Leisure Attitude, Self-Rated Health, and Psychological Well-Being in Older Adults: A Moderated Mediation Model.

Purpose: A positive leisure attitude among older adults may have a beneficial effect on psychological well-being, both directly and indirectly by fostering a more positive perception of one's health. This paper presents a correlational design that explores associations among leisure attitude, self-rated health, and psychological well-being, and analyzes the potential moderating role of gender in these relationships. Patients and Methods: The sample was selected using simple random probability sampling (N= 409; 61.9% female; Mean age = 72.9; SD = 8.43¸ Range of age 53 to 93 years). Diverse sociodemographic information was collected, and leisure attitudes, self-perceived health, and psychological well-being (positive affect and emotional ties) were assessed. Results: The results revealed a positive effect of leisure attitude on self-rated health and psychological well-being, with self-rated health fully mediating the association between the behavioral component of leisure attitude and psychological well-being. Furthermore, the moderating effect of gender on the relationship between self-rated health and psychological well-being was stronger among men. Conclusion: Positive cognitive and emotional perceptions of leisure among older adults seem to benefit psychological well-being and improve self-rated health, thereby contributing to healthy ageing.

Utilización de antibióticos en faringoamigdalitis aguda en la provincia de Albacete / Use of antibiotics in acute pharyngotonsillitis in the province of Albacete

Introducción: la faringoamigdalitis aguda (FAA) es una de las patologías más prevalentes en la población pediátrica y una de las principales causas de prescripción de antibióticos en este grupo de población. Material y métodos: estudio observacional, descriptivo de utilización de antibióticos en FAA. La muestra del estudio son todos los niños del área que durante los tres años del estudio han recibido la prescripción de un antibiótico como tratamiento de una FAA. Resultados: durante los tres años del proyecto se atendieron un total de 53 995 procesos de FAA, de los que 33 426 (61,9%) fueron tratados con antibióticos. Considerando los niños menores de 3 años, se atendieron un total de 10 901 procesos de FAA (20,2% del total de las FAA), de los que recibieron antibiótico 6494 (59,6%). En cuanto a la selección del antibiótico se utilizó preferiblemente penicilinas sensibles a betalactamasas (fenoximetilpenicilina, fenixometilpenicilina-benzatina) y amoxicilina: 60,3% el primer año, 60,9% el segundo y 66,8% el tercero; con menor uso de otros grupos antibióticos: amoxicilina-ácido clavulánico en 2475 procesos (18,2%) durante el primer año, 1754 (17,7%) durante el segundo y 1644 (16,6%) durante el tercero. También se observó menor uso de macrólidos: 2825 (20,7%) en el primer año del proyecto, 1933 (19,6%) en el segundo y 1419 (14,3%) en el último. Conclusión: el uso de amoxicilina-ácido clavulánico y de macrólidos está muy por encima de lo esperado si consideramos la baja prevalencia de estado de portador de Streptococccus pyogenes a nivel faríngeo o la baja prevalencia de alergia a penicilina en la población pediátrica (AU)

Introduction: acute tonsillitis is one of the most prevalent pathologies among the pediatric population and one of the leading causes of antibiotic prescribing in this group.Materials and methods: observational and descriptive study of the use of antibiotics in acute tonsillitis. We have included all the children from our health area who have been prescribed antibiotics as treatment of an acute tonsillitis during the three years of the study.Results: a total of 53,995 acute tonsillitis were diagnosed during the three years of the project, some of which, 33,426 (61.9%), were treated with antibiotics. In children under the age of 3 years, 10,901 cases of acute tonsillitis were diagnosed (20.2% of the tonsillitis), being treated with antibiotics 6,494 (59.6%).We have observed that the most prescribed antibiotics were beta-lactamase sensitive penicillins (phenoxymethylpenicillin, benzathine phenoxymethylpenicillin) and amoxicillin: 60.3% in the first year, 60.9% in the second one and 66.8% in the third year, meanwhile other groups of antibiotics were less commonly used: amoxicillin/clavulanic acid in 2,475 cases (18.2%) in the first year of the study, 1,754 (17.7%) in the second and 1,644 (16.6%) in the third one. Furthermore, a decreased use of macrolides has been observed: 2,825 (20.7%) in the first year, 1,933 (19.6%) in the second and 1,419 (14.3%) in the last one.Conclusions: the use of amoxicillin/clavulanic acid and macrolides is significantly above from what could be expected considering the low prevalence of carriers of Streptococcus pyogenes in the pharynx or of children allergic to penicillin. (AU)

Characteristics of RCTs focusing on health promotion in community samples: a scoping review protocol based on the d-CoSPICO framework.

INTRODUCTION: Developing the capabilities of individuals, groups and communities to enhance their health has received a great deal of attention in the literature. One essential source of results is evidence-based intervention programmes, which often involve a number of different variables. This paper describes a methodology for carrying out a scoping review that maps available evidence on randomised controlled trials focusing on health promotion intervention programmes. METHODS AND ANALYSIS: The scoping review protocol follows the general Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Joanna Briggs Institute guidelines. It also incorporates some modifications to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review flowchart and complements its methodological framework. This new format, called documents, Concept, Studies, Participants, Interventions, Comparator, and Outcomes (d-CoSPICO), guides the review sequence, which is represented in a flowchart. The search will focus on different sources of information using formal (searches in thematic -PubPsych, ERIC, MedLine, PsychINFO- and multidisciplinary databases -Academic Search Ultimate, Core Collection Web of Science, Scopus and ProQuest-, repositories and other websites), informal (contact with researchers), and retrospective (previous reviews on this topic) strategies to identify relevant publications until 2021, including grey literature. Coding, identification, selection, and data extraction will be carried out following the generation of a database in which each retrieved record's content (abstract and/or full text) can be analysed. The review is expected to be completed in 2023. ETHICS AND DISSEMINATION: Ethical approval is not required for this review. The d-CoSPICO framework and the results will be disseminated through (a) peer-reviewed publications; (b) presentations at scientific dissemination events and (c) training activities for applying this protocol.

Utilización de antibióticos en la población menor de 14 años / Use of antibiotics in the population aged less than fourteen years

Objetivo: obtener un mapa de prescripción de antibióticos por edades en procesos infecciosos, en el ámbito de la atención primaria en menores de 14 años. Material y métodos: estudio observacional, descriptivo, de utilización de medicamentos, realizado sobre la prescripción de antibióticos. La muestra del estudio son todos los niños del área que, durante el periodo del estudio (enero de 2017 a diciembre de 2019), han recibido la prescripción de un antibiótico. Se ha calculado el valor de los indicadores descritos en el programa de optimización de uso de antibióticos. Resultados: durante el 2017 el número total de antibióticos prescritos fue 28 030, un 12% y 14% más que en 2018 y 2019, respectivamente. En el año 2018 un 31,4% de la población estudiada recibió al menos la prescripción de un antibiótico al año, mientras que en el 2019 este valor fue 35,8%. En el caso de dos prescripciones al año, el valor fue 15,4% en 2018 y 14,4% en 2019. La prescripción del grupo de penicilinas sensibles a betalactamasas ha pasado de 1,7% en 2017 a 7,7% en 2019, mientras que en el grupo de los macrólidos ha sido a la inversa, pasando de 19,6% en 2017 a 14,9% en 2019. Conclusión: en este estudio se obtienen por primera vez indicadores cuantitativos y cualitativos de uso de antibióticos en edad pediátrica, en patología infecciosa prevalente. Se confirma el elevado consumo de antibióticos, especialmente en el grupo de 0-4 años, así como la mala selección de determinados grupos de antibióticos, como macrólidos y cefalosporinas, en patologías en las que no son de primera elección (AU)

Objective: to map antibiotic prescription for management of infections by age group in children aged less than 14 years at the primary care level.Patients and methods: observational descriptive study of medication use focused on antibiotic prescription. The study population corresponded to all children in our health care area that received antibiotic prescriptions during the study period (January 2017 to December 2019). We assessed the usefulness of the indicators described in the antibiotic use optimization programme.Results: in 2017, the total number of prescribed antibiotics was 28 030, 12% and 14% more than in 2018 and 2019, respectively. In 2018, 31.4% of the population under study received a prescription for at least one antibiotic per year, while in 2019 the percentage was 35.8%. When it came to children who received 2 prescriptions per year, the percentage was 15.4% in 2018 and 14.4 % in 2019. The prescription of beta-lactamase sensitive penicillins increased from 1.7 % in 2017 to 7.7% in 2019, while prescription of macrolides exhibited the opposite trend, decreasing from 19.6% in 2017 to 14.9% in 2019.Conclusion: this study is the first to obtain quantitative and qualitative indicators of antibiotic use in paediatric age for management of common infectious diseases. It confirmed the high consumption of antibiotics, especially in children under 4 years of age, in addition to the inappropriate use of certain groups of antibiotics, such as macrolides and cephalosporins, for diseases for which they are not the first-line treatment. (AU)

Perfil de efectividad y seguridad de la colchicina en pacientes con diagnóstico de COVID-19 en un área sanitaria / Efficacy and safety profile of colchsicine in patients diagnosed with COVID-19 in a healthcare area

Objetivo: describir la evolución y la seguridad de la utilización de colchicina en pacientes no ingresados con diagnóstico de COVID-19 leve-moderado en la Gerencia de Atención Integrada (GAI) de Albacete. Métodos: estudio observacional retrospectivo. De los 389 participantes incluidos en el primer reclutamiento, se seleccionaron 315 con datos válidos. La variable principal del estudio ha sido el fallecimiento o ingreso hospitalario en pacientes con diagnóstico de COVID-19 y tratamiento con colchicina. Se registraron variables sociodemográficas, clínicas y tratamientos y comorbilidades concomitantes. Resultados: fallecieron 6 (1,90%) pacientes y 49 (15,5%) requirieron ingreso hospitalario. A un 58,4% se les prescribió un antibiótico, siendo la azitromicina el más utilizado y el responsable en un 32,7% de las posibles interacciones. Un 34,5% y un 43% de pacientes recibieron heparinas de bajo peso molecular (HBPM) y corticosteroides respectivamente. En el 42,3% de pacientes no se tuvo en cuenta el valor del aclaramiento de creatinina al dosificar la colchicina. La edad elevada muestra una relación estadísticamente significativa con la gravedad de la clínica (68,5 versus 58,9) y con la variable recaída (ingreso + urgencias) (63,25 versus 58,54). Conclusiones: en nuestra muestra, la utilización de colchicina en pacientes ambulatorios no ha modificado el curso de la enfermedad en pacientes diagnosticados de COVID-19.(AU)

Objective: to describe the evolution and safety of the use of colchicine in outpatients with a diagnosis of mild-moderate COVID-19 in the Integrated Care Management of Albacete. Methods: retrospective observational study. Of the 389 participants included in the first recruitment, 315 subjects with valid data were selected. The main variable of the study has been death or hospital admission in patients diagnosed with COVID-19 and treatment with colchicine. Sociodemographic, clinical and treatment variables and concomitant comorbidities were recorded. Results: 6 (1.90%) patients died and 49 (15.5%) required hospital admission. 58.4% of the patients were prescribed an antibiotic, azithromycin being the most used and responsible for 32.7% of the interactions detected. 34.5% and 43% of the patients received LMWH and corticosteroids, respectively. In 42.3% of the patients, the value of creatinine clearance was not taken into account when dosing colchicine. High age shows a statistically significant relationship with the severity of the symptoms (68.5 vs 58.9) and with the variable relapse (admission + emergency room) (63.25 vs 58.54). Conclusions: in our sample, the use of colchicine in outpatients has not modified the course of the disease in patients diagnosed with COVID-19.(AU)

Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine.

OBJECTIVE: To analyze the incidence of Covid-19 in patients who are chronic users of hydroxychloroquine. PATIENTS AND METHODS: Cross-sectional retrospective observational multicenter study in health areas and districts from Castilla La-Mancha and Andalucia. Of the 4451 participants included in the first recruitment, 3817 with valid data were selected. The main variable of the study is the presence or absence of Covid-19 infection by clinical, serological or polymerase chain reaction diagnosis. Sociodemographic and clinical variables and treatment and concomitant comorbidities were recorded. RESULTS: 169 (4,45%) patients had Covid-19 infection, of which 12 (7.1 %) died and 32 (18.9%) required hospital admission. Previous respiratory pathology was related to Covid-19 infection (P < .05). Maculopathy appears in 5.3% of patients and is significantly related to the dose of hydroxychloroquine consumed (P < .05). CONCLUSION: There is no relationship between chronic use of hydroxychloroquine and the incidence of Covid-19.

OBJETIVO: Analizar la incidencia de la enfermedad del coronavirus 19 (COVID-19) en pacientes consumidores crónicos de hidroxicloroquina. PACIENTES Y MÉTODOS: Estudio multicéntrico observacional retrospectivo transversal en Áreas de Salud de Castilla La-Mancha y distritos sanitarios de Andalucía. De los 4.451 participantes incluidos en el primer reclutamiento se seleccionaron 3.817 sujetos con datos válidos. La variable principal del estudio ha sido la presencia o ausencia de infección por la COVID-19 por diagnóstico clínico, serológico o por reacción en cadena de la polimerasa. Se registraron variables sociodemográficas, clínicas y tratamientos y comorbilidades concomitantes. RESULTADOS: Ciento sesenta y nueve (4,45%) pacientes presentaron infección por la COVID-19, de los cuales fallecieron 12 (7,1%) y 32 (18,9%) requirieron ingreso hospitalario. La enfermedad respiratoria previa se relacionó con la infección por la COVID-19 (p < 0,05). La maculopatía aparece en un 5,3% de los pacientes y está relacionada significativamente con la dosis de hidroxicloroquina consumida (p < 0,05). CONCLUSIÓN: No existe relación entre consumo crónico de hidroxicloroquina e incidencia de la COVID-19.

Incidencia de la COVID-19 en pacientes en tratamiento crónico con hidroxicloroquina / Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine

Objetivo: Analizar la incidencia de la enfermedad del coronavirus 19 (COVID-19) en pacientes consumidores crónicos de hidroxicloroquina.Pacientes y métodosEstudio multicéntrico observacional retrospectivo transversal en Áreas de Salud de Castilla La-Mancha y distritos sanitarios de Andalucía. De los 4.451 participantes incluidos en el primer reclutamiento se seleccionaron 3.817 sujetos con datos válidos. La variable principal del estudio ha sido la presencia o ausencia de infección por la COVID-19 por diagnóstico clínico, serológico o por reacción en cadena de la polimerasa. Se registraron variables sociodemográficas, clínicas y tratamientos y comorbilidades concomitantes.ResultadosCiento sesenta y nueve (4,45%) pacientes presentaron infección por la COVID-19, de los cuales fallecieron 12 (7,1%) y 32 (18,9%) requirieron ingreso hospitalario. La enfermedad respiratoria previa se relacionó con la infección por la COVID-19 (p<0,05). La maculopatía aparece en un 5,3% de los pacientes y está relacionada significativamente con la dosis de hidroxicloroquina consumida (p<0,05).ConclusiónNo existe relación entre consumo crónico de hidroxicloroquina e incidencia de la COVID-19. (AU)

Objective: To analyze the incidence of Covid-19 in patients who are chronic users of hydroxychloroquine.Patients and methodsCross-sectional retrospective observational multicenter study in health areas and districts from Castilla La-Mancha and Andalucia. Of the 4451 participants included in the first recruitment, 3817 with valid data were selected. The main variable of the study is the presence or absence of Covid-19 infection by clinical, serological or polymerase chain reaction diagnosis. Sociodemographic and clinical variables and treatment and concomitant comorbidities were recorded.Results169 (4,45%) patients had Covid-19 infection, of which 12 (7.1%) died and 32 (18.9%) required hospital admission. Previous respiratory pathology was related to Covid-19 infection (P<.05). Maculopathy appears in 5.3% of patients and is significantly related to the dose of hydroxychloroquine consumed (P<.05).ConclusionThere is no relationship between chronic use of hydroxychloroquine and the incidence of Covid-19. (AU)

[Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine]. / Incidencia de la COVID-19 en pacientes en tratamiento crónico con hidroxicloroquina.

OBJECTIVE: To analyze the incidence of Covid-19 in patients who are chronic users of hydroxychloroquine. PATIENTS AND METHODS: Cross-sectional retrospective observational multicenter study in health areas and districts from Castilla La-Mancha and Andalucia. Of the 4451 participants included in the first recruitment, 3817 with valid data were selected. The main variable of the study is the presence or absence of Covid-19 infection by clinical, serological or polymerase chain reaction diagnosis. Sociodemographic and clinical variables and treatment and concomitant comorbidities were recorded. RESULTS: 169 (4,45%) patients had Covid-19 infection, of which 12 (7.1%) died and 32 (18.9%) required hospital admission. Previous respiratory pathology was related to Covid-19 infection (P<.05). Maculopathy appears in 5.3% of patients and is significantly related to the dose of hydroxychloroquine consumed (P<.05). CONCLUSION: There is no relationship between chronic use of hydroxychloroquine and the incidence of Covid-19.

Presenteeism, Overcommitment, Workplace Bullying, and Job Satisfaction: A Moderated Mediation Relationship.

Presenteeism is a hazardous behaviour that may have personal and organizational consequences. The main objective of this research was to investigate the relationship between presenteeism and job satisfaction and evaluate the role of overcommitment as a mediator and the role of work-related and personal bullying as moderators in these relationships. Results from 377 subjects showed that presenteeism and overcommitment are positively related to job satisfaction, with overcommitment being a mediator in the relationships. These relationships are moderated by work-related bullying but not by personal bullying. The findings are discussed, and implications, future research pathways, and limitations are noted.

The Mediating Role of Psychological Capital between Motivational Orientations and Their Organizational Consequences.

Just as we can speak of different personality traits, it is also possible to identify distinct motivational traits, which may be related to a series of organizational consequences. In this sense, understanding how these traits are related to workers performance is fundamental. Specifically, the purpose of this study is to test the mediating role of psychological capital in the relationship between such traits and organizational citizenship behaviors and counterproductive work behaviors, which is expected to be more significant in the first case. The study was carried out using a panel design, with a sample group of Spanish employees aged over 40 (n = 741), in two waves (with a 4-month interval). The results support the hypothesis that psychological capital resources may play a mediating role in some of the relationships explored and that approach orientation traits are mainly related to a better performance, fostering organizational citizenship behaviors and diminishing counterproductive work behavior. The findings show that employees who develop their personal resources may have a positive impact on their organizations. The implications of this study for counseling practices are discussed.

Is Job Involvement Enough for Achieving Job Satisfaction? The Role of Skills Use and Group Identification.

The main objective of this research is to evaluate the influence of job involvement over job satisfaction mediated through the professional skill use and moderated by group identification. The sample of the current research was composed of 420 subjects. The main results showed that job involvement was strongly related to skill use and group identification. Moreover, the interaction of job involvement and group identification is negatively related with skill use. Our results show that there is no statistically significant relationship between job involvement and job satisfaction. Furthermore, the use of skills is strongly related to job satisfaction. Lastly, we found that a strong group identification tends to harm job satisfaction values.

Diferentes índices radiográfcos versus Índice Acetabular en la decisión de colocación de Arnés de Pavlik en pacientes con diagnóstico de Displasia de Cadera / Different X-ray indices versus Acetabular Index on Pavlik Harness Placement Decision in Patients Diagnosed with Hip Dysplasia

Existen diferentes índices y clasifcaciones radiográfcas para el diagnóstico de Displasia del Desarrollo de la Cadera, este estudio comparó la utilidad de diferentes parámetros radiográfcos en pacientes con índices acetabulares elevados a fn de determinar si se benefciarán o no de un tratamiento ortopédico. Pacientes y Métodos: Estudio de cohorte retrospectivo. Pacientes de 3 a 7 meses, atendidos en la consulta externa de Traumatología y Ortopedia pediátrica del Hospital Vozandes Quito en el período enero a diciembre de 2017 fueron incluidos en el estudio. Signos de inestabilidad de la cadera al examen físico, mediciones radiográfcas: índice acetabular, porcentaje de migración de cabeza femoral, índice de Smith, clasifcación de Tonnis por cuadrantes, formación de la ceja acetabular radiográfca se obtuvieron del prontuario médico de cada paciente. Resultados: Se evaluaron 104 pacientes, la mediana de la edad al momento del diagnóstico fue 4,63 meses, el 52% eran del sexo masculino y la media del índice acetabular fue de 37,9˚. Los pacientes fueron subdivididos en 2 grupos de acuerdo con el tratamiento ortopédico instaurado: con arnés de Pavlik (38,5%) y sin arnés (61,5%). Al comparar pacientes sin y con arnés obtuvimos un OR de 1,07 y un valor p = 0.69. Pacientes con una escala de Tonnis grado I tuvieron 96% de probabilidad de desarrollar una cadera normal en relación con el grado II de Tonnis (60%), con un OR de 21,3 y p = 0,69. Conclusión: Existe un grupo de pacientes con un índice acetabular elevado y caderas estables al examen físico que no se benefciarían de un tratamiento ortopédico. Dentro de todos los parámetros evaluados observamos que la ceja acetabular radiográfca normal y la escala de Tonnis grado I fueron parámetros predictores de una buena respuesta a los 2 meses. El índice de Smith y el porcentaje de Reimers no tiene valor pronóstico en pacientes con sospecha de displasia de cadera

There are different x-ray indices and classifcations for the diagnosis of Hip Developmental Dysplasia, this study compared the usefulness of different x-ray parameters in patients with high acetabular indices to determine whether or not would beneft from orthopedic treatment. Patients and Methods: Retrospective cohort study. Patients aged 3 to 7 months, attended in the external consultation of Traumatology and Pediatric Orthopedics of the Hospital Vozandes Quito in the period January to December 2017 were included in the study. Signs of hip instability to physical examination, radiographic measurements: acetabular index, percentage of femoral head migration, Smith index, Tonnis classifcation by quadrants, formation of the radiographic acetabular eyebrow were obtained from the medical record of each patient. Results: 104 patients were evaluated, the median age at the time of diagnosis was 4.63 months, 52% were male and the mean acetabular index was 37.9 degrees. Patients were subdivided into 2 groups according to the orthopedic treatment instituted: with Pavlik harness (38.5%) and without a harness (61.5%). When comparing patients without and with harness we got an OR of 1.07 and a value of p-0.69. Patients with a Grade I Tonnis scale had a 96% chance of developing a normal hip relative to Tonnis Grade II (60%), with an OR of 21.3 and p-0.69. Conclusions: There is a group of patients with a high acetabular index and hips stable to the physical examination who would not beneft from orthopedic treatment, within all the parameters evaluated we observe that the normal radiographic acetabular eyebrow and the Tonnis scale grade I were predictor parameters of a good response at 2 months. Smith's index and reimers percentage have no prognostic value in patients with suspected hip dysplasia

Older Worker Identity and Job Performance: The Moderator Role of Subjective Age and Self-Efficacy.

Older Worker Identity consists of the internalization of negative beliefs and attitudes towards aged employees by these same people. This research aims to explore the moderator role both of subjective age and self-efficacy in the relationship between older worker identity and job performance. The study was conducted with a panel design, including a sample of +40 Spanish workers (n = 200), with two waves (4-months interval). The findings supported the moderator role of subjective age in the relationship, while it failed to support the moderator role of self-efficacy. These findings underline that workers who actively manage their subjective age perceptions could age successfully at work. The implications of this study for counseling practices are discussed.

Transcriptomic immunologic signature associated with favorable clinical outcome in basal-like breast tumors.

BACKGROUND: Most patients with early stage triple negative breast cancer (TNBC) receive adjuvant chemotherapy. Activation of the immune system is associated with tumor response and may help identify TNBC with favorable outcome. METHODS: Gene expression data were obtained from the GEO Dataset GDS2250/GSE3744. Affymetrix CEL files were downloaded and analyzed with Affymetrix Transcriptome Analysis Console 3.0. Functional genomics was implemented with David Bioinformatics Resources 6.8. Data contained at Oncomine were used to identify genes upregulated in basal-like cancer compared to normal breast tissue. Data contained at cBioportal were used to assess for molecular alterations. The KMPlotter online tool, METABRIC and GSE25066 datasets were used to associate gene signatures with clinical outcome. RESULTS: 1564 upregulated genes were identified as differentially expressed between normal and basal-like tumors. Of these, 16 genes associated with immune function were linked with clinical outcome. HLA-C, HLA-F, HLA-G and TIGIT were associated with both improved relapse-free survival (RFS) and overall survival (OS). The combination of HLA-F/TIGIT and HLA-C/HLA-F/TIGIT showed the most favorable outcome (HR for RFS 0.44, p<0.001; HR for OS 0.22, p<0.001; and HR for RFS 0.46, p<0.001; HR for OS 0.15, p<0.001; respectively). The association of HLA-C/HLA-F with outcome was confirmed using the METABRIC and GSE25066 datasets. No copy number alterations of these genes were identified. CONCLUSION: We describe a gene signature associated with immune function and favorable outcome in basal-like breast cancer. Incorporation of this signature in prospective studies may help to stratify risk of early stage TNBC.

Metotrexato: toxicidad pulmonar, hepática y hematológica / No disponible

Metotrexato ha sido durante años ampliamente utilizado para el tratamiento de diversas enfermedades. El tratamiento con bajas dosis de metotrexato oral ha alcanzado gran aceptación para su uso en la artritis reumatoide debido a su eficacia y tolerabilidad. La toxicidad del metotrexato es la causa principal para la interrupción del tratamiento. Las complicaciones gastrointestinales son los efectos adversos más comunes del tratamiento con metotrexato oral a bajas dosis, seguido de la estomatitis, hepatotoxicidad, erupción cutánea, pérdida de cabello, toxicidad pulmonar y hematológica, aunque la pancitopenia es un efecto adverso raro de la terapia oral con bajas dosis. El factor de riesgo más importante para la toxicidad de metotrexato es la disminución de la función renal (AU)

Methotrexate has been widely used for many years in the treatment of a variety of diseases. Low-dose oral methotrexate therapy has gained wide acceptance for its use in rheumatoid arthritis because of its efficacy and tolerability. The toxicity of methotrexate is the main reason for cessation of treatment. Gastrointestinal complications are the most common adverse effects of low-dose oral methotrexate therapy, followed by stomatitis, hepatotoxicity, skin rash, hair loss, pulmonary and haematological toxicity, although pancytopenia is a rare adverse effect of low-dose oral methotrexate therapy. The most important risk factor for methotrexate toxicity is impaired renal function (AU)

¿Qué inyectables pueden ser administrados por vía oral o enteral? / Which injectable medication can be administered orally or enterally?

En este artículo recogemos los principios éticos y legales cuando hemos de decidir sobre el uso de un medicamento en condiciones distintas a las de su ficha técnica. Los medicamentos no siempre están disponibles en formulaciones adecuadas para pacientes con dificultades para tragar o pacientes con sondas de alimentación enteral. Por lo tanto, la modificación de las formas farmacéuticas puede ser necesaria. Se proporciona una lista de inyectables que pueden ser administrados por vía enteral mediante sondas de alimentación o por vía oral cuando no hay alternativas disponibles. Sin embargo, la idoneidad para la administración oral o enteral puede variar ampliamente. En este trabajo no consideramos la vía rectal, como una vía enteral adecuada para la administración de inyectables (AU)

In this article we collect the ethical and legal principles when we have to decide on the use of a drug in conditions other than those on its data sheet. Medicines are not always available in formulations which are suitable for patients with swallowing difficulties or patients with enteral feeding tubes. The alteration of medication formulations may therefore be necessary. This text provides a list of injectables that can be administered orally or via enteral feeding tubes when there are no available alternatives. However, they vary widely in their suitability for oral or enteral feeding administration. In this paper we do not consider the rectal route, as an adequate enteral route for administration of injectables (AU)