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BACKGROUND The ETOP 10-16 BOOSTER trial failed to demonstrate a progression-free survival (PFS) benefit for adding bevacizumab to osimertinib in second line. An exploratory subgroup analysis, however, suggested a PFS benefit of the combination in patients with a smoking history and prompted us to do this study. METHODS A systematic review and meta-analysis to evaluate the differential effect of smoking status on the benefit of adding an angiogenesis inhibitor to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor therapy was carried out. All relevant randomized controlled trials appearing in main oncology congresses or in PubMed as of 1 November 2021 were used according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Primarily PFS according to smoking status, and secondarily overall survival (OS) were of interest. Pooled and interaction hazard ratios (HRs) were estimated by fixed or random effects models, depending on the detected degree of heterogeneity. Bias was assessed using the revised Cochrane tool for randomized controlled trials (RoB 2). RESULTS Information by smoking was available for 1291 patients for PFS (seven studies) and 678 patients for OS (four studies). The risk of bias was low for all studies. Combination treatment significantly prolonged PFS for smokers [n = 502, HR = 0.55, 95% confidence interval (CI): 0.44-0.69] but not for nonsmokers (n = 789, HR = 0.92, 95% CI: 0.66-1.27; treatment-by-smoking interaction P = 0.02). Similarly, a significant OS benefit was found for smokers (n = 271, HR = 0.66, 95% CI: 0.47-0.93) but not for nonsmokers (n = 407, HR = 1.07, 95% CI: 0.82-1.42; treatment-by-smoking interaction P = 0.03). CONCLUSION In advanced EGFR-non-small-cell lung cancer patients, the addition of an angiogenesis inhibitor to EGFR-tyrosine kinase inhibitor therapy provides a statistically significant PFS and OS benefit in smokers, but not in non-smokers. The biological basis for this observation should be pursued and could determine whether this might be due to a specific co-mutational pattern produced by tobacco exposure.

[EN] Finding angiogenic prognostic markers in advanced non-small-cell lung cancer is still an unmet medical need. We explored a set of genetic variants in the VEGF-pathway as potential biomarkers to predict clinical outcomes of patients with non-small-cell lung cancer treated with chemotherapy plus bevacizumab. We prospectively analyzed the relationship between VEGF-pathway components with both pathological and prognostic variables in response to chemotherapy plus bevacizumab in 168 patients with non-squamous non-small-cell lung cancer. Circulating levels of VEGF and VEGFR2 and expression of specific endothelial surface markers and single-nucleotide polymorphisms in VEGF-pathway genes were analyzed. The primary clinical endpoint was progression-free survival. Secondary endpoints included overall survival and objective tumor response. VEGFR-1 rs9582036 variants AA/AC were associated with increased progression-free survival (p = 0.012 and p = 0.035, respectively), and with improved overall survival (p = 0.019) with respect to CC allele. Patients with VEGF-A rs3025039 harboring allele TT had also reduced mortality risk (p = 0.049) compared with the CC allele. The VEGF-A rs833061 variant was found to be related with response to treatment, with 61.1% of patients harboring the CC allele achieving partial treatment response. High pre-treatment circulating levels of VEGF-A were associated with shorter progression-free survival (p = 0.036). In conclusion, in this prospective study, genetic variants in VEGFR-1 and VEGF-A and plasma levels of VEGF-A were associated with clinical benefit, progression-free survival, or overall survival in a cohort of advanced non-squamous non-small-cell lung cancer patients receiving chemotherapy plus antiangiogenic therapy., The authors thank Drs. Blanca Piedrafita and Vanessa Marfil at Medical Statistics Consulting for medial writing services. RR also wish to acknowledge the support by the Asociacion Espanola Contra el Cancer (AECC).

Objectives: Multiple reasons for suboptimal treatment of breakthrough cancer pain (BTcP) have been reported in the literature. We aimed to ascertain the perception of physicians on the potential inappropriate use and prescription of rapid-onset opioids (ROOs) for breakthrough cancer pain (BTcP) and the causes thereof.Methods: Observational study based on an online survey addressed to doctors from different specialties (radiation oncology, medical oncology, anesthesia, palliative care and general practitioners) with experience in the management of BTcP in the Spanish public health setting.Results: A total of 114 eligible specialists mainly from radiation oncology (37.7%), medical oncology (24.6%) and pain units (18.4%) participated in the study. Most agreed on important aspects of BTcP management, such as their preference for ROOs or the need for early follow-up after treatment initiation. However, their answers revealed a lack of standardization of BTcP diagnosis. Half of respondents believed that their BTcP patients might misuse ROOs. Physicians polled believed that lack of training in pain management (71.9%) and inadequate BTcP diagnosis and evaluation (66.7%) were the greatest obstacles for prescribing opioids. Specialists also thought that they do not provide the necessary information to patients (51.8%) and caregivers (57.9%) to guarantee the correct use of these drugs.Conclusions: These results are of utmost importance as they highlight the need to increase physicians' awareness of BTcP and its management and the need to improve communication with patients and their caregivers. Our findings also indicate the need for future research on the possible misuse of opioids in BTcP patients and its causes.

© 2019 24th European Meeting of Environmental and Engineering Geophysics. All rights reserved. This work evaluates the potential of magnetometry to detect the inaccessible sediment-filled caves of the Sierra de Atapuerca karstic system. This karst consists of numerous caves filled with sediments that bear outstanding archaeo-paleontological remains from the Early and Middle Pleistocene. In order to find the continuity of the caves, the Sierra de Atapuerca sites have already been the target of ERT and GPR surveys, which have revealed their suitability for detecting different karstic features. Although our expectations were to find positive anomalies when crossing these filled conduits, the results showed a negative anomaly of the magnetic field where these sediments were expected. So far, the only explanation for this phenomenon is that these sediments were deposited in a reversed magnetic polarity period. This theory is supported by the fact that the Matuyama-Brunhes boundary is present in many of the studied caves.

Lung cancer is the most common cancer globally and has the highest mortality. Although this disease is not associated with a particular gender, its incidence is rising among women, who are diagnosed at an increasingly younger age compared with men. One of the main reasons for this rise is women taking up smoking. However, many non-smoking women also develop this disease. Other risk factors implicated in the differential development of lung cancer in women are genetic predisposition, tumour histology and molecular profile. Proportionally more women than men with lung cancer have a mutation in the EGFR gene. This consensus statement reviews the available evidence about the epidemiological, biological, diagnostic, therapeutic, social and psychological aspects of lung cancer in women.

This work is part of the study of the dissemination of Greek and Latin classics through translations published in Spanish collections in the nineteenth and twentieth centuries. It focuses on the Biblioteca Universal, a collection created by Joaquín Pi y Margall, and describes the collection’s main characteristics and those of the classic authors’ volumes contained in that collection. The Biblioteca Universal has peculiar characteristics that make it a representative example of a certain type of dissemination, directed at the general public by maintaining a very affordable price. The volumes published in it therefore achieved a wide circulation, not only among the general public but also among the intellectuals of the time. Having presented in the first part of the paper the general characteristics of the collection and the translations published by Angel Lasso de la Vega, it will be studied now the rest of translators and versions and some conclusions on the relevance of this collection as a vehicle for disseminating the classics will be drawn. Este trabajo se enmarca en el estudio de la divulgación de los clásicos grecolatinos por medio de traducciones publicadas en colecciones españolas a lo largo de los siglos XIX y XX. Se centra en la Biblioteca Universal de Joaquín Pi y Margall, describiendo las características principales de la colección y las de los volúmenes de autores clásicos en ella publicados. La Biblioteca Universal tiene características peculiares que la convierten en un ejemplo representativo de un tipo determinado de divulgación, la dirigida a un público generalista gracias al mantenimiento de un precio muy económico. Los volúmenes en ella publicados lograron, por ello, una notable difusión, pero no sólo entre el público general, sino también entre los intelectuales de la época. Tras haber presentado en la primera parte del trabajo las características generales de la colección y las traducciones que en ella publicó Ángel Lasso de la Vega, abordamos ahora el resto de traductores y versiones y ofrecemos unas conclusiones sobre la relevancia de esta colección como vehículo de difusión de los clásicos.

Introduction: Hemangiomas are benign lesions of the blood vessels or vascular elements, in the nose, they are a rarity, when intraosseous, even more so. When intraosseous hemangioma, characteristic imaging may suggest this diagnosis. Keywords: Nasal hemangioma; Cavernous; Intraosseous imaging Case Presentation: We describe the case of a 48-year-old woman manifesting a solid mass in the lateral aspect of the nose. Computer tomography (CT) of the Para nasal sinuses revealed an expansive lesion of the left lateral aspect of the nose, originating from the left nasal bone (Figure 1). This lesion appeared heterogeneous with calcifications in its interior, not disturbing adjacent tissues (Figure 2). Excised in an open nasal Para lateral approach (Figure 3), pathology analysis revealed an intraosseous hemangioma. Discussion: Imaging characteristics that may contribute to the diagnosis of intraosseous hemangiomas include: a rounded unilocular with radial trabeculation lesion, with a honeycomb or soap balls pattern. Recommended treatment is surgical excision, for cure and posterior definitive histopathological diagnosis.

This work is part of the study of the dissemination of Greek and Latin classics through translations published in Spanish collections in the nineteenth and twentieth centuries. It focuses on the Biblioteca Universal, a collection created by Joaquín Pi y Margall, and describes the collection’s main characteristics and those of the classic authors’ volumes contained in that collection. The Biblioteca Universal has peculiar characteristics that make it a representative example of a certain type of dissemination, directed at the general public by maintaining a very affordable price. The volumes published in it therefore achieved a wide circulation, not only among the general public but also among the intellectuals of the time. In the first part of the paper we describe the general characteristics of the collection and the translations published by Ángel Lasso de la Vega. Este trabajo se enmarca en el estudio de la divulgación de los clásicos grecolatinos por medio de traducciones publicadas en colecciones españolas a lo largo de los siglos XIX y XX. Se centra en la Biblioteca Universal de Joaquín Pi y Margall, describiendo las características principales de la colección y las de los volúmenes de autores clásicos en ella publicados. La Biblioteca Universal tiene características peculiares que la convierten en un ejemplo representativo de un tipo determinado de divulgación, la dirigida a un público generalista gracias al mantenimiento de un precio muy económico. Los volúmenes en ella publicados lograron, por ello, una notable difusión, pero no sólo entre el público general, sino también entre los intelectuales de la época. En la primera parte del trabajo presentamos las características generales de la colección y las traducciones que en ella publicó Ángel Lasso de la Vega.

Approximately up to 40% of patients with lung cancer develop bone metastasis, with 22% to 59% of them experiencing skeletal-related events (SREs), which result in an important quality of life deterioration and economic burden. Denosumab, a fully human antibody that targets the receptor activator of nuclear factor-kappa B (RANK) ligand (RANKL), is indicated for prevention of SREs in patients with solid tumors and has demonstrated superiority in breast and prostate cancer, and in other solid tumors, in reducing the risk of first SRE by 17% versus zoledronic acid. In the subset of patients with nonesmall-cell lung carcinoma (NSCLC), denosumab has also shown a positive trend to SRE risk reduction. Denosumab might have direct or indirect antitumor effects. Cancer cells produce factors that stimulate increased bone resorption by osteoclasts, which in turn release tumor growth factors into the bone microenvironment, initiating a tumor/bone vicious cycle. An increasing body of evidence suggests RANK/RANKL signaling plays a role in this tumorigenesis. Both proteins are overexpressed in different tumor types including lung cancer cells. RANK/RANKL signaling activates nuclear factor-kappa B pathways related to lung carcinogenesis and increases intercellular adhesion molecule 1 expression and MEK/extracellular signal-regulated kinase phosphorylation, which in turn enhances tumor cell migration. In animal NSCLC models, denosumab delayed bone metastases and reduced skeletal tumor growth. In patients with lung cancer (post hoc analysis), denosumab prolonged overall survival by 1.2 months versus zoledronic acid (P = .01). This hypothesis-generating outcome warrants further investigation and 2 studies in lung cancer are ongoing to elucidate the therapeutic potential of denosumab beyond SRE prevention.

A floating liquid bridge configuration that operates in a pulsed relaxation mode in which charge (cations) and fluid injection alternatively assume forward and opposite directions in the bridge structure is reported. Cations formed at the high voltage anode are surrounded by clusters of dimethylsulphoxide (DMSO) molecules that migrate to the cathode resulting in forward fluid transport with a period of ~200 s until an equilibrium point is attained. The fluid motion then assumes the opposite direction of the current for~60 s. Charged clusters travel to the bridge surface modifying its structural properties forming a plastic layer with an ~85 KPa stiffness.

We designed a study to assess the prevalence of type 1 diabetes mellitus among the Portuguese population. The study was based on a cohort of young Portuguese men inspected at the different recruitment Centres of the Portuguese Armed Forces in 1995 and 1999. We found a prevalence of 1.28 and 1.58 cases per 1,000 young men aged 20 (median), in 1995 and 1999, respectively. As far as the geographical distribution of this population was concerned, the recruitment centres (RC) with highest prevalence of diabetes in 1995 were that of Oporto, Évora and Lisboa. In 1999, highest prevalence was in Évora, Faro and Lisbon. The greatest increase was found at the RCs in Faro, Évora and Vila Real. Although the regional asymmetries are not very significant, they point to a higher prevalence in the southern region and in the urban areas of Lisbon and Oporto.

10.1002/ajpa.22020

The Atapuerca Quaternarian sites are of worldwide interest due to the presence of human remains belonging to the last million years. The oribatid mites (Acari, Oribatida) found in several archaeological samples extracted from the Atapuerca Quaternarian deposits, have been analyzed during the 2003 excavation campaign to study the Palaeoentomology of the site. The oribatid mite fauna consists of 7 individuals, 6 of which were obtained from Gran Dolina site (about 300.000 years old) and belong to families Cosmochthoniidae, Scheloribatidae, Oribatulidae and Hemileiidae. Most of the taxa were identified to species level. The results obtained were used as a basis to reconstruct the paleo-environments of the site in correspondence with the biological and ecological preferences of the taxa. Los yacimientos cuaternarios de la Sierra de Atapuerca ofrecen interés mundial por haber hospedado varias especies de homínidos que vivieron en el último millón de años. En este contexto, durante la campaña de excavaciones de 2003 se realizó un muestreo puntual en algunos de sus yacimientos para obtener los primeros datos de restos de artrópodos que pudieran conservarse en los mismos. En este trabajo se presentan los resultados obtenidos de ácaros subfósiles pertenecientes al suborden de los oribátidos (Acari, Oribatida). Después de procesar los sedimentos, se obtuvieron un total de 7 individuos en el conjunto de los yacimientos muestreados, de los cuales 6 aparecieron en Gran Dolina en un nivel con datación en torno a los 300.000 años. Los ejemplares, identificados en su mayoría a nivel taxonómico de especie, pertenecen a las familias Cosmochthoniidae, Scheloribatidae, Oribatulidae y Hemileiidae. Dado el conocimiento que se dispone de la biología de los taxones encontrados, que pertenecen a géneros y especies presentes en la actualidad, se han realizado inferencias sobre los ambientes pretéritos en que los animales vivieron.

European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium Furio Pacini, Martin Schlumberger, Henning Dralle, Rossella Elisei, Johannes W A Smit, Wilmar Wiersinga and the European Thyroid Cancer Taskforce Section of Endocrinology and Metabolism, University of Siena, Via Bracci, 53100 Siena, Italy, Service de Medicine Nucleaire, Institut Gustave Roussy, Villejuif, France, Department of General, Visceral and Vascular Surgery, University of Halle, Germany, Department of Endocrinology, University of Pisa, Italy, Department of Endocrinology and Metabolic Disease, Leiden University Medical Center, The Netherlands and Department of Endocrinology and Metabolism, University of Amsterdam, The Netherlands

El dolor neuropático es una forma de dolor crónico con gran repercusión sobre los pacientes. La diabetes mellitus es una de las prinicipales causas de de dolor neuropático. Es uno de los síndromes dolorosos más complejos, con diversos síntomas y signos que fluctúan con el tiempo tanto en su número como en intensidad. Suele asociar clínica acompañante repercutiendo sobre la actividad social y laboral, con la consiguiente disminución de la calidad de vida. Su tratamiento es difícil y, en general, poco satisfactorio, debido a la falta de conocimiento de los mecanismos fisiopatológicos. Los antidepresivos han sido, hasta ahora, los fármacos de primera elección, pero dada su limitada eficacia y efectos secundarios, se han tenido que buscar alternativas terapéuticas. Mediante una búsqueda en la base de datos del Medline, hemos analizado los estudios controlados que estudian la eficacia de la amitriptilina y de la gabapentina en el tratamiento del dolor neuropático del diabético. Los antidepresivos se han considerado, durante años, tratamiento de primera elección en el dolor neuropático del diabético, siendo la amitriptilina el más empleado. Es creciente la importancia de los anticomiciales para el tratamiento de este tipo de dolor, y se apunta a la gabapentina como el más efectivo. Los efectos secundarios anticolinérgicos de la amitriptilina limitan su uso, sobre todo en los pacientes de mayor edad. La gabapentina parece ser un fármaco bien tolerado, siendo los efectos secundarios más frecuentes el mareo y la somonolencia, por lo parece una buena alternativa como tratamiento de primera elección del dolor neuropático en pacientes añosos. Únicamente se han publicado dos estudios controlados y aleatorizados que comparan ambos tratamientos. No obstante, estos estudios no pueden considerarse concluyentes debido al pequeño tamaño muestral. La gabapentina puede considerarse de primera elección en el tratamiento del dolor neuropático del diabético. La elección de uno u otro fármaco debe hacerse de forma individualizada, basándose en la relación riesgo/beneficio.

El dolor neuropático es una forma de dolor crónico con gran repercusión sobre los pacientes. La diabetes mellitus es una de las prinicipales causas de dolor neuropático. Es uno de los síndromes dolorosos más complejos, con diversos síntomas y signos que fluctúan con el tiempo tanto en su número como en intensidad. Suele asociar clínica acompañante repercutiendo sobre la actividad social y laboral, con la consiguiente disminución de la calidad de vida. Su tratamiento es difícil y, en general, poco satisfactorio, debido a la falta de conocimiento de los mecanismos fisiopatológicos. Los antidepresivos han sido, hasta ahora, los fármacos de primera elección, pero dada su limitada eficacia y efectos secundarios, se han tenido que buscar alternativas terapéuticas. Mediante una búsqueda en la base de datos del Medline, hemos analizado los estudios controlados que estudian la eficacia de la amitriptilina y de la gbapentina (GBP) en el tratamiento del dolor neuropático del diabético. Los antidepresivos se han considerado, durante años, tratamiento de primera elección en el dolor neuropático del diabético, siendo la amitriptilina el más empleado. Es creciente la importancia de los anticomiciales para el tratamiento de este tipo de dolor, y se apunta a la GBP como el más efectivo. Los efectos secundarios anticolinérgicos de la amitriptilina limitan su uso, sobre todo en los pacientes de mayor edad. La GBP parece ser un fármaco bien tolerado, siendo los efectos secundarios más frecuentes el mareo y la somnolencia, por lo que parece una buena alternativa como tratamiento de primera elección del dolor neuropático en pacientes añosos. Únicamente se han publicado dos estudios controlados y aleotorizados que comparan ambos tratamientos. No obstante, estos estudios no pueden considerarse concluyentes debido al pequeño tamaño muestral. La GBP puede considerarse de primera elección en el tratamiento del dolor neuropático del diabético. La elección de uno u otro fármaco debe hacerse de forma individualizada, basándose en la relación riesgo/beneficio.

Two of the most important subjects in Ovid’s Tristia and Epistulae ex Ponto are friendship and Literature. In Fray Luis de Leon’s poetry the idea of man’s life on Earth as an spiritual exile has remarkable importance. Fray Luis uses in its Oda a Francisco de Salinas the Ovidian poetry of exile to allude to the triangle exile-friendship-Literature. Dos de los temas más importantes en Tristia y Epistulae ex Ponto de Ovidio son la amistad y la literatura. En la poesía de Fray Luis posee notable importancia la idea del exilio espiritual que supone la vida del hombre sobre la tierra. El agustino utiliza en su Oda a Francisco de Salinas la poesía ovidiana para aludir al triángulo exilioamistad- literatura.

Sin resumen

this paper studies the sense of ________ in the teoch. 13,5. this adjetive has been connected by previous research with the epic world and the portrait of heracles as a hero. on the basis of the comparison with a pindaric pasage, this study proposes to conect the world with the erotic world . an ironic use of the world is highly probable. the hero is portrayed in a complex way that mixes not only the epic and erotics worlds,but also past and presents.

Sin resumen

Gastric cancer is the most chemosensitive adenocarcinoma among digestive neoplasms. A few years ago, we performed a phase II trial with the FLEP regimen, in which fluorouracil (5-FU) and leucovorin are combined with etoposide and cisplatin (Platinol). This regimen resulted in a 39% response rate and high toxicity. Then we used the combination UFT (tegafur and uracil)/leucovorin/etoposide: UFT 390 mg/m2/day orally on days 1 to 14; leucovorin 500 mg/m2 i.v. day 1, and 15 mg/12 h orally on days 2 to 14; and etoposide 100 mg/m2 i.v. on day 1 and then 200 mg/m2/day orally on days 2 and 3. Forty-six patients received a median of five courses. Five patients (11%) achieved a complete response and 12 (26%) a partial response, for an overall response rate of 37%. The response rate was 50% in patients with an Eastern Cooperative Oncology Group performance status of 0 to 1. Grades 3 to 4 toxicities appeared as follow: 17% of patients had diarrhea, 11% had nausea/vomiting, and 13% of patients had anemia. One patient died of neutropenia and sepsis. The median survival time was 9 months. In summary, UFT/leucovorin/etoposide is effective and moderately toxic in patients with advanced gastric cancer. A new trial with UFT/leucovorin/epirubicin is ongoing.

En este trabajo se describen las acciones de vacunación contra el sarampión por el método de aerosol inhalado llevadas a cabo en la República Mexicana entre 1988 y 1990. Se hace mención pormenorizada del equipo simplificado que se empleó, del personal, de su adiestramiento, de la promoción y de la estructura de las campañas correspondientes. También se precisa la vacuna usada: cepa Edmonston-Zagreb cultivada en células diploides, del Instituto Nacional de Virología de la Secretaría de Salud en México, con un título que varió, de 10(4.5) unidades formadoras de placa/ml (PFU/ml) a 10(4.8) PFU/ml, administrada en 30 segundos de inhalación, con una descarga del nebulizador, durante este lapso, de 2 800 a 4 000 PFU por niño, estimándose la dosis retenida en 25%, por ejemplo, 700 a 1 000 PFU. En total se tiene documentada la vacunación de 3 760 684 niños prescolares y escolares en 13 de las 32 entidades federativas del país. No se observaron efectos indeseables de gravedad y los estudios limitados que se realizaron, tanto serológicos como de campo, avalan la efectividad y seguridad de este método que es, por otra parte, mucho más barato, rápido y aceptable por la población que el de inyección subcutánea..The present work describes the anti-measles vaccination program by the inhaled aerosol method undertaken in Mexico between 1988 and 1990. Detailed descriptions are given of the equipment, staff, training programs, promotion and campaigns. The vaccine is specified: Edmonston-Zagreb strain cultured in diploid cells at the Instituto Nacional de Virología of the Secretaría de Salud in Mexico with titres varying from 1045 plaque forming units (PFU/ml) to 1 048 PFU/ml administered in a 30 sec inhalation with aerosol. During this exposure period, 2 800 to 4 000 PFU per child are estimated to enter the child, of which approximately 25% is the retained dosis, i.e. 700 to 1 000 PFU/child. A total of 3 760 684 children of school and pre-school age have been vaccinated in 13 of the 32 federal entities of the country. No undesirable effects of any importance were observed, and the limited serological and field studies support the effectiveness and security of this method. On the other hand, the method is much cheaper, faster and better accepted by the population than the subcutaneous injection.

Fundamento: el derrame pericárdico y el taponamiento cardíaco son complicaciones conocidas de las enfermedades malignas aunque raramente son su forma de manifestación inicial. Caso clínico: se presenta el caso de una mujer de 52 años que acudió a urgencias por un cuadro de disnea, astenia y dolor en punta de costado izquierdo de 4-5 días de evolución que se etiquetó en un principio como neumonía alveolointersticial. A las 24 horas de ingreso presentó taponamiento cardíaco que requirió actuación inmediata con drenaje pericárdico. El análisis del líquido mostró células malignas, compatibles con adenocarcinoma. El estudio efectuado no logró hallar el tumor primario y, un mes más tarde, la paciente murió en su domicilio de forma súbita sin que se practicara el estudio necrópsico. Discusión: se aporta un nuevo caso de taponamiento cardíaco como presentación de cáncer de origen desconocido, hecho que se describe en la bibliografía de forma muy excepcional.

A study carried out during 1976-1988 on patients with colorectal cancer revealed an increase in the incidence of this disease of 150%, with a sex ratio of 1:1.17, there being a slight predominance in males. In the patients studied, 3.41% were older than 40. In patients in the 60-70 age group, 63.4% of the cases were diagnosed. The most frequent location of the tumor is the rectum (24.4%) and the least frequent (1.57% and 1.04%, respectively) in the hepatic and splenic angles. This was observed in all the years comprising the study. Adenocarcinoma was the commonest type of tumor, there being a highly significant association (p less than 0.001) between the histological type of cancer and the state of infiltration observed at the time of diagnosis.

Comparison of the figures for measles morbidity in Mexico over the years is difficult because of the different rates of reporting of cases. In the 1960s, approximately 3% of the true number of cases of measles was reported, whereas in 1980 this percentage increased to approximately 20%. A more representative time curve can be drawn for mortality, which dropped sharply in 1973-1980 as a result of the extensive use of measles vaccine. The relationship between measles and immunization is close, and morbidity for the above period is a mathematical function of the number of doses of vaccine distributed. During 1981, about four million doses of vaccine were administered, and in 1982 another four million children will be immunized, with a coverage of 70% of the susceptible population. It is hoped that in 1982 the incidence of measles will decrease to the low levels obtained in 1974-1975, although eradication in the near future seems unlikely.The relationship between measles and immunization is such that morbidity is almost a mathematical function of the number of doses of vaccine distributed. After Mexico's massive immunization campaign of 1973, a sharp decrease in measles morbidity and mortality was registered in 1974 and 1975. Unfortunately, the campaign was not able to eliminate measles completely because of 2 factors: the large number of small villages with scattered populations that were not reached by immunization brigades, and problems restricting vaccine distribution only to the targeted children 6-18 months of age. In 1976-79 the mass immunization strategy was abandoned in favor of routine immunization throughout the year for children who were brought to health centers as a result of vaccination promotional activities. Beginning in 1980, intensive phases of immunization were introduced into the routine year-long immunization program. It is hoped that the 1981-82 policy of routine year-long immunization in health centers as well as intensive house-by-house immunization activities will reach at least 70% of susceptible preschool children and reduce measles to the low incidence achieved in Mexico in 1974-75. Special attention will be paid to reinforcing levels of immunity in those states or zones where measles morbidity is greatest.

The primary structure of papain-solubilized human histocompatibility antigen HLA-B40 (-Bw60) has been determined. Its comparison with that of the cross-reactive HLA-B7 antigen allows for the first time a direct sequence comparison between two HLA-B locus products and an outline of the location of their alloantigenic sites. Overall sequence homology between HLA-B40 and HLA-B7 is 93%. Of 19 detected differences, 18 are located in the two amino-terminal domains (residues 1-182). Half of them are clustered in two short segments spanning residues 63-74 and 147-156, respectively, which suggests that they may encompass major sites of their alloantigenic determinants. The first of these segments is highly polymorphic in HLA and H-2 molecules. It is proposed that it may belong to a hypervariable region of class I histocompatibility antigens. The remaining substitutions are scattered through the N-terminal portions of the two external domains. Thus, in addition to the above-mentioned segments, other positions may contribute significantly to the antigenic polymorphism of these molecules.

An analytical investigation of the buckling/wrinkling behavior of GFRP webs in cell-core sandwiches subjected to combined in-plane shear and bending stresses is conducted. Web-core panels are modeled as long orthotropic plates stabilized by a relatively thick layer of elastic foam. The boundary condition of the plate is defined according to the interaction between the webs and face sheets in the presence of the core material by applying a series of numerical analyses using the three-dimensional finite element modeling. Two approaches are adopted to predict the wrinkling behavior. The first is to predict the buckling/wrinkling of webs subjected to combined shear and bending loads using a mixed-mode interaction formula. In the second approach, the wrinkling behavior of web-core panels is treated as a biaxial compression-tension local buckling problem. The developed approaches are applied to predict the wrinkling loads of thin-walled webs in GFRP cell-core sandwich beams designed for the GFRP cell-core sandwich roof of the Novartis Campus Main Gate Building constructed in Switzerland. (C) 2012 Elsevier Ltd. All rights reserved.

Glass-fiber-reinforced polymer (GFRP) cell-core sandwiches are composed of outer GFRP face sheets, a foam core, and a grid of GFRP webs integrated into the core to reinforce the shear load capacity. One of the critical failure modes of cell-core sandwich structures is shear wrinkling, a local buckling failure in the sandwich webs because of shear loading. The shear wrinkling behavior of GFRP laminates with different laminate sequences, stabilized by a polyurethane foam core, was experimentally and numerically investigated. Shear wrinkling was simulated by a biaxial compression-tension setup. The results show that an increasing transverse tension load significantly decreases the wrinkling load. The decreasing effect of tension is explained by the lateral contraction because of Poisson's effect, which causes an increase in the initial imperfections and subsequent accelerated bending. DOI: 10.1061/(ASCE)CC.1943-5614.0000212. (C) 2011 American Society of Civil Engineers.

Slender webs of glass fiber-reinforced polymer (GFRP) beams are sensitive to shear buckling. Shear buckling can bee seen as an in-plane biaxial compression-tension buckling problem. The transverse tensile load thereby delays the onset of buckling and increases the ultimate load. Thin-walled GFRP plates of two different fiber stacking sequences, [0/90]S and [90/0]S, were subjected to in-plane biaxial compression-tension loading. The buckling loads were almost duplicated by increasing the tensile load while the ultimate loads were increased by up to 20%. The fiber stacking sequence thereby had significant effects on buckling mode shape and buckling and ultimate loads.

Introdução e Objectivos: Em Portugal, a experiência em retroperitoneoscopia pediátrica é escassa. Os autores apresentam a primeira série portuguesa de nefrectomias realizadas por esta via, em crianças com idade inferior a nove anos, e uma revisão da literatura sobre o tema. Material e Métodos: Análise retrospectiva dos processos das crianças submetidas a nefrectomia laparoscópica retroperitoneal (NLR), de Janeiro de 2009 e Dezembro de 2009, num Departamento de Cirurgia Pediátrica. A revisão da literatura foi realizada através de uma pesquisa na base de dados Medline. Resultados: Foram realizadas oito NLR. A média de idades dos doentes operados foi 4,5 anos (mínimo = 11 meses, máximo = 8,6 anos). As indicações cirúrgicas encontradas foram: quatro rins multiquísticos, três nefropatias de refluxo, uma nefropatia obstructiva. Quatro NLR foram realizadas à esquerda. O tempo cirúrgico médio foi 99 minutos (mínimo = 50 minutos, máximo 180 minutos), notando-se um encurtamento do mesmo à medida que aumenta a experiência da equipa. Não houve nenhuma conversão para lombotomia. A média de tempo de internamento foi 1,5 dias (mínimo = 1 dia, máximo = 2 dias). Não se registaram complicações intra-operatórias nem pós-operatórias. Conclusão: A NLR é exequível em crianças de idade inferior a nove anos e deve ser considerado tratamento de eleição na idade pediátrica.

Different authors have investigated the immunohistochemical expression of some proteins in the adenocarcinoma of the stomach, including cell cycle regulators proteins like p53 and Bcl-2; growth factors (c-erb-B2 and EPO-R); angiogenesis-related markers such as COX-2 and cellular adhesion molecules (beta-catenin and E-cadherin). While these proteins have been studied in gastric adenocarcinoma, their immunophenotyping in non tumoral gastric mucous membrane remains unexplored. In the present study, we investigated the expression, function and behavior of these proteins in normal gastric mucous membrane to contribute to gain further knowledge on the significance of their loss or overexpression in malignant gastric tumors.

A model for predicting the buckling and wrinkling behavior of glass-fiber-reinforced polymer (GFRP) plates and sandwich panels subjected to in-plane biaxial compression-tension loading is presented in this paper. In-plane biaxial compression-tension loading occurs in the webs of plate girders or cell-core sandwiches. The model is able to simulate two counteracting effects of increasing transverse tension load on buckling and wrinkling loads as observed in experiments. A stabilizing effect tends to push the plate back to the median plane and thereby delays the onset of buckling/wrinkling instability. In contrast, lateral contraction accelerates the bending of the plate, which leads to a significant decrease in buckling/wrinkling loads. In composite plates, the first effect predominates and increases the buckling loads, while in sandwich panels the second effect is dominant and decreases the wrinkling loads. The theoretical predictions are in good agreement with the corresponding experimental results. DOI: 10.1061/(ASCE)CC.1943-5614.0000277. (C) 2012 American Society of Civil Engineers.

Biomarkers; Non-small cell lung cancer Biomarcadors; Carcinoma de pulmó de cèl·lules no petites Biomarcadores; Carcinomas de pulmón de células no pequeñas El carcinoma de pulmón de no célula pequeña (CPNCP) presenta el mayor número de dianas terapéuticas identificadas, algunas de ellas con utilidad terapéutica. En la actualidad se considera imprescindible en estos pacientes determinar las mutaciones de EGFR, BRAF, KRAS y MET, las traslocaciones de ALK, ROS1, NTRK y RET y la expresión de PD-L1. El uso de la secuenciación masiva (next-generation sequencing [NGS]) facilita el diagnóstico molecular de forma precisa y permite determinar otras mutaciones emergentes, como la mutación de HER2 y los biomarcadores predictivos de respuesta a inmunoterapia. En este consenso, un grupo de expertos en el diagnóstico y tratamiento del CPNCP seleccionado por la Sociedad Española de Anatomía Patológica (SEAP) y la Sociedad Española de Oncología Médica (SEOM) ha evaluado la información actualmente disponible y propone una serie de recomendaciones para optimizar la determinación y utilización en la práctica clínica diaria de los biomarcadores. Non-small cell lung cancer (NSCLC) presents the greatest number of identified therapeutic targets, some of which have therapeutic utility. Currently, detecting EGFR, BRAF, KRAS and MET mutations, ALK, ROS1, NTRK and RET translocations, and PD-L1 expression in these patients is considered essential. The use of next-generation sequencing (NGS) facilitates precise molecular diagnosis and allows the detection of other emerging mutations, such as the HER2 mutation and predictive biomarkers for immunotherapy responses. In this consensus, a group of experts in the diagnosis and treatment of NSCLC selected by the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM) have evaluated currently available information and propose a series of recommendations to optimize the detection and use of biomarkers in daily clinical practice. SEOM y SEAP agradecen el apoyo financiero de este proyecto en forma de colaboración sin restricciones en la logística por parte de AstraZeneca y Roche.