Estudio de calidad de vida de pacientes con coxartrosis

La artroplastia de cadera secundaria a artrosis es una de las intervenciones más frecuentes dentro de la cirugía ortopédica. La coxartrosis produce una limitación funcional severa, que invalida a los pacientes y los hace dependientes para sus actividades cotidianas. Se calcula la calidad de vida aportada en las intervenciones de reemplazo articular de cadera de 85 pacientes con coxartrosis utilizando el “EQ-5D”. La puntuación media preoperatoria fue 0,222 ± 0,320 y la postoperatoria 0,794 ± 0,251. El incremento de calidad de vida en función de la edad de los pacientes siguió una tendencia descendente (β= −0,010), sin diferencias significativas (p=0,214). El incremento de calidad de vida no se vió condicionado por la presencia de infección (p>0,5), duración de la intervención (p>0,5) ni tiempo de estancia hospitalaria (p>0,5). La sustitución de esta articulación ha transformado la vida de muchos de los pacientes incrementando su calidad de vida, principalmente en pacientes que ingresan por coxartrosis en comparación con otros diagnósticos.Hip replacement secondary to osteoarthritis is one of the most performed surgeries in orthopaedic surgery. Osteoarthritis produces a severe functional limitation that invalidates patients and makes them dependent for their daily activities. It is calculated the quality of life provided by hip replacement procedure in 85 osteoarthritis patients using the “EQ-5D”. The mean preoperative score was 0.222 ± 0.320 and the postoperative score 0.794 ± 0.251. The increase in quality of life according to patients age followed a descendent tendency (β= −0.010), without a statitically relationship (p=0.214). The increase in quality of life was not conditioned by infection (p>0.5), length of stay (p>0.5) or length of the procedure (p>0.5). Joint replacement has changed the lives of many patients, increasing their quality of life, mainly in osteoarthritis patients compared to patients with other diagnosis

Super-rough dynamics on tumor growth

The growth of a cultivated typical brain tumor is studied in this work. The tumor is analyzed both dynamically and morphologically. We have measured its fractal dimension to be d(f) = 1.21 +/- 0.05. From its dynamical behavior we determine the scaling critical exponents of this circular symmetry system which are compatible with the linear molecular beam epitaxy universality class. A very important feature of tumor profiles is that they are super-rough, which constitutes the first (1 + 1)-dimensional experiment in literature with super-roughness. The results obtained from the dynamics study make manifest two very surprising features of tumor growth: Its dynamics is mainly due to contour cells and the tendency of an interface cell to duplicate is a function of the local curvature. [S0031-9007(98)07545-0]

Pinning of tumoral growth by enhancement of the immune response

Tumor growth is a surface phenomenon of the molecular beam epitaxy universality class in which diffusion at the surface is the determining factor. This Letter reports experiments performed in mice showing that these dynamics can, however, be changed. By stimulating the immune response, we induced strong neutrophilia around the tumor. The neutrophils hindered cell surface diffusion so much that they induced new dynamics compatible with the slower quenched-disorder Edwards-Wilkinson universality class. Important clinical effects were also seen, including remarkably high tumor necrosis (around 80%-90% of the tumor), a general increase in survival time [the death ratio in the control group is 15.76 times higher than in the treated group (equivalent to a Cox's model hazard ratio of 0.85; 95% confidence interval 0.76-0.95, p=0.004)], and even the total elimination of some tumors

Reply to Comments by Buceta and Galeano Regarding the Article “The Universal Dynamics of Tumor Growth”

Depto. de Análisis Matemático y Matemática AplicadaFac. de Ciencias MatemáticasTRUEpu

Study of tumor growth indicates the existence of an "immunological threshold" separating states of pro- and antitumoral peritumoral inflammation

Peritumoral inflammation-a response mainly involving polimorphonuclear neutrophils-has traditionally been thought protumoral in its effects. In recent years, however, a number of studies have indicated that it may play an important antitumoral role. This discrepancy has been difficult to explain. This work describes a tool for simulating tumor growth that obeys the universal model of tumor growth dynamics, and shows through its use that low intensity peritumoral inflammation exerts a protumoral effect, while high intensity inflammation exerts a potent antitumoral effect. Indeed, the simulation results obtained indicate that a sufficiently strong antitumoral effect can reverse tumor growth, as has been suggested several times in the clinical literature. The present result indicate that an 'immunological threshold' must exist, marking the boundary between states in which peritumoral inflammation is either harmful or beneficial. These findings lend support to the idea that stimulating intense peritumoral inflammation could be used as a treatment against solid tumors

The Universal Dynamics of Tumor Growth

Scaling techniques were used to analyze the fractal nature of colonies of 15 cell lines growing in vitro as well as of 16 types of tumor developing in vivo. All cell colonies were found to exhibit exactly the same growth dynamics—which correspond to the molecular beam epitaxy (MBE) universality class. MBE dynamics are characterized by 1), a linear growth rate, 2), the constraint of cell proliferation to the colony/tumor border, and 3), surface diffusion of cells at the growing edge. These characteristics were experimentally verified in the studied colonies. That these should show MBE dynamics is in strong contrast with the currently established concept of tumor growth: the kinetics of this type of proliferation rules out exponential or Gompertzian growth. Rather, a clear linear growth regime is followed. The importance of new cell movements—cell diffusion at the tumor border—lies in the fact that tumor growth must be conceived as a competition for space between the tumor and the host, and not for nutrients or other factors. Strong experimental evidence is presented for 16 types of tumor, the growth of which cell surface diffusion may be the main mechanism responsible in vivo. These results explain most of the clinical and biological features of colonies and tumors, offer new theoretical frameworks, and challenge the wisdom of some current clinical strategies

Study of tumor growth indicates the existence of an "immunological threshold" separating states of pro- and antitumoral peritumoral inflammation.

BACKGROUND:Peritumoral inflammation-a response mainly involving polimorphonuclear neutrophils-has traditionally been thought protumoral in its effects. In recent years, however, a number of studies have indicated that it may play an important antitumoral role. This discrepancy has been difficult to explain. METHODS AND FINDINGS:This work describes a tool for simulating tumor growth that obeys the universal model of tumor growth dynamics, and shows through its use that low intensity peritumoral inflammation exerts a protumoral effect, while high intensity inflammation exerts a potent antitumoral effect. Indeed, the simulation results obtained indicate that a sufficiently strong antitumoral effect can reverse tumor growth, as has been suggested several times in the clinical literature. CONCLUSIONS:The present result indicate that an 'immunological threshold' must exist, marking the boundary between states in which peritumoral inflammation is either harmful or beneficial. These findings lend support to the idea that stimulating intense peritumoral inflammation could be used as a treatment against solid tumors

Regulation of neutrophilia by granulocyte colony-stimulating factor: a new cancer therapy that reversed a case of terminal hepatocellular carcinoma

This work reports the possible cure of a 56-year-old patient with advanced hepatocarcinoma. Intense peritumoral neutrophilia was achieved by administering granulocyte colonystimulating factor (G-CSF), an experimental treatment based on the theory of universal tumour dynamics. After the first 8-week cycle of treatment, the patient’s α-fetoprotein (AFP) levels were reduced to normal and his general condition improved sufficiently to allow him to return to work. Following a second cycle of treatment, administered because of doubt regarding the tumoral or inflammatory nature of the now smaller liver mass, the patient’s AFP levels remained normal and he continued to enjoy good general health