Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study.

A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice. CEIPC 2008 Spanish Adaptation]. / Guía Europea de Prevención Cardiovascular en la Práctica Clínica. Adaptación española del CEIPC 2008.

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure<140/90mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is<130/80mmHg. Serum cholesterol should be<200mg/dl and cLDL<130mg/dl, although in patients with CVD or diabetes, the objective is<100mg/dl (80mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin<7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

[European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: CEIPC 2008 Spanish adaptation]. / Guía europea de prevención cardiovascular en la práctica clínica: Adaptación española del CEIPC 2008.

We present the Spanish adaptation from the CEIPC of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure <140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be <200 mg/dl and cLDL <130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by BMI -body mass index- and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.

The cytoskeleton of Entamoeba histolytica: structure, function, and regulation by signaling pathways.

Pathogenesis in the parasite Entamoeba histolytica has been related to motility of the trophozoites. Motility is an important feature in amebas as they perform multiple motile functions during invasion of host tissues. As motility depends on the organization and regulation of the cytoskeleton elements, in particular of the actin cytoskeleton, the study of the molecular components of the machinery responsible for movement has been a key aspect to study in this parasite. Although many of the components have high homology in amino acid sequence and function to those characterized in higher eukaryotic cells, there are important differences to suggest that parasitic organisms may have developed adaptative differences that could be useful as targets to stop invasion. The purpose of this review is to evaluate current knowledge about the cytoskeleton of E. histolytica and the ways in which the parasite controls motility.

Cyclophosphamide hypersensitivity in a leukemic child.

Although hypersensitivity reactions to chemotherapeutic drugs have rarely been reported, they may occur with any of these agents. A Mexican native 44-kg 13-year-old boy suffering from acute lymphoblastic leukemia (ALL) received chemotherapy for 7 years. Three years later, a recurrence of ALL was detected in his right testicle. The patient was scheduled to receive 12 weekly cycles of 50 mg/kg of cyclophosphamide (CPM) as a 1-hour intravenous infusion. The patient did not have any history of drug allergies or any other type of ADR. Immediately after the fourth cycle of CPM, the patient developed itchy, maculopapular rash, sweating, respiratory distress, and anxiety. According to the algorithm developed by Naranjo et al, the ADR was classified as probably secondary to CPM. Skin tests were negative to hypersensitivity to CPM, and a new cycle of CPM was administered. However, the patient developed a similar hypersensitivity reaction to CPM. After an analysis of the clinical course of the ADR and the need to continue the chemotherapeutic treatment with CPM, we decided to desensitize the patient to this drug. Total duration of the procedure was 5 hours and was performed on only 1 occasion. The program of 12 cycles of chemotherapy was successfully completed without any sign or symptom of hypersensitivity to CPM. In conclusion, we have reported a case of hypersensitivity to CPM who was successfully desensitized to CPM.

[Changes in lung function after a bronchial provocation test with cockroach antigens]. / Cambios en la función pulmonar después de una prueba de reto bronquial con antígenos de cucaracha.

BACKGROUND: Cockroach allergens sensitized patients at a very young age and can predispose to severe asthma on atopic children. OBJECTIVE: To evaluate the FEV, changes induced after bronchoprovocation with Blatella germanica (Bg) or placebo on allergic respiratory children. MATERIAL AND METHODS: A prospective transversal study was performed in 25 children from 8 to 16 yr with allergic rhinitis and/or asthma diagnosis with sensibility only to Bg (Bayer Corp allergens) by Prick skin test, with a 1:20 weight/volume dilution. After previous training on spirometry, they assisted for a double blind bronchial challenge with 10, 25, 50, 75, 100, 150, 200, 300, 400, 500 until 750 proteic nitrogen units of Bg or 0.9% NaCl solution in a nebulized open circuit, with a 5 litter flow for 3 min. A week after, they returned for the crossover double blind bronchial challenge. At the beginning of the study a basal spirometry was performed and subsequent spirometrics at 1.5 and 3 min after each challenge with a 10 min rest between the challenges. The test was interrupted if cough, dyspnea, wheezing and/or a 15% or more FEV1 fall appeared. RESULTS: Twelve patients showed a FEV1 fall with the antigen challenge, all with specific lgE for Bg. All they had positive skin test to Bg, 9 had asthma and rhinitis and 3 only asthma. When placebo was used 6 patients showed a FEV1 fall. When comparing the average basal and final FEV1 values after the challenges, the fall was statistical significant in both groups with a p = 0.0015 when Bg was used, and p = 0.046 with placebo. CONCLUSION: These results show that two times fold number of patients challenged with Bg had a FEV1 fall than placebo, and the t Student test showed that antigen challenge was more significant than placebo. We demonstrated that respiratory allergic patients sensitised with Bg after a bronchial challenge with these allergens show a FEV1 fall. This suggests that cockroach allergen sensitisation can be on account of children's asthma.

Desensibilización a insulina DNA recombinante humana en una adolescente con diabetes mellitus insulinodependiente / Desensitization to human recombinant DNA insulin in an adolescent with insulin-dependent diabetes mellitus

Antecedentes: las reacciones adversas a fármacos se han incrementado durante los últimos años, en cerca del 15 por ciento de esos efectos quizá haya una participación inmunológica de acuerdo con el mecanismo de daño involucrado de la clasificación de Gell y Coombs, que pueden ser tipo I (inmediatas), tipo II (citotóxica), tipo III (influidas por complejos inmunitarios), y tipo IV (retardada). La alergia a la insulina se define como una respuesta inmunológica tipo I y, en menor frecuencia, tipo II o III a las preparaciones de insulina exógena y ocurre del 0.1 al 0.2 por ciento de los pacientes. Pacientes: se comunica el caso de una paciente de 13 años de edad, con antecedentes de diabetes mellitus dependiente de insulina, con manifestaciones de hipersensibilidad a la insulina recombinante humana (exantema urticariforme y prurito generalizado) sin respuesta favorable a la terapia previa a la medicación e imposibilidad para utilizar un tratamiento alternativo para su control metabólico. Por esta razón se procedió a la desensibilización con insulina. Métodos: la prueba cutánea con insulina rápida fue positiva a una dilución 1:10, los anticuerpos específicos IgE para insulina resultaron negativos y la IgE total fue normal. La desensibilización se inició con insulina rápida, a una dilución de 1:1000 por vía intradérmica, posteriormente subcutánea hasta alcanzar la dosis acumulada necesaria para la paciente durante el día. En el transcurso del proceso apareció un exantema maculopapular y prurito generalizado que remitió con antihistamínicos intravenosos. Resultados: la paciente toleró la desensibilización muy bien. Los últimos 14 meses ha sido tratada con insulina recombinante humana administrada por vía subcutánea sin problemas. Discusión: la desensibilización a fármacos no es un procedimiento frecuente y sólo se debe utilizar cuando es imposible sustituir la terapéutica. Nuestra paciente quizá tuvo una reacción de hipersensibilidad tipo I a insulina; sin embargo, no se puede descartar una reacción citotóxica influida por anticuerpos IgG o IgM o por complejos inmunitarios. La desensibilización fue bien tolerada y 14 meses después la paciente ha tolerado en forma adecuada su dosis diaria de insulina recombinante humana.

Procedimiento para realizar pruebas broncodinámicas con alergenos inhalados / Proccedings to bronchodynamics tests with inhalated allergens

El asma es una de las enfermedades crónicas más frecuentes de los niños. Se caracteriza por hiperreactividad de las vías aéreas a estímulos inespecíficos (metacolina e histamina) y específicos (alergenos). Las pruebas broncodinámicas determinan la broncolabilidad del niño asmático y ayudan a establecer el diagnóstico funcional. Deben realizarse con extractos antigénicos de alta calidad, acuosos liofilizados y estandarizados; se puede utilizar un circuito abierto o cerrado y un dosímetro, la dosis inicial del alergeno es más baja que con la que se obtuvo la reactividad cutánea positiva, realizando incrementos sucesivos hasta que el VEF-1 descienda 15 por ciento o más. La seguridad del paciente es fundamental, por eso las pruebas debe realizarlas personal especialmente adiestrado.

Medición de la flujimetría en niños alérgicos a ácaros antes y después del reto con pruebas por prick / Flujimetry subsequent to the Dermatophagoides pteronisinnus through tests cutaneous for prick in allergy children

Objetivo. Determinar la obstrucción del flujo aéreo por flujimetría posterior a la aplicación de pruebas cutáneas específicas (dermathophagoides pteronisinnus), en niños sensibles a éste. Material y método. Se estudiaron 44 pacientes de uno y otro sexo con diagnóstico de asma y antecedente de sensibilidad al ácaro Dermathophagoides pteronisinnus mediante pruebas cutáneas por prick, con una edad promedio de 6 a 16 años, captados de la consulta externa del servicio de alergia del Hospital Infantil de México Federico Gómez. Es un estudio longitudinal, prospectivo, ciego cruzado, en el que previamente se hizo una prueba de reto con antígeno estandarizado de Dermatophagoides pteronisinnus o glicerina, previa lectura de flujimetría. Resultados. De los pacientes retados con antígeno en 23 hubo descenso del flujo espiratorio máximo, con una p<0.05, pero sin significado clínico. Cuando se retaron con placebo sólo disminuyó en siete pacientes el flujo espiratorio máximo, también estadísticamente significativo, pero sin relevancia clínica. Conclusión. Las pruebas cutáneas son una herramienta útil en alergia y seguras, pues casi no producen reacciones sistémicas graves

Colon tóxico amibiano con y sin perforación: conducta quirúrgica / Amoebic toxic colon with and without perfuration: surgical management

Se trataron quirúrgicamente 47 pacientes de colon tóxico amibiano en el Instituto Nacional de Pediatría, 27 con perforación del colon y 20 sin perforación durante un período de 12 años (enero de 1972 a diciembre de 1984). En los 27 pacientes perforados, las zonas más afectadas fueron el colon ascendente, transverso y descendente; en 4 pacientes estuvo afectada la totalidad del colon. A 18 se les practicó colectomía subtotal, a 4 hemicolectomía, a otros 4 colectomía total y en 1 caso colostomia. A los pacientes no perforados sólo se les practicó derivación fecal mediante ileostomía. En ambos grupos hubo un número importante de complicaciones posoperatorias, de todas ellas una de las más frecuentes fue la estenosis en el colon desfuncionalizado (40% de los pacientes que sobrevivieron). La reintervención quirúrgica que ocupó el primer lugar fue el cierre de la ileostomía; otro grupo importante fue la resolución quirúrgica de las zonas de estenosis incluyendo 3 pacientes a quienes se practicó rectoplastía sagital posterior sin que se alterara la continencia fecal. La mortalidad global fue de 47%