Repeated pancreatic resection for pancreatic metastases from renal cell Carcinoma: A Spanish multicenter study (PANMEKID).

BACKGROUND AND OBJECTIVES: Recurrent isolated pancreatic metastasis from Renal Cell Carcinoma (RCC) after pancreatic resection is rare. The purpose of our study is to describe a series of cases of relapse of pancreatic metastasis from renal cancer in the pancreatic remnant and its surgical treatment with a repeated pancreatic resection, and to analyse the results of both overall and disease-free survival. METHODS: Multicenter retrospective study of patients undergoing pancreatic resection for RCC pancreatic metastases, from January 2010 to May 2020. Patients were grouped into two groups depending on whether they received a single pancreatic resection (SPS) or iterative pancreatic resection. Data on short and long-term outcome after pancreatic resection were collected. RESULTS: The study included 131 pancreatic resections performed in 116 patients. Thus, iterative pancreatic surgery (IPS) was performed in 15 patients. The mean length of time between the first pancreatic surgery and the second was 48.9 months (95 % CI: 22.2-56.9). There were no differences in the rate of postoperative complications. The DFS rates at 1, 3 and 5 years were 86 %, 78 % and 78 % vs 75 %, 50 % and 37 % in the IPS and SPS group respectively (p = 0.179). OS rates at 1, 3, 5 and 7 years were 100 %, 100 %, 100 % and 75 % in the IPS group vs 95 %, 85 %, 80 % and 68 % in the SPS group (p = 0.895). CONCLUSION: Repeated pancreatic resection in case of relapse of pancreatic metastasis of RCC in the pancreatic remnant is justified, since it achieves OS results similar to those obtained after the first resection.

A yeast-based high-throughput screen identifies inhibitors of trypanosomatid HRG heme transporters with potent leishmanicidal and trypanocidal activity.

OBJECTIVES: New drugs are required to treat neglected diseases caused by trypanosomatid parasites such as Leishmania, Trypanosoma brucei and Trypanosoma cruzi. An Achilles' heel of these parasites is their heme auxotrophy; they have an absolute dependence on scavenging this molecule from the host, and trypanosomatid HRG heme transporters (TrypHRG) play an important role in this process. As these proteins are essential for the parasites and have low similarity with their human orthologue, they have been proposed as attractive therapeutic targets. Here, we have developed two yeast-based assays that allow an inexpensive high-throughput screening of TrypHRG inhibitors within a cellular context. METHODS: We first assessed that Leishmania major, Leishmania donovani and T. brucei HRG proteins were heterologously expressed in the digestive vacuole membrane of a mutant heme auxotrophic yeast strain. Here, TrypHRG imports hemoglobinderived heme into the cytosol, allowing mutant yeast to grow in the presence of low hemoglobin concentrations and promoting the activity of hemeproteins such as catalase, which was used as a reporter of cytosolic heme levels. RESULTS: In the presence of a TrypHRG inhibitor, both catalase activity (test 1) and yeast growth (test 2) were diminished, being easily monitored. The assays were then tested on a pilot scale for HTS purposes using a collection of repurposing drugs and food antioxidants. Some of the TrypHRG inhibitors identified in yeast presented strong trypanocidal and leishmanicidal activity in the submicromolar range, proving the potential of this approach. CONCLUSIONS: Cumulatively, it was shown that the inhibition bioassays developed were robust and applicable to large-scale HTS.

In Vitro and In Silico Antiviral Activity of Di-Halogenated Compounds Derived from L-Tyrosine against Human Immunodeficiency Virus 1 (HIV-1).

HIV-1 infection is considered one of the major public health problems worldwide. Due to the limited access to antiretroviral therapy, the associated side effects, and the resistance that the virus can generate, it has become necessary to continue the development of new antiviral agents. The study aimed to identify potential antiviral agents for HIV-1 by evaluating the in vitro and in silico activity of 16 synthetic di-halogenated compounds derived from L-Tyrosine. The compounds were tested for cytotoxicity, which was determined using MTT, and a combined antiviral screening strategy (pre- and post-infection treatment) was performed against R5 and X4 strains of HIV-1. The most promising compounds were evaluated against a pseudotyped virus (HIV-GFP-VSV-G), and the effectiveness of these compounds was measured through GFP flow cytometry. Also, the antiviral effect of these compounds was evaluated in PBMCs using flow cytometry and ELISA for p24. The TODB-2M, TODC-2M, TODC-3M, and YDC-3M compounds showed low toxicity and significant inhibitory activity against HIV-1. In silico docking and molecular dynamics assays suggest that the compounds' antiviral activity may be due to interaction with reverse transcriptase, viral protease, or envelope gp120.

Influence of the tumor site and histopathology after resection for non-colorectal non-neuroendocrine liver metastases. A single center experience / Influencia del origen e histopatología tumoral tras la resección de metástasis hepáticas de origen no colorrectal no neuroendocrino. Experiencia unicéntrica

Introduction: It remains unclear whether liver resection is justified in patients with non-colorectal non-neuroendocrine liver metastases (NCNNLM). A single-center study was conducted to analyse overall survival (OS), disease-free survival (DFS), and potential prognostic factors in patients with different types of NCNNLM. Method: A retrospective analysis of all patients who underwent liver resection of NCNNLM from January 2006 to July 2019 was performed. Results: A total of 62 patients were analyzed. 82.3% presented metachronous metastases and 74.2% were unilobar. The most frequent primary tumor site (PTS) were breast (24.2%), urinary tract (19.4%), melanoma (12.9%), and pancreas (9.7%). The most frequent primary tumor pathologies were breast carcinoma (24.2%), non-breast adenocarcinoma (21%), melanoma (12.9%) and sarcoma (12.9%). The most frequent surgical procedure performed was minor hepatectomy (72.6%). R0 resection was achieved in 79.5% of cases. The major complications’ rate was 9.7% with a 90-day mortality rate of 1.6%. The 1, 3 and 5-year OS/DFS rate were 65%/28%, 45%/36% and 46%/28%, respectively. We identified the response to neoadjuvant therapy and PTS as possible prognostic factors for OS (P =0.06) and DFS (P =0.06) respectively. Conclusion: Based on the results of our series, NCNNLM resection produces beneficial outcomes in terms of OS and DFS. PTS and the response to neoadjuvant therapy could be the main prognostic factors after resection. (AU)

Introducción: No está totalmente aclarado si la resección hepática está justificada en pacientes con metástasis hepáticas no colorrectales no neuroendocrinas (MHNCNN). Hemos realizado un estudio en un solo centro para analizar la supervivencia global (SG), la supervivencia libre de enfermedad (SLE) y posibles factores pronósticos en pacientes con diferentes tipos de MHNCNN. Método: Se realizó un análisis retrospectivo de todos los pacientes que se sometieron a resección hepática de MHNCNN desde enero de 2006 hasta julio de 2019. Resultados: Se analizaron un total de 62 pacientes. El 82,3% presentó metástasis metacrónicas y el 74,2% fueron unilobares. El sitio original del tumor primario (STP) más frecuente fue mama (24,2%), tracto urinario (19,4%), melanoma (12,9%) y páncreas (9,7%). Las histopatologías tumorales primarias más frecuentes fueron el carcinoma de mama (24,2%), el adenocarcinoma no mamario (21%), el melanoma (12,9%) y el sarcoma (12,9%). El procedimiento quirúrgico realizado con mayor frecuencia fue la hepatectomía menor (72,6%). La resección R0 se logró en el 79,5% de los casos. La tasa de complicaciones mayores fue del 9,7% con una tasa de mortalidad a los 90 días del 1,6%. La tasa de SG / SLE a 1, 3 y 5 años fue de 65% / 28%, 45% / 36% y 46% / 28%, respectivamente. Identificamos la respuesta a la terapia neoadyuvante y el STP como posibles factores pronósticos de SG (p = 0,06) y SLE (p = 0,06) respectivamente. Conclusión: Según los resultados de nuestra serie, la resección de MHNCNN produce resultados beneficiosos en términos de SG y SLE. El STP y la respuesta a la terapia neoadyuvante podrían ser los principales factores pronósticos tras la resección. (AU)

Testing field adaptation strategies for delaying grape ripening and improving wine composition in a cv. Macabeo Mediterranean vineyard.

Under semiarid and warm climates, field practices for climate change adaptation have to be defined in order to modulate grape composition according to the desired wine styles. Under this context, the present study investigated several viticulture practices in cv. Macabeo for Cava production. The experiment was carried out over 3 years in a commercial vineyard located in the province of Valencia (eastern Spain). The techniques tested were (i) vine shading, (ii) double pruning (bud forcing), and (iii) the combined application of soil organic mulching and shading, all of them tested against a control. Double pruning significantly modified phenology and grape composition, improving the wine alcohol-to-acidity ratio and reducing the pH. Similar results were also achieved by shading. However, the shading strategy did not significantly affect yield, unlike double pruning, which reduced vine yield even in the year following its application. Shading alone or in combination with mulching significantly improved the vine water status, suggesting that these techniques can also be used to alleviate water stress. Particularly, we found that the effect of soil organic mulching and canopy shading on stem water potential was additive. Indeed, all the techniques tested were useful for improving wine composition for cava production, but double pruning is only recommended for premium Cava production.

Influence of the tumor site and histopathology after resection for non-colorectal non-neuroendocrine liver metastases. A single center experience.

INTRODUCTION: It remains unclear whether liver resection is justified in patients with non-colorectal non-neuroendocrine liver metastases (NCNNLM). A single-center study was conducted to analyse overall survival (OS), disease-free survival (DFS), and potential prognostic factors in patients with different types of NCNNLM. METHOD: A retrospective analysis of all patients who underwent liver resection of NCNNLM from January 2006 to July 2019 was performed. RESULTS: A total of 62 patients were analyzed. 82.3% presented metachronous metastases and 74.2% were unilobar. The most frequent primary tumor site (PTS) were breast (24.2%), urinary tract (19.4%), melanoma (12.9%), and pancreas (9.7%). The most frequent primary tumor pathologies were breast carcinoma (24.2%), non-breast adenocarcinoma (21%), melanoma (12.9%) and sarcoma (12.9%). The most frequent surgical procedure performed was minor hepatectomy (72.6%). R0 resection was achieved in 79.5% of cases. The major complications' rate was 9.7% with a 90-day mortality rate of 1.6%. The 1, 3 and 5-year OS/DFS rate were 65%/28%, 45%/36% and 46%/28%, respectively. We identified the response to neoadjuvant therapy and PTS as possible prognostic factors for OS (P =0.06) and DFS (P =0.06) respectively. CONCLUSION: Based on the results of our series, NCNNLM resection produces beneficial outcomes in terms of OS and DFS. PTS and the response to neoadjuvant therapy could be the main prognostic factors after resection.

Programmed acoustic tags reveal novel information on late-phase marine life in Atlantic salmon, Salmo salar.

This pilot study used programmed acoustic tags implanted into Salmo salar smolts, in conjunction with an extensive offshore marine receiver array, to investigate late-stage migratory behaviour and survival of returning adult salmon. A total of 100 smolts were tagged in 2020, and a number of individuals were successfully detected as returning adults in 2021. After detection efficiency was accounted for, 5-9 adults were estimated to have returned to the offshore array c. 45 km from the river mouth. A total of three fish were subsequently detected in the river. Losses of between 40% and 66% were evident during the final stages of ocean migration, and one tagged fish provided direct evidence of a predation event.

Textbook outcome in the surgical treatment of liver hydatid cyst.

BACKGROUND: Textbook outcome is a composite measure used in surgery to define the ideal postoperative period and to assess the quality of care. The aim of this study was to analyze the incidence of textbook outcome and the factors independently associated with its achievement following surgical treatment of liver hydatid cysts. METHODS: Retrospective cohort study of patients operated on for liver hydatid cysts between January 2006 and December 2021. Textbook outcome was achieved when all the following criteria were fulfilled: no mortality within 90 days, no major complications within 90 days, no hospital readmission within 90 days, and no prolonged hospital stay. Univariable and multivariable analyses were performed to identify factors associated with textbook outcome. RESULTS: During the study period, 296 patients underwent surgery. Textbook outcome was recorded in 65.9% (195/296). Female gender (odds ratio 2.02; P = .010), noncomplicated cyst (odds ratio 3.97, P < .001), and radical surgery (odds ratio 2.26, P = .003) were the variables associated with a higher probability of achieving textbook outcome. CONCLUSION: Textbook outcome may be a useful measure to assess the variations in surgical management between different centers, and to improve quality of care after liver hydatid cysts resection.

Dependencia a los dispositivos móviles: revisión sistemática en Latinoamérica y Cuba durante la última década / Dependence on mobile devices: systematic review in Latin America and Cuba during the last decade

Introducción: la adicción a los dispositivos móviles se caracteriza por la dependencia patológica hacia estos, puede llegar a ocasionar ansiedad, estrés, baja competencia social y dificultades en la concentración. Resulta de suma importancia la revisión teórica de los principales resultados sobre el tema como punto de partida para la elaboración de estrategias de desarrollo. Objetivo: realizar una revisión sistemática de las principales investigaciones relacionadas con la adicción a los dispositivos móviles en Latinoamérica y particularmente, en Cuba. Métodos: se realizó una revisión sistemática para analizar los principales resultados en Latinoamérica y Cuba, se consideraron artículos originales publicados entre 2012 y 2022. Fueron utilizadas las pautas de revisiones sistemáticas PRISMA. Tras la identificación de los estudios en las bases de datos consultadas se realizó la lectura del título, resumen y contenido para determinar su relación con los objetivos del estudio. Desarrollo: se constató que existen pocos estudios en materia de adicciones a los dispositivos móviles en el contexto latinoamericano y cubano; las investigaciones muestran el impacto negativo sobre la salud mental de quienes padecen esta adicción, se destaca su influencia negativa en estudiantes universitarios, así como la validación de instrumentos que permitirán profundizar en esta temática. Conclusiones: se destaca la calidad de los estudios y la validez de los resultados científicos y se sugiere emplearlos como base para el desarrollo de proyectos de carácter terapéutico.

Background: addiction to mobile devices is characterized by pathological dependence on them, it can cause anxiety, stress, low social competence, and difficulties in concentration. The theoretical review of the main results on the subject is extremely important as a starting point for the elaboration of development strategies. Objective: to carry out a systematic review of the main investigations related to addiction to mobile devices in Latin America and particularly, in Cuba. Methods: a systematic review was carried out to echnol the main results in Latin America and Cuba, original articles published from 2012 to 2022 were considered. PRISMA systematic review guidelines were used. After identifying the studies in the consulted databases, the title, abstract and content were read to determine their relationship with the objectives of the study. Development: it was found that there are few studies on addictions to mobile devices in the Latin American and Cuban context; Research shows the negative impact on the mental health of those who suffer from this addiction, its negative influence on university students stands out, as well as the validation of instruments that will allow us to delve into this subject. Conclusions: the quality of the studies and the validity of the scientific results stand out and it is suggested to use them as a basis for the development of projects of a therapeutic nature.

Retraction: Rendon-Marin et al. Canine Morbillivirus from Colombian Lineage Exhibits In Silico and In Vitro Potential to Infect Human Cells. Pathogens 2021, 10, 1199.

The authors retract the article "Canine Morbillivirus from Colombian Lineage Exhibits In Silico and In Vitro Potential to Infect Human Cells" [...].

Resection of isolated pancreatic metastases from pulmonary neoplasia: a systematic review.

Several types of cancers have been reported to metastasize to the pancreas. Lung cancer with isolated pancreatic metastasis is extremely rare. In selected patients, surgery is advocated. The aim of our study is to carry out a systematic review of the articles published on the surgical treatment of these patients. Our goal was to realize a systematic review in accordance with PRISMA guidelines. We conducted a literature search using MEDLINE (PubMed), EMBASE and SCOPUS databases to identify all studies published from 1967 to 2020 reporting patients with pancreatic resection for metastatic lung cancer to the pancreas. The data of the articles finally selected were represented in tables. The median age of included patients was calculated as well as the median survival. The proportion of patients was calculated according to sex, type of surgery performed and location of the lesion. 3150 articles were included at the beginning. After the screening process, 20 articles were selected for the systematic review. These articles reported data on 23 patients. Presentation was mainly metachronous, with a disease-free interval of 10 (0-54) months. Of these patients, 43.5% were symptomatic at diagnosis and 34.8% had extrapancreatic metastases. Mean overall survival was 17.65 (± 14.56) months. Based in this review, there is limited evidence on the treatment due to the small number of published articles, most of them being case report. Surgical resection of pancreatic metastases from lung cancer could be a safe procedure and it could improve survival rates in selected patients.

Adenosquamous cancer of the pancreas: A multicenter retrospective study / Cancer adenoescamoso de pancreas. Estudio retrospectivo multicéntrico

Introduction: Adenosquamous cancer of the pancreas (ASCP) is an aggressive, infrequent subtype of pancreatic cancer that combines a glandular and squamous component and is associated with poor survival. Methods: Multicenter retrospective observational study carried out at three Spanish hospitals. The study period was: January 2010–August 2020. A descriptive analysis of the data was performed, as well as an analysis of global and disease-free survival using the Kaplan–Meier statistic. Results: Of a total of 668 pancreatic cancers treated surgically, twelve were ASCP (1.8%). Patient mean age was 69.2±7.4 years. Male/female ratio was 1:1. The main symptom was jaundice (seven patients). Correct preoperative diagnosis was obtained in only two patients. Nine pancreatoduodenectomies and three distal pancreatosplenectomies were performed. 25% had major complications. Mean tumor size was 48.6±19.4mm. Nine patients received adjuvant chemotherapy. Median survival time was 5.9 months, and median disease-free survival was 4.6 months. 90% of patients presented recurrence. Ten of the twelve patients in the study (83.3%) died, with disease progression being the cause in eight. Of the two surviving patients, one is disease-free and the other has liver metastases. Conclusion: ASCP is a very rare pancreatic tumor with aggressive behavior. It is rarely diagnosed preoperatively. The best treatment, if feasible, is surgery followed by the standard chemotherapy regimens for pancreatic adenocarcinoma.(AU)

Introducción: El cáncer adenoescamoso de páncreas (CPAS) es un subtipo de cáncer de páncreas agresivo e infrecuente que combina un componente glandular y escamoso, y presenta baja supervivencia. Métodos: Estudio observacional retrospectivo multicéntrico realizado en tres hospitales españoles. El período de estudio fue: enero 2010 - agosto 2020. Se realizó un análisis descriptivo de los datos, así como un análisis de supervivencia global y libre de enfermedad mediante Kaplan-Meier. Resultados: De un total de 668 cánceres de páncreas tratados quirúrgicamente, doce fueron CPAS (1,8%). La edad media de los pacientes fue de 69,2±7,4 años. La proporción hombre /mujer fue de 1: 1. El síntoma principal fue la ictericia (siete pacientes). Se obtuvo un diagnóstico preoperatorio correcto en solo dos pacientes. Se realizaron nueve duodenopancretectomías cefálicas y tres pancreatoesplenectomías distales. El 25% tuvo complicaciones mayores. El tamaño medio del tumor fue de 48,6±19,4mm. Nueve pacientes recibieron quimioterapia adyuvante. La mediana de supervivencia fue de 5,9 meses y la mediana de supervivencia libre de enfermedad fue de 4,6 meses. El 90% de los pacientes presentó recidiva. Diez de los doce pacientes del estudio (83,3%) fallecieron, y la progresión de la enfermedad fue la causa en ocho. De los dos pacientes que sobrevivieron, uno está libre de enfermedad y el otro tiene metástasis hepáticas. Conclusión:El CPAS es un tumor pancreático muy raro y de comportamiento agresivo. Rara vez se diagnostica antes de la operación. El mejor tratamiento, si es posible, es la cirugía seguida de los regímenes de quimioterapia estándar para el adenocarcinoma de páncreas.(AU)

A comparison of the behaviour and survival of angling vs. trap-sampled Salmo salar smolts.

An experiment was undertaken, using acoustic telemetry, to compare the survival and migratory timing of Salmo salar L. smolts sampled, under optimal conditions, in a traditional fixed Wolf trap against a sample of rod-caught fish captured using a sensitive angling technique. No significant difference was evident in survival with 83% of both samples detected in the river outflow, 67% of the trap and 76% of the rod samples were detected in coastal waters and finally 43% of the trap and 35% of the rod samples were detected on an offshore array c. 50 km from the river outlet. No significant difference was evident in the time taken for trap- and rod-sampled fish to reach either the river outflow, coastal or offshore waters. Angling, if undertaken sensitively, can provide an effective, resource-efficient and ethically justifiable sampling tool for juvenile salmonid age classes.

Surgical treatment of liver hydatid cyst in elderly patients: A propensity score-matching retrospective cohort study.

BACKGROUND: Cystic echinococcosis is a clinically complex chronic parasitic disease and a major socioeconomic problem in endemic areas. The safety of liver resection in elderly patients is often debated among medical professionals. We analyzed the postoperative morbidity and mortality rates of elderly patients who underwent surgery at our unit. METHODS: We retrospectively evaluated patients with liver hydatid cysts which were surgically removed at our unit. Patients were divided into two groups: Group 1 (patients < 70 years), and Group 2 (patients ≥ 70 years). Propensity score matching (PSM) and comparative analyses between groups were performed. RESULTS: The unmatched cohort consisted of 279 patients (Group 1: 244; Group 2: 35). After PSM, we compared the outcomes for 56 patients from Group 1 to 31 patients from Group 2. A higher rate of severe complications was observed in Group 2 (25.8% vs 5.36%, p = 0.014). No difference was found in the rates of infectious, cardiorespiratory, or hemorrhagic complications between both groups, and in the mortality rate either (0.00% vs 6.45%, p = 0.124). CONCLUSIONS: Liver surgery in selected elderly patients is safe and practicable. The low postoperative morbidity rate in these patients is acceptable, albeit higher, due to their comorbidities.

Prognostic value of pre-operative systemic immune-inflammation index and platelet to lymphocyte ratio in peritoneal carcinomatosis of ovarian origin.

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate the impact of systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) on the survival outcomes of patients who underwent to cytoreductive surgery (CRS) and HIPEC for ovarian peritoneal carcinomatosis. METHODS: A retrospective analysis of 68 cases following surgery at our department between 2015 and 2020 was performed. Receiver Operating Characteristic (ROC) curve was used with Youden index to calculate the optimal cutoff values for SII, PLR and NLR. RESULTS: Univariate analysis revealed that high preoperative values of SII, PLR and NLR were correlated with worse overall survival (OS) and disease-free survival (DFS) in these patients. In the multivariable analysis, high SII was recognized as an independent prognostic factor for OS (CI 95%: 0.002- 3.835, p = 0.097) and high PLR was recognized as an independent prognostic factor for DFS (CI 95%: 0.253-2.248, p = 0.007). CONCLUSION: SII and PLR could be useful prognostic tools to predict outcomes of patients who underwent to CRS and HIPEC for ovarian peritoneal carcinomatosis.

Pancreatic metastases from renal cell carcinoma. Postoperative outcome after surgical treatment in a Spanish multicenter study (PANMEKID).

BACKGROUND: Renal Cell Carcinoma (RCC) occasionally spreads to the pancreas. The purpose of our study is to evaluate the short and long-term results of a multicenter series in order to determine the effect of surgical treatment on the prognosis of these patients. METHODS: Multicenter retrospective study of patients undergoing surgery for RCC pancreatic metastases, from January 2010 to May 2020. Variables related to the primary tumor, demographics, clinical characteristics of metastasis, location in the pancreas, type of pancreatic resection performed and data on short and long-term evolution after pancreatic resection were collected. RESULTS: The study included 116 patients. The mean time between nephrectomy and pancreatic metastases' resection was 87.35 months (ICR: 1.51-332.55). Distal pancreatectomy was the most performed technique employed (50 %). Postoperative morbidity was observed in 60.9 % of cases (Clavien-Dindo greater than IIIa in 14 %). The median follow-up time was 43 months (13-78). Overall survival (OS) rates at 1, 3, and 5 years were 96 %, 88 %, and 83 %, respectively. The disease-free survival (DFS) rate at 1, 3, and 5 years was 73 %, 49 %, and 35 %, respectively. Significant prognostic factors of relapse were a disease free interval of less than 10 years (2.05 [1.13-3.72], p 0.02) and a history of previous extrapancreatic metastasis (2.44 [1.22-4.86], p 0.01). CONCLUSIONS: Pancreatic resection if metastatic RCC is found in the pancreas is warranted to achieve higher overall survival and disease-free survival, even if extrapancreatic metastases were previously removed. The existence of intrapancreatic multifocal compromise does not always warrant the performance of a total pancreatectomy in order to improve survival.

Adenosquamous cancer of the pancreas: A multicenter retrospective study.

INTRODUCTION: Adenosquamous cancer of the pancreas (ASCP) is an aggressive, infrequent subtype of pancreatic cancer that combines a glandular and squamous component and is associated with poor survival. METHODS: Multicenter retrospective observational study carried out at three Spanish hospitals. The study period was: January 2010-August 2020. A descriptive analysis of the data was performed, as well as an analysis of global and disease-free survival using the Kaplan-Meier statistic. RESULTS: Of a total of 668 pancreatic cancers treated surgically, twelve were ASCP (1.8%). Patient mean age was 69.2±7.4 years. Male/female ratio was 1:1. The main symptom was jaundice (seven patients). Correct preoperative diagnosis was obtained in only two patients. Nine pancreatoduodenectomies and three distal pancreatosplenectomies were performed. 25% had major complications. Mean tumor size was 48.6±19.4mm. Nine patients received adjuvant chemotherapy. Median survival time was 5.9 months, and median disease-free survival was 4.6 months. 90% of patients presented recurrence. Ten of the twelve patients in the study (83.3%) died, with disease progression being the cause in eight. Of the two surviving patients, one is disease-free and the other has liver metastases. CONCLUSION: ASCP is a very rare pancreatic tumor with aggressive behavior. It is rarely diagnosed preoperatively. The best treatment, if feasible, is surgery followed by the standard chemotherapy regimens for pancreatic adenocarcinoma.

Prediction of potential cysteine synthase inhibitors of Leishmania braziliensis and Leishmania major parasites by computational screening.

Leishmaniasis is a neglected tropical disease considered a public health problem that requires innovative strategies for its chemotherapeutic control. In the present investigation, a molecular docking approach was carried out using the protein cysteine synthase (CS) of Leishmania braziliensis (CSLb) and Leishmania major (CSLm) parasites to identify new compounds as potential candidates for the development of selective leishmaniasis therapy. CS protein sequence similarity, active site, structural modeling, molecular docking, and ADMET properties of compounds were analyzed using bioinformatics tools. Molecular docking analyses identified 1000 ligands with highly promising binding affinity scores for both CS proteins. A total of 182 compounds for CSLb and 173 for CSLm were selected for more detailed characterization based on the binding energy and frequency values and ADMET properties. Based on Principal Component Analysis (PCA) and K-means clusterization for both CS proteins, we classified compounds into 5 clusters for CSLb and 7 for CSLm, thus providing an excellent starting point for verification of enzyme inhibition in in vitro studies. We found the ZINC16524774 compound predicted to have a high affinity and stability for both CSLb and CSLm proteins, which was also evaluated through molecular dynamics simulations. Compounds within each of the five clusters also displayed pharmacological and structural properties that make them attractive drug candidates for the development of selective cutaneous leishmaniasis chemotherapy.

Implementación de un centro de referencia regional en cirugía pancreática. Experiencia tras 631 procedimientos / Implementation of a regional reference center in pancreatic surgery. Experience after 631 procedures

Introducción: El objetivo principal de este estudio es determinar si la Unidad de Cirugía Hepato-Bilio-Pancreática y Trasplante Hepático del Hospital Universitario de Badajoz cumple los estándares de calidad exigidos por la comunidad científica a los centros de referencia de cirugía pancreática (CP) en términos de resultados perioperatorios. Los objetivos secundarios consisten en comparar las diferentes técnicas de CP realizadas en función de la morbimortalidad postoperatoria precoz y analizar el impacto de las resecciones extendidas en dichos términos. Método: Estudio descriptivo, retrospectivo y unicéntrico, correspondiente al periodo 2006-2019. Se compararon los resultados obtenidos con los estándares de calidad propuestos por Bassi et al. y Sabater et al., exigidos a los centros de referencia en cirugía pancreática. La muestra se dividió según técnica quirúrgica y se compararon en términos de morbimortalidad postoperatoria precoz, estudiando el impacto de las resecciones vasculares y viscerales extendidas. Se incluyeron todos los pacientes sometidos a cirugía pancreática en nuestra unidad por patología pancreática, maligna y benigna, desde que ésta se implementó como centro de referencia. Se excluyeron las realizadas de urgencia. Resultados: Se analizaron 631 pacientes. Los valores obtenidos en los estándares de calidad se encuentran en rango. La cirugía más frecuente fue duodenopancreatectomía cefálica, la cual asoció mayor tasa de morbimortalidad perioperatoria (p ≤ 0,05). Las resecciones vasculares añadidas impactaron en el grupo de duodenopancreatectomía cefálica asociando mayor estancia media (p = 0,01) y mayor tasa de reintervención (p = 0,02). Conclusiones: La experiencia acumulada permite cumplir con los estándares de calidad exigidos, así como realizar resecciones extendidas a la pancreatectomía con buenos resultados en términos de morbimortalidad postoperatoria. (AU)

Introduction: The main objective of this study is to determine if our unit meets the quality standards required by the scientific community from the reference centers for pancreatic surgery in terms of peri-operative results. The secondary objectives are to compare the different pancreatic surgery techniques performed in terms of early post-operative morbidity and mortality and to analyze the impact of the resections added in these terms. Method: Descriptive, retrospective and single-center study, corresponding to the period 2006-2019. The results obtained were compared with the proposed quality standards, by Bassi et al. and Sabater et al., required from the reference centers in pancreatic surgery. The sample was divided according to surgical technique and compared in terms of early post-operative morbidity and mortality, studying the impact of extended vascular and visceral resections. All patients undergoing pancreatic surgery in our unit due to pancreatic, malignant and benign pathology were included, since it was implemented as a reference center. Emergency procedures were excluded. Results: 631 patients were analyzed. The values ??obtained in the quality standards are in range. The most frequent surgery was cephalic duodenopancreatectomy, which associated higher peri-operative morbidity and mortality rates (p ≤ 0.05). The extended vascular resections impacted the cephalic duodenopancreatectomy group, associating a longer mean stay (p = 0.01) and a higher rate of re-interventions (p = 0.02). Conclusions: The experience accumulated allows to meet the required quality standards, as well as perform extended resections to pancreatectomy with good results in terms of post-operative morbi-mortality.

Implementation of a regional reference center in pancreatic surgery. Experience after 631 procedures.

INTRODUCTION: The main objective of this study is to determine whether our unit meets the quality standards required by the scientific community from the reference centers for pancreatic surgery in terms of peri-operative results. The secondary objectives are to compare the different pancreatic surgery techniques performed in terms of early post-operative morbidity and mortality and to analyze the impact of the resections added in these terms. METHOD: Descriptive, retrospective and single-center study, corresponding to the period 2006-2019. The results obtained were compared with the proposed quality standards, by Bassi et al. and Sabater et al., required from the reference centers in pancreatic surgery. The sample was divided according to surgical technique and compared in terms of early post-operative morbidity and mortality, studying the impact of extended vascular and visceral resections. All patients undergoing pancreatic surgery in our unit due to pancreatic, malignant and benign pathology were included, since it was implemented as a reference center. Emergency procedures were excluded. RESULTS: 631 patients were analyzed. The values ​​obtained in the quality standards are in range. The most frequent surgery was pancreaticoduodenectomy, which associated higher peri-operative morbidity and mortality rates (P ≤ .05). The extended vascular resections impacted the pancreaticoduodenectomy group, associating a longer mean stay (P = .01) and a higher rate of re-interventions (P = .02). CONCLUSIONS: The experience accumulated allows to meet the required quality standards, as well as perform extended resections to pancreatectomy with good results in terms of post-operative morbidity and mortality.