Regulation of CO2 by the sea in areas around Latin America in a context of climate change.

Anthropogenic activities are increasing the atmospheric carbon dioxide (CO2); around a third of the CO2 emitted by these activities has been taken up by the ocean. Nevertheless, this marine ecosystem service of regulation remains largely invisible to society, and not enough is known about regional differences and trends in sea-air CO2 fluxes (FCO2), especially in the Southern Hemisphere. The objectives of this work were as follows: first to put values of FCO2 integrated over the exclusive economic zones (EEZ) of five Latin-American countries (Argentina, Brazil, Mexico, Peru, and Venezuela) into perspective regarding total country-level greenhouse gases (GHG) emissions. Second, to assess the variability of two main biological factors affecting FCO2 at marine ecological time series (METS) in these areas. FCO2 over the EEZs were estimated using the NEMO model, and GHG emissions were taken from reports to the UN Framework Convention on Climate Change. For each METS, the variability in phytoplankton biomass (indexed by chlorophyll-a concentration, Chla) and abundance of different cell sizes (phy-size) were analyzed at two time periods (2000-2015 and 2007-2015). Estimates of FCO2 at the analyzed EEZs showed high variability among each other and non-negligible values in the context of greenhouse gas emissions. The trends observed at the METS indicated, in some cases, an increase in Chla (e.g., EPEA-Argentina) and a decrease in others (e.g., IMARPE-Peru). Evidence of increasing populations of small size-phytoplankton was observed (e.g., EPEA-Argentina, Ensenada-Mexico), which would affect the carbon export to the deep ocean. These results highlight the relevance of ocean health and its ecosystem service of regulation when discussing carbon net emissions and budgets.

Distribution of segmental chromosomal alterations in neuroblastoma.

BACKGROUND: Neuroblastoma (NB) is a heterogeneous tumor with extremely diverse prognosis according to clinical and genetic factors such as specific combinations of chromosomal imbalances. METHODS: Molecular karyotyping data from a national neuroblastic tumor database of 155 NB samples were analyzed and related to clinical data. RESULTS: Segmental chromosomal alterations (SCA) were detected in 102 NB, whereas 45 only displayed numerical alterations. Incidence of SCA was higher in stage M (92%) and MYCN amplified (MNA) NB (96%). Presence of SCA was associated with older age, especially 1q gain and 3p deletion. 96% of the deaths were observed in the SCA group and 85% of the relapsed NB contained SCA. The alteration most commonly associated with a higher number of other segmental rearrangements was 11q deletion, followed by 4p deletion. Whole-chromosome 19 gain was associated with lower stages, absence of SCA and better outcome. CONCLUSIONS: SCA are not randomly distributed and are concentrated on recurrent chromosomes. The most frequently affected chromosomes identify prognostic factors in specific risk groups. SCA are associated with older age and MNA. We have identified a small subset of patients with better outcome that share whole-chromosome 19 numeric gain, suggesting its use as a prognostic biomarker in NB.

Precision medicine in Ewing sarcoma: a translational point of view.

Ewing sarcoma is a rare tumor that arises in bones of children and teenagers but, in 15% of the patients it is presented as a primary soft tissue tumor. Balanced reciprocal chimeric translocation t(11;22)(q24;q12), which encodes an oncogenic protein fusion (EWSR1/FLI1), is the most generalized and characteristic molecular event. Using conventional treatments, (chemotherapy, surgery and radiotherapy) long-term overall survival rate is 30% for patients with disseminated disease and 65-75% for patients with localized tumors. Urgent new effective drug development is a challenge. This review summarizes the preclinical and clinical investigational knowledge about prognostic and targetable biomarkers in Ewing sarcoma, finally suggesting a workflow for precision medicine committees.

Li-Fraumeni syndrome heterogeneity.

Clinical variability is commonly seen in Li-Fraumeni syndrome. Phenotypic heterogeneity is present among different families affected by the same pathogenic variant in TP53 gene and among members of the same family. However, causes of this huge clinical spectrum have not been studied in depth. TP53 type mutation, polymorphic variants in TP53 gene or in TP53-related genes, copy number variations in particular regions, and/or epigenetic deregulation of TP53 expression might be responsible for clinical heterogeneity. In this review, recent advances in the understanding of genetic and epigenetic aspects influencing Li-Fraumeni phenotype are discussed.

Metastatic neuroblastoma in infants: are survival rates excellent only within the stringent framework of clinical trials?

INTRODUCTION: SIOPEN INES protocol yielded excellent 5-year survival rates for MYCN-non-amplified metastatic neuroblastoma. Patients deemed ineligible due to lack or delay of MYCN status or late registration were treated, but not included in the study. Our goal was to analyse survival at 10 years among the whole population. MATERIALS AND METHODS: Italian and Spanish metastatic INES patients' data are reported. SPSS 20.0 was used for statistical analysis. RESULTS: Among 98 infants, 27 had events and 19 died, while 79 were disease free. Five- and 10-year event-free survival (EFS) were 73 and 70 %, and overall survival (OS) was 81 and 74 %, respectively. MYCN status was significant for EFS, but not for OS in multivariate analysis. CONCLUSIONS: The survival rates of patients who complied with all the inclusion criteria for INES trials are higher compared to those that included also not registered patients. Five-year EFS and OS for INES 99.2 were 87.8 and 95.7 %, while our stage 4s population obtained 78 and 87 %. Concerning 99.3, 5-year EFS and OS were 86.7 and 95.6 %, while for stage 4 we registered 61 and 68 %. MYCN amplification had a strong impact on prognosis and therefore we consider it unacceptable that many patients were not studied for MYCN and probably inadequately treated. Ten-year survival rates were shown to decrease: EFS from 73 to 70 % and OS from 81 to 74 %, indicating a risk of late events, particularly in stage 4s. Population-based registries like European ENCCA WP 11-task 11 will possibly clarify these data.

Paediatric tumour boards in Spain: a national survey.

PURPOSE: Multidisciplinary tumour boards (MDTs) are conducted worldwide for the management of patients with cancer, and they deliver a higher standard of care by simultaneously involving different specialists in diagnosis and treatment planning. However, information of paediatric MDTs functioning is scarce. A pilot study was conducted in Spain in the frame of the European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment (ExPO-r-Net). METHODS: A specific questionnaire was designed regarding various features of MDT practice. Data collected included information on the centres and the team, infrastructure for meetings, MDT organization/logistics and clinical decision-making. The survey was distributed to all Paediatric Oncology Units that register patients in the Spanish Registry of Childhood Tumours (RETI-SEHOP). RESULTS: 32 out of 43 contacted centres responded the questionnaire (74 % response rate; 88 % response rate for centres with >25 new patients/year). All units with >25 new patients/year have a dedicated Paediatric MDT compared to 76 % of units with ≤25 new patients/year. MDTs should be improved at institutional level by clear protected time in service planning for all specialists involved, incentives for attendance and attendance registration. Clinical decision-making process and follow-up of recommendation adherence should be assessed and potential legal responsibilities for physicians participating in Tumour Board defined. Network collaboration through virtual MDTs, using available videoconferencing tools, is an opportunity to share expertise among centres.

Genotypic Diversity of Streptococcus mutans in Caries-Free and Caries-Active Preschool Children.

Aim. The aim of the present paper was to evaluate the genotypic diversity of S. mutans in caries-free and caries-active preschool children in Brazil. Design. Twenty-eight preschool children were examined regarding caries experience by the dmft index. DNA from 280 isolates of S. mutans was extracted. S. mutans evaluated using to the PCR method, with primers for the glucosyltransferase gene. The genetic diversity of S. mutans isolates was analyzed by arbitrary primed-PCR (AP-PCR) reactions. The differences between the diversity genotypic and dmft/caries experience were evaluated by chi2 test and Spearman's correlation. Results. The Spearman correlation test showed a strong association between genotypic diversity and caries experience (r = 0.72; P < .001). There were more S. mutans genotypes in the group of preschool children with dental caries, compared with the caries-free group. Among the children with more than 1 genotype, 13 had dental caries (2 to 5 genotypes) and 4 were caries-free (only 2 genotypes). Conclusion. Our results support the previous findings of genetic diversity of S. mutans in preschool children being associated with dental caries. The investigation of such populations may be important for directing the development of programs for caries prevention worldwide.

Resultados de la aplicación de una investigación operacional en el servicio de ginecología del hospital nacional "Guillermo Almenara Irigoyen" / Results of the application of an operational research at the gynaecology service of the Guillermo Almenara Irigoyen National hospital

Se da a conocer los resultados de una Investigación Operacional que aplicó un Modelo Administrativo (Pre operatorio un día-Alta Precoz) en el Servicio de Ginecología del Hospital Nacional Guilermo Almenara Irigoyen, a partir de enero de 1993, con el fin de solucionar el "embalse de pacientes" en espera de turno operatorio y mejorar los indicadores que miden el aprovechamiento de los recursos hospitalarios que hasta esa fecha se encontraban muy por encima de los estándares establecidos por la administración hospitalaria moderna. Se cumplieron 2 objetivos: El Normativo,-provando que esta nueva forma de prestación de servicios resultó beneficiosa, al solucionar los problemas observados- y el Programático.- al cambiar el funcionamiento del programa existente, mediante la identificación de maneras más eficientes y eficaces de emplear los recursos- Debido al éxito obtenido, el modelo ha quedado instituido en el Servicio y está sujeto a perfeccionarse. Su aplicación ha generado un evidente aunque no cuantificado ahorro a al Institución y podría tener buen impacto social de aplicarse en otros servicios quirúrgicos del IPSS.

Desarrollo en un producto alimenticio a base de arroz, para uso infantil / Development on an infant food product based on rice

Se desarrolló un producto alimenticio deshidratado para niños a base de arroz, complementado con soya y frutas para mejorar sus características nutricionales y organolépticas. El proceso consistió en la precocción de los ingredientes y un secado posterior en un deshidratador de tambores. Se obtuvo así un producto final en forma de hojuelas, con un contenido de humedad de 2 a 3%, el cual es de fácil rehidratación cuando se mezcla con un líquido como leche, agua o agua de panela. El panel de catación no detectó diferencia alguna entre las formulaciones con un contenido de soya de: 10, 15 y 20%, respectivamente

[Splenectomy in histiocytosis X]. / Esplenectomía en histiocitosis X.

Present concepts of histiocytosis X are reviewed and the results obtained in three patients that underwent splenectomy are described; postoperative survival is analyzed in order to evaluate the possible beneficial influence of splenectomy. One case corresponded to a female with a survival of nine years and another one a male with a survival of fifteen months; both received postoperative treatment with corticosteroids and are asymptomatic at the present time. The third case had an unfavorable evolution (he did not receive postoperative treatment). Even though present experience dose not alow to establish definitive conclusions, we must consider in the usefulness of splenectomy as a part of the treatment of histiocytosis X.