Los asentamientos rurales en Cantabria. Propuesta de clasificación según el tipo de planta.

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La arquitectura popular indicador socioeconómico del medio rural. Situación en Cantabria.

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LA FATIGA EN EL CÁNCER: IMPACTO Y ALCANCE DEL PROBLEMA.

The Fatigue is one of the most frequent symptom among oncology patients , specially to whom are receiving any kind of treatment against cancer. The most significative symptoms and signs of Fatigue are asthenia, tiredness, lack of energy or weakness. The purpose of this study is to determine the perception of Fatigue of the oncology patients whom are receiving chemo or radiotherapy in our Hospital , their sensation grade of fatigue and how could modify it their quality of life. We tried to evaluate the intensity of Fatigue using the method described by Dr. Piper scale for these kind of patients. The outcomes obtained, indicates that in these patients the physical capacities are the most altered according to their own perception, and in a minor way the cognitive and affective ones. However in most of the cases (58%) the presence of this sensation of fatigue did not follow the circadian cycle , however all of them agree about the chronic nature of the fatigue, with presence of brief and higher picks. Anyhow, not existing some clear determinations of the fatigue mechanisms, an intervention are complex. From the point of view of nursing, it should be focused to the symptoms management and the emotional support mainly.La fatiga es uno de los síntomas subjetivos más referidos por los pacientes que sufren un Cáncer, y sobre todo por aquellos que reciben algún tipo de terapia activa para combatirlo, y se caracteriza principalmente por la aparición de síntomas tales como astenia, laxitud, falta de energía o debilidad. En el presente trabajo nos propusimos determinar el grado de percepción que los pacientes oncológicos del HMA tienen de su sensación de fatiga y del modo en que ésta alteraba su calidad de vida. Para ello, utilizamos una herramienta universalmente conocida elaborada por la Doctora en Enfermería Bárbara Piper, y que consiste en una encuesta evaluadora de la intensidad de la fatiga en los pacientes oncológicos. Los resultados obtenidos nos indican que las capacidades que se encuentran más alteradas - según su propia impresión- son las físicas, y en un rango inferior, las cognitivas y las afectivas. En la mayoría de los casos (58 %) la presencia de esta sensación de fatiga no se correspondió con patrón circadiano alguno si bien todos ellos coincidieron en que su naturaleza era crónica, con breves picos de mayor intensidad. De todos modos al no existir unas causas claras del mecanismo de producción de la fatiga, se hace complicada una intervención que desde la perspectiva de Enfermería, debería ir dirigida al control de síntomas y efectos secundarios adversos con una intención holística

Metabolomic and Lipidomic Profiling Identifies The Role of the RNA Editing Pathway in Endometrial Carcinogenesis

Endometrial cancer (EC) remains the most common malignancy of the genital tract among women in developed countries. Although much research has been performed at genomic, transcriptomic and proteomic level, there is still a significant gap in the metabolomic studies of EC. In order to gain insights into altered metabolic pathways in the onset and progression of EC carcinogenesis, we used high resolution mass spectrometry to characterize the metabolomic and lipidomic profile of 39 human EC and 17 healthy endometrial tissue samples. Several pathways including lipids, Kynurenine pathway, endocannabinoids signaling pathway and the RNA editing pathway were found to be dysregulated in EC. The dysregulation of the RNA editing pathway was further investigated in an independent set of 183 human EC tissues and matched controls, using orthogonal approaches. We found that ADAR2 is overexpressed in EC and that the increase in expression positively correlates with the aggressiveness of the tumor. Furthermore, silencing of ADAR2 in three EC cell lines resulted in a decreased proliferation rate, increased apoptosis, and reduced migration capabilities in vitro. Taken together, our results suggest that ADAR2 functions as an oncogene in endometrial carcinogenesis and could be a potential target for improving EC treatment strategies

Poor outcome in hypoxic endometrial carcinoma is related to vascular density

Background Identification of endometrial carcinoma (EC) patients at high risk of recurrence is lacking. In this study, the prognostic role of hypoxia and angiogenesis was investigated in EC patients. Methods Tumour slides from EC patients were stained by immunofluorescence for carbonic anhydrase IX (CAIX) as hypoxic marker and CD34 for assessment of microvessel density (MVD). CAIX expression was determined in epithelial tumour cells, with a cut-off of 1%. MVD was assessed according to the Weidner method. Correlations with disease-specific survival (DSS), disease-free survival (DFS) and distant disease-free survival (DDFS) were calculated using Kaplan–Meier curves and Cox regression analysis. Results Sixty-three (16.4%) of 385 ECs showed positive CAIX expression with high vascular density. These ECs had a reduced DSS compared to tumours with either hypoxia or high vascular density (log-rank p = 0.002). Multivariable analysis showed that hypoxic tumours with high vascular density had a reduced DSS (hazard ratio [HR] 3.71, p = 0.002), DDFS (HR 2.68, p = 0.009) and a trend for reduced DFS (HR 1.87, p = 0.054). Conclusions This study has shown that adverse outcome in hypoxic ECs is seen in the presence of high vascular density, suggesting an important role of angiogenesis in the metastatic process of hypoxic EC. Differential adjuvant treatment might be indicated for these patients.publishedVersio

Clinical Outcomes of a Zika Virus Mother-Child Pair Cohort in Spain

BACKGROUND: Zika virus (ZIKV) infection has been associated with congenital microcephaly and other neurodevelopmental abnormalities. There is little published research on the effect of maternal ZIKV infection in a non-endemic European region. We aimed to describe the outcomes of pregnant travelers diagnosed as ZIKV-infected in Spain, and their exposed children. METHODS: This prospective observational cohort study of nine referral hospitals enrolled pregnant women (PW) who travelled to endemic areas during their pregnancy or the two previous months, or those whose sexual partners visited endemic areas in the previous 6 months. Infants of ZIKV-infected mothers were followed for about two years. RESULTS: ZIKV infection was diagnosed in 163 PW; 112 (70%) were asymptomatic and 24 (14.7%) were confirmed cases. Among 143 infants, 14 (9.8%) had adverse outcomes during follow-up; three had a congenital Zika syndrome (CZS), and 11 other potential Zika-related outcomes. The overall incidence of CZS was 2.1% (95%CI: 0.4-6.0%), but among infants born to ZIKV-confirmed mothers, this increased to 15.8% (95%CI: 3.4-39.6%). CONCLUSIONS: A nearly 10% overall risk of neurologic and hearing adverse outcomes was found in ZIKV-exposed children born to a ZIKV-infected traveler PW. Longer-term follow-up of these children is needed to assess whether there are any later-onset manifestations

Preoperative risk stratification in endometrial cancer (ENDORISK) by a Bayesian network model: A development and validation study

Background: Bayesian networks (BNs) are machine-learning-based computational models that visualize causal relationships and provide insight into the processes underlying disease progression, closely resembling clinical decision-making. Preoperative identification of patients at risk for lymph node metastasis (LNM) is challenging in endometrial cancer, and although several biomarkers are related to LNM, none of them are incorporated in clinical practice. The aim of this study was to develop and externally validate a preoperative BN to predict LNM and outcome in endometrial cancer patients.Methods and findings: Within the European Network for Individualized Treatment of Endometrial Cancer (ENI-TEC), we performed a retrospective multicenter cohort study including 763 patients, median age 65 years (interquartile range [IQR] 58-71), surgically treated for endometrial cancer between February 1995 and August 2013 at one of the 10 participating European hospitals. A BN was developed using score-based machine learning in addition to expert knowledge. Our main outcome measures were LNM and 5-year disease-specific survival (DSS). Preoperative clinical, histopathological, and molecular biomarkers were included in the network. External validation was performed using 2 prospective study cohorts: the Molecular Markers in Treatment in Endometrial Cancer (MoMaTEC) study cohort, including 446 Norwegian patients, median age 64 years (IQR 59-74), treated between May 2001 and 2010; and the PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study cohort, including 384 Dutch patients, median age 66 years (IQR 60-73), treated between September 2011 and December 2013. A BN called ENDORISK (preoperative risk stratification in endometrial cancer) was developed including the following predictors: preoperative tumor grade; immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PR), p53, and L1 cell adhesion molecule (L1CAM); cancer antigen 125 serum level; thrombocyte count; imaging results on lymphadenopathy; and cervical cytology. In the MoMaTEC cohort, the area under the curve (AUC) was 0.82 (95% confidence interval [CI] 0.76-0.88) for LNM and 0.82 (95% CI 0.77-0.87) for 5-year DSS. In the PIPENDO cohort, the AUC for 5-year DSS was 0.84 (95% CI 0.78-0.90). The network was well-calibrated. In the MoMaTEC cohort, 249 patients (55.8%) were classified with Conclusions: In this study, we illustrated how BNs can be used for individualizing clinical decision-making in oncology by incorporating easily accessible and multimodal biomarkers. The network shows the complex interactions underlying the carcinogenetic process of endometrial cancer by its graphical representation. A prospective feasibility study will be needed prior to implementation in the clinic.</div

Cancer-related fatigue: impact and scope of the problem

La fatiga es uno de los síntomas subjetivos más referidos por los pacientes que sufren un Cáncer, y sobre todo por aquellos que reciben algún tipo de terapia activa para combatirlo, y se caracteriza principalmente por la aparición de síntomas tales como astenia, laxitud, falta de energía o debilidad. En el presente trabajo nos propusimos determinar el grado de percepción que los pacientes oncológicos del HMA tienen de su sensación de fatiga y del modo en que ésta alteraba su calidad de vida. Para ello, utilizamos una herramienta universalmente conocida elaborada por la Doctora en Enfermería Bárbara Piper, y que consiste en una encuesta evaluadora de la intensidad de la fatiga en los pacientes oncológicos. Los resultados obtenidos nos indican que las capacidades que se encuentran más alteradas - según su propia impresión- son las físicas, y en un rango inferior, las cognitivas y las afectivas. En la mayoría de los casos (58 %) la presencia de esta sensación de fatiga no se correspondió con patrón circadiano alguno si bien todos ellos coincidieron en que su naturaleza era crónica, con breves picos de mayor intensidad. De todos modos al no existir unas causas claras del mecanismo de producción de la fatiga, se hace complicada una intervención que desde la perspectiva de Enfermería, debería ir dirigida al control de síntomas y efectos secundarios adversos con una intención holística.ABSTRACT The Fatigue is one of the most frequent symptom among oncology patients , specially to whom are receiving any kind of treatment against cancer. The most significative symptoms and signs of Fatigue are asthenia, tiredness, lack of energy or weakness. The purpose of this study is to determine the perception of Fatigue of the oncology patients whom are receiving chemo or radiotherapy in our Hospital , their sensation grade of fatigue and how could modify it their quality of life. We tried to evaluate the intensity of Fatigue using the method described by Dr. Piper scale for these kind of patients. The outcomes obtained, indicates that in these patients the physical capacities are the most altered according to their own perception, and in a minor way the cognitive and affective ones. However in most of the cases (58%) the presence of this sensation of fatigue did not follow the circadian cycle , however all of them agree about the chronic nature of the fatigue, with presence of brief and higher picks. Anyhow, not existing some clear determinations of the fatigue mechanisms, an intervention are complex. From the point of view of nursing, it should be focused to the symptoms management and the emotional support mainly