Actualización del manejo de metástasis encefálicas / Metastasis management update encephalic

Brain metastases represent a critical stage of oncological disease and its frequency is increasing over the recent years. The treatment of brain metastases has moved from a conservative approach to an active management that should be individualized for each patient: in case of single brain metastasis, surgery or radiosurgery should be considered as first option of treatment; in case of multiple lesions, whole-brain radiotherapy is the standard of care. The aim of this review is to present general aspects including new approaches in management of patients with brain metastases.(AU)

Papel del estrés oxidativo en la evolución de la sepsis en pacientes pediátricos / Role of oxidative stress in the development of sepsis in pediatric patients

La sepsis se define como una reacción defensiva e inflamatoria sistémica exagerada que ocurre en respuesta a una infección, la cual conduce a la posterior pérdida de la homeostasis corporal. La sepsis y la falla multiorgánica constituyen la principal causa de muerte en las unidades de cuidados intensivos de pacientes pediátricos, y su incidencia va aumentando anualmente. Estudios recientes han reportado que el estrés oxidativo cumple un papel fundamental en su fisiopatología, con un aumento en los niveles de lipoperoxidación y la detección directa de radicales en la circulación, y una disminución de la capacidad antioxidante. Por otro lado, se ha reportado que el uso de antioxidantes en el tratamiento de esta patología aumentaría el porcentaje de supervivencia de los pacientes de unidades de cuidados intensivos, tanto de adultos como en pacientes pediátricos, ya que se reduciría el daño mitocondrial y el desarrollo de estrés oxidativo.

Sepsis is defined as a defensive reaction and exaggerated systemic inflammatory response that occurs in an infection, which leads to further loss of body homeostasis. Sepsis and multiple organ failure are the leading cause of death in intensive care units of pediatric patients, and its incidence is increasing annually. Recent studies have reported that oxidative stress plays a key role in the pathophysiology of this disease, with increased levels of lipid peroxidation and direct detection of free radicals in circulation, and decreased antioxidant capacity. On the other hand, it has been reported that the use of antioxidants in the treatment of this condition would increase the survival rate of patients in intensive care units in both adult and pediatric patients, as this reduces mitochondrial damage and the development of oxidative stress.