Fundamento del derecho natural según los principios de la doctrina de la ciencia

1.-El carácter de la racionalidad consiste en que el agente [das Handelnde] y lo actuado [das Behandelte] son uno y lo mismo; y con esta descripción se ha agotado el ámbito de la razón como tal. El uso del lenguaje ha depositado en la palabra Yo este concepto sublime para aquéllos que son capaces de él, para los que son capaces de la abstracción de su propio Yo

The role of motor variability in motor control and learning depends on the nature of the task and the individual’s capabilities

Recent studies have found that motor variability is actively regulated as an exploration tool to promote learning in reward and error-based tasks. Based on this functional role of variability, several researches have manipulated motor variability by practicing in order to maximize learning processes. However, the effectiveness of such variable practice as a tool to improve motor performance has shown several controversial results. The present work reviews how the interaction between the features of individuals with different motor capabilities (i.e. experience and brain disorders) and task constraints modulates the relation between motor variability and motor control and learning. Examining how the process of skill learning can be improved by the variability modulation according to individuals’ is not only of theoretical interest, but may also have several practical implications in motor learning and neuro-rehabilitation.Estudios recientes han demostrado que la variabilidad motora es activamente regulada como herramienta de exploración con objeto de incrementar el rendimiento motor tanto en tareas de aprendizaje basadas en la aplicación de recompensas como en la percepción del error. Basándose en este rol funcional de la variabilidad, varios investigadores han manipulado la variabilidad motora al practicar para maximizar los procesos de aprendizaje motor. Sin embargo, la efectividad de la práctica variable como herramienta para la mejora de la ejecución motora, ha mostrado resultados contradictorios en la literatura científica. El presente trabajo revisa cómo la interacción entre las características de individuos con diferentes capacidades motrices (i.e. experiencia y alteraciones neurológicas) y las características de las tareas modulan la relación entre la variabilidad motora, el control y el aprendizaje motor. El estudio de cómo los procesos de aprendizaje motor pueden ser mejorados mediante la manipulación de la carga de variabilidad al practicar no tiene sólo un interés teórico, sino que puede tener implicaciones prácticas en relación al aprendizaje motor o la neuro-rehabilitación

SEOM clinical guidelines for the treatment of malignant pleural mesothelioma (2020)

Mesothelioma is a rare and aggressive tumour with dismal prognosis arising in the pleura and associated with asbestos exposure. Its incidence is on the rise worldwide. In selected patients with early-stage MPM, a maximal surgical cytoreduction in combination with additional antitumour treatment may be considered in selected patients assessed by a multidisciplinary tumor board. In patients with unresectable or advanced MPM, chemotherapy with platinum plus pemetrexed is the standard of care. Currently, no standard salvage therapy has been approved yet, but second-line chemotherapy with vinorelbine or gemcitabine is commonly used. Novel therapeutic approaches based on dual immunotherapy or chemotherapy plus immunotherapy demonstrated promising survival benefit and will probably be incorporated in the future

Efecto de la resección intestinal de los triglicéridos de cadena media y del ácido ursodeoxicólico sobre la utilización nutritiva del Calcio, Fósforo y Magnesio en ratas

Se estudia el efecto de la resección intestinal y de la administración de dos tipos de dieta sobre la utilización nutritiva de calcio, fósforo y magnesio en ratas controles "falsamente operadas" y con resección del 50% de intestino delgado distal al mes y a los tres meses de la intervención quirúrgica. La exclusión del 50% de intestino delgado distal conduce a un descenso en la utilización digestiva de calcio, fósforo y magnesio, reflejándose en el contenido mineral del hueso. A los tres meses de haber practicado la resección, la utilización nutritiva de calcio no se recupera, en cambio mejora la eficacia digestiva de fósforo y el aprovechamiento digestivo y metabólico de magnesio. La dieta que contiene triglicéridos de cadena media (MCT) y aceite de girasol en sustitución de 2/3 de aceite de oliva adicionada de ácido ursodeoxicólico, eleva la absorción de fósforo y magnesio cuando es ingerida por ratas resecadas durante un mes. A los tres meses de haber practicado la resección, el suministro de la misma dieta mejora la utilización digestiva y metabólica de calcio. En relación al fósforo, la mejor utilización nutritiva encontrada al mes, se hace aún más patente a los tres meses.The nutntIve utilization of calcium, phosphorus and magnesium was studied in adult rats in which 50% of the distal small intestine (DSI) had been resected and in sham-operated controls one month and three months after the operation. Resection of half the DSI reduced the digestive utilization of Ca, P. and Mg as reflected by mineral content in bone. Three months after resec tion, nutritive utilizatíon of Ca had still not recovered; in contrast digestive utilization of P and nutritive utilization of Mg were seen to recover by three months postsurgery. When dietary fat was supplied as equal parts of medium chain trig Iycerides, sunflower seed oil and olive oil instead of lOO%·'oÍive 01-1,' additionate of ursodeoxycholic acid, P and Mg absorption were ' en'hanced in resected rats after one month. After a period of three months durin& which res'ected rats were given the same diet, digestive and metabolic utilization of Ca improve. In relation to P, the better nutritive utilization found one month after resection is more notable at three months

Metabolismo proteico en ratas con resección intestinal. Influencia de los triglicéridos de cadena media y del ácido ursodeoxicólico

Se estudia en ratas adultas controles "falsamente operadas" y con resección del 50% de intestino delgado distal, el efecto de dicha resección y de la administración de distintos tipos de dieta sobre la utilización nutritiva de la proteína, cuando han transcurrido un mes y tres meses después de la resección. La resección intestinal conlleva a un deterioro de la utilización digestiva de la proteína, al mes de la intervención; este deterioro es paliado con el trans curso del tiempo. La modificación de la calidad lipídica por sustitución de 2/3 de aceite de oliva por triglicéridos de cadena media (MCT) a partes iguales, mejora la utilización digestiva de la proteína al mes de la intervención quirúrgica. Sin embargo, este efecto beneficioso se manifiesta a los tres meses de la resección cuando las ratas tienen como aporte lipídico sólo aceite de oliva o bien si la dieta modificada es adicionada de ácido ursodeoxicólico.The effects of different types of diet and resecting 50% of the distal small intestine on the digestive and metabolic utilization of protein were studied in resected rats and sham-operated controls, one month and three months after the operation. Intestinal resection led to a deterioration in digestive utilization of protein, which improved with time (3 months postsurgery). A qualitative change in the dietary fat source from 100% olive oil to equal parts of medium chain trig\ycerides, sunflower seed oil and olive oil favored digestive utilization of protein as recordered 1 month after surgery. However, the beneficial effects were maintaned at 3 months in resected rats given dietary fat in the form of 100% olive oil or if the modificate diet is additionate of ursodeoxycholic acid

Assessment of the psychosocial and economic impact according to sex in non-small cell lung cancer patients: an exploratory longitudinal study

Background: Little is known about the impact of sex on lung cancer patients from the psychological, economic and social perspectives. This study was designed to explore the psychosocial and economic impact according to sex of metastatic non-small cell lung cancer (mNSCLC) in patients and caregivers. Methods: Exploratory study of two cohorts of patients starting first-line treatment for mNSCLC. The following questionnaires were administered at baseline, 4 months later and following the first and second disease progression: APGAR, relationship impact scale, DUKE-UNC scale, economic impact in patients and caregiver, and Zarit scale. It was planned to include 1250 patients to get an 80% possibility of detecting as significant (p < 0.05) effect sizes less than 0.19 between men and women. Univariate comparisons were made between the tests applied to men and women. Overall survival was estimated with Kaplan–Meier method. Cox analyses were done to estimate hazard ratios (HRs) with 95% CI. Results: 333 patients were included. Most families reported to continue being functional despite the lung cancer diagnosis. Regardless of sex, they did not perceive changes in their partner relationship. Most patients felt their social support was normal. Roughly 25% of people reported a worsening in their economic situation, without remarkable differences by sex. Statistically significant differences were found between both groups regarding the caregiver’s relationship to the patient (more parents were the caregiver in females than in males, p < 0.0001) and the caregiver’s employment situation (more employed caregivers in females) (p < 0.0001). Most caregivers of both sexes considered that taking care of their relative did not pose a significant burden. Conclusions: This study provides a preliminary insight into sex-related characteristics in the management of advanced NSCLC and its impact on the emotional, social and economic burden of patients and their caregivers, and recall the high priority of researching in cancer from a sex perspective. Nevertheless, due to the low recruitment rate and the relevant loss of patients during the follow-up, it was difficult to find differences by sex. Trial registration: ClinicalTrials.gov identifier: NCT02336061. Ethics committee: Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona, Spain. Reference number: HCB/2014/0705

Metabolismo proteico en ratas con resección intestinal. Influencia de los triglicéridos de cadena media y del ácido ursodeoxicólico

The effects of different types of diet and resecting 50% of the distal small intestine on the digestive and metabolic utilization of protein were studied in resected rats and sham-operated controls, one month and three months after the operation. Intestinal resection led to a deterioration in digestive utilization of protein, which improved with time (3 months postsurgery). A qualitative change in the dietary fat source from 100% olive oil to equal parts of medium chain triglycerides, sunflower seed oil and olive oil favored digestive utilization of protein as recordered 1 month after surgery. However, the beneficial effects were maintaned at 3 months in resected rats given dietary fat in the form of 100% olive oil or if the modificate diet is additionate of ursodeoxycholic acid.Se estudia en ratas adultas controles "falsamente operadas" y con resección del 50% de intestino delgado distal, el efecto de dicha resección y de la administración de distintos tipos de dieta sobre la utilización nutritiva de la proteína, cuando han transcurrido un mes y tres meses después de la resección. La resección intestinal conlleva a un deterioro de la utilización digestiva de la proteína, al mes de la intervención; este deterioro es paliado con el transcurso del tiempo. La modificación de la calidad lipídica por sustitución de 2/3 de aceite de oliva por triglicéridos de cadena media (MCT) a partes iguales, mejora la utilización digestiva de la proteína al mes de la intervención quirúrgica. Sin embargo, este efecto beneficioso se manifiesta a los tres meses de la resección cuando las ratas tienen como aporte lipídico sólo aceite de oliva o bien si la dieta modificada es adicionada de ácido ursodeoxicólico

Efecto de la resección intestinal de los triglicéridos de cadena media y del ácido ursodeoxicólico sobre la utilización nutritiva del Calcio, Fósforo y Magnesio en ratas

The nutritive utilization of calcium, phosphorus and magnesium was studied in adult rats in which 50% of the distal small intestine (DSI) had been resected and in sham-operated controls one month and three months after the operation. Resection of half the DSI reduced the digestive utilization of Ca, P. and Mg as reflected by mineral content in bone. Three months after resection, nutritive utilizatíon of Ca had still not recovered; in contrast digestive utilization of P and nutritive utilization of Mg were seen to recover by three months postsurgery. When dietary fat was supplied as equal parts of medium chain triglycerides, sunflower seed oil and olive oil instead of 100% olive oil, additionate of ursodeoxycholic acid, P and Mg absorption were enhanced in resected rats after one month. After a period of three months during which resected rats were given the same diet, digestive and metabolic utilization of Ca improve. In relation to P, the better nutritive utilization found one month after resection is more notable at three months.Se estudia el efecto de la resección intestinal y de la administración de dos tipos de dieta sobre la utilización nutritiva de calcio, fósforo y magnesio en ratas controles "falsamente operadas" y con resección del 50% de intestino delgado distal al mes y a los tres meses de la intervención quirúrgica. La exclusión del 50% de intestino delgado distal conduce a un descenso en la utilización digestiva de calcio, fósforo y magnesio, reflejándose en el contenido mineral del hueso. A los tres meses de haber practicado la resección, la utilización nutritiva de calcio no se recupera, en cambio mejora la eficacia digestiva de fósforo y el aprovechamiento digestivo y metabólico de magnesio. La dieta que contiene triglicéridos de cadena media (MCT) y aceite de girasol en sustitución de 2/3 de aceite de oliva adicionada de ácido ursodeoxicólico, eleva la absorción de fósforo y magnesio cuando es ingerida por ratas resecadas durante un mes. A los tres meses de haber practicado la resección, el suministro de la misma dieta mejora la utilización digestiva y metabólica de calcio. En relación al fósforo, la mejor utilización nutritiva encontrada al mes, se hace aún más patente a los tres meses

Effect of central nervous system (CNS) metastases in a real-world multicenter cohort study of Spanish ALK-positive non-small cell lung cancer (NSCLC) patients (p)

Background: CNS is a common site of metastases in patients with ALK-positive NSCLC. CNS metastases are associated with a number of deleterious effects, such as reduction in quality of life. However, the relationship between brain metastases and prognosis remains unclear. We aimed to evaluate the effect of CNS metastases on overall survival (OS) in a multicenter cohort of Spanish ALK-positive NSCLC patients diagnosed between 2008 and 2017. Methods: We included patients with stage IV at diagnoses, followed up to April 2018; OS (months [m]) was estimated with the Kaplan-Meier method. Survival curves were compared between groups of patients using the log-rank test. Hazard risk (HR) to death was estimated with multivariable Cox model. Results: Out of 163 patients in the cohort, a total of 116 were evaluated, with a median of follow-up of 29.2 m and 59 deaths reported. Characteristics at diagnosis were a median age of 58 years, 50% female, 58.6% never-smokers, 54.3% with comorbidities, PS by ECOG 0-1 93.1%. CNS metastases (median number of lesions 6) were present in 43.1% of patients and 34% of patients with CNS metastases were treated with local therapy (11.8 % local radiotherapy and 76.5% holocraneal radiotherapy). ALK inhibitors as first line and second line treatment were administered to 45.5% and 78.6% of patients, respectively. The median OS was 39 months; OS in patients with CNS metastases at diagnosis was 34.4 m and 39.0 m in those without CNS metastases at diagnosis (p=.9). In patients without CNS metastases at baseline (n=60), 22 developed CNS, with a median OS greater than in those without CNS metastases during follow-up, although the difference is not significant (45.5 m vs 33.3 m; p=.9). There were 81 patients who presented with metastases in more than one organ and 33 patients with metastases in a single organ. The risk of death increased as the number of metastatic organs at diagnoses increased (HR=1.26, p=.0305), with worse OS in those presenting with liver metastases at diagnoses (21.1%, OS: 20 m), compared to those without tumor involvement (OS: 45.4 m; p =.008). Conclusions: OS was similar for ALK-positive NSCLC patients with and without CNS metastases at diagnoses. OS was worse as the number of metastatic organs at diagnosis increased, with liver metastases being associated with the highest risk of mortality