Effect of exercise on bone health in children and adolescents with cancer during and after oncological treatment: A systematic review and meta-analysis

Background: Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions. Objective: This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment. Methods: A systematic search was conducted in the MEDLINE (via PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1–19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Results: A total of eight trials with 341 participants were included. The metaanalyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: −0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: −0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: −0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: −0.17, 0.25) and after the ES was 0.07 (95%CI: −0.20, 0.33). Conclusion: To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment.Spanish Ministry of Science and Innovation (ref: PID2020-117302RA-I00La Caixa Foundation (ref: LCF/BQ/PR19/11700007)the University of Granada Plan Propio de Investigación 2021-Excellence actions: Unit of Excellence on Exercise, Nutrition and Health (UCEENS)CIBEROBN, Centro de Investigación Biomédica en Red (CB22/03/ 00058Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – European Regional Development Fund. AM-P is recipient of a predoctoral fellowship (FPU20/05530) by the Spanish Ministry of Education, Culture and Sport. EU-G is supported by the Maria Zambrano fellowship by the Ministerio de Universidades y la Unión Europea—NextGenerationEU

Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: A randomized clinical trial with long-term follow-up

The aim of this clinical trial (ID Number NCT01803347) was to determine the safety and efficacy of autologous adipose-derived stem cells (ASCs) for treatment of cryptoglandular fistula. This research was conducted following an analysis of the mistakes of a same previous phase III clinical trial. We designed a multicenter, randomized, single-blind clinical trial, recruiting 57 patients. Forty-four patients were categorized as belonging to the intent-to-treat group. Of these, 23 patients received 100 million ASCs plus intralesional fibrin glue (group A) and 21 received intralesional fibrin glue (group B), both after a deeper curettage of tracks and closure of internal openings. Fistula healing was defined as complete re-epithelialization of external openings. Those patients in whom the fistula had not healed after 16 weeks were eligible for retreatment. Patients were evaluated at 1, 4, 16, 36, and 52 weeks and 2 years after treatment. Results were assessed by an evaluator blinded to the type of treatment. After 16 weeks, the healing rate was 30.4% in group A and 42.8% in group B, rising to 55.0% and 63.1%, respectively, at 52 weeks. At the end of the study (2 years after treatment), the healing rate remained at 50.0% in group A and had reduced to 26.3% in group B. The safety of the cellular treatment was confirmed and no impact on fecal continence was detected. The main conclusion was that autologous ASCs for the treatment of cryptoglandular perianal fistula is safe and can favor long-term and sustained fistula healing.RETIC Program of ISCIII-FEDER, Grant/Award Numbers: RD16/0011/0005, RD16/0011/0013, RD16/0011/0015; Spanish Ministry of Health and Consumer Affairs, Grant/Award Numbers: EC11/074, EC11/394, EC11/26

Is higher physical fitness associated with better psychological health in young pediatric cancer survivors? A cross-sectional study from the iBoneFIT project

Objective: To examine the associations of self-perceived and objectively-measured physical fitness with psychological well-being and distress indicators in young pediatric cancer survivors. Materials and Methods: A total of 116 participants (12.1 ± 3.3 years, 56.9% boys) from the iBoneFIT project participated in this cross-sectional study. Objectively-measured physical fitness (muscular fitness) was obtained by handgrip strength and standing long jump tests for the upper and lower body, respectively. Self-perceived physical fitness was obtained by the International Fitness Scale (IFIS). Positive and negative affect were assessed by the positive affect schedule for children (PANAS-C), happiness by Subjective Happiness Scale (SHS), optimism by Life Orientation Test-Revised (LOT-R), self-esteem by the Rosenberg Self-Esteem Scale (RSE), anxiety by State–Trait Anxiety Inventory for Children (STAIC-R), and depression by Children Depression Inventory (CDI). Multiple linear regressions adjusted by key covariates were performed to analyze associations. Results: No associations were found between objectively-measured muscular fitness and any of the psychological well-being and distress indicators (p > 0.05). Self-perceived overall fitness and flexibility were positively associated with positive affect (β ≥ 0.258, p < 0.05). Self-perceived cardiorespiratory fitness, speed/ agility, and flexibility were negatively associated with depression (β ≥ −0.222, p < 0.05). Finally, self-perceived cardiorespiratory fitness was also negatively associated with anxiety and negative affect (β ≥ −0.264, p < 0.05). Conclusions: Perceived physical fitness, but not objectively physical fitness, seems to be inversely related to psychological distress variables and to less extent positively related to psychological well-being. The findings from this study highlight the importance of promoting self-perceived fitness in the pediatric oncology population.Ministry of Science and Innovation, Spain (MICINN) Spanish Government PID2020-117302RA-I00La Caixa Foundation LCF/BQ/PR19/11700007European Union's Horizon 2020 research and inno-vation programme under the Marie Sklodowska Curie 10102892

Autologous adipose‐derived stem cells for the treatment of complex cryptoglandular perianal fistula: A randomized clinical trial with long‐term follow‐up

FISPAC Collaborative Group.The aim of this clinical trial (ID Number NCT01803347) was to determine the safety and efficacy of autologous adipose‐derived stem cells (ASCs) for treatment of cryptoglandular fistula. This research was conducted following an analysis of the mistakes of a same previous phase III clinical trial. We designed a multicenter, randomized, single‐blind clinical trial, recruiting 57 patients. Forty‐four patients were categorized as belonging to the intent‐to‐treat group. Of these, 23 patients received 100 million ASCs plus intralesional fibrin glue (group A) and 21 received intralesional fibrin glue (group B), both after a deeper curettage of tracks and closure of internal openings. Fistula healing was defined as complete re‐epithelialization of external openings. Those patients in whom the fistula had not healed after 16 weeks were eligible for retreatment. Patients were evaluated at 1, 4, 16, 36, and 52 weeks and 2 years after treatment. Results were assessed by an evaluator blinded to the type of treatment. After 16 weeks, the healing rate was 30.4% in group A and 42.8% in group B, rising to 55.0% and 63.1%, respectively, at 52 weeks. At the end of the study (2 years after treatment), the healing rate remained at 50.0% in group A and had reduced to 26.3% in group B. The safety of the cellular treatment was confirmed and no impact on fecal continence was detected. The main conclusion was that autologous ASCs for the treatment of cryptoglandular perianal fistula is safe and can favor long‐term and sustained fistula healing.RETIC Program of ISCIII‐FEDER, Grant/Award Numbers: RD16/0011/0005, RD16/0011/0013, RD16/0011/0015; Spanish Ministry of Health and Consumer Affairs, Grant/Award Numbers: EC11/074, EC11/394, EC11/260

Autologous adipose-derived stem cells for the treatment of complex cryptoglandular perianal fistula: a randomized clinical trial with long-term follow-up

The aim of this clinical trial (ID Number NCT01803347) was to determine the safety and efficacy of autologous adipose-derived stem cells (ASCs) for treatment of cryptoglandular fistula. This research was conducted following an analysis of the mistakes of a same previous phase III clinical trial. We designed a multicenter, randomized, single-blind clinical trial, recruiting 57 patients. Forty-four patients were categorized as belonging to the intent-to-treat group. Of these, 23 patients received 100 million ASCs plus intralesional fibrin glue (group A) and 21 received intralesional fibrin glue (group B), both after a deeper curettage of tracks and closure of internal openings. Fistula healing was defined as complete re-epithelialization of external openings. Those patients in whom the fistula had not healed after 16 weeks were eligible for retreatment. Patients were evaluated at 1, 4, 16, 36, and 52 weeks and 2 years after treatment. Results were assessed by an evaluator blinded to the type of treatment. After 16 weeks, the healing rate was 30.4% in group A and 42.8% in group B, rising to 55.0% and 63.1%, respectively, at 52 weeks. At the end of the study (2 years after treatment), the healing rate remained at 50.0% in group A and had reduced to 26.3% in group B. The safety of the cellular treatment was confirmed and no impact on fecal continence was detected. The main conclusion was that autologous ASCs for the treatment of cryptoglandular perianal fistula is safe and can favor long-term and sustained fistula healing

Tutoría y atención personal al estudiante en la universidad

Se abordan el rol y las funciones que desempeñan las tutorías adaptadas a las características y necesidades de los estudiantes universitarios, en el marco del Espacio Europeo de Educación Superior, a través de diversos artículos distribuidos en dos bloques. En una primera parte se hace referencia a los aspectos conceptuales y formativos necesarios para el desempeño de la tutoría universitaria. Se analiza el papel que desempeña la universidad en la sociedad actual en la era del conocimiento, el planteamiento teórico y conceptual sobre la tutoría y la orientación, así como el modelo organizativo que inspira los contenidos del Programa de Formación de Tutores, su diseño, ejecución y evaluación. En segundo lugar, se proponen siete experiencias prácticas de Planes de Acción Tutorial desarrolladas en diversos centros y titulaciones de la Universidad de Granada (España), la Universidad Autónoma de Yucatán (México) y la Universidad Autónoma de San Luis de Potosí (México).MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]