Establishing a molecular laboratory in COVID-19 pandemic: The experience of a regional laboratory in Spain.

The high demand for COVID-19 diagnosis overwhelmed reference hospitals. Regional laboratories had to incorporate molecular technology to respond to the emergency. This work described the implementation of molecular diagnostic tools and the detection of SARS-CoV-2, in a regional hospital with no previous experience, from October 2020 to March 2022. The laboratory structure was significantly modified. The staff grew from 3 to 4 clinical microbiologists, and from 7 to 17 laboratory technicians to provide 24/7 coverage. A total of 144,442 samples were processed during the period of study. The highest peaks were reached in July 2021 with 25,285 samples processed, and between December 2021 and January 2022, with 32,245. COVID-19 pandemic has represented not only the challenge, but the opportunity to introduce Nucleic Acid Amplification Techniques (NAAT) in inexperienced laboratories. These secondary settings have shown an extraordinary ability to adapt and cannot be left behind in the progress of diagnostic techniques.

Early Clinical Experience with Trifluridine/Tipiracil for Refractory Metastatic Colorectal Cancer: The ROS Study.

Trifluridine/tipiracil is currently approved for metastatic colorectal cancer (mCRC) refractory to available therapies. However, there is no consensus on factors that predict treatment outcomes in daily practice. We assessed the early clinical experience with trifluridine/tipiracil in Spain and potential survival markers. This was a retrospective cohort study of mCRC patients who participated in the trifluridine/tipiracil early clinical experience programme in Spain. The primary outcome was overall survival (OS). Associations between OS and patient characteristics were assessed using multivariate Cox regression analyses. A total of 379 patients were included in the study. Trifluridine/tipiracil was administered for a median of 3.0 cycles and discontinued mainly due to disease progression (79.2%). The median OS was 7.9 months, with a 12-month OS rate of 30.5%. Cox analyses revealed that the following variables independently enhanced OS: ≤2 metastatic sites, no liver metastasis, alkaline phosphatase < 300 IU, trifluridine/tipiracil dose reductions, and neutrophil/lymphocyte ratio < 5. Grade ≥ 3 toxicities were reported in 141 (37.2%) patients, including mainly afebrile neutropaenia (23.2%), anaemia (12.1%), and thrombocytopaenia (5.3%). This study supports the real-life efficacy and safety of trifluridine/tipiracil for refractory mCRC and identifies tumour burden, liver metastasis, alkaline phosphatase, dose reductions, and neutrophil/lymphocyte ratio as survival markers.

Initial Biomechanical Properties of Transtibial Meniscal Root Repair are Improved By Using a Knotless Anchor as a Post-Insertion Tensioning Device.

The importance of meniscal root integrity to preserve contact load distribution and stability at the knee joint is recognised. Transosseous suture technique is commonly used to repair meniscal root tears. However, clinical results are not completely satisfactory. Specifically, concern exists about the development of substantial displacements at the repaired root. This study aims to assess if the use of a post-insertion tensioning knotless-anchor at the distal exit of the tibial tunnel improves time-zero biomechanical properties of the transtibial repair compared to knotting sutures over a cortical button. Twenty porcine tibia with detached posterior medial meniscal roots were randomized into two groups depending on the method to fix the sutures after root repair: knotless-anchor (KA) or suture-button (SB). Specimens underwent cyclic and load-to-failure testing. Group KA showed significantly smaller residual root displacements after low-level repetitive loads. At the load-to-failure test, Group KA exhibited significantly lower displacements at representative subcritical loads and higher resistance to development of clinically relevant displacements. The authors conclude that use of a knotless suture anchor attached at the distal outlet of the bone tunnel may be an effective solution to reduce root displacements in transtibial meniscal root repairs, a matter reported to alter biomechanics of joint contact.

Fibromialgia. Avances en su tratamiento / Fibromyalgia. Advances in its treatment

Introducción: resulta de notable significación el hecho de enfatizar en la difusión de los avances en el tratamiento de la fibromialgia, ya que en décadas precedentes, ha ido alcanzando cada vez mayor magnitud hasta devenir hoy en una problemática de salud pública de atención prioritaria. Objetivo: reportar los avances en el tratamiento de la fibromialgia. Desarrollo: diversos factores pueden exponer esta situación: la elevada incidencia de la fibromialgia en la población general adulta; el escaso conocimiento de su origen y los componentes que la causan; así como el no hallazgo de tratamiento curativo, la inconformidad de los casos y los profesionales en el tratamiento actual del síndrome. Conclusiones: no existen evidencias de que el tratamiento farmacológico de la fibromialgia resulte más efectivo que el no farmacológico, de ahí la notable importancia de estudios como el presente(AU)

Introduction: it is of remarkable significance to emphasize the diffusion of advances in the treatment of fibromyalgia, since in previous decades, it has been reaching ever greater magnitude until becoming today a priority public health problem. Objective: To report the advances in the treatment of fibromyalgia. Development : Several factors can expose this situation: the high incidence of fibromyalgia in the general adult population; the limited knowledge of its origin and the components that cause it; as well as the non-discovery of curative treatment, the nonconformity of cases and professionals in the current treatment of the syndrome. Conclusions: There is no evidence that the pharmacological treatment of fibromyalgia is more effective than the non-pharmacological treatment, hence the remarkable importance of studies such as the present one(AU)

Histopathology and ultrastructure of rabbit retina after intravitreous injection of perfluorohexyloctane (F6H8).

PURPOSE: To describe changes in rabbit retina after intravitreous injection of perfluorohexyloctane (F6H8). METHODS: Intravitreous injections of C3F8 were performed in the right eye of 48 male New Zealand albino rabbits. All 48 eyes were injected with C3F8. The animals were divided in three groups of 18 each. 18 eyes (6 in each group) were used as controls and 30 (10 in each group) were further injected with F6H8. Animals were sacrificed at days 15, 30, and 60 and the eyes processed for light and electron microscopy and immunohistochemistry. RESULTS: Vitreous tracts were observed behind the lens in all groups. Epiretinal and retrolental membranes developed in most of the treated eyes. Light microscopy showed retinal vacuolization in all eyes. No significant ultrastructural changes appeared in any of them. Macrophages were observed in the inner limiting membrane. CONCLUSIONS: Ultrastructural findings can be considered signs of good tolerance to F6H8, though the appearance of epiretinal membranes associated with the presence of macrophagic response suggests we should refrain from using F6H8 until results from clinical trials are available.

Capecitabine as first-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study.

PURPOSE: To determine the tolerability of capecitabine in elderly patients with advanced colorectal cancer (CRC). PATIENTS AND METHODS: Fifty-one patients with advanced CRC who were >/= 70 years and considered ineligible for combination chemotherapy received oral capecitabine 1,250 mg/m(2) twice daily on days 1 to 14 every 3 weeks. Patients with a creatinine clearance of 30 to 50 mL/min received a dose of 950 mg/m(2) twice daily. RESULTS: A total of 248 cycles of capecitabine were administered (median, five cycles; range, one to eight cycles). The overall response rate was 24% (95% CI, 15% to 41%), including two complete responses (CR; 4%) and 10 partial responses (PR; 20%). Disease control (CR + PR + stable disease) was achieved in 67% of patients. The median times to disease progression and overall survival were 7 months (95% CI, 6.4 to 9.5 months) and 11 months (95% CI, 8.6 to 13.3 months), respectively. Of the 35 patients evaluated for clinical benefit response, 14 (40%; 95% CI, 24% to 58%) showed clinical benefit. Capecitabine was well tolerated. Treatment-related grade 3 and 4 adverse events were observed in only six patients (12%), and the most common events were diarrhea, hand-foot syndrome, and thrombocytopenia. One patient (2%) had an episode of angina, but no treatment-related deaths were reported. CONCLUSION: Our findings suggest that capecitabine is effective and well tolerated in elderly patients with advanced CRC who are considered ineligible for combination chemotherapy.