High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer

BACKGROUND

Tumour vascular endothelial growth factor (VEGF) and tumour urokinase-type plasminogen activator (uPA) are prognostic factors in gastric cancer but surgical specimens are required for testing. The prognostic value of preoperative serum VEGF (s-VEGF) and serum uPA (s-uPA) levels was evaluated in patients undergoing potentially curative (R0) gastric cancer resection.

METHODS

Concentrations of s-VEGF and s-uPA were measured 97 patients with gastric cancer and 20 controls. Angiogenesis was measured in vitro based on human endothelial cell tube formation.

RESULTS

Levels of s-VEGF were higher in patients with gastric cancer than controls (median 288 versus 189 pg/ml respectively; P = 0.002). They were associated with pathological tumour node metastasis (pTNM) stage, pT, pN, lymph node ratio and perineural invasion, and correlated with platelet counts. In multivariable analysis, s-VEGF over 320 pg/ml was the only preoperative predictor of both recurrence and disease-specific survival. Serum from patients with raised s-VEGF levels enhanced angiogenesis in vitro significantly more than serum from those with a s-VEGF level of 320 pg/ml or less.

CONCLUSION

High preoperative s-VEGF level is an independent prognostic factor for recurrence and survival after R0 resection of gastric cancer. This may provide a useful guide to decision making regarding neoadjuvant and adjuvant therapies.

Heterogeneous catalytic wet peroxide oxidation systems for the treatment of an industrial pharmaceutical wastewater

The aim of this work was to assess the treatment of wastewater coming from a pharmaceutical plant through a continuous heterogeneous catalytic wet peroxide oxidation (CWPO) process using an Fe(2)O(3)/SBA-15 nanocomposite catalyst. This catalyst was preliminary tested in a batch stirred tank reactor (STR), to elucidate the influence of significant parameters on the oxidation system, such as temperature, initial oxidant concentration and initial pH of the reaction medium. In that case, a temperature of 80 degrees C using an initial oxidant concentration corresponding to twice the theoretical stoichiometric amount for complete carbon depletion and initial pH of ca. 3 allow TOC degradation of around 50% after 200 min of contact time. Thereafter, the powder catalyst was extruded with bentonite to prepare pellets that could be used in a fixed bed reactor (FBR). Results in the up-flow FBR indicate that the catalyst shows high activity in terms of TOC mineralization (ca. 60% under steady-state conditions), with an excellent use of the oxidant and high stability of the supported iron species. The activity of the catalyst is kept constant, at least, for 55h of reaction. Furthermore, the BOD(5)/COD ratio is increased from 0.20 to 0.30, whereas the average oxidation stage (AOS) changed from 0.70 to 2.35. These two parameters show a high oxidation degree of organic compounds in the outlet effluent, which enhances its biodegradability, and favours the possibility of a subsequent coupling with a conventional biological treatment.

Vascular endothelial growth factor serum concentrations in hypercholesterolemic patients

OBJECTIVE

Vascular endothelial growth factor (VEGF) promotes normal and pathological angiogenesis. VEGF is a chemotactic factor for macrophages and vascular smooth muscle cells, and induces synthesis of metalloproteinases and adhesion molecules. VEGF expression is regulated by hypoxia, cytokines, oncogenes, and oxidized low-density lipoprotein (LDL). The purpose of this study was to determine the relationship between levels of lipid parameters and VEGF, to investigate whether pravastatin treatment influences VEGF serum concentrations, and to examine the relationship between VEGF and the variations in post-treatment lipid and inflammatory parameters.

MATERIAL AND METHODS

Eighteen patients aged 48+/-6.8 years with total cholesterol (TC) >6.1 mmol/L comprised the hypercholesterolemic group. The controls included 12 individuals aged 50+/-7.4 years with TC <5.1 mmol/L. TC, high-density lipoprotein cholesterol (HDLC), triglycerides, LDLC, C-reactive protein (CRP), and VEGF were determined in both groups at baseline, and in the hypercholesterolemic group after 4 months of treatment with 20 mg/day pravastatin.

RESULTS

A significant correlation was observed between concentrations of VEGF and TC, LDLC and TG, and a significant difference in VEGF concentration was observed between the control group (mean 142 ng/L) and the hypercholesterolemic group (mean 272.9 ng/L). A significant decrease was observed in TC (14.7 %), LDLC (21.5 %), CRP (22.7 %), and VEGF (14.8 %) after 4 months of treatment with pravastatin.

CONCLUSIONS

A relationship was found between serum levels of VEGF and most atherogenic lipoproteins. In patients with hypercholesterolemia treated with pravastatin, a reduction in VEGF and CRP was seen in addition to lipid decreases.

Survival prediction in terminally ill cancer patients: Description and validation of a new predictive score

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Background: Determining an accurate prognosis for terminally ill cancer patients is one of the biggest challenges that confronts a physician. Correct predictions can be done in only 20–40% of all cases. Although the current prognostic scales are helpful, they have significant limitations. Our objective consists of determining the potential indicators that influence the survival of these patients and develop and validate a new predictive model. Methods: A prospective, multicentric and observational study was conducted in 880 terminally ill cancer patients. At first, 40 clinical, demographic and laboratory variables were recorded in 406 patients. A forward stepwise regression method was applied for the multivariate survival analysis. Hence, a predictive model was constructed. Subsequent validation was performed in 474 patients. Results: Median age was 66.4 years (range 18–95). The median overall survival was 21 days in the first 406 patients studied and 19 days in the validation group. A prognostic model with 9 variables was constructed (age, ECOG, the amount of time between initial diagnosis up to being considered terminal phase, nauseas, anorexia, cognitive impairment, lymphocytes, LDH and albumin). Afterwards, to simplify the model, 4 variables that were considered more objective and with greater Odds ratio were selected and assigned one point per each prognostically poor category. We obtained a survival model that discriminates 3 prognostic categories: Good prognoses (score 0) with a median survival of 95 days (44–146), intermediate prognoses (score 1–2) with a median survival of 33 days (26.8–39.2) and bad prognoses (score 3–4) with a median survival of 15 days (11.1–18.9). In the validation group, median survival times were 60 (47.1–72.8), 27 (22.8–31.1) and 11 days (9.2–12.7) respectively. Conclusions: We propose a predictive score model that is objective and easy to use to help in accurately predicting life expectancy in terminally ill cancer patients. Its effectiveness has been validated in a group of independent centers.

No significant financial relationships to disclose.

Integrated heterogeneous sono-photo Fenton processes for the degradation of phenolic aqueous solutions

The removal of organic compounds from aqueous solutions has been tackled by a novel integrated heterogeneous system. The efficacy of the different systems has been assessed using Fenton-like processes (H2O2/Fe2O3-SBA-15) and phenol as model pollutant. Sono- and photo-Fenton processes separately applied as well as combined systems were studied in order to evaluate of possible beneficial effects on the use of coupled systems. The sequential system evidences an enhancement in terms of phenol and TOC conversions compared to the ultrasound or UV-light irradiation processes. A total phenol degradation and ca. 90% TOC reduction are achieved by sequentially ultrasound followed by UV-visible light irradiation. These effects are ascribed cavitation effect of ultrasound producing a reduction of particle size that provides a higher amount of available active sites due to an increased surface area for the subsequent photo-Fenton system. These encouraging results open new paths for the existing oxidation technologies for potable water and wastewater treatment.

Significance of serum CA125 and TPS antigen levels for determination of overall survival after three chemotherapy courses in ovarian cancer patients during long-term follow-up

PURPOSE OF INVESTIGATION

To evaluate the prognostic significance for overall survival rate for the marker combination TPS and CA125 in ovarian cancer patients after three chemotherapy courses during long-term clinical follow-up.

METHODS

The overall survival of 212 (out of 213) ovarian cancer patients (FIGO Stages I-IV) was analyzed in a prospective multicenter study during a 10-year clinical follow-up by univariate and multivariate analysis.

RESULTS

In patients with ovarian cancer FIGO Stage I (34 patients) or FIGO Stage II (30 patients) disease, the univariate and multivariate analysis of the 10-year overall survival data showed that CA125 and TPS serum levels were not independent prognostic factors. In the FIGO Stage III group (112 patients), the 10-year overall survival was 15.2%; while in the FIGO Stage IV group (36 patients) a 10-year overall survival of 5.6% was seen. Here, the tumor markers CA125 and TPS levels were significant prognostic factors in both univariate and multivariate analysis (p < 0.0001). In a combined FIGO Stage III + FIGO Stage IV group (60 patients with optimal debulking surgery), multivariate analysis demonstrated that CA125 and TPS levels were independent prognostic factors. For patients in this combined FIGO Stage III + IV group having both markers below respective discrimination level, 35.3% survived for more than ten years, as opposed to patients having one marker above the discrimination level where the 10-year survival was reduced to 10% of the patients. For patients showing both markers above the respective discrimination level, none of the patients survived for the 10-year follow-up time.

CONCLUSION

In FIGO III and IV ovarian cancer patients, only patients with CA 125 and TPS markers below the discrimination level after three chemotherapy courses indicated a favorable prognosis. Patients with an elevated level of CA 125 or TPS or both markers after three chemotherapy courses showed unfavorable prognosis.

Initial distribution assessment of Aedes albopictus (Diptera: Culicidae) in the Barcelona, Spain, area

The invasive species Aedes (Stegomyia) albopictus (Skuse 1894) (Diptera: Culicidae) has reached several European countries, including Albania, Belgium, Bosnia and Herzegovina, Croatia, France, Greece, Israel, Italy, Montenegro, Serbia, Slovenia, Switzerland, The Netherlands, and recently Spain (Med. Vet. Entomol. 20: 150-152, 2006). Here, we present the initial characterization of the distribution of Ae. albopictus in the municipality of Sant Cugat del Vallès, Barcelona, Spain, where it was found for the first time in the Iberian Peninsula. An ovitrap sampling campaign was developed from September to December 2004 to assess the spatial distribution and abundance of Ae. albopictus to evaluate the potential of an eradication attempt. The population of Ae. albopictus in the whole area was shown to be widespread within the municipality, and it included at least another one neighboring town, so authorities were advised to develop large-scale control measures. Some indirect evidence was collected on the introduction means and date.

First description of the pupa of Ochlerotatus gilcolladoi

The pupa of Ochlerotatus gilcolladoi is described and illustrated for the first time. Specimens were caught near Madrid. A table lists the range and mode of the branches of each pupal seta.

Protein S-100β serum levels predicts clinical outcome of high-risk melanoma patients treated with high-dose adjuvant interferon alfa2b

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Background: S-100β serum levels have been shown to be useful to monitor response to therapy in metastatic melanoma patients. We have recently reported that S-100β levels could also be useful in the adjuvant context. In this study we analyze the clinical relevance of S-100β serum levels in an homogeneuos stage IIB-III group of patients treated with high-dose interferon. Methods: Patients with melanoma diagnosis were prospectively tested for serum S-100β protein by luminoimmunometric assay (LIA) before starting interferon (baseline) and every 3 months thereafter (on.therapy), until treatment was completed. Median time to progression and overall survival were assessed. Multivariate analysis using the Cox proportional hazards model with covariable dependent on time was perfomed since S-100β under therapy changes during time. Results: Ninety-seven patients were included. Median follow-up was 62.9 months (range 32.7–87.4). Median baseline S-100β levels were 0.06μg/l (range 0.06–0.53). S-100 was considered high (=0.15 μg/l) in 20.6% of the patients. High baseline S-100β levels were associated with positive lymph-node status (p=0.02). High S-100β levels (while on therapy) showed relation with positive lymph-node status (p=0.014), number of positive lymph-nodes (p=0.01), macroscopic lymph-node involvement (p=0.002) and second melanoma diagnosis at study entry (p=0.001). By univariate analysis, high baseline S-100β levels were associated with disease free survival (DFS) (p=0.004) and overall survival (OS) (p=0.0007). Similarly, high on therapy S-100β levels were associated with DFS (p<0.0001) and OS (p<0.0001). In the multivariate analysis, high on therapy S-100β levels (HR 1.029, CI95% 1.015–1.042; p<0.0001) was an independent prognostic factor for DFS. High on therapy S-100β levels (HR 1.017, CI 95% 1.10–1.026; p<0.0001) and high baseline S-100β levels (HR 3.31, CI 95% 1.10–9.89; p=0.032) were independent prognostic factors for OS. Conclusions: These results provide novel evidence of the clinical usefulness of serum S-100β levels determination for monitoring the clinical outcome of high-risk melanoma patients treated with adjuvant therapy.

No significant financial relationships to disclose.

A survey of mosquitoes breeding in used tires in Spain for the detection of imported potential vector species

The used tire trade has facilitated the introduction, spread, and establishment of the Asian tiger mosquito, Aedes albopictus, and other mosquito species in several countries of America, Africa, Oceania, and Europe. A strategy for detecting these imported mosquito vectors was developed in Spain during 2003-2004 by EVITAR (multidisciplinary network for the study of viruses transmitted by arthropods and rodents). A survey in 45 locations found no invasive species. Eight autochthonous species of mosquitoes were detected in used tires, including Culex pipiens, Cx. hortensis, Cx. modestus, Anopheles atroparvus, An. claviger, Culiseta longiareolata, Cs. annulata, and Aedes caspius. Dominant species were Cx. pipiens and Cs. longiareolata. Aedes caspius was found in only once, near its natural breeding habitat. Considering the recent discovery of an established population of Ae. albopictus in Catalonia, the increasing commerce of used tires in Spain for recycling, storage, and recapping might greatly contribute to the rapid spread of this species across the Iberian Peninsula.

Reproductive behaviour in bulls raised under tropical and subtropical conditions

The present review describes the behavioral characteristics of bulls raised under tropical and subtropical conditions and emphasizes the difficulties associated with adequately monitoring their performance in the field to predict reproductive potential. Most of the information generated for improving our understanding of bull behavior under range conditions has been generated in Bos taurus bulls. The limited information available in Bos indicus indicates that males searching for cows in estrus display different sexual patterns when compared to B. taurus bulls and a poor selection of a sire utilized in range conditions can have an important impact in cattle production. Screening and selecting [cg1] bulls for desirable reproductive traits and high libido is known to improve the reproductive performance of the herd. The reproductive and genetic potential of a bull is influenced by factors such as management, age, nutrition and problems related to the female such as embryonic death and anestrus. However, behavioral characteristics of bulls when detecting and serving cows in estrus is poorly understood.

A leishmaniosis surveillance system among stray dogs in the region of Madrid: ten years of serodiagnosis (1996–2006)

Two seroepidemiological surveys on canine leishmaniosis in stray dogs were performed annually in the Madrid region for 10 years (November 1996-April 2006). The presence of anti-Leishmania antibodies was detected by immunofluorescence antibodies test (cut off 1:100). The overall seroprevalence found in the 1,803 dogs studied was 7.8% (141 positive dogs). Seropositivity was not associated with either breed or sex. Statistical analysis revealed greater seroprevalence in groups of older dogs, indicating that the probability of exposure to the bite of sand flies infected with Leishmania infantum increased with age. The most important result was a high proportion of seropositivity for leishmaniosis (79.5%) among dogs without clinical signs of canine leishmaniosis. These data are very important because stray dogs can play an important role in the epidemiology of this zoonotic disease. Furthermore, the stray population could be useful sentinels to follow the progress of the disease in endemic areas.

Melanoma inhibiting activity protein (MIA), beta-2 microglobulin and lactate dehydrogenase (LDH) in metastatic melanoma

BACKGROUND

Serum levels of melanoma markers may have a role in monitoring disease evolution in metastatic melanoma.

PATIENTS AND METHODS

Serial measurements of melanoma inhibiting activity protein (MIA), lactate dehydrogenase (LDH), S-100 and beta2-microglubulin were obtained from 42 metastatic melanoma patients during their biochemotherapy treatment.

RESULTS

High pre-treatment serum levels of S-100, LDH, MIA and P2-microglobulin were detected in 50%, 57%, 50% and 24% of the patients, respectively. Only S-100 had prognostic significance for both disease-free (p=0.011) and overall survival (p=0.021). In patients who responded to treatment, S-100 levels decreased significantly from pre-treatment to the time of response (p = 0.050). When patients progressed, levels of MIA and P2-microglobulin increased significantly (p =0.028 and p =0.030, respectively).

CONCLUSION

Correlation with disease evolution was found for S-100, MIA and P2-microglobulin levels. Despite the small sample size of the study, S-100 was a significant prognostic marker for overall survival and disease-free survival.

Evaluation of a spray of permethrin and pyriproxyfen for the protection of dogs against Phlebotomus perniciosus

Dogs are the main domestic reservoir of Leishmania infantum in the Old World (Leishmania chagasi in the New World) a parasite responsible for many cases of human visceral leishmaniasis in both endemic and non-endemic regions. One strategy for the control of leishmaniasis would be to prevent dogs from being bitten by sandflies, the vector of leishmaniasis. This study was designed to assess the efficacy of spraying a combination of permethrin and pyriproxyfen on to dogs artificially exposed to sandflies. Two groups of four male dogs, one of them treated and the other left untreated as controls, were exposed for one hour to 100 female sandflies seven days before the treatment, on the day of treatment and seven, 14, 21, and 28 days later. After each exposure, sandflies were collected, counted and scored. The prevention of sandfly bite was calculated by measuring the number of fed sandflies (dead and alive) after treatment. In this experimental assay, the repellent effect of the treatment against sandfly bites after 21 days was 71.4 per cent, but the insecticidal effect was only 7.2 per cent.

Tumor VEGF expression and serum VEGF levels are independent prognostic factors in curatively resected gastric cancer patients

4021

Background: Increased serum and/or tumor vascular endothelial growth factor (VEGF) and urokinase-type plasminogen activator (uPA) have been shown to predict poor survival in several neoplasms, but their prognostic value in gastric cancer (GC) remains unknown. Methods: Serum VEGF (S-VEGF) and uPA concentrations were measured by commercially available ELISA in 20 healthy controls and 97 GC patients (70% I-II stages) before an R0 gastric resection. Tumor expression of VEGF and uPA were assessed by immunohistochemistry. Additional variables, including demographic, histological and therapeutic data were also evaluated. Univariate (Kaplan-Meier, log-rank test) and multivariate (Cox regression) analyses were performed to select prognostic factors regarding survival and tumor recurrence. Results: S-VEGF, but not uPA levels were significantly higher in GC patients than in controls. After a mean follow-up of 47 ± 3 months, the probability of cancer-related survival at 2, 5, and 10 years was 86%, 69% and 59%, respectively. Univariate analysis identified tumor VEGF expression (p=0.001) and high (> 289 pg/ml) S-VEGF levels (p=0.045), along with pTMN stage, grade of curability, perineural invasion, lymph node ratio, and extent of lymphadenectomy as variables associated with cancer-related survival. The mean disease-free survival was 20 ± 3 months, the probability of tumor recurrence being 78%, 62% and 62% at 2, 5 and 10 years, respectively. Prognostic variables for recurrence were the same as those identified for survival. Multivariate analysis identified tumor VEGF expression and high S-VEGF levels as independent prognostic survival factors. Conclusions: After a long follow-up, tumor VEGF expression and S-VEGF levels are independent prognostic factors for recurrence and survival in curatively resected gastric cancer patients. Such markers for increased angiogenic activity might help to identify patients at high risk of recurrence that could mostly benefit from adjuvant therapies. It is tempting to speculate that trials assessing the potential benefit of a.ntiangiogenic agents might be particularly warranted in patients with resected GC and a highly angiogenic phenotype.

No significant financial relationships to disclose.