Tratamiento con radioterapia quimioterapia neoadyuvante vs adyuvante en adenocarcinomade recto: experiencia de 15 años / Treatment with neoadjuvant chemotherapy vs adjuvant in rectum adenocarcinoma: 15 years' experience

Experiencia 15 años tratamiento neoadyuvante vs., adyuvante ADC recto. MÉTODO: 223 pacientes ADC recto tratamiento RT QT período 2000-2015, divididos 3 grupos: 1. Tratamiento adyuvante (110), 2. ratamiento neoadyuvante (93), 3. Tratamiento neoadyuvante no operados (20). RT administrada técnica conformada 3D todos los pacientes excepto 3 RT intensidad modulada, dosis 4 500-4 600 cGy fracciones diarias 180-200 cGy, a pelvis técnica 4 campos, reducción sitio lesión macroscópica (RT neoadyuvante) o áreade nastomosis (RT adyuvante) 5 000-5 040 cGy. Esquemas QT más utilizados 5FU, 5FU-leucovorina, capecitabina sola o combinación oxaliplatino. RESULTADOS: Mayoría estadio III, mayor IIIB grupo neoadyuvante, 44 % vs. 30 % grupo adyuvante. Sobrevida global 5 años grupo RT-QT adyuvante 69,03 % vs. 81,24 % grupo RT-QT neoadyuvante, resultado no estadísticamente significativo (P=0,37) sobrevida libre enfermedad 5 años 80 % grupo RT-QT neoadyuvante vs. 56 % pacientes grupo RT-QT adyuvante, diferencia estadísticamente significativa (P=0,000392). 20 tratamiento neoadyuvante no cirugía, sobrevida global 5 años 50 %, resultados inferiores a tratamiento adyuvante y neoadyuvante. 59,2 % grupo neoadyuvante 86,4 % adyuvante se pudo preservar el esfínter. Toxicidad aguda más frecuente gastrointestinal, grado II-III, mayor grupo adyuvante (57 % vs. 45 %). Complicaciones crónicas GI, grado III, 2 pacientes grupo adyuvante 1 grupo neoadyuvante, grado IV. 2 grupo adyuvante 1 neoadyuvante. CONCLUSIONES: En 223 pacientes ADC recto, no se encontraron diferencias significativas SG tratamiento adyuvante vs., neoadyuvante pero SLE fue superior grupo tratamiento neoadyuvante. Toxicidad parece menor con tratamiento preoperatorio(AU)

OBJECTIVE: 15 years' experience treatment ADC rectal with adjuvant RT-CT vs., neoadjuvant RT-CT. METHOD: 223 patients rectal ADC treated with RT-CT surgery, during 2000-2015. Divided 3 groups: 1. Adjuvant therapy (110). 2. Neoadjuvant therapy (93) 3. Neoadjuvant therapy without surgery (20). Three D conformal RT used all patients except 3 treated with intensity modulated RT, doses 4 500-4 600 with 180-200 cGy daily fractions pelvis 4 field technique, 5 000- 5 040 cGy boost rectal tumor or the anastomosis. Chemotherapy more frequently was 5FU, 5FU-leucovorin, capecitabine alone or oxaliplatin. RESULTS: Majority stage III, IIIB was more frequent neoadjuvant group, 44 % vs., 30 % adjuvant group. 5 years overall survival was 69.03 % adjuvant RT-CT vs. 81.24 % with neoadjuvant RT-QT (P=0.37 disease free survival was higher neoadjuvant therapy, 80 % vs. 56 %, (P=0.000392). 20 treated neoadjuvant RT-CT no surgery, had 50 % OS 5 years, lower than adjuvant or neoadjuvant therapy. Grade II-III acute gastrointestinal toxicity was more common in patients with adjuvant therapy, 57 % vs. 45 % neoadjuvant therapy. One patient in each group grade IV, acute GI toxicity. Chronic grade III GI toxicity occurred, 2 with adjuvant therapy one neoadjuvant therapy, grade IV also 1 patient with preoperative RT-CT in 2 postoperative RT-CT. CONCLUSIONS: 223 rectal ADC, did not show significant difference in OS between adjuvant RT-CT and neoadjuvant RT-CT but DFS was higher with preoperative therapy. Toxicity seems lower in group treated with neoadjuvant therapy(AU)

Relación entre autoestima y felicidad desde la psicología positiva en estudiantes de enfermería intercultural / Relationship of self-esteem and happiness from the positive psychology among intercultural nursing students

ResumenIntroducción.Se observa contradicciones acerca de la relación entre la autoestima y la felicidad, dado que para algunos existe y para otros no, e incluso, hay quienes sostienen que la autoestima influye sobre la felicidad. Dichas variables son elementales para el ejercicio de la enfermería, sin embargo, su estudio dentro de los entornos interculturales es poco. El objetivo de la presente investigación es conocer la asociación entre la autoestima y la felicidad en estudiantes de enfermería intercultural desde la psicología positiva.Método.Se realizó una investigación cuantitativa, descriptiva, transversal y correlacional, con un diseño no experimental, con una muestra de 55 estudiantes de la licenciatura en enfermería intercultural. Se aplicó dos cuestionarios: la escala de autoestima de Robenberg y la escala de felicidad de Lima.Resultados.Se obtuvo niveles altos de autoestima y felicidad. Luego, mediante la correlación de Pearsony la regresión jerárquica se encontró que la autoestima se asocia de manera negativa y positiva con ciertos factores de la felicidad, lo cual se repite en cuanto a su influencia.Conclusión.Dentro de la psicología positiva es posible asociar de manera relevante variables como autoestima y felicidad como fortalezas, más aún en el caso de estudiantes de enfermería intercultural, quienes buscan contribuir al desarrollo de los pueblos originarios, al aportar profesionales en enfermería con niveles favorables de autoestima y de la percepción del bienestar subjetivo para contrarrestar una herencia histórica de atraso. A partir de la psicología positiva es posible que dicho modelo educativo contribuya al enriquecimiento mutuo y el empoderamiento dentro del quehacer de la enfermería intercultural.

AbstractIntroduction:There are contradictions on the relationship between self-esteem and happiness: it exists for some researches, for others it does not, and even some argüe that self-esteem affects happiness. These variables are elementary for the practice of Nursing; however, their study is small within intercultural environments. The objective of this research is to know the association between self-esteem and happiness among Intercultural Nursing students from the positive psychology.Method:A quantitative, descriptive, transversal and correlational, research with a non-experimental design was realized, with a sample of 55 students of Intercultural Nursing. Two questionnaires were applied: the scale of Robenberg self-esteem and happiness of Lima scale.Results:High levéis of self-esteem and happiness were obtained. Through correlation of Pearson and hierarchical regression we found that self-esteem is associated in negative and positive way with certain factors of happiness; the same thing happened in the level of influence.Conclusión:In positive psychology is possible to associate variables such as self-esteem and happiness as strengths. Much more in the case of Intercultural Nursing students which have the aim to contribute to the indigenous communities development, that require nurses with favorable levéis of self-esteem and the perception of subjective well-being to counteract an historical legacy of backwardness. From positive psychology is possible that this educational model will contribute to the mutual enrichment and empowerment within the work of the Intercultural Nursing.

Slow degeneration of zebrafish Rohon-Beard neurons during programmed cell death.

Rohon-Beard cells are large, mechanosensory neurons located in the dorsal spinal cord of anamniote vertebrates. In most species studied to date, these cells die during development. We followed labeled Rohon-Beard cells in living zebrafish embryos and found that they degenerate slowly, over many days. During degeneration, the soma shrinks and finally disappears, and the processes become beady in appearance and finally break apart, but they do not retract. Zebrafish Rohon-Beard cells apparently fragment their DNA, as revealed by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) labeling, before undergoing degenerative morphologic changes. We also followed the development of labeled dorsal root ganglion neurons, as they are developing at the same stages that Rohon-Beard cells are degenerating. We found that, although axons of both cell types extend into similar regions, Rohon-Beard cells degenerate normally in mutants lacking dorsal root ganglia, providing evidence that interactions between the two cell types are not responsible for Rohon-Beard cell degeneration. Developmental Dynamics 229:30-41,2004.