The immune system plays a central role in the pathogenesis of cancer, inhibiting as well as promoting effects on tumor development. Tumor-infiltrating lymphocytes (TIL) and PD-L1 expression have been described as factors with prognostic influence in the early stages of breast cancer. However, its relationship to other classical prognostic factors of estimated importance is unknown.

Boletin correspondiente al Ano XCVII. Enero a Diciembre. Num. 167. Contiene: Contiene: Galeria de academicos, "Galeria de Academicos", Ilmo. Sr. Dr. D. Manuel Pineda Priego. Antonio Cruz Casado, "Fabulas mitologicas ovidianas en poetas cordobeses del Siglo de Oro (En el bimilerario de la muerte de Ovidio)". Jose Cosano Moyano, "Apertura del curso academico 2017-2018 en la Real Academia de Cordoba". Eduardo Baena Ruiz, "La libertad de testar". Francisco de Paula Sanchez Zamorano, "Contestacion al discurso del Excmo. Sr. D. Eduardo Baena Ruiz en su ingreso como Numerario". Javier Eiroa Escalada, "Reflexiones protocolarias en torno al pintor palentino Casado del Alisal". Carlos Hugo Garrido Chalen, "La imprescindible necesidad del estilo en el arte y la literatura". Pilar Leon, "Tres estampas arqueologicas en los albores de Colonia Patricia". Jose Sarria Cuevas, "La palabra encendida. Breve analisis de la literatura hispanomagrebi". Fernando Penco Valenzuela, "Fernan Gomez de Guzman: entre Lope y la realidad". Antonio Bernal Redondo, "Origen y genesis de una imagen de San Juan de Avila para la catedral de Cordoba". Jose Ignacio Perez Peinado, "La astronomia de Alpetragio". Rafael Pineda y Manuel Pineda, "Seguridad alimentaria mundial: el papel de las Ciencias Biologicas". Jose Javier Rodriguez Alcaide, "Memoria de un constituyente academico". Ma Jose Porro Herrera, "Las poetas de la revista ARKANGEL: Ana Ma Martinez Sagi, Gloria Fuertes y Amparo Gaston". Rosa Luque Reyes, "Gongora siempre. Ofrenda literaria leida ante el sepulcro de Gongora en el dia que la Real Academia de Cordoba dedica al poeta". Aniceto Lopez Fernandez, "Aspectos ecologicos de la evolucion humana". Juan Aranda Doncel, "Advocaciones populares en la Cordoba de los siglos XVIII y XIX: La ermita del Cristo de las Animas (1760-1820)". Manuel A. Garcia Parody, "Cordoba en la crisis de 1917". Amelia de Paz de Castro, "Ascenso y caida del inclito doctor Reinoso, gallo de las bravatas (1597)". Antonio Cruz Casado, "Visiones de Rusia en la cultura espanola de los siglos XVII a XIX (perspectivas literarias)". Antonio Varo Baena, "Aportaciones ineditas a la biografia del poeta Juan Ugart". Ana Padilla Mangas y Clara Cobo Guijarro, "Bibliografia completa sobre la obra de Antonio Gala". Ana Recio Mir, "Nacimiento al amor. El fuego que enamora". Carmen Fernandez Ariza, "La ultima vuelta de tuerca en la obra narrativa de Javier Cercas: El Monarca de las sombras". Jose Antonio Ponferrada Cerezo, "Dos fotografias ilustradas (en torno a Jose Jimenez Poyato y Manuel Lopez Alejandre)". Jose Maria Palencia Cerezo, "La huella de Murillo en Cordoba". Pedro Benito Lopez, "El sistema cerebral de recompensa, del aprendizaje a la adiccion". Rafael Jordano Salinas, "Produccion agroalimentaria de calidad en la provincia de Cordoba y su vinculacion al territorio". Enrique Pozon Lobato, "Rabanales: de la Universidad Laboral al Campus Universitario". Alberto Monterroso, "Vaquerizo Gil, D. (coord.), Los barrios de Cordoba en la historia de la ciudad (1): De los vici romanos a los arrabales islamicos. Real Academia de Cordoba, Cordoba, 2018". Nader Al Jallad, "Monferrer Sala, J.P. (coord.), La ciudad y sus legados historicos (2): Cordoba Islamica. Real Academia de Cordoba, Cordoba, 2018". Luis Segado Gomez, "Cosano Moyano, J.; Abril Hernandez, J.Ma. (coords.), Bujalance. Universo de pueblo campines. Real Academia de Cordoba, Col. A. Jaen Morente, II, Cordoba, 2018". Soledad Gomez Navarro, "Porro Herrera, Ma.J.; Escobar Camacho, J.M.; Luque Reyes, R. (coords.), Cordobesas de ayer y de hoy. Real Academia de Cordoba, Cordoba, 2017". Jose Lucena Llamas, "Escobar Camacho, J.M., Marquez Cruz, F.S. (coords.), Academicos en el recuerdo. Real Academia de Cordoba, Col. F. de Borja Pavon, I, Cordoba, 2018". Gregorio Galvez Valdivieso y Rafael Blasco Pla, "Biotecnologia: aplicaciones y controversias, de Rafael Pineda Reyes y Manuel Pineda Priego. UCOPress, Cordoba, 2017". Rafael Pineda y Manuel Pineda, "Historia General de la Agricultura. De los pueblos nomadas a la Biotecnologia. Editorial Guadalmazan (Almuzara). Cordoba, 2018". Antonio Cruz Casado, "Casa Luna (Granada, 2016), la tercera novela del ubetense Miguel Pasquau Liano". Juan Miguel Moreno Calderon, "Aranda Doncel, J. (coord.), Martinez Millan, J., Gonzalez Barrionuevo, H., Pineda Navajas, A.T., Las capillas de musica en el Barroco. Instituto Universitario “La Corte en Europa” – UAM y Ateneo de Musica Sacra “Villa Cervantina” de Castro del Rio, Cordoba, 2018". Manuel Gahete, "Los simbolos de Iris. Paloma Fernandez Goma. Rute (Cordoba): Anfora Nova, 2017". Antonio Cruz Casado, "Un volumen de estudios sobre cofradias y hermandades del Rosario de la Aurora". Jose Cosano Moyano, "Cuadro donado por la familia Garcia Cabrera". Inmaculada Garcia Cabrera, "Palabras pronunciadas por Da Inmaculada Garcia Cabrera en el acto de donacion a la Real Academia de Cordoba de un oleo sobre lienzo de D. Francisco Marchesi Butler". Antonio Cruz Casado, "Homenaje al Ilmo. Sr. Dr. D. Julian Garcia Garcia, academico numerario. Laudatio". Jose Cosano Moyano, "Clausura del curso academico 2017-2018 en la Real Academia de Cordoba". Jose Manuel Escobar Camacho, "Memoria del curso academico 2017-2018".

Background: This multicentre, randomised, and phase II study evaluated mFOL-FOX+cetuximab followed by maintenance mFOLFOX+cetuximab or single-agent cetuximab in metastatic colorectal cancer (mCRC) patients (NCT01161316). Patients and methods: Previously, untreated mCRC patients (wild-type KRAS) were randomised to receive cetuximab+mFOLFOX-6 (8 cycles for 2 weeks) followed by maintenance therapy: single-agent cetuximab (Arm-A) or mFOLFOX-6 + cetuximab (Arm-B) until progression. Primary endpoint was progression-free survival (PFS) at 9 months. Results: One hundred ninety-three patients (median [range] age 60 [33-74] years) were randomised (2: 1): 129 Arm-A versus 64 Arm-B. PFS at 9 months (95% confidence interval) showed non-inferiority between arms (Arm-A/Arm-B: 60 [52, 69]%/72 [61, 83]%, p [non-inferiority]< 0.1). There were no statistically significant differences in the PFS (Arm-A/Arm-B: 9 [95% CI 7, 10] months/10 [7,13] months, hazard ratio [HR] = 1.19 [0.80, 1.79]) or overall survival (23 [19, 28] months/27 [18, 36] months, HR = 1.24 [0.85, 1.79]) between arms. The objective response rate was also similar (48 [39, 57]%/39 [27, 52]%). The safety profile was similar between arms, and all patients experienced at least one adverse event (AE) (Arm-A/Arm-B grade >= III AEs: 70%/68%). The most common grade >= III AEs were as follows: neutropenia (Arm-A/Arm-B: 28%/26%), rash acneiform (15%/24%) and sensory neuropathy (2%/15%) in any group. Arm-A was associated with less grade >= III rash and sensory neuropathy and a lower rate of serious AEs (20%/27%). Conclusion(s): This phase II exploratory trial with a non-inferiority design suggests that maintenance therapy with single-agent cetuximab following mFOLFOX+cetuximab induction could be a valuable option compared with mFOLFOX+cetuximab treatment continuation. We await phase III trials to confirm single-agent cetuximab as maintenance therapy in mCRC patients. (C) 2018 Elsevier Ltd. All rights reserved.

Qualitative two-phase flow regime data are obtained from high-speed visualization of condensing flows of R-134a at mass fluxes from 75 to 150 kg m−2 s−1 and quality from 0.1 to 0.8 in square microchannels (DH = 0.84 mm) cooled from a single side. Superheated R-134a is distributed into multiple parallel microchannels and then partially condensed, using a counterflow water loop, to the desired quality prior to the inlet of a visualization section. This experimental arrangement mitigates the potential for flow maldistribution. Despite very small heat duties, a low uncertainty in the quality in the visualization section is maintained by enforcing a large temperature difference on the water-side (ΔT > 10 K). For all conditions, annular or annular/wavy type flow were observed, with no distinct intermittent flow. Data are compared with flow macro and mini/microchannel maps, which are shown to over predict the occurrence of intermittent or wavy flow.

Bevacizumab is the only therapeutic target approved for patients with persistent, recurrent or advanced cervical cancer from a phase III study that combined with chemotherapy; it proves a significant increase in overall survival. To retrospectively assess the efficacy and safety of bevacizumab as the first-line treatment in patients from usual clinical practice with recurrent/persistent or advanced cervical cancer.

In the VELOUR study, aflibercept + FOLFIRI regimen resulted in improved survival in metastatic colorectal cancer (mCRC) patients who progressed after oxaliplatin. The use of aflibercept outside the clinical trial framework needs to be further assessed in terms of effectiveness and tolerability.

Aim: The optimal duration and content of first-line therapy in p with mCRC once they have achieved the maximal response remains controversial. This multicenter, randomized, phase II study was aimed to evaluate the efficacy and tolerability of 8 cycles of mFOLFOX plus C followed by maintenance mFOLFOX plus C or s/a C.

The efficacy of epidermal growth factor-targeting therapies has been found to be limited in tumors with the wild-type K-RAS gene, suggesting a predictive value of K-RAS gene analysis in tumoral response. However, the prognostic value of K-RAS is controversial. This study included patients diagnosed with metastatic colorectal cancer. The presence of K-RAS mutations was analyzed, and the tumors positive for a K-RAS mutation were further analyzed to identify the mutation type. Similarly, the following clinical and pathological variables were also collected. The study was composed of 53.3 % of patients with wild-type K-RAS and 46.7 % of patients with mutated K-RAS (mutated codon 12 was the most frequent). With a mean follow-up of 15 months (range, 1–45), the median survival of patients with wild-type K-RAS was 31.6 months. The median survival was 24.8 months for patients with K-RAS mutated in codon 12 and 17.8 months for patients with mutated codon 13 ( p = 0.37). In a univariate analysis, K-RAS was associated with stage IV at diagnosis ( p < 0.005). When K-RAS was mutated, a lower overall survival was observed in cases of G→A transition compared with G→T transversion (19.5 vs. 24.2 months, respectively; p = 0.47). When the amino acid change resulted in an acidic substitution, survival was lower, but it increased when the substitution resulted in a polar or nonpolar amino acid (19.5 vs. 23.2 vs. 24.4 months, p = 0.79). The type of K-RAS mutation or amino acid changes may have prognostic implications in metastatic colon cancer patients. Further research is needed in patients treated in prospective controlled trials.

Primary signet-ring cell adenocarcinoma of the urinary bladder is a rare tumor. We report in this study the case of a 53 year old man consulting for gross hematuria. Computed tomography imaging demonstrated right hydronephrosis and an invasive bladder tumor. The bladder biopsy showed a signet-ring cell carcinoma; the exploration of the gastrointestinal tract did nor reveal any other tumor localization. A total cystoprostatectomy was performed followed by adjuvant chemotherapy with cisplatin and gemcitabine. The aim of this study is to determine the anatomoclinical, therapeutic and evolutionary characteristics of this rare tumor.

OBJECTIVE:To calculate excess mortality in an annual cohort of tuberculosis patients and study the factors associated with death.MATERIAL AND METHOD:Cases of tuberculosis reported in Catalonia (May 1996-April 1997). Patients were classified as completed treatment/cured (compliant), non-compliant, failures, transfers out and deaths. Excess mortality was defined as the ratio actual deaths/expected deaths (according to general mortality figures for Catalonia, May 1996-April 1997). Factors associated with death were determined by a comparative study of variables (demographic, substance abuse, comorbidity, tuberculosis-related disease) in deaths after diagnosis and survivors. Time from diagnosis to death was recorded.RESULTS:Patients included: 2,085. Patients classified as: completed treatment/cured (compliant), 1,406 (67.43 %); noncompliant, 165 (7, 91%); failures, 5 (0.24%); transfers out, 25 (1.21%); deaths, 133 (6.38%), 28 of which occurred before diagnosis and 105 after diagnosis. Insufficient data in medical record for classification, 351 (16.83%) patients. Excess mortality: 5.98 (95% CI: 4.96-7.0). Factors associated with death: treatment with non-standardized guidelines, 46%; OR: 10.3 (6.2-17.4); HIV infection, 40%; OR: 13.0 (6.6-25.8); age greater than 64 years, 40%; OR: 14.6 (3.0-69.8); alcoholism, 25%; OR: 2.0 (1.1-3.6); neoplasm, 16%; OR: 3.9 (1.8-8.6; renal failure, 8%; OR: 10.1 (3.1-32.3). The shortest time from diagnosis to death was in patients with only one risk factor, except for HIV infection, where the time passed was the longest observed.CONCLUSIONS:We found substantial excess mortality in tuberculosis patients. Death was associated with the efficacy of treatment, HIV coinfection, advanced age, alcoholism and the coexistence of neoplasms or renal failure.

SETTING AND OBJECTIVE:Smoking habit and tuberculosis (TB) appear to have common epidemiological and clinical links. The present study was to evaluate risk factors in TB patients with and without a smoking habit. DESIGN:A cross-sectional observational study of cases (TB with smoking) and controls (TB without smoking) from the same registry. Data were retrieved from case notes and interviews of patients registered in the Tuberculosis Control Programme in Cataluuña, Spain, between 1 January 1996 and 31 December 2002. Statistical analyses included univariate and stepwise multiple logistic regression analyses. RESULTS:There were 13,038 recorded patients. Social factors associated with TB in smokers were male sex (adjusted odds ratio [aOR] 2.2), age <64 years, alcohol use >30 g/day (aOR 7.4) and intravenous drug use (aOR 1.5). Smokers developed more pulmonary disease (aOR 1.5) and more cavitary lesions (aOR 1.9), and were more likely to require hospitalisation (aOR 1.8) which was more protracted. Differences in mortality and delay in diagnosis did not reach statistical significance. CONCLUSIONS:Smoking leads to faster and more severe progression of TB. The cost of TB-related hospitalisation for smokers increases by approximately one million euros per year.

BACKGROUND:Health system delay (HSD) is an important issue in tuberculosis (TB) control. This report investigates HSD and associated factors in a cohort of Spanish culture-confirmed TB patients.METHODS:Data were collected from clinical records. Using logistic regression with two different cut-off points to define HSD (median and 75th percentile), adjusted odds ratios were used to estimate the association between HSD and different variables.RESULTS:A total of 5184 culture-confirmed TB cases were included. Median and 75th percentile HSD were 6 and 25 days respectively. HSD significantly greater than the median was associated with: age >44 years, past or present intravenous drug use, diagnosis at a primary-care centre, prior preventive therapy, positive histology, request for drug-sensitivity testing, presence of silicosis or neoplasia in addition to TB, presence of non-TB related symptoms, and gastrointestinal site. HSD greater than the 75th percentile was related to the same variables, with the exception of diagnosis at a primary-care centre, positive histology, silicosis, non-TB-related symptoms and gastrointestinal site, for which the association disappeared; in contrast, an association with female gender emerged.CONCLUSION:Despite free health care being universally available in Spain, there are some groups of TB patients whose treatment is unduly delayed.

BACKGROUND:Patient delay was investigated in a cohort of TB patients identified from May 1996 until April 1997 in 13 Autonomous Regions in Spain. The study covered almost 67% of the total Spanish population.METHODS:Data were collected from clinical records. Using unconditional logistic regression with two different cut-off points to define 'patient delay' (the median and 75th percentile), the association between patient delay and different factors was estimated.RESULTS:A total of 7,037 cases were included. Median and 75th percentile delays were 22 and 57 days respectively. Factors associated with patient delay greater than the median (p<0.05) were: non-respiratory symptoms of TB and age over 14 years, although the effect of age was not linear. Furthermore, an interaction was observed between intravenous drug user (IDU) and HIV status, in that, whereas patient delay was greater in IDUs than in non-IDUs among cases whose HIV status was either negative or unknown, among HIV-positive patients no such IDU-related differences were in evidence. Factors associated with extreme patient delay (greater than the 75th percentile) were essentially the same, but the above-described interaction disappeared, with IDU status showing no direct effect. In addition, likelihood of extreme patient delay increased in the case of alcoholism and female gender and decreased in the case of chronic renal failure, corticoid treatment, prison inmates and residents of old age homes.CONCLUSION:Although there is a universally enjoyed right to health care in Spain, some groups of TB patients could nevertheless be experiencing problems in seeking medical attention.

Background: Patients with positive sputum smears are those with the capacity to spread infection. The objective of this study was to describe the incidence of tuberculosis in Catalonia (an autonomous community in the northeast of Spain which includes Barcelona) and to determine risk factors associated to patients with positive sputum smear test. Methods: New cases of tuberculosis detected by active surveillance between May 1996 and April 1997 were studied. The study was analysed as a coincident cases and controls study. The rate of incidence was calculated per 100,000 persons-year. The association of the dependent variable – case of tuberculosis with positive sputum smear – with the remainder of independent variables was determined by odds ratio (OR) with a 95% confidence interval (CI). Results: A total of 2508 cases of tuberculosis were detected. The rate of incidence was 41.4 per 100,000 persons-year. Of these 19.4% (487/2508) were coinfected with HIV and 35.6% (893/2508) presented a positive sputum smear, which implies a rate of 14.7 per 100,000 persons-year. In an adjusted multivariate analysis, cases with positive smears were positively associated with the 15–24 (OR=1.9; 95% CI: 1.4–2.4), 25–34 (OR=2.1; 95% CI: 1.7–2.7) and 35–44 years (OR=1.7; 95% CI: 1.3–2.2) age compared with persons 45 years old and above; with males (OR=1.8; 95% CI: 1.5–2.2) and consumers of alcohol (OR=2.1; 95% CI: 1.7–2.7) and negatively with those under 15 years of age (OR=0.1; 95% CI: 0.1–0.2) and coinfection with HIV (OR=0.5; 95% CI: 0.3–0.7). Conclusions: Measures to control tuberculosis transmission (prompt diagnosis, study of contacts and directly observed treatments) should be reinforced for male adults with excessive consumption of alcohol.