The influence of age, period, and cohort factors on the incidence of kidney cancer in Spain 1990-2019: Evidence from the global burden of disease study.

OBJECTIVE: This study aimed to assess the influence of age, period, and cohort (A-P-C) factors on kidney cancer (KC) incidence trends in Spain from 1990 to 2019. METHODS: Employing data from the Global Burden of Disease Study 2019, we employed joinpoint analysis to determine long-term patterns and A-P-C modelling to quantify net drift, local drift, longitudinal age curves, and rate ratios (RRs) of period and cohort effects. RESULTS: Over the period 1990-2019, an estimated 142,811 cases of KC were diagnosed in Spain. A consistent upward trend in KC incidence was observed for both men and women, with the male-to-female ratio remaining stable at 2.6. Joinpoint analysis identified three distinct periods for men: An initial period (1990-1995) characterised by a significant increase in rates, a subsequent period (1995-2016) characterised by a slowdown in the rate of increase, and a final period (2016-2019) in which rates have plateaued. In women, 2 time periods were observed: an initial period (1990-2007) in which rates increased significantly, followed by a period of stabilization (2007-2019). Men born in the early-mid 20th century had a rising KC risk, peaking in the 1960s. Women's risk rose steadily, peaking in the late 1990s. CONCLUSION: A-P-C analysis reveals steady KC incidence increase in both genders over three decades. This highlights the need for targeted public health policies and effective prevention strategies.

Tendencias de la mortalidad por cáncer de vejiga en España, 1980-2021 / Bladder cancer mortality trends in Spain: 1980-2021

Objetivo Nos proponemos actualizar las tasas de mortalidad por cáncer de vejiga en España de 1980 a 2021, estandarizadas por sexo, grupo de edad y comunidades autónomas (CC. AA.). Materiales y métodos Se utilizaron las bases de datos públicas en línea del Instituto Nacional de Estadística para obtener datos sobre población y mortalidad por cáncer de vejiga. Se calcularon las tasas de mortalidad estandarizadas por edad (TMEE) para todas las edades y las truncadas (<75 y ≥75 años) y se presentaron como tasas por cada 100.000 personas. Se utilizó el modelo de regresión Joinpoint para el cálculo y análisis de las tendencias de las TMEE por cáncer de vejiga. Resultados En la última década, las TMEE por cáncer de vejiga (todas las edades,<75 años y ≥75 años) disminuyeron significativamente en España para ambos sexos. Esta tendencia se observó en 12 CC. AA. para los hombres y en 4 CC. AA. (Andalucía, Canarias, Cataluña y Madrid) para las mujeres, aunque en proporciones diferentes. Para los hombres, la TMEE permaneció estable en Castilla-León y La Rioja (<75 años), Cantabria, Castilla-La Mancha y Valencia (≥75 años) y las 2 regiones castellanas (todas las edades). En el caso de las mujeres, las TMEE también disminuyeron en Valencia (<75 y ≥75), Castilla-León (≥75), Galicia (≥75 y todas las edades) y Navarra (<75 y todas las edades). Conclusión Nuestros resultados revelan variaciones significativas en las tendencias por CC. AA., sexo y grupo de edad, enfatizando la necesidad de un seguimiento continuado e intervenciones específicas para reducir aún más las tasas de mortalidad por cáncer de vejiga en España (AU)

Objective We propose to update bladder cancer mortality rates in Spain from 1980 to 2021, by sex and age-group, by autonomous community (AC). Materials and methods The public online databases of the National Statistical Institute were used to obtain data on population and bladder cancer mortality. Age-standardised mortality rates (ASMRs), all ages and truncated (<75 and ≥75) were estimated and reported as rates per 100,000 persons. Joinpoint regression software was used for estimation and trend analysis of ASMRs bladder cancer. Results In the last decade, the ASMR for bladder cancer (all ages,<75 years and ≥75 years) decreased significantly in Spain for both sexes. This trend was observed in 12 ACs for men and in 4 ACs (Andalusia, Canary Islands, Catalonia and Madrid) for women, although to different degrees. For men, ASMR remained stable in Castilla-León and La Rioja (<75 years), Cantabria, Castilla-La Mancha and Valencia (≥75years) and the 2 Castilian regions (all ages). For women, ASMR also decreased in Valencia (<75 and ≥75), Castilla-León (≥75), Galicia (≥75 and all ages) and Navarre (<75 and all ages). Conclusion Our results reveal significant variations in trends by AC, sex and age group, emphasizing the need for continued follow-up and targeted interventions to further reduce bladder cancer mortality rates in Spain (AU)

Bladder cancer mortality trends in Spain: 1980-2021.

OBJECTIVE: We propose to update bladder cancer mortality rates in Spain from 1980 to 2021, by sex and age-group, by autonomous community (AC). MATERIALS AND METHODS: The public online databases of the National Statistical Institute were used to obtain data on population and bladder cancer mortality. Age-standardised mortality rates (ASMRs), all ages and truncated (<75 and ≥75) were estimated and reported as rates per 100,000 persons. Joinpoint regression software was used for estimation and trend analysis of ASMRs bladder cancer. RESULTS: In the last decade, the ASMR for bladder cancer (all ages, <75 years and ≥75 years) decreased significantly in Spain for both sexes. This trend was observed in 12 ACs for men and in 4 ACs (Andalusia, Canary Islands, Catalonia and Madrid) for women, although to different degrees. For men, ASMR remained stable in Castilla-León and La Rioja (<75 years), Cantabria, Castilla-La Mancha and Valencia (≥75 years) and the 2 Castilian regions (all ages). For women, ASMR also decreased in Valencia (<75 and ≥75), Castilla-León (≥75), Galicia (≥75 and all ages) and Navarre (<75 and all ages). CONCLUSION: Our results reveal significant variations in trends by AC, sex and age group, emphasizing the need for continued follow-up and targeted interventions to further reduce bladder cancer mortality rates in Spain.

Hydrocarbon exposure effect on energetic metabolism and immune response in Crassostrea virginica.

Crassostrea virginica was exposed to different light crude oil levels to assess the effect on transcriptomic response and metabolic rate. The exposure time was 21 days, and levels of 100 and 200 µg/L were used, including a control. The most significant difference among treatments was the overexpression of several genes associated with energy production, reactive oxygen species (ROS) regulation, immune system response, and inflammatory response. Also, a hydrocarbon concentration-related pattern was identified in ROS regulation, with a gene expression ratio near 1.8:1 between 200 and 100 µg/L treatments. Statistical analysis showed no interaction effect for metabolic rate; however, significant differences were found for oil concentration and time factors, with a higher oxygen consumption at 200 µg/L. Our findings provide novel information about the metabolic response of C. virginica during hydrocarbons exposure. In addition, our results point out which biological processes should be investigated as targets for searching bioindicators.

A linear-polymer-based lactoferrin-selective recognition element for an ELISA mimic: A proof of concept.

The synthesis of polymers with tailored properties for the recognition of macromolecules such as proteins is challenging. In this work, the synthesis of a new polymer format, a linear polymer (LP), as the selective recognition element for the globular protein lactoferrin (LF) is proposed as a proof-of-concept study. For the synthesis, a solid-phase strategy using the reversible deactivation radical polymerisation (RDRP) mechanism is proposed. This approach, which is usually used in molecular imprinting, involves the immobilisation of LF on the surface of a solid support, but, unlike classical imprinting, a cross-linker in the polymerisation mixture is not required. Consequently, the copolymer is soluble and flexible, thus overcoming the drawbacks associated with traditional synthetic polymers for macromolecule imprinting. This new polymer format has great potential for replacing natural antibodies in bioassays such as enzyme-linked immunosorbent assays (ELISA), dot blot, western blot, or pull-down. In our case, the linear polymer was used as a recognition element to replace natural antibodies in a LF-selective ELISA. The responses of the linear polymer between LF concentrations of 0.1 nM and 0.25 µM were studied, and a significant difference was observed between the non-specific signals and the signals measured in the presence of the polymeric material. Further, the response versus log concentration curves were fitted to a logistic equation, allowing estimation of the EC50 value: 11.8 ± 1.4 nM. We also confirmed the selective detection of LF using the competitive inhibition of the selective LF-biotin conjugate (LF-Bi) binding to the plastic receptor (LP) for closely related proteins (e.g. those having similar molecular weights or isoelectric points) such as human lysozyme, trypsin, and albumin, which are present in human body fluids. The system presents a cross-reactivity value or selectivity of 1.95% for lysozyme, 0.028% for trypsin, and 0.016% for albumin. The applicability of this method for the determination of urine LF levels in inflammatory and infectious diseases of the human urinary tract is also demonstrated.

Tendencias recientes en cáncer de próstata en España / Recent trends in prostate cancer in Spain

OBJETIVO: Evaluar las tendencias recientes de incidencia, supervivencia y mortalidad por cáncer de próstata en España utilizando datos actualizados. Sujetos y método: Las defunciones por cáncer de próstata se han obtenido del Instituto Nacional de Estadística (INE). Los casos incidentes se han obtenido de las bases de datos Cancer incidence in five continents (CI5) y European Cancer Information System. Para el análisis de tendencias se usaron modelos de regresión joinpoint. En los resultados se muestran los años (período) que componen cada tendencia, así como el porcentaje de cambio anual (PCA) para cada una de ellas. La dirección y magnitud de las tendencias recientes (últimos 5 años disponibles) se evaluaron mediante los porcentajes de cambio anual medio (PCAM). RESULTADOS: Las tasas de incidencia aumentaron de forma significativa, pasando de 16,4 en 1980 a 61,3 en 2014. El análisis joinpoint muestra 3 períodos: 2 iniciales de incrementos significativos (1980-1990; 3,5% y 1990-2004; 8,4%) seguidos de uno final en el que las tasas se estabilizan (2004-2014; -0,5%, no significativo). Las tasas de mortalidad descienden pasando de 12,9 en 1980 a 7,9 en el año 2018, con un PCAM de -1,2% (p < 0,05). Sin embargo, el análisis joinpoint identificó 3 períodos de tiempo: un período inicial de aumento estadísticamente significativo (1980-1998; PCA: 0,6%, p < 0,05) y 2 períodos de disminución en las tasas (1992-2008; PCA: -3,3%, p < 0,05 y 2008-2018; PCA: -2,4%, p < 0,05). CONCLUSIÓN: Las tendencias recientes (últimos 5 años) muestran que las tasas de mortalidad han disminuido y que las tasas de incidencia se han estabilizado e incluso descendido en algunos grupos de edad

OBJECTIVE: To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data. Subjects and method: Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC). RESULTS: Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p < 0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p < 0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p < 0.05 and 2008-2018; APC: -2.4%, p < 0.05). CONCLUSION: Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups

Recent trends in prostate cancer in Spain. / Tendencias recientes en cáncer de próstata en España.

OBJECTIVE: To assess recent trends in prostate cancer incidence, survival and mortality in Spain using updated data. SUBJECTS AND METHOD: Prostate cancer mortality data have been obtained from the National Institute of Statistics (INE). Incidence cases have been obtained from the databases Cancer Incidence in Five Continents (CI5) and European Cancer Information System. Joinpoint regression models were used for trend analysis. The results show the duration (years) of each trend, as well as the Annual Percent Change (APC) for each of them. The direction and magnitude of recent trends (last 5 years available) were evaluated using the percentages of Average Annual Percent Change (AAPC). RESULTS: Incidence rates increased significantly from 16.4 in 1980 to 61.3 in 2014. The joinpoint analysis shows three periods: two initial periods of significant rise (1980-1990; 3.5% and 1990-2004; 8.4%) followed by a final one in which rates stabilize (2004-2014; -0.5%, non-significant). Mortality rates drop from 12.9 in 1980 to 7.9 in 2018, with an AAPC of -1.2% (p<0.05). However, the joinpoint analysis identified three time periods: an initial period of statistically significant rise (1980-1998; APC: 0.6%, p<0.05) and two periods of decreasing rates (1992-2008; APC: -3.3%, p<0.05 and 2008-2018; APC: -2.4%, p<0.05). CONCLUSION: Recent trends (last 5 years) show that mortality rates have decreased and incidence rates have stabilized or even decreased in some age groups.

Curva de aprendizaje en el manejo de los inhibidores de tirosina quinasa como primera línea de tratamiento en pacientes con cáncer renal metastásico / Learning curve for the management of tyrosine kinase inhibitors as the first line of treatment for patients with metastatic renal cancer

Objetivos: Analizar la curva de aprendizaje en el manejo de los inhibidores de la tirosina quinasa como primera línea en el tratamiento de los paciente con cáncer renal metastásico. Material y métodos: Evaluamos 32 pacientes consecutivos tratados en nuestro servicio de cáncer renal metastásico con inhibidores de la tirosina quinasa (pazopanib o sunitinib) en primera línea entre septiembre de 2012 y noviembre de 2015. Analizamos retrospectivamente dicha muestra. Medimos tiempo hasta retirada de primera línea, tiempo hasta progresión y supervivencia global mediante curvas de Kaplan Meier. La curva de aprendizaje fue analizada con "cumulative sum (CUSUM) methodology". Resultados: En nuestra serie la mediana hasta la retirada de primera línea fue de 11 meses (IC 95% 4,9-17,1). El tiempo medio hasta progresión 30,4 meses (IC 95% 22,7-38,1) y la media de la supervivencia global 34,9 meses (IC 95% 27,8-42). Al aplicar la metodología CUSUM obtenemos una gráfica para el valor CUSUM tiempo hasta retirada de la primera línea (CUSUM TR) observando 3 fases bien diferenciadas: fase 1 o fase de aprendizaje inicial (1-15), fase 2 (16-26) en el que se mejora progresivamente el manejo del fármaco y una tercera fase (27-32) de máxima experiencia o maestría en el manejo de estos fármacos. Estimamos en 15 el número necesario de pacientes tratados para conseguir el manejo adecuado de estos pacientes. Conclusiones: Pese a la limitación del tamaño muestral y el tiempo de seguimiento estimamos en 15 pacientes el número necesario para alcanzar el nivel de experiencia óptimo de madurez en el manejo con inhibidores de la tirosina quinasa de estos pacientes. No observamos relación entre el tiempo hasta retirada de primera línea por cualquier causa y la progresión

Objectives: To analyse the learning curve for the management of tyrosine kinase inhibitors as the first line of treatment for patients with metastatic renal cancer. Material and methods: We evaluated 32 consecutive patients treated in our department for metastatic renal cancer with tyrosine kinase inhibitors (pazopanib or sunitinib) as first-line treatment between September 2012 and November 2015. We retrospectively analysed this sample. We measured the time to the withdrawal of the first-line treatment, the time to progression and overall survival using Kaplan-Meier curves. The learning curve was analysed with the cumulative sum (CUSUM) methodology. Results: In our series, the median time to the withdrawal of the first-line treatment was 11 months (95% CI 4.9-17.1). The mean time to progression was 30.4 months (95% CI 22.7-38.1), and the mean overall survival was 34.9 months (95% CI 27.8-42). By applying the CUSUM methodology, we obtained a graph for the CUSUM value of the time to withdrawal of the first-line treatment (CUSUM TW), observing 3 well-differentiated phases: phase 1 or initial learning phase (1-15), phase 2 (16-26) in which the management of the drug progressively improved and phase 3 (27-32) of maximum experience or mastery of the management of these drugs. The number of treated patients needed to achieve the proper management of these patients was estimated at 15. Conclusions: Despite the limitations of the sample size and follow-up time, we estimated (in 15 patients) the number needed to reach the necessary experience in the management of these patients with tyrosine kinase inhibitors. We observed no relationship between the time to the withdrawal of the first-line treatment for any cause and progression

Low-dose-rate brachytherapy for prostate cancer in renal transplant recipients.

PURPOSE: Prostate cancer (PCa) is the most common malignancy among men and one of the most common neoplasms affecting renal transplant recipients (RTRs). The available treatments for localized PCa among the general population (GP), surgery and external beam radiotherapy, carry a risk of damage to the transplanted kidney, the ureters, and the bladder and therefore tend to be avoided by most groups. The objective of this study was to assess the efficacy and feasibility of low-dose-rate brachytherapy (LDR-BT) for PCa in RTRs. METHODS AND MATERIALS: We carried out a retrospective review on all RTRs diagnosed of PCa who had undergone LDR-BT at our institution between 2000 and 2015. Nine patients met these criteria, but 1 did not fulfill the followup. Hence, we analyzed 8 patients. We reviewed all clinical data for PCa and graft function in these patients and compared the results with the GP. RESULTS: Mean baseline prostate-specific antigen was 6.8 ± 1.9 ng/mL. All PCa had a Gleason score of 6 and were classified as low risk according the Europe Association of Urology guidelines. Mean followup after seed implantation was 48 ± 12.8 months. All 8 patients remain free of prostate-specific antigen failure. Five-year progression-free survival, cancer-specific survival, and overall survival rates were 100%, 100%, and 62.5%. There was no specific toxicity associated with LDR-BT, and there were no acute adverse events affecting the graft. CONCLUSIONS: LDR-BT is a feasible and acceptable treatment for localized PCa in RTRs. Oncological outcomes are similar to the GP, and there is minimal toxicity to the renal graft.

Learning curve for the management of tyrosine kinase inhibitors as the first line of treatment for patients with metastatic renal cancer. / Curva de aprendizaje en el manejo de los inhibidores de tirosina quinasa como primera línea de tratamiento en pacientes con cáncer renal metastásico.

OBJECTIVES: To analyse the learning curve for the management of tyrosine kinase inhibitors as the first line of treatment for patients with metastatic renal cancer. MATERIAL AND METHODS: We evaluated 32 consecutive patients treated in our department for metastatic renal cancer with tyrosine kinase inhibitors (pazopanib or sunitinib) as first-line treatment between September 2012 and November 2015. We retrospectively analysed this sample. We measured the time to the withdrawal of the first-line treatment, the time to progression and overall survival using Kaplan-Meier curves. The learning curve was analysed with the cumulative sum (CUSUM) methodology. RESULTS: In our series, the median time to the withdrawal of the first-line treatment was 11 months (95% CI 4.9-17.1). The mean time to progression was 30.4 months (95% CI 22.7-38.1), and the mean overall survival was 34.9 months (95% CI 27.8-42). By applying the CUSUM methodology, we obtained a graph for the CUSUM value of the time to withdrawal of the first-line treatment (CUSUM TW), observing 3 well-differentiated phases: phase 1 or initial learning phase (1-15), phase 2 (16-26) in which the management of the drug progressively improved and phase 3 (27-32) of maximum experience or mastery of the management of these drugs. The number of treated patients needed to achieve the proper management of these patients was estimated at 15. CONCLUSIONS: Despite the limitations of the sample size and follow-up time, we estimated (in 15 patients) the number needed to reach the necessary experience in the management of these patients with tyrosine kinase inhibitors. We observed no relationship between the time to the withdrawal of the first-line treatment for any cause and progression.

Prediabetes en estudiantes de 1er año del campus ciencias de la salud de una universidad Mexicana / Prediabetes in 1st year students of the health sciences campus from a Mexican university

Introducción. Dado el aumento dramático de diabetes en el mundo, el objetivo de esta investigación fue analizar los valores de la glucemia en una población universitaria de nuevo ingreso para sustentar estrategias de detección y manejo preventivo de prediabetes y diabetes. Métodos. Estudio observacional, analítico, transversal, no probabilístico. Se analizaron los valores de glucemia en ayunas de 367 estudiantes de nuevo ingreso en 2011, y 430 en 2016 al campus de Ciencias de la Salud de una universidad del sureste de México. Se aplicaron pruebas de tendencia central, comparaciones y proyecciones. Resultados. En la muestra de 2011 hubo prevalencia de 11 por ciento de mujeres y 12,4 por ciento de hombres con glucemia en valores de prediabetes. En la de 2016, hubo 30,3 por ciento de mujeres y 40 por ciento en prediabetes. Hubo diferencia de los promedios de glucemia entre ambas muestras de 5,4 mg/dL (0,3 mmol/L) en mujeres, t = - 4,582 (p = 0,0001) y 10,81 mg/dL (0,6 mmol/L) en hombres, t = - 6,428 (p = 0,0001). No se encontró correlación con masa corporal. Conclusiones. En la muestra de 2016 hubo incremento en la prevalencia de prediabetes y de adultos jóvenes en riesgo de desarrollar diabetes mellitus de tipo 2, por lo que es necesario desarrollar estrategias para mejorar el estilo de vida.(AU)

Introduction. Given the dramatic increase of diabetes in the world, the aim of this research was to analyze the values of blood glucose in a university population again income to support strategies for detection and preventive management of pre-diabetes and diabetes. Methods. Study observational, analytical, transverse, non-probability. The blood glucose values were analyzed in fasting of 367 freshmen students from move income in 2011 and 430 in 2016 to the campus of Health Sciences from a University in the Southeast of Mexico. Testing central tendency, comparisons and projections were applied. Results. In the sample of 2011 there was prevalence of 11 percent of women and 12.4 percent of men with blood glucose values of pre-diabetes. In the 2016 there were 30.3 percent of women and 40 percent in pre-diabetes. There was a difference of blood glucose averages among both samples of 5.4 mg/dL (0.3 mmol/L) in women, t = - 4.582 (p = 0.0001) and 10.81 mg/dL (0.6 mmol/L) in males, t = - 6.428 (p = 0.0001). Correlation with body mass was not found. C Conclusions. In the sample of 2016 there was increase in the prevalence of pre-diabetes and young adults at risk of developing type 2 diabetes mellitus by what is needed to develop strategies to improve lifestyle.(AU)

Cáncer de cuello uterino: una mirada integral con perspectiva de género / Cervical cancer: a comprehensive view from a gender perspective / O câncer cervical: um género comprehensive

Este artículo es una revisión de tema sobre cáncer de cuello uterino, con el fin de visibilizar la necesidad de un enfoque diferencial \r\ncon perspectiva de género y evidenciar que el contexto social, cultural y de desigualdad de las mujeres las hace más vulnerables \r\na este tipo de enfermedad. El enfoque biologicista ha limitado la mirada desde la morbilidad femenina diferencial y de esta forma \r\nha evitado poner de manifiesto cómo las mujeres, debido a su condición de género, tienen mayor probabilidad de enfermar y \r\ncómo la falta de autonomía sobre su cuerpo las pone en riesgo de sufrir esta clase de cáncer.\r\nEl texto plantea la importancia de realizar investigaciones sobre cáncer de cuello uterino para redefinir políticas públicas inclu\r\n-\r\nyentes con enfoque de género, que procuren cambios de paradigmas en la población, para generar transformaciones que \r\nconduzcan a un abordaje integral de esta patología

A review article on the topic of cervical cancer is presented \r\nin order to visualize the need of a differentiated approach to \r\ngender, and to demonstrate that social, cultural and egalitarian \r\nattitudes towards women makes women more vulnerable to \r\nthis type of disease. The biological focus has limited the view \r\nfrom the differential female morbidity, and has hindered the \r\ncase that women, due to the specifics of their gender, are more \r\nlikely to get sick and are at a higher risk of developing this type \r\nof cancer due to the lack of autonomy over their bodies.\r\nThe article shows the importance of cervical cancer research \r\nto redefine inclusive public policies with a gender perspective, \r\nwhich promote paradigm shifts in the population, to generate \r\ntransformations leading to a comprehensive approach to this \r\ncondition.

O artigo tem como objetivo rever o tema câncer de colo do \r\nútero, a fim de visualizar a necessidade de uma abordagem \r\ndiferenciada em relação ao sexo, e demonstrar que o contexto \r\nsocial, cultural e de desigualdade das mulheres as torna mais \r\nvulneráveis a este tipo doença. A abordagem biológica tem \r\nlimitado a visão da morbidade feminina diferencial e, desta \r\nforma, evitado colocar em destaque como as mulheres, por \r\ncausa da carga de gênero, são mais propensas a ficar doentes \r\ne, com a falta de autonomia sobre seus corpos, coloca-as em \r\nrisco de desenvolvimento deste tipo de câncer.\r\nO artigo mostra a importância da investigação sobre o câncer \r\nde colo do útero para redefinir políticas públicas inclusivas com \r\nenfoque de gênero, que promovam mudanças de paradigma \r\nadotivos na população, para gerar transformações que levem \r\na uma abordagem abrangente desta condição.

¿Ha dejado de disminuir la mortalidad por cáncer de próstata en España? / Has prostate cancer mortality stopped its decline in Spain?

Objetivo: Describir la evolución de la mortalidad por cáncer de próstata en España durante el periodo 1980-2013. Sujetos y método: Los datos de mortalidad por cáncer de próstata y las poblaciones necesarias para el cálculo de los indicadores fueron facilitados por el Instituto Nacional de Estadística. Se calcularon las tasas específicas por grupos de edad, crudas y estandarizadas globales mediante el método directo (población estándar europea), que se expresan como tasas por 100.000 personas-año. Para el análisis de tendencias de las tasas se utilizaron modelos de regresión joinpoint. Resultados: Las tasas ajustadas (globales) por edad en España descienden de 21,7 a 15,4 defunciones por 100.000 varones-año entre los años extremos del periodo estudiado (PCA: -0,9%; p < 0,05). El análisis joinpoint refleja 2 periodos: 1980-1998 (incremento del 0,7% anual; p < 0,05) y 1998-2013 en el que las tasas disminuyen de forma significativa (-3%; p < 0,05). Exceptuando las ciudades autónomas de Ceuta y Melilla, en las que las tasas permanecen estables a lo largo del periodo de estudio, el resto de comunidades muestran 1 o 2 puntos de inflexión en las tendencias y todas muestran un periodo final con descenso de las tasas (exceptuando Galicia y Cataluña, en las que en el periodo 2008-2013 se estabilizan). Conclusión: El descenso de la mortalidad por cáncer de próstata en España parece haberse detenido en Galicia y Cataluña

Objective: To describe the evolution of prostate cancer mortality in Spain during the period 1980-2013. Subject and method The prostate cancer mortality data and population data needed to calculate the indicators were provided by the National Institute of Statistics. We calculated the specific rates by age group, raw and standardised globally using the direct method (European standard population). The rates are expressed for 100,000 person-years. For the analysis of trends in the rates, we used joinpoint regression models. Results: The overall rates adjusted for age in Spain decreased from 21.7 to 15.4 deaths per 100,000 men-years between the starting and ending date of the study period (annual percentage change: -.9%; P < .05). The joinpoint analysis reflects 2 periods: 1980-1998 (.7% annual increase; P < .05) and 1998-2013, during which the rates decreased significantly (-3%; P < .05). Except for the autonomous cities of Ceuta and Melilla where the rates remained stable over the course of the study period, the communities showed 1 or 2 points of inflection in the trends, and all had a final period with a reduction in the rates (except for Galicia and Catalonia, where the rates stabilised in 2008-2013). Conclusion: The decline in prostate cancer mortality in Spain appears to have stopped in Galicia and Catalonia

Comparación de datos anatomopatológicos entre biopsia de próstata y pieza de prostatectomía radical en pacientes con cáncer de bajo y muy bajo riesgo / Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer

Objetivo: Analizar la correlación entre los datos anatomopatológicos encontrados en prostatectomía radical y la biopsia previa realizada en pacientes con cáncer de próstata de bajo riesgo. Material y métodos: Se ha realizado un estudio descriptivo transversal para valorar las características de las prostatectomías radicales realizadas en nuestro centro desde enero de 2012 a noviembre de 2014. Los criterios de inclusión fueron pacientes con enfermedad de bajo riesgo (cT1c-T2a, PSA ≤ 10 ng/ml y Gleason ≤ 6). Fueron excluidos aquellos con menos de 8 cilindros en la biopsia, número de cilindros afectos no especificados, tacto rectal no recogido en historia clínica o biopsia realizada en otro centro. Resultados: De las 184 prostatectomías realizadas en este periodo, 87 pacientes cumplían con los criterios de inclusión y 26 de estos presentaban < 3 cilindros afectados y un PSAd ≤ 0,15 (muy bajo riesgo). Encontramos en la muestra total un porcentaje de infragradación (Gleason ≥ 7) del 18,4% (IC 95%: 10,3-27,6%) y de afectación extracapsular (pT3) del 10,35% (IC 95%: 4,6-17,2%). El porcentaje de márgenes positivos fue del 21,8% (IC 95%: 12,6-29,9%). En el grupo de muy bajo riesgo no encontramos ningún caso de afectación extracapsular y un solo caso de infragradación (Gleason 7 [3 + 4]) representando un 3,8% del total (IC 95%: 0-12,5%). Resultaron ser variables predictoras de no correlación (estadio ≥ pT3a o infragradación) el grupo de riesgo inicial, volumen, PSA densidad y cilindros afectados. Conclusiones: El volumen prostático, el valor del PSA densidad, el número de cilindros afectados y el grupo de riesgo inicial del paciente influyen en la aparición de datos de mal pronóstico anatomopatológico en la pieza de prostatectomía radical (afectación extracapsular y Gleason ≥ 7)

Objective: To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer. Material and methods: A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c-T2a, PSA ≤ 10 ng/mL and Gleason score ≤ 6). We excluded patients who had fewer than 8 cores in the biopsy, an unspecified number of affected cores, rectal examinations not reported in the medical history or biopsies performed in another center. Results: Of the 184 patients who underwent prostatectomy during this period, 87 met the inclusion criteria, and 26 of these had < 3 affected cores and PSA density ≤ .15 (very low risk). In the entire sample, the percentage of undergrading (Gleason score ≥ 7) and extracapsular invasion (pT3) was 18.4% (95% CI 10.3 − 27.6) and 10.35% (95% CI 4.6 − 17.2), respectively. The percentage of positive margins was 21.8% (95% CI 12.6-29.9). In the very low-risk group, we found no cases of extracapsular invasion and only 1 case of undergrading (Gleason 7 [3 + 4]), representing 3.8% of the total (95% CI 0 - 12.5). Predictors of no correlation (stage ≥ pT3a or undergrading) were the initial risk group, volume, PSA density and affected cores. Conclusions: Prostate volume, PSA density, the number of affected cores and the patient's initial risk group influence the poor pathological prognosis in the radical prostatectomy specimen (extracapsular invasion and Gleason score ≥ 7)

Has prostate cancer mortality stopped its decline in Spain?

OBJECTIVE: To describe the evolution of prostate cancer mortality in Spain during the period 1980-2013. SUBJECT AND METHOD: The prostate cancer mortality data and population data needed to calculate the indicators were provided by the National Institute of Statistics. We calculated the specific rates by age group, raw and standardised globally using the direct method (European standard population). The rates are expressed for 100,000 person-years. For the analysis of trends in the rates, we used joinpoint regression models. RESULTS: The overall rates adjusted for age in Spain decreased from 21.7 to 15.4 deaths per 100,000 men-years between the starting and ending date of the study period (annual percentage change: -.9%; P<.05). The joinpoint analysis reflects 2 periods: 1980-1998 (.7% annual increase; P<.05) and 1998-2013, during which the rates decreased significantly (-3%; P<.05). Except for the autonomous cities of Ceuta and Melilla where the rates remained stable over the course of the study period, the communities showed 1 or 2 points of inflection in the trends, and all had a final period with a reduction in the rates (except for Galicia and Catalonia, where the rates stabilised in 2008-2013). CONCLUSION: The decline in prostate cancer mortality in Spain appears to have stopped in Galicia and Catalonia.

Comparison of pathological data between prostate biopsy and radical prostatectomy specimen in patients with low to very low risk prostate cancer.

OBJECTIVE: To analyze the correlation between pathological data found in radical prostatectomy and previously performed biopsy in patients at low risk prostate cancer. MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted to assess the characteristics of radical prostatectomies performed in our center from January 2012 to November 2014. The inclusion criteria were patients with low-risk disease (cT1c-T2a, PSA≤10ng/mL and Gleason score≤6). We excluded patients who had fewer than 8 cores in the biopsy, an unspecified number of affected cores, rectal examinations not reported in the medical history or biopsies performed in another center. RESULTS: Of the 184 patients who underwent prostatectomy during this period, 87 met the inclusion criteria, and 26 of these had<3 affected cores and PSA density≤.15 (very low risk). In the entire sample, the percentage of undergrading (Gleason score≥7) and extracapsular invasion (pT3) was 18.4% (95% CI 10.3-27.6) and 10.35% (95% CI 4.6-17.2), respectively. The percentage of positive margins was 21.8% (95% CI 12.6-29.9). In the very low-risk group, we found no cases of extracapsular invasion and only 1 case of undergrading (Gleason 7 [3+4]), representing 3.8% of the total (95% CI 0-12.5). Predictors of no correlation (stage≥pT3a or undergrading) were the initial risk group, volume, PSA density and affected cores. CONCLUSIONS: Prostate volume, PSA density, the number of affected cores and the patient's initial risk group influence the poor pathological prognosis in the radical prostatectomy specimen (extracapsular invasion and Gleason score≥7).

Preservación vesical electiva en tumor vesical músculo invasivo / Elective Bladder-Sparing Treatment for Muscle Invasive Bladder Cancer

Objetivos: La cistoprostatectomía radical es el tratamiento de elección en el carcinoma vesical músculo invasivo localizado. Planteamos la posibilidad de ofrecer a pacientes estrictamente seleccionados la preservación vesical con RTU ± quimioterapia (QMT) y radioterapia (RDT) como tratamiento alternativo. Material y métodos: Analizamos retrospectivamente 30 pacientes diagnosticados de carcinoma vesical músculo invasivo entre marzo de 1991 y octubre de 2010. La media de edad es de 62,7 años (51-74). Todos ellos eran candidatos a tratamiento curativo y han seguido estrictos criterios de selección: estadio T2, primario, único y menor de 5 cm, con impresión macroscópica de RTU completa en profundidad, sin repercusión en tracto urinario superior y BMN negativa. La TAC de extensión fue siempre negativa y la re-RTU o biopsia de lecho negativa para tumor o con infiltración muscular microscópica. Catorce de estos pacientes fueron tratados con RTU monoterapia, 13 con RTU + QMT y 3 RTU + QMT + RDT. Resultados: El seguimiento medio ha sido de 88,7 meses (19-220). Catorce han permanecido libres de recidiva (46,66%) y 10 han presentado recidiva superficial (33,33%). Conseguimos un 81,3% de respuestas completas y un 71% de conservación vesical a los 5 años. La supervivencia global a los 5 años fue de 79%, siendo la cáncer específica del 85%. Conclusiones: Aunque la cistoprostatectomía radical continúa siendo el tratamiento de elección ante el tumor vesical infiltrante localizado, en casos estrictamente seleccionados, la conservación vesical ofrece una alternativa válida con buenos resultados a largo plazo

Objectives: Radical cystectomy is the standard treatment for localized muscle invasive bladder cancer (MIBC). We offer a bladder-sparing treatment with TURB ± Chemotherapy + Radiotherapy to selected patients as an alternative. Material and methods: We analyze, retrospectively, 30 patients diagnosed with MIBC from March 1991 to October 2010. The mean age was 62.7 years (51-74). All patients were candidates for a curative treatment, and underwent strict selection criteria: T2 stage, primary tumor, solitary lesion smaller than 5 cm with a macroscopic disease-free status after TURB, negative random biopsy without hydronephrosis. Staging CT evaluation was normal. Restaging TURB or tumor bed biopsy showed a disease-free status or microscopic muscle invasion. 14 patients underwent TURB alone, 13 TURB + Chemotherapy and 3 TURB + Chemotherapy + Radiotherapy. Results: The mean follow up was 88.7 months (19-220). 14 patients remained disease free (46.6%), 10 had recurrent non-muscle invasive bladder cancer (33%). 81.3% complete clinical response. 71% bladder preserved at 5-years. Overall, 5-years survival rate was 79% and 85% cancer-specific survival rate. Conclusions: Although radical cystectomy is the standard treatment for localized MIBC, in strictly selected cases, bladder-sparing treatment offers an alternative with good long term results

Elective bladder-sparing treatment for muscle invasive bladder cancer.

OBJETIVES: Radical cystectomy is the standard treatment for localised muscle invasive bladder cancer (MIBC). We offer a bladder-sparing treatment with TURB +/- Chemotherapy+Radiotherapy to selected patients as an alternative. MATERIAL AND METHODS: We analyze, retrospectively, 30 patients diagnosed with MIBC from March 1991 to October 2010. The mean age was 62.7 years (51-74). All patients were candidates for a curative treatment, and underwent strict selection criteria: T2 stage, primary tumor, solitary lesion smaller than 5cm with a macroscopic disease-free status after TURB, negative random biopsy without hydronephrosis. Staging CT evaluation was normal. Restaging TURB or tumor bed biopsy showed a disease-free status or microscopic muscle invasion. 14 patients underwent TURB alone, 13 TURB+Chemotherapy and 3 TURB+Chemotherapy+Radiotherapy. RESULTS: The mean follow up was 88.7 months (19-220). 14 patients remained disease free (46.6%), 10 had recurrent non-muscle invasive bladder cancer (33%). 81.3% complete clinical response. 71% bladder preserved at 5-years. Overall, 5-years survival rate was 79% and 85% cancer-specific survival rate. CONCLUSIONS: Although radical cystectomy is the standard treatment for localised MIBC, in strictly selected cases, bladder-sparing treatment offers an alternative with good long term results.

Cellular neurochemical characterization and subcellular localization of phospholipase C ß1 in rat brain.

The present study describes a complete and detailed neuroanatomical distribution map of the phospholipase C beta1 (PLCß1) isoform along the adult rat neuraxis, and defines the phenotype of cells expressing PLCß1, along with its subcellular localization in cortical neurons as assessed by double-immunofluorescence staining and confocal laser scanning. Immunohistochemical labeling revealed a considerable morphological heterogeneity among PLCß1-positive cells in the cortex, even though there was a marked predominance of pyramidal morphologies. As an exception to the general non-matching distribution of GFAP and PLCß1, a high degree of co-expression was observed in radial glia-like processes of the spinal cord white matter. In the somatosensory cortex, the proportion of GABAergic neurons co-stained with PLCß1 was similar (around 2/3) in layers I, II-III, IV and VI, and considerably lower in layer V (around 2/5). Double immunofluorescence against PLCß1 and nuclear speckle markers SC-35 and NeuN/Fox3 in isolated nuclei from the rat cortex showed a high overlap of both markers with PLCß1 within the nuclear matrix. In contrast, there was no apparent co-localization with markers of the nuclear envelope and lamina. Finally, to assess whether the subcellular expression pattern of PLCß1 involved specifically one of the two splice variants of PLCß1, we carried out Western blot experiments in cortical subcellular fractions. Notably, PLCß1a/1b ratios were statistically higher in the cytoplasm than in the nuclear and plasma membrane fractions. These results provide a deeper knowledge of the cellular distribution of the PLCß1 isoform in different cell subtypes of the rat brain, and of its presence in the neuronal nuclear compartment.

LOW-ORDER 4D DYNAMICAL MODELING OF HEART MOTION UNDER RESPIRATION.

This work is motivated by the limitations of current techniques to visualize the heart as it moves under contraction and respiration during interventional procedures such as ablation of atrial fibrillation. Our long-term goal is to integrate high resolution models routinely obtained from pre-procedure imaging (here, via MRI) with the low resolution, sparse, images, along with a few scalar measurements such as ECG, which are feasible during the real-time procedure. A key ingredient to facilitate this integration is the extraction from the pre-procedure model of an individualized, low complexity, dynamic model of the moving and beating heart. This is the immediate goal we address here. Our approach stems from work on distributed parameter dynamical systems and uses a combination of truncated basis expansions to obtain the requisite four dimensional low order model. The method's potential is illustrated not only by modeling results but also by estimation of an arbitrary slice from the parameterized model.