Retrospective analysis of the use of G-CSF and its impact on dose response for anthracycline plus taxane-based schedules in early breast cancer

PURPOSE: T cells are dominant in the immune regulation of malignant pleural effusion (MPE). However, it is unclear about the role of IL-17+ T cells, particularly for IL-17+CD8+ Tc17 cells in antitumor immunity. This retrospective study is aimed at evaluating the prognostic significance of IL-17+ T cells in patients with MPE. METHODS: The frequency of IL-17+CD4+ Th17 and IL-17+CD8+ Tc17 cells in peripheral blood (PB), pleural fluids (PF), and tumor tissues in 24 patients undergoing thoracoscopy was determined by flow cytometry, immunohistochemistry, and ELISA. The association among the different measures was analyzed by Spearman's correlation tests. RESULTS: The percentages of PF Th17 and Tc17 cells were significantly higher than those in the PB of MPE patients and healthy controls (p < 0.01). Analysis of Th17 and Tc17 cells in the tumor tissues indicated that the percentages of Th17 and Tc17 cells in the invading tumor edge were significantly higher than those in the non-tumor tissues and intra-tumor regions (p < 0.05). More importantly, the percentages of IL-17+ T cells were associated with prolonged survival of patients with MPE. CONCLUSIONS: Both Th17 and Tc17 cells were involved in the tumor immunity against MPE. Increased frequency of Tc17 cells may serve as a biomarker for the prognosis of patients with MPE (AU)

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Aprender a dormir / To learn how to sleep

Introducción: aprender a dormir en la infancia tiene repercusiones relevantes en el desarrollo integral del niño. Como profesionales sanitarios, debemos ser capaces de proporcionar las directrices adecuadas para la adquisición de hábitos saludables en la necesidad de dormir de los más pequeños. El análisis de cada caso requiere una solución adaptada a cada familia para lograr el descanso nocturno. En nuestra sociedad actual, se utilizan diferentes métodos para la adquisición de buenos hábitos para dormir de forma saludable desde los primeros años de vida. Eduard Estivill, a través de su libro Duérmete, niño, y Carlos González, con Bésame mucho, han expuesto dos estilos diferentes sobre cómo crear correctos hábitos del sueño infantil. Material y métodos: en este trabajo se realiza una investigación cualitativa a través del estudio de dichas metodologías y del testimonio de dos familias. Se quiere profundizar en los beneficios y dificultades que han aportado ambos métodos en el aprendizaje del dormir de los más pequeños. Resultados: el conocimiento de ambos métodos nos enriquece, ya que incrementa las herramientas disponibles para solventar cualquier situación relacionada con los hábitos del sueño. Después de analizar las dos entrevistas, se comprueba que las dos metodologías fueron llevadas a término con éxito, al conseguir dormir a los pequeños. Conclusiones: lo más importante no es el método utilizado, sino que los padres, ante la dificultad de enseñar a dormir a sus hijos, pasan por diferentes etapas en las que tanto su salud como la de sus niños pueden estar en situación de riesgo, sobre todo cuando se trata del primer hijo y cada situación es un nuevo reto (AU)

Introduction: learning how to sleep in the first years, play an important role in the child’s development. As healthcare professionals, we should try to provide parents with an appropriate guidance on child’s healthy sleeping habits. The analysis of each case requires a solution adapted to each family for the night's rest. Nowadays, there are different methods in order to get good sleeping habits in the early years. For instance, Eduard Estivill, through his book Duérmete, niño and Carlos González in Bésame mucho. They have exposed two different styles of how to create correct child sleeping habits. Materials and methods: this work is a qualitative research through the study of these methodologies and two families' evidences. We want to explore the benefits and difficulties of these two methods on the acquisition of sleeping well in children. Results: the knowledge of both methods provides us with the opportunity to solve any situation related to sleeping habits in the early years. Moreover, the two families’ interviews prove that both methods work successfully. To sum up, the most important issue is not the method. Conclusions: the most important thing is being conscious that there are different stages that parents have to go through while teaching their children how to sleep well, and these stages could imply risky situations in parents and children health. Especially when it's their first child, with whom any situation is a challenge for the parents (AU)

Cuidados Paliativos Pediátricos / Pediatric Palliative Cares

Los Cuidados Paliativos Pediátricos (CPP) son una subespecialidad emergente de la Pediatría en constante crecimiento desde sus inicios en la década de los 90. Desde sus primeros pasos, dados por pediatras preocupados por la asistencia al paciente terminal en hospitales, se ha logrado la formación de unidades multidisciplinarias que realizan una atención domiciliaria y que tratan a pacientes que no son necesariamente terminales. Aunque esto ha supuesto un gran logro, existe una gran heterogeneidad dependiendo de la región donde se encuentre el paciente. Para minimizar este desequilibrio es importante que todos los profesionales relacionados con la atención pediátrica reciban formación sobre CPP y así conseguir una amplia red de profesionales con conocimientos suficientes para realizar una atención adecuada de forma extrahospitalaria. Esta revisión pretende ser una aproximación de carácter práctico que pueda ser útil a todos los profesionales sanitarios implicados en el manejo de pacientes pediátricos que puedan beneficiarse de cuidados paliativos, centrando principalmente la atención en el control de síntomas (AU)

Pediatric Palliative Care (CPP) is an emerging subespecialty in constant growth since its beginning in the early90's. Pediatricians concerned about terminal patient care in hospitals gave first steps to achieve the formation of multidisciplinary units performing home care and treating not necessarily terminal patients. Although this has represented a great achievement, there are important differences depending on where the patient lives. For minimazing this imbalance is important that all professionals involved in pediatric care get CPP training; in this way, a wide network of professionals with knowledge enough for proper care in the outpatient setting will be available. This review pretends to be a practical approach useful for all health professionals involved in pediatric patients management who may benefit of palliative care, mainly focusing on symptoms control (AU)

Leptospirosis: Aspects of Innate Immunity, Immunopathogenesis and Immune Evasion Fromthe Complement System

Leptospirosis is a neglected infectious disease caused by spirochetes from the genus Leptospira. It constitutes a major public health problem in developing countries, with outcomes ranging from subclinical infections to fatal pulmonary haemorrhage and WeilŒs syndrome. To successfully establish an infection, leptospires bind to extracellular matrix compounds and host cells. The interaction of leptospires with pathogen recognition receptors is a fundamental issue in leptospiral immunity as well as in immunophatology. Pathogenic but not saprophytic leptospires are able to evade the host complement system, circulate in the blood and spread into tissues. The target organs in human leptospirosis include the kidneys and the lungs. The association of an autoimmune process with these pathologies has been explored and diverse mechanisms that permit leptospires to survive in the kidneys of reservoir animals have been proposed. However, despite the intense research aimed at the development of a leptospirosis vaccine supported by the genome sequencing of Leptospira strains, there have been relatively few studies focused on leptospiral immunity. The knowledge of evasion strategies employed by pathogenic leptospires to subvert the immune system is of extreme importance as they may represent targets for the development of new treatments and prophylactic approaches in leptospirosis.