Quality of life related to health in children and adolescents with cancer treated at Oncohematology services Havana, 2011-2013

Introduction: The impact and psychological repercussion of cancer in childhood justify the importance of the researches on quality of life related to patients’ health. Objective: Describe the researches with socio-demographic and clinical variables on onco-pediatric patients who are under oncohematological services in Havana from 2011 to 2013. Material and Methods:  A descriptive research with 150 children that fulfill the inclusion criteria. A system of life quality evaluation for children who suffer from cancer was applied; this system of evaluation was developed in Cuba. Punctual and at interval appraisals were done to the 95% of the global arithmetic average and by dimension through socio-demographic and clinical variables. Different test were used; t student for independent samples, the ANOVA of one way and the Scheffe. Results: The global average of the quality of life related to health was 3, 49. The worst evolutions were on the dimension of symptoms associated to treatment (5, 88) and for preoccupations. There were significant differences in different dimensions for socio-demographic and clinical variables. Conclusions: The patients showed high and average levels of quality of life related to health. The dimensions: symptoms associated to treatment, preoccupations, emotional symptoms, validity and primary symptoms were the worst evaluated dimensions. Academic level, type of treatment, and time of evolution differentiate patients with a tendency to have a better or worse global quality of life related to health. Key words: oncohematology, quality of life related with health, pediatrics, cancer, pediatric oncology.</p

Exploring the origin and fate of surface and sub-surface marine microplastics in the Canary Islands region

The presence of different types of microplastics (MPs) in the Atlantic Ocean has been well-documented, with data collected from the Canary Islands indicating high concentrations of MPs at four different beaches (hot spots). However, critical gaps persist regarding the abundance of MPs in diverse open ocean regions, at varying depths, and their transport behavior and origin. This study aims to evaluate, for the first time, the large-scale (&gt;100 km) and mesoscale (10-100 km) ocean dynamic processes and the resulting transport of MPs in the region. On the one hand, this study investigates the surface velocity of currents between 27-32°N latitude range, establishing correlation with the accumulation of MPs on diverse beaches across several islands of the archipelago. This analysis goes beyond studying the predominant current by integrating data at a smaller geographical scale over a two-year period. Concurrently, previous and ongoing research suggests the presence of small MPs (SMPs,&lt;1 mm) at high concentration at a depth of 1100 meters in this region. By integrating these vertical profiles of MPs with a deep understanding of the physical processes of the Canary region accumulated over decades of research, our study introduces an innovative model that outlines how SMPs are sink and transported in open oceans by water mases. This comprehensive approach not only enhances our understanding of the complex dynamics influencing the distribution of MPs but also provides crucial insights to address the widespread problem of MP pollution in the Atlantic

Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

SLE can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in >50% of SLE patients. To describe the GI manifestations of SLE in the RELESSER (Registry of SLE Patients of the Spanish Society of Rheumatology) cohort and to determine whether these are associated with a more severe disease, damage accrual and a worse prognosis. METHODS: We conducted a nationwide, retrospective, multicentre, cross-sectional cohort study of 3658 SLE patients who fulfil =4 ACR-97 criteria. Data on demographics, disease characteristics, activity (SLEDAI-2K or BILAG), damage (SLICC/ACR/DI) and therapies were collected. Demographic and clinical characteristics were compared between lupus patients with and without GI damage to establish whether GI damage is associated with a more severe disease. RESULTS: From 3654 lupus patients, 3.7% developed GI damage. Patients in this group (group 1) were older, they had longer disease duration, and were more likely to have vasculitis, renal disease and serositis than patients without GI damage (group 2). Hospitalizations and mortality were significantly higher in group 1. Patients in group 1 had higher modified SDI (SLICC Damage Index). The presence of oral ulcers reduced the risk of developing damage in 33% of patients. CONCLUSION: Having GI damage is associated with a worse prognosis. Patients on a high dose of glucocorticoids are at higher risk of developing GI damage which reinforces the strategy of minimizing glucocorticoids. Oral ulcers appear to decrease the risk of GI damage. © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology

Bioética en el diagnóstico prenatal en la drepanocitosis

El desarrollo de la biología molecular y la aplicación de técnicas altamente sensibles han permitido conocer mejor las bases genéticas de las enfermedades hereditarias y utilizarlas en prevenir, diagnosticar y tratarlas. En Cuba el estado de portador de la hemoglobina S es del 3,08 % por lo que representa un problema de salud pública y desde la década del 90 del siglo pasado se realiza el diagnóstico prenatal de la enfermedad, cumpliendo los principios éticos de autonomía, beneficencia, no maleficencia y justicia. El conflicto ético más importante surge cuando se cuestiona el beneficio de la información obtenida por el diagnóstico prenatal para el feto, los padres y la sociedad. El diagnóstico prenatal de la drepanocitosis en Cuba tiene un importante impacto científico-social y requiere de un trabajo serio desde la atención primaria de salud, brindando apoyo científico-técnico a la pareja de riesgo y su futuro hijo pero respetando siempre sus derechos bioéticos

Aplasia medular: Actualización Bone marrow aplasia: Update

La aplasia medular, según su etiología puede ser congénita y adquirida; esta última es la más frecuente. La causa del fallo de la hematopoyesis parece ser multifactorial. Se revisan las causas de aplasia medular adquirida, sus mecanismos fisiopatológicos y se hace énfasis en los mecanismos inmunes, que desempeñan un papel central en su fisiopatología. Se actualizan los criterios diagnósticos, los elementos de pronóstico desfavorable, así como las enfermedades con las que debe hacerse el diagnóstico diferencial. Las terapéuticas actuales más efectivas son los inmunosupresores y el trasplante de médula ósea, cada uno de ellos ofrece ventajas y desventajas y requiere de indicaciones precisas<br>Bone marrow aplasia according to its etiology may be congenital or acquired. The latter is the most frequent. Haemopoietic failure seems to be caused by several factors. The causes of acquired medullary aplasia and its physiopathological mechanisms are reviewed. Emphasis is made on th immune mechanisms, which play an important role in its physiopathology. The diagnostic criteria as well as the elements of an unfavorable diagnosis and the disease that must be taken into consideration to make the differential diagnosis are analyzed in this paper. The most effective treatments at present are the immunosuppressors and bone marrow transplantation. Each has advantages and disadvantages and requires specific indication

Artralgias en el adolescente ¿Pensamos en todos los diagnósticos?

Musculoskeletal pathology is a very frequent reason for consultation. Thinking about its possible etiologies is essential for an adequate medical approach. It is important to recognize them in order to make better both the prognosis and the quality of life of our patients. It is extremely important to make adequate differential diagnoses and be aware of the clues that can guide us towards an adequate diagnosis. We will review juvenile idiopathic arthritis (JIA) as the most common cause of rheumatological disease in childhood. This review article aims to highlight the importance of knowing rheumatic diseases in order to refer on time to a specialized consultation and request the necessary complementary testsLa patología musculoesquelética constituye un motivo de consulta muy frecuente. Tener presente sus posibles etiologías, nos permitirá realizar un adecuado abordaje. El enfoque diagnóstico de las enfermedades reumáticas supone un reto para el Pediatra de Atención Primaria siendo fundamental su conocimiento para reconocerlas y así influir tanto en el pronóstico como en la calidad de vida de nuestros pacientes. Es de suma importancia hacer adecuados diagnósticos diferenciales y estar pendientes de las pistas que nos puedan orientar hacia un diagnóstico adecuado. Revisaremos la artritis idiopática juvenil (AIJ) como causa más frecuente de enfermedad reumática en la infancia. Con este artículo de revisión, queremos poner de relieve la importancia que tiene su conocimiento para derivar a tiempo o bien, ir iniciando si es preciso pruebas complementaria

Homotopía propia simplicial II

Taking into account the simplicial models given in the category of exterior spaces we define and develop homology invariants for this category: the M-homology and the R-homology, as well as the tubular and the closed tubular homologies. As an application we give a description of the reduced Steenrod homology for compact metric spaces, X, in terms of the closed tubular homology of the Lefschetz's fundamental complex OFC(X)

Estudio de algunos parámetros hematológicos, de la función hepática y renal en niños con drepanocitosis Study of some hematological parameters and of the hepatic and renal function in children with sickle cell anemia

Se realizó un estudio longitudinal retrospectivo de algunos parámetros hematológicos y de la función hepática y renal en 88 niños con drepanocitosis, 35 del sexo femenino y 53 del masculino; 63 con anemia drepanocítica y 25 con hemoglobinopatía SC, seguidos entre enero de 1986 y diciembre de 1997 en el Instituto de Hematología e Inmunología, con el objetivo de estudiar posibles alteraciones y su relación con la edad, sexo y el tipo de hemoglobinopatía. Se analizó el promedio anual de la hemoglobina, reticulocitos, leucocitos, plaquetas y los valores de alaninoamino transferasa (ALT), aspartato transferasa, fosfatasa alcalina sérica (FAS) y creatinina por año, agrupados en grupos etáreos (de 2 a 5, de 6 a 8, de 9 a 11 y de 12 a 15 años). La hemoglobina y reticulocitos mostraron diferencias significativas entre las hemoglobinopatías ( pA retrospective longitudinal study of some hematological parameters and of hepatic and renal function of 88 children with sickle cell anemia, 35 females and 53 females; 63 with sickle cell anemia and 25 with hemoglobinopathy was conducted from January 1977 to December 1986 in the Hematology and Immunology Institute, with the objective of studying possible disorders and their relation with age, sex and type of hemoglobinopathy. The yearly average rate of hemoglobin, reticulocytes, leukocytes, platelets and the annual values of alanine aminotransferase(ALAT), asparte transferase, serum alkaline phosphatase(SAP) and creatinine were analyzed, grouped in age groups (2-5 y, 6-8 y, 9-11 y and 2-15 y). Hemoglobin and reticulocytes showed significant differences among hemoglobinopathies ( p< 0,05). Hepatic and renal functions were within standard parameters, but it was observed that in sickle cell anemia, ALAT, SAP and creatinine values progressively increases with the age ( p< 0,05