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1.
J Clin Microbiol ; 60(7): e0018722, 2022 07 20.
Artículo en Inglés | MEDLINE | ID: mdl-35730949

RESUMEN

COVID-19 has brought unprecedented attention to the crucial role of diagnostics in pandemic control. We compared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test performance by sample type and modality in close contacts of SARS-CoV-2 cases. Close contacts of SARS-CoV-2-positive individuals were enrolled after informed consent. Clinician-collected nasopharyngeal (NP) swabs in viral transport media (VTM) were tested with a routine clinical reference nucleic acid test (NAT) and PerkinElmer real-time reverse transcription-PCR (RT-PCR) assay; positive samples were tested for infectivity using a VeroE6TMPRSS2 cell culture model. Self-collected passive drool was also tested using the PerkinElmer RT-PCR assay. For the first 4 months of study, midturbinate swabs were tested using the BD Veritor rapid antigen test. Between 17 November 2020 and 1 October 2021, 235 close contacts of SARS-CoV-2 cases were recruited, including 95 with symptoms (82% symptomatic for ≤5 days) and 140 asymptomatic individuals. Reference NATs were positive for 53 (22.6%) participants; 24/50 (48%) were culture positive. PerkinElmer testing of NP and saliva samples identified an additional 28 (11.9%) SARS-CoV-2 cases who tested negative by reference NAT. Antigen tests performed for 99 close contacts showed 83% positive percent agreement (PPA) with reference NAT among early symptomatic persons, but 18% PPA in others; antigen tests in 8 of 11 (72.7%) culture-positive participants were positive. Contacts of SARS-CoV-2 cases may be falsely negative early after contact, but more sensitive platforms may identify these cases. Repeat or serial SARS-CoV-2 testing with both antigen and molecular assays may be warranted for individuals with high pretest probability for infection.


Asunto(s)
COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , Prueba de COVID-19 , Humanos , Pandemias , Sensibilidad y Especificidad
2.
Pain Manag Nurs ; 23(3): 311-317, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34493439

RESUMEN

Anecdotal reports have suggested people with intellectual disabilities experience more pain than the general population due to additional co-morbidities and secondary conditions. This multicenter comparative cross-sectional study aimed to evaluate the prevalence, factors, and treatment modalities in people with intellectual disabilities (PID) as observed by their caregivers and reported through distributed questionnaires. The study sample included 130 PID users of centers in Ciudad Real (Spain). Variables related to sociodemographic characteristics, health problems, problem behaviors, and pain were collected. Among participants, 78 (60%) of PID were males, and their mean age was 43.8 years (SD = 13.57). Pain was identified in 29 PID (22.3%; 95% confidence interval [CI] 14.99-29.81), and drugs for pain were administered to 33 PID (26.4%; 95%CI 19-34). The prevalence of pain in the sampled PID, its severity, and the analgesic administration rate were lower than those in the general population. This situation may be aggravated for PID with communication problems.


Asunto(s)
Personas con Discapacidad , Discapacidad Intelectual , Adulto , Estudios Transversales , Femenino , Humanos , Discapacidad Intelectual/complicaciones , Discapacidad Intelectual/epidemiología , Discapacidad Intelectual/terapia , Masculino , Dolor/tratamiento farmacológico , Encuestas y Cuestionarios
3.
Eur Arch Otorhinolaryngol ; 279(7): 3679-3684, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34993612

RESUMEN

PURPOSE: Proviral integration site for Moloney murine leukemia virus (PIMs) are proto-oncogenes encoding serine/threonine kinases that phosphorylate a variety of substrates involved in the regulation of cellular processes. Elevated expression of PIM-1 has been associated with poor prognosis in several types of cancer. There are no studies that have analyzed the response to radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) according to the expression of PIM-1. The aim of our study was to analyze the relationship between the transcriptional expression of PIM-1 and local response to radiotherapy in HNSCC patients. METHODS: We determined the transcriptional expression of PIM-1 in 135 HNSCC patients treated with radiotherapy, including patients treated with chemoradiotherapy (n = 65) and bioradiotherapy (n = 15). RESULTS: During the follow-up, 48 patients (35.6%) had a local recurrence of the tumor. Patients with local recurrence had a higher level of PIM-1 expression than those who achieved local control of the disease (P = 0.017). Five-year local recurrence-free survival for patients with a high expression of PIM-1 (n = 43) was 44.6% (95% CI 29.2-60.0%), and for patients with low expression (n = 92) it was 71.9% (95% CI 62.5-81.3%) (P = 0.007). According to the results of multivariate analysis, patients with a high PIM-1 expression had a 2.2-fold increased risk of local recurrence (95% CI 1.22-4.10, P = 0.009). CONCLUSION: Patients with elevated transcriptional expression levels of PIM-1 had a significantly higher risk of local recurrence after radiotherapy.


Asunto(s)
Neoplasias de Cabeza y Cuello , Animales , Quimioradioterapia , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Ratones , Proteínas Serina-Treonina Quinasas , Proteínas Proto-Oncogénicas c-pim-1/genética , Proteínas Proto-Oncogénicas c-pim-1/metabolismo , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/radioterapia
4.
J Surg Oncol ; 121(7): 1058-1066, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32153030

RESUMEN

BACKGROUND AND OBJECTIVES: The number of patients diagnosed with head and neck squamous cell carcinoma (HNSCC) at an advanced age has increased. The aim of this study is to evaluate the age at which disease-specific survival (DSS) significantly decreases in HNSCC. METHODS: We performed a retrospective study of 5469 patients with HNSCC treated at our center (1985-2016). External validation with 2082 oral squamous cell carcinomas from a collaborative institution from another continent was performed. RESULTS: We observed an orderly decrease in overall survival as age at diagnosis increased. There were no differences in DSS based on age for patients <80 years old (P = .623), while older patients had a significant decrease in DSS. These results were validated in the independent dataset. In a multivariable analysis performed in the test set, compared to patients <80 years old, patients between 80 to 85 had a 1.50 times higher risk of disease-specific death (95% confidence interval [CI]: 1.19-1.89; P = .001), and patients >85 had a 2.19 times higher risk (95% CI: 1.68-2.87; P < .001). CONCLUSIONS: DSS started to significantly decrease in HNSCC at 80 years old. These findings, validated in an independent cohort, indicate that chronological age on its own should not withhold curative treatment in the majority of patients with HNSCC.


Asunto(s)
Neoplasias de Cabeza y Cuello/mortalidad , Carcinoma de Células Escamosas de Cabeza y Cuello/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia
5.
Eur Arch Otorhinolaryngol ; 276(11): 3179-3184, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31346690

RESUMEN

PURPOSE: Extended total laryngectomy with en-bloc resection of overlying cervical skin (ETL) is indicated in cases with infiltration of the pre-laryngeal soft tissues. The present study analyses the surgical indications and the results of ETL in our hospital. METHODS: Retrospective review of 38 patients treated with an ETL during the period 1988-2016. RESULTS: The indications for ETL were the initial treatment of tumors with extralaryngeal extension (n = 16), salvage treatment after failure of partial surgery or radiotherapy (n = 17), and total laryngectomy in patients with infection or fibrosis of the skin over the larynx (n = 5). The surgical defect was reconstructed with local flaps in 3 cases, with pectoralis major flaps in 34 cases, and with an internal mammary artery perforator flap in one case. The rate of pharyngocutaneous fistula in the postoperative period was 16%. 5-year cancer-specific survival for patients treated with an ETL was 67.1%. The patients with positive margins and those operated as a salvage treatment after failure of previous treatments showed worse survival. CONCLUSIONS: ETL offers acceptable oncological results for patients with tumors with extralaryngeal extension. Myocutaneous or myofascial pectoralis major flaps allow for adequate reconstruction of the surgical defect with a low rate of complications.


Asunto(s)
Neoplasias Laríngeas , Laringectomía , Laringe , Músculos Pectorales/trasplante , Terapia Recuperativa/métodos , Fístula Cutánea/etiología , Femenino , Humanos , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Laringectomía/efectos adversos , Laringectomía/métodos , Laringe/patología , Laringe/cirugía , Masculino , Persona de Mediana Edad , Colgajo Miocutáneo , Evaluación de Procesos y Resultados en Atención de Salud , Estudios Retrospectivos , España
6.
Eur Arch Otorhinolaryngol ; 275(1): 225-232, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29177949

RESUMEN

INTRODUCTION: Tumor-infiltrating lymphocytes (TILs) have a recognized antitumor activity in head and neck squamous cell carcinoma (HNSCC). CD45 is one of the most highly expressed proteins in lymphocytes. We carry out a study to assess the prognostic value of transcriptional expression of CD45 in HNSCC. MATERIAL AND METHODS: We determined the transcriptional expression of CD45 in 160 consecutive HNSCC patients and compared the TIL values according to the CD45 expression. RESULTS: Five-year disease-free survival for patients with a high transcriptional expression of CD45 (n = 107) was 62.4% and for patients with a low expression (n = 53) it was 36.2% (P = 0.003). Patients with a high expression of CD45 had a better local recurrence-free survival and disease-specific survival. The results of a multivariate analysis showed that patients with a low expression of CD45 had 2.0-fold high risk of recurrence (95% CI 1.2-3.2, P = 0.003). In oropharyngeal carcinomas, HPV-positive tumors showed a higher transcriptional CD45 expression than HPV-negative tumors. Tumors with high CD45 expression had immunohistochemical TIL scores significantly higher than those with low CD45 expression. CONCLUSION: According to our results, CD45 expression is a potential marker for tumor outcome in HNSCC patients.


Asunto(s)
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/mortalidad , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/mortalidad , Antígenos Comunes de Leucocito/genética , Transcripción Genética , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/metabolismo , ADN Viral/análisis , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/metabolismo , Humanos , Inmunohistoquímica , Linfocitos Infiltrantes de Tumor/metabolismo , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación , Pronóstico , ARN Mensajero/metabolismo , Carcinoma de Células Escamosas de Cabeza y Cuello
7.
Eur Arch Otorhinolaryngol ; 274(1): 527-533, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27509897

RESUMEN

Few studies have analyzed the appearance of extracapsular spread (ECS) in salvage neck dissections carried out after regional recurrence of the disease. The aim of our study was to evaluate the frequency of ECS in patients with an isolated regional recurrence treated with a salvage neck dissection, and to assess the influence of ECS on prognosis. We conducted a retrospective study of 123 patients treated with a salvage neck dissection. Eighty-two patients (66.7 %) had nodes with ECS. Five-year salvage-specific survival for patients without ECS was 77.2 %, whereas for patients with ECS it was 32.0 % (P = 0.0001). According to the results of a multivariate analysis, the presence of ECS in the salvage neck dissection was the only variable significantly related to the salvage-specific survival. Sixty-six percent of the patients with nodes with ECS had adjuvant treatment with radiotherapy or chemoradiotherapy. Five-year salvage-specific survival for patients with ECS who had not received adjuvant treatment (n = 26) was 15.2 %, whereas for patients treated with adjuvant radiotherapy (n = 39) or chemotherapy (n = 17), 5-year salvage-specific survival was 36.4 and 47.1 %, respectively. Patients with ECS could benefit from adjuvant treatment with radiotherapy or chemoradiotherapy.


Asunto(s)
Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía , Adulto , Anciano , Quimioradioterapia , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Disección del Cuello/métodos , Invasividad Neoplásica , Pronóstico , Radioterapia Adyuvante , Recurrencia , Estudios Retrospectivos , Terapia Recuperativa , Carcinoma de Células Escamosas de Cabeza y Cuello , Resultado del Tratamiento
8.
J Pathol ; 235(1): 125-35, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25256272

RESUMEN

Prostacyclin (PGI2 ) plays a role in cancer progression but the mechanism is currently poorly understood. Additionally, no data are available about the prognostic value of the PGI2 pathway in head and neck squamous cell carcinoma (HNSCC) therapy. We evaluated the expression of the PGI2 pathway in HNSCC patients. PGI2 production and PGI synthase (PGIS) expression, in terms of mRNA (RT-PCR) and protein (immunoblotting), were lower in tumour samples than in non-tumoural mucosa, whereas, as expected, COX-2 expression was increased in HNSCC tumour samples. Using local control of the tumour after radiotherapy or chemoradiotherapy as a dependent variable, patients were classified into two categories of PGIS transcript levels. The high-PGIS group had a significantly lower frequency of local and distant failure than the low-PGIS group, and the 5-year cancer-specific survival was higher [90.2% (95% CI 81.0-99.4%) versus 60.5% (95% CI 44.4-76.6%)]. None of the four HNSCC cell lines analysed expressed PGIS and therefore they did not produce PGI2 . However, HNSCC-conditioned media enhanced PGI2 production in endothelial cells (ECs). The stable analogue of PGI2 , carbaprostacyclin (cPGI2 ), exerted little effect on HNSCC cell line migration, and no effect on cell cycle distribution or proliferation rate after radiation injury was observed. Nevertheless, cPGI2 promoted EP-4-dependent in vitro angiogenesis. Von Willebrand factor expression (EC marker) and capillary density were significantly higher in the group of patients with high expression of PGIS. Our results indicate that PGIS expression was associated with radiotherapy efficiency. Although we do not provide direct evidence of a relationship between tumour vascularization and radiotherapy efficiency, our results suggest that the effect of PGI2 is related to its ability to promote vascularization. These results also support the concept that co-adjuvant therapy with PGIS enhancers, such as retinoids, could have therapeutic value for HNSCC treatment.


Asunto(s)
Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/radioterapia , Sistema Enzimático del Citocromo P-450/metabolismo , Endotelio Vascular/metabolismo , Neoplasias de Cabeza y Cuello/metabolismo , Neoplasias de Cabeza y Cuello/radioterapia , Oxidorreductasas Intramoleculares/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Células Cultivadas , Ciclooxigenasa 2/metabolismo , Femenino , Neoplasias de Cabeza y Cuello/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Carcinoma de Células Escamosas de Cabeza y Cuello
9.
Eur Arch Otorhinolaryngol ; 273(12): 4417-4424, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27188507

RESUMEN

After a local and/or regional recurrence of head and neck squamous cell carcinoma (HNSCC) not all patients are candidates to salvage treatment. The objective of this study was to identify the variables related to performance of salvage surgery with curative intent in these patients. We performed a retrospective study of 1088 HNSCC patients with a local and/or regional recurrence. According to a multivariate analysis, the variables related to performance of salvage surgery were the Karnofsky index, the location and extension of the primary tumor, the initial treatment, the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence, and the year the recurrence was diagnosed. Considering salvage surgery as the dependent variable, the results of a recursive partitioning analysis defined four categories of patients in function of the category of local and regional extension of the initial tumor, the location of the primary tumor, the initial treatment and the disease-free interval between treatment of the initial tumor and diagnosis of the recurrence.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Manejo de la Enfermedad , Neoplasias de Cabeza y Cuello/cirugía , Recurrencia Local de Neoplasia/cirugía , Terapia Recuperativa , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Femenino , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello , Resultado del Tratamiento
10.
Eur Arch Otorhinolaryngol ; 273(12): 4525-4533, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27328961

RESUMEN

Expression of the CXCL12/CXCR4 chemokine axis has been related with the appearance of metastatic recurrence survival, including regional and distant recurrence, in patients with head and neck squamous cell carcinoma (HNSCC). RT-PCR was used to determine mRNA expression levels of CXCL12 and CXCR4 in biopsy tumor samples in 111 patients with HNSCC. Five-year regional recurrence-free survival for patients with low CXCR4 expression (n = 39, 31.5 %) was 97.4 %, for patients with high CXCR4/high CXCL12 expression (n = 22, 19.8 %) it was 94.7 %, and for patients with high CXCR4/low CXCL12 expression (n = 50, 45.0 %) it was 63.3 %. We found significant differences in the regional recurrence-free survival according to CXCR4/CXCL12 expression values (P = 0.001). HNSCC patients with high CXCR4 and low CXCL12 expression values had a significantly higher risk of regional recurrence and could benefit from a more intense treatment of lymph node areas in the neck.


Asunto(s)
Carcinoma de Células Escamosas/metabolismo , Quimiocina CXCL12/metabolismo , Neoplasias de Cabeza y Cuello/metabolismo , Proteínas de Neoplasias/metabolismo , Receptores CXCR4/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Femenino , Humanos , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , ARN Mensajero/metabolismo , Transducción de Señal , Carcinoma de Células Escamosas de Cabeza y Cuello
11.
Cancer ; 120(13): 1948-59, 2014 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-24668684

RESUMEN

BACKGROUND: Metastatic dissemination is the most frequent cause of death in patients with sporadic colorectal cancer (sCRC). It is believed that the metastatic process is related at least in part to a specific background of genetic alterations accumulated in cells from primary tumors, and the ability to detect such alterations is critical for the identification of patients with sCRC who are at risk of developing metastases. METHODS: The authors used high-resolution, 500-K single nucleotide polymorphism arrays to identify copy number alteration profiles present at diagnosis in primary tumors from patients with metastatic (n = 23) versus nonmetastatic (n = 26) sCRC. RESULTS: The results revealed a characteristic pattern of copy number alterations in metastatic sCRC tumors that involved losses of 23 regions at chromosomes 1p, 17p, and 18q, together with gains of 35 regions at chromosomes 7 and 13q. CONCLUSIONS: In line with expectations, the copy number profile investigated involved multiple genes that were associated previously with sCRC (ie, SMAD2) and/or the metastatic process (ie, podocalyxin-like [PODXL]), and it also was associated with a poorer outcome.


Asunto(s)
Aberraciones Cromosómicas , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Variaciones en el Número de Copia de ADN , Proteínas de Neoplasias/genética , Polimorfismo de Nucleótido Simple , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/cirugía , Femenino , Humanos , Hibridación Fluorescente in Situ , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias
12.
Anal Biochem ; 450: 37-45, 2014 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-24440232

RESUMEN

Antibody arrays hold great promise for biomedical applications, but they are typically manufactured using chemically functionalized surfaces that still require optimization. Here, we describe novel hetero-functionally activated glass surfaces favoring oriented antibody binding for improved performance in protein microarray applications. Antibody arrays manufactured in our facility using the functionalization chemistries described here proved to be reproducible and stable and also showed good signal intensities. As a proof-of-principle of the glass surface functionalization protocols described in this article, we built antibody-based arrays functionalized with different chemistries that enabled the simultaneous detection of 71 human leukocyte membrane differentiation antigens commonly found in peripheral blood mononuclear cells. Such detection is specific and semi-quantitative and can be performed in a single assay under native conditions. In summary, the protocol described here, based on the use of antibody array technology, enabled the concurrent detection of a set of membrane proteins under native conditions in a specific, selective, and semi-quantitative manner and in a single assay.


Asunto(s)
Anticuerpos Inmovilizados/química , Vidrio/química , Análisis por Matrices de Proteínas/métodos , Animales , Anticuerpos Inmovilizados/inmunología , Antígenos HLA/inmunología , Humanos , Leucocitos Mononucleares/inmunología , Reproducibilidad de los Resultados , Propiedades de Superficie
13.
Eur Arch Otorhinolaryngol ; 271(5): 1187-90, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-23832261

RESUMEN

The aim of this study was to define the role of elective neck dissection in patients with a second N0 head and neck squamous cell carcinoma (HNSCC). We carried out a retrospective study in 74 patients with a second N0 HNSCC treated with an elective neck dissection. Thirteen patients (17.6%) had occult neck node metastases. The risk of occult neck nodes was low for patients with a second glottic tumor (0%), and for patients with non-glottic T1-T2 tumors who had received previous radiotherapy in the neck (5.3%). Patients with non-glottic locally advanced tumors (T3-T4) and non-glottic T1-T2 tumors who had not received previous radiotherapy in the neck had a risk of occult neck nodes of 28.1 and 33.3%, respectively. Elective neck dissection could be omitted in patients with glottic tumors and in patients with an early tumor (T1-T2) who had received previous radiotherapy in the neck.


Asunto(s)
Carcinoma de Células Escamosas/cirugía , Procedimientos Quirúrgicos Electivos , Disección del Cuello , Neoplasias Primarias Secundarias/cirugía , Neoplasias de Oído, Nariz y Garganta/cirugía , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/radioterapia , Terapia Combinada , Humanos , Estimación de Kaplan-Meier , Metástasis Linfática/patología , Estadificación de Neoplasias , Neoplasias Primarias Secundarias/mortalidad , Neoplasias Primarias Secundarias/patología , Neoplasias de Oído, Nariz y Garganta/mortalidad , Neoplasias de Oído, Nariz y Garganta/patología , Neoplasias de Oído, Nariz y Garganta/radioterapia , Pronóstico , Radioterapia Adyuvante , Reoperación , Estudios Retrospectivos
14.
Rev Enferm ; 37(4): 8-14, 2014 Apr.
Artículo en Español | MEDLINE | ID: mdl-24864410

RESUMEN

OBJECTIVE: Falls are the second leading cause of accidental or unintentional injury deaths worldwide, also, falls generate severe disabilities, institutionalization and increase healthcare costs. People with intellectual disabilities (ID) fall over frecuently. It's due to they are usually sicker than the rest of the population, and for environmental, professional and organizational factors. The aim of the study was to assess risk factors and injury due to falls. Also the methods of assessment and prevention of falls were analyzed. METHODOLOGY. It was carried out a literature review. We searched for articles in major biomedical databases and on the website of the Spanish Confederation of Organizations for Persons with Intellectual Disability (FEAPS). Sixteen studies were analyzed. The articles analyzed showed that age, history of seizures, gait and behavioral problems and environmental factors were the main risk factors for falling. Many fallers (84 6%) had suffered injuries. RESULTS/CONCLUSIONS: There is no consensus on an appropriate instrument to assess the risks factors and problems that cause falls. These instruments have not been validated in Spanish. A few suggestions found to prevent falls and injury in people with intellectual disability are based on educational and environmental approaches. The best way to contribute to the prevention could be research on intervention programs and organizational and staff characteristics. Nurses must lead these investigations.


Asunto(s)
Accidentes por Caídas/prevención & control , Discapacidad Intelectual/complicaciones , Humanos , Factores de Riesgo
15.
Artículo en Inglés | MEDLINE | ID: mdl-37931687

RESUMEN

OBJECTIVE: To analyze the predictive capacity at the primary location of the tumor of the FAT1 transcriptional expression in patients with head and neck squamous cell carcinoma treated with radiotherapy. MATERIAL AND METHODS: We conducted a retrospective study from biopsies of the primary location of the tumor in 82 patients with head and neck squamous cell carcinoma treated with radiotherapy. The transcriptional expression of FAT1 was determined by RT-PCR. The level of FAT1 transcriptional expression was categorized according to the local control after radiotherapy using a recursive partitioning analysis. RESULTS: Elevated FAT1 transcriptional expression was associated with an increased risk of local recurrence after radiotherapy. Patients with a high expression level of FAT1 (n=18; 22.0%) had a 5-year local recurrence-free survival of 42.1% (95% CI: 18.6%-65.6%), whereas for patients with a low expression (n=64; 78.0%) it was 72.4% (95% CI: 61.5%-83.3%) (p=0.002). According to the result of a multivariate analysis, patients with a high FAT1 expression category had a 2.3-fold increased risk of local recurrence (95% CI: 1.0-5.2; p=0.043). CONCLUSIONS: Elevated FAT1 transcriptional expression was associated with a significantly increased risk of local recurrence in patients with head and neck squamous cell carcinoma treated with radiotherapy.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Humanos , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/radioterapia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/radioterapia , Estudios Retrospectivos , Biopsia , Cadherinas
16.
Aten Primaria ; 44(2): 89-96, 2012 Feb.
Artículo en Español | MEDLINE | ID: mdl-22019112

RESUMEN

OBJECTIVE: To evaluate the efficacy of a program of home blood pressure monitoring (HBPM) on therapeutic Inertia (TI) in mild-to-moderate hypertension (AHT). DESIGN: Controlled, randomised clinical trial. SETTING: Forty six clinics in 35 primary care centres. Spain. PARTICIPANTS: A total of 232 patients with uncontrolled hypertension were included. INTERVENTION: Two groups with 116 patients were formed: 1) Control group (CG): standard health intervention; 2) Intervention group (IG): patients who were included in the HBPM program. MAIN MEASUREMENTS: TI was calculated by the ratio: Number of patients whose pharmacological treatment was not changed in each visit/Number of patients with an average BP 140mmHg and/or 90mmHg in the general population or 130 and/or 90 mmHg in diabetics. The mean BPs and the percentage of controlled patients were calculated. The mean number of people that required an intervention in order to avoid TI was calculated (NI). RESULTS: A total of 209 patients completed the study, with TI in 35.64% (95% CI=29.85%-41.43%) of the sample, and in 71.63% (95% CI=63.9-79.36%) of the uncontrolled hypertensive patients. The TI was 22.42% (95% CI=24.2-37%) in the IG and 50% (95% CI=37.75-62.25) in the CG (p<.05) in visit 2, and 25.23% (95% CI=14.84-35.62) and 46.07% (95% CI=33.85-58.29) in the final visit for IG and CG, respectively (P<.05). The NI was 4.3. CONCLUSIONS: TI was very significant among the uncontrolled hypertensive patients. The studied interventions are effective for improving TI.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Adhesión a Directriz , Hipertensión/terapia , Pautas de la Práctica en Medicina , Femenino , Humanos , Masculino , Persona de Mediana Edad
17.
Cir Esp ; 90(8): 518-24, 2012 Oct.
Artículo en Español | MEDLINE | ID: mdl-22871493

RESUMEN

INTRODUCTION: There are no quantified data on the real activity carried out by residents during the 5 years of training in the specialty of general and digestive surgery (GGS) in Spain. There are also limited data on programs in other surgical specialities, and in other countries. The aim of the study is to estimate the mean overall surgical activity by specific skill areas and by the level of complexity of the Spanish program in the specialty of GGS. PATIENTS AND METHOD: A prospective, observational, multicentre study was performed on the activity of GGS residents in Spain using the Resident Computerised Logbook of the Spanish Surgeons Association (LIR-AEC). Each of the residents registered their own activity supervised by their tutor. The sample period was 6 months. The medians of the annual activity and the period of residency were calculated from the results. RESULTS: Surgical activity: during the residency, it was estimated that that they attended 1,325 operations, 654 (49%) as lead surgeon. Health care activity: the mean number of times on-call was 5.2±1.8 per month. Activity in outpatient clinics was 548 first visits, and almost double for second visits. Scientific activity: the total number of courses and conferences attended was 34. The estimated mean number of presentations at conferences was 14, with 3 publications. CONCLUSIONS: LIR-AEC is a suitable tool to verify activity in the Spanish GGS Program. These results may be useful for comparing with training programs in other countries and in other surgical specialties.


Asunto(s)
Computadores , Procedimientos Quirúrgicos del Sistema Digestivo/educación , Cirugía General/educación , Internado y Residencia , Estudios Prospectivos
18.
Clin Transl Oncol ; 24(11): 2175-2180, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-35752749

RESUMEN

PURPOSE: FNDC4 gene encodes the fibronectin type III domain-containing 4 protein. Elevated expression of FNDC4 has been associated with poor prognosis in several types of cancer. There are no studies that have evaluated the prognostic capacity of FNDC4 in patients with head and neck cancer (HNSCC). The aim of our study was to analyze the relationship between the transcriptional expression of FNDC4 and prognosis in HNSCC patients. METHODS: We determined the transcriptional expression of FNDC4 in 67 patients with advanced-stage HNSCC (III-IV) treated with chemoradiotherapy. The FNDC4 expression was categorized according to the disease-specific survival with a recursive partitioning analysis. RESULTS: There were significant differences in disease-specific survival as a function of the level of FNDC4 transcriptional expression. The 5-year disease-specific survival for patients with high FNDC4 expression (n = 44, 65.7%) was 32.9% (95% CI: 16.5-49.3%), and for patients with low expression (n = 23, 34.3%) it was 85.4% (95% CI: 70.2-100%) (P = 0.0001). Patients with a high FNDC4 expression had poorer local (P = 0.097), regional (P = 0.008), and distant (0.034) recurrence-free survival. The results of a multivariate analysis showed that patients with a high FNDC4 expression had a 6.15-fold increased risk of death as a consequence of the HNSCC (95% CI: 1.71-22.06). CONCLUSION: FNCF4 transcriptional expression was significantly related to the disease-specific survival of HNSCC patients treated with chemoradiotherapy. Patients with elevated FNDC4 expression had a significant decrease in disease-specific survival.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Carcinoma de Células Escamosas/patología , Quimioradioterapia/métodos , Dominio de Fibronectina del Tipo III , Neoplasias de Cabeza y Cuello/genética , Neoplasias de Cabeza y Cuello/terapia , Humanos , Pronóstico , Proteínas , Carcinoma de Células Escamosas de Cabeza y Cuello/genética , Carcinoma de Células Escamosas de Cabeza y Cuello/terapia
19.
Artículo en Inglés | MEDLINE | ID: mdl-34844674

RESUMEN

OBJECTIVE: To analyse the trend in the percentage of patients with squamous cell carcinoma of the head and neck (SCCHN) of female gender over the last decades, and differences in survival according to gender. MATERIAL AND METHODS: Retrospective study of 5828 SCCHN diagnosed during the period 1985-2019. In the survival analysis we only included only patients with more than two years of follow-up. RESULTS: The proportion of tumours in female patients increased significantly over the study period. There was greater increase of tumours located in the oral cavity, oropharynx and larynx in the percentage of female patients. When considering the total number of patients, there were no significant differences in disease-specific survival according to gender. We observed a variable behaviour of disease-specific survival according to gender depending on the primary location of the tumour. For tumours of the larynx and oropharynx the female patients had a disease-specific survival significantly higher than that of men, while for tumours of the oral cavity, the female patients had a significant reduction of disease-specific survival. CONCLUSIONS: In our setting, the percentage of female patients with HNSCC has been increasing steadily over recent decades. There were differences in disease-specific survival according to gender depending on the location of the primary tumour.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias de Cabeza y Cuello , Carcinoma de Células Escamosas/epidemiología , Femenino , Humanos , Masculino , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello , Análisis de Supervivencia
20.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33618830

RESUMEN

OBJECTIVE: To analyse the trend in the percentage of patients with squamous cell carcinoma of the head and neck of female gender over the last decades, and differences in survival according to gender. MATERIAL AND METHODS: Retrospective study of 5,828 squamous cell carcinoma of the head and neck diagnosed during the period 1985-2019. In the survival analysis we only included only patients with more than two years of follow-up. RESULTS: The proportion of tumours in female patients increased significantly over the study period. There was greater increase of tumours located in the oral cavity, oropharynx and larynx in the percentage of female patients. When considering the total number of patients, there were no significant differences in disease-specific survival according to gender. We observed a variable behaviour of disease-specific survival according to gender depending on the primary location of the tumour. For tumours of the larynx and oropharynx the female patients had a disease-specific survival significantly higher than that of men, while for tumours of the oral cavity, the female patients had a significant reduction of disease-specific survival. CONCLUSIONS: In our setting, the percentage of female patients with squamous cell carcinoma of the head and neck has been increasing steadily over recent decades. There were differences in disease-specific survival according to gender depending on the location of the primary tumour.

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