Towards evidence-based empiric antibiotic recommendations for spontaneous infections in patients with cirrhosis.

BACKGROUND: With the emergence of multidrug-resistant infections, healthcare professionals must evaluate the effectiveness of empiric antibiotic treatments. AIMS: To assess the antibiotic susceptibility patterns of microorganisms causing spontaneous infections in patients with cirrhosis and to evaluate the suitability of empiric antibiotic treatments based on major clinical guidelines. METHODS: This cross-sectional study utilized two datasets from prospective studies of patients with cirrhosis and culture-positive spontaneous bacterial infections in Argentina and Uruguay. We estimated susceptibility to commonly used antibiotics and assessed coverage following European and American recommendations. RESULTS: We analyzed 238 episodes of culture-positive spontaneous infections in 229 patients. When implementing the recommendations for empiric treatment of community-acquired spontaneous infections, ceftazidime would result in 39 % coverage, whereas ceftriaxone would reach 70 %. Cefepime, which is not included in the recommendations, would have provided coverage of 74 %. Using ertapenem for nosocomial infections would have only covered 56 % of these episodes, whereas meropenem or imipenem reached 73 % coverage. Only the combination of meropenem or imipenem plus vancomycin would achieve a coverage surpassing 85 % in healthcare-associated or nosocomial spontaneous bacterial infections. CONCLUSIONS: Our study uncovers inadequate coverage in specific clinical scenarios when adhering to recommendations, underscoring the necessity of guidelines based on local epidemiological data.

Management of hereditary hemorrhagic telangiectasia-like symptoms induced by trastuzumab emtansine in a breast cancer patient: case report.

Trastuzumab emtansine (T-DM1) is a targeted therapy combining trastuzumab and emtansine for human epidermal growth factor receptor 2(HER2)-positive breast cancer, with common side effects including fatigue, nausea, pain, headache, low platelet count, and elevated liver enzymes. Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant vascular dysplasia characterized by vascular malformations and telangiectasias in various organs. We present a case of a female patient with advanced breast cancer who developed HHT-like symptoms while on T-DM1 treatment. A 59-year-old woman treated with radiotherapy and T-DM1 every 21 days developed recurring nosebleeds and mucocutaneous and liver telangiectasias indistinguishable from HHT three months after receiving the first dose of T-DM1. Other organ vascular malformations were ruled out through screening protocols. The patient had no previous HHT symptoms or family history. Nasal care measures like lubrication and antifibrinolytics (tranexamic acid) were provided. In addition, propranolol was also prescribed due to its antiangiogenic and antitumoral properties, leading to significantly decreased epistaxis and telangiectasias. Microtubule disruptions caused by T-DM1, along with other angiogenic mechanisms may contribute to the development of telangiectasias resembling HHT. The use of propranolol, an initial approach for HHT, proved to be effective in this case. It is crucial for oncologists and HHT specialists to be aware of this rare adverse event associated with T-DM1 and to implement appropriate management strategies.

Microencapsulation of peanut skin polyphenols for shelf life improvement of sunflower seeds.

Derived from industrial processing waste, peanut skins contain polyphenols that delay oxidative food spoilage. However, these compounds are susceptible to light, heat, and oxygen exposure. Microencapsulation provides a solution by offering protection from these factors. The aim of this study was to evaluate the protective effect of peanut skin extract microcapsules on the chemical, microbiological, and sensory property and shelf life of sunflower seeds during storage. Five roasted sunflower seed samples were prepared: control (S-C); added with butylhydroxytoluene (S-BHT); coated with carboxymethyl cellulose (S-CMC); coated with CMC and the addition of peanut skin crude extract (S-CMC-CE); coated with CMC and the addition of microcapsules (S-CMC-M20). Sensory acceptability was determined using hedonic testing. Chemical (peroxide value, conjugated dienes, hexanal and nonanal content, and fatty acid profile), microbiological, and descriptive analyses were carried out on samples stored for 45 days at room temperature. Shelf life was calculated using a simple linear regression. All samples were microbiologically fit for human consumption and accepted by consumer panelists, scoring above five points on the nine-point hedonic scale. S-CMC-M20 exhibited the lowest peroxide value (6.59 meqO2/kg) and hexanal content (0.4 µg/g) at the end of the storage. Estimated shelf life showed that S-MC-M20 (76.3 days) extended its duration nearly ninefold compared to S-C (8.3 days) and doubled that of S-CMC-CE (37.5 days). This indicates a superior efficacy of microencapsulated extract compared to its unencapsulated form, presenting a promising natural strategy for improving the shelf life of analogous food items. PRACTICAL APPLICATION: Incorporating peanut skin extract microcapsules in coating sunflower seeds presents a promising strategy to extend the shelf life of lipid-rich foods, capitalizing on the antioxidant properties of polyphenols. This innovative approach not only enhances nutritional quality but also addresses sustainability concerns by repurposing agro-industrial byproducts, such as peanut skins. By meeting consumer demand for functional foods with added health benefits, this technique offers potential opportunities for the development of novel, value-added food products while contributing to circular economy principles and waste management efforts.

Identification of key markers for the stages of nonalcoholic fatty liver disease: An integrated bioinformatics analysis and experimental validation.

BACKGROUND: The identification of biomarkers for the early diagnosis of nonalcoholic fatty liver disease (NAFLD) is urgently needed. Here, we aimed to identify NAFLD biomarkers in the early stages of steatosis (SS) and nonalcoholic steatohepatitis (NASH) based on differential gene expression from bioinformatics data. METHODS: A meta-analysis was performed from transcriptomic databases retrieved from public repositories containing data from biopsies of patients at various stages of NAFLD development. The status of the selected molecules was validated in the serum of patients with NAFLD by ELISA. RESULTS: We identified 121 differentially expressed genes (DEGs) associated with SS and 402 associated with NASH. Gene Ontology (GO) enrichment revealed that the altered genes were primarily associated with dysfunction of primary cellular processes, and pathway analyses were mainly related to cholesterol metabolism. We identified ACSS2, PCSK9, and CYP7A1 as candidate biomarkers for SS and ANGPTL3, CD36, CYP51A1, FASN, FAS, FDFT1, and LSS as candidate biomarkers for NASH. CONCLUSIONS: By experimental validation of bioinformatics data from patients with NAFLD, we identified promising biomarkers for detecting SS and NASH that might be useful for screening and diagnosing early NAFLD stages in humans.

A model of alcoholic liver disease based on different hepatotoxics leading to liver cancer.

The worst-case scenario related to alcoholic liver disease (ALD) arises after a long period of exposure to the harmful effect of alcohol consumption along with other hepatotoxics. ALD encompasses a broad spectrum of liver-associated disorders, such as steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Based on the chronic administration of different hepatotoxics, including ethanol, sucrose, lipopolysaccharide, and low doses of diethylnitrosamine over a short period, here we aimed to develop a multiple hepatotoxic (MHT)-ALD model in the mouse that recapitulates the human ALD-associated disorders. We demonstrated that the MHT-ALD model induces ADH1A and NXN, an ethanol metabolizer and a redox-sensor enzyme, respectively; promotes steatosis associated with the induction of the lipid droplet forming FSP27, inflammation identified by the infiltration of hepatic neutrophils-positive to LY-6G marker, and the increase of MYD88 level, a protein involved in inflammatory response; and stimulates the early appearance of cellular senescence identified by the senescence markers SA-ß-gal activity and p-H2A.XSer139. It also induces fibrosis associated with increased desmin, a marker of hepatic stellate cells whose activation leads to the deposition of collagen fibers, accompanied by cell death and compensatory proliferation revealed by increased CASP3-mediated apoptosis, and KI67- and PCNA-proliferation markers, respectively. It also induces histopathological traits of malignancy and the level of the HCC marker, GSTP1. In conclusion, we provide a useful model for exploring the chronological ALD-associated alterations and stages, and addressing therapeutic approaches.

Iron-saturated bovine lactoferrin: a promising chemopreventive agent for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a tumor with minimal chance of cure due to underlying liver diseases, late diagnosis, and inefficient treatments. Thus, HCC treatment warrants the development of additional strategies. Lactoferrin (Lf) is a mammalian multifunctional iron-binding glycoprotein of the innate immune response and can be found as either a native low iron form (native-Lf) or a high iron form (holo-Lf). Bovine Lf (bLf), which shares many functions with human Lf (hLf), is safe for humans and has several anticancer activities, including chemotherapy boost in cancer. We found endogenous hLf is downregulated in HCC tumors compared with normal liver, and decreased hLf levels in HCC tumors are associated with shorter survival of HCC patients. However, the chemoprotective effect of 100% iron saturated holo-bLf on experimental hepatocarcinogenesis has not yet been determined. We aimed to evaluate the chemopreventive effects of holo-bLf in different HCC models. Remarkably, a single dose (200 mg kg-1) of holo-bLf was effective in preventing early carcinogenic events in a diethylnitrosamine induced HCC in vivo model, such as necrosis, ROS production, and the surge of facultative liver stem cells, and eventually, holo-bLf reduced the number of preneoplastic lesions. For an established HCC model, holo-bLf treatment significantly reduced HepG2 tumor burden in xenotransplanted mice. Finally, holo-bLf in combination with sorafenib, the advanced HCC first-line treatment, synergistically decreased HepG2 viability by arresting cells in the G0/G1 phase of the cell cycle. Our findings provide the first evidence suggesting that holo-bLf has the potential to prevent HCC or to be used in combination with treatments for established HCC.

Severe thrombocytopenia associated to bevacizumab in a patient with scleroderma, gastrointestinal angiodysplasias and refractory gastrointestinal bleeding.

This case report discusses the medical history of a 64-year-old woman diagnosed with scleroderma and diffuse gastrointestinal angiodysplasia. The patient received bevacizumab (BVZ) therapy to address gastrointestinal bleeding that was unresponsive to endoscopic treatment. Subsequently, she developed severe thrombocytopenia. Although there were suspicions of an immune-mediated mechanism resulting from BVZ treatment, the laboratory results did not provide conclusive evidence. The patient underwent transfusions, received gamma globulin, and was treated with Romiplostim. Over time, her platelet levels gradually improved, and the bleeding was successfully controlled. It's worth noting that BVZ-induced thrombocytopenia is a relatively rare yet severe adverse effect. Recognizing and understanding the mechanisms behind thrombocytopenia is essential for developing safer treatment approaches. Further research is required to identify potential risk factors associated with this condition.

DCLK1 is Overexpressed and Associated with Immune Cell Infiltration in Hepatocellular Carcinoma.

Recent research has shown that Doublecortin-like kinase 1 (DCLK1) is overexpressed in different types of cancer. It has recently been described as a cancer stem cells (CSCs) marker, is associated with carcinogenesis, and positively correlates with infiltration of multiple immune cell types in some cancers. However, studies focused on assessing DCLK1 expression in HCC are limited, and the role of DCLK1 in HCC tumor immunity remains to be determined. In this study, we used a modified model of the resistant hepatocyte (MRHM) to evaluate DCLK1 expression in HCC. Furthermore, DCLK1 expression in HCC was analyzed using TIMER 2.0, UALCAN, GEPIA, GEO, and HPA web-based tools. Correlations between DCLK1 expression and clinicopathological factors in patients were analyzed using the UALCAN web-based tool. Finally, correlations between DCLK1 and immune infiltrates were investigated using the TIMER 2.0 and TISIDB web-based tools. The results showed that DCLK1 is significantly overexpressed during progression of the HCC carcinogenic process in the MRHM. DCLK1 is overexpressed in HCC according to multiple publics web-based tools, and its overexpression is associated with cancer stage. Furthermore, DCLK1 expression was correlated with infiltration levels of multiple immune cells, immunomodulatory factors, immunoinhibitors, MHC molecules, chemokines, receptors, and immune cell-specific markers. These results suggest that DCLK1 is a potential prognostic biomarker that determines cancer progression and correlates with immune cell infiltration in HCC.

Evaluación de un programa motivacional de establecimiento de objetivos para la optimización del rendimiento en deportistas de alto nivel: una aproximación cualitativa / Evaluation of a motivational program to goal setting to optimize performance in high level athletes: a qualitative approach / Avaliação de um programa motivacional de estabelecimento de objectivos para a optimização do rendimento em desportistas de alto nível: uma abordagem qualitativa

El propósito de este estudio se orienta a descubrir las bondades de un programa de entrenamiento por establecimiento de objetivos (EO) desde la óptica de los propios implicados. Para ello, se diseña y se aplica un programa motivacional de EO en dos equipos de fútbol de alto nivel, con metas a corto, medio y largo plazo, individual y colectivo, abordando tipologías de objetivos autoimpuestos en los planos físico, técnico-táctico y psicológico. La metodología empleada se sustenta en el método de investigación evaluativa. El enfoque metodológico predominante es de naturaleza interpretativa, y se concreta en un diseño articulado desde los preceptos de la Grounded Theory (o Teoría Fundamentada en los datos). El análisis de los datos cualitativos se llevó a cabo mediante el software Atlas.ti. Los datos registrados se utilizaron como base para la elaboración de networks (o mapas conceptuales) y para el cálculo del coeficiente C, posteriormente se exportan a una matriz de datos cuantitativa para trabajar técnicas estadísticas descriptiva y correlacional (medidas de dispersión y coeficientes de contingencia). Los resultados obtenidos ofrecen una caracterización de objetivos establecidos por deportistas de alto nivel, según categoría y demarcación de los jugadores. Se llega a la conclusión de que la mayor parte de los objetivos que se plantean los jugadores son fundamentalmente de corte psicológico, más que físicos o técnico-tácticos, al igual que los objetivos perseguidos por centrocampistas y porteros

The purpose of this study was to discover the benefits of a training program by goal setting from the perspective of those involved. To this end, a motivational goal setting program is designed and implemented in two high-level football teams, with short, medium and long term goals, individual and collective, addressing typologies of selfimposed objectives in the physical, technical-tactical and psychological. The methodology used was based on the method of evaluative research. The predominant methodological approach is of an interpretive nature, and is concretized in a design articulated from the Grounded Theory. The analysis of the qualitative data was carried out using Atlas.ti software. The data recorded were used as a basis for the elaboration of networks (or conceptual maps) and for the calculation of the coefficient C, subsequently exported to a quantitative data matrix to work descriptive and correlational statistical techniques (dispersion measures and contingency coefficients). The results obtained offer a characterization of objectives established by high level athletes, according to category and demarcation of the players. It is concluded that most of the objectives that the players pose are fundamentally psychological, rather than physical or technical-tactical, as are the goals pursued by midfielders and goalkeepers

O objetivo deste estudo foi descobrir os benefícios de um programa de treino tendo por base o estabelecimento de objetivos da perspectiva dos envolvidos. Para isso, um programa motivacional de estabelecimento de objetivos foi desenvolvido e aplicada a duas equipas de futebol de alto nível, com objetivos a curto, médio e longo prazo, bem como individuais e coletivos abordando tipologias de objetivos auto-impostas ao nível físico, técnico-tático e psicológico. A metodologia utilizada baseiou-se no método de pesquisa avaliadora. A abordagem metodológica foi predominante de natureza interpretativa e é concretizada numprojeto articulado a partir dos pressupostos da Grounded Theory (ou teoria fundamentada nos dados). A análise dos dados qualitativos foi realizada utilizando o software Atlas.ti. Os dados registados foram utilizados com base para o desenvolvimento de redes (ou mapas conceituais) e para o cálculo do coeficiente C, depois foram exportados para uma matriz de dados quantitativos, sendo analisados com recurso a uma análise descritiva e de correlação estatísticas descritivas e correlacionais (medidas de dispersão e coeficientes de contingência). Os resultados obtidos oferecem uma caracterização dos objetivos estabelecidos pelos atletas de alto nível, de acordo com a categoria e limitação dos jogadores. Conclui-se que a maioria dos objetivos que os jogadores criam são maioritariamente psicológicos, comparativamente aos físicos ou técnico-táticos, bem como os objetivos perseguidos pelos médios-centro e guarda-redes

Actividad física y percepción de salud de los estudiantes universitarios / Physical Activity and Self-Rated Health in University Students

Introducción. Son indiscutibles los beneficios que la práctica regular y adecuada de actividad física conlleva sobre el estado de salud. Objetivo. Valorar la práctica de actividad física de los estudiantes de la Universidad de Sevilla y determinar la relación existente entre esta y la percepción de salud, teniendo en cuenta la edad y el sexo. Materiales y métodos. Estudio transversal realizado en 1085 estudiantes -569 mujeres y 516 hombres- con diseño muestral aleatorio y estratificado según facultad y sexo. Se aplicó un cuestionario ad hoc donde se recogieron todas las variables del estudio; la edad media de la muestra fue 21 años, σ=3.05. Resultados. El 46.2% de los estudiantes practica actividad física, aunque solo el 54.8% de los practicantes lo hace siguiendo las recomendaciones del American College of Sports Medicine; quienes practican según estas indicaciones señalan mejor percepción de salud que aquellos que practican sin cumplirlas (p=0.001). El alumnado que practica actividad física mantiene una mejor percepción de salud que el alumnado no practicante (p=0.000). Así mismo, los hombres han señalado mejor percepción de salud que las mujeres (p=0.004). Conclusiones. Debido a la estrecha relación entre práctica regular de actividad física y percepción de salud, así como a los bajos índices de práctica de esta población, puede considerarse el alumnado universitario como una población clave para promover la práctica deportiva e intentar evitar el abandono de la actividad.

Background. There is irrefutable evidence regarding the benefits of regular physical activity in terms of health condition. Ojective. To assess the physical activity level of students from University of Seville and to determine its association with self-rated health, as well as differences by gender and age. Materials and Methods. A transversal study applied to a sample of 1085 students (569 women and 516 me), with a random and stratified sampling design by faculty and sex in which an ad hoc questionnaire that considered all study variables. The sample age mean was 21 years old, σ=3.05). Results. Results showed that 46.2% of students practice physical activity, but only 54.8% of them do it according to the American College of Sports Medicine recommendations. Those who abide by these recommendations point out to have a better self-rated health than those who practice physical activity without taking into account such recommendations (p=0.001). Likewise, men stated a better self-rated health than women did (p=0.004). Conclusion. Due to the meaningful relationship between physical activity and self-rated health, university students are a key population for promoting sport practice, especially among women, in order to try to avoid dropping out of sport.

The shift from low to high non-structural protein 1 expression in rotavirus-infected MA-104 cells

A hallmark of group/species A rotavirus (RVA) replication in MA-104 cells is the logarithmic increase in viral mRNAs that occurs four-12 h post-infection. Viral protein synthesis typically lags closely behind mRNA synthesis but continues after mRNA levels plateau. However, RVA non-structural protein 1 (NSP1) is present at very low levels throughout viral replication despite showing robust protein synthesis. NSP1 has the contrasting properties of being susceptible to proteasomal degradation, but being stabilised against proteasomal degradation by viral proteins and/or viral mRNAs. We aimed to determine the kinetics of the accumulation and intracellular distribution of NSP1 in MA-104 cells infected with rhesus rotavirus (RRV). NSP1 preferentially localises to the perinuclear region of the cytoplasm of infected cells, forming abundant granules that are heterogeneous in size. Late in infection, large NSP1 granules predominate, coincident with a shift from low to high NSP1 expression levels. Our results indicate that rotavirus NSP1 is a late viral protein in MA-104 cells infected with RRV, presumably as a result of altered protein turnover.

Relaciones entre ansiedad-rasgo y ansiedad-estado en competiciones deportivas / Relationship among state and trait anxiety in sport competitions

En esta investigación se pretende comprobar la teoría de la interacción de Spielberger (1972) en el ámbito de la competición deportiva, analizando las relaciones entre ansiedad-estado y ansiedad-rasgo en la competición, según las dimensiones somáticas y cognitivas de la ansiedad-rasgo y ansiedad estado. Para evaluar ambos constructos se utilizó la versión alemana de los cuestionarios WAI-T y WAI-S, en una muestra de 135 deportistas de Luxemburgo. Los resultados obtenidos señalan que se pueden confirmar las hipótesis de Spielberger (1972), sobre la interacción entre ansiedad-rasgo y ansiedad-estado, ampliándose su validez en el ámbito de las competiciones deportivas. Asimismo, se comprueba la necesidad de separación multidimensional en las componentes somáticas y cognitivas de la ansiedad para el registro de la ansiedad-rasgo competitiva y la ansiedad-estado competitivo (AU)

This research aims to test the theory of the interaction of Spielberger (1972) in the field of sports competition, analyzing the relationship between state anxiety and trait anxiety in the competition, according to the somatic and cognitive dimensions of trait anxiety and state anxiety. In order to assess both constructs, the German versions of the WAI-T and WAI-S questionnaires were used in a sample of 135 athletes from Luxembourg. The obtained results confirmed Spielberger’s (1972) hypothesis of interaction between trait anxiety and state anxiety, extending its validity in the field of sports competitions. Moreover, the need for multidimensional separation of somatic and cognitive components of anxiety was verified for the assessment of competitive trait and state anxiety (AU)

Nessa pesquisa pretende comprovar a teoria da interação de Spielberger(1972) no âmbito da competição esportiva, analisando as relações entre ansiedade-traço e ansiedade- estado na competição, segundo as dimensões somáticas e cognitivas da ansiedade -traço e ansiedade- estado. Para avaliar ambos padrões foram utilizados a versão alemã dos questionários WAI-T eWAI-S, com uma mostra de 135 esportistas de Luxemburgo. Os resultados obtidos apontam que se podem confirmar a hipóteses de Spielberger (1972), sobre a interação entre ansiedade -traço e ansiedade- estado, ampliando sua validade ao âmbito das competições esportivas. Mesmo que, comprovamos a necesidade da separaçao multidimensional em algumas competencias somáticas e cognitivas da ansiedade para o registro da ansiedade-rasgo competitiva e a ansiedade-estado competitiva (AU)

Género y profesión como moduladores de la modificación de los estereotipos / Gender and Profession as Modulators in Modification of Stereo-types

Esta investigación presenta un estudio sobre la influencia que ejercen dos variables, género y profesión en la modificación de los estereotipos. Partiendo de los modelos clásicos sobre modificación de estereotipos, de conversión y subtipo, y de los estudios sobre categorización cruza-da, se analiza la influencia de factores a través del modo en que presentamos la información del sujeto estímulo, ya sea esta concentrada o dispersa. Para el análisis de los datos empleamos como variables de respuesta el índice de estereotipia y la percepción de tipicalidad. El diseño del estudio es un 2 (profesión) x 2 (género) x 2 (forma de presentación), que genera ocho condiciones experimentales. Los resultados demuestran que la información ocupacional y/o la información sobre la calidad del desempeño en una determinada ocupación son tanto o más influyentes al emitir un juicio, y en consecuencia modificarlo, que el asignar al sujeto estímulo dentro de la categoría de hombre o mujer (AU)

This paper presents the results of the research about the influence of two variables such as gender and profession in the modification of stereotypes. Starting from the classical models about modification of stereotypes, conversion and subtype, and studies based on crossed categorizations, throughout this research the influence of those factors in the way of how the individual stereotype information is presented, either concentrated or scattered it is analyzed. The stereotype index and the perception of typicality were used as variables for the data analysis. The design of this study is based on a 2 (profession) x 2 (gender) x 2 (style of presentation) model which generates eight experimental conditions. The results of this study show how remarkable are the occupational information and/or the information related to the quality level reached in a specific occupation which is being carried out, in the case of establishing, and consequently modifying, a valued judgement which is going to take place. This factor is more influential than allocating men´s or women´s category to an individual (AU)

Experiencia en el Instituto Nacional de Cancerología con infusores para quimioterapia ambulatoria a través de un catéter de permanencia prolongada / Experience at the Instituto Nacional de Cancerología with infusors for ambulatory chemoterapy through a long-lasting catheter

Se presenta la experiencia con el uso infusores para quimioterapia ambulatoria vigilado por un Equipo de Terapia Intravenosa en el Instituto Nacional de Cancerología. Se incluyeron todos los pacientes que recibieron quimioterapia ambulatoria por medio de infusores a través de un catéter para permanencia prolongada de abril de 1989 a diciembre de 1991. Se registraron los días/infusores, ciclos de quimioterapia, días de neutropenia, complicaciones infecciosas y no infecciosas relacionadas al uso de infusores así como del catéter de permanencia prolongada. En los casos con infección, se recabaron los microorganismos aislados. Se estudiaron 32 pacientes con edad promedio 53 años. Se administraron 106 ciclos de quimioterapia con 418 infusores. No se identificó ninguna complicación infecciosa relacionada al uso de infusores; únicamente se registraron dos episodios de infección del sitio de inserción del catéter, uno de ellos con bacteremia secundaria. Solo en un caso hubo falla mecánica de infusor. No hubo mortalidad asociada ni al uso de infusores ni al catéter para permanencia prolongada. La quimioterapia a través del uso de infusores es una opción real en nuestro medio, siempre y cuando los pacientes se apeguen estrictamente a las normas establecidas por el Equipo de Terapia Intravenosa