The Effect of Short Irrigation Frequencies on the Development of Verticillium Wilt in the Susceptible Olive Cultivar 'Picual' under Field Conditions.

The effect of irrigation frequency (daily [T1], biweekly [T2], and dryland [T3]) on Verticillium wilt of olive was studied in two fields that were naturally infested with Verticillium dahliae in southern Spain and planted to 'Picual' olive. Disease onset (average 61 weeks after planting) and disease incidence (average 75.6%) did not differ among irrigation treatments in both fields. Irrigation consistently increased disease development regarding dryland treatment, but this effect varied over time. In experiment I, T1, the relative area under the disease progress curve was greater on all recording dates (ranging from 15.8 to 33.7) in comparison with T3 (average 6.6). Data for experiment II were similar to this on the most favorable dates for disease (March to April). The T2 treatment value varied over time depending on the season and experimental field, being difficult to differentiate from the values of T1 and T3. Significant correlation between disease incidence and severity increments during spring and fall with the soil water content of the same or previous favorable seasons was observed. Through these correlations, we detected soil water contents of 24.3% (experiment I) and 23.6% (experiment II), where the increments of disease parameters remained at zero. Therefore, scheduling irrigation treatments based on rainfall may be a feasible method for maintaining the soil moisture below levels that favor for disease development.

The Influence of Irrigation Frequency on the Onset and Development of Verticillium Wilt of Olive.

The influence of irrigation frequency on the onset and development of Verticillium wilt of olive (VWO) was studied. A split-plot design in microplots with naturally infested soil was established for studying four irrigation frequencies for three olive cultivars with differing levels of disease resistance. Final disease incidence (DI) and mortality in 'Picual' plants subjected to daily irrigation treatment (T1) reached values of 100 and 63%, respectively. For Picual-T1 samples, the area under the disease progress curve values were significantly different between 15 December 2012 and 15 July 2013 (14.8 to 42.8%) compared with the average results of the other treatments, which were weekly (T2), biweekly (T3), and deficit (T4) (0.4 to 11.5%). No significant differences between the irrigation treatments were observed in 'Arbequina', although the DI progressed consistently (60% in all treatments). In 'Frantoio', little disease developed. We conclude that a daily irrigation treatment encourages VWO development in susceptible Picual. Therefore, in susceptible cultivars growing in infested soils under daily irrigation regimes, the extension of irrigation frequency may reduce disease incidence. In the context of an integrated control, the use of resistant cultivars seems to be more relevant than the detrimental effects observed in frequent irrigation schedules.

Field Resistance to Verticillium Wilt in Selected Olive Cultivars Grown in Two Naturally Infested Soils.

The resistance of 11 olive cultivars to Verticillium dahliae was assessed in two experimental field trials. One-year-old rooted olive cuttings from the World Olive Germplasm Bank (IFAPA research center, Córdoba, Spain) were planted in a heavily infested field in Utrera (Sevilla province) and in a moderately infested field in Andújar (Jaén province) of southern Spain. Plants were assessed for Verticillium wilt resistance during 22 months based on disease severity and tree growth. Severe disease symptoms were observed 6 months after planting in both trials. Twenty months after planting in the heavily infested soil, V. dahliae had killed nearly all of the trees of 'Bodoquera', 'Cornicabra', 'Manzanilla de Sevilla', and 'Picual', demonstrating the elevated risk of planting susceptible cultivars in a soil heavily infested with V. dahliae. 'Arbequina', 'Koroneiki', 'Sevillenca', and especially 'Frantoio', 'Empeltre', and 'Changlot Real' showed a high level of disease resistance. However, all of them were affected by the disease. Although the field results confirmed the level of resistance previously obtained for these olive genotypes under controlled conditions, there were some discrepancies. This information will be useful in managing the disease and also in selecting new cultivars for the breeding of Verticillium wilt resistance.

First Report of Verticillium Wilt of Pistachio Caused by Verticillium dahliae in Spain.

Pistachio (Pistacia vera L.) trees in the Castilla La Mancha and Andalusia regions of central and southern Spain are grown close to olive orchards, which are often severely affected by Verticillium dahliae. During the last decade, wilt and death of one or several branches have been observed on pistachio (cv. Kerman) scions grafted on rootstock (P. terebinthus). Discoloration of vascular tissue was occasionally observed. In five surveyed orchards, incidence of affected trees was less than 2%. Wood chips with the bark removed from symptomatic trees were washed in running tap water, surface disinfested in 0.5% sodium hypochlorite for 1 min, and placed onto potato dextrose agar plates incubated at 25°C in the dark. Isolates were identified as V. dahliae on the basis of the characteristics of microsclerotia, conidiophores, and conidia. V. dahliae isolate V117 from olive was used as reference (1). The fungus was also isolated from soil in pistachio orchards using wet sieving and a modified sodium polypectate agar medium (1). Inoculum density varied from 0 to 4.73 microsclerotia per gram of soil. P. terebinthus seedlings were inoculated with two isolates of V. dahliae from pistachio trees by injecting the stems with 50 µl of a conidial suspension (107 conidia per ml) (2). Wilt symptoms of varying severity developed in 12 and 15 seedlings of the 20 pistachio seedlings inoculated with each of two isolates. No symptoms developed on the control seedlings. The pathogen was recovered from stem tissues of inoculated plants. To our knowledge, this is the first report of Verticillium wilt of pistachio in Spain. This study demonstrates the susceptibility of certain rootstocks to V. dahliae and the importance of using resistant rootstocks, such as UCBI (2), in pistachio plantations established on soils infested by V. dahliae. References: (1) F. J. López-Escudero and M. A. Blanco-López. Plant Dis. 91:1372, 2007. (2) D. P. Morgan et al. Plant Dis. 76:310, 1992.

Relationship Between the Inoculum Density of Verticillium dahliae and the Progress of Verticillium Wilt of Olive.

An experiment was conducted in microplots which were artificially infested with a defoliating isolate of Verticillium dahliae using seven different treatments of inoculum densities ranging from 0 to 10 microsclerotia per gram of soil (ppg). The experiment was conducted in Andalucía (southern Spain), and the susceptible Spanish olive cv. Picual was used to determine the relationship between pathogen inoculum density and the progress of Verticillium wilt of olive (VWO). The inoculum, produced on a sodium pectate cellophane medium, was found to efficiently infect olive trees. Symptoms first appeared 30 weeks after the trees were transplanted into infested soil. Periods of increasing disease incidence in the following seasons and years were mainly during spring and autumn, particularly in the second year after planting. Olive trees exhibited a high susceptibility to the defoliating pathotype of the pathogen, even at very low inoculum levels; in fact, diseased plants were encountered throughout the experiment regardless of the inoculum density treatment. Inoculum densities greater than 3 ppg in the soil resulted in final disease incidence greater than 50% for the trees after 2.5 years. Therefore, these inoculum densities must be considered very high for olive trees. There were no differences in final disease incidence, mean symptom severity, or area under the disease progress curve between plots infested with 10 or 3.33 ppg, whereas other treatments exhibited lower values for each of these disease parameters. The temporal variations of disease incidence and severity were highly correlated for the higher inoculum density treatments, with r2 values ranging from 0.92 to 0.84 for disease incidence and from 0.93 to 0.88 for severity. However, r2 was slightly lower for the treatments involving lower inoculum densities of the pathogen in microplots. The slopes of the linear regression curves were statistically different for nearly all the inoculum density treatments. Positive correlation was found between the initial inoculum density and final disease incidence values after the study period that was accurately explained by mathematical models. The results suggest that susceptible olive cultivars should not be planted in soils infested with virulent defoliating pathotypes of V. dahliae. Results also clarify that inoculum density levels obtained from field soil analyses can be used for establishing a risk prediction system with a view to controlling VWO in olive tree plantations.

[Historical evolution of breast reconstruction]. / Evolución histórica de la reconstrucción mamaria.

Breast reconstruction forms an essential part of the treatment of mastectomised women. Although the first attempts to reconstruct a breast date back to the end of the XIX century, it was not until the 1970s that there was a progressive development of the different techniques employed today. Until the 1970s, breast reconstruction was not popular, mainly because the teachings of Halsted, who believed that plastic surgery interfered with the local control of the cancer. When it was found that breast reconstruction did not have a negative influence on the neoplastic disease, but was instead of transcendental importance for the physical and psychological rehabilitation of the patient, its development benefited from several advances: the tendency towards less aggressive mastectomy techniques, which facilitate cutaneous covering; the introduction and progress of silicone breast prostheses; the submuscular implantation of the prostheses, which avoid local complications; the technique of breast tissue expansion; and great advances in the anatomical understanding of the different available flaps, especially musculocutaneous ones and those transferred microsurgically. Today the mastectomised patient can be offered reconstruction either using a silicone prosthesis or a completely autogenous reconstruction; the most recent advance is the introduction of microsurgical perforator flaps.

[Tissue reaction to breast prostheses. Periprosthetic capsular contracture]. / Reacción tisular a las prótesis mamarias. Contractura capsular periprotésica.

Silicone breast prostheses prompt the development of a fibrous casing or periprosthetic capsule. Capsular contracture, due to retraction of the fibrous tissue, is the most frequent and important complication of these implants. It produces varying degrees of hardening and, in advanced cases, deformity of the breast. It has been closely related to the type of surface of the implant (smooth or textured) and with the alignment of the collagen fibers, and it has been suggested that the formation of a continuous capsule, with collagen fibers aligned in parallel and circularly around the smooth prostheses, promotes the development of concentric contractile forces that pulling in unison give rise to contracture. With microporous textured prostheses a significantly lower incidence of capsular contracture has been shown in comparison with smooth prostheses. It is believed that tissue growth within the microporous structure gives rise to multidirectional contractile forces, with a tendency to neutralize one another when their effect is added over the implant. The capsule of these implants presents a base zone composed of multiple layers of collagen fibers aligned in parallel, which might contract. However, the adherence of the microporous textured prostheses might counteract the contractile forces.

[Breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM) flap]. / Reconstrucción mamaria con el colgajo musculocutáneo recto abdominal transverso (TRAM).

The transverse rectus abdominis musculocutaneous (TRAM) flap has been the most employed technique in autogenous breast reconstruction. It provides a new breast of adequate volume, ptosis and natural appearance, and does not require the implantation of prosthesis; a good symmetry with the contralateral breast is obtained, which lasts over time. The drawback of this technique is the morbidity of the abdominal wall. This flap sacrifices the muscle and the anterior rectus sheath which can result in consequences such as hernias and eventrations. To minimise this problem the microsurgical TRAM flap was developed, which only sacrifices a portion of muscle, significantly reducing the number of sequels. A drawback is the difficulty of the surgical technique, which requires mastery of vascular-nervous microsurgery. In conclusion, a new breast can be returned to the mastectomised woman in a completely autogenous way, with a volume, form and texture similar to the healthy side, which helps in short to recover lost self-esteem.

[Breast reconstruction with microsurgical perforator flaps]. / Reconstrucción mamaria con colgajos microquirúrgicos de perforantes.

Autogenous breast reconstruction is frequently carried out with abdominal tissue, since a better and lasting aesthetic result is obtained, providing a new breast that is very similar in texture, consistency and ptosis to the contralateral breast. The main problem presented by this type of reconstruction is the sequel at the level of the donor abdominal area. Perforator flaps are being developed as the main resource for solving this problem, as they hardly damage the muscle and its fascia. The DIEP flap (deep inferior epigastric perforator) has proved itself to be an alternative for reconstruction for many women, with low rates of local complications, due to the absence of any sacrifice of the abdominis rectus muscle, and a significant level of satisfaction with the result obtained. One drawback is its greater technical difficulty and the need for a surgical team that is expert in vascular microsurgery. However, the DIEP flap is a surgical technique for which there is growing demand.

[Reconstruction of the tuberous breast]. / Reconstrucción de la mama tuberosa.

The tuberous breast is a malformation that affects adolescent women uni- or bilaterally, becoming apparent at puberty with the growth of the breast. It is characterised by an alteration of the vertical and horizontal dimensions of the breast, which is translated into a lack of development of the breast and into the herniation of the glandular tissue within the areola with hypertrophy of the latter. Numerous terms have been employed to describe this deformity, besides that of tuberous breast: tubular breast, caprine breast, areolar hernia, hypoplasia of the lower pole or constricted breast. At its most developed degree it is a serious deformity, which affects the emotional stability of the patient in an important way, altering their relational life. Surgical treatment varies depending on the degree and severity of the deformity and includes procedures such as: glandular remodelling, augmentation mammoplasty, mastopexy or a combination of both.

Carcinoma mamario infiltrante tras mastectomía subcutánea / Infiltrating breast cancer alter subcutaneous mastectomy

Aunque la mastectomía subcutánea es una técnica quirúrgica que pretende eliminar todo el tejido mamario macroscópico, conservando el complejo areola-pezón, suele quedar tejido glandular residual en la zona retroareolar, cola de mama y colgajos cutáneos. Por consiguiente, existe la posibilidad de desarrollar carcinoma mamario en este tejido residual. Describimos un caso de carcinoma mamario infiltrante en una paciente en la que previamente se le había realizado una mastectomía subcutánea por presentar un carcinoma intraductal extenso tipo comedo en el seno de un fibroadenoma, que sobrepasaba la cápsula de éste

Although subcutaneous mastectomy aims to remove the entire macroscopic breast gland while conserving the nipple-areola complex, some residual glandular tissue usually remains in the nipple, subareolar region, axillary tail and skin flaps. Consequently, there is a risk of developing breast cancer in the residual tissue. We describe the case of a patient with infiltrating breast cancer who had previously undergone subcutaneous mastectomy for an extensive comedo-type intraductal carcinoma within a fibroadenoma that spread through the fibroadenoma capsule

Reacción tisular a las prótesis mamarias. Contractura capsular periprotésica / Tissue reaction to breast prostheses. Periprosthetic capsular contracture

Las prótesis mamarias de silicona provocan eldesarrollo de una envoltura fibrosa o cápsula periprotésica.La contractura de la cápsula, por retracción deltejido fibroso, es la complicación más frecuente eimportante de estos implantes. Produce un endurecimientode grado variable y, en los casos avanzados,deformidad de la mama. Se ha relacionado estrechamentecon el tipo de superficie del implante (lisa o texturada)y con la disposición de las fibras de colágeno,habiéndose sugerido que la formación de una cápsulacontinua, con fibras de colágeno dispuestas paralela ycircularmente alrededor de las prótesis lisas, promueveel desarrollo de fuerzas contráctiles concéntricas,que traccionando al unísono producirían la contractura.Con las prótesis texturadas microporosas se hademostrado una incidencia significativamente másbaja de contractura capsular en comparación con laslisas. Se considera que el crecimiento tisular dentro dela estructura microporosa origina fuerzas contráctilesmultidireccionales, con tendencia a neutralizarse entreellas cuando su efecto se suma sobre el implante. Lacápsula de estos implantes presenta una zona basalcompuesta de múltiples capas de fibras de colágenoalineadas paralelamente, la cual podría contraerse. Sinembargo, la adherencia de las prótesis texturadasmicroporosas podría contrarrestar las fuerzas contráctiles

Silicone breast prostheses prompt the ;;development of a fibrous casing or periprosthetic ;;capsule. Capsular contracture, due to retraction of the ;;fibrous tissue, is the most frequent and important ;;complication of these implants. It produces varying ;;degrees of hardening and, in advanced cases, ;;deformity of the breast. It has been closely related to ;;the type of surface of the implant (smooth or textured) ;;and with the alignment of the collagen fibers, and it has ;;been suggested that the formation of a continuous ;;capsule, with collagen fibers aligned in parallel and ;;circularly around the smooth prostheses, promotes ;;the development of concentric contractile forces that ;;pulling in unison give rise to contracture. With ;;microporous textured prostheses a significantly lower ;;incidence of capsular contracture has been shown in ;;comparison with smooth prostheses. It is believed that ;;tissue growth within the microporous structure gives ;;rise to multidirectional contractile forces, with a ;;tendency to neutralize one another when their effect is ;;added over the implant. The capsule of these implants ;;presents a base zone composed of multiple layers of ;;collagen fibers aligned in parallel, which might ;;contract. However, the adherence of the microporous ;;textured prostheses might counteract the contractile ;;forces

Reconstrucción mamaria con el colgajo musculocutáneo recto abdominal transverso (TRAM) / Breast reconstruction with the transverse rectus abdominis musculocutaneous (TRAM) flap

El colgajo musculocutáneo de recto abdominaltransverso ha sido la técnica quirúrgica más utilizadaen reconstrucción mamaria autógena. Proporciona unanueva mama con volumen adecuado, ptosis, aspectonatural y no requiere la implantación de prótesis, obteniéndoseuna buena simetría con la mama contralateral,que perdura en el tiempo. El inconveniente de estatécnica es la morbilidad de la pared abdominal. Estecolgajo sacrifica el músculo y la vaina anterior delrecto que puede tener consecuencias como hernias yeventraciones. Para minimizar este problema se desarrollóel colgajo de recto abdominal microquirúrgico,que sólo sacrifica una porción muscular, disminuyendosignificativamente el número de secuelas. Como inconvenientepresenta la dificultad de la técnica quirúrgica,requiriendo dominio de la microcirugía vasculonerviosa.En conclusión, se puede devolver a la mujer mastectomizadauna nueva mama de forma completamenteautógena, con volumen, forma y textura similares allado sano que ayude, en definitiva, a recuperar la autoestimaperdida

The transverse rectus abdominis ;;musculocutaneous (TRAM) flap has been the most ;;employed technique in autogenous breast ;;reconstruction. It provides a new breast of adequate ;;volume, ptosis and natural appearance, and does not ;;require the implantation of prosthesis; a good ;;symmetry with the contralateral breast is obtained, ;;which lasts over time. The drawback of this technique ;;is the morbidity of the abdominal wall. This flap ;;sacrifices the muscle and the anterior rectus sheath ;;which can result in consequences such as hernias and ;;eventrations. To minimise this problem the ;;microsurgical TRAM flap was developed, which only ;;sacrifices a portion of muscle, significantly reducing ;;the number of sequels. A drawback is the difficulty of ;;the surgical technique, which requires mastery of ;;vascular-nervous microsurgery. In conclusion, a new ;;breast can be returned to the mastectomised woman in ;;a completely autogenous way, with a volume, form and ;;texture similar to the healthy side, which helps in short ;;to recover lost self-esteem

Reconstrucción mamaria con colgajos microquirúrgicos de perforantes / Breast reconstruction with microsurgical perforator flaps

La reconstrucción mamaria autógena se realizafrecuentemente con tejido abdominal, ya que se obtieneel mejor resultado estético perdurable en el tiempo,con una nueva mama muy similar en textura, consistenciay ptosis a la contralateral. La secuela a nivel dela zona donante abdominal es el principal problemaque plantea este tipo de reconstrucciones. Los colgajosde perforantes se desarrollan como el gran recursopara solventar dicho problema, ya que apenas dañan elmúsculo y su fascia. El colgajo DIEP (Deep Inferior EpigastricPerforator) ha demostrado ser una alternativareconstructiva destinada a gran cantidad de mujeres,con bajas tasas de complicaciones locales, debido a lafalta de sacrificio del músculo recto abdominal, eimportante grado de satisfacción por el resultado obtenido.Como inconveniente presenta su mayor dificultadtécnica y la necesidad de un equipo quirúrgico quedomine la microcirugía vascular. No obstante, el colgajoDIEP se presenta como una técnica quirúrgica conuna demanda en importante ascenso

Autogenous breast reconstruction is frequently ;;carried out with abdominal tissue, since a better and ;;lasting aesthetic result is obtained, providing a new ;;breast that is very similar in texture, consistency and ;;ptosis to the contralateral breast. The main problem ;;presented by this type of reconstruction is the sequel ;;at the level of the donor abdominal area. Perforator ;;flaps are being developed as the main resource for ;;solving this problem, as they hardly damage the ;;muscle and its fascia. The DIEP flap (deep inferior ;;epigastric perforator) has proved itself to be an ;;alternative for reconstruction for many women, with ;;low rates of local complications, due to the absence of ;;any sacrifice of the abdominis rectus muscle, and a ;;significant level of satisfaction with the result obtained. ;;One drawback is its greater technical difficulty and the ;;need for a surgical team that is expert in vascular ;;microsurgery. However, the DIEP flap is a surgical ;;technique for which there is growing demand

Influence of the time interval between embryo catheter loading and discharging on the success of IVF.

BACKGROUND: To ascertain the influence of the duration of the 'interval loading-discharging embryos' (ILDE) on the results of embryo transfer. METHODS: The population under study consisted of 450 consecutive fresh embryo transfers. ILDE was measured in all transfers. Pregnancy and implantation rates were analyzed. RESULTS: Conceptional cycles had a lower (mean +/- SD) ILDE than non conceptional cycles (53.5 +/- 43.6 s vs 63.7 +/- 49.3). When only easy transfers--defined as those not requiring cervical tenaculum--were considered, similar differences were observed. The following pregnancy rates were obtained according ILDE duration: 38.9% (ILDE < 30 s), 33.2% (ILDE 31-60), 31.6% (ILDE 61-120) and 19.1% (ILDE > 120) (P < 0.05). When only easy transfers were considered, similar results were obtained: 40.0%, 33.3%, 32.0% and 19.4%, respectively. Similar results were observed regarding implantation rates regarding the whole population (21.2%, 15.4%, 15.9% and 9.4%, respectively; P < 0.01) as well as when only easy transfers were considered. CONCLUSIONS: ILDE duration is a prognostic factor of pregnancy rate and of implantation rate in IVF. The longer the ILDE duration, the lower the pregnancy and implantation rates. The decrease in pregnancy and implantation rates is gradual until an ILDE of 120 s, and decreases sharply afterwards. It is recommended to speed up the embryo transfer process, wherever possible. ILDE > 120 s carries a poor prognosis and should, when possible, be avoided.

Ovarian stimulation in intrauterine insemination with donor sperm: a randomized study comparing clomiphene citrate in fixed protocol versus highly purified urinary FSH.

BACKGROUND: The study was conducted to compare the results of intrauterine donor insemination (DI) under ovarian stimulation with either clomiphene citrate (CC), in a fixed protocol, or FSH, with ovarian monitoring. METHODS: Forty-nine patients were randomized using a computer-generated list to receive highly purified urinary FSH (starting dose of 150 IU) and were subjected to periodic vaginal ultrasound and estradiol determinations. HCG was given when > or =2 follicles (> or =17 mm) were identified and estradiol reached >400 pg/ml. Intrauterine insemination (IUI) was performed 36 h later. The other 51 received CC on a fixed protocol (100 mg/day from the day 5-10 of the ovarian cycle) with HCG being administered on the day 12, and IUI performed 36 h later. Up to six IUI cycles were performed on all patients if pregnancy was not reached before. Women failing to conceive in the CC group underwent IUI with FSH. The main outcome measures were intrauterine gestational sac observed by transvaginal ultrasound, per cycle and per woman pregnancy rate (PR) and multiple PR. RESULTS: The per cycle PR was significantly higher in the FSH group, 14.4% (30/209) versus 6.1% (16/261), as well as the per woman PR, 61.2% (30/49) versus 31.4% (16/51). 12.5% (2/16) of pregnancies obtained in the CC group were multiple, compared with 20% (6/30) in the FSH group. There were no triplets or higher order pregnancies in CC versus two in FSH (6.7% of pregnancies). Patients failing to conceive with CC, who later underwent intrauterine DI with FSH, had similar results to the primary FSH group: 54.3% PR per patient (19/35) and 16.0% per cycle (19/118), with a multiple PR of 31.6% (6/19). The PR for women starting with CC cycles and, if pregnancy was not obtained, continuing with six FSH cycles, was 69.2%. CONCLUSIONS: The PR obtained with CC stimulation was approximately half that obtained with FSH. There was a trend to lower multiple PR with CC. It is recommended that each case should be considered on an individual basis and the treatment options discussed with patients. In our opinion, CC could be a reasonable approach for young women with good prognosis, whereas in the remaining cases FSH would be the preferable method.

Ultrasound-guided embryo transfer improves pregnancy rates and increases the frequency of easy transfers.

BACKGROUND: Recent reports have suggested that ultrasound (US) guidance during embryo transfer might improve pregnancy rates. METHODS: A prospective randomized (computer-generated random table) trial was performed to compare embryo transfer under abdominal US guidance (n = 255 women) with clinical touch embryo transfer (n = 260). RESULTS: The clinical pregnancy rate was 26.3% (67/255) in the US-guided transfer group compared with 18.1% (47/260) in the clinical touch transfer group (P < 0.05). The implantation rate was 11.1% (100/903) in the US group compared with 7.5% (66/884) in the clinical touch group (P < 0.05). US-guided transfer was associated with a decrease in the difficulty of the transfers: 97% of transfers were easy in the US-guided group compared with 81% in the clinical touch group (P < 0.05). CONCLUSIONS: US-guided embryo transfer increased pregnancy and implantation rates in IVF cycles, as well as the frequency of easy transfers. It is suggested that the decrease in cervical and uterine trauma can play a role in the increase in pregnancy rates associated with US-guided transfer. It is recommended that embryo transfer should be performed under US guidance.

Cystosarcoma phyllodes maligno metastásico en muslo / Malignant metastasis of a phyllodes tumour in the thigh

Describimos las características clínicas de un tumor phyllodes maligno en una mujer de 41 años de edad que metastatizó en los tejidos blandos del muslo. Relacionamos estos hallazgos con los criterios histopatológicos asociados con el comportamiento clínico y metastásico de este tumor. El sobrecrecimiento estromal es el criterio histológico más importante para predecir el comportamiento metastásico del tumor phyllodes maligno (AU)

Evolución de los resultados del tratamiento del cáncer de endometrio en España entre 1980 y 1999. análisis de las casuísticas nacionales de la sociedad española de ginecología y obstetricia / Evolution of the results of treatment of endometrial cancer in Spain between 1980 and 1999. Analysis of the national casuistic of the Spanish Society of Obstetrics and Gynecology

La Sección de Ginecología Oncológica de la Sociedad Española de Obstetricia y Ginecología (SEGO) ha analizado en los últimos años las casuísticas conjuntas de numerosos hospitales del país, sobre adenocarcinoma de endometrio, por medio de dos encuestas hechas en 1991 para los casos diagnosticados y tratados entre 1980 y 1985, y en 1999 para los casos de 1993. En los aspectos fundamentales los resultados parecen ser notoriamente superiores en la encuesta más reciente, lo que debería significar que se han producido cambios importantes en el diagnóstico y en el tratamiento de estos procesos. Sin embargo, el análisis comparado de ambas encuestas, en cuya realización existen algunas deficiencias, indica que los cambios pueden haber sido menos pronunciados de lo esperado. Tanto la supervivencia global a 5 años (el 59,1 frente al 71,4 por ciento) como la supervivencia libre de enfermedad (el 55,6 frente al 63,1 por ciento) fueron estadísticamente superiores en la casuística más moderna (p = 0,0000). Los casos de la primera casuística fueron más avanzados que los de la segunda y en ellos hubo más casos diagnosticados como adenocarcinomas exclusivamente y con grado de diferenciación histológico significativamente peor. Los casos de 1993 fueron tratados primariamente con cirugía en el 88,9 por ciento de las ocasiones frente a solamente el 76,4 por ciento de los de la casuística más antigua (p = 0,0000). Solamente el 28,9 por ciento de los casos fue tratado en hospitales que atendían 25 casos o más en la primera casuística, mientras que este porcentaje ascendió al 50,5 por ciento en la casuística de 1993. En el primer período estudiado hubo más pacientes perdidas para el seguimiento que en el segundo (el 24,2 frente al 7,0 por ciento; p = 0,0000). La clasificación quirúrgica de la FIGO (1988) no parecía estar implantada todavía en 1993 pues solamente se realizó en el 27,2 por ciento de las pacientes. Estos hechos, junto con la apreciación de que las pacientes son diagnosticadas a edades tardías (61,0 ñ 9,7 años en la primera casuística y 64,0 ñ 10,5 años en la segunda), hacen considerar que la atención sobre el cáncer de endometrio en España es todavía mejorable (AU)