Anticuerpos del virus de la hepatitis C en pacientes con liquen plano bucal

El liquen plano bucal es una enfermedad inflamatoria crónica cuya etiologíapermanece desconocida. Se acepta que representa una respuesta inmune mediadapor células, en la que existe una interacción linfocito-epitelio, que culmina con ladegeneración del estrato basal epitelial. Se ha planteado una alta asociación conenfermedades hepáticas crónicas, como es el caso de la Hepatitis C, no teniendoreportes de estudios similares en nuestro país, por lo que se realizó la detección dede anticuerpos al virus de la Hepatitis C a 51 pacientes de liquen plano bucalprocedentes de la consulta de Patología Bucal de la Facultad de Estomatología,atendidos durante el período de 1991-2001 y a 45 controles, mediante una técnicade inmunoensayo con el objetivo de determinar el grado de asociación entre ambasentidades. Encontramos que tres pacientes resultaron positivos y sólo uno delgrupo control; sin embargo, la relación entre estas dos enfermedades no se logróestablecer, debido probablemente a los bajos índices de seroprevalencia registradosen nuestro país y quizás también al pequeño tamaño de la muestra.Palabras clave: Liquen plano bucal, Hepatitis C, virus de la Hepatitis C, VHC

Displasia Epitelial como característica histopatológica del Liquen Plano Bucal

El liquen plano bucal constituye una de las lesiones blancas más frecuentes de la mucosa bucal y posee cierto riesgo de transformación maligna. La presencia de displasia epitelial como predictor histológico de cambios malignos ha sido escasamente estudiada en el liquen plano bucal, por lo que nos propusimos determinar la presencia de displasia epitelial en biopsias de pacientes con dicha enfermedad.  Se emplearon las biopsias de 40 pacientes de la consulta de Patología Bucal de la Facultad de Estomatología del ISCM-H. Las láminas fueron procesadas por la técnica de inclusión en parafina y coloreadas con Hematoxilina/Eosina. Se determinó el tipo de queratinización, el grado de infiltrado inflamatorio, la presencia de degeneración vacuolar y la existencia de displasia epitelial, según los criterios de Smith y Pindborg aprobados por la OMS.  Se encontró displasia epitelial ligera en 57.5%, el resto no presentó displasia. Este alto grado de displasia ligera pudo deberse a que las muestras fueron tomadas de formas erosivas de liquen, a la subjetividad del método o en respuesta al intenso infiltrado inflamatorio también encontrado.  Palabras clave: Liquen plano bucal, displasia epitelial

Breast cancer patient experiences through a journey map: A qualitative study.

Background: Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual). Objective: This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey. Methods: This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach. Results: The diagnosis and treatment of breast cancer entails a radical change in patients' day-today that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the 'new' day-today, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey. Conclusions: Comprehending patients' experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life

Optimism and Social Support as Contributing Factors to Spirituality in Cancer Patients

Background/objective: The impact a cancer diagnosis and its treatment are affected by psychosocial factors and how these factors interrelate among themselves. The objective of this study was to analyze the relationship between optimism and social support in spiritual wellbeing in cancer patients initiating chemotherapy. Methods: A cross-sectional, multi-center (15 sites), prospective study was conducted with 912 cancer patients who had undergone curative surgery for a stage I-III cancer and were to receive adjuvant chemotherapy. They completed the Functional Assessment of Chronic Illness-Spiritual Well-being Scale (FACIT-Sp), Life Orientation Test-Revised (LOT-R), and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: Significant differences on spirituality scales (meaning/peace and faith) were detected depending on age (≤ 65 vs > 65), sex, marital status, employment, and cancer treatment. Married or partnered participants had significantly higher meaning/peace scores compared to their non-partnered counterparts (p = 0.001). Women, > 65 years, unemployed, and patients treated with chemotherapy and radiotherapy had significantly higher faith scores versus men, ≤ 65 years, employed, and subjects only receiving adjuvant chemotherapy (all p < 0.030). Multivariate analyses indicated that meaning/peace and faith correlated positively with optimism and social support. Conclusion: During oncological treatment, the positive effects of optimism and social support exhibit a positive correlation with spiritual coping. A brief assessment evaluation of these factors can aid in identifying at risk for a worse adaptation to the disease

Clinical trials and Haemophilia during the COVID-19 pandemic: Madrid's experience

This is the peer reviewed version of the following article: "Clinical trials and Haemophilia during the COVID‐19 pandemic: Madrid's experience". Haemophilia (2020): 16 May, which has been published in final form at https://doi.org/10.1111/hae.14055. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Version

Ascertaining breast cancer patient experiences through a journey map: A qualitative study protocol

This study seeks to describe breast cancer patients' experience over the course of the various stages of illness by means of a journey model. This is a qualitative descriptive study. Individual, semi-structured interviews will be administered to women with breast cancer and breast cancer survivors. Patients will be recruited from nine large hospitals in Spain and intentional sampling will be used. Data will be collected by means of a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data will be processed adopting a thematic analysis approach. The outcomes of this study will afford new insights into breast cancer patients' experiences,providing guidance to improve the care given to these individuals. This protocol aims to describe the journey of patients with breast cancer through the healthcare system to establish baseline data that will serve as the basis for the development and implementation of a patient-centered, evidence-based clinical pathway

Multidimensional Scale of Perceived Social Support (MSPSS) in cancer patients: psychometric properties and measurement invariance

Background: The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Multidimensional Scale of Perceived Social Support (MSPSS) in cancer patients. Method: Confi rmatory factor analysis (CFA) was conducted to explore the scale's dimensionality and test for strong measurement invariance across sex and age in a cross-sectional, multicenter, prospective study. Patients completed the MSPSS and Satisfaction with Life Scale (SWLS). Results: A total of 925 consecutive patients were recruited in 13 hospitals between July 2015 and December 2018. The CFA indicated that the original three factor model was replicated in patients with cancer. The results of the multi-group CFA revealed a strong invariance according to sex and age. The Spanish version of the MSPSS had high estimated reliability with values exceeding .90. The simple sum of the items of each scale was a good indicator of oncology patients' perceived social support. The three MSPSS subscales correlated signifi cantly with the SWLS. Women scored higher on social support by friends than men. Conclusion: The Spanish version of the MSPSS proved to be a valid, reliable instrument to assess perceived social support in cancer patients

Six Collective Challenges for Sustainability of Almería Greenhouse Horticulture

Globally, current food consumption and trade are placing unprecedented demand on agricultural systems and increasing pressure on natural resources, requiring tradeoffs between food security and environmental impacts especially given the tension between market-driven agriculture and agro-ecological goals. In order to illustrate the wicked social, economic and environmental challenges and processes to find transformative solutions, we focus on the largest concentration of greenhouses in the world located in the semi-arid coastal plain of South-east Spain. Almería family farming, predominantly cooperative, greenhouse intensive production, commenced after the 1960s and has resulted in very significant social and economic benefits for the region, while also having important negative environmental and biodiversity impacts, as well as creating new social challenges. The system currently finds itself in a crisis of diminishing economic benefits and increasing environmental and social dilemmas. Here, we present the outcomes of multi-actor, transdisciplinary research to review and provide collective insights for solutions-oriented research on the sustainability of Almeria’s agricultural sector. The multi-actor, transdisciplinary process implemented collectively, and supported by scientific literature, identified six fundamental challenges to transitioning to an agricultural model that aims to ameliorate risks and avoid a systemic collapse, whilst balancing a concern for profitability with sustainability: (1) Governance based on a culture of shared responsibility for sustainability, (2) Sustainable and efficient use of water, (3) Biodiversity conservation, (4) Implementing a circular economy plan, (5) Technology and knowledge transfer, and (6) Image and identity. We conclude that the multi-actor transdisciplinary approach successfully facilitated the creation of a culture of shared responsibility among public, private, academic, and civil society actors. Notwithstanding plural values, challenges and solutions identified by consensus point to a nascent acknowledgement of the strategic necessity to locate agricultural economic activity within social and environmental spheres.This paper demonstrates the need to establish transdisciplinary multi-actor work-schemes to continue collaboration and research for the transition to an agro-ecological model as a means to remain competitive and to create value

Solar decathlon latino América y Caribe. Cali 2015 (Colombia), Proyecto AURA

Solar Decathlon Latin America and the Caribbean 2015 will take place in the city of Cali, Colombia. Coming from North America and after the European and Asian editions, now the competition for sustainable housing arrives Latin America. ‘Solar Decathlon’ is an international competition inviting students around the world from universities specialized in Engineering, Architecture, Urban Design, Renewable Energies and related careers to participate on creating, building and operating Self-sustaining social solutions, run by solar power. In addition to the founding principles of the original Solar Decathlon, the SD LAC2015 Organization has decided to focus on the following four components, which will be fundamental to the proposals in order to adapt them to tropical climate and cultural conditions. The components are: 1. Social Housing: As social inequality is one of the most pressing issues in Latin America and the Caribbean, the Solar Decathlon should strive to prove that sustainable housing based on alternative energy sources can be accessible to the population at large, prioritizing dense urban areas where most of the population is living. 2. Density: Nowadays, most of the population lives in cities where building areas are increasingly scarce and expensive. Moreover, denser housing solutions can help minimize the environmental impact. Consequently, the SD LAC2015 will favour projects that optimize the architectural and urban footprint. 3. Rational Use of Environmental Resources: The vast majority of the Latin American population lives in the tropics, enjoying high solar radiation all year long and exceptional availability of water sources. 4. Regional Relevance: The SD LAC2015 embraces the goal of developing and promoting ideas, capacities and technologies that can be implemented for the benefit of the inhabitants of the LAC region. The actual construction of prototypes will take place in the ‘Universidad del Valle’ campus. The competition combines both theoretical and practical knowledge considering projects must be built on real scale and be tested on 10 different contests. The hisCali team, from the Sevilla University, will take part in competition together with the ‘University of Santiago de Cali’, and with the support of the IUACC and the official masters of Innovation and Sustainability, both from the Sevilla University.El Decatlón Solar para América Latina y el Caribe - SD LAC2015 – se llevará a cabo en la ciudad de Cali, Colombia, convirtiéndose en la primera sede de esta versión del concurso, tras la primigenia norteamericana y las sucesivas versiones europeas y asiáticas. "Solar Decathlon" es un concurso internacional que invita a los estudiantes de las universidades especializadas en arquitectura, diseño urbano, energías renovables y carreras afines a que participen en el diseño, la construcción y la operación de soluciones de vivienda auto-sostenibles y energéticamente eficientes para contribuir a la mitigación del cambio climático a través de la implantación de tecnologías limpias. Los proyectos que se presentan a este concurso deben seguir un esquema reglamentario específico que se adapta a las condiciones climáticas y culturales de la región presentando propuestas de viviendas sociales como soluciones de impacto positivo para la región. 1. Vivienda Social: Debido a las circunstancias de desigualdad social y económica que enfrenta la región de América Latina y del Caribe, SDLAC2015 se presenta como un espacio dinámico de elaboración de propuestas y construcción de soluciones reales que impacten de manera positiva a la comunidad. 2. Densidad: Como consecuencia del desplazamiento masivo de la población hacia la zona urbana, una de las características de diseño y distribución que debe tenerse en cuenta para las construcciones del futuro es la densidad. 3. Uso Racional de Recursos del Medio Ambiente: La mayoría de la población de América Latina y del Caribe vive en la zona tropical, enfrentando emisiones de radiación solar a lo largo del año y una disponibilidad excepcional de las fuentes de agua. 4. Relevancia Regional: La meta será desarrollar ideas y tecnologías que beneficien a los habitantes de la región. El campus de la Universidad del Valle, en la ciudad de Cali, Colombia, es el escenario escogido para llevar a cabo la construcción real de los prototipos diseñados por cada equipo participante que serán evaluados en 10 pruebas diferentes a lo largo de la competencia. A esta convocatoria de Solar Decathlon Latino América y Caribe 2015, se presenta el equipo hísCali, con profesores de áreas de conocimiento de la Universidad de Sevilla tales como Construcción, Urbanismo, Proyectos, Estructuras, Derecho, Economía, Matemática Aplicada y Bellas Artes, junto con la Universidad de Santiago de Cali y con el apoyo del IUACC y los másteres de Innovación y de Sostenibilidad, ambos asimismo de la Universidad de Sevilla

Prediction of quality of life in early breast cancer upon completion of adjuvant chemotherapy

Quality of life (QoL) is a complex, ordinal endpoint with multiple conditioning factors. A predictive model of QoL after adjuvant chemotherapy can support decision making or the communication of information about the range of treatment options available. Patients with localized breast cancer (n = 219) were prospectively recruited at 17 centers. Participants completed the EORTC QLQC30 questionnaire. The primary aim was to predict health status upon completion of adjuvant chemotherapy adjusted for multiple covariates. We developed a Bayesian model with six covariates (chemotherapy regimen, TNM stage, axillary lymph node dissection, perceived risk of recurrence, age, type of surgery, and baseline EORTC scores). This model allows both prediction and causal inference. The patients with mastectomy reported a discrete decline on all QoL scores. The effect of surgery depended on the interaction with age. Women with ages on either end of the range displayed worse scores, especially with mastectomy. The perceived risk of recurrence had a striking effect on health status. In conclusion, we have developed a predictive model of health status in patients with early breast cancer based on the individual's profile