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1.
Pediatr Blood Cancer ; 71(8): e31120, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38825724

ABSTRACT

The EPICO (Spanish general registry of COVID-19 in children)-SEHOP (Spanish Society of Pediatric Hematology and Oncology) platform gathers data from children with SARS-CoV-2 in Spain, allowing comparison between children with cancer or allogeneic hematopoietic stem cell transplantation (alloHSCT) and those without. The infection is milder in the cancer/alloHSCT group than in children without comorbidities (7.1% vs. 14.7%), except in children with recent alloHSCT (less than 300 days), of which 35.7% experienced severe COVID-19. These data have been shared with the SEHOP members to support treatment and isolation policies akin to those for children without cancer, except for those with recent alloHSCT or additional comorbidities. This highlights the collaborative registries potential in managing pandemic emergencies.


Subject(s)
COVID-19 , Comorbidity , Hematopoietic Stem Cell Transplantation , Neoplasms , SARS-CoV-2 , Humans , COVID-19/epidemiology , COVID-19/complications , Child , Male , Adolescent , Female , Child, Preschool , Risk Factors , Neoplasms/epidemiology , Neoplasms/therapy , Infant , Spain/epidemiology , Registries , Transplantation, Homologous
2.
An. pediatr. (2003. Ed. impr.) ; 100(4): 259-267, abril 2024. ilus, graf, tab
Article in Spanish | IBECS | ID: ibc-232096

ABSTRACT

Introducción: La irradiación corporal total (ICT) forma parte del acondicionamiento mieloablativo del trasplante de progenitores hematopoyéticos (TPH) en hemopatías malignas. Esta terapia ha demostrado recientemente mayor supervivencia en leucemia linfoblástica aguda (LLA) frente a regímenes basados en quimioterapia. Sin embargo, los efectos secundarios son una limitación importante, especialmente en la población pediátrica.Pacientes y métodosAnalizamos retrospectivamente la supervivencia de pacientes con LLA que recibieron un TPH en un hospital terciario entre los años 1996 a 2009 (N=69 TPH en 57 pacientes). Diferenciamos una cohorte que había recibido ICT (N=44) y otra que no (N=25). Posteriormente entrevistamos a los supervivientes del grupo ICT con un mínimo de 10 años de seguimiento (N=18), preguntando acerca de la presencia de efectos secundarios.ResultadosLa supervivencia global (SG) a los 2 y 5 años fue del 79,1 y 65,2%, respectivamente para el grupo ICT y del 66,2 y 55,8% para el grupo no ICT, aunque esta diferencia no fue significativa (p=0,31). La supervivencia libre de evento (SLE) a los 2 y 5 años fue del 77,3 y 63,6%, respectivamente para el grupo ICT y del 56 y 32% para el grupo no ICT (p=0,02). La probabilidad de recidiva (PR) a los 2 años habiendo recibido ICT fue del 10% y sin haber recibido ICT del 28,6% (p=0,005). Los supervivientes que recibieron ICT desarrollaron neoplasias secundarias (39%), dislipemia (67%), alteraciones cognitivas (44%), infecciones respiratorias de repetición (39%), alteraciones tiroideas (45%), insuficiencia ovárica precoz (89%), cataratas (22%) y problemas psicológicos (44%), aunque la calidad de vida, valorada por ellos mismos, fue considerada como buena para el 83% de los encuestados.ConclusionesLos pacientes que recibieron ICT tuvieron significativamente mayor SLE y menor PR. Sin embargo, los efectos adversos son frecuentes e importantes, aunque no afectan subjetivamente a la calidad de vida. (AU)


Introduction: Total body irradiation (TBI) is part of the myeloablative conditioning for hematopoietic stem cell transplantation (HSCT) in malignant hematologic disorders. This therapy has recently shown improved survival in acute lymphoblastic leukemia (ALL) compared to chemotherapy-based regimens. However, side effects are a significant limitation, especially in the pediatric population.Patients and methodsWe retrospectively analyzed the survival of patients with ALL who underwent an HSCT at a tertiary hospital between 1996 and 2009 (N=69 HSCT in 57 patients). We differentiated a cohort that received TBI (N=44) from another that did not (N=25). Subsequently, we interviewed the survivors from the TBI group with a minimum of 10 years of follow-up (N=18), asking about the presence of side effects.ResultsThe overall survival (OS) at 2 and 5 years was 79.1% and 65.2% respectively for the TBI group and 66.2% and 55.8% for the non-TBI group, although this difference was not significant (P=.31). The event-free survival (EFS) at 2 and 5 years was 77.3% and 63.6% respectively for the TBI group and 56% and 32% for the non-TBI group (P=.02). The probability of relapse (PR) at 2 years for those who received TBI was 10% compared to 28.6% for those who did not receive TBI (P=.005). Survivors who received TBI developed secondary neoplasms (39%), dyslipidemia (67%), cognitive impairments affecting memory (44%), recurrent respiratory infections (39%), thyroid abnormalities (45%), premature ovarian failure (89%), cataracts (22%), and psychological problems (44%). However, the quality of life, as self-assessed by the patients, was considered good for 83% of the participants.ConclusionsPatients who received TBI had significantly higher EFS and lower PR. However, adverse effects are frequent and significant, although they do not subjectively affect quality of life. (AU)


Subject(s)
Humans , Leukemia, Biphenotypic, Acute , Whole-Body Irradiation , Transplants , Drug Therapy
3.
Sensors (Basel) ; 24(5)2024 Feb 28.
Article in English | MEDLINE | ID: mdl-38475075

ABSTRACT

In photovoltaic power plant inspections, techniques for module assessment play a crucial role as they enhance fault detection and module characterization. One valuable technique is luminescence. The present paper introduces a novel technique termed passive luminescence. It enhances both electroluminescence and photoluminescence imaging acquisition in photovoltaic power plants under normal operation in high irradiance conditions. This technique is based on the development of an electronic board, which allows the polarity of the module to be changed, enabling the current generated by the photovoltaic string to be injected into the module and producing electroluminescence effects. Additionally, the board can bypass the module and set an open circuit, inducing photoluminescence emission using sunlight as an excitation source. The proper coordination of the board and an InGaAs camera with a bandpass filter has allowed for the integration of a lock-in technique, which has produced electroluminescence and photoluminescence pictures that can be used for fault detection.

4.
Cureus ; 16(2): e54556, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38516490

ABSTRACT

Late bioprosthetic valve thrombosis (bPVT) is a rare and potentially life-threatening complication following valve replacement with thrombus formation leading mostly to valvular stenosis or embolic phenomena. Clinically, it manifests as symptoms of fatigue, dyspnea, or reduced exercise capacity. The existing treatment guidelines lack clear recommendations for managing this specific presentation. In this case study, we present a distinct clinical scenario wherein the use of anticoagulation, specifically apixaban, successfully reversed very late, severe thrombotic stenosis in a 78-year-old woman with a Medtronic Hancock II porcine mitral valve (Dublin, Ireland). This case highlights the need to consider bPVT as an alternative etiology to valve degeneration in the setting of late bioprosthetic valve stenosis. Additionally, it demonstrates how apixaban therapy may serve as a viable treatment modality in these scenarios.

5.
An Pediatr (Engl Ed) ; 100(4): 259-267, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38548564

ABSTRACT

INTRODUCTION: Total body irradiation (TBI) is part of the myeloablative conditioning for hematopoietic stem cell transplantation (HSCT) in malignant hematologic disorders. This therapy has recently shown improved survival in acute lymphoblastic leukemia (ALL) compared to chemotherapy-based regimens. However, side effects are a significant limitation, especially in the pediatric population. PATIENTS AND METHODS: We retrospectively analyzed the survival of patients with ALL who underwent an HSCT at a tertiary hospital between 1996 and 2009 (N = 69 HSCT in 57 patients). We differentiated a cohort that received TBI (N = 44) from another that did not (N = 25). Subsequently, we interviewed the survivors from the TBI group with a minimum of 10 years of follow-up (N = 18), asking about the presence of side effects. RESULTS: The overall survival (OS) at 2 and 5 years was 79.1% and 65.2% respectively for the TBI group and 66.2% and 55.8% for the non-TBI group, although this difference was not significant (P=.31). The event-free survival (EFS) at 2 and 5 years was 77.3% and 63.6% respectively for the TBI group and 56% and 32% for the non-TBI group (P=.02). The probability of relapse (PR) at 2 years for those who received TBI was 10% compared to 28.6% for those who did not receive TBI (P=.005). Survivors who received TBI developed secondary neoplasms (39%), dyslipidemia (67%), cognitive impairments affecting memory (44%), recurrent respiratory infections (39%), thyroid abnormalities (45%), premature ovarian failure (89%), cataracts (22%), and psychological problems (44%). However, the quality of life, as self-assessed by the patients, was considered good for 83% of the participants.. CONCLUSIONS: Patients who received TBI had significantly higher EFS and lower PR. However, adverse effects are frequent and significant, although they do not subjectively affect quality of life.


Subject(s)
Hematopoietic Stem Cell Transplantation , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Whole-Body Irradiation , Humans , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Female , Retrospective Studies , Whole-Body Irradiation/adverse effects , Male , Child , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/methods , Adolescent , Child, Preschool , Treatment Outcome , Transplantation Conditioning/methods , Transplantation Conditioning/adverse effects , Infant , Follow-Up Studies , Survival Rate , Disease-Free Survival
7.
bioRxiv ; 2024 Feb 07.
Article in English | MEDLINE | ID: mdl-38370768

ABSTRACT

To investigate the co-development of vasculature, mesenchyme, and epithelium crucial for organogenesis and the acquisition of organ-specific characteristics, we constructed a human pluripotent stem cell-derived organoid system comprising lung or intestinal epithelium surrounded by organotypic mesenchyme and vasculature. We demonstrated the pivotal role of co-differentiating mesoderm and endoderm via precise BMP regulation in generating multilineage organoids and gut tube patterning. Single-cell RNA-seq analysis revealed organ specificity in endothelium and mesenchyme, and uncovered key ligands driving endothelial specification in the lung (e.g., WNT2B and Semaphorins) or intestine (e.g., GDF15). Upon transplantation under the kidney capsule in mice, these organoids further matured and developed perfusable human-specific sub-epithelial capillaries. Additionally, our model recapitulated the abnormal endothelial-epithelial crosstalk in patients with FOXF1 deletion or mutations. Multilineage organoids provide a unique platform to study developmental cues guiding endothelial and mesenchymal cell fate determination, and investigate intricate cell-cell communications in human organogenesis and disease. Highlights: BMP signaling fine-tunes the co-differentiation of mesoderm and endoderm.The cellular composition in multilineage organoids resembles that of human fetal organs.Mesenchyme and endothelium co-developed within the organoids adopt organ-specific characteristics.Multilineage organoids recapitulate abnormal endothelial-epithelial crosstalk in FOXF1-associated disorders.

8.
Eur J Haematol ; 112(6): 910-916, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38333914

ABSTRACT

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is a procedure with high morbidity and mortality. Identifying patients for maximum benefit and risk assessment is crucial in the decision-making process. This has led to the development of predictive risk models for HSCT in adults, which have limitations when applied to pediatric population. Our goal was to develop an automatic learning algorithm to predict survival in children with malignant disorders undergoing HSCT. METHODS: We studied allogenic HSCTs performed on children with malignant disorders at a third-level hospital between 1991 and 2021. Survival was analyzed using the Kaplan-Meier method, log-rank test for the univariate analysis, and Cox regression for the multivariate analysis. A prognostic index was constructed based on these findings. Lastly, we constructed a predictive model using a random forest algorithm to forecast 1-year survival after HSCT. RESULTS: We analyzed 229 HSCTs in 201 patients with a median follow-up of 1.64 years. Variables that impacted on the multivariate analysis were older age (hazard ratio [HR] 1.40, 95% confidence interval [CI] 1.12-1.76, p = .003), oldest period of HSCT (HR 0.46, 95% CI 0.29-0.73, p < .001), and mismatched donor (HR 2.65, 95% CI 1.51-4.65, p = .001). Our prognostic index was associated with 3-year overall survival (OS; p < .001). A random forest was developed using as variables: diagnosis, age, year of HSCT, time from diagnosis to HSCT, disease stage, donor type, and conditioning. This achieved 72% accuracy in predicting 1-year OS. CONCLUSIONS: Our index and random forest was effective in predicting 1-year survival. However, further validation in diverse populations is necessary to establish their generalizability.


Subject(s)
Artificial Intelligence , Hematopoietic Stem Cell Transplantation , Transplantation, Homologous , Humans , Hematopoietic Stem Cell Transplantation/methods , Hematopoietic Stem Cell Transplantation/adverse effects , Male , Female , Child , Child, Preschool , Adolescent , Prognosis , Infant , Kaplan-Meier Estimate , Proportional Hazards Models
10.
JBRA Assist Reprod ; 28(2): 240-246, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38289203

ABSTRACT

OBJECTIVE: To analyze if partial premature ovulation (PPO) detection during oocyte pick-up (OPU) impairs the quality of the retrieved oocyte cohort. METHODS: The PPO concept refers to the situation when premature ovulation happens only in some of the follicles and it is detected during OPU. This study constitutes a retrospective analysis performed in an infertility clinic (Spain) during 2016-2021 with patients undergoing OPU after controlled ovarian hyperstimulation for an in vitro fertilization (IVF) treatment. Study code: 2110-VLC-091- VG, registered on December 9 2021. Data from women with PPO (n=111) were compared to a matched control sample of cycles without PPO (n=333) at a proportion of 1:3. RESULTS: Cycles were matched for age, body mass index (BMI), treatment year, embryo genetic analysis and stimulation protocol type. The mean numbers of oocytes (6.1 vs. 11.2), mature oocytes (4.7 vs. 8.8), correctly fertilized oocytes (3.6 vs. 6.6) and top-quality blastocysts (0.9 vs. 1.8) were significantly lower in the PPO group than the nonPPO group (p<0.05). However, maturation, fertilization, top-quality blastocyst and pregnancy rates were statistically comparable among groups (p>0.05). CONCLUSIONS: Cycles with PPO have fewer available oocytes and, thus, fewer available embryos for transfer, al though their quality is intact, and still offer chances of pregnancy in these cases. Hence cycle cancellation may not be worth associated money, time and morale losses once PPO is detected.


Subject(s)
Fertilization in Vitro , Oocyte Retrieval , Ovulation Induction , Ovulation , Female , Humans , Retrospective Studies , Adult , Fertilization in Vitro/methods , Ovulation/physiology , Ovulation Induction/methods , Oocytes/physiology , Pregnancy , Ovarian Follicle
11.
Pest Manag Sci ; 80(3): 1607-1614, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37984851

ABSTRACT

BACKGROUND: This article assesses whether the European Union's (EU's) plant health regulations have had an impact on imports. A dynamic modelling approach was applied, using a two-step generalized method of moments estimator for panel data, and covering an 8-year period (2013-2020). The estimated equation includes volumes of trade, economic drivers, the trading partner, and variables capturing categories of import requirements (phytosanitary certificates, exemptions, restrictions) with regards to external border measures for enhanced biosecurity. RESULTS: From the analysis we can conclude that the import regime and its recent changes have had a limited impact, if any, on trade flows of the affected products. The most significant impact is found for products classified as high-risk plants, while the extension of the phytosanitary certificate requirement to new products seems to have had negligible effects on trade. CONCLUSION: Therefore, the plant protection regime for extra-EU trade seems to be not trade distorting while supplying a framework to enhance plant health in the EU. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

13.
Cir. Esp. (Ed. impr.) ; 101(8): 548-554, ago. 2023. tab, ilus, graf
Article in Spanish | IBECS | ID: ibc-223780

ABSTRACT

Introducción: Las fracturas de pelvis por traumatismo de alta energía presentan un alto riesgo de lesiones asociadas que comprometen el pronóstico funcional y vital. El objetivo de este estudio fue analizar la correlación entre las fracturas traumáticas de pelvis y sus lesiones asociadas según la clasificación de Tile. Métodos: Estudio observacional retrospectivo de pacientes que sufrieron fracturas traumáticas de pelvis (tipo A, B o C de la clasificación de Tile) con lesiones asociadas concomitantes, analizando los niveles de hemoglobina, entre 6/2013 y 1/2016. Resultados: Se incluyeron un total de 42 pacientes; de ellos, el 69% (n=29) eran varones, la edad media era de 48 años. El 45% (n=19) sufrió accidentes de tránsito; el 26,2% (n=11) caídas. Hubo una proporción diferente en las lesiones pélvicas: Tile A (n=15, 35,7%), B (n=20, 47,6%) y C (n=7, 16,6%) de los casos. El 54,8% (n=23) fueron intervenidos quirúrgicamente, el 21,4% (n=9) necesitó fijación externa. Se encontraron diferencias significativas entre las fracturas Tile A y de escápula (p=0,032), y las Tile B con fracturas sacras (p=0,033), y con lesiones viscerales (p=0,049), mientras que existía solo una asociación sin significación estadística entre Tile C y fracturas costales. El 61,9% (n=26) necesitó transfusión de sangre; el 9,5% (n=4) presentó shock hipovolémico. Conclusiones: Las fracturas pélvicas Tile A se asociaron a las fracturas de escápula, y las Tile B con fracturas transforaminales del sacro y con lesiones viscerales (pulmonares, hepáticas y génito-urinarias). El número reducido de fracturas Tile C no permite realizar asociación estadística con ninguna enfermedad, si bien son las que presentan mayor alteración hemodinámica y lesiones torácicas. (AU)


Introduction: Pelvic fractures due to high energy trauma present a high risk of associated injuries that compromise the functional and vital prognosis of the patients. The objective of this study was to analyze the relationship between traumatic pelvic fractures and their associated injuries according to the Tile classification. Methods: Retrospective observational study of patients who suffered traumatic pelvic fractures (Type A, B or C of the Tile classification) with concomitant associated injuries, analyzing hemoglobin levels, between 6/2013 and 1/2016. Results: A total of 42 patients were included; of those 69% (n=29) were males, mean age was 48 years. 45% (n=19) suffered traffic accidents and 26.2% (n=11) falls. There was a different proportion in pelvic injuries: Tile A (n=15, 35.7%), B (n=20, 47.6%), and C (n=7, 16.6%) of cases. 54.8% (n=23) underwent surgery, 21.4% (n=9) needed temporary or definitive external fixation. Significant differences were found between Tile A type and scapula fractures (P=.032), and Tile B with sacral fractures (P=.033) and visceral injuries (P=.049), while there is a tendency without a statistical significal between Tile C and costal fractures. 61.9% (n=26) needed blood transfusion; 9.5% (n=4) presented hypovolemic shock. Conclusions: Tile A pelvic fractures were associated with scapular fractures, and Tile B with transforaminal fractures of the sacrum and with visceral injuries (lungs, liver and genitourinary). The small number of Tile C prevent us to confirm an association with any pathology, although they are the ones which presnt more hemodynamically instability and thoracic injuries. (AU)


Subject(s)
Humans , Pelvis/injuries , Fractures, Bone , Retrospective Studies , Correlation of Data
14.
Nanomaterials (Basel) ; 13(13)2023 Jun 27.
Article in English | MEDLINE | ID: mdl-37446468

ABSTRACT

In this work, we study the influence of the different surface terminations of c-plane sapphire substrates on the synthesis of graphene via plasma-enhanced chemical vapor deposition. The different terminations of the sapphire surface are controlled by a plasma process. A design of experiments procedure was carried out to evaluate the major effects governing the plasma process of four different parameters: i.e., discharge power, time, pressure and gas employed. In the characterization of the substrate, two sapphire surface terminations were identified and characterized by means of contact angle measurements, being a hydrophilic (hydrophobic) surface and the fingerprint of an Al- (OH-) terminated surface, respectively. The defects within the synthesized graphene were analyzed by Raman spectroscopy. Notably, we found that the ID/IG ratio decreases for graphene grown on OH-terminated surfaces. Furthermore, two different regimes related to the nature of graphene defects were identified and, depending on the sapphire terminated surface, are bound either to vacancy or boundary-like defects. Finally, studying the density of defects and the crystallite area, as well as their relationship with the sapphire surface termination, paves the way for increasing the crystallinity of the synthesized graphene.

15.
Front Pediatr ; 11: 1166176, 2023.
Article in English | MEDLINE | ID: mdl-37325355

ABSTRACT

Objectives: This study aimed to evaluate the characteristics and outcomes of infant patients with leukemia. Methods: A retrospective analysis was conducted in a cohort of 39 patients diagnosed with infant leukemia from 1990 to 2020 who underwent treatment at the pediatric hemato-oncology department of a tertiary hospital in Madrid, Spain. Results: Of the 588 diagnosed cases of childhood leukemia, 39 (6.6%) cases were infant leukemia. The 5-year event-free survival and the 5-year overall survival were 43.6% (SE 4.1) and 46.5% (SD 24.08), respectively. In a univariate analysis, a younger age at diagnosis was associated with poorer outcomes (p = 0.027), as was induction failure (p = 0.0024). Patients treated with hematopoietic stem cell transplantation had better outcomes than non-transplanted patients (p = 0.001); however, the group comparisons that exclude patients who were unable to undergo transplantation due to refractoriness/relapse or death during treatment showed no significant differences. Conclusions: The main risk factors that affected survival in our study were an age younger than 6 months and a poor response to induction therapy. It is important to identify poor prognostic factors in this population in order to seek different approaches that could improve outcomes.

16.
Nanoscale Adv ; 5(7): 1890-1909, 2023 Mar 28.
Article in English | MEDLINE | ID: mdl-36998660

ABSTRACT

Crystal phase quantum dots (QDs) are formed during the axial growth of III-V semiconductor nanowires (NWs) by stacking different crystal phases of the same material. In III-V semiconductor NWs, both zinc blende (ZB) and wurtzite (WZ) crystal phases can coexist. The band structure difference between both crystal phases can lead to quantum confinement. Thanks to the precise control in III-V semiconductor NW growth conditions and the deep knowledge on the epitaxial growth mechanisms, it is nowadays possible to control, down to the atomic level, the switching between crystal phases in NWs forming the so-called crystal phase NW-based QDs (NWQDs). The shape and size of the NW bridge the gap between QDs and the macroscopic world. This review is focused on crystal phase NWQDs based on III-V NWs obtained by the bottom-up vapor-liquid-solid (VLS) method and their optical and electronic properties. Crystal phase switching can be achieved in the axial direction. In contrast, in the core/shell growth, the difference in surface energies between different polytypes can enable selective shell growth. One reason for the very intense research in this field is motivated by their excellent optical and electronic properties both appealing for applications in nanophotonics and quantum technologies.

17.
Cir Esp (Engl Ed) ; 101(8): 548-554, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36265775

ABSTRACT

INTRODUCTION: Pelvic fractures due to high energy trauma present a high risk of associated injuries that compromise the functional and vital prognosis of the patients. The objective of this study was to analyze the relationship between traumatic pelvic fractures and their associated injuries according to the Tile classification. METHODS: Retrospective observational study of patients who suffered traumatic pelvic fractures (Type A, B or C of the Tile classification) with concomitant associated injuries, analyzing hemoglobin levels, between 6/2013 and 1/2016. RESULTS: A total of 42 patients were included; of those 69% (n = 29) were males, mean age was 48 years. 45% (n = 19) suffered traffic accidents and 26.2% (n = 11) falls. There was a different proportion in pelvic injuries: Tile A (n = 15, 35.7%), B (n = 20, 47.6%), and C (n = 7, 16.6%) of cases. 54.8% (n = 23) underwent surgery, 21.4% (n = 9) needed temporary or definitive external fixation. Significant differences were found between Tile A type and scapula fractures (P = .032), and Tile B with sacral fractures (P = .033) and visceral injuries (P = .049), while there is a tendency without a statistical significal between Tile C and costal fractures. 61.9% (n = 26) needed blood transfusion; 9.5% (n = 4) presented hypovolemic shock. CONCLUSIONS: Tile A pelvic fractures were associated with scapular fractures, and Tile B with transforaminal fractures of the sacrum and with visceral injuries (lungs, liver and genitourinary). The small number of Tile C prevent us to confirm an association with any pathology, although they are the ones which presnt more hemodynamically instability and thoracic injuries.


Subject(s)
Fractures, Bone , Pelvic Bones , Male , Humans , Middle Aged , Female , Fractures, Bone/epidemiology , Fractures, Bone/complications , Pelvic Bones/injuries , Sacrum , Pelvis , Prognosis
18.
Front Immunol ; 14: 1280580, 2023.
Article in English | MEDLINE | ID: mdl-38292483

ABSTRACT

Introduction: Loss of B-cell aplasia (BCA) is a well-known marker of functional loss of CD19 CAR-T. Most relapses and loss of BCA occur in the first months after CD19 CAR-T infusion. In addition, high tumor burden (HTB) has shown to have a strong impact on relapse, especially in CD19-negative. However, little is known about the impact of late loss of BCA or the relationship between BCA and pre-infusion tumor burden in patients infused with tisagenlecleucel for relapsed/refractory B-cell acute lymphoblastic leukemia. Therefore, the optimal management of patients with loss of BCA is yet to be defined. Methods: We conducted a Spanish, multicentre, retrospective study in patients infused with tisagenlecleucel after marketing authorization. A total of 73 consecutively treated patients were evaluated. Results: Prior to infusion, 39 patients had HTB (≥ 5% bone marrow blasts) whereas 34 had a low tumor burden (LTB) (<5% blasts). Complete remission was achieved in 90.4% of patients, of whom 59% relapsed. HTB was associated with inferior outcomes, with a 12-month EFS of 19.3% compared to 67.2% in patients with LTB (p<0.001) with a median follow-up of 13.5 months (95% CI 12.4 - 16.2). In the HTB subgroup relapses were mainly CD19-negative (72%) whereas in the LTB subgroup they were mainly CD19-positive (71%) (p=0.017). In the LTB group, all CD19-positive relapses were preceded by loss of BCA whereas only 57% (4/7) of HTB patients experienced CD19-positive relapse. We found a positive correlation between loss of BCA and CD19-positive relapse (R-squared: 74) which persisted beyond six months post-infusion. We also explored B-cell recovery over time using two different definitions of loss of BCA and found a few discrepancies. Interestingly, transient immature B-cell recovery followed by BCA was observed in two pediatric patients. In conclusion, HTB has an unfavorable impact on EFS and allo-SCT might be considered in all patients with HTB, regardless of BCA. In patients with LTB, loss of BCA preceded all CD19-positive relapses. CD19-positive relapse was also frequent in patients who lost BCA beyond six months post-infusion. Therefore, these patients are still at significant risk for relapse and close MRD monitoring and/or therapeutic interventions should be considered.


Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma , Receptors, Antigen, T-Cell , Receptors, Chimeric Antigen , Salicylates , Humans , Child , Young Adult , Receptors, Chimeric Antigen/therapeutic use , Retrospective Studies , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Recurrence , T-Lymphocytes , Cost of Illness
20.
Sensors (Basel) ; 22(23)2022 Nov 26.
Article in English | MEDLINE | ID: mdl-36501909

ABSTRACT

Within this paper, a PLC system that takes advantage of the loop resonance of an entire DC-PV string configured as a circular signal path is developed and implemented. Low cost and extremely simple transceivers intended to be installed within each PV module of a string have been designed and successfully tested. In addition, an anti-saturation coil has been conceived to avoid saturation of the core when the entire DC current of the string flows through it. Bi-directional half-duplex communication was successfully executed with up to a 1 MHz carrier frequency (150 kbps bitrate), using a simple ASK modulation scheme. The transmission and reception performance are presented, along with the overall system cost in comparison to the previous literature.


Subject(s)
Communication , Equipment Design
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