How we approach the treatment of patients with high-risk neuroblastoma with naxitamab: experience from the Hospital Sant Joan de Déu in Barcelona, Spain.

Naxitamab [humanized 3f8 (hu3F8)] is a humanized monoclonal antibody (mAb) targeting the disialoganglioside GD2. It was approved in 2020 by the United States Food and Drug Administration (FDA) in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) for treatment of pediatric and adult patients with relapsed/refractory high-risk neuroblastoma, limited to the bone or bone marrow (BM). The team at Sant Joan de Déu Children's Hospital in Barcelona, Spain, have been using naxitamab to treat neuroblastoma under clinical trial protocols [e.g. Trial 201, and hu3F8, irinotecan, temozolomide, and sargramostim (GM-CSF) (HITS) study] and compassionate use since 2017. The team has experience with two primary regimens: naxitamab with GM-CSF only, or naxitamab in combination with irinotecan, temozolomide, and GM-CSF (chemoimmunotherapy). This article aims to provide a practical overview of the team's experience with naxitamab to date, including preparing the treatment room and selecting the team. Adverse event management, including the use of ketamine to manage pain during anti-GD2 mAb infusions, is also discussed. We hope this will provide practical information for other health care providers considering offering this treatment.

Association between the sitting posture and back pain in college students / Asociación entre la postura en sentado y el dolor de espalda en estudiantes universitarios

Introduction: Back pain is a significant public health problem, its prevalence among college students is high, 30 - 70%; Its association with the sitting position in workers has been reported, but its study in university populations is limited. Objective: To evaluate the association between sitting posture with back pain among college students. Methods: Cross-sectional study. Explanatory variables: sociodemographic characteristics, adequate lighting in the classroom, sitting posture and type of chair. Outcome variables: neck or back pain the day of the survey, acute and chronic. Log-binomial regression models estimated prevalence ratios (PR) and their 95% CI. Results: 516 students from health deparment, age 21.3 ± 2.6 years, 69.2% women, 29,5% were in third year; 72,8% belong to middle socioeconomical level (3 and 4); and 18,4% of the students had an additional working activity. 87,8% of the classrooms had adequate lighting. Sitting posture with rounded back, feet supported on another chair and crossed legs was associated with neck pain the day of the survey (PR: 2.84), acute (PR: 2.41) and chronic (PR: 4.13). Other sitting posture with rounded back and crossed leg was associated with back pain the day of the survey (PR: 1.81) and acute (PR: 2.0). The screen time at the computer was associated with the outcome variables (PR 1.01 - 2.08). Conclusion: The results support the implementation of policies and institutional projects in order to prevent and control the back pain in college students.

Introducción: El dolor de espalda es un problema importante de salud pública, su prevalencia en estudiantes universitarios está entre el 30 al 70%; su asociacion con la postura sentada en trabajadores ha sido reportada, pero en poblacion universitaria su estudio es limitado. Objetivo: Evaluar la asociación entre la postura en sentado con el dolor de espalda en estudiantes universitarios. Métodos: Estudio de corte transversal. Variables explicatorias: características sociodemográficas, iluminación del salón de clase, postura en sedente y tipo de silla. Variables de salida: dolor de cuello o espalda el día de la encuesta, agudo y crónico. Modelos de regresión log-binomial estimaron las razones de prevalencia (RP) y sus IC95%. Resultados: Participaron 516 estudiantes de la facultad de salud, edad 21,3±2,6 años, 69,2% mujeres, 29,5% estaban en tercer año; y el 72,8% pertenecía a los estratos socioeconómicos 3 y 4, con un 18,4% de los estudiantes, que además de estudiar desarrollaban actividades laborales. El 87,8% de los salones de clase presentan iluminación adecuada. La postura en sedente con espalda redondeada, pies en otra superficie y pierna cruzada se asoció con dolor de cuello el día de la encuesta (RP: 2,84), agudo (RP: 2,41) y crónico (RP: 4,13). Otra postura sentada con espalda redondeada y una pierna cruzada se asoció con dolor de espalda el día de la encuesta (RP: 1,81) y agudo (RP: 2,0). El tiempo en computador se asoció con las variables de salida (RP 1.01 - 2,08). Conclusión: Los resultados apoyan la implementación de políticas y proyectos institucionales dirigidos a prevenir y controlar el dolor de espalda en universitarios.

Pielonefritis xantogranulomatosa: conceptos actuales en el diagnóstico y tratamiento / Xanthogranulomatous pyelonephritis: current concepts of diagnosis and treatment

Introducción: La Pielonefritis Xantogranulomatosa (PNF XG) es una patología de baja prevalencia, frecuentemente asociada a litiasis y destrucción del parénquima renal. Dada la gran masificación de la tomografía axial computada su diagnóstico y manejo es cada vez más precoz disminuyendo así la morbi-mortalidad perioperatoria. Objetivos: Describir la experiencia de nuestro servicio en PNF XG y realizar un análisis de la literatura sobre los conceptos actuales en el diagnóstico y tratamiento de esta patología. Materiales y métodos: Análisis retrospectivo de todas la nefrectomías totales realizadas en nuestro servicio entre los años 2000 y 2007. Se incluyeron sólo las piezas con el diagnóstico histológico de PNF XG. Resultados: Se encontraron 11 casos con el diagnóstico histológico de PNF XG. La edad promedio de presentación fue de 54 años con una leve tendencia al sexo femenino. En todos los pacientes se encontró una historia actual o reciente de litiasis urinaria. En todos los casos se realizó un estudio imagenológico preoperatorio, siendo 9 de ellos estudiados con TAC de abdomen y encontrándose la presencia de litiasis en 7 pacientes. Todos los pacientes fueron manejados mediante una nefrectomía total por lumbotomía, sin registrarse mortalidad. Conclusiones: La PNF XG constituye un desafío en sí misma. A pesar de ser una patología rara y de difícil diagnóstico, una cuidadosa evaluación preoperatoria y alto índice de sospecha, pueden ayudarnos a realizar un diagnóstico oportuno y realizar el manejo más adecuado, disminuyendo así las complicaciones perioperatorias.

Introduction: Xanthogranulomatous pyelonephritis (XG PNF) is a low prevalence disease, often associated with lithiasis and renal parenchymal destruction. The wide availability of tomographic (CT) diagnosis allows for frequent early management decreasing perioperative morbidity and mortality. We describe the experience at our institution in XG PNF and perform an analysis of the literature onthe current concepts in diagnosis and treatment of this condition. Materials and methods: Retrospective analysis of all nephrectomies performed at our department between 2000 and 2007. Only surgical specimens with histological diagnosis of XG PNF were included. Results: We found 11 cases with histologic diagnosis of XG PNF. Average age of presentation was 54 years with a slight tendency towards females. All patients had a current or recent history of urolithiasis. In all cases a preoperative imaging study was made, 9 of them were studied with abdominal CT scan and found the presence of stones in 7 patients. All patients were treated by an open total nephrectomy without mortality. Conclusions: The XG PNF is a challenge in itself. Despite being infrequent and difficult to diagnosis, a careful preoperative evaluation and a high index of suspicion can help to make an early diagnosis and management, thus reducing perioperative complications.

Pattern and process in Amazon tree turnover, 1976-2001.

Previous work has shown that tree turnover, tree biomass and large liana densities have increased in mature tropical forest plots in the late twentieth century. These results point to a concerted shift in forest ecological processes that may already be having significant impacts on terrestrial carbon stocks, fluxes and biodiversity. However, the findings have proved controversial, partly because a rather limited number of permanent plots have been monitored for rather short periods. The aim of this paper is to characterize regional-scale patterns of 'tree turnover' (the rate with which trees die and recruit into a population) by using improved datasets now available for Amazonia that span the past 25 years. Specifically, we assess whether concerted changes in turnover are occurring, and if so whether they are general throughout the Amazon or restricted to one region or environmental zone. In addition, we ask whether they are driven by changes in recruitment, mortality or both. We find that: (i) trees 10 cm or more in diameter recruit and die twice as fast on the richer soils of southern and western Amazonia than on the poorer soils of eastern and central Amazonia; (ii) turnover rates have increased throughout Amazonia over the past two decades; (iii) mortality and recruitment rates have both increased significantly in every region and environmental zone, with the exception of mortality in eastern Amazonia; (iv) recruitment rates have consistently exceeded mortality rates; (v) absolute increases in recruitment and mortality rates are greatest in western Amazonian sites; and (vi) mortality appears to be lagging recruitment at regional scales. These spatial patterns and temporal trends are not caused by obvious artefacts in the data or the analyses. The trends cannot be directly driven by a mortality driver (such as increased drought or fragmentation-related death) because the biomass in these forests has simultaneously increased. Our findings therefore indicate that long-acting and widespread environmental changes are stimulating the growth and productivity of Amazon forests.

Endothermy by flowers of Rhizanthes lowii (Rafflesiaceae).

Rhizanthes lowii (Beccari) Harms (Rafflesia- ceae) is a parasitic plant that grows in the understory of the rainforest in South-East Asia. This plant does not have leaves, stems, or photosynthetic tissue and is characterised by the emission of a strong odour that attracts the natural pollinators, carrion flies. Flowers that volatilise odorous compounds and attract carrion flies, beetles and other insects are often thermogenic. Here we present evidence of both thermogenesis and thermoregulation in R. lowii from microclimate and tissue temperatures measured during different stages of flower development in R. lowii, in natural conditions in Brunei, Borneo. Endothermy was detected in young and mature buds as well as in blooming flowers and even in decaying tissues 3 or more days after blooming. Tissue temperatures were maintained at 7-9 K above air temperature, in both female and male flowers, at all stages of floral development.

Hydraulic architecture and water relations of a flood-tolerant tropical tree, Annona glabra.

Hydraulic architecture parameters, water relation parameters and wood anatomy were studied in roots and shoots of the flood-tolerant tree Annona glabra L. on Barro Colorado Island, Panama. Hydraulic conductivity, leaf specific conductivity, and Huber value were similar to the corresponding values for tree species living in non-flooded habitats. The vulnerability of stems to loss of hydraulic conductivity resulting from embolism was low (50% loss of conductivity at -3.3 MPa). The lowest leaf water potential measured in the field was about -1.0 MPa, indicating that A. glabra has a large margin of safety from embolism, which may provide protection against rare drought events, or may be an adaptation to brackish mangrove habitats. Low absolute conductivity of roots was compensated for by an increase in the number of roots. More than two-thirds of whole-plant resistance to water flow was located in the roots.

Vulnerability to drought-induced cavitation of riparian cottonwoods in Alberta: a possible factor in the decline of the ecosystem?

Vulnerability of xylem to loss of hydraulic conductivity caused by drought-induced cavitation was determined for three riparian cottonwood species in Lethbridge, Alberta: Populus deltoides Bartr., P. balsamifera L., and P. angustifolia James. These species suffered 50% loss of hydraulic conductivity in one-year-old stem segments when xylem pressure potential fell to -0.7 MPa for P. deltoides and -1.7 MPa for P. balsamifera and P. angustifolia, making them the three most vulnerable tree species reported so far in North America. The possible contribution of drought-induced xylem dysfunction to the decline of riparian ecosystems in dammed rivers is discussed.

Physiological determinants of Ficus fruit temperature and implications for survival of pollinator wasp species: comparative physiology through an energy budget approach.

Figs are completely dependent for pollen dispersal on species-specific fig-pollinating wasps that develop within developing fig fruits. These wasps are very sensitive to heat and die at temperatures only a few degrees above ambient. Such temperatures are expected and observed in objects exposed to full sunlight, as fig fruits frequently are. In detailed field and experimental studies of 11 species of Panamanian figs with fruit ranging in size from 5 mm to 50 mm in diameter, we found that both the relative and absolute contribution of transpiration to maintaining non-lethal fruit temperatures increased with fruit size. Small and large fruits reached temperatures of 3 and 8°C, respectively, above air temperature in full sunlight when transpiration was prevented by grease. The temperature reached by large, nontranspiring fruits was sufficient to kill their pollinators. Control fruits which transpired reached temperatures of 2-3°C above air temperature in sunlight, regardless of size. An analysis of the solar energy budget of fruit revealed that large fruits must transpire to maintain tolerable temperatures for the wasps because heat diffusion from fruit to air was too low to balance net radiation in sunlight. By contrast, small fruits do not need to transpire to maintain tolerable temperatures for the pollinators.