Pro-hepcidina, su relación con indicadores del metabolismo del hierro y de inflamación en pacientes hemodializados tratados o no con eritropoyetina recombinante / Pro-hepcidin, its relation with indicators of iron metabolism and of inflammation in patients hemodialyzed treated or not with recombinant erythropoietin

La hepcidina, péptido antimicrobiano, cuya síntesis se encuentra regulada por el estado del hierro e inflamación, juega un importante papel en la homeostasis del hierro en pacientes hemodializados (HD). Es medida a través de la prohepcidina sérica. Objetivo: Determinar los niveles séricos de prohepcidina y su relación con ferritina sérica, proteína C reactiva (PCR) y albúmina en pacientes HD tratados o no con eritropoyetina recombinante (EPO), que asistieron a un Centro de Salud del Estado Carabobo-Venezuela. Metodología: Esta investigación es de tipo descriptiva, correlacional y de campo, cuya muestra estuvo conformada por 71 pacientes HD; 57 de éstos tratados con EPO. Se determinó prohepcidina sérica, ferritina, hemoglobina, hematocrito, PCR y albúmina. Se definió anemia (hemoglobina < 10 g/dL) y deficiencia de hierro (ferritina < 100 ng/mL) de acuerdo al criterio recomendado por grupo K/DOQUI. Valores de referencia: Albúmina 3,5 a 4,8 g/dL, para procesos inflamatorios agudos (PCR > 10 mg/L). Resultados: El promedio para la prohepcidina fue de 397,5 ng/mL. Se observó un alto porcentaje de anemia (87,3%) y un 22,5% de pacientes con ferritina sérica baja. No se observaron diferencias estadísticamente significativas para ferritina, albúmina, PCR y prohepcidina, entre pacientes con y sin tratamiento con EPO. Solo la variable PCR se correlaciona significativamente (rho = 0,276; p =0,020), con prohepcidina. Conclusión: Pacientes HD presentan niveles elevados de prohepcidina, esto pudiera deberse al proceso inflamatorio frecuentemente observado en estos pacientes y no al estado de hierro medido a través de los niveles de ferritina sérica (AU)

Hepcidin, an antimicrobial peptide which synthesis is regulated by iron status and inflammation, plays an important role in iron homeostasis in hemodialysed (HD) patients. It is measured by measuring serum prohepcidin. Objective: To determine serum prohepcidin levels and their relationship with serum ferritin, C reactive protein (CRP), and albumin in HD patients treated or not with recombinant erythropoietin (EPO) that attended the Health Centre of the Carabobo State in Venezuela. Methodology: This is a descriptive, correlational, and field investigation with a sample comprised by 71 HD patients of whom 57 were treated with EPO. Serum prohepcidin, ferritin, haemoglobin, hematocrit, CRP, and albumin were determined. Anaemia (haemoglobin < 10 g/dL) and iron deficiency (ferritin < 100 ng/mL) were defined according to the criteria recommended by the K/DOQUI group. Reference values: Albumin 3.5-4.8 g/dL, and for acute inflammatory conditions (CRP > 10 mg/L.). Results: The mean value for prohepcidin was 397.5 ng/mL. A high percentage of anaemia was observed (87.3%) and 22.5% of the patients had low levels of serum ferritin. There were no statistically significant differences for ferritin, albumin, CRP, or prohepcidin, between patients with and without EPO therapy. Only the CRP value was significantly correlated (rho = 0.276; p = 0.020) with prohepcidin. Conclusion: HD patients present high levels of prohepcidin, and this may be due to the common ongoing inflammatory process in these patients and not to the iron status measured through serum ferritin levels (AU)

[Teaching coping strategies to parents of children suffering from cancer using a short film]. / Enseñar estrategias de afrontamiento a padres de niños con cáncer a través de un cortometraje.

This paper studies the usefulness of a short film in teaching strategies for parents of children with cancer to cope with the situation. The short film is based on an analysis of the transcripts from eight sessions of a self-help group. The short film has been evaluated by psychologists working for each of the parent groups belonging to the Federation of parents of children with cancer. Furthermore, the film has been exhibited in group sessions that took place in the Valencia and Alicante branches of ASPANION (Association of Parents with Oncologic Children in the Valencia Region). About 70% of the experts have declared that the film is a valuable resource for teaching useful strategies to parents. The film also improves the group sessions since it addresses a number of issues that had not been addressed before, and it stimulates the participation of, and communication between, parents during the session.

[Parent-doctor relations in oncology: a qualitative approach]. / Relaciones padres-médicos en oncología: un enfoque cualitativo.

We want to learn how parents of children with cancer perceive their relationship with hospital staff, especially with doctors. We used group-based qualitative methodology. The sample is composed of 14 mothers/fathers whose children contracted the disease more than two years previously. All parents want information that is both intelligible and detailed. The word cancer has a strong social stigma and is avoided when giving information to parents and to children. Communication between doctors and parents can lead to situations of tension during diagnosis and relapses. Parents trust the professionalism of doctors. Parents also want doctors to be competent and to have human qualities. The preparation of reports by physicians is the task most criticized by parents.