Trends of inflammatory markers and cytokines after one month of phototherapy in patients with rheumatoid arthritis

Objective. to evaluate changes in the expression of tumor necrosis factor-α in patients with rheumatoid arthritis submitted to phototherapy. Materials and methods. This was an open label study, enrolling ten patients. The phototherapy scheme within a range of 425 to 650 nm, 11.33 Joules/cm2, 30 cm above the chest was as follows: a) 45-min daily sessions from Monday to Friday for 2 to 3 months; b) three, 45-min weekly sessions for 1 to 2 months; c) twice weekly 45-min sessions for 1 to 2 months, and d) one weekly session for 1 to 2 months until completion. Erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor were measured in peripheral blood and tumor necrosis factor-α, interleukin-1β, and interleukin-10 in leukocytes by quantitative real-time Reverse transcriptase-Polymerase chain reaction. In all the patients the next indexes: Karnofsky scale, Rheumatoid Arthritis-specific quality of life instrument, Steinbrocker Functional Capacity Rating and the Visual Analog Scale were evaluated. Results. Erythrocyte sedimentation rate, C-reactive protein, and rheumatoid factor declined notoriously after the indicated sessions. In gene expression, there was a tendency in tumor necrosis factor-α to decrease after 1 month, from 24.5±11.4 to 18±9.2 relative units, without reaching a significant statistical difference. The four tested indexes showed improvement. Conclusion. Phototherapy appears to be a plausible complementary option to reduce the inflammatory component in rheumatoid arthritis

Bronchopulmonary Lophomoniasis, Infection by Endocommensal Protozoa of Intradomiciliary Cockroaches: Presentation of a Case in an Immunocompromised Patient from Querétaro, Mexico

Infection in humans by the intestinal protozoan of cockroaches and termites called Lophomonas blattarum has been diagnosed in respiratory infections of children aged 2–5 years contaminated orally or by air, with cysts or trophozoites contained in the feces of the cockroach Periplaneta americana. In respiratory infections of adults, it is difficult to diagnose since the cyst or trophozoite is not recognized as a human pathogen and is only related to immunosuppressed patients, transplant patients with severe lung disease and those living in poor and unhealthy sanitary conditions. Normally, its presence is manifested with fevers of 38–39°C, cough with thick expectoration, respiratory insufficiency and pulmonary abscesses. The laboratory diagnosis is mainly based on bronchoscopic cytologies and bronchoalveolar lavage biopsies. The case in question is about a 60-year-old male. Single, he lives alone, with a diagnosis of 9 baths behind non-Hodgkin lymphoma, undergoing treatment with radiotherapy and chemotherapy. For edema after treatment, thoracentesis and pericardiocentesis were performed, as well as gastrostomy, which he maintained for 1 year. He started with throat discomfort, followed by production of productive cough without blood, general weakness, and difficulty breathing, with apparent diagnosis of possible respiratory failure due to mycobacteria. It was possible to visualize the protozoan, in fresh preparations of bronchial aspirate and expectoration in wet assembly with saline solution and stained with Pap smears, Harris Hematoxylin and Eosin (H/E), and Giemsa

Psychometric properties and factorial analysis of invariance of the Satisfaction with Life Scale (SWLS) in cancer patients

Purpose The purpose of this study was to assess the psychometric properties of the Satisfaction with Life Scale (SWLS), evaluate the measurement invariance with respect to sex, age, and tumor location, as well as analyze associations between life satisfaction and socio-demographic and clinical variables among individuals with resected, non-advanced cancer. Methods A confirmatory factor analysis was conducted to explore the dimensionality of the scale and test invariance across gender, age, and tumor localization in a prospective, multicenter cohort of 713 patients who completed the following scales: SWLS, Health-related Quality of Life Questionnaire (EORTC QLQ-C30), Brief Symptom Inventory (BSI-18). Results Confirmatory factor analysis results indicated that the SWLS is an essentially unidimensional instrument, providing accurate scores: both McDonald's omega and Cronbach's alpha estimates were 0.91. Strong measurement invariance was found to hold across gender, age, and tumor localization. Low satisfaction with life was associated with psychological symptoms (anxiety, depression, and somatization), and decreased quality of life (malfunction, symptoms, poor global QoL). Conclusion The SWLS is a reliable, valid satisfaction with life measurement among people with cancer and should be recommended as an indicator of psychological adjustment in oncological patients

The relationship between physician and cancer patient when initiating adjuvant treatment and its association with sociodemographic and clinical variables

Purpose The aim of this study was to analyze differences in physician and patient satisfaction in shared decision-making (SDM); patients' emotional distress, and coping in subjects with resected, non-metastatic cancer. Methods 602 patients from 14 hospitals in Spain were surveyed. Information was collected regarding physician and patient satisfaction with SDM, participants' emotional distress and coping, as well as patient sociodemographic and clinical characteristics by means of specific, validated questionnaires. Results Overall, 11% of physicians and 19% of patients were dissatisfied with SDM; 22% of patients presented hopelessness or anxious preoccupation as coping strategies, and 56% presented emotional distress. By gender, female patients showed a higher prevalence of dissatisfaction with SDM (23 vs 14%), anxious preoccupation (26 vs 17%), and emotional distress (63 vs 44%) than males. Hopelessness was more prevalent in individuals with stage III disease than those with stages I-II (28 vs 18%). Conclusion Physicians must be mindful of the importance of emotional support and individual characteristics when communicating treatment options, benefits, and adverse effects of each alternative to oncological patients

Co-circulation of Junin virus and other mammarenaviruses in a geographical area without confirmed cases of Argentine Hemorrhagic Fever

Desde la identificación del virus Junin en la década del 50, se realizaron numerosos estudios en roedores silvestres dentro del área endémica de la Fiebre Hemorrágica Argentina (FHA) que per-mitieron registrar, además, actividad del virus de la coriomeningitis linfocitaria (LCMV) y del virus Latino (LATV). La ausencia de casos confirmados de FHA desde la década del 90 en el departamento Río Cuarto, provincia de Córdoba, promovió la vigilancia ecoepidemiológica y de infección del Calomys musculinus (reservorio del virus Junin) y la búsqueda de reservorios e infección de los otros mammarenavirus. Durante dos años de muestreo estacional, con un sistema de captura, marcación y liberación capturamos 857 roedores, que correspondieron 57.3% a los reservorios: C. musculinus (especie más abundante), C. venustus y Mus musculus. Detectamos anticuerpos y caracterizamos molecularmente los tres agentes virales. Observamos una prevalencia de infección de 3.5% (9/254) para virus Junin, 100% (3/3) para LCMV y 24.1% (21/87) para LATV. En conclusión, demostra¬mos circulación de virus Junin en su roedor reservorio, en una región considerada histórica para FHA con riesgo potencial para la población y cocirculación espacio-temporal de los tres mammarenavirus en la región central de Argentina.Since the identification of Junin virus in the 1950s, many studies were carried out in wild rodents within the endemic area of the Argentine Hemorrhagic Fever (AHF) that recorded also the activity of the lymphocytic choriomeningitis virus (LCMV) and the Latino virus (LATV). The absence of confirmed cases of AHF since the 1990s in the department of Rio Cuarto, Córdoba province, promoted ecoepidemiological surveillance of infection of Calomys musculinus (Junin virus reservoir) and the search of reservoirs of the other mammarenaviruses. During two years of seasonal sampling, with a capture, mark and release system, 857 rodents were captured, corresponding 57.3% to the rodent reservoirs: C. musculinus, C. venustus and Mus musculus, being the first the most abundant species. Antibodies were detected and the three viral agents were molecularly characterized, showing a prevalence of infection of 3.5% (9/254) for Junin virus, 100% (3/3) for LCMV and 24.1% (21/87) for LATV. In conclusion, we demonstrated Junin virus circulation in its rodent reservoir in a region considered historic for AHF with potential risk for the population and the spatio-temporal co-circulation of the three mammarenaviruses in the central region of Argentina.Fil: Calderón, Gladys Ethel. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Virales Humanas; ArgentinaFil: Provensal, María Cecilia. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Fisicoquímicas y Naturales. Departamento de Ciencias Naturales; ArgentinaFil: Martin, Maria Laura. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Virales Humanas; ArgentinaFil: Brito Hoyos, Diana Marcela. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas, Fisicoquímicas y Naturales. Departamento de Ciencias Naturales; ArgentinaFil: Garcia, Jorge Braulio. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Virales Humanas; ArgentinaFil: González Ittig, Raúl Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Diversidad y Ecología Animal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto de Diversidad y Ecología Animal; ArgentinaFil: Levis, Silvana del Carmen. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Virales Humanas; Argentin

Differences in coping strategies among young adults and the elderly with cancer

Background: Coping with cancer and the oncologist-patient relationship can vary depending on the patient's age. Our aim is to examine and compare young and elderly adults with non‐metastatic, resected cancer. Methods: Two groups of patients were selected, young ( 70) with a diagnosis of non‐metastatic, resected cancer requiring adjuvant chemotherapy from a pre‐exiting, national database (NEOCOPING Study). Epidemiological variables were collected and subjects' emotional responses, perceptions of the physician-patient relationship, support network, fears, and regret about the decision to receive chemotherapy were assessed with questionnaires validated in previous studies: Mini‐Mental Adjustment to Cancer, Brief Summary Inventory (18 items), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire‐C30, Shared Decision‐Making Questionnaire‐Physician's version, Shared Decision‐Making Questionnaire‐Patient's version, and Informed Risk (physician and patient versions). Results: Data from 46 young and 46 elderly participants were collected. The most common neoplasms in both groups were breast (50%) and colorectal (22%). The younger adults had a higher level of education and were actively employed (72% vs. 7%). The leading coping strategy in the younger cohort was hope, and resignation among the elderly. Young adults sought more social support and the impact of diagnosis was more negative for them than for older individuals. No significant differences were detected in quality of life; both age groups demanded more time at their first visit with the doctor, while the older group exhibited greater satisfaction with shared decision‐making. At the end of adjuvant chemotherapy, neither age group regretted their decision to receive said treatment. Conclusion: Higher levels of education, greater demands of the labour market, and the advent of the age of information have entailed drastic changes in the physician-patient relationship paradigm. This is especially true in the younger cancer patient population, who require more information and active participation in decision‐making, can display more anxiety about their diagnosis, but also greater capacity to fight

Las preguntas más frecuentes de la normalización de competencias laborales 2015 - 2020

Informe en el que se consolidan preguntas y temas relacionados con la normalización de competencias laborales que provienen de quienes están adscritos a la unidad sectorial de normalización del SENA.Report in which questions and issues related to the standardization of labor competencies that come from those who are attached to the SENA sectoral standardization unit are consolidated.Preguntas relacionadas con el análisis y mapa funcional -- Preguntas relacionadas con la estructura funcional de la ocupación -- Preguntas relacionadas con la norma sectorial de competencia laboralna12 página

Psychometric properties of the Shared Decision-Making Questionnaire (SDM-Q-9) in oncology practice

Background/Objective: This study sought to assess the psychometric properties of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) in patients with resected, non-metastatic cancer and eligible for adjuvant chemotherapy. Method: A total of 568 patients were recruited from a multi-institutional, prospective, transversal study. Patients answered the SDM-Q-9 after visiting their medical oncologist who, in turn, completed the SDM-Q---Physician version. Reliability, factorial structures [exploratory factor analysis (EFA), confirmatory factor analysis (CFA)], and convergent validity of the SDM-Q-9 scores were explored. Results: SDM-Q-9 showed a clear factorial structure, compatible with a strong and replicable general factor and a secondary group factor, in patients with resected, non-metastatic cancer. Total sum scores derived from the general factor showed good reliability in terms of omega coefficient: .90. The association between patient and physician perception of SDM was weak and failed to reach statistical significance. Males and patients over 60 years of age displayed the greatest satisfaction with SDM. Conclusions: SDM-Q-9 can aid in evaluating SDM from the cancer patients' perspective. SDM-Q-9 is helpful in studies examining patient perspectives of SDM and as an indicator of the degree of quality and satisfaction with health care and patient-physician relationship

Propiedades psicométricas del Shared Decision-Making Questionnaire (SDM-Q-9) en oncología

Antecedentes/Objetivo: Este estudio analiza las propiedades psicométricas del cuestionario Shared Decision-Making (SDM-Q-9) en pacientes con cáncer resecado, no metastásico y elegibles para quimioterapia adyuvante. Método: Estudio multicéntrico, prospectivo, transversal en el que se reclutaron 568 pacientes que respondieron al SDM-Q-9 después de visitar a su oncólogo quien, a su vez, completó el SDM-Q-versión médico. Se estudiaron la fiabilidad, la estructura factorial [análisis factorial exploratorio (EFA), análisis factorial confirmatorio (CFA)] y la validez convergente de las puntuaciones del SDMQ-9. Resultados: La escala SDM-Q-9 mostró una estructura factorial clara, compatible con un factor general fuerte y replicable, y un factor de grupo secundario. La puntuación del factor general mostró una buena fiabilidad en términos de coeficiente omega: 0,90. La asociación entre la percepción del médico y del paciente en la SDM fue débil y no logró alcanzar significación estadística. Los hombres y los pacientes mayores de 60 años mostraron mayor satisfacción con la toma de decisiones compartidas con el oncólogo. Conclusiones: El cuestionario SDM-Q-9 puede ayudar en la evaluación de la toma de decisiones compartidas desde la perspectiva de los pacientes con cáncer y como indicador del grado de calidad y satisfacción en la relación médico-paciente

Psychometric properties of Liverpool Stoicism Scale (LSS) in a cohort of patients with resected cancer in adjuvant treatment

Stoicism has been used to describe a wide range of behaviors in the face of disease that go from silence, resistance to the adversity, or 'to make the best of a bad disease'. This study pursued two objectives: 1) analyze the psychometric properties of the Spanish version of the LSS; 2) assess the relation between stoicism and gender, age, and the five-factor personality model. NEOcoping is a prospective, multicenter, observational, non-interventionist study. Patients were recruited consecutively at thirteen Spanish teaching hospitals. The following scales were administered: Liverpool Stoicism Scale (LSS) and Big Five Inventory (BFI-10). A total of 443 patients (250 females) with a mean age of 59.8 years (SD =12.3) were enrolled. Colon cancer was the most common, followed by breast cancer. At the total-scale level, mean LSS was lower than the originally reported British sample. The four-factor structure fitted the data well, had a clear interpretation, and the derived scales showed acceptable reliabilities. The personality trait of introversion predicted 4.1% of the variance of stoicism (p<.001). Even though it needs to be improved, the LSS scale demonstrates acceptable psychometric properties to appraise stoicism in the Spanish population with resected cancer