New Technologies to Improve Pain, Anxiety and Depression in Children and Adolescents with Cancer: A Systematic Review.

Pain, anxiety, or depression are very prevalent in children and adolescents with cancer, which is a great challenge for health professionals. Several studies pointing out the positive effect of technology on the management of symptoms have been published in recent years. Considering these studies is important in order to reduce the negative impact on the quality of life of this population. This study aimed to analyze the available evidence and to describe the benefits of the new technologies in the treatment of pain, anxiety, and depression in children and adolescents with cancer. A systematic search using six electronic databases was conducted to identify studies using technological interventions with a focus on pain, anxiety, and depression that were published from 2008 to 2018 including oncology patients from 0-18 years old. Out of the 1261 studies that were identified, five studies met the inclusion criteria for this systematic review. Robots were used in two studies, providing amusement and social interventions that showed significant improvements. Virtual reality, a mobile application, and a videogame were used in three studies and obtained beneficial results in pain and anxiety. The studies included in this review suggest that new technologies can be used as an innovative form of non-pharmacological intervention with therapeutic benefits.

Resveratrol reduces cerebral edema through inhibition of de novo SUR1 expression induced after focal ischemia.

Cerebral edema is a clinical problem that frequently follows ischemic infarcts. Sulfonylurea receptor 1 (SUR1) is an inducible protein that can form a heteromultimeric complex with aquaporin 4 (AQP4) that mediate the ion/water transport involved in brain tissue swelling. Transcription of the Abcc8 gene coding for SUR1 depends on the activity of transcriptional factor SP1, which is modulated by the cellular redox environment. Since oxidative stress is implicated in the induced neuronal damage in ischemia and edema formation, the present study aimed to evaluate if the antioxidant resveratrol (RSV) prevents the damage by reducing the de novo expression of SUR1 in the ischemic brain. Male Wistar rats were subjected to 2 h of middle cerebral artery occlusion followed by different times of reperfusion. RSV (1.9 mg/kg; i.v.) was administered at the onset of reperfusion. Brain damage and edema formation were recognized by neurological evaluation, time of survival, TTC (2,3,5-Triphenyltetrazolium chloride) staining, Evans blue extravasation, and water content. RSV mechanism of action was studied by SP1 binding activity measured through the Electrophoretic Mobility Shift Assay, and Abcc8 and Aqp4 gene expression evaluated by qPCR, immunofluorescence, and Western blot. We found that RSV reduced the infarct area and cerebral edema, prevented blood-brain barrier damage, improved neurological performance, and increased survival. Additionally, our findings suggest that the antioxidant activity of RSV targeted SP transcription factors and inhibited SUR1 and AQP4 expression. Thus, RSV by decreasing SUR1 expression could contribute to reducing edema formation, constituting a therapeutic alternative for edema reduction in stroke.

Incidence and Risk Factors of Dry Eye in a Spanish Adult Population: 11-Year Follow-Up From the Salnés Eye Study.

PURPOSE: To estimate the incidence of dry eye (DE) and to evaluate risk factors in an adult cohort in Spain. METHODS: The Salnés Eye Study (SES) was a cross-sectional population-based study of 654 subjects conducted from 2005 to 2006. After 11 years, 264 individuals (65.8% response rate) participated in SES 2. The incidence cohort consisted of 209 subjects not diagnosed with DE in SES 1 [mean age (SD) 67.6 years (±10.1), range: 51-92, women 69.4%]. DE was defined as the simultaneous presence of symptoms and at least 1 sign. A Schirmer test score ≤5 mm, tear film breakup time ≤10 seconds, rose bengal staining ≥3, and fluorescein staining ≥1 were considered indicative of signs. Poisson regression models were performed to evaluate risk factors. RESULTS: The 11-year incidence of DE was 25.4% (95% confidence interval, 19.5-31.3) and that of symptoms was 31.6% (confidence interval, 25.4-37.8). DE incidence was significantly associated with age (P < 0.05). After adjusting for age, secondary or university studies were protective factors for DE; taking anxiolytics or antidepressants and angiotensin-converting enzyme inhibitors increased the risk of symptoms; a history of hypertension, chronic obstructive pulmonary disease, or autoimmune diseases increased the risk of signs. CONCLUSIONS: The annual incidence of DE, symptoms, and signs, was found to be 2.3 per 100 person-years. The incidence of symptoms was higher than that reported in similar studies. This study suggests that some factors may increase the risk of symptoms, whereas other factors may increase the risk of signs.

Role of LOXs and COX-2 on FAK activation and cell migration induced by linoleic acid in MDA-MB-231 breast cancer cells.

BACKGROUND: Epidemiological studies and animal models suggest a link between high levels of dietary fat intake and an increased risk of developing breast cancer. Particularly, free fatty acids (FFAs) are involved in several processes, including proliferation, migration and invasion, in breast cancer cells. Linoleic acid (LA) is a dietary n-6 polyunsaturated fatty acid that is known to induce proliferation and invasion in breast cancer cells. So far, however, the contribution of LA to focal adhesion kinase (FAK) activation and cell migration in breast cancer cells has not been studied. RESULTS: Here, we show that LA promotes FAK and Src activation, as well as cell migration, in MDA-MB-231 breast cancer cells. FAK activation and cell migration require Src, Gi/Go, COX-2 and LOXs activities, whereas both are independent of Δ6 desaturase activity. In addition, we show that cell migration requires FAK activity, whereas FAK activation requires Src activity, thus suggesting a reciprocal catalytic activation mechanism of FAK and Src. CONCLUSIONS: In summary, our findings show that LA induces FAK activation and cell migration in MDA-MB-231 breast cancer cells.

Apoptosis-inducing factor and colon cancer.

Programmed cell death is a fundamental requirement for embryogenesis, organ metamorphosis, and tissue homeostasis. Since the vast majority of cytotoxic modalities exert their anti-tumor effects by induction of apoptosis, programmed cell death has emerged as a potential target for cancer treatment at various stages of tumor progression. Immuno-regulation and chemoradiosensitization are potential pathways where insight in apoptotic mechanisms may lead to improvement of chemoradiotherapeutic modalities. The central mediator of the intrinsic pathway of apoptosis is the mitochondrion, in which changes of the outer membrane's permeability cause an outflow of cytochrome c and more than 40 molecules involved in apoptosis. These include Smac/DIABLO, Omi/HTR A2, endonuclease G, and apoptosis inducing factor (AIF). AIF, a 57 kDa mitochondrial oxidoreductase, is released into the cytoplasm and translocates to the nucleus to induce cell death in response to poly-(ADP-ribose) polymerase-1 activation, resulting is DNA fragmentation independent of caspase activation. As a caspase-independent mechanism of apoptosis, AIF may be a potential target for chemoradiotherapeutic intervention in a number of malignancies. The aim of this review is to provide the available evidence of the role AIF in several malignancies with a particular emphasis in colon carcinogenesis.

[Arthroscopy of the trapeziometacarpal joint: anatomical study on cadavers]. / Artroscopía de la articulación trapeciometacarpiana: estudio anatómico en cadáver.

INTRODUCTION: Osteoarthritis of the trapeziometacarpal joint is one of the most common degenerative diseases of the hand for which a variety of surgical procedures have been developed. Arthroscopic techniques offer good results, although they have not been standardized. OBJECTIVE: To identify the main anatomical structures in relation to arthroscopy portals from the trapeziometacarpal joint and to determine their security area. MATERIAL AND METHODS: We conducted a transversal and descriptive study in which the anatomy was analyzed in seven cadaveric specimens. Fourteen thumbs were dissected after the arthroscopic portals were made. In all of the specimens the distance between the radial artery, the articular line and the arthroscopy portals was measured. RESULTS: The radial artery was found dorsal to the Extensor Pollicis Longus (EPL), 4-5 mm proximal to the dorsal arthroscopic portal, 4-8 mm to the articular line and 8-11 mm to the Extensor Pollicis Brevis (EPB). In two cases sensitive branches of the radial nerve were found through the dorsal portal. CONCLUSION: The anatomical evaluation defined a secure area for the dorsal portal between the EPL and the EPB. The proximal radial zone to the EPL must be avoided so that the dorsal branch of the radial nerve is not damaged.

Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors signaling complexes in Bergmann glia.

Glutamate, the major excitatory neurotransmitter, induces a wide array of signals from the membrane to the nucleus regulating gene expression. In Bergmann glia, Ca2+ -permeable alpha-amino-3-hydroxy-5-methyl-4-isoxazole- propionic acid (AMPA) receptors are involved in the short- and long-term interactions between these cells and the neurons that they surround. After activation, AMPA receptors become tyrosine phosphorylated and by these means form multiprotein signaling complexes. To characterize these events, cultured chick Bergmann glia cells as well as chick cerebellar slices were exposed to glutamate, and, by using a combination of immunoprecipitation assays coupled to Western blot analysis, we identified several signaling proteins that become associated with these receptors. A dose- and time-dependent association among AMPA receptors, the focal adhesion kinase pp125FAK, the phosphatidylinositol-3 kinase and paxillin was found. These results extend the concept of the transducisome to AMPA receptors and provide a framework in which a plausible control of the cytoskeletal network by glutamate is taking place, most possibly through AMPA receptors.

Endartectomía carotídea sin shunt. Bases anatomofisiológicas / Carotid artery endarterectomy without a shunt. Anatomophysiological bases

Se presentan 26 casos de ateromatosis carotídea con sintomatología variada desde la isquemia cerebral transitoria hasta crisis apopléjica. El diagnóstico se completó con Doppler color, arteriografía en todos los casos; completándose protocolo con electroencefalograma y valoración cardiaca. En todos los casos iniciamos la cirugía de la arteria carótida sin shunt, siguiendo una técnica cuidadosa con las estructuras vecinas y la pared de la arteria intervenida; nuestro tiempo de pinzamiento temporal de la arteria carótida varió entre 11 y 24 minutos. Este es el grupo de pacientes en el que no fue necesario utilizar shunt ni parche, porque tanto la pared arterial y los bordes de la arteriotomía nos permitieron cerrar con surgete continuo. Hasta el momento no hemos tenido ninguna complicación con esta técnica

¿ Continúa siendo adecuado crear una fístula arteriovenosa con vasos nativos? / Does it continue being an adequated option to create AV fistula with native vessels?

El objetivo de este trabajo fue evaluar los resultados en forma retrospectiva, prospectiva, longitudinal y clínica de la creación de la fístula arteriovenosa en pacientes con insuficiencia renal crónica en fase terminal en programa de hemodiálisis permanente determinando el tipo de procedimiento quirúrgico para obtener la permeabilidad en la fístula A-V realizada y las complicaciones de la misma; teniendo la característica de no haberse previamente realizado un acceso vascular. En el periodo de la investigación de enero de 1995 a agosto de 1998, fueron efectuados en 52 pacientes, 65 procedimientos quirúrgicos para la realización de una fístula arteriovenosa permeable en el Hospital Darío Fernández Fierro, ISSSTE, México, D.F. Contando con 35 pacientes del sexo masculino y 17 pacientes del sexo femenino (con límites de 10 a 75 años de edad). Se realizaron en 42 pacientes fístulas A-V tipo Cimino-Brescia, en cuatro pacientes se utilizó injerto PTFE con carbón, en otros cuatro con vena safena autóloga, en un paciente anastomosis arteriavena latero terminal y por último en un paciente se creó una fístula safena femoral para acceso de hemodiálisis. Hubo en ocho pacientes infección de herida quirúrgica, en seis pacientes presentron parestesias tolerables durante el proceso de hemodiálisis, en siete pacientes se presentó edema de la extremidad que mejora paulatinamente, sin embargo fue necesario el cierre de la fístula por edema importante, al igual que en otro que presentó insuficiencia cardiaca severa. En tres pacientes se presentó trombosis temprana (<6 semanas), uno por hipotensión durante la hemodiálisis (PTFE) y otro por compresión excesiva después de hemodiálisis (vena-safena). La creación de una fístula arterio-venosa como acceso vascular para hemodiálisis permanente en pacientes con insuficiencia renal crónica, es adecuado iniciar con una fístula A-V con la técnica Cimino-Brescia, teniendo como segunda alternativa el uso de injerto puente con materiales sintéticos o autólogos