Gestación tras cáncer / Pregnancy after cancer

El embarazo o el deseo gestacional en personas con antecedentes oncológicos son situaciones clínicas de frecuencia creciente que requieren un abordaje global. El consejo preconcepcional es básico en estos casos, y debe incluir una valoración conjunta y una coordinación multidisciplinar entre los especialistas de oncología o del proceso de base, de fertilidad o reproducción, y obstetricia o medicina maternofetal. El objetivo de esta valoración incluye consensuar el momento óptimo para asumir una gestación de forma segura sin empeorar el pronóstico de su enfermedad y planificar el seguimiento de la gestación de acuerdo con las posibles complicaciones maternas o perinatales. En la presente revisión se detallan los aspectos reproductivos más relevantes de tres de los tipos de cáncer más frecuentes en la edad reproductiva: el cáncer de mama, el cáncer de cérvix y los cánceres hematológicos.(AU)

Pregnancy or reproductive desire in people with a previous cancer represents a clinical situation of increasing frequency that requires a global approach. Preconceptional counseling is mandatory in these cases and should include a global assessment and multidisciplinary coordination between specialists in oncology, fertility and obstetrics or maternal-fetal medicine. The objective of this assessment includes determining the optimal time-to-pregnancy safe for the mother, without worsening the prognosis of the disease and planning the pregnancy follow-up according to possible maternal or perinatal complications. This review details the most relevant reproductive aspects of three of the most frequent types of cancer during reproductive age: breast cancer, cervical cancer and hematological cancers.(AU)

Pollen production in olive cultivars and its interannual variability.

BACKGROUND AND AIMS: Olive (Olea europaea subsp. europaea var. europaea) is the most extensively cultivated fruit crop worldwide. It is considered a wind-pollinated and strictly outcrossing crop. Thus, elevated pollen production is crucial to guarantee optimum fruit set and yield. Despite these facts, the variability of pollen production within the cultivated olive has been scarcely studied. This study aimed to characterize this feature by analysing a representative set of worldwide olive cultivars. METHODS: We evaluated the average number of pollen grains per anther in 57 principal cultivars over three consecutive years. We applied a standard generalized linear model (GLM) approach to study the influence of cultivar, year and the previous year's fruit load on the amount of pollen per anther. Additionally, the K-means method was used for cluster analysis to group cultivars based on their pollen production capacity. KEY RESULTS: Pollen production per anther was highly variable among olive cultivars. The cultivar significantly accounted for 51.3 % of the variance in pollen production and the year for 0.3 %. The interaction between the two factors explained 8.4 % of the variance, indicating that not all cultivars were equally stable in producing pollen across the years. The previous year's fruit load and its interaction with the year were significant, but barely accounted for 1.5 % of the variance. Olive cultivars were classified into four clusters according to their capacity to produce pollen. Interestingly, the fourth cluster was composed of male-sterile cultivars, which presumably share this character by inheritance. CONCLUSIONS: Pollen production per anther varied extensively within the cultivated olive. This variation was mainly driven by the cultivar and its interaction with the year. The differential capacity of olive cultivars to produce pollen should be considered not only for designing new orchards but also gardens where this species is used as an ornamental.

Long-term trends and influence of climate and land-use changes on pollen profiles of a Mediterranean oak forest.

Climate change is disrupting phenology and interaction patterns of natural ecosystems, but also human activities that modify land-uses have a direct impact, especially on species distribution and loss of biodiversity. The objective of this study is to evaluate the impact of climate and land-use changes on phenology and airborne pollen spectrum in a Mediterranean natural area, dominated by Quercus Forest and 'dehesa', in the South of the Iberian Peninsula. 61 different pollen types were identified over a 23-year period (1998-2020), mainly from trees and shrubs, such as Quercus, Olea, Pinus or Pistacia, and from herbaceous plants, such as Poaceae, Plantago, Urticaceae or Rumex. A comparison of pollen data from the first years of the study (1998-2002) up recent years (2016-2020), showed a substantial decrease in the relative abundance of pollen from autochthonous species associated with natural areas, such as Quercus or Plantago. However, the relative abundance of the pollen from cultivated ones such as Olea and Pinus, which is used for reforestation has increased. Regarding flowering phenology trends, our analyses revealed variations between -1.5 and 1.5 days per year. Taxa showing an advance phenology were Olea, Poaceae and Urticaceae, whereas Quercus, Pinus, Plantago, Pistacia or Cyperaceae experienced delayed pollination. Meteorological trends in the area generally resulted in an increase in both minimum and maximum temperatures, along with a decrease in precipitations. Changes in pollen concentration and phenology were correlated with changes in air temperatures and precipitation, although the positive or negative influence varied for each pollen type. The results suggest that climate change together with those motivated by land cover changes lead by human activities are having an impact on the phenology and pollen concentration, with the related consequences on pollination and therefore biodiversity more concerning in threatened areas as the Mediterranean Basin.

Reacción cútanea debida a remdesivir en paciente con enfermedad por SARS-CoV-2 / Skin reaction due to remdesivir in a patient with SARS-CoV-2 disease

En diciembre de 2019 se detectó por primera vez en la ciudad china de Wuhan una nueva enfermedad infecciosa con el nombre oficial de COVID-19, causada por un nuevo tipo de coronavirus denominado virus SARS-CoV-2, la infección se ha propagado rápida y extensamente por todo el mundo, por lo que el 11 de marzo de 2020 la Organización Mundial de la Salud la declaró pandemia. Al tratarse de una nueva infección, no existe por el momento evidencia que permita recomendar un tratamiento específico, en la actualidad el único medicamento con indicación autorizada por la Agencia Europea de Medicamentos (EMA) es el remdesivir. A continuación presentamos el caso de una reacción adversa a remdesivir, si bien no fue grave, cabe destacar la importancia de notificar efectos adversos y más en medicamentos novedosos como este. (AU)

In December 2019, a new infectious disease with the official name of COVID-19 was detected for the first time in the Chinese city of Wuhan, caused by a new type of coronavirus called SARS-CoV-2 virus, the infection has spread rapidly and widely throughout the world, which is why on March 11, 2020, the World Health Organization declared it a pandemic. As it is a new infection, there is currently no evidence to recommend a specific treatment, currently the only drug with an indication authorized by the European Medicines Agency (EMA) is remdesivir.We present the case of an adverse reaction to remdesivir, although it was not serious, it is worth highlighting the importance of reporting adverse effects and more in novel drugs like this one. (AU)

Variaciones en la incidencia de bronquiolitis tras la aparición del SARS-CoV-2 / Variations in the incidence of bronchiolitis after the onset of SARS-CoV-2

Introducción. Durante la temporada 2020-2021 se ha asistido a una disminución de la incidencia de hospitalizaciones por bronquiolitis. Los cambios en la evolución de la pandemia de SARS-CoV-2 y en la aplicación de medidas preventivas podrían relacionarse con un aumento de la incidencia de bronquiolitis grave durante la temporada 2021-2022. Objetivo. Determinar la incidencia de hospitalizaciones por bronquiolitis en un hospital terciario durante la temporada 2021-2022 y compararla con temporadas previas. Método. Estudio epidemiológico de tipo observacional, descriptivo y ambispectivo. A través de la base de datos de un hospital terciario, se compararon la incidencia, la etiología y los indicadores de gravedad de las hospitalizaciones por bronquiolitis. Se analizaron 3 cohortes en época epidémica: la temporada 2020-2021 y la 2021-2022 (prospectivas); y la temporada 2018-2019 (retrospectiva). También se analizó una cohorte prospectiva entre los meses de abril y octubre de 2021. Resultados. La incidencia acumulada de hospitalizaciones fue de 113,6/10.000 niños menores de 2 años en la temporada pre-covídica; de 3,6/10.000 en la temporada 2020-2021; y de 65,7/10.000 en la temporada 2021-2022. El porcentaje de ingresos en UCIP fue de 36,6%, 0 % y 30,8%, respectivamente. La incidencia acumulada de hospitalizaciones en el periodo no epidémico fue de 60,8/10.000, precisando ingreso en UCIP el 19%. El microorganismo más frecuente fue el virus respiratorio sincitial en todas las cohortes. Conclusiones. La incidencia durante los meses típicamente epidémicos de bronquiolitis bajó drásticamente la temporada en la que apareció el SARS-CoV-2, aumentando notablemente el año posterior, aunque sin alcanzar la incidencia previa a la pandemia. Se ha observado una incidencia alta de casos de bronquiolitis entre abril y octubre de 2021 (AU)

Introduction. A decrease has been observed during the 2020-2021 season in the incidence of hospitalizations for bronchiolitis. Changes in the evolution of the SARS-CoV-2 pandemic and in the application of preventive measures could be related to an increase in the incidence of severe bronchiolitis during the 2021-2022 season. Objective. To determine the incidence of bronchiolitis hospitalizations in a tertiary hospital during the 2021-2022 season and to compare it with previous seasons. Method. An observational, descriptive and ambispective epidemiological study. A tertiary hospital database was used to compare the incidence, etiology, and severity indicators of bronchiolitis hospitalizations. 3 cohorts were analyzed in epidemic times: the 2020-2021 season and the 2021-2022 season (prospective); and the 2018-2019 season (retrospective). A prospective cohort between the months of April and October 2021 was also analyzed. Results. The cumulative incidence of hospitalizations was 113.6/10,000 children under 2 years of age in the pre-covid season; 3.6/10,000 in the 2020-2021 season; and 65.7/10,000 in the 2021-2022 season. The percentage of admissions in PICU was 36.6%, 0% and 30.8%, respectively. The cumulative incidence of hospitalizations in the non-epidemic period was 60.8/10,000, with 19% requiring admission to the PICU. The most frequent microorganism was the respiratory syncytial virus in all cohorts. Conclusions. The incidence during the typically epidemic months of bronchiolitis drastically decreased the season in which SARS-CoV-2 appeared, noticeably increasing the next year, although without reaching the pre-pandemic incidence. A high incidence of bronchiolitis cases was observed between April and October 2021 (AU)

Realidad virtual: ¿puede ayudar en la realización de procedimientos invasivos a niños? / Virtual reality: can this help in the performance of invasive procedures on children?

Objetivo. Valorar si el uso de gafas de realidad virtual (RV) es un procedimiento con posible aplicación para disminuir el dolor percibido por los niños al enfrentarse a procedimientos dolorosos. Material y métodos. Se realizó un estudio prospectivo observacional en pacientes pediátricos que acuden al hospital de día de Cuidados Intensivos Pediátricos (CIP) para la realización de procedimientos invasivos que precisan canalizar una vía venosa. Resultados. Participaron en el estudio 22 pacientes (13 niños y 9 niñas) de edades comprendidas entre 5 y 16 años, con una media de edad de 9,7 ± 3,5 años. La medición del dolor se llevó a cabo mediante las escalas de Wong-Baker y la Escala Visual Analógica (EVA), según la edad de los pacientes, obteniéndose una media de dolor de 2,42 ± 2,06 sobre 10 puntos. Además, se recogió el nivel de satisfacción con la intervención, mediante una encuesta no validada valorada del 0 al 4, con una satisfacción de 3,89 puntos en los pacientes; 3,71 en sus padres; 3,94 en el personal médico y 3,50 en el de enfermería. Conclusiones. El uso de RV es fácilmente aplicable a niños sometidos a procedimientos dolorosos, con un alto nivel de satisfacción con la intervención, y podría contribuir a disminuir el dolor percibido por el paciente (AU)

Objective. Evaluate if using Virtual Reality (VR) could be useful to reduce perceived pain between children facing painful procedures. Material and methods. An observational prospective study was performed in paediatric patients who attended the Paediatric ICU’s Day hospital to get invasive procedures done, where a previous venipuncture was needed. Results. 22 patients were included (13 males and 9 females) of ages between 5 and 16 years old, with an average of 9.7 ± 3.5 years old. The most common procedure, performed in 14 patients, was digestive endoscopy. Pain measurement was analyzed with Wong-Baker and visual analog scales, depending on childrens’ ages, getting a final pain average of 2.42 ± 2.06 out of 10 points. What is more, the satisfaction level was studied with a non validate scale going from 0 to 4, getting a result of 3.89 points between patients; 3.71 between their parents; 3.94 between doctors and 3.50 between nurses. Conclusion. Using VR is suitable for children undergoing painful procedures, getting a high satisfaction level with the intervention, and it could contribute to diminish pain level perceived by the patient (AU)