¿Es cierto que el trasplante de médula ósea autóloga mejora el pronóstico de los pacientes con mieloma múltiple?: experiencia de una sola institución en México.

En un periodo de 14 años, en una sola institución, realizamos 30 trasplantes de células hematopoyéticas autólogas a pacientes con mieloma múltiple. La mediana de supervivencia no se ha alcanzado, es mayor de siete años, mientras que la supervivencia a 84 meses fue de 77%. Estos datos son claramente superiores a los obtenidos en un grupo de 23 pacientes con mieloma múltiple tratados en la misma institución con melfalán y prednisona, quienes tuvieron una mediana de supervivencia de 33 meses y una supervivencia a 72 meses de 30%. En nuestra experiencia de una sola institución, la supervivencia a largo plazo en individuos con mieloma múltiple que recibieron un autotrasplante fue claramente superior a la de los pacientes tratados con quimioterapia convencional. El pronóstico a largo plazo de los pacientes con mieloma múltiple mejoró en la Clínica Ruiz de Puebla desde la introducción del trasplante de células hematopoyéticas autólogas para rescatar el tratamiento con quimioterapia a dosis altas

El AMD3100 (plerixafor) puede mejorar la movilización de células hematopoyéticaspara hacer trasplantes autólogos : Informe de un caso.

La quimioterapia a dosis alta rescatada con trasplante de células hematopoyéticas autólogas se ha convertido en el tratamiento de elección en los pacientes con mieloma múltiple menores de 65 años de edad. El éxito del autotrasplante depende de la infusión de un número suficiente de células CD34+. Algunos pacientes no movilizan adecuadamente células CD34 de la médula ósea a la sangre periférica para hacer los trasplantes, principalmente aquellos quienes han recibido quimioterapia previa. En estos casos, además de los agentes movilizantes habituales como el G-CSF, la adición de plerixafor incrementa la colección de células CD34+. Se presenta el caso de un paciente con mieloma múltiple quien había sido sometido a un trasplante de células hematopoyéticas autólogas y que, al intentar un segundo trasplante, no movilizó adecuadamente células CD34 al usar filgrastim. La adición de plerixafor permitió hacer adecuadamente la movilización de las células hematopoyética y trasplantar al paciente. No existen en la literatura nacional publicaciones sobre este tema

Impact of the Method Used to Select Gas Exchange Data for Estimating the Resting Metabolic Rate, as Supplied by Breath-by-Breath Metabolic Carts

The method used to select representative gas exchange data from large datasets influences the resting metabolic rate (RMR) returned. This study determines which of three methods yields the lowest RMR (as recommended for use in human energy balance studies), and in which method the greatest variance in RMR is explained by classical determinants of this variable. A total of 107 young and 74 middle-aged adults underwent a 30 min RMR examination using a breath-by-breath metabolic cart. Three gas exchange data selection methods were used: (i) steady state (SSt) for 3, 4, 5, or 10 min, (ii) a pre-defined time interval (TI), i.e., 6–10, 11–15, 16–20, 21–25, 26–30, 6–25, or 6–30 min, and (iii) “filtering”, setting thresholds depending on the mean RMR value obtained. In both cohorts, the RMRs yielded by the SSt and filtering methods were significantly lower (p < 0.021) than those yielded by the TI method. No differences in RMR were seen under the different conditions of the SSt method, or of the filtering method. No differences were seen between the methods in terms of the variance in RMR explained by its classical determinants. In conclusion, the SSt and filtering methods return the lowest RMRs and intra-measurement coefficients of variation when using breath-by-breath metabolic carts.This study was supported by the Spanish Ministry of Economy and Competitiveness via the Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01393), Retos de la Sociedad (DEP2016-79512-R) and European Regional Development Funds (ERDF), the Spanish Ministry of Education (FPU 15/04059 and FPU14/04172), the Fundación Iberoamericana de Nutrición (FINUT), the Redes Temáticas de Investigación Cooperativa RETIC (Red SAMID RD16/0022), the AstraZeneca HealthCare Foundation, the University of Granada Plan Propio de Investigación 2016 Excellence Actions: Unit of Excellence on Exercise and Health (UCEES) and Plan Propio de Investigación 2018 and 2019 Programa Contratos-Puente and Plan Propio de Investigación 2018 Programa Perfeccionamiento de Doctores, and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (ERDF: ref. SOMM17/6107/UGR), and the Fundación Alfonso Martín Escudero

Dental treatment for handicapped patients: sedation vs general anesthesia and update of dental treatment in patients with different diseases

Dental treatment on Handicapped Patients is often difficult because many people with a wide range of ages (from children to the elderly) with different pathologies that can affect the oral cavity and differ widely are included in this group. This situation creates some controversy, because according to pathology, each patient will be treated differently depending on collaboration, general health status, age or medication used to treat this pathologies. Ac - cording to this situation we can opt for an outpatient treatment without any kind of previous medication, a treat - ment under conscious or deep sedation or a under general anesthesia treatment. With this systematic review is intended to help clarify in which cases patients should be treated under general anesthesia, sedation (conscious or deep) or outpatient clinic without any medication, as well as clarify what kind of treatments can be carried in private dental clinics and which should be carried out in a hospital. It will also discuss the most common diseases among this group of patients and the special care to be taken for their dental treatment

Association of meal timing with body composition and cardiometabolic risk factors in young adults

Purpose To investigate the association of meal timing with body composition and cardiometabolic risk factors in young adults. Methods In this cross-sectional study participated 118 young adults (82 women; 22 ± 2 years old; BMI: 25.1 ± 4.6 kg/m2). Meal timing was determined via three non-consecutive 24-h dietary recalls. Sleep outcomes were objectively assessed using accelerometry. The eating window (time between first and last caloric intake), caloric midpoint (local time at which ≥ 50% of daily calories are consumed), eating jetlag (variability of the eating midpoint between non-working and working days), time from the midsleep point to first food intake, and time from last food intake to midsleep point were calculated. Body composition was determined by DXA. Blood pressure and fasting cardiometabolic risk factors (i.e., triglycerides, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and insulin resistance) were measured. Results Meal timing was not associated with body composition (p > 0.05). The eating window was negatively related to HOMA-IR and cardiometabolic risk score in men (R2 = 0.348, β = − 0.605; R2 = 0.234, β = − 0.508; all p ≤ 0.003). The time from midsleep point to first food intake was positively related to HOMA-IR and cardiometabolic risk score in men (R2 = 0.212, β = 0.485; R2 = 0.228, β = 0.502; all p = 0.003). These associations remained after adjusting for confounders and multiplicity (all p ≤ 0.011). Conclusions Meal timing seems unrelated to body composition in young adults. However, a longer daily eating window and a shorter time from midsleep point to first food intake (i.e., earlier first food intake in a 24 h cycle) are associated with better cardiometabolic health in young men. Clinical trial registration NCT0236512

Distribution of Brown Adipose Tissue Radiodensity in Young Adults: Implications for Cold [18F]FDG-PET/CT Analyses

Procedures: We measured 125 individuals after a personalized cooling protocol with a static [18F]FDG-PET/CT scan. We quantified BAT using different combination of threshold in every single HU for all participants. Results: We observed that the SUV threshold influences BAT quantification by [18F]FDG-PET/ CT scans more than the HU range. We found that the range from − 50 to − 10 HU had the highest proportion of total BAT volume (43.2 %), which represents 41.4 % of the total BAT metabolic activity in our cohort. We also observed that BAT volume was not different between categories of body mass index, as well as BAT activity (SUVmean). In addition, BAT was less dense in women than in men, although the BAT activity (SUVmean) was higher in all ranges of HU. We also observed that the radiodensity of BAT located in the cervical area was mainly in the range from − 50 to − 10 HU. Conclusion: Therefore, all future human studies using static [18F]FDG-PET/CT scans should include BAT in the radiodensity range from − 50 to − 10 HU.This study was supported by the Spanish Ministry of Economy and Competitiveness, Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI13/01393) and Retos de la Sociedad (DEP2016-79512-R), Fondos Estructurales de la Unión Europea (FEDER), by the Spanish Ministry of Education (FPU 13/04365), by the Fundación Iberoamericana de Nutrición (FINUT), the Redes Temáticas de Investigación Cooperativa RETIC (Red SAMID RD16/0022), the AstraZeneca HealthCare Foundation, the University of Granada Plan Propio de Investigación 2016 - Excellence actions: Unit of Excellence on Exercise and Health (UCEES) - and Plan Propio de Investigación 2018 - Programa Contratos-Puente, and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (FEDER, ref. SOMM17/6107/UGR)

Acute Effects of Whole-Body Electromyostimulation on Energy Expenditure at Resting and during Uphill Walking in Healthy Young Men

The effects of the different electrical frequencies of whole-body electrical stimulation (WB-EMS) on energy expenditure (EE) and the respiratory exchange ratio (RER) remain poorly understood. This study aimed to determine the effects of different WB-EMS electrical frequencies on EE and the RER during supine resting and uphill walking. A total of 10 healthy and recreationally active men (21.6 +/- 3.3 years old) participated in the present study. Participants completed two testing sessions in a randomized order. In each session, a variety of impulse frequencies (1 hertz (Hz), 2 Hz, 4 Hz, 6 Hz, 8 Hz, and 10 Hz) were applied in a randomized order, allowing a 10 min passive recovery between them. Oxygen consumption and carbon dioxide production were measured to calculate EE and the RER. All frequencies increased EE at rest (all p = 0.923). During uphill walking, the frequency that elicited the highest increase in EE was 6 Hz (Delta = 4.87 +/- 0.84 kcal/min) compared to the unstimulated condition. None of the impulse frequencies altered the RER during uphill walking. WB-EMS increases EE in healthy young men both during resting and uphill walking.WiemsPro S.L.University of GranadaUnit of Excellence on Exercise and Health (UCEES)Plan Propio de Investigacion 2016, Excellence actions: Units of Excellenc

Impact of methods for data selection on the day-to-day reproducibility of resting metabolic rate assessed with four different metabolic carts

This work was supported by the Spanish Ministry of Economy and Competitiveness via Retos de la Sociedad grant DEP2016-79512-R (to JRR) , and European Regional Development Funds (ERDF) ; Spanish Ministry of Education grant (FPU15/04059 to JMAA; FPU19/01609 to LJ-F; and FPU18/03357 to MD -M) ; the University of Granada Plan Propio de Investigacion 2016 -Excellence actions: Unit of Excellence on Exercise and Health (to JRR) ; the University of Granada Plan Propio 2020 and 2018 Programa Contratos-Puente (to JMA and GS -D, respectively) , and Programa Perfeccionamiento de Doctores (to GS -D) ; Junta de Andalucia, Consejena de Conocimiento, Investigacion y Universidades grant SOMM17/6107/UGR (to JRR) via the ERDF; Grant FJC2020-044453-I funded by MCIN/AEI/10.13039/501100011033 and by "European Union Next- GenerationEU/PRTR " (to JMA) ; the Fundacion Alfonso Martin Escudero (to GS -D) ; and a Marie Sklodowska-Curie Actions-Individual Fellowship grant (Horizon2020, 101028941, to GS -D) .Background and aims: Accomplishing a high day-to-day reproducibility is important to detect changes in resting metabolic rate (RMR) and respiratory exchange ratio (RER) that may be produced after an intervention or for monitoring patients' metabolism over time. We aimed to analyze: (i) the influence of different methods for selecting indirect calorimetry data on RMR and RER assessments; and, (ii) whether these methods influence RMR and RER day-to-day reproducibility.Methods and results: Twenty-eight young adults accomplished 4 consecutive RMR assessments (30-min each), using the Q-NRG (Cosmed, Rome, Italy), the Vyntus CPX (Jaeger-CareFusion, H & ouml;chberg, Germany), the Omnical (Maastricht Instruments, Maastricht, The Netherlands), and the Ultima CardiO2 (Medgraphics Corporation, St. Paul, Minnesota, USA) carts, on 2 consecutive mornings. Three types of methods were used: (i) short (periods of 5 consecutive minutes; 6-10, 11-15, 16-20, 21-25, and 26-30 min) and long time intervals (TI) methods (6-25 and 6-30 min); (ii) steady state (SSt methods); and, (iii) methods filtering the data by thresholding from the mean RMR (filtering methods). RMR and RER were similar when using different methods (except RMR for the Vyntus and RER for the Q-NRG). Conversely, using different methods impacted RMR (all P <= 0.037) and/or RER (P <= 0.009) day-to-day reproducibility in all carts. The 6-25 min and the 6-30 min long TI methods yielded more reproducible measurements for all metabolic carts.Conclusion: The 6-25 min and 6-30 min should be the preferred methods for selecting data, as they result in the highest day-to-day reproducibility of RMR and RER assessments.Spanish Government DEP2016-79512-R, FPU15/04059, FPU19/01609, FPU18/03357European Union (EU)University of Granada Plan Propio de Investigacion 2016 -Excellence actions: Unit of Excellence on Exercise and HealthPrograma Perfeccionamiento de DoctoresJunta de Andalucía, Consejena de Conocimiento, Investigacion y Universidades via the ERDF SOMM17/6107/UGRMCIN/AEI FJC2020-044453-IFundación Alfonso Martín EscuderoMarie Sklodowska-Curie Actions-Individual Fellowship grant (Horizon2020) 101028941“European Union NextGenerationEU/PRTR