el convencional

Background: The surveillance of non-muscle-invasive bladder cancer (NMIBC) is usually performed by cystoscopy and cytology. Until today, no effective urinary biomarker has been used to reduce the morbidity and cost associated with these procedures. Objective: To describe the performance of urinary biomarkers in the surveillance of NMIBC. Evidence acquisition: on August 1, 2018, a bibliographic search was carried out in Pubmed, Embase and Cochrane Library, limited to the last 10 years, with the terms: bladder cancer, recurrence, detection and urine marker.973 registers were obtained, and 27 publications were selected following the PRISMA recommendations. Evidence synthesis: The negative predictive values (NPV) of several assays could reduce the number of cystoscopies in NMIBC surveillance. Six transcription-factor trials had an NPV rate greater than 90%, and one of them can be performed at the control point. Six transcription-factors evaluations describe anticipated diagnosis between 68% and 83% of their "false positives". Two transcription factors and one protein assays proved reduction between 23% and 35% of surveillance cystoscopies. Nowadays, cell-based assays are restricted to reflex test after doubtful cytologies. Conclusion: There are few studies analysing the improvement of the NMIBC surveillance protocols. Several transcription factor assays are more precise and allow anticipatory diagnosis. Currently, there are no comparative studies between alternative surveillance protocols and classic ones

Comparison of a 2D iPad application and 3D body scanner to air displacement plethysmography for measurement of body fat percentage.

BACKGROUND: Novel and innovative imaging methods that rapidly estimate body fat percentage (%BF) are publicly available, yet little is known about their accuracy. The present study evaluated the test-retest reliability of a two-dimensional iPad (Apple, Inc., Cupertino, CA, USA) application (2D APP) and a three-dimensional body scanner (3D SCAN) for estimating %BF and compared both imaging methods with air displacement plethysmography (Bod Pod; Cosmed USA, Inc., Concord, CA, USA). METHODS: Seventy-nine adults (37 female, 42 male) varying widely in age [mean (SD), range] [32.9 (12.4), 18-65 years] and body mass index [25.0 (4.9), 18.2-41.8 kg m-2 ] were measured with the Bod Pod and twice with the 3D SCAN and the 2D APP in a repeated-measures design. RESULTS: Test-retest reliability was excellent for both the 2D APP (intraclass correlation = 0.993) and the 3D SCAN (intraclass correlation = 0.993) with the SEM <1% BF for both methods. Although the three methods were highly correlated with each other (r = 0.857-0.923), the mean %BF estimations were significantly different (P = 0.001). The 2D APP [19.9 (8.2)%BF] underestimated the Bod Pod value [21.9 (9.4)%BF] and the 3D SCAN [24.0 (6.8)%BF] overestimated. Additionally, the SE of estimate and total error exceeded 4% BF for both 2D APP and 3D SCAN, and both methods tended to overestimate lean participants and underestimate fat participants. CONCLUSIONS: Although highly reliable, neither the 2D APP, nor the 3D SCAN provided valid estimates of %BFBod Pod .

Urinary markers in the surveillance of non-muscle invasive bladder cancer. A literature review. / Marcadores urinarios en la vigilancia del tumor vesical no músculo infiltrante. Revisión de la literatura.

BACKGROUND: The surveillance of non-muscle-invasive bladder cancer (NMIBC) is usually performed by cystoscopy and cytology. Until today, no effective urinary biomarker has been used to reduce the morbidity and cost associated with these procedures. OBJECTIVE: To describe the performance of urinary biomarkers in the surveillance of NMIBC. EVIDENCE ACQUISITION: on August 1, 2018, a bibliographic search was carried out in Pubmed, Embase and Cochrane Library, limited to the last 10 years, with the terms: bladder cancer, recurrence, detection and urine marker.973 registers were obtained, and 27 publications were selected following the PRISMA recommendations. EVIDENCE SYNTHESIS: The negative predictive values (NPV) of several assays could reduce the number of cystoscopies in NMIBC surveillance. Six transcription-factor trials had an NPV rate greater than 90%, and one of them can be performed at the control point. Six transcription-factors evaluations describe anticipated diagnosis between 68% and 83% of their "false positives". Two transcription factors and one protein assays proved reduction between 23% and 35% of surveillance cystoscopies. Nowadays, cell-based assays are restricted to reflex test after doubtful cytologies. CONCLUSION: There are few studies analysing the improvement of the NMIBC surveillance protocols. Several transcription factor assays are more precise and allow anticipatory diagnosis. Currently, there are no comparative studies between alternative surveillance protocols and classic ones.

Predictive value of hypoxia in advanced head and neck cancer after treatment with hyperfractionated radio-chemotherapy and hypoxia modification

Purpose. Hypoxia has predictive value in head and neck cancer (HNC). It has been well described, albeit in a small number of clinical Centres. The aim of this study was to describe our experience using the polarographic probe technique to assess the predictive value of tumour oxygenation in patients with advanced HNC treated with hyperfractionated radio-chemotherapy. Hypoxia modification was induced using percutaneous spinal cord stimulation (SCS). Methods/patients. Male patients (n = 12; stage IVb n = 8; IVa n = 4; mean age 58: range 46-70 years) with advanced HNC were evaluated. Planned therapy was hyperfractionated-radiotherapy, oral tegafur (precursor of 5-fluorouracil) and hypoxia modification using SCS. Pre-treatment analyses included: haemoglobin levels and tumour oxygenation (using the Eppendorf polarographic probe device). Oxygenation was expressed as median-pO2 (in mmHg) and hypoxia as the percentage of pO2 values ≤5 mmHg (HP5) and ≤2.5 mmHg (HP2.5). Results. Lower haemoglobin levels were directly correlated with median pO2 (p = 0.017) and inversely correlated with HP5 (p = 0.020) and more advanced stages (IVb vs. IVa; p = 0.028). Patients who subsequently developed systemic metastasis had tumours that were more hypoxic, with lower median pO2 (p = 0.036) and higher HP5 (p = 0.036). The subgroup of patients with HP2.5 above the median (the most hypoxic tumours) had lower loco-regional control (p = 0.027), cause-specific survival (p = 0.008), and overall survival (p = 0.008). Conclusions. Higher tumour hypoxia showed predictive value in HNC in our study, and was significantly associated with lower overall survival, cause-specific survival, and loco-regional control. Tumour hypoxia determination could be used to select patients who would most benefit by hypoxia modification during chemo-radiotherapy of HNC (AU)

No disponible

[Polymyositis secondary to a non-Hodgkin's lymphoma]. / Polimiositis secundaria a un linfoma no Hodgkin.

TITLE: Polimiositis secundaria a un linfoma no Hodgkin.

Predictive value of hypoxia in advanced head and neck cancer after treatment with hyperfractionated radio-chemotherapy and hypoxia modification.

PURPOSE: Hypoxia has predictive value in head and neck cancer (HNC). It has been well described, albeit in a small number of clinical Centres. The aim of this study was to describe our experience using the polarographic probe technique to assess the predictive value of tumour oxygenation in patients with advanced HNC treated with hyperfractionated radio-chemotherapy. Hypoxia modification was induced using percutaneous spinal cord stimulation (SCS). METHODS/PATIENTS: Male patients (n = 12; stage IVb n = 8; IVa n = 4; mean age 58: range 46-70 years) with advanced HNC were evaluated. Planned therapy was hyperfractionated-radiotherapy, oral tegafur (precursor of 5-fluorouracil) and hypoxia modification using SCS. Pre-treatment analyses included: haemoglobin levels and tumour oxygenation (using the Eppendorf polarographic probe device). Oxygenation was expressed as median-pO2 (in mmHg) and hypoxia as the percentage of pO2 values ≤5 mmHg (HP5) and ≤2.5 mmHg (HP2.5). RESULTS: Lower haemoglobin levels were directly correlated with median pO2 (p = 0.017) and inversely correlated with HP5 (p = 0.020) and more advanced stages (IVb vs. IVa; p = 0.028). Patients who subsequently developed systemic metastasis had tumours that were more hypoxic, with lower median pO2 (p = 0.036) and higher HP5 (p = 0.036). The subgroup of patients with HP2.5 above the median (the most hypoxic tumours) had lower loco-regional control (p = 0.027), cause-specific survival (p = 0.008), and overall survival (p = 0.008). CONCLUSIONS: Higher tumour hypoxia showed predictive value in HNC in our study, and was significantly associated with lower overall survival, cause-specific survival, and loco-regional control. Tumour hypoxia determination could be used to select patients who would most benefit by hypoxia modification during chemo-radiotherapy of HNC.

Economic and financial viability of small-scale dairy systems in central Mexico: economic scenario 2010-2018.

A simulation Monte Carlo model was used to assess the economic and financial viability of 130 small-scale dairy farms in central Mexico, through a Representative Small-Scale Dairy Farm. Net yields were calculated for a 9-year planning horizon by means of simulated values for the distribution of input and product prices taking 2010 as base year and considering four scenarios which were compared against the scenario of actual production. The other scenarios were (1) total hiring in of needed labour; (2) external purchase of 100 % of inputs and (3) withdrawal of subsidies to production. A stochastic modelling approach was followed to determine the scenario with the highest economic and financial viability. Results show a viable economic and financial situation for the real production scenario, as well as the scenarios for total hiring of labour and of withdrawal of subsidies, but the scenario when 100 % of feed inputs for the herd are bought-in was not viable.

Therapeutic enquiries about biological agents as a tool to identify safety aspects and patterns of use.

BACKGROUND: Biotechnological agents (BA) are increasingly being used in clinical practice. We aimed to determine, whether enquiries about them to a therapeutic consultation service have also become more frequent, and to describe the information requested in these consultations. METHODS: We retrospectively reviewed 14 104 therapeutic consultations collected in a computerised database between 2000 and 2014. Enquiries about BA (monoclonal antibodies, fusion proteins or cytokine antagonists) were chosen. Information on the type of BA, underlying condition, type of enquiry and affiliation of the enquirer was retrieved and compared with data from consultations about other agents. RESULTS: During the study period, 365 enquiries about 30 different BA were received. Only 4% of them were received before 2004, while 48.8% were received after 2010. Rituximab, infliximab, adalimumab and etanercept were most frequently enquired about. Agent selection (n=184) and/or adverse effects (n=174) were the most frequent reasons for making an enquiry. Most enquiries about an agent selection were made about an off-label use (n=164), mainly for systemic autoimmune diseases (n=61). Over half of the enquiries about adverse effects were about their teratogenic potential (n=96). Enquiries about BA more often requested an opinion (87.7% vs 77.7%) were made by physicians (89.9% vs 76.9%), from a hospital (81.6% vs 44.5%) and regarded a specific patient (87.4% vs 74.5%). CONCLUSIONS: Therapeutic consultations about BA are increasing. Most of them are related to uncertainties of health professionals regarding any new medicine: their off-label use, actual adverse effects or the teratogenic potential of the involved agents.

Extensive emphysematous pyelonephritis in a renal allograft: case report and review of literature.

Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and perirenal tissue, which results in the presence of gas within the renal parenchyma, collecting system, or perinephric tissue. EPN of renal allograft is rare, with only 23 cases reported in Western literature. Here, we report a patient treated successfully with surgery. We also review the literature, focusing on old and new suggested classification systems for EPN.

Generation and initial characterization of the prolactin-inducible protein (PIP) null mouse: accompanying global changes in gene expression in the submandibular gland.

The human prolactin-inducible protein/gross cystic disease fluid protein-15 (hPIP/GCDFP-15) is a secretory glycoprotein found primarily in apocrine tissues including the breast and salivary glands. With largely unknown functions, PIP has been implicated in breast cancer and metastasis, host defense processes and T lymphocyte apoptosis. To begin to address PIP function in vivo, we generated the PIP null mouse (Pip-/-). Additionally, to determine the effect of the loss of PIP on gene expression and to gain insight into some of the molecular mechanisms underlying PIP function, microarray analysis of the submandibular gland was also undertaken. Pip-/- mice developed normally with no overt differences in behaviour or gross morphology and were fertile. However, histological examination of 3-month-old Pip-/- mice sometimes showed enlarged submandibular lymph nodes, lymphocytic aggregations within the prostate lobes, and enlarged medulla in the thymus. Functional analysis of gene expression revealed sets of multiple differentially expressed genes associated with cell death and survival, lipid metabolism, inflammation, immune disease, and cancer, as a consequence of mPIP abrogation. Taken together, these studies lend support to an immunomodulatory role for PIP in vivo and provide further insights into potentially novel signaling pathways and regulatory networks for PIP.

Role of undecan-2-one on ethanol-induced apoptosis in HepG2 cells.

Based on the reduced expression of ethanol-oxidizing enzymes in human hepatocellular carcinoma (HepG2) cells, we analyzed the role of nonoxidative metabolites in ethanol-induced apoptosis in HepG2 cells. For this purpose, an analysis of volatile metabolites of ethanol using ion-mobility spectrometry and gas chromatography-mass spectrometry was performed. HepG2 cells exposed to 1 mmol/L ethanol exhibited significant synthesis of undecan-2-one compared to untreated cells. Undecan-2-one is a fatty acid ethyl ester metabolite synthesized through a nonoxidative pathway. Undecan-2-one had a dose-dependent cytotoxic effect on HepG2 cells as shown by release of lactate dehydrogenase (LDH). The most notable finding of this study was the potentiation of ethanol-induced apoptosis demonstrated by an increased apoptotic rate induced by undecan-2-one in ethanol-treated HepG2 cells. The data presented in this study contribute to the better understanding of the molecular mechanisms of ethanol exposure at low concentration in HepG2 cells, a human hepatocellular carcinoma-derived cell line.

Preparation of Entamoeba histolytica antigens without enzymatic inhibitors.

The goal of this work is to report a novel assay that preserves antigenicity of extracts with high protease content without using enzymatic inhibitors. A great reduction of proteolytic activity in the insoluble chloroform/methanol and heated amoebic fraction (IC:MC) was obtained by this method, even in the presence of sodium dodecyl sulphate and 2-mercaptoethanol. The substrates azo-casein and the hide powder azure were used to determine the reduction of proteolytic activity of IC:MC compared with the activity of crude extract and crude extract with iodoacetamide. The IC:MC SDS-PAGE pattern shows a higher quantity of bands than extract with the inhibitor iodoacetamide or than crude extract. In addition, anti-Entamoeba histolytica antibodies from amoebic liver abscess patients recognized a richer antigenic Western blot pattern in the IC:MC fraction than in crude extract alone or with inhibitor. The described method has proved to be suitable to preserve amoebic antigens for its use in diagnostic tests and it can be used for immunological response studies against E. histolytica antigens. Furthermore we propose that this method to obtain the IC:MC fraction can be applied for the study of other microorganisms or cells with high enzymatic content.