Expresión de genes relacionados con la angiogénesis como predictores de respuesta al tratamiento combinado (cirugía y quimioterapia) en el carcinoma de ovario seroso de alto grado

Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid. Facultad de Medicina, Departamento de Medicina. Fecha de Lectura: 19-12-2018Ha sido financiado por un proyecto FIS (PI10/630) y por una beca recibida de la Fundación Mutua Madrileñ

Análisis del contenido polínico de mieles producidas por Apis mellifera L. (Hymenoptera: Apidae) en el estado de Tabasco, México

We studied 40 honey samples from Tabasco State, Mexico with melissopalynology methods. Pollen grains of 29 taxa were important (>=10%): Avicennia germinans (Acanthaceae); Borreria verticillata (Rubiaceae); Bursera simaruba (Burseraceae); Cecropia obtusifolia (Moraceae); Coccoloba aff. diversifolia (Polygonaceae), Conocarpus sp. (Combretaceae), Rumex sp. 1(Polygonaceae), Eleocharis sp. 1 (Cyperaceae); Eragrostis sp. (Poaceae), Asteraceae sp. 1 y sp. 2. (Asteraceae), Andira (Fabaceae), Diphysa carthagenensis (Fabaceae), Erythrina (Fabaceae), Haematoxylum campechianum(Fabaceae), Heliocarpus appendiculatus (Tiliaceae), Machaerium sp. (Fabaceae); Mimosa albida (Fabaceae); Mimosa pigra var.berlandieri (Fabaceae); Phyla nodiflora (Verbenaceae); Piper sp. 1, sp. 2 y sp. 3.(Piperaceae), Quercus oleoides (Fagaceae); Spondias mombin (Anacardiaceae); Spondias radlkoferi (Anacardiaceae); Cocos nucifera (Arecaceae), Muntingia calabura (Elaeocarpaceae) y Zeamays (Poaceae). In general, 14 monofloral, 7 bifloral and 19 multifloral honey samples were characterized. Most samples contained from 20,000 to 100,000 pollen grains per ten grams of honey. According to ecological parameters, homogeneous resource exploitation was registered with high diversity indexes and heterogeneous forage behavior matched with low H’ values. We registered significant correlationships between some localities by the presence of Mimosa albida, Bursera simaruba and Cecropia obtusifolia.Se estudiaron 40 muestras de miel de Apis mellifera L. con métodos melisopalinológicos, correspondientes a cuatro subregiones del estado de Tabasco. El polen de 29 taxa, la mayoría pertenecientea la flora nativa, fueron importantes (>=10%): Avicennia germinans (Acanthaceae); Borreria verticillata (Rubiaceae); Bursera simaruba (Burseraceae); Cecropia obtusifolia (Moraceae); Coccoloba aff.diversifolia (Polygonaceae), Conocarpus sp. (Combretaceae), Rumex sp. 1. (Polygonaceae), Eleocharis sp. 1 (Cyperaceae); Eragrostis sp. (Poaceae), Asteraceae sp. 1 y sp. 2. (Asteraceae), Andira sp. (Fabaceae), Diphysa carthagenensis (Fabaceae), Erythrina sp. 1(Fabaceae), Haematoxylum campechianum (Fabaceae), Heliocarpus appendiculatus (Tiliaceae), Machaerium sp. (Fabaceae); Mimosa albida (Fabaceae); Mimosa pigra var. berlandieri (Fabaceae); Phyla nodiflora (Verbenaceae); Piper sp. 1, sp. 2 y sp. 3. (Piperaceae), Quercus oleoides (Fagaceae); Spondias mombin (Anacardiaceae); Spondias radlkoferi (Anacardiaceae); Cocos nucifera (Arecaceae), Muntingia calabura (Elaeocarpaceae) y Zea mays (Poaceae). En general, se caracterizaron 14 mieles como monoflorales, 7 biflorales y 19 multiflorales. El mayor número de mieles fue del grupo II, conteniendo de 20,000 a 100,000 granos de polen en diez gramos de miel. Con base a los parámetros ecológicos, la explotación de recursos por A. mellifera fue más homogénea cuando se presentó una mayor diversidad de especies botánicas y un comportamiento de recolecta heterogéneo que coincidió con índices de diversidad bajos. Se encontró correlación entre algunas subregiones por la presencia de Mimosa albida, Bursera simaruba y Cecropia obtusifolia

Fatigue, emotional distress, and illness uncertainty in patients with metastatic cancer: results from the prospective NEOETIC_SEOM study

A cancer diagnosis can have a substantial impact on a patient's mental health and quality of life. The aim of this study was to investigate the prevalence of fatigue, emotional distress, and uncertainty and examine the predictive value they have on the quality of life of advanced cancer patients. A prospective, multicenter study was conducted between February 2020 and May 2021 of individuals diagnosed with an advanced, unresectable neoplasm prior to initiating systemic antineoplastic treatment. Participants completed questionnaires to quantify fatigue, emotional distress, disease uncertainty, and quality of life. A linear regression analysis was performed to study the predictive QoL variables. The study population comprised 508 patients, 53.7% of whom were male and had a mean age of 54.9 years. The most common cancers were digestive (40.6%), bronchopulmonary (29.1%), and breast (8.5%); the most frequent histology was adenocarcinoma (63%); and most were stage IV (79.7%). More than half (55.7%) suffered fatigue, and 47.7% exhibited emotional distress; both were more prevalent among women. Fatigue, emotional distress, and disease uncertainty all correlate with diminished quality of life. Similarly, ECOG performance status and the demographic variables of age, sex, and comorbidities impacted quality of life. This patient sample displayed a high prevalence of fatigue and emotional distress, together with illness uncertainty, which are clearly linked to waning quality of life. To decrease the experience of fatigue and improve mental health treatment in cancer patients, interventions based on a biopsychosocial model must be intensified

Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer

Purpose: Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients. Methods: This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated. Results: The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85. Conclusion: This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer

Psychological factors and prognostic communication preferences in advanced cancer: multicentre study

Objectives: Communication regarding prognosis to patients with advanced cancer is fundamental for informed medical decision making. Our objective was to analyse (1) the proportion of subjects with advanced cancer who prefer to know their prognosis, (2) the characteristics associated with patients’ preference for prognostic information, (3) the psychological factors that impact the preference to know prognosis and 4) the concordance between preference for prognostic information perceived among physicians and patients. Methods: A prospective, cross-sectional design was adopted. Data were collected from 748 participants with advanced cancer at 15 tertiary hospitals in Spain. Participants completed the following questionnaires: Mental Adjustment to Cancer; Trust in the Physician; Uncertainty in Illness Scale Patient’s Prognostic Preferences. Results: Fifty-two per cent of advanced cancer sufferers preferred to know the prognosis of their disease. Compared with participants who preferred not to know, those who did reported more uncertainty, greater satisfaction with their physician and higher scores on positive attitude (all p=0.001). Thirty-seven per cent of the physicians believed that patients want to know their prognosis, indicating that they underestimate the number of such patients. No significant differences were found regarding preference to know prognosis as a function of sociodemographic and clinical variables. Conclusions: A substantial proportion of individuals with advanced cancer prefer to know the prognosis of their disease. It appears that knowing their prognosis was mainly motivated by a need to maintain a positive attitude, lessen uncertainty and by satisfaction with the physician. It is important to explore patients’ preferences for information to offer more personalised communication

Role of sex on psychological distress, quality of life, and coping of patients with advanced colorectal and non-colorectal cancer

Patients with advanced gastrointestinal cancer must cope with the negative effects of cancer and complications. However, data on psychological distress, quality of life, and coping strategies in patients with advanced colorectal cancer compared to non-colorectal cancer based on sex is lacking. This was a multicenter study conducted in 203 patients that completed questionnaires evaluating psychological distress, quality of life, and coping strategies before starting systemic cancer treatment. Based on these data, the degree of disease acceptance in gastrointestinal malignancies may depend on sex and location of the primary digestive neoplasm

Can Oncologists Prompt Patient Prognostic Awareness to Enhance Decision-Making? Data From the NEOetic Study

Introduction: Anti-neoplastic therapy improves the prognosis for advanced cancer, albeit it is not curative. An ethical dilemma that often arises during patients’ first appointment with the oncologist is to give them only the prognostic information they can tolerate, even at the cost of compromising preference-based decision-making, versus giving them full information to force prompt prognostic awareness, at the risk of causing psychological harm. Methods: We recruited 550 participants with advanced cancer. After the appointment, patients and clinicians completed several questionnaires about preferences, expectations, prognostic awareness, hope, psychological symptoms, and other treatment-related aspects. The aim was to characterize the prevalence, explanatory factors, and consequences of inaccurate prognostic awareness and interest in therapy. Results: Inaccurate prognostic awareness affected 74%, conditioned by the administration of vague information without alluding to death (odds ratio [OR] 2.54; 95% CI, 1.47-4.37, adjusted P = .006). A full 68% agreed to low-efficacy therapies. Ethical and psychological factors oriented firstline decision-making, in a trade-off in which some lose quality of life and mood, for others to gain autonomy. Imprecise prognostic awareness was associated with greater interest in low-efficacy treatments (OR 2.27; 95% CI, 1.31-3.84; adjusted P = .017), whereas realistic understanding increased anxiety (OR 1.63; 95% CI, 1.01-2.65; adjusted P = 0.038), depression (OR 1.96; 95% CI, 1.23-3.11; adjusted P = .020), and diminished quality of life (OR 0.47; 95% CI, 0.29-0.75; adjusted P = .011). Conclusion: In the age of immunotherapy and targeted therapies, many appear not to understand that antineoplastic therapy is not curative. Within the mix of inputs that comprise inaccurate prognostic awareness, many psychosocial factors are as relevant as the physicians’ disclosure of information. Thus, the desire for better decision-making can actually harm the patient

Systematic Collaborative Reanalysis of Genomic Data Improves Diagnostic Yield in Neurologic Rare Diseases

Altres ajuts: Generalitat de Catalunya, Departament de Salut; Generalitat de Catalunya, Departament d'Empresa i Coneixement i CERCA Program; Ministerio de Ciencia e Innovación; Instituto Nacional de Bioinformática; ELIXIR Implementation Studies (CNAG-CRG); Centro de Investigaciones Biomédicas en Red de Enfermedades Raras; Centro de Excelencia Severo Ochoa; European Regional Development Fund (FEDER).Many patients experiencing a rare disease remain undiagnosed even after genomic testing. Reanalysis of existing genomic data has shown to increase diagnostic yield, although there are few systematic and comprehensive reanalysis efforts that enable collaborative interpretation and future reinterpretation. The Undiagnosed Rare Disease Program of Catalonia project collated previously inconclusive good quality genomic data (panels, exomes, and genomes) and standardized phenotypic profiles from 323 families (543 individuals) with a neurologic rare disease. The data were reanalyzed systematically to identify relatedness, runs of homozygosity, consanguinity, single-nucleotide variants, insertions and deletions, and copy number variants. Data were shared and collaboratively interpreted within the consortium through a customized Genome-Phenome Analysis Platform, which also enables future data reinterpretation. Reanalysis of existing genomic data provided a diagnosis for 20.7% of the patients, including 1.8% diagnosed after the generation of additional genomic data to identify a second pathogenic heterozygous variant. Diagnostic rate was significantly higher for family-based exome/genome reanalysis compared with singleton panels. Most new diagnoses were attributable to recent gene-disease associations (50.8%), additional or improved bioinformatic analysis (19.7%), and standardized phenotyping data integrated within the Undiagnosed Rare Disease Program of Catalonia Genome-Phenome Analysis Platform functionalities (18%)

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD Primera Edición 2023 Vol. 21 Editorial EIDEC Sello Editorial EIDEC (978-958-53018) NIT 900583173-1 ISBN: 978-628-95884-1-5 Formato: Digital PDF (Portable Document Format) DOI: https://doi.org/10.34893/e1150-3660-8721-s Publicación: Colombia Fecha Publicación: 13/09/2023 Coordinación Editorial Escuela Internacional de Negocios y Desarrollo Empresarial de Colombia – EIDEC Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEES Revisión y pares evaluadores Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEE

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years