Educación sanitaria para pacientes con cáncer de pulmón en tratamiento de inmunoterapia

El cáncer de pulmón es el tumor con mayor incidencia en el mundo y el 4º en España, siendo su tasa de mortalidad la mayor. La principal causa de esta patología sigue siendo el hábito tabáquico. La mayoría de los casos de tumores de pulmón que se diagnostican se encuentran ya en estadios avanzados, por lo que el tratamiento suele ser meramente paliativo. En los casos en que el diagnóstico es más temprano, el tratamiento muchas veces, no resulta efectivo o los pacientes acaban sufriendo recidivas al cabo de un tiempo. Es por ello que hoy en día se están desarrollando nuevos tratamientos experimentales frente a estos tumores, como es el caso de la inmunoterapia. La inmunoterapia con anticuerpos monoclonales (también denominados inmunodesbloqueadores), está teniendo resultados prometedores en el cáncer de pulmón, así como otros tumores. Sin embargo, debido a que existen diversos inmunodesbloqueadores, y el tratamiento es relativamente nuevo, no todos los pacientes son elegibles para estos tratamientos. Debido al desconocimiento de los pacientes sobre este tratamiento, en este TFG se ha realizado una revisión bibliográfica sobre el mecanismo de acción de la inmunoterapia con inmunodesbloqueadores, su efectividad en cáncer de pulmón y sus efectos adversos. Con esta información se ha desarrollado un plan de intervención educacional para pacientes con cáncer de pulmón en tratamiento con inmunoterapia, para que puedan conocer las bases del tratamiento y los posibles efectos adversos, con el fin de realizar una intervención temprana antes de que estos empeoren.Lung cancer is the tumor with the highest incidence in the world and the 4th in Spain, with the highest mortality rate. The main cause of this pathology is the tobacco. Most of the lung cancers that are diagnosed are already in advanced stages, thus the treatment is usually merely palliative. In cases where the diagnosis is performed earlier, treatment is often ineffective or after some time cancer recurrence occurs. Thus today, new experimental treatments are being developed against these tumors, including immunotherapy. Immunotherapy with monoclonal antibodies (also called immune checkpoint blockers), is having promising results in lung cancer as well as other tumors. However, because of the variety of immune checkpoint blockers, and the novelty of the treatment, not all patients are eligible for these treatments. Due to the lack of knowledge of patients about this treatment, in this TFG a bibliographic review has been carried out about the mechanisms of action of immunotherapy with immune checkpoint blockers, its effectiveness in lung cancer and its adverse effects. With this information, an educational intervention plan has been developed for patients with lung cancer receiving immunotherapy. In this way they can understand the bases of the treatment and recognize potential adverse effects, in order to carry out an early intervention before these effects worsen.Graduado o Graduada en Enfermería por la Universidad Pública de NavarraErizaintzan Graduatua Nafarroako Unibertsitate Publikoa

Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms:A Randomized Clinical Trial

Objectives: To directly compare the effects of agility exergaming (EXE) and stationary cycling (CYC) exercise training on Parkinson’s disease (PD) patients’ mobility and clinical symptoms. Design: Randomized clinical trial. Setting: Outpatient physiotherapy clinic in a hospital. Participants: Seventy-four stage 2–3, nondemented PD patients were included in this study. Intervention: The groups were as follows: EXE (n = 25), CYC (n = 25), and a wait-listed control group (CON; n = 24). The EXE and CYC groups exercised 5×/week for 5 weeks, matched at 80% of the age-predicted maximal heart rate. Main Outcomes: The primary outcome was the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (UPDRS-II) score. Secondary outcomes were Parkinson’s Disease Quastionnaire-39 (PDQ-39), the Beck Depression Inventory (BDI), the Schwab and England Activities of Daily Living (SE-ADL) scale, Euro-Quality of Life-5 Dimensions (EQ-5D) questionnaire, the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Tinetti Assessment Tool (TAT), the Dynamic Gait Index, the 6-min walk test (6MWT), and standing posturography. Results: After treatment, UPDRS-II scores improved (mean change: EXE, –4.5 points; CYC, –3.2 points). The results for the other outcomes (EXE and CYC, respectively) were: PDQ, 13 and 17%; BDI, –2.5 and –2.1 points; 6MWT, 129.6 and 141.6 m; and EQ-5D, 12 and 9% (all p 0.05). Conclusion: Two highly different exercise programs resulted in similar improvement of most motor and clinical symptoms in PD patients

Interbentzio praktiko baten proposamena lesio muskuloeskeletiko ohikoenak ekiditeko: ile-apaintzaileen osasun laboral prebentziorako esparruan

111 p. : il.-- Bibliogr.: p. 61-65[EUS] Ile-apaintzailetza munduko populazioaren ehuneko handi batek erabiltzen duen zerbitzu bat bilakatu da. Eskakizun handiko lanpostua da, gorputz jarreren mantentzea, mugimendu berdinen errepikapena eta material pisutsuen eustea eskatzen duena. Kirol askotan bezala, lanpostuaren zereginetarako aurretiko prestaketa faltarekin eta ekintza batzuek eskatzen duten trebetasun maila ezarekin batera, lesio muskulo eskeletiko ugari agertzen dira. Honen arira, lesio muskulu eskeletikoen garapena mundu laboralaren arloan gorakada nabarmena izan du azken urteetan eta egoerak okerrera egingo duela erakusten dute datuek. Ile-apaintzaile lanpostua zehazki aztertuz, datuek adierazten dute gehien kaltetutako gorputz atalak sorbaldak, ukondoak, besaurreak, eskuak, eskumuturrak eta hatzak direla, gehiegizko kargak edo angelu okerrak jasaten dituztelako, besteak beste, giharretako gainkargak, kapsulitisa, tendinitisa eta pertsonen bizitzan eragin handia duten lesioak agerrarazten dituztenak. Lan honetan ile-apaintzaileek garatzen dituzten ohiko lesio muskulu eskeletikoen garapena prebenitzeko hiru interbentzio faseetako proposamena burutu da, lanpostuko gorputz jarrera egokiaren berreztean, lanpostuaren aurreko, bitarteko eta ondorengo lesioen prebentziorako estrategien erakusketan eta giltzadura zehatzen lesioak ekiditeko, prebentzio-ariketen programa baten erakusketan oinarrituta dagoena. Prebentzioaren ikuspuntutik interbentzio proposamen hau burutzeko, ariketa fisikoaz eta honen praktikaren onuretaz baliatu egin da, zuzenketa, jarraibide eta ariketa ezberdinen bateriak sortuz.[EN] Hairdressing has become a service used by a large percentage of the world's population. It is a very demanding profession, requiring the maintenance of bodily positions, the repetition of equal movements, and the maintenance of heavy materials. As in many sports, along with the lack of prior training in occupations and the lack of skill required by some activities, numerous skeletal muscular injuries occur. In the light of this, the development of skeletal muscle disturbances in the field of the laboratory world has had a marked rise in recent years and data shows that it will make the situation worse. Examining the job of a hairdresser, the data indicates that the most damaged parts are shoulders, elbows, forearms, hands, wrists, and fingers, because they suffer excessive charges or erroneous angles, including muscle overcharges, capsulitis, tendinitis, and injuries that have a major impact on the lives of people. Three stages of intervention have been completed to prevent the development of the usual skeletal muscles of hairdressers in this work, based on the re-introduction of the proper body attitude in the workplace, the display of strategies for prevention of prior, intermediate, and subsequent injuries, and the avoidance of specific kidney injuries based on a programme of preventive exercises. In order to carry out this proposal of intervention from a preventive point of view, he has taken advantage of physical exercise and the benefits of his practice by creating batteries of various corrections, guidelines, and exercises

Estudio mecánico y caracterización de comportamiento de pelota para paleta goma maciza

La pelota vasca abarca un amplio conjunto de deportes en los que se emplea un objeto, medio de golpeo, denominado herramienta del que se vale el deportista para imprimir velocidad a la pelota. Tanto la herramienta como la pelota ofrecen un amplio abanico de oportunidades para investigar en torno a su desarrollo tecnológico. Con el fin de aportar facilidades para incidir en el desarrollo de los deportes que se practica, en este trabajo se pretende comprender y estudiar el comportamiento de los componentes empleados en la paleta goma maciza, una de las modalidades que componen el conjunto de deportes denominados pelota vasca. El objetivo del trabajo es comprender tanto la práctica del deporte así como las características principales de los elementos implicados en el juego. Para ello, se realizaran una serie de estudios y ensayos que nos permitan conocer mejor el comportamiento de dichos elementos más allá de la práctica del deporte. Mediante el análisis de los elementos implicados, la pala y la pelota, se llegará a entender la necesidad del conocimiento de las características y comportamientos de estos. Para poder realizar estudios complementarios en cuanto al avance en el diseño de las herramientas. El estudio se centrará principalmente en la pelota, observando su comportamiento frente al material original y así poder buscar materiales que generen un comportamiento similar para el rediseño de la pala. Los modelos generados a partir de diferentes materiales al de la madera de haya no han dado resultado, esto ha sido debido al desconocimiento de la mecánica del golpeo, generándose modelos no funcionales en cuanto a la sensación de juego. Como complemento, con el fin de aportar un punto de vista diferente al del puro diseño, se mostrarán los resultados obtenidos del análisis del impacto del ciclo de vida de una pala y una pelota de caucho comprimido. La metodología de trabajo a seguir consistirá en analizar las características de la pala y pelotas originales, buscar similitudes de la mecánica de golpeo frente a otros deportes y obtener datos mediante ensayos para la caracterización de las pelotas de caucho comprimido. A lo largo del trabajo se dan a conocer los factores que afectan al comportamiento de la pelota. Estos mismos pueden ser útiles para caracterizarla y ofrecer una nueva forma de clasificación. Mediante este trabajo, se pretende allanar el camino a futuros trabajos de investigación en torno a la mejora tanto de las herramientas empleadas en las diferentes modalidades como la mejora de las pelotas empleadas.The pelota vasca encompasses a wide range of sports in which an object is used, a hitting medium, called a tool that the athlete uses to give the ball speed. Both the tool and the ball offer a wide range of opportunities to investigate their technological development. In order to provide facilities to influence the development of the sports that are practiced, this work aims to understand and study the behavior of the components used in the paleta goma maciza, one of the modalities that make up the set of sports called ball Basque. The objective of the work is to understand both the practice of sport as well as the main characteristics of the elements involved in the game. For this, a series of studies and tests will be carried out that allow us to better understand the behavior of these elements beyond the practice of sport. Through the analysis of the elements involved, the shovel and the ball, the need to know their characteristics and behaviors will be understood. To be able to carry out complementary studies regarding the advance in the design of the tools. The study will focus mainly on the ball, observing its behavior against the original material and thus being able to look for materials that generate a similar behavior for the redesign of the blade. The models generated from different materials than beech wood have not given results, this has been due to the ignorance of the mechanics of the hit, generating non-functional models in terms of the sensation of the game. As a complement, in order to provide a point of view different from that of pure design, the results obtained from the analysis of the impact of the life cycle of a shovel and a compressed rubber ball will be shown. The work methodology to be followed will consist of analyzing the characteristics of the original shovel and balls, looking for similarities in the hitting mechanics compared to other sports and obtaining data through tests for the characterization of the compressed rubber balls. Throughout the work, the factors that affect the behavior of the ball are disclosed. These can be useful to characterize it and offer a new way of classification. Through this work, it is intended to pave the way for future research work on the improvement of both the tools used in the different modalities and the improvement of the balls used.Graduado o Graduada en Ingeniería en Diseño Mecánico por la Universidad Pública de NavarraDiseinu Mekanikoko Ingeniaritzan Graduatua Nafarroako Unibertsitate Publikoa

Estudi, disseny i realització de pràctiques autocontingudes d'automatització de processos industrials dirigides als estudiants de grau

L’objectiu del treball fi de carrera és el d’elaborar una sèrie de recursos docents que facilitin la realització de les activitats de laboratori vinculades amb el temari d’automatització industrial de l’assignatura de Control Industrial i Automatització de manera que s’adeqüin al nou marc metodològic de l’EEES

Nonmetastatic Colon Cancer Model C26 Upregulates Glycolysis in Osteocytes in Vitro and Bone in Vivo

Background: Developing effective treatments for musculoskeletal complications in cancer patients requires understanding metabolic effects of cancer on bone, and particularly osteocytes, the most abundant bone cell and key regulator of bone remodeling. However, little is known regarding how cancer impacts normal osteocyte energy metabolic pathways, such as glycolysis. Given that changes in metabolism are important regulators of cellular function, it is essential to determine how osteocyte metabolism is disrupted by cancer and how this may impact skeletal and whole-body health. Methods: Mice inoculated with saline (N=5) or C26 cells (N=6) were sacrificed after 2 weeks. Bones were harvested for metabolic profiling by GC-MS, gene expression by RT-PCR and bone morphology by µCT. Differentiated IDG-SW3 osteocyte-like cells were cocultured with C26 cells for 12-24hrs and metabolites and gene expression analyzed by GC-MS and RT-PCR. Results: Trabecular bone mass was significantly decreased in the C26 mice. GC-MS analysis revealed decreased glucose in C26 mice tibiae, but no change in lactate. The bone resorption promoting gene Rankl was upregulated, whereas the inhibitor Opg was unchanged. Bone mineralization regulators Mepe and Phex were decreased. In vitro metabolic studies revealed increased glucose and lactate in IDG-SW3 cell lysate; culture media glucose levels were decreased whereas lactate was increased in the co-cultures with C26 cells. RT-PCR demonstrated increases in the glycolysis promoter Hif1α in addition to glycolysis pathway genes including Glut1, Hk2, Slc16a3 and Pdk1. Rankl was also increased in the IDG-SW3 cells co-cultured with the C26 cells whereas Opg, Phex, and Mepe were downregulated. Conclusion: Glycolysis is upregulated in mouse bone and in vitro IDG-SW3 cells exposed to cancer. Our study provides novel understanding for how cancer affects bone metabolism. Integrating these results with whole body metabolism will aid in the development of novel therapeutic strategies to target musculoskeletal and systemic complications of cancer

Effects of Exercise Dose and Detraining Duration on Mobility at Late Midlife:A Randomized Clinical Trial

Background: Office workers near retirement tend to be sedentary and can be prone to mobility limitations and diseases. We examined the dose effects of exergaming volume and duration of detraining on motor and cognitive function in office workers at late midlife to reduce sedentariness and mobility limitations. Methods: In an assessor-blinded randomized trial, 160 workers aged 55-65 years performed physically active video games in a nonimmersive form of virtual reality (exergaming) in small, supervised groups for 1 h, 1x, 2x, or 3x/week for 8 weeks followed by detraining for 8 and 16 weeks. Exergaming comprises high-intensity, full-body sensorimotor coordination, balance, endurance, and strengthening exercises. The primary outcome was the 6-minute walk test (6MWT), and secondary outcomes were body mass, self-reported physical activity, sleep quality, Berg Balance Scale, Short Physical Performance Battery, fast gait speed, dynamic balance, heart rate recovery after step test, and 6 cognitive tests. Results: The 3 groups were not different in any of the outcomes at baseline (all p > 0.05). The outcomes were stable and had acceptable reliability (intraclass correlation coefficients >= 0.334) over an 8-week control period. Training produced an inverted U-shaped dose response of no (1x), most (2x), and medium (3x/week) effects of exergaming volume in most motor and selected cognitive outcomes. The distance walked in the 6MWT (primary outcome) increased most (94 m, 19%, p < 0.05), medium (57 m, 12%, p < 0.05), and least (4 m, 1%) after exergaming 2x, 3x, or 0x (control) (all different p < 0.05). The highest responders tended to retain the exercise effects over 8 weeks of detraining, independent of training volume. This maintenance effect was less consistent after 16 weeks of detraining. Conclusion: Less was more during training and lasted longer after detraining. A medium dose volume of exergaming produced the largest clinically meaningful improvements in mobility and selected cognitive tests in 60-year-old office workers with mild mobility limitations and intact cognition

Premature Convergence Problem of Gaussian EDA

Gaussovský estimation-of-distribution algoritmus (Gaussovský EDA) je populační optimalizační algoritmus, který pro generování nové populace používá odhadnuté normální rozdělení. Trpí však problémem předčasné konvergence, kdy příliš rychle klesá diverzita populace. V této práci jsem prezentoval možné metody řešení tohoto problému. Metody byly testovány na lineární a elipsoidní účelové funkci, čímž bylo zjištěno, které metody problém předčasné konvergence skutečně řeší. Následně jsem porovnal účinnost metod k řešení účelových funkcí pomocí nástroje ,,Comparing Continuous Optimizers`` (COCO). Také byly vyzkoušeny i slibné kombinace metod. Bylo objeveno, že některé z těchto kombinací dokáží na vybraných příkladech konkurovat i v praxi úspěšnému algoritmu CMA-ES.Gaussian estimation-of-distribution algorithm (Gaussian EDA) is a population-based optimalization algorithm, which uses estimated normal distribution for sampling a new population. However, it suffers from the premature convergence problem, which means a too rapid decline in population diversity. In this thesis, I have presented possible solutions to this problem. These methods were tested on a linear and an ellipsoid objective function, discovering which methods truly solve the problem. Subsequently, I have compared the efficiency of the methonds in solving objective functions with a benchmarking tool "Comparing Continuous Optimizers" (COCO). Also tested were promising combinations of methods. It was discovered, that some of these combinations were in selected cases able to compete with CMA-ES, a successful algorithm in practice