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1.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(4): 205-218, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35523467

RESUMEN

In diabetes mellitus (DM) patients retinal complications were typically considered part of a vascular process. Recent research suggests that retinal degeneration in DM might also be caused by a neuropathy that could precede microvascular alterations. The present work reviews the currently available bibliography about neurodegeneration in patients with type 2 DM (DM2) without diabetic retinopathy (DR). In patients with non-severe, early DM2 without DR and good metabolic control visual function parameters show early abnormalities that precede clinical DR (in which we diagnose with a conventional ophthalmological examination). Using optical coherence tomography (OCT) technology, a reduction in macular and peripapillary thickness has been observed in different studies. Recent researches suggest that systemic complications (especially ischaemia) and a possible microvascular alteration eventually contributes to retinal neurodegeneration, which opens the door to new studies that include new techniques for evaluating the microvascularization of the retinal layers.


Asunto(s)
Diabetes Mellitus Tipo 2 , Retinopatía Diabética , Diabetes Mellitus Tipo 2/complicaciones , Retinopatía Diabética/complicaciones , Retinopatía Diabética/etiología , Humanos , Retina , Tomografía de Coherencia Óptica/métodos , Visión Ocular
2.
Clin Transl Oncol ; 23(9): 1794-1800, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33730312

RESUMEN

AIM: Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) are essential tools in radiation oncology. In Spain, the use of these techniques continues to grow as older linear accelerators (linacs) are replaced with modern equipment. However, little is known about inter-centre variability in prescription and dose heterogeneity limits. Consequently, the SBRT-Spanish Task Group (SBRT-SG) of the Spanish Society of Radiation Oncology (SEOR) has undertaken an initiative to assess prescription and homogeneity in SRS/SBRT treatment. In the present study, we surveyed radiation oncology (RO) departments to obtain a realistic overview of prescription methods used for SBRT and SRS treatment in Spain. METHODS: A brief survey was developed and sent to 34 RO departments in Spain, mostly those who are members of the SEOR SBRT-SG. The survey contained seven questions about the specific prescription mode, dose distribution heterogeneity limits, prescription strategies according to SRS/SBRT type, and the use of IMRT-VMAT (Intensity Modulated Radiation Therapy-Volumetric Modulated Arc Therapy). RESULTS: Responses were received from 29 centres. Most centres (59%) used the prescription criteria D95% ≥ 100%. Accepted dose heterogeneity was wide, ranging from 107 to 200%. Most centres used IMRT-VMAT (93%). CONCLUSIONS: This survey about SRS/SBRT prescription and dose heterogeneity has evidenced substantial inter-centre variability in prescription criteria, particularly for intended and accepted dose heterogeneity. These differences could potentially influence the mean planning target volume dose and its correlation with treatment outcomes. The findings presented here will be used by the SEOR SBRT-SG to develop recommendations for SRS/SBRT dose prescription and heterogeneity.


Asunto(s)
Encuestas de Atención de la Salud/estadística & datos numéricos , Oncología por Radiación/normas , Radiocirugia/métodos , Dosificación Radioterapéutica/normas , Humanos , Prescripciones/normas , Radioterapia de Intensidad Modulada/estadística & datos numéricos , Sociedades Médicas , España
3.
Sci Total Environ ; 721: 137702, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32169645

RESUMEN

Suspended particulate matter (SPM) measurements and backward air mass trajectory analysis using the HYSPLIT model were performed to better understand the main sources and transport pathways of heavy metals in atmospheric aerosols reaching the Antarctic region. Field campaigns were carried out during the austral summer 2016-2017 at the "Gabriel de Castilla" Spanish Antarctic Research Station, located on Deception Island. Aerosols were deposited in an air filter through a low-volume sampler and chemically analysed using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The study of air masses and high enrichment factor values of several elements (Hf, Zr, As, Cu, Sn, Zn, Pb) together with their correlations (Hf/Zr, V/As, Ti/Mn and Cu/Sn) suggests a potentially significant role of three main sources in this area: remote maritime traffic, local petrol combustion (generators and/or tourist cruises), and remote/local crust. Additionally, the investigation of atmospheric flow patterns through backward trajectory analysis revealed that Hf/Zr correlation was related to a remote crustal origin, V/As to anthropogenic local pollution, Ti/Mn to terrestrial inputs on the island and Cu/Sn to remote anthropogenic sources. Overall, the present study demonstrates the existence of anthropogenic pollution at this remote site from distant as well as local sources following the Antarctic circumpolar wind pattern.

4.
Sci Total Environ ; 665: 125-132, 2019 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-30772541

RESUMEN

The present work reports on the analysis of atmospheric aerosols in the Antarctic region, Deception Island, collected during austral summer 2016-2017 by field measurements carried from Gabriel de Castilla Spanish Research Station. A low-volume sampler was used to capture the aerosols depositing them onto the air filters. A chemical analysis of the samples using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) and Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES) provided the total carbon (TC), organic carbon (OC), elemental Carbon (EC) and elements such as Al, Ca, Fe, K, Mg, Na, P, S, Cu, Pb, Sr, Ti, Zn and Cr. The average mass concentration of particulate matter (PM10) originated by natural and anthropogenic activities was calculated as 10 ±â€¯4 µg/m3, although values such as 28.2 µg/m3 were also obtained which is very high even when compared to other places in the coast of the Antarctic region. In addition, high enrichment factors have been found for elements such as Pb, Cr, Cu and Zn showing a remote anthropogenic contribution to particulate matter in this region. Correlations were found between Na, Mg, Ca, Al, Ti and S, where Na/Mg displayed the influence of marine environments, S correspond to volcanic activities, Ca to penguin colonies and influence of sea whereas Al/Ti indicated the crustal origin. Polar contour graphical maps were obtained from meteorological data using chemometrics methods, which allowed reproducing wind maps revealing the distribution of the aerosols and possible emission sources of different elements in the area. Given that this island has not been previously studied for atmospheric contamination, this work provides an interesting insight about the site-specific characteristics of particulate matter.

5.
J Hum Nutr Diet ; 32(4): 468-479, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-30663156

RESUMEN

BACKGROUND: The influence of nutrition on breast cancer prognosis is still inconclusive and therefore dietary interventions incorporating dietary biomarkers are needed to confirm compliance with dietary goals and clarify biological mechanisms. The present study assessed whether a lifestyle intervention in breast cancer survivors could affect dietary biomarkers of fruit and vegetables and fatty acids. METHODS: In this phase II single-arm trial, 37 overweight/obese early stage breast cancer patients completed a 12-week diet and exercise intervention. The intervention involved 1-h weekly diet sessions delivered by a dietician and 75-min bi-weekly physical activity sessions of moderate-to-high intensity led by trained monitors. Before and after the intervention, three 24-h dietary recalls were carried out to calculate nutrient intakes and, in addition, blood samples were taken to measure plasma carotenoids, vitamin E and retinol concentrations and erythrocyte membrane fatty acid (EFA) composition. Wilcoxon signed rank tests were used to assess changes in dietary and biomarkers measurements over the intervention period. RESULTS: After the intervention, there was a significant increase in the intake of dietary carotenoids (+15.1% compared to baseline) but not plasma carotenoids levels (+6.3%). Regarding the EFA levels, we observed a significant decrease in percentage of saturated fatty acids (-1.4%) and n-6 polyunsaturated fatty acids (-2.9%) and an increase in monounsaturated fatty acids (1.7%) and total and long-chain n-3 polyunsaturated fatty acids (by 13.1% and 13.7%, respectively). A favourable decrease in the ratio of long-chain n-6 to n-3 polyunsaturated fatty acids (-9.1%) was also observed. CONCLUSIONS: After a short-term diet and exercise intervention in overweight/obese breast cancer survivors, we observed significant changes in dietary nutrients and fatty acid biomarkers, suggesting positive dietary changes that could be relevant for breast cancer prognosis.


Asunto(s)
Neoplasias de la Mama/sangre , Carotenoides/sangre , Dieta/métodos , Membrana Eritrocítica/metabolismo , Ácidos Grasos/análisis , Estilo de Vida , Adulto , Biomarcadores/sangre , Neoplasias de la Mama/complicaciones , Supervivientes de Cáncer/psicología , Dieta/psicología , Ingestión de Energía , Ejercicio Físico , Femenino , Humanos , Persona de Mediana Edad , Obesidad/sangre , Obesidad/complicaciones , Obesidad/terapia , Sobrepeso/sangre , Sobrepeso/complicaciones , Sobrepeso/terapia , Cooperación del Paciente , Resultado del Tratamiento , Adulto Joven
6.
Ann Oncol ; 29(suppl_2): ii1-ii9, 2018 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-29506228

RESUMEN

Body composition, defined as the proportions and distribution of lean and fat tissues in the human body, is an emergent theme in clinical oncology. Severe muscle depletion (sarcopenia) is most easily overlooked in obese patients; the advent of secondary analysis of oncologic images provides a precise and specific assessment of sarcopenia. Here, we review the definitions, prevalence and clinical implications of sarcopenic obesity (SO) in medical and surgical oncology. Reported prevalence of SO varies due to the heterogeneity in the definitions and the variability in the cut points used to define low muscle mass and high fat mass. Prevalence of SO in advanced solid tumor patient populations average 9% (range 2.3%-14.6%) overall, and one in four (24.7%, range 5.9%-39.2%) patients with body mass index ≥ 30 kg/m2 are sarcopenic. SO is independently associated with higher mortality and higher rate of complications in systemic and surgical cancer treatment, across multiple cancer sites and treatment plans. These associations remain unexplained, however, it has been hypothesized that patients with sarcopenia are generally unfit and unable to tolerate stress. Another proposed mechanism relates to increased exposure to antineoplastic therapy, i.e. a large fat mass would be expected to inflate drug dose in BSA-based treatments, causing an increased rate of dose-limiting toxicity. Pharmacokinetic data are needed to confirm or refute this hypothesis. Old age, deconditioning, cancer progression, acute or chronic nonmalignant disease and drug side-effects are suggested causes of muscle loss, and it is unknown the degree to which this can be reversed. Sarcopenia can be readily detected before start of cancer treatment, however, clinical management protocols for SO patients require development. Studies of cancer treatment dose-modulation are in progress.


Asunto(s)
Neoplasias/terapia , Obesidad/epidemiología , Complicaciones Posoperatorias/epidemiología , Sarcopenia/epidemiología , Antineoplásicos/efectos adversos , Composición Corporal/efectos de los fármacos , Composición Corporal/efectos de la radiación , Índice de Masa Corporal , Quimioradioterapia/efectos adversos , Quimioradioterapia/métodos , Ensayos Clínicos como Asunto , Humanos , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/efectos de la radiación , Terapia Neoadyuvante/efectos adversos , Terapia Neoadyuvante/métodos , Neoplasias/complicaciones , Neoplasias/mortalidad , Obesidad/etiología , Complicaciones Posoperatorias/etiología , Prevalencia , Sarcopenia/etiología , Procedimientos Quirúrgicos Operativos/efectos adversos , Análisis de Supervivencia
7.
Ann Oncol ; 29 Suppl 2: ii1-ii9, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32169202

RESUMEN

Body composition, defined as the proportions and distribution of lean and fat tissues in the human body, is an emergent theme in clinical oncology. Severe muscle depletion (sarcopenia) is most easily overlooked in obese patients; the advent of secondary analysis of oncologic images provides a precise and specific assessment of sarcopenia. Here, we review the definitions, prevalence and clinical implications of sarcopenic obesity (SO) in medical and surgical oncology. Reported prevalence of SO varies due to the heterogeneity in the definitions and the variability in the cut points used to define low muscle mass and high fat mass. Prevalence of SO in advanced solid tumor patient populations average 9% (range 2.3%-14.6%) overall, and one in four (24.7%, range 5.9%-39.2%) patients with body mass index ≥ 30 kg/m2 are sarcopenic. SO is independently associated with higher mortality and higher rate of complications in systemic and surgical cancer treatment, across multiple cancer sites and treatment plans. These associations remain unexplained, however, it has been hypothesized that patients with sarcopenia are generally unfit and unable to tolerate stress. Another proposed mechanism relates to increased exposure to antineoplastic therapy, i.e. a large fat mass would be expected to inflate drug dose in BSA-based treatments, causing an increased rate of dose-limiting toxicity. Pharmacokinetic data are needed to confirm or refute this hypothesis. Old age, deconditioning, cancer progression, acute or chronic nonmalignant disease and drug side-effects are suggested causes of muscle loss, and it is unknown the degree to which this can be reversed. Sarcopenia can be readily detected before start of cancer treatment, however, clinical management protocols for SO patients require development. Studies of cancer treatment dose-modulation are in progress.

8.
Oral Oncol ; 71: 67-74, 2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28688694

RESUMEN

OBJECTIVE: The purpose of the study is to evaluate changes in body composition and nutritional status that occur throughout the oncological treatment in head and neck cancer patients. METHODS: A prospective cohort observational study in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) that underwent treatment with induction chemotherapy (iCT) followed by chemoradiotherapy or bioradiotherapy were invited to participate. All patients had dietetic counseling from the diagnosis and a close monitoring throughout the treatment implementing nutritional support as needed. RESULTS: From June 2011 until October 2012, 20 patients were included. Nutritional and anthropometric parameters were collected at diagnosis, post iCT, after radiotherapy, 1 and 3months post radiotherapy. According to Patient Generated Subjective Global Assessment, 30% of patients were malnourished at diagnosis. After iCT there was an increase in weight, body mass index (BMI) and fat free mass (FFM) with almost complete improvement in dysphagia and odynophagia. Nevertheless a significant nutritional deterioration (p=0.0022) occurred at the end of radiotherapy with 95% of patients becoming severe or moderate malnourished. Nutritional parameters such as weight, BMI and hand grip strength also decrease significantly during treatment. CONCLUSIONS: Despite an intensive nutritional support from the diagnosis throughout the oncological treatment in advanced HNSCC cancer patients, nutritional status deteriorates during radiotherapy. Our findings suggest that iCT may help improve nutritional status by ameliorating the symptoms that limit the oral intake. This improvement in the nutritional status could contribute to minimize further deterioration. Further investigations are needed involving novel approaches to avoid nutritional deterioration.


Asunto(s)
Carcinoma de Células Escamosas/fisiopatología , Quimioradioterapia , Neoplasias de Cabeza y Cuello/fisiopatología , Estado Nutricional , Índice de Masa Corporal , Carcinoma de Células Escamosas/terapia , Femenino , Neoplasias de Cabeza y Cuello/terapia , Humanos , Quimioterapia de Inducción , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello
9.
Actas Urol Esp ; 41(10): 646-651, 2017 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-28739142

RESUMEN

INTRODUCTION AND OBJECTIVE: There is growing interest in the use of more aggressive therapeutic modalities for treating metastatic prostate cancer. In this study, we examine the use of stereotactic body radiation therapy (SBRT) for patients with oligorecurrent prostate cancer. We analysed the biochemical response and toxicity of patients who underwent this therapy at our centre. MATERIAL AND METHOD: We selected patients who experienced oligorecurrence between January 2015 to December 2016 and were administered SBRT. The association of androgen deprivation (AD) was left in each case to the decision of the tumour committee. We describe the clinical situation at diagnosis of oligorecurrence, the treatment administered and the biochemical response. We considered a biochemical response to be a 50% reduction in the absolute prostate-specific antigen (PSA) readings. RESULTS: SBRT was administered to 11 patients with bone (82%) and/or lymph node oligometastasis (18%). The treatment regimen for bone oligometastasis was 27Gy divided into 3 sessions, while the treatment for lymph node oligometastasis reached 70Gy. Seven patients had no treatment at the time of diagnosis, 2 were in the castration-resistant phase, 1 patient was in the off phase of intermittent AD, and 1 patient had adjuvant AD for pN1. Seven patients presented a biochemical response with a PSA reduction of 75-100%. The response was not assessable in 4 patients due to the continuing adjuvant AD. With a mean follow-up of 10.5 months, only 2 patients had progressed. Grade 1 gastrointestinal toxicity was detected in only 1 patient. CONCLUSION: Our data suggest that the use of SBRT in carefully selected patients with metastatic oligorecurrence of prostate cancer can achieve biochemical response and potentially delay progression and the use of systemic treatments.


Asunto(s)
Recurrencia Local de Neoplasia/radioterapia , Neoplasias de la Próstata/radioterapia , Anciano , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/sangre , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Radiocirugia/efectos adversos , Resultado del Tratamiento
11.
Arch Soc Esp Oftalmol ; 91(3): 108-13, 2016 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-26743186

RESUMEN

OBJECTIVE: To evaluate the anesthetic block provided by contact topical anesthesia (CTA) in strabismus surgery in adult patients. To analyze postoperative pain and surgical outcome obtained by CTA compared with general anesthesia (GA). METHODOLOGY: Prospective longitudinal cohort study of adult patients undergoing strabismus surgery by CTA or GA. The intensity of pain perceived by patients during the course of surgery and in the postoperative period was measured using Numerical Pain Scale. The success of the surgical outcome, considered as a residual ocular deviation<10 prism diopters, was evaluated. RESULTS: Twenty-three patients were operated using CTA and 26 using AG. During the course of surgery, pain intensity experienced by patients in ATC group was 3.17±2.44. There were no differences between CTA group and AG group in the intensity of pain in the immediate postoperative period (2.13±2.39 vs. 2.77±2.18, respectively; P=.510) and during the first postoperative day (3.22±2.84 vs. 3.17±2.73; P=.923). Surgical success was significantly higher in the CTA group than in the GA group (78.3 vs. 73.1%; P=.019). CONCLUSIONS: CTA provides adequate sensory block to perform strabismus surgery. The control of postoperative pain is similar to that obtained with AG. Conservation of ocular motility providing CTA enables better surgical outcome.


Asunto(s)
Anestesia General , Anestesia Local , Dolor Postoperatorio , Estrabismo/cirugía , Adulto , Anestésicos Locales , Humanos , Estudios Prospectivos
12.
Rev Esp Anestesiol Reanim ; 62(5): 265-9, 2015 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-25217143

RESUMEN

OBJECTIVE: To analyze the effectiveness and usefulness of contact topical anesthesia in strabismus surgery in adult patients. MATERIAL AND METHODS: A prospective study was conducted on 20 patients undergoing strabismus surgery using contact topical anesthesia and sedation with remifentanil. The intensity of pain was recorded using a numeric pain rating scale at the time of anesthesia implementation, during the surgical procedure, 30 min afterwards, and during the first postoperative day. The incidence of oculocardiac reflex, postoperative nausea and vomiting, corneal ulcers, patient satisfaction (numerically from 0 to 10) and the degree of residual ocular deviation were also assessed. RESULTS: The operation was performed successfully in all patients. Average pain intensity was 1.40 ± 1.73 during anesthesia implementation, 4.20 ± 2.57 during the surgical procedure, 2.50 ± 2.54 30 min after surgery, and 3.55 ± 2.89 during the first postoperative day. Oculocardiac reflex was observed in 7 patients (35%), postoperative nausea and vomiting in 4 (20%), and corneal ulcer in 4 (20%). The patient satisfaction was 9.53 ± 2.51. More than two-thirds (70%) of patients had a residual ocular deviation less than 10 prism diopters. CONCLUSIONS: Contact topical anesthesia is a safe and effective alternative for strabismus surgery in adult patients. Contact topical anesthesia provides adequate pain control, lower incidence of postoperative nausea and vomiting and oculocardiac reflex, and optimal setting of ocular alignment.


Asunto(s)
Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Estrabismo/cirugía , Administración Oftálmica , Adulto , Anciano , Anciano de 80 o más Años , Bupivacaína/administración & dosificación , Sedación Consciente , Úlcera de la Córnea/complicaciones , Femenino , Humanos , Hipnóticos y Sedantes/uso terapéutico , Lidocaína/administración & dosificación , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Satisfacción del Paciente , Piperidinas/uso terapéutico , Náusea y Vómito Posoperatorios/epidemiología , Náusea y Vómito Posoperatorios/etiología , Estudios Prospectivos , Reflejo Oculocardíaco , Remifentanilo , Estrabismo/complicaciones , Resultado del Tratamiento , Adulto Joven
13.
Med Oncol ; 31(1): 783, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24310809

RESUMEN

Energy restriction from a low-calorie diet and increased energy expenditure induced by physical activity (PA) could promote weight loss/maintenance and be important determinants of breast cancer (BC) prognosis. The aim of this study was to assess participation and adherence of overweight and obese BC survivors to a lifestyle intervention and to demonstrate the capacity of this intervention to induce weight loss and nutritional changes. This single-arm pre-post study, which involved one-hourly weekly diet sessions delivered by a dietician and 75-min bi-weekly PA sessions of moderate-to-high intensity led by PA monitors, was offered to overweight and obese BC survivors shortly after treatment. Before and after the intervention, anthropometry, dietary information, quality of life (QoL) and cardiorespiratory fitness (CRF) were collected. A total of 112 BC survivors were invited to participate: 42 of them started the intervention and 37 completed it. Participants attended more than 90 % of the sessions offered and showed a significant weight loss of 5.6 ± 2.0 kg, as well as significant decreases in body mass index, fat mass and waist circumference. Significant decreases in total energy (-25 %), fat (-35 %), saturated fat (-37 %) and carbohydrate (-21 %) intakes were observed while QoL and CRF showed significant increases. This feasibility study demonstrated the success of a short-term diet and PA intervention to induce weight loss and promote healthful changes in BC survivors. Assessing the long-term effects of these changes, and in particular their possible impact of BC prognosis, and designing interventions reaching a wider number of BC survivors are still issues to be addressed.


Asunto(s)
Neoplasias de la Mama/fisiopatología , Dieta , Terapia por Ejercicio , Obesidad/complicaciones , Sobrepeso , Adulto , Anciano , Antropometría , Índice de Masa Corporal , Peso Corporal , Neoplasias de la Mama/terapia , Sistema Cardiovascular , Estudios de Evaluación como Asunto , Estudios de Factibilidad , Femenino , Humanos , Estilo de Vida , Persona de Mediana Edad , Ciencias de la Nutrición , Obesidad/terapia , Cooperación del Paciente , Pronóstico , Calidad de Vida , Sobrevivientes , Programas de Reducción de Peso
15.
Nutr Hosp ; 28(1): 155-63, 2013.
Artículo en Español | MEDLINE | ID: mdl-23808444

RESUMEN

INTRODUCTION: Patient Generated Subjective Global Assessment (PG-SGA) is a validated tool for nutrition evaluation in patients with cancer. AIM: The aim of our study was to estimate the prevalence of malnutrition in head and neck cancer patients at diagnosis and evaluate the independent prognostic factors for malnutrition from PG-SGA. MATERIAL AND METHODS: All outpatients attending at the Head and Neck Cancer Multidisciplinary Meeting for primary diagnosis, staging and treatment were evaluated by an oncology dietitian using the patient generated subjective global assessment (PG-SGA). Patients with recurrences or secondary tumours will be excluded. RESULTS: 64 patients were evaluated (55 men and 9 women) with an average age of 63 years and body mass index (BMI) of 25.3 kg/m(2) (SD ± 5.18). After the nutritional assessment we observed that 43.8% of patients were malnourished or at risk of malnutrition. The most frequent symptom at diagnosis was dysphagia (48.4%) and anorexia (26.6%). From PG-SGA, the main prognostic factors (p<0,001) were the percentage of weight loss, serum albumin levels, BMI and the presence of dysphagia or/and anorexia prior diagnosis. CONCLUSIONS: Parameters as BMI, weight loss and low albumin levels at the time of diagnosis in head and neck cancer patients are independent predictors for malnutrition as well as the presence of anorexia or dysphagia.reaffirms the need for sustainability of interventions over time.


Introducción: La valoración global subjetiva generada por el paciente (VGS-GP) es una herramienta validada para la valoración nutricional de los pacientes oncológicos. Objetivo: El objetivo de nuestro estudio es conocer la prevalencia de desnutrición de los pacientes con cáncer de cabeza y cuello en el momento del diagnóstico y evaluar los factores pronósticos independientes de desnutrición a partir de la VGS-GP. Material y métodos: Todos los pacientes ambulatorios que fueron evaluados por el Comité de Tumores de Cabeza y Cuello para diagnóstico primario, estadiaje y decisión terapéutica fueron evaluados a través de la VGSGP. Se excluyeron recidivas tumorales y segundas neoplasias. Resultados: Se evaluaron 64 pacientes (55 hombres y 9 mujeres) con una edad media de 63 2013s y un índice de masa corporal (IMC) de 25,3 kg/m2. Después de realizar la VGS-GP se observó que el 43,8% presentaban desnutrición o riesgo de padecerla. Los síntomas más frecuentes en el momento del diagnóstico fueron la disfagia (48,4%) y la anorexia (26.6%). Dentro de la VGS-GP, los principales factores pronósticos (p<0,001) fueron el porcentaje de pérdida de peso, los niveles de albúmina, el valor del IMC y la presencia de disfagia y/o anorexia. Conclusiones: Parámetros como el IMC, la pérdida de peso y las cifras de albúmina en el momento del diagnóstico de cáncer de cabeza y cuello, son factores predictivos independientes para el diagnóstico de desnutrición, así como la presencia de anorexia o disfagia.


Asunto(s)
Neoplasias de Cabeza y Cuello/complicaciones , Desnutrición/etiología , Anorexia/etiología , Índice de Masa Corporal , Trastornos de Deglución/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Pronóstico , Pérdida de Peso
18.
J Chromatogr A ; 1232: 158-65, 2012 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-22186492

RESUMEN

A method for the analysis of serotonin (5-HT) and its precursors, 5-hydroxytryptophan (5-HTP) and l-tryptophan (TP) in chocolate samples by capillary liquid chromatography-mass spectrometry (cLC-MS) has been developed. Optimum chromatographic conditions were established by using a personalized multifactorial experimental design. Finally the cLC separation was achieved through a mixture of acetonitrile and 5mM ammonium formate at pH 4 (3:97, v/v) as mobile phase in gradient elution, setting the injection volume at 10 µL and using pure water as injection solvent for focusing purposes on the head of the capillary column. For extraction of targets in chocolate samples a new, fast and simple procedure based on the use of acidic extraction medium and sonication was developed. Working in selected ion mode (m/z 177 for 5-HT, m/z 205 for l-tryptophan and m/z 221 for 5-HTP) detection limits were between 0.01 and 0.11 µg g(-1) and linearity was in the concentration range of 0.5-25 µg g(-1). Recoveries higher than 76% with RSDs lower than 8% were obtained from spiked samples for all analytes, showing the effectiveness of the proposed method. Serotonin and its precursors were determined in 5 kinds of commonly consumed chocolates with different cocoa contents (70-100%). The highest serotonin content was found in chocolate with a cocoa content of 85% (2.93 µg g(-1)). Regarding l-tryptophan, the highest content of this amino acid (13.27-13.34 µg g(-1)) was found in chocolate samples with the lowest cocoa content (70-85%). 5-Hydroxytryptophan was not detected in any chocolate samples.


Asunto(s)
Cacao/química , Cromatografía Liquida/métodos , Espectrometría de Masas/métodos , Serotonina/análisis , 5-Hidroxitriptófano/análisis , Límite de Detección , Reproducibilidad de los Resultados , Triptófano/análisis
19.
Actas Urol Esp ; 35(6): 339-44, 2011 Jun.
Artículo en Español | MEDLINE | ID: mdl-21481974

RESUMEN

INTRODUCTION: We review the experience with prostate carcinoma patients treated with permanent implants of 125-I seeds and the outcome eight years after the beginning of this technique. MATERIAL AND METHODS: From 2002 to 2007 we have performed 250 implants with LDR brachytherapy with RapidStrand(®) and preplanning system. Mean age was 68 (49-78). Mean PSA was 7.32 (2.31 - 14.6). T1-T2a was the stage in 98%, and Gleason ≤ 6 in 96%. Low risk cases were 81% and intermediate risk 19% (ten of them received 46 Gy EBRT). Hormonal treatment was used in 42%. RESULTS: With a mean follow-up of 48 months, 14 patients (5.7%) showed biochemical failure (BF). Eleven patients (4.5%) with theoretical BF were observed and PSA decreased without treatment. Actuarial PSA relapse-free survival at 5 years was 91%, (92% low risk, 86% intermediate cases), and 92% vs 81% with PSA <10 vs >10 (p<0.05). Rectum complications were G2 in 0.6%. A urinary catheter was necessary in 6.5%. Sexual function was conserved in 60%. Mean V100 was 89% and D90 143 Gy. CONCLUSION: The outcome of patients with low risk prostate carcinoma treated with I-125 seed is very good with very low complications rate. Cases with PSA bounces should be controlled before starting a salvage treatment.


Asunto(s)
Adenocarcinoma/radioterapia , Braquiterapia , Radioisótopos de Yodo/uso terapéutico , Neoplasias de la Próstata/radioterapia , Planificación de la Radioterapia Asistida por Computador , Adenocarcinoma/sangre , Adenocarcinoma/tratamiento farmacológico , Anciano , Anilidas/uso terapéutico , Antineoplásicos Hormonales/uso terapéutico , Terapia Combinada , Sistemas de Computación , Humanos , Radioisótopos de Yodo/administración & dosificación , Masculino , Persona de Mediana Edad , Nitrilos/uso terapéutico , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/tratamiento farmacológico , Radiografía Intervencional , Estudios Retrospectivos , Compuestos de Tosilo/uso terapéutico , Resultado del Tratamiento
20.
Anal Bioanal Chem ; 400(10): 3547-60, 2011 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21487707

RESUMEN

In this paper, the enantiomeric separation of two aryloxyphenoxypropionic esters (fluazifop-butyl and quizalofop-ethyl) and a safener herbicide (mefenpyr-diethyl), which is widely used for protecting crop plants, has been studied by direct liquid chromatography (LC) with UV detection on an α(1)-acid glycoprotein as chiral stationary phase. Optimization of separation conditions was done by factorial experimental design. Experimental factors and ranges selected were propanol (5-10%), phosphate buffer pH (6.5-7.0), and column temperature (15-25 °C). Responses were expressed in terms of enantioresolution (R(s)) and adjusted retention time of the second eluted enantiomer (t(r2)'). The chemometric method used to explore data was response surface analysis. Multiple response analyses were carried out to determine the combination of experimental factors which simultaneously optimize experimental responses. Under optimum conditions for enantioseparation of each herbicide, partially overlapped or fully resolved enantiomers were obtained. Deconvolution tools were employed as an integration method to fit chromatographic data and to achieve a more precise enantiomeric ratio (ER) and enantiomeric fraction (EF) values. Applicability of both direct chiral LC and peak deconvolution methods was evaluated in spiked soil samples at different R/S enantiomeric ratios. Acceptable and reproducible recoveries between 71% and 96% with precision in the range 1-6% were achieved for herbicide-spiked levels from 0.50 to 9.0 µg g(-1). In addition, parameters such as R(s), ER, and EF were calculated and compared with values obtained using the common valley drop integration method.


Asunto(s)
Cromatografía Liquida/métodos , Herbicidas/análisis , Contaminantes del Suelo/análisis , Propionatos/análisis , Reproducibilidad de los Resultados , Estereoisomerismo
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