66 research outputs found

    Identification of seasonal variation in the diagnosis of acute myeloid leukaemia:a population-based study

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    Until now, the role that seasonal factors play in the aetiology of acute myeloid leukaemia (AML) has been unclear. Demonstration of seasonality in AML diagnosis would provide supportive evidence of an underlying seasonal aetiology. To investigate the potential seasonal and long‐term trends in AML diagnosis in an overall population and in subgroups according to sex and age, we used population‐based data from a Spanish hospital discharge registry. We conducted a larger study than any to date of 26 472 cases of AML diagnosed in Spain between 2004 and 2015. Using multivariable Poisson generalized linear autoregressive moving average modelling, we found an upward long‐term trend, with monthly incidence rates of AML annually increasing by 0.4% [95% confidence interval (CI), 0.2%–0.6%; p = 0.0011]. January displayed the highest incidence rate of AML, with a minimum average difference of 7% when compared to February (95% CI, 2%–12%; p = 0.0143) and a maximum average difference of 16% compared to November (95% CI, 11%–21%; p < 0.0001) and August (95% CI, 10%–21%; p < 0.0001). Such seasonal effect was consistent among subgroups according to sex and age. Our finding that AML diagnosis is seasonal strongly implies that seasonal factors, such as infectious agents or environmental triggers, influence the development and/or proliferation of disease, pointing to prevention opportunities

    Prognostic significance of FLT3-ITD length in AML patients treated with intensive regimens

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    FLT3-ITD mutations are detected in approximately 25% of newly diagnosed adult acute myeloid leukemia (AML) patients and confer an adverse prognosis. The FLT3-ITD allelic ratio has clear prognostic value. Nevertheless, there are numerous manuscripts with contradictory results regarding the prognostic relevance of the length and insertion site (IS) of the FLT3-ITD fragment. We aimed to assess the prognostic impact of these variables on the complete remission (CR) rates, overall survival (OS) and relapse-free survival (RFS) of AML patients with FLT3-ITDmutations. We studied the FLT3-ITD length of 362 adult AML patients included in the PETHEMA AML registry. We tried to validate the thresholds of ITD length previously published (i.e., 39 bp and 70 bp) in intensively treated AML patients (n = 161). We also analyzed the mutational profile of 118 FLT3-ITD AML patients with an NGS panel of 39 genes and correlated mutational status with the length and IS of ITD. The AUC of the ROC curve of the ITD length for OS prediction was 0.504, and no differences were found when applying any of the thresholds for OS, RFS or CR rate. Only four out of 106 patients had ITD IS in the TKD1 domain. Our results, alongside previous publications, confirm that FLT3-ITD length lacks prognostic value and clinical applicability. © 2021, The Author(s)

    Aula de memoria. Recursos didácticos para recuperar la historia de los olvidados.

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    Depto. de Didáctica de las Ciencias Experimentales , Sociales y MatemáticasFac. de EducaciónFALSEVicerrectorado de Calidad, UCMsubmitte

    Subscapular and triceps skinfolds reference values of Hispanic American children and adolescents and their comparison with the reference of Centers for Disease Control and Prevention (CDC)

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    Introduction: the assessment of the skinfold thickness is an objective measure of adiposity. Therefore, it is a useful tool for nutritional diagnosis and prevention of metabolic risk associated with excess fat in chilhood and adolescence. Objective: to provide percentiles of subscapular and triceps skinfolds for Hispanic American schoolchildren and compare them with those published by the Centers for Disease Control and Prevention (CDC) from United States, that it have been commonly used as a reference in most of these countries. Methods: subscapular and triceps skinfolds were measured in 9.973 schoolchildren 4-19 aged from Spain, Argentina, Cuba, Venezuela and Mexico with Holtain caliper with 0.2 mm accuracy. Percentiles were obtained with the LMS statistical method and were presented in tables divided in stages of 6 months and in curves graphics. The difference between Hispanic American and CDC mean values were provided for P3, P50 and P97 in mm and also were graphically represented. Results: skinfolds measurements obviously increased with age in both sexes but, in boys, this increase is much more marked in highest percentiles between 8 and 13 years; this maximum is reached earlier than what occurs in CDC reference. In both sexes, all percentiles analized in Hispanic American schoolchildren were higher than the CDC reference except P97 up to 10 or 13 years that was notably smaller. Conclusions: the skinfolds percentiles of Hispanic American children and adolescents differ from CDC that are usually used as reference. The values of subscapular and triceps skinfolds provided in this study, could be applied to populations of a similar ethnic background, especially in comparative studies of body composition

    Recomendaciones basadas en la evidencia del grupo andaluz para la reflexión e investigación en nutrición (Garin) para el manejo del paciente con síndrome de intestino corto

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    In order to develop evidence-based recommendations and expert consensus for the nutritional management of patients with short bowel syndrome (SBS), we conducted a systematic literature search using the PRISMA methodology plus a critical appraisal following the GRADE scale procedures. Pharmacological treatment with antisecretory drugs, antidiarrheal drugs, and somatostatin contributes to reducing intestinal losses. Nutritional support is based on parenteral nutrition; however, oral intake and/or enteral nutrition should be introduced as soon as possible. In the chronic phase, the diet should have as few restrictions as possible, and be adapted to the SBS type. Home parenteral nutrition (HPN) should be individualized. Single-lumen catheters are recommended and taurolidine should be used for locking the catheter. The HPN’s lipid content must be greater than 1 g/kg per week but not exceed 1 g/kg per day, and omega-6 fatty acids (ω6 FAs) should be reduced. Trace element vials with low doses of manganese should be used. Patients with chronic SBS who require long-term HPN/fluid therapy despite optimized treatment should be considered for teduglutide treatment. All patients require a multidisciplinary approach and specialized follow-up. These recommendations and suggestions regarding nutritional management in SBS patients have direct clinical applicability

    Efficacy and safety of native versus pegylated Escherichia coli asparaginase for treatment of adults with high-risk, Philadelphia chromosome-negative acute lymphoblastic leukemia

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    Native or pegylated (PEG) asparaginase (ASP) are commonly used in treatment of acute lymphoblastic leukemia (ALL), but have been scarcely compared in the same trial in adult patients. Native vs. PEG-ASP administered according to availability in each center were prospectively evaluated in adults with high-risk ALL. Ninety-one patients received native ASP and 35 PEG-ASP in induction. No significant differences were observed in complete remission, minimal residual disease levels after induction and after consolidation, disease-free survival, and overall survival. No significant differences in grades 3–4 toxicity were observed in the induction period, although a trend for higher hepatic toxicity was observed in patients receiving PEG-ASP. In this trial the type of ASP did not influence patient response and outcome.Supported in part with the grants PI10/01417 from Fondo de Investigaciones Sanitarias and RD12/0036/0029 from RTICC, Instituto de Salud Carlos III, 2014 SGR225(GRE), CERCA Program, Generalitat de Catalunya, Spain, and a funding from ‘La Caixa’ Foundation

    Competencias para el ejercicio de la dirección de instituciones educativas : reflexiones y experiencias en Iberoamérica

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    El presente texto es el resultado de las aportaciones al encuentro realizado por los miembros de la Red de Apoyo a la Gestion Educativa (http://www.redage.org) en junio de 2011 en la ciudad de Lima. Constituye el tercer documento de la Serie Informes que ha producido la RedAGE y es expresión del compromiso constitutivo por analizar y difundir temáticas relacionadas con la organizaciÓn y dirección de los sistemas y centros educativos. El ejercicio directivo analizado desde la perspectiva de las competencias es la temática que se aborda en esta ocasión. Por una parte, se continúa la reflexión iniciada con el segundo informe, dedicado a la Dirección de centros educativos en Iberoamérica (http://www.redage.org/files/adjuntos/ Libro%20Red_AGE%20vd.pdf); por otra, se profundiza desde la perspectiva de las competencias con la idea de difundir e impulsar el nuevo enfoque. Tratamos así de un tema incipiente en algunos de los países, pero presente y parte de la agenda de los responsables de la política educativa, con la idea de aportar elementos para las posibles acciones a desarrollar o a mejorar al respecto. Hablamos de competencias y sobre competencias1 y con ello nos referimos a las características de la persona relacionadas con una actuación de éxito en su lugar de trabajo. Se identifican así con la activación y aplicación de manera coordinada de elementos de diferente naturaleza (cognoscitivos, afectivos y procedimentales) para resolver situaciones profesionales concretas. El concepto de competencia es utilizado desde hace tiempo en el campo de la formación profesional, abriéndose camino, poco a poco, en todo el sistema educativo y en los procesos de formación continua, donde la gestión por competencias se ha convertido en un modelo integrador y orientador de las diferentes políticas de recursos humanos
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