Bacille Calmette-Guerin (BCG) is the immunotherapy of choice for high-risk non-muscle invasive bladder cancer (BC), although recurrence eventually occurs in 50% of patients and 20% progress to adva...

The limits of segmental dichotomy: rethinking how we classify and compare minimally invasive liver resections

Objective To evaluate the effectiveness and safety of external cephalic version (ECV) performed with tocolysis and sedation or spinal anesthesia, and to identify predictors of ECV success, complicat...

Background/Objectives: Posterior fossa brain metastases (PFBMs) pose particular risks owing to their proximity to the brainstem and fourth ventricle. We evaluated the safety (treatment-related complications), local effectiveness, and procedural efficiency of volumetric modulated arc therapy (VMAT)-based stereotactic radiosurgery (VMAT-SRS) for PFBMs. Methods: This single-centre, retrospective study derived a PFBM subgroup from an overall institutional cohort of 123 patients treated with VMAT-RapidArc SRS/fSRS. The doses were 12–20 Gy (single fraction) or 5 × 6 Gy (selected cases). Local response (mRECIST) and predefined safety endpoints (symptomatic oedema with brainstem/IV-ventricle compromise, obstructive hydrocephalus, haemorrhagic transformation, CSF diversion, and urgent neurosurgery) were assessed. Overall survival and procedural time were analysed. Results: Thirty-one patients (39 lesions) were included; 76.9% of them received single-fraction SRS. In addition, 74.2% of patients had supratentorial metastases with posterior fossa involvement. Kaplan–Meier overall survival at 6, 12, 24, and 48 months was 74%, 58%, 26%, and 9.7%, respectively; the median survival time was 12.6 months. Among evaluable lesions, local control was 84.5% (per-lesion response: 15.5% PD, 28.1% SD, 34.4% PR, and 22.0% CR). No clinically significant posterior fossa local complications were observed. Three patients developed radiation-induced leukoencephalopathy after whole-brain radiotherapy (WBRT) and radiosurgery for synchronous supratentorial metastases. The median procedural time was 25.0 min (IQR 9.0) with one isocentre versus 52.5 min (IQR 9.75) with two. Conclusions: VMAT-SRS/fSRS for PFBMs achieved high local control, very low posterior fossa toxicity, and favourable procedural efficiency, supporting its use as a safe, rapid, frameless alternative to WBRT and other radiosurgical platforms such as Gamma Knife in appropriately selected patients.

HLA-C*05:311, a novel HLA class I allele detected by next-generation sequencing.

Background Surgical management of perihilar cholangiocarcinoma (pCCA) is one of the most challenging procedures within hepatobiliary surgery. Robotic platform, with its intrinsic advantages, is emerging as a promising tool for these complex procedures. The aim of the study was to compare perioperative outcomes of robotic and open resections of pCCA. Methods Retrospective, single-referral center, observational study comparing preoperative, intraoperative, and postoperative outcomes between the first 10 consecutive robotic resections and the last 20 consecutive open resections of histologically confirmed pCCA. All cases were potentially candidates for both approaches. Exclusion criteria were palliative resections, unresectable/metastatic disease, associated vascular resections, concomitant malignancies or prior major hepatectomy. Results Baseline characteristics were similar between the open and robotic groups, with a median age of 69 years, a predominance of male (73%) and a homogeneous representation of Bismuth type (I-23%; II-13%; IIIa-13%; IIIb-27%; IV-23%). The only preoperative difference was the use of bilateral biliary drains exclusively in the open group (p = 0.029). Intraoperatively, robotic approach required less blood transfusions (p = 0.038) and allowed more extended lymphadenectomies (p = 0.001), with a consequently higher number of retrieved nodes (median 9 [6–16] vs. 4 [2–8], p = 0.022), at cost of longer operative time (660 vs 345 min, p < 0.001). Postoperative complications, 90-days mortality rates and hospital stay were comparable (p = 0.175, p > 0.99 and p = 0.055). Conclusions Robotic-assisted resection for pCCA appears to be a feasible and safe approach in selected patients and experienced hands, offering potential advantages over open surgery.

Allergic contact dermatitis is very common in patients with anogenital lesions referred for patch testing in Spain. Key allergens include fragrances, preservatives and topical treatments like anaesth...

Telomeres are essential for chromosome protection and genomic stability, and telomerase function is critical for organ homeostasis. Zebrafish is a useful vertebrate model for understanding cellular and molecular mechanisms of regeneration. The regeneration capacity of the caudal fin of wild-type zebrafish is not affected by repetitive amputation, but the behaviour of telomeres during this process has not yet been studied. Here, we characterize the regeneration process in a telomerase-deficient zebrafish model, and study the regenerative capacity after repetitive amputations at different ages. We find that the regenerative efficiency decreases with aging in all genotypes but telomere length is maintained even in telomerase-deficient fish. Our data indicate that telomere length can be maintained by the regenerating cells through the recombination-mediated Alternative Lengthening of Telomeres (ALT) pathway, which likely supports high rates of cell proliferation during the caudal fin regeneration process.

Background. The work of the anatomist surgeon Joseph Maclise has been forgotten by history. His contributions are unknown to younger generations. This study aims to analyze his legacy, focusing on ...

Mónica Roldán-Medinaa,b, Alejandro Riquelme-Péreza,b, Ramón López-Palopa, Pilar Carrilloa, Javier Lacunzaa, Raúl Valdesusoa, Juan García de Laraa, José Hurtado-Martíneza, Juan M. Durána, Eduardo Pinar-Bermúdeza, Juan R. Gimenoa,c,d, y Domingo Pascual-Figala,c,d,e aServicio de Cardiología...