Articles publicats (Ciències Mèdiques Bàsiques)
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- ItemOpen AccessPlatelet levels and age are determinants of survival after mild-moderate TBI: A prospective study in Spain(Frontiers Media, 2023) Yuguero Torres, Oriol; Vena Martínez, Ana Belén; Bernal, Maria; Martínez Alonso, Montserrat; Farré, Joan; Purroy Garcia, FranciscoIntroduction: Traumatic brain injury (TBI) is a very important reason for consultation in emergency departments. Methods: A hospital cohort study with patients who attended a hospital emergency department between June 1, 2018 and December 31, 2020 due to TBI was studied. Clinical and sociodemographic variables were recorded. The levels of biomarkers and management variables were used. Qualitative variables were analyzed using Pearson's chi-square test, and quantitative variables using the Mann–Whitney U-test. Survival analyses were performed by fitting a multivariable Cox regression model for patient survival during the follow-up of the study in relation to the patient's characteristics upon admission to the emergency department. Results: A total of 540 patients were included. The mean age was 83 years, and 53.9% of the patients were men. Overall, 112 patients (20.7%) died during the study follow-up. The mortality rate per 100 person-years was 14.33 (11.8–17.24), the most frequent mechanism being falls in the home, with none caused on public roads. The multivariable Cox proportional hazards model showed that survival after TBI was significantly associated with age, S100 levels, Charlson index, patient's institutionalized status, the place where the TBI occurred, and hemoglobin and platelet levels. Discussion: The most common profile for a patient with a TBI was male and aged between 80 and 90 years. The combination of the variables age, Charlson index, place of TBI occurrence, and hemoglobin and platelet levels could offer early prediction of survival in our population independently of TBI severity. With the data obtained, a therapeutic algorithm could be established for patients suffering from mild TBI, allowing the patient to be supervised at home, avoiding futile referrals to emergency services.
- ItemOpen AccessSustainable Environmental Development from the Regional Perspective—The Interesting Case of Poland(MDPI, 2023) Tejada Gutiérrez, Eva Luz; Koloszko Chomentowska, Zofia; Fiore, Mariantonietta; Spada, AlessiaThe EU regional development policy aims to reduce through its cohesion policy the socio-economic development disparities between its most developed regions and peripheral regions. Research shows that despite this strategy, the economic development of EU countries in the spatial system is not homogeneous. In addition, contemporary strategies take into account economic devel opment with respect to environmental protection. The goal of this paper was to assess sustainable regional development in Poland, taking into account environmental and innovative activity indi cators, as well as mobility and accessibility in remote areas. To recognize the effects of supporting sustainable development, the evaluation was carried out considering the indicators from the Statis tics Poland platform, concerning 2011 and 2021, and related them to economic development, the environment, mobility and accessibility of 16 regions. Comparing results obtained with the K-means clustering method with those obtained with the partitioning around medoids method, it was possible to verify, with greater reliability, the migration of regions into different clusters. Results showed that development of all the regions was significant yet highly disproportionate, thus highlighting the consolidated presence of dynamically growing regions versus peripheries, which means further regional polarization. An educational cross-sectorial approach can play a crucial role in promoting green pro-innovative development.
- ItemOpen AccessAntibiotic Susceptibility and Clarithromycin Resistance Determinants in Helicobacter pylori in the Northeast of Spain: A One-Year Prospective Study(MDPI, 2023) Mormeneo Bayo, Saray; Bellés Bellés, Alba; Vázquez Gómez, Diego; Planella de Rubinat, Montse; Bayas Pastor, Diana Carolina; Morales Portillo, Arturo; Jover, Alfredo; López González, Éric; Prim, Núria; Garcia Gonzalez, MercedesHelicobacter pylori is one of the most widespread infections, and it is reaching alarming resistance levels worldwide. The recommended first-line empirical treatment differs according to the local rate of clarithromycin resistance. Macrolide resistance is mainly associated with three point mutations in the 23S rRNA gene. The aim of this study was to describe the antibiotic susceptibility of H. pylori in our healthcare area and the main mechanisms involved in clarithromycin resistance. Gastric biopsies (n = 641) were collected and cultured in a one-year prospective study. Antibiotic susceptibility testing was performed by gradient diffusion. A multiplex real-time PCR test (AllplexTM H.pylori & ClariR Assay, Seegene) was used to detect the most frequent mutations associated with clarithromycin resistance. Overall, 141 isolates were available for antibiotic susceptibility testing. The highest resistance rates were detected in metronidazole and levofloxacin. The rate of clarithromycin resistance was 12.1%, and the associated mutations were A2143G and A2142G. More than half of the clarithromycin-resistant isolates presented high MIC values (>256 mg/L). Tetracycline resistance was not detected, suggesting that therapies that contain tetracycline could be a suitable option. The low clarithromycin resistance rate coupled with the high rates of metronidazole resistance may support the recovery of the classical triple therapy in our healthcare area.
- ItemOpen AccessBiomarkers Found in the Tumor Interstitial Fluid may Help Explain the Differential Behavior Among Keratinocyte Carcinomas(Elsevier, 2023) Matas Nadal, Clara; Bech Serra, Joan Josep; Gatius Calderó, Sònia; Gómez, Xavier; Ribes Santolaria, Marina; Guasch Vallés, Marta; Pedraza González, Neus; Casanova i Seuma, Josep M. (Josep Manel); de la Torre Gómez, Carolina; Garí Marsol, Eloi; Aguayo Ortiz, RafaelBasal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (SCCs) are the most frequent types of cancer, and both originate from the keratinocyte transformation, giving rise to the group of tumors called keratinocyte carcinomas (KCs). The invasive behavior is different in each group of KC and may be influenced by their tumor microenvironment. The principal aim of the study is to characterize the protein profile of the tumor interstitial fluid (TIF) of KC to evaluate changes in the microenvironment that could be associated with their different invasive and metastatic capabilities. We obtained TIF from 27 skin biopsies and conducted a label-free quantitative proteomic analysis comparing seven BCCs, 16 SCCs, and four normal skins. A total of 2945 proteins were identified, 511 of them quantified in more than half of the samples of each tumoral type. The proteomic analysis revealed differentially expressed TIF proteins that could explain the different metastatic behavior in both KCs. In detail, the SCC samples disclosed an enrichment of proteins related to cytoskeleton, such as Stratafin and Ladinin-1. Previous studies found their upregulation positively correlated with tumor progression. Furthermore, the TIF of SCC samples was enriched with the cytokines S100A8/S100A9. These cytokines influence the metastatic output in other tumors through the activation of NF-kB signaling. According to this, we observed a significant increase in nuclear NF-kB subunit p65 in SCCs but not in BCCs. In addition, the TIF of both tumors was enriched with proteins involved in the immune response, highlighting the relevance of this process in the composition of the tumor environment. Thus, the comparison of the TIF composition of both KCs provides the discovery of a new set of differential biomarkers. Among them, secreted cytokines such as S100A9 may help explain the higher aggressiveness of SCCs, while Cornulin is a specific biomarker for BCCs. Finally, the proteomic landscape of TIF provides key information on tumor growth and metastasis, which can contribute to the identification of clinically applicable biomarkers that may be used in the diagnosis of KC, as well as therapeutic targets.
- ItemOpen AccessModelling Cancer Metastasis in Drosophila melanogaster(MDPI, 2023) Sharpe, Joanne L.; Morgan, Jason; Nisbet, Nicholas; Campbell, Kyra; Casali, AndreuCancer metastasis, the process by which tumour cells spread throughout the body and form secondary tumours at distant sites, is the leading cause of cancer-related deaths. The metastatic cascade is a highly complex process encompassing initial dissemination from the primary tumour, travel through the blood stream or lymphatic system, and the colonisation of distant organs. However, the factors enabling cells to survive this stressful process and adapt to new microenvironments are not fully characterised. Drosophila have proven a powerful system in which to study this process, despite important caveats such as their open circulatory system and lack of adaptive immune system. Historically, larvae have been used to model cancer due to the presence of pools of proliferating cells in which tumours can be induced, and transplanting these larval tumours into adult hosts has enabled tumour growth to be monitored over longer periods. More recently, thanks largely to the discovery that there are stem cells in the adult midgut, adult models have been developed. We focus this review on the development of different Drosophila models of metastasis and how they have contributed to our understanding of important factors determining metastatic potential, including signalling pathways, the immune system and the microenvironment.
