Guided Imagery for Symptom Management of Patients with Life-Limiting Illnesses: A Systematic Review of Randomized Controlled Trials.

Background: Patients with life-limiting illnesses receiving palliative care have a high symptom burden that can be challenging to manage. Guided imagery (GI), a complementary and integrative therapy in which patients are induced to picture mental images with sensory components, has proven in quasi-experimental studies to be effective as a complementary therapy for symptom management. Objective: To systematically review randomized controlled trials that report evidence of guided imagery for symptom management in patients with life-limiting illnesses. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed for this review and the search strategy was applied in Medline, CINHAL, and Web of Science. The quality of articles was evaluated using the Cochrane Collaboration's Risk-of-Bias Tool 2 (RoB 2). The results are presented using the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. Results: A total of 8822 studies were initially identified through the search strategy, but after applying exclusion criteria, 14 randomized controlled trials were included in this review. The quality assessment revealed that four studies had a high risk of bias, nine had some concerns, and one had a low risk of bias. Out of the 14 studies, 6 evaluated oncological diagnosis, while the remaining 8 focused on nononcological diagnoses across 6 different diseases. GI was found to be effective in managing symptoms in 10 out of the 14 studies. Regardless of the disease stage, patients who received guided imagery experienced relief from anxiety, depression, pain, sleep disturbances, and fatigue. Conclusion: GI therapy has shown promising results regarding symptom management in palliative care patients with life-limiting illnesses at different stages.

Differential Immunoexpression of BRAF/V600E, Senescence Markers, PTEN, and T-type Calcium Channels in Acquired Naevi According to their Histopathological and Dermoscopic Classification.

BRAF/V600E mutation and other cell growth/growth-control mechanisms are involved in naevogenesis and melanomagenesis. Immunoexpression of BRAF/V600E and other molecules (p16, phosphatase and tensin homologue (PTEN), Ki67, hTERT and Cav3.1 and 3.2 calcium channels) were investigated in 80 histopatho-logically and dermoscopically classified acquired naevi. Regarding BRAF/V600E, dysplastic naevi showed lower immunostaining than common naevi, which was significant in comparison with intradermal naevi, which showed the highest BRAF/V600E histoscore. Junctional naevi showed the lowest BRAF/V600E levels. Globular/cobblestone and reticular dermoscopic patterns were consistently associated with high and low BRAF/V600E immunoexpression, respectively, but Zalaudek's peripheral globule pattern (CR/PG) showed the highest BRAF/V600E immunoexpression. Among global patterns, the previously not investigated multicomponent pattern showed the lowest BRAF/V600E immunoexpression. Regarding the remaining biomarkers, new immunohistochemical features were found, in particular p16 and PTEN low expression in multicomponent pattern; and Ki67, hTERT and Cav.3.1 high expression in CR/PG. In conclusion, histopathology and dermoscopy provide complementary information regarding the biology of melanocytic naevi.

Molecular and functional analyses support a role of Ornithine-{delta}-aminotransferase in the provision of glutamate for glutamine biosynthesis during pine germination.

We report the molecular characterization and functional analysis of a gene (PsdeltaOAT) from Scots pine (Pinus sylvestris) encoding Orn-delta-aminotransferase (delta-OAT; EC 2.6.1.13), an enzyme of arginine metabolism. The deduced amino acid sequence contains a putative N-terminal signal peptide for mitochondrial targeting. The polypeptide is similar to other delta-OATs from plants, yeast, and mammals and encoded by a single-copy gene in pine. PsdeltaOAT encodes a functional delta-OAT as determined by expression of the recombinant protein in Escherichia coli and analysis of the active enzyme. The expression of PsdeltaOAT was undetectable in the embryo, but highly induced at early stages of germination and seedling development in all different organs. Transcript levels decreased in later developmental stages, although an increase was observed in lignified stems of 90-d-old plants. An increase of delta-OAT activity was observed in germinating embryos and seedlings and appears to mirror the observed alterations in PsdeltaOAT transcript levels. Similar expression patterns were also observed for genes encoding arginase and isocitrate dehydrogenase. Transcripts of PsdeltaOAT and the arginase gene were found widely distributed in different cell types of pine organs. Consistent with these results a metabolic pathway is proposed for the nitrogen flow from the megagametophyte to the developing seedling, which is also supported by the relative abundance of free amino acids in embryos and seedlings. Taken together, our data support that delta-OAT plays an important role in this process providing glutamate for glutamine biosynthesis during early pine growth.

La atención de los varones en el espacio público de la salud en México Distrito Federal desde la mirada género sensible y sociosanitaria / Male attention in the public health space in México Federal District from a gender sensible and socio-sanitary perspective / Atenção dos homens no espaço público de saúde no México Distrito Federal desde um olhar gênero sensível e sócio-sanitário

El trabajo aborda las prácticas institucionales del personal de salud del sistema público de atención en la Secretaría de Salud del Gobierno del Distrito Federal (SSGDF) en varios hospitales de la red, forma parte de un trabajo más amplio, que constituye una tesis doctoral que se llevó a cabo entre 2003 y 2008 en la Ciudad de México. En esta ocasión se hace particular énfasis en el análisis y discusión de los hallazgos encontrados alrededor de la atención en salud a varones hetero y homosexuales, tanto en la población atendida como en la situación laboral del personal de salud identificada como homosexual prestando el servicio. Desde una mirada género sensible se puede concluir que ser hombre es un factor de riesgo para la atención y el cuidado de la salud y la prevención de la enfermedad; que, con población masculina hetero y homosexual, prevalecen los prejuicios sociales más que la preparación, desarrollo de habilidades y capacidades de atención de la problemática específicamente masculina dentro de los servicios. La exclusión, la discriminación, la desinformación muestran que el bagaje anatomofisiológico y la técnica quirúrgica o el conocimiento farmacéutico no son suficientes para brindar atención de calidad que hagan verdaderamente integrales las prácticas institucionales de salud llevadas a cabo por hombres y mujeres en el Sistema Público de atención de la Secretaría de Salud del Gobierno del Distrito Federal en México.

This article discusses the institutional practices of the health personnel from the public attention system from the Department of Health of the Federal District Government (SSGDF) in varioushospitals. The article is also part of a broader study, which constitutes a doctoral dissertation carried out between 2003 and 2008 in the city of Mexico. The study emphasizes analysis and discussions about the findings regarding health care to hetero and homosexual males, in both the population served, as well as people identified as homosexual within the personnel offering the health services. Concluding, from a gender sensitive perspective, being a male is a risk factorin health care and attention, as well as in disease prevention. Social prejudice still prevails with the hetero and homosexual male population, more than preparation and development ofattention skills specific to the male problem within health services. Exclusion, discrimination, and lack of information illustrate that the anatomy-physiologic burden and surgical technique or pharmaceutical knowledge are not enough to provide quality care. Care that could make the institutional health practices of the Department of Health of the Federal District Government in Mexico, truly comprehensive.

Autotransfusión en cirugía de escoliosis 1987-1988 Hospital del Niño / Autotransfusion in Surgery of Scoliosis 1987-1988 Hospital del Niño

En este trabajo se informa sobre 4 pacientes intervenidos quirúrgicamente por escoliosis en los que se utilizó el método de hemodilución como alternativa a la transfusión sanguínea homóloga por los múltiples inconvenientes que esta última presenta. Se evalúa la eficacia de la hemodilución como método seguro y económico en este tipo de cirugía en que se espera grandes pérdidas de sangre

Autotransfusion

En este trabajo se reporta un caso en el cual se usó el método de autotransfusión en lugar de la transfusión de sangre homóloga durante la extirpación de un tumor abdominal gigante (Wilms), llevando un estricto control de los parámetros sanguíneos con énfasis en el nivel de hemoglobina y hematocrito antes, durante y después de la operación. Se hace una evaluación de los peligros de una transfusión de sangre homóloga, sobre todo ahora con la amenaza del S.I.D.A., en comparación con las ventajas de los diferentes métodos de autotransfusión como una alternativa en las intervenciones quirúrgicas