El objetivo principal del presente estudio fue llevar a cabo un entrenamiento en Funciones Ejecutivas (FE) para comprobar sus efectos sobre las Habilidades Matemáticas Básicas (HMB) y la Conciencia ...Fonológica (CF) en niños de Educación Infantil (EI). La investigación se realizó a lo largo de tres fases: una de evaluación previa a la intervención, una segunda fase en la que implementó un entrenamiento en FE, y finalmente una fase de evaluación al finalizar el entrenamiento. Este entrenamiento se aplicó por separado a dos grupos de 6 niños de 6º curso de EI (un grupo TIC y un grupo en lápiz y papel) que recibieron igual tratamiento. Los resultados mostraron mejoras tanto en HMB como en CF en ambos grupos.
Objective: a good assessment of the performance level in the activities of daily living is crucial to develop treatments adapted to the needs of every patient. The aim of this article is to present ...the scale of " Instrumental activities of daily living (IADLs) and Activities of Daily Living Assessment " designed by Mariel Pellegrini; to carry out a psychometric study of its reliability and validity; and to study the relationships between cognitive impairment, demographic variables and Activities of Daily Living (ADL) and instrumental activities of daily
living (IADL). Methods: 80 patients beginning treatment in the cognitive impairment unit were assessed. The Mini-Mental State Examination was administered and a reliability and validity analysis of the scale was performed. Results: the two subscales or sections (ADLs and IADLs) and the global assessment met the Cronbach Alpha criterion> 0.7. The total scores of the global assessment and its two subscales differentiated the functional performance of the sample divided by age and sex groups, but not by level of cognitive functioning. Conclusion: the scale produced an adequate psychometric functioning in patients with mild cognitive impairment. Correlations have been found between the ADLs and IADLs assessment scale and the demographic variables studied, highlighting the protective factor of the roles played throughout life in keeping patients’ autonomy. This study provides an assessment tool that will allow to identify different ADLs performance levels in patients with cognitive impairment.
Objetivo: la valoración del nivel desempeño en actividades de la vida diaria es de gran utilidad para desarrollar tratamientos adaptados a las necesidades de cada paciente. Los objetivos de este artículo son presentar la escala de “Valoración de las actividades de la vida diaria e instrumentales” creada por Mariel Pellegrini, realizar un estudio psicométrico de la fiabilidad y validez de dicha escala, estudiar las relaciones entre el deterioro cognitivo y las variables demográficas con las actividades de la vida diaria básicas e instrumentales. Método: se ha evaluado con ella a 80 pacientes que iniciaron tratamiento en la Unidad de Deterioro Cognitivo. Se ha administrado el Mini-Mental State Examination. Se han realizado análisis de fiabilidad y validez de la escala. Resultados: las dos subescalas o secciones (actividades de la vida diaria básicas y actividades de la vida diaria instrumentales) y el global de la valoración de actividades de la vida diaria e
instrumentales cumplieron el criterio Alpha de Cronbach > 0.7. Las puntuaciones to
tales de la valoración y de sus dos subescalas (actividades de la vida diaria básicas e instrumentales) diferencian el desempeño funcional entre grupos organizados por edad y sexo, pero no por nivel de funcionamiento cognitivo. Conclusión: la escala presenta un funcionamiento psicométrico adecuado en los pacientes con deterioro cognitivo leve. Se han encontrado relaciones entre la escala Valoración de las actividades de la vida diaria e
instrumentales y las variables demográficas estudiadas. Destacar el factor protector de los roles desempañados a lo largo de la vida para el mantenimiento de la autonomía. Tras este estudio disponemos de una escala que va a permitir evaluar los diferentes niveles de actividades de la vida diaria en pacientes con deterioro cognitivo.
Abstract 3654▪▪This icon denotes a clinically relevant abstract
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, showing affected patients a highly variable outcome. The improvement ...in survival gained with the addition of rituximab to CHOP chemotherapy (R-CHOP) led to re-define the international prognostic index (IPI). The new index, known as revised IPI (R-IPI), showed to be simpler as it groups the patients in only 3 risk groups. However, the effect of prior rituximab-therapy upon the usefulness and significance of previously recognized prognostic factors on patients relapsed or refractory and receiving subsequent treatment with rituximab plus chemotherapy in DLBCL remains unexplored. Biological parameters, including expression of Bcl-6, Bcl-2, p53 and MUM-1 have been described as IPI-independent prognostic factors.
The objective of this study was to evaluate the benefit of the R-IPI to predict the outcome of DLBCL patients at the relapse time following a front line treatment with chemotherapy and rituximab. We also aimed to establish in this population the relationship between immunohistochemical expression of biological parameters and outcome.
Patients and methods: this was a multicentric, observational, post-authorization and cross-sectional study (ClinicalTrials.gov identifier: NCT01369784). Inclusion criteria were: patients with age ≥ 18 years with DLBCL refractory/relapsed after first line treatment with rituximab, with or without transplantation. Patients must have finished a rescue treatment including rituximab. Written informed consent was obtained from participants. When the data of the biopsies at diagnosis and relapse were available, immunohistochemical results of bcl-2, bcl-6, p53 and MUM-1 were obtained.
152 patients were included (146 evaluables) with a median age of 58 years. At LDBCG diagnosis 48% had > 1 extranodal localization (29% had bone marrow disease), and 30% had ECOG 2 or greater. Eighty-one percent presented stages III or IV and 72% had elevated LDH. Three percent had very good prognosis R-IPI, 69% good prognosis R-IPI and 27% poor prognosis R-IPI. Most patients received R-CHOP as first line therapy. Overall response rate was 79% (40% complete remission). Relapse was confirmed with biopsy and histological study in 55 patients. At relapse 31% presented > 1 extranodal localization, 30% ECOG 2–4, 64% stages III-IV and 72% elevated LDH. R-IPI prognostic groups distribution at relapse were as follows: 8% very good, 75% good and 27% poor. R-ESHAP and R-GEMOX were the two more used rescue therapies resulting in 60% overall response rate (31% complete remission). R-IPI at relapse was significantly associated (p < 0,05) with overall response rate following R-chemotherapy rescue therapy. None of the immunohistochemical parameters analized correlated with rescue therapy results.
This is the largest reported series analizing R-IPI in DLBCL at relapse/refractory in patients receiving R-chemotherapy. In this series of patients R-IPI calculated at the relapse time was the only prognostic factor capable of predicting the overall response to the second line of treatment. Thus R-IPI prognostic score is a simple and useful predictor for outcome in DLBCL at relapse/refractory
No relevant conflicts of interest to declare.
Sleeve gastrectomy (SG) has become a technique in its own right although a selective or global indication remains controversial. The weight loss data at 5 years are heterogeneous. The aim of the ...study is to identify possible prognostic factors of insufficient weight loss after SG.
A SG retrospective multicenter study of more than one year follow-up was performed. Failure is considered if EWL>50%. Univariate and multivariate study of Cox regression were performed to identify prognostic factors of failure of weight loss at 1, 2 and 3 years of follow up.
A total of 1,565 patients treated in 29 hospitals are included. PSP per year: 70.58±24.7; 3 years 69.39±29.2; 5 years 68.46±23.1. Patients with EWL<50 (considered failure): 17.1% in the first year, 20.1% at 3 years, 20.8% at 5 years. Variables with influence on the weight loss failure in univariate analysis were: BMI>50kg/m
, age>50years, DM2, hypertension, OSA, heart disease, multiple comorbidities, distance to pylorus> 4cm, bougie>40F, treatment with antiplatelet agents. The reinforcement of the suture improved results. In multivariate study DM2 and BMI are independent factors of failure.
The SG associates a satisfactory weight loss in 79% of patients in the first 5 years; however, some variables such as BMI>50, age>50, the presence of several comorbidities, more than 5cm section of the pylorus or bougie>40F can increase the risk of weight loss failure.
Abstract Introduction Sleeve gastrectomy (SG) has become a technique in its own right although a selective or global indication remains controversial. The weight loss data at 5 years are ...heterogeneous. The aim of the study is to identify possible prognostic factors of insufficient weight loss after SG. Methods A SG retrospective multicenter study of more than one year follow-up was performed. Failure is considered if EWL >50%. Univariate and multivariate study of Cox regression were performed to identify prognostic factors of failure of weight loss at 1, 2 and 3 years of follow up. Results A total of 1565 patients treated in 29 hospitals are included. PSP per year: 70.58 ± 24.7; 3 years 69.39 ± 29.2; 5 years 68.46 ± 23.1. Patients with EWL <50 (considered failure): 17.1% in the first year, 20.1% at 3 years, 20.8% at 5 years. Variables with influence on the weight loss failure in univariate analysis were: BMI >50 kg/m2 , age >50 years, DM2, hypertension, OSA, heart disease, multiple comorbidities, distance to pylorus >4 cm, bougie >40F, treatment with antiplatelet agents. The reinforcement of the suture improved results. In multivariate study DM2 and BMI are independent factors of failure. Conclusion The SG associates a satisfactory weight loss in 79% of patients in the first 5 years; however, some variables such as BMI >50, age >50, the presence of several comorbidities, more than 5 cm section of the pylorus or bougie >40F can increase the risk of weight loss failure.
La amnioinfusión se ha usado históricamente para mejorar los resultados neonatales en casos de aspiración de meconio durante el parto. Se expone el caso de una gestante a término, de bajo riesgo, con ...líquido amnótico meconial, en trabajo de parto activo en el que se descarta su uso por presentar registro cardiotocográfico con desaceleraciones variables atípicas. Aunque algunos estudios sugieren que la amnioinfusión puede reducir el riesgo de aspiración meconial éstos presentan sesgos y limitaciones. Se recomienda su uso en centros con recursos limitados para la vigilancia materno-fetal y en casos de sospecha de compresión funicular. Sin embargo, en registros con variables atípicas se deben considerar otras medidas para corregir posibles problemas placentarios y mejorar la situación fetal.
Abstract
Background: Hidroxyurea acts synergistically with DNA alkylating agents; pioglitazone is a ligand of PPAR-gamma, a nuclear receptor with great potential in controlling oncogenic mechanisms ...unexplored in clinic, upregulated after exposure to several cytotoxic agents. Purpose: To evaluate pharmacodynamic effects of the combination of carboplatin and paclitaxel, associated with either hydroxyurea or pioglitazone, within a phase 1-2 clinical study.
Material and Methods: Patients with unresectable, advanced solid tumors, refractory to standard therapies were considered eligible for this randomized, dose escalating trial. Patients received weekly administration of carboplatin (AUC = 2) and paclitaxel (80 mg/m2) on days 1, 8, 15 q 28d. Patients were randomly allocated to additionally receive either pioglitazone (P) or hydroxyurea (H). The doses of P were 30, 45 and 60 mg/d, whereas the doses of H were 1000 and 1500 mg/d.
The comet assay was chosen as a tool to assess the added effects of hydroxyurea, whereas UCP-2 (Uncoupling Protein 2) was selected for the evaluation of the effects of pioglitazone. These events were determined in mononuclear cells from peripheral blood, at baseline and at week 4. Alkaline comet assays were performed using a single-cell electrophoresis protocol and comet lengths were measured with the ImageJ software. UCP-2 was determined by quantitative RT-PCR. For these results, intrapatient and intercohort variations were analyzed.
Results: The UCP-2 gene expression was increased after treatment in the majority of patients in our cohort. The increased expression of UCP-2 was lower in patients treated with pioglitazone versus hydroxyurea, however there were no significant differences between treatments. The rate of affected cells with double-strand breaks after treatment, was significantly higher in patients treated with hydroxyurea than in patients treated with pioglitazone (27.1% vs. 16.3% of cells affected, P<0.05).
Conclusions: Our study has the limitations of a small sample size, but we have seen that the use of hydroxyurea can lead further damage to cellular DNA. UCP-2 expression was increase after both treatments, and we can not attribute it to one drug in particular. We should note that we could not discriminate between the different drug doses administered to patients due to small sample. A correlation between these effects and tumor response will be analyzed and shown.
Citation Format: M. Teresa Agulló-Ortuño, Carlos Pérez, C. Vanesa Díaz-García, Blanca Homet, Alba Agudo-López, Analia Rodríguez Garzotto, Elena Prieto-García, Jorge Adeva, María C. Riesco, Raquel Rodríguez, M. Luisa Durán, Elena Laguna, Carmen Montalbán, Hernán Cortés-Funes, José A. López-Martín. Pharmacodynamic evaluation of the combination of carboplatin and paclitaxel associated with either pioglitazone or hydroxyurea, within a randomized phase 1 dose escalation clinical trial in patients with advanced solid tumors. abstract. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2575. doi:10.1158/1538-7445.AM2015-2575
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