Chemotherapy, Alopecia, and Scalp Cooling Systems. / Alopecia, quimioterapia y gorras de frío o «scalp cooling system¼.

Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice.

Alopecia, quimioterapia y gorras de frío o «scalp cooling system» / Chemotherapy, Alopecia, and Scalp Cooling Systems

La alopecia es un efecto generalmente transitorio del tratamiento con citostáticos, generador de una importante repercusión emocional en el tratamiento contra el cáncer, muchas veces responsable de rechazo de distintas maniobras terapéuticas. Si bien en la mayoría de los casos es reversible, esto puede involucrar meses, amplificando el impacto, sobre todo psicológico, de los tratamientos. En los últimos años han surgido estrategias con gorras de frío, o «scalp cooling system» que buscan prevenir, o al menos limitar, este efecto adverso, con resultados que se han mostrado promisorios. El objetivo de esta revisión es analizar la evidencia con la que contamos respecto a los efectos y eficacia de este tipo de técnicas que han empezado a inmiscuirse dentro de nuestra práctica clínica diaria (AU)

Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice (AU)

[Translated article] Chemotherapy, Alopecia, and Scalp Cooling Systems / Alopecia, quimioterapia y gorras de frío o «scalp cooling system»

Chemotherapy-induced hair loss in cancer is usually temporary but can take a significant emotional toll on patients and lead to treatment refusal in many cases. Although hair loss is usually reversible, regrowth can take months, causing greater psychological distress. Recent years have seen the emergence of cold caps, or scalp cooling systems, designed to prevent or at least reduce chemotherapy-induced hair loss. The results to date are encouraging. We review the evidence on the effects and effectiveness of these systems, which are making their way into routine clinical practice (AU)

La alopecia es un efecto generalmente transitorio del tratamiento con citostáticos, generador de una importante repercusión emocional en el tratamiento contra el cáncer, muchas veces responsable de rechazo de distintas maniobras terapéuticas. Si bien en la mayoría de los casos es reversible, esto puede involucrar meses, amplificando el impacto, sobre todo psicológico, de los tratamientos. En los últimos años han surgido estrategias con gorras de frío, o «scalp cooling system» que buscan prevenir, o al menos limitar, este efecto adverso, con resultados que se han mostrado promisorios. El objetivo de esta revisión es analizar la evidencia con la que contamos respecto a los efectos y eficacia de este tipo de técnicas que han empezado a inmiscuirse dentro de nuestra práctica clínica diaria (AU)

Modification of the Fluctuation Dynamics of Ultrathin Wetting Films.

We report on the effect of intermolecular forces on the fluctuations of supported liquid films. Using an optically induced thermal gradient, we form nanometer-thin films of wetting liquids on glass substrates, where van der Waals forces are balanced by thermocapillary forces. We show that the fluctuation dynamics of the film interface is strongly modified by intermolecular forces at lower frequencies. Data spanning three frequency decades are in excellent agreement with theoretical predictions accounting for van der Waals forces. Our results emphasize the relevance of intermolecular forces on thermal fluctuations when fluids are confined at the nanoscale.

The relationship between second-hand smoke and wheezing in infants from Córdoba, Argentina.

BACKGROUND: Wheezing constitutes a common respiratory symptom in children, and several risk factors have been associated with the prevalence of recurrent wheezing (RW) and its severity, especially viral respiratory infections and second-hand smoke (SHS) exposure. OBJECTIVE: To analyze the relationship between smoking patterns in the home and wheezing, in infants from the city of Córdoba, Argentina, during their first year of life. METHODS: Parents of infants were invited to complete a standardized questionnaire voluntarily and anonymously (WQ-P1-EISL). Wheezing in the first 12 months of life was classified as occasional wheezing (OW) when having one or two episodes during the first 12 months of life; recurrent wheezing (RW) if having three or more, and more frequent wheezing (MFW) ≥6 episodes. RESULTS: 409 infants (39.0%) had one or more episodes of wheezing in the first 12 months. Of these, 214 infants (52.3%) presented occasional wheezing (OW), 135 (33%) had recurrent wheezing (RW), and 60 (14.7%) more frequent wheezing (MFW). SHS was significantly related to MFW, especially if the mother smoked (OR=2.7; IC 95%: 1.4-5.18; p=0.0009) or if she smoked during pregnancy (OR=4; IC 95%: 1.8-8.5; p=0.0001). This group of MFW was also associated with SHS as well as having been to the emergency room for wheezing (40.87%, p=0.0056). CONCLUSION: The results indicate that second-hand tobacco smoke is a significant risk factor for the presence of wheezing in infants, and for its severity. Our findings have significant implications for public health, as smoking is a modifiable behavior.

Postmenopausal androgen-secreting ovarian tumors: challenging differential diagnosis in two cases.

Postmenopausal hyperandrogenism constitutes a very rare condition of tumoral or non-tumoral origin primarily residing either in the ovary or in the adrenal glands. We present herein two cases with this condition; one with abnormal postmenopausal genital bleeding and mild increase in facial hair, and the second with slow-developing hirsutism and virilization. Both cases shared a notorious increase in libido. The laboratory tests showed high levels of testosterone (>100 ng/ml). A normal value of dehydroepiandrosterone sulfate and a normal cortisol level at 9 am after 1 mg of dexamethasone administered at midnight (Nugent test) made an adrenal etiology very unlikely. On the other hand, a high level of inhibine B oriented to an ovarian source. Transvaginal sonography failed to demonstrate an ovarian tumor, but an abdominal and pelvic computed tomography scan or magnetic resonance imaging detected an ovarian tumor and normal adrenal glands. A laparoscopic oophorectomy was performed, and the histological study demonstrated a steroidal cell tumor in the first case and a Leydig cell tumor in the second.

Simvastatin interferes with cancer 'stem-cell' plasticity reducing metastasis in ovarian cancer.

Cell plasticity of 'stem-like' cancer-initiating cells (CICs) is a hallmark of cancer, allowing metastasis and cancer progression. Here, we studied whether simvastatin, a lipophilic statin, could impair the metastatic potential of CICs in high-grade serous ovarian cancer (HGS-ovC), the most lethal among the gynecologic malignancies. qPCR, immunoblotting and immunohistochemistry were used to assess simvastatin effects on proteins involved in stemness and epithelial-mesenchymal cell plasticity (EMT). Its effects on tumor growth and metastasis were evaluated using different models (e.g., spheroid formation and migration assays, matrigel invasion assays, 3D-mesomimetic models and cancer xenografts). We explored also the clinical benefit of statins by comparing survival outcomes among statin users vs non-users. Herein, we demonstrated that simvastatin modifies the stemness and EMT marker expression patterns (both in mRNA and protein levels) and severely impairs the spheroid assembly of CICs. Consequently, CICs become less metastatic in 3D-mesomimetic models and show fewer ascites/tumor burden in HGS-ovC xenografts. The principal mechanism behind statin-mediated effects involves the inactivation of the Hippo/YAP/RhoA pathway in a mevalonate synthesis-dependent manner. From a clinical perspective, statin users seem to experience better survival and quality of life when compared with non-users. Considering the high cost and the low response rates obtained with many of the current therapies, the use of orally or intraperitoneally administered simvastatin offers a cost/effective and safe alternative to treat and potentially prevent recurrent HGS-ovCs.

Risk factors for recurrent wheezing in the first year of life in the city of Córdoba, Argentina.

BACKGROUND: Wheezing is a very common respiratory symptom in infants. The prevalence of wheezing in infants, conducted in developed countries shows prevalence rates ranging between 20% and 30%. However, we do not know the risk factors in our population of wheezing infants. METHODS: A standardised written questionnaire (WQ-P1-EISL) in infants between 12 and 18 months of age residing in the city of Cordoba was used; population/sample included 1031 infants. Recurrent wheezing (RW) was defined as three or more episodes of wheezing reported by the parents during the first 12 months of life. Data obtained were coded in Epi-Info™ (version 7) and statistically analysed with SPSS (version 17.5) software in Spanish. Parametric tests (one-way ANOVA) were performed for identifying significantly associated variables. RESULTS: The prevalence of wheezing infants was 39.7%; recurrent wheezing 33%; and severe wheezing 14.7%; 13.7% had pneumonia before the first year and of these 6.3% were hospitalised, multiple variables as risk factors for wheezing were found such as: >6 high airway infections and bronchiolitis in the first three months of life, smokers who smoke in the home among other risk factors and protective factors in those who have an elevated socioeconomic status. CONCLUSION: It is known that persistent respiratory problems in children due to low socioeconomic status is a risk factor for wheezing, pneumonia and could be a determining factor in the prevalence and severity of RW in infants. Research suggests that there are areas for improvement in the implementation of new educational strategies.

Enfermedades emergentes: eosinofilia en el niño migrante / Emerging diseases: eosinophilia in migrant children

La eosinofilia es uno de los hallazgos analíticos más frecuentes en los protocolos de cribado del niño migrante; de ahí la necesidad de implantar algoritmos diagnósticos. Aunque ha quedado demostrada la importante asociación entre eosinofilia y parasitación por helmintos en pacientes procedentes de áreas endémicas, el diagnóstico diferencial es más amplio y requiere un estudio estructurado y unificado. El objetivo de esta revisión es ilustrar con casos clínicos concretos una realidad cada vez más patente en nuestro medio como es la patología emergente y, a su vez, proponer un protocolo de cribado específico de eosinofilia en la edad pediátrica, sobre todo en estos pacientes con antecedentes epidemiológicos de movilidad geográfica. Este tipo de actuaciones permitirán la detección precoz y el tratamiento específico de las enfermedades asintomáticas u oligosintomáticas, que en muchas ocasiones no son percibidas por estas familias como un problema de salud (AU)

Eosinophilia is one of the most frequent analytical findings in paediatrics screenings focused on migrant children. On this basis, it is necessary to propose a specific diagnosis protocol for those patients. Although it has been proved there is a significant association between eosinophilia and parasitic infection by helminths in patients from endemic areas, the differential diagnosis is wider and requires a unified and structured approach. The objective of this report is to use specific case reports to illustrate the emerging diseases as a growing phenomenon, as well as to propose a specific pediatrics screening protocol for eosinophilia, especially for patients with a geographical mobility background. These diagnoses will lead to an early detection and specific treatment of asymptomatic or mildly symptomatic children, because those conditions are not often perceived as a health problem by these families (AU)

Evaluation of Bone Mineral Density in Patients with Type 1 Gaucher Disease in Argentina.

The purpose of this study was to evaluate the frequency of osteoporosis (OP) in patients with Gaucher disease (GD) in Argentina. GD patients from 28 centers were consecutively included from April 2012 to 2014. Bone mineral density (BMD) was determined by dual X-ray absorptiometry in the lumbar spine and the femoral neck or the total proximal femur for patients ≥20 yr of age, and by whole-body scan in the lumbar spine in patients <20 yr of age. In children, mineral density was calculated using the chronological age and Z height. OP diagnosis was determined following adult and pediatric official position of the International Society for Clinical Densitometry. A total of 116 patients were included, of which 62 (53.5%) were women. The median age was 25.8 yr. All patients received enzyme replacement therapy, with a median time of 9.4 yr. Normal BMD was found in 89 patients (76.7%), whereas low bone mass (LBM) or osteopenia was found in 15 patients (13%) and OP in 12 patients (10.3%). The analysis of the pediatric population revealed that 4 patients (9.3%) had LBM and 3 (7%) had OP (Z-score ≤ -2 + fractures height-adjusted by Z), whereas in the adult population (n = 73), 11 patients (15%) had LBM or osteopenia and 9 (12.3%) had OP. Bone marrow infiltration and the presence of fractures were significantly correlated with the presence of OP (p = 0.04 and <0.001, respectively). This is the first study in Argentina and in the region describing the frequency of OP or LBM in GD patients treated with imiglucerase using the official position of the International Society for Clinical Densitometry.

Atención psicosocial al niño desplazado y refugiado / Psychosocial care to displaced ad refugee children

No disponible

Proinflammatory and proosteoclastogenic potential of peripheral blood mononuclear cells from Gaucher patients: Implication for bone pathology.

Gaucher disease (GD) is caused by mutations in the GBA gene that confer a deficient level of activity of glucocerebrosidase (GCase). This deficiency leads to the accumulation of the glycolipid glucocerebroside in the lysosomes of cells of monocyte/macrophage system. Bone compromise in Gaucher disease patients is the most disabling aspect of the disease. However, pathophysiological aspects of skeletal alterations are still poorly understood. On the other hand it is well known that inflammation is a key player in GD pathology. In this work, we revealed increased levels of the proinflammatory CD14(+)CD16(+) monocyte subset and increased inflammatory cytokine production by monocytes and T cells in the circulation of GD patients. We showed increased levels of osteoclast precursors in PBMC from patients and a higher expression of RANKL in the surface of T cells. PBMC from patients presented higher osteoclast differentiation compared to healthy controls when cultured in the presence of M-CSF alone or in combination with RANKL. In vitro treatment with Velaglucerase reduced osteoclast levels to control levels. On the other hand THP-1 derived osteoclast precursors cultured in the presence of conditioned media from PBMC of GD patients presented higher differentiation to active osteoclasts. This induction involved TNF-α and RANKL.

Salud infantil y cooperación internacional: una aproximación pediátrica / Child health and international cooperation: A paediatric approach

La cooperación internacional al desarrollo en salud infantil despierta un especial interés en el ámbito pediátrico. En los últimos decenios se han ido revelando nuevas evidencias en torno al análisis de los factores vinculados a la morbimortalidad en las primeras etapas de la vida en los países menos adelantados. Este mayor conocimiento del origen de los problemas de salud y las posibles respuestas en forma de intervenciones con impacto determina la necesidad de su divulgación entre los profesionales de Pediatría interesados. Se hacen necesarios mayores esfuerzos para profundizar en materias relacionadas con salud global infantil y favorecer el que los pediatras conozcan y participen en estos procesos. Este artículo pretende ofrecer un acercamiento pediátrico social hacia los elementos relacionados con cooperación internacional y salud infantil

The international development cooperation in child health arouses special interest in paediatric settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with impact, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters

[Child health and international cooperation: A paediatric approach]. / Salud infantil y cooperación internacional: una aproximación pediátrica.

The international development cooperation in child health arouses special interest in paediatric settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with impact, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters.

Cellular vaccines in listeriosis: role of the Listeria antigen GAPDH.

The use of live Listeria-based vaccines carries serious difficulties when administrated to immunocompromised individuals. However, cellular carriers have the advantage of inducing multivalent innate immunity as well as cell-mediated immune responses, constituting novel and secure vaccine strategies in listeriosis. Here, we compare the protective efficacy of dendritic cells (DCs) and macrophages and their safety. We examined the immune response of these vaccine vectors using two Listeria antigens, listeriolysin O (LLO) and glyceraldehyde-3-phosphate-dehydrogenase (GAPDH), and several epitopes such as the LLO peptides, LLO189-201 and LLO91-99 and the GAPDH peptide, GAPDH1-22. We discarded macrophages as safe vaccine vectors because they show anti-Listeria protection but also high cytotoxicity. DCs loaded with GAPDH1-22 peptide conferred higher protection and security against listeriosis than the widely explored LLO91-99 peptide. Anti-Listeria protection was related to the changes in DC maturation caused by these epitopes, with high production of interleukin-12 as well as significant levels of other Th1 cytokines such as monocyte chemotactic protein-1, tumor necrosis factor-α, and interferon-γ, and with the induction of GAPDH1-22-specific CD4(+) and CD8(+) immune responses. This is believed to be the first study to explore the use of a novel GAPDH antigen as a potential DC-based vaccine candidate for listeriosis, whose efficiency appears to highlight the relevance of vaccine designs containing multiple CD4(+) and CD8(+) epitopes.

Problemas de salud prevalentes en los menores en centros de acogida / Prevalent health problems of children in residential care centers

Introducción: La población infantil sujeta a medidas de protección es una franja de población vulnerable, no sólo desde el punto de vista social, sino también sanitario. La principal limitación detectada en la bibliografía recientemente revisada es la escasez de estudios que evalúen la situación sanitaria de los menores durante su estancia en el sistema de protección. Nos proponemos analizar el estado de salud de una población en programa residencial básico, atendiendo a las diferencias entre grupos etarios, así como la asociación de distintas variables con el tiempo de institucionalización. Material y métodos: Se diseña un estudio transversal, realizándose dos visitas a los 26 centros de la provincia de Granada (entre diciembre de 2006 y marzo de 2007). En la primera se revisan los expedientes de los menores y en la segunda se procede a su valoración clínica. En cuanto al estudio estadístico, la muestra se distribuye en tres grupos de edad (0-5, 6-12 y 13-18 años), y se realiza el análisis comparativo y la inferencia estadística mediante las pruebas de la chi2, Kruskal-Wallis y Mann-Whitney. Resultados: Se revisa un total de 294 menores. La prevalencia global de desnutrición es del 4%, más frecuente en el grupo de 0-5 años, y la de sobrepeso del 18%, más habitual en el grupo de 6-12 años. Las alteraciones más frecuentemente detectadas son otorrinolaringológicas (ORL) (63,9%), dermatológicas (34,9%) –más prevalentes en los menores de 12 años– y conductuales (28,1%), más frecuentes en los mayores de 6 años. El seguimiento en consultas especializadas fue del 40%. En cuanto al tiempo de estancia en la institución, se observaron mayores estancias en los menores con un diagnóstico psicopatológico y con un mayor número de seguimientos en las consultas especializadas (AU)

Conclusiones: El estado de salud de los menores institucionalizados se podría considerar adecuado en líneas generales. Las principales diferencias con la población general derivan de la existencia de tasas de desnutrición algo superiores en los menores de 0-5 años y una alta prevalencia de patología ORL, dermatológica, mental y conductual. Cabe destacar la vulnerabilidad del grupo de niños de 6-12 años con un número más elevado de necesidades sanitarias (AU)

Introduction: Children under protection measures constitute a vulnerable population from both social and health standpoints. The main limitation detected in a review of the recent literature is the scarcity of studies on the health status of minors during their stay in the protection system. We proposed to study the health status of a population in a basic residential care program, investigating differences among age groups and analyzing the association of different variables with time of institutionalization. Methods: A cross-sectional study was designed that involv­ed two visits to the centres: the first to review the records of the minors and the second to carry out physical examinations. For the statistical study, the sample was divided into three age groups (0-5, 6-12 and 13-18 yrs) and the chi2, Kruskal-Wallis and Mann-Whitney tests were used for comparative analyses and statistical significances. Results: We revised 294 children. Prevalence of global malnutrition was 4%, highest in the 0-5-yr group; prevalence of overweight was 18%, highest in the 6-12-yr group. The most frequent disorders were: ENT (63.9%); dermatological (34.9%), most prevalent in children <12 yrs; and behavioural (28.1%), most prevalent in children >6 yrs old; 40% were under specialist follow-up. Longer stays in the institution were associated with a psychopathological diagnosis and higher frequency of specialist follow-up. Conclusions: The health status of institutionalised minors can in general be considered adequate. The main differences with the general population derive from the presence of somewhat higher malnutrition rates in the 0 to 5-year-olds and an elevated prevalence of ENT, dermatological, psychological and behavioural pathologies. We highlight the vulnerability of 6 to 12-year-olds, who have a larger number of healthcare needs (AU)

Induction of low-nutritious food intake by subsequent nutrient supplementation in sheep (Ovis aries).

Acceptance of and preference for a particular food depends not only on its intrinsic (e.g. nutritional) properties but also on expected or recent food experiences. An instance of this type of phenomenon has been called induction effect, which consists of an increased intake of a type of food when it precedes a hedonically preferred food in a sequence familiar to the animal, relative to controls that have access only to the less-preferred food. The purpose of our study was to assess intake induction of a low-nutritious food when followed by different high-nutritious supplements in sheep (Ovis aries). In this experiment, we ran a supplemented phase where animals fed oat hay (a low-nutritious food) in the first part of the daily feeding sessions followed by a supplement with either a high (soya bean meal; group GS) or a low (ground corn; group GC) protein-energy ratio in the second part ate more oat hay than controls that were fed oat hay in both parts of sessions (group GH). In addition, supplemented animals presented a stronger preference for oat hay over alfalfa hay than controls in a subsequent choice. When all animals received no food in the second part of the sessions (Non-supplemented phase), intake of oat hay converged to the control's intake level in all the groups, suggesting that the presence of supplements after access to oat hay was responsible for intake induction. Lastly, we repeated the supplemented phase with a different control group where animals received oat hay in the first part of the sessions and no food in the second part (group NF), thus equalizing groups in terms of the time of access to oat hay in a session. Groups GS and GC still developed higher intake of oat hay than group NF. In both supplemented phases of the experiment, we estimated animals' daily metabolizable energy (ME) and crude protein (CP) intake. CP intake was higher in group GS than in groups GC, GH and NF, but there was no difference between group GC and the controls. In turn, groups did not differ in ME intake in the First supplemented phase, and only group GS presented higher ME intake than the rest of the groups in the Second supplemented phase. Therefore, a nutritional account of the present induction effect seems insufficient. We propose that a learned association between oat hay and the post-ingestive feedback from the subsequent high-nutritious supplements underlay sheep's intake induction and increased preference for oat hay.