Fatigue, emotional distress, and illness uncertainty in patients with metastatic cancer: results from the prospective NEOETIC_SEOM study

A cancer diagnosis can have a substantial impact on a patient's mental health and quality of life. The aim of this study was to investigate the prevalence of fatigue, emotional distress, and uncertainty and examine the predictive value they have on the quality of life of advanced cancer patients. A prospective, multicenter study was conducted between February 2020 and May 2021 of individuals diagnosed with an advanced, unresectable neoplasm prior to initiating systemic antineoplastic treatment. Participants completed questionnaires to quantify fatigue, emotional distress, disease uncertainty, and quality of life. A linear regression analysis was performed to study the predictive QoL variables. The study population comprised 508 patients, 53.7% of whom were male and had a mean age of 54.9 years. The most common cancers were digestive (40.6%), bronchopulmonary (29.1%), and breast (8.5%); the most frequent histology was adenocarcinoma (63%); and most were stage IV (79.7%). More than half (55.7%) suffered fatigue, and 47.7% exhibited emotional distress; both were more prevalent among women. Fatigue, emotional distress, and disease uncertainty all correlate with diminished quality of life. Similarly, ECOG performance status and the demographic variables of age, sex, and comorbidities impacted quality of life. This patient sample displayed a high prevalence of fatigue and emotional distress, together with illness uncertainty, which are clearly linked to waning quality of life. To decrease the experience of fatigue and improve mental health treatment in cancer patients, interventions based on a biopsychosocial model must be intensified

Análisis de las presas de la Lechuza de Campanario (Tytonidae) en Oaxaca Central, México

Barn Owls have a flexible diet for catching their prey based on availability. However, little has been explored about the age class distribution of their main prey. In this work we analyzed the prey diversity, niche width and age class frequency of their main prey from pellets of Barn Owls (Tyto alba) found in a cave surrounded by oak forest in Central Oaxaca, Mexico. From entire and disintegrated pellets, material of 12 prey taxa was recorded, mainly mammals (83.33%). Based on the analysis of 69 pellets, 133 individuals comprising six mammal species were found, in which Heteromys irroratus and Reithrodontomys sp. represented 68.84%. In both species, age classes III (subadults) and IV (adults) were the most frequent. The indexes of trophic niche breadth and prey diversity were moderate, denoting a specialist diet. Based on our results and literature review, we found that genera Heteromys, Reithrodontomys, Peromyscus, Sigmodon, Dipodomys, Perognatus and Chaetodipus are the main prey of Barn Owls in Mexico.Keywords: diet, Heteromys irroratus, trophic niche.La lechuza de campanario (Tyto alba) tiene una dieta flexible depredando presas en base a su disponibilidad. Sin embargo, poco se ha explorado en cuanto a la distribución por clases de edades de sus principales presas. En este trabajo, analizamos la diversidad de presas, amplitud de nicho y la frecuencia de edades de las presas de la lechuza de campanario a partir de egagrópilas colectadas en una cueva rodeada por encinares en la región central de Oaxaca, México. En egagrópilas completas y material disgregado se encontraron 12 taxones presa, principalmente mamíferos (83.33%). A partir del análisis de 69 egagrópilas completas se identificaron un total de 138 individuos de seis especies de mamíferos, de las cuales Heteromys irroratus y Reithrodontomys sp. representaron el 68.84%. En ambas especies las clases de edades III (subadultos) y IV (adultos) fueron las más frecuentes. El índice de amplitud del nicho trófico y la diversidad de presas fueron moderados, indicando una dieta casi especialista. Con base en los resultados y en revisión de literatura, se encontró que en México la lechuza de campanario basa su alimentación en roedores de los géneros Dipodomys, Perognatus, Chaetodipus, Heteromys, Peromyscus, Reithrodontomys y Sigmodon principalmente.Palabras clave: dieta, Heteromys irroratus, nicho trófico

Efectividad del aceite de canola en dietas de cerdos para mejorar el perfil lipídico de la carne

The objective of this study was to determine the maximum level of inclusion of canola oil (CO) in diets for finishing pigs, to increase the content of oleic acid and unsaturated fatty acids and improve the Ω6:Ω3 ratio in meat, without affecting the productive performance, carcass characteristics and physicochemical characteristics of the meat. The treatments were: the gradual substitution of soybean oil (6 %) for CO in diets for pigs at finishing stage I and II (0, 2, 4 and 6 % of CO). The experimental units were 48 castrated pigs with initial live weight of 50.00 ± 4.5 kg, evaluated for four weeks at each stage. With the data obtained, an ANOVA was performed, and linear or quadratic trends were detected (P≤0.10). At finishing stage I, the average daily gain decreased with the inclusion of 2 % of CO, although the incorporation of 2 and 4 % of CO had no effect. At finishing stage II, a level between 2-4 % of CO reduced average daily feed intake and improved feed conversion (P≤0.05). The addition of CO did not modify the characteristics of the carcass and did not affect the physicochemical characteristics of the meat (P≥0.10). CO in the diet increased the concentration of monounsaturated fatty acids (MUFAs) and oleic acid (P≤0.05); it reduced linoleic acid (P≤0.03), polyunsaturated fatty acids (P≤0.07) and the Ω6:Ω3 ratio (P≤0.01). In conclusion, the addition of CO (2-6 %) in the diet of finishing pigs gradually increases the content of oleic acid and MUFAs, in addition, it improves the Ω6:Ω3 ratio in pork, without affecting the productive variables and the quality of the meat.El objetivo de este estudio fue determinar el nivel máximo de inclusión de aceite de canola (AC) en dietas para cerdos en finalización, para incrementar el contenido de ácido oleico y ácidos grasos insaturados y mejorar la relación Ω6: Ω3 en la carne, sin afectar el comportamiento productivo, características de la canal y fisicoquímicas de la carne. Los tratamientos fueron: la sustitución gradual de aceite de soya (6%) por AC en dietas para cerdos en etapa de finalización I y II (0, 2, 4 y 6% de AC). Las unidades experimentales fueron 48 cerdos machos castrados con peso vivo inicial de 50.00 ± 4.5 kg, evaluados durante cuatro semanas en cada etapa. Con los datos obtenidos se realizó un ANDEVA y se detectaron tendencias lineales o cuadráticas (P≤0.10). En finalización I la ganancia de peso disminuyó con la inclusión de 2% de AC, aunque la incorporación de 2 y 4% de AC no tuvo efecto. En finalización II, un nivel entre 2-4% de AC redujo el consumo de alimento y mejoró la conversión alimenticia (P≤0.05). La adición de AC no modificó las características de la canal y no afectó las características fisicoquímicas de la carne (P≥0.10). El AC en la dieta aumentó la concentración de ácidos grasos monoinsaturados (AGMI) y ácido oleico (P≤0.05); redujo el ácido linoleico (P≤0.03), ácidos grasos poliinsaturados (P≤0.07) y la relación Ω6:Ω3 (P≤0.01). En conclusión, la adición de AC (2-6%) en la dieta de cerdos en finalización incrementa gradualmente el contenido de ácido oleico y de AGMI, además, mejora la relación Ω6:Ω3 en la carne de cerdo, sin afectar las variables productivas y la calidad de la carne

Can Oncologists Prompt Patient Prognostic Awareness to Enhance Decision-Making? Data From the NEOetic Study

Introduction: Anti-neoplastic therapy improves the prognosis for advanced cancer, albeit it is not curative. An ethical dilemma that often arises during patients’ first appointment with the oncologist is to give them only the prognostic information they can tolerate, even at the cost of compromising preference-based decision-making, versus giving them full information to force prompt prognostic awareness, at the risk of causing psychological harm. Methods: We recruited 550 participants with advanced cancer. After the appointment, patients and clinicians completed several questionnaires about preferences, expectations, prognostic awareness, hope, psychological symptoms, and other treatment-related aspects. The aim was to characterize the prevalence, explanatory factors, and consequences of inaccurate prognostic awareness and interest in therapy. Results: Inaccurate prognostic awareness affected 74%, conditioned by the administration of vague information without alluding to death (odds ratio [OR] 2.54; 95% CI, 1.47-4.37, adjusted P = .006). A full 68% agreed to low-efficacy therapies. Ethical and psychological factors oriented firstline decision-making, in a trade-off in which some lose quality of life and mood, for others to gain autonomy. Imprecise prognostic awareness was associated with greater interest in low-efficacy treatments (OR 2.27; 95% CI, 1.31-3.84; adjusted P = .017), whereas realistic understanding increased anxiety (OR 1.63; 95% CI, 1.01-2.65; adjusted P = 0.038), depression (OR 1.96; 95% CI, 1.23-3.11; adjusted P = .020), and diminished quality of life (OR 0.47; 95% CI, 0.29-0.75; adjusted P = .011). Conclusion: In the age of immunotherapy and targeted therapies, many appear not to understand that antineoplastic therapy is not curative. Within the mix of inputs that comprise inaccurate prognostic awareness, many psychosocial factors are as relevant as the physicians’ disclosure of information. Thus, the desire for better decision-making can actually harm the patient

Acute diplopia posterior to chemical laberinthectomy

[ES]Introducción: La laberintectomía química con gentamicina es un procedimiento ambulatorio considerado seguro y eficaz y que provoca poca iatrogenia. Presentamos un caso clínico de una rara complicación de la técnica y se revisa la literatura. Caso clínico: Paciente diagnosticada de enfermedad de Ménière izquierda que no responde a esquema de tratamiento conservador. Se propone realizar terapia intratimpánica con corticoide y después una laberintectomía química. Aparece de forma aguda una diplopia sin otra sintomatología acompañante. Discusión: El 95% de los pacientes con enfermedad de Ménière presentan un vértigo controlable con tratamientos médicos convencionales. La seguridad de la inyección intratimpánica de gentamicina está reconocida desde hace años. La susceptibilidad a la acción del fármaco es extremadamente variable y debemos utilizar la menor dosis total posible de gentamicina para no provocar iatrogenia. La monitorización con VHIT puede ser una nueva arma diagnóstica para evitar complicaciones. No hemos encontrado en la literatura referencia alguna a la aparición de diplopia tras la laberintectomía química. Es importante la aplicación de gafas de Frenzel o métodos de grabación de movimientos oculares para diagnosticar en esa fase temprana la aparición de la diplopia. Conclusiones: La terapia intratimpánica es una alternativa segura y eficaz en el manejo del paciente con enfermedad de Meniere. La aparición de la diplopia tras la aplicación de gentamicina puede estar infradiagnosticada. Normalmente se corrige el defecto por sí sólo y no es necesario ningún tratamiento específico. Debemos utilizar todos los medios a nuestro alcance para detectar precozmente la abolición del vestíbulo y realizar la mínima aplicación posible de gentamicina intratimpánica. [EN] Introduction: Chemical laberinthectomy with gentamicin is an ambulatory procedure with a low rate of iatrogenical effects. We present a case with a rare complication and review the especifical literature. Clinical repport: We present a women with a left Meniere´s syndrome. A corticoid intratimpanic threathment was done and we don´t get control of symptoms. A gentamicin laberinthectomy was done, and an accute diplopia with no other clinical manifestations appears. Discussion: 95% of Ménière´s symptoms gets control with medical theathments. Security of gentamicin is accepted since 80`s decade. Susceptibility of action in inner ear is variable. We have to use minimal dosis of gentamicin to have control of the disease. Monitoring with VHIT is a new diagnosys arm to avoid complications. No references of diplopia postlaberintectomy was collected on medical literature. It´s very important control ocular movements by a recording metod or Frenzel glasses. Conclussion: Intratimpanic therapy is a secure metod. A diplopia postlaberinthectomy is undiagnosed. Usually no speciffic treathment is required. We have to use all recurses to detect a earl abolition of vestible and use minimal dose of gentamicin as possible

Reporte de caso clínico: hipotermia inducida como manejo de la taquicardia de la unión recidivante al tratamiento convencional

La hipotermia es la temperatura corporal central menor de 35ºC, utilizada en el ámbito de la cirugía cardíaca como manejo de la taquicardia ectópica de la unión con escasa respuesta al tratamiento convencional para disminuir el gasto cardíaco y por ende las demandas metabólicas. Se presenta el caso de un paciente en edad preescolar al que se le realiza cierre de comunicación interauricular, comunicación interventricular y decerclaje de la arteria pulmonar. En el postquirúrgico presenta taquicardia supraventricular recidivante al uso de antiarrítmicos con descompensación hemodinámica y signos de bajo gasto cardíaco, por lo que se maneja con hipotermia moderada durante 48 horas, tratamiento que resultó exitoso y sin complicaciones secundarias. Al ser un proceso autolimitado en 48-72 horas, el objetivo principal del tratamiento es mantener un gasto cardíaco apropiado esperando la remisión espontánea de la arritmia. El tratamiento debe incluir corrección de los trastornos hidroelectrolíticos, equilibrio ácido base, eliminación de estímulos adrenérgicos, correcta sedación y disminución de inotrópicos y vasodilatadores.En base a la información recabada y a la experiencia con este caso clínico es posible considerar a la hipotermia moderada (32-34ºC) de gran utilidad para mejorar la situación crítica en pacientes con bajo gasto cardíaco y otras patologías críticas

Synchronization of the estrous during a short period, using a low dose of equine chorionic gonadotropin (eCG) in primiparous and multiparous ewes

Objective: To evaluate the effect of reducing the synchronized luteum phase and of applying eCG on reproductive response variables and hormone profile in primiparous and multiparous ewes. Design/methodology/approach: The experimental design was completely randomized with a 2 x 2 x 2 factorial array. Eight-one ewes were divided by their reproductive activity: primiparous (n=38) and multiparous (n=43). The percentage of presentation of estrus and pregnancy were analyzed with a c2 test. The estrus onset and duration for an analysis of variance and the Tukey test of comparison of means. The P4 concentration was performed using the PROC MIXED procedure, which included fixed effects of the treatment and day and the interaction of the two. Results: The response in estrus presentation was not different between treatments, however; the onset and duration of estrus were affected by physiological state and the synchronized luteum phase. P4 concentrations in serum were higher in primiparous ewes than in multiparous ewes. There were no differences in pregnancy rate or prolificity by principal effects. Limitations on study/implications: The estrus onset and duration varied by effects of the reproductive physiological status and the duration of the synchronized luteum phase (6 and 12 d), Therefore, it must be taken into account when artificial insemination is performed at a fixed time. Findings/conclusions: The combination of cronolone sponges with 100 IU eCG during short (6 d) are effective for the synchronization of estrous. The P4 concentrations in serum were higher in primiparous ewes, but this was not determinant for increasing gestation and prolificity in treated ewes.Objective: To evaluate the reduction effect of the synchronized luteal phase and the eCG application in the reproductive variables and hormone profile response of primiparous and multiparous ewes. Design/Methodology/Approach: The experimental design was completely random, with a 2 × 2 × 2 factorial arrangement. Based on their reproductive activity, the 81 specimens were divided into primiparous (n=38) and multiparous (n=43) ewes. The estrous and pregnancy stages were analyzed using the c2 test. An analysis of variance and the Tukey’s mean comparison test were used to determine the start and the duration of the estrous. P4 concentration was measured using the PROC MIXED which influenced the fixed effects of the treatment and the day, as well as their interaction. Results: There was no difference between treatments, regarding the occurrence of the estrous; however, its start and duration were not impacted by the physiological state and the synchronized luteal phase. P4 concentrations in plasm were higher in primiparous ewes than in multiparous ewes. The main effects did not impact the pregnancy and the prolificity rates. Study Limitations/Implications: The variation in the start and the duration of the estrous was caused by the physiological reproductive state and the duration of the synchronized luteal phase (6 and 12 days). Therefore, these effects should be taken into account when the artificial insemination takes place at a fixed period. Finding/Conclusions: The combination of the cronolone sponges with 100 UI of eCG during short periods (6 days) effectively synchronizes the estrous. P4 concentrations in serum were higher in primiparous ewes, although these concentrations were not a determining factor in the increase of pregnancy and prolificity

El derecho del trabajo y la seguridad social en la encrucijada: retos para la disciplina laboral

Ministerio de Economía y Competitividad DER2012-32111Ministerio de Economía y Competitividad DER2015-6936

Contribución de las asignaturas teórico-prácticas del Grado en Estudios Franceses a la adquisición de los niveles de lengua francesa (MCERL)

Memoria ID-0078. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017

Wnt pathway genes in osteoporosis and osteoarthritis: differential expression and genetic association study

Producción CientíficaIn comparison with hip fractures, increased expression of genes in the Wnt pathway and increased Wnt activity were found in bone samples and osteoblast cultures from patients with osteoarthritis, suggesting the involvement of this pathway in subchondral bone changes. No consistent differences were found in the genetic association study