La reinserción laboral en los pacientes con cáncer colorrectal

Aim: Employment and work-related disability were investigated in a cohort of colorectal cancer patients to describe a possible discrimination and other work issues. Patients and Methods: The study included consecutively 73 colorectal cancer patients who were employed at diagnosis. The questionnaire included cancer-related symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face. The study was approved by the Ethical Committee of La Paz Hospital. All patients gave consent to participate. Results: Eighty six per cent of patients were unable to work after diagnosis, but 55% returned to work at the end of treatment. The age, having a metastatic illness and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. Conclusions: This is the fi rst exploratory study in Spain about labour reintegration in colorectal cancer. Further studies are necessary.Objetivo: Analizar los factores que infl uyen en la vuelta al trabajo en una cohorte de enfermos con cáncer colorrectal y los posibles problemas de discriminación que pueden tener. Pacientes y métodos: El estudio incluyó 73 pacientes consecutivos diagnosticados de un cáncer colorrectal y empleados en el momento del diagnóstico. Los pacientes rellenaron un cuestionario que incluía aspectos demográficos, clínicos y laborales. El estudio fue aprobado por el Comité Ético y de Investigación Clínica del Hospital La Paz. Todos los pacientes dieron su consentimiento para participar en el estudio y para la utilización de los datos de su historia clínica. Resultados: El 86% de los pacientes pasaron a inactivos tras comenzar el tratamiento de la enfermedad y un 45% lo seguían estando tras éste. No hubo diferencias en la influencia de las distintas variables analizadas con respecto a la actividad laboral tras el diagnóstico. Sin embargo, la edad avanzada, el tener un estadio IV de la enfermedad y la presencia de secuelas derivadas del tumor o del tratamiento de éste, sí infl uyeron en la reinserción laboral una vez fi nalizado el tratamiento específico. La mayoría de los pacientes no creían que el tener la enfermedad les perjudicaría en su puesto de trabajo y, en casi todos los casos, tanto sus compañeros como sus jefes conocían que tenían un tumor. Conclusiones: Éste es el primer estudio exploratorio en nuestro país acerca de la reinserción laboral de los pacientes diagnosticados de una neoplasia maligna colorrectal. Son necesarios más trabajos para poder establecer las medidas adecuadas para la mejora de este proceso

Returning to work in colorectal cancer patients

Aim: Employment and work-related disability were investigated in a cohort of colorectal cancer patients to describe a possible discrimination and other work issues. Patients and Methods: The study included consecutively 73 colorectal cancer patients who were employed at diagnosis. The questionnaire included cancer-related symptoms and work-related factors. Clinical details were obtained from the medical record. Patients were interviewed face to face. The study was approved by the Ethical Committee of La Paz Hospital. All patients gave consent to participate. Results: Eighty six per cent of patients were unable to work after diagnosis, but 55% returned to work at the end of treatment. The age, having a metastatic illness and the sequelae of the disease or its treatment were independently associated with the ability to work after the end of treatment. Almost all patients told their employers and co-workers about their disease. Conclusions: This is the fi rst exploratory study in Spain about labour reintegration in colorectal cancer. Further studies are necessary

Mountain strongholds for woody angiosperms during the Late Pleistocene in SE Iberia

Mediterranean mountains played an essential role during glacial periods as vegetation refugia. The SE Iberia Late Pleistocene woody angiosperm fossil and floristic evidences are reviewed in the context of phylogeographical studies aiming to identify (i) spatial patterns related to woody angiosperms glacial survival, (ii) structural and functional characteristics of montane refugia, and (iii) gaps in knowledge on the woody angiosperm patterns of survival in Mediterranean mountains. The distribution of palaeobotanical data for SE Iberia refugia has been found to be taphonomically biased due to the scarcity of available and/or studied high-altitude Late Pleistocene sites. However, Siles Lake data together with floristic inference provide evidences for woody angiosperms’ survival in a high-altitude Mediterranean area. The main features boosting survival at montane contexts are physiographic complexity and water availability. Phylogeography studies have mainly been conducted at a continental scale. Although they cohere with palaeobotanical data to a broad scale, a general lack of sampling of SE Iberian range-edge populations, as well as misconceptions about the origin of the populations sampled, impede to infer the proper location of woody angiosperms’ mountain refugia and their importance in the post-glacial European colonisation. We conclude that floristic, geobotanical, palaeobotanical, ethnographical and genetic evidence should be merged to gain a deeper understanding on the role played by Mediterranean mountains as glacial refugia in order to explain the current distribution of many plants and the large biodiversity levels encountered in Mediterranean mountain areas. This is hallmark for effective and efficient conservation and management

Pseudomembranous colitis in a patient with lamotrigine-induced drug rash with eosinophilia and systemic symptoms syndrome

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity reaction with rash, fever and multiorgan dysfunction potentially lethal in up to 10% of cases. It often affects liver function, but it can also affect kidney, lungs, and heart. Severe gastrointestinal involvement is rare. We present a case of a 31-year-old hispanic woman with pseudomembranous colitis associated with lamotrigine-induced DRESS syndrome. To the best of our knowledge, this is the fourth reported case of severe involvement of the gastrointestinal tract and the first to report pseudomembranous colitis in the setting of DRESS syndrome

T Helper 17/Regulatory T Cell Balance and Experimental Models of Peritoneal Dialysis-Induced Damage

Fibrosis is a general complication in many diseases. It is the main complication during peritoneal dialysis (PD) treatment, a therapy for renal failure disease. Local inflammation and mesothelial to mesenchymal transition (MMT) are well known key phenomena in peritoneal damage during PD. New data suggest that, in the peritoneal cavity, inflammatory changes may be regulated at least in part by a delicate balance between T helper 17 and regulatory T cells. This paper briefly reviews the implication of the Th17/Treg-axis in fibrotic diseases. Moreover, it compares current evidences described in PD animal experimental models, indicating a loss of Th17/Treg balance (Th17 predominance) leading to peritoneal damage during PD. In addition, considering the new clinical and animal experimental data, new therapeutic strategies to reduce the Th17 response and increase the regulatory T response are proposed. Thus, future goals should be to develop new clinical biomarkers to reverse this immune misbalance and reduce peritoneal fibrosis in PD.This work was supported in part by grants from Ministerio de Economia y competitividad SAF2010-21249 to Manuel López-Cabrera, Comunidad Autónoma de Madrid 2010-BMD2321 (FIBROTEAM) to Manuel Lopez Cabrera, and Fondo de Investigaciones Santitarias RETICS 06/0016 and PI 09/0064 to Rafael Selgas and FIS 12/01175 to Abelardo Aguilera Peralta. Georgios Liappas is fully supported from European Union, Seventh Framework Program “EuTRiPD,” under Grant Agreement PITN-GA-2011-287813. The authors would like to thank Juliette Siegfried and her team at ServingMed.com for editing the language of the paper.Peer Reviewe