ABSTRACT
Immune checkpoint inhibitors (ICI) have changed the prognosis of many tumors. However, concerning associated cardiotoxicity has been reported. Little is known about the real-life incidence-specific surveillance protocols or the translational correlation between the underlying mechanisms and the clinical presentation of ICI-induced cardiotoxicity. The lack of data from prospective studies led us to review the current knowledge and to present the creation of the Spanish Immunotherapy Registry of Cardiovascular Toxicity (SIR-CVT), a prospective registry of patients receiving ICI that aims to examine the role of hsa-miR-Chr8:96, (a specific serum biomarker of myocarditis) in the early diagnosis of ICI-induced myocarditis. An exhaustive prospective cardiac imaging study will be performed before and during the first 12 months of treatment. The correlation between clinical, imaging, and immunologic parameters may improve our understanding of ICI-induced cardiotoxicity and enable simpler surveillance protocols. We assess ICI-induced cardiovascular toxicity and describe the rationale of the SIR-CVT.
Subject(s)
Myocarditis , Humans , Myocarditis/chemically induced , Myocarditis/drug therapy , Myocarditis/pathology , Cardiotoxicity/etiology , Prospective Studies , Immunotherapy/adverse effects , RegistriesSubject(s)
Object Attachment , Psychopathology , Stress, Psychological , Grief , Risk Factors , Protective FactorsABSTRACT
Introduction: Congenital Cystic Adenomatous Malformation (CCAM) is an infrequent entity due to an alteration in alveolar-pulmonary development. Material and Methods: A descriptive, retrospective study of newborns presenting CCAM in a tertiary care hospital in Madrid, Spain. Results: Seven patients were found. All were full term, normal weight births. Two patients showed respiratory distress at birth. Two chest x-rays were normal. CT scans showed three clear CCAM lesions, four suggestive of hybrid lesions. All were referred to medical centers with pediatric surgery for followup. Discussion: At birth, this pathology may be asymptomatic and appear as a chest x-ray finding. Long term management is complicated by infection and malignization. Conservative treatment of asymptomatic patients includes regular follow up of lesions. Surgical treatment is reserved for symptomatic or complicated patients. Conclusions: Prenatal suspicion of CCAM is important since clinical exam and radiology may be normal in neonatal period. Chest CT scans are important in confirming diagnosis and determining future surgery. More studies are necessary for the proper diagnosis and management of this disorder.
Introducción: La malformación adenomatoidea quística (MAQ) es una entidad congénita poco frecuente debida a una alteración en el desarrollo alveolar pulmonar. Pacientes y Método: Se realizó un estudio descriptivo y retrospectivo de los recién nacidos con el diagnóstico prenatal de MAQ durante 6 años en un hospital terciario de Madrid (España). Resultados: Se encontraron un total de siete pacientes. Todos fueron recién nacidos a término de peso adecuado. Dos pacientes presentaron distress respiratorio al nacimiento. Dos radiografías de tórax fueron normales. En la tomografía axial (TAC), tres lesiones fueron MAQ y cuatro fueron su-gerentes de lesión híbrida. Todos se derivaron a centro con cirugía pediátrica para seguimiento. Discusión: Al nacimiento, esta patología puede permanecer asintomática y ser un hallazgo casual en una radiografía torácica. A largo plazo el riesgo de infección y malignización complican el manejo. El tratamiento conservador, que se dirige a pacientes asintomáticos, obliga a realizar controles seriados de las lesiones. El tratamiento quirúrgico se reserva para los pacientes con sintomatología o complicaciones postnatales. Conclusiones: El diagnóstico de sospecha prenatal de MAQ es fundamental dado que la clínica y radiología pueden ser normales en el período neonatal. Se debe realizar TAC torácico para confirmar la lesión y valorar futura cirugía. Se necesitan más estudios sobre el correcto diagnóstico y manejo de esta patología.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Cystic Adenomatoid Malformation of Lung, Congenital/epidemiology , Cystic Adenomatoid Malformation of Lung, Congenital , Clinical Evolution , Follow-Up Studies , Gestational Age , Cystic Adenomatoid Malformation of Lung, Congenital/diagnosis , Prenatal Diagnosis , Radiography, Thoracic , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
El objetivo de esta investigación es analizar qué importancia y nivel de desarrollo otorgan a las competencias genéricas, además de observar en qué espacios didácticos reportan haberlas ido adquiriendo y/o desarrollando, así como conocer la organización y planificación de su tiempo de trabajo autónomo. La muestra está compuesta por 83 estudiantes de 3°, 4° y 5° de psicología. Los resultados muestran que el nivel de importancia de las competencias está por encima del nivel de desarrollo alcanzado; los espacios didácticos predominantes son las clases teóricas y las prácticas. El mayor porcentaje de tiempo está dedicado a trabajar en grupo y preparar exámenes. Se han encontrado diferencias significativas en función del sexo, turno y curso. Se plantean sugerencias de mejora para aumentar la calidad docente.
The objective of this investigation is to analyze the importance and the development level attributed to generic competences, also to observe in what didactic spaces have these been acquired and/or developed, as well as knowing the organization and the planning of the time of autonomous work. The sample is composed by 83 psychology students of 3rd, 4th and 5th semester. The results show that the level of importance of the competences is above the level of development reached; the didactic spaces where they have acquired most of the competences are the theoretical classes and the practical activities. The biggest percentage of their time is dedicated to work in groups and to prepare for exams. There have been significant differences in terms of gender, schedule and course. Suggestions to improve quality of education are made.