Impact of COVID-19 pandemic on patients and health professionals of a radiation oncology department at a Spanish tertiary hospital.

BACKGROUND: The sanitary emergency created by the COVID-19 pandemic forced us to take exceptional measures that affect decision-making and administration of treatments with radiotherapy. The aim of the study was to analyze the impact of the COVID-19 pandemic on patients and professionals in a radiation oncology department. MATERIALS AND METHODS: We implement a plan with the objectives of maintaining radiotherapy treatment in those patients who need it and, at the same time, reducing the risk of spreading the virus to staff and patients. This plan included measures aimed at limiting the patient's stay in hospital, selecting those patients in whom radiotherapy cannot be delayed and protecting against infection through the use of physical protective measures. RESULTS: Between March 16 and May 31, 2020, 360 patients received radiotherapy in our department. In 14 patients (4.7%) the start of treatment was delayed by an average of 28 days. Four patients had a positive COVID-19 polymerase chain reaction (PCR ) (6.6% and 1.1% of tested and all patients, respectively). Among the professionals, two PCR s were positive (16.6% and 4% of tested and all individuals, respectively). In the serology analysis 4 out of 50 department members were IgG positive (8%). CONCLUSIONS: Despite the fact that our department is located in a region with a high incidence of COVID-19 infection, the impact of the pandemic on our patients and staff has been moderate. The implementation of measures against infection and an adequate selection of patients for treatment allows radiation oncology departments to maintain clinical activity.

Physiological changes of growth hormone during lactation in pup rats artificially reared.

During the lactation period, rat pups are fed by the dam, and the patterns of mother-pup interaction change during this period. Additionally, there are changes in feeding; first, mother´s milk is the only food needed for sustenance, and later, it is combined with solid food and water. GH serum concentrations depend on both maternal-pup interaction and energy metabolism. In the artificial rearing (AR) procedure, pups are deprived of mother-pup interaction, and the feeding pattern is controlled. This rearing paradigm has been used in rats to analyze the effects of maternal deprivation on social behavior. In the present study, we analyzed the variation in GH, acylated ghrelin and IGF-1 serum concentrations throughout the lactation period in AR pups. At pnd7, the maternal rearing (MR) pups responded to a 4 h fast with a drop in GH serum concentration, which is a well-known response to maternal deprivation. GH serum levels in the AR pups did not change, suggesting an adaptation phenomenon. A dopamine inhibitory effect of GH secretion was observed in pnd7 cultured somatotropes, suggesting dopamine regulation of GH secretion at this age. Acylated ghrelin serum levels in the AR pups showed an inverted pattern compared to that in the MR pups, which was related to the artificial feeding pattern. IGF-1 serum levels were lower in the AR pups than in MR pups, which was associated with hepatic GH resistance and with low Igf1 mRNA expression at pnd7. Interestingly, at pnd14, both pup groups showed high hepatic Igf1 mRNA expression but low IGF-1 serum levels, and this was inverted at pnd21. However, serum glucose levels were lower in the AR pups at pnd14 but reached the same levels as the MR pups at pnd21. Moreover, hepatomegaly and higher hepatic GH-receptor levels were observed in the AR pups at pnd21, which was in agreement with an absence of a solid food meal. During AR, the pups lost the maternal interaction-stimulated GH secretion, which correlated with lower IGF-1 serum levels during the first week of postnatal development. Later, the AR pups exhibited hepatic responses, in order to satisfy the metabolic demand for the normal weaning, with low carbohydrates levels in their meal.

Predicción de madurez pulmonar fetal mediante el conteo de cuerpos gemerales en líquido amniótico / Prediction of fetal lung maturity through lamellar body count in amniotic fluid

Introducción. La enfermedad de membrana hialina (EMH) es causa común de morbilidad y mortalidad neonatal, los exámenes para madurez pulmonar juegan un importante papel para establecer el manejo obstétrico y neonatal. El conteo de cuerpos lamelares (CCL) en líquido amniótico es un nuevo estudio que permite conocer la madurez fetal pulmonar. Material y métodos. Estudio prospectivo realizado con el objetivo de correlacionar el CCL en líquido amniótico con la presencia de EMH. Se analizaron las muestras de líquido amniótico de recién nacidos prematuros y de término obtenidos por cesárea. Las variables analizadas fueron: edad gestacional (semanas), peso (g), CCL/µL, presencia o ausencia de EMH con un conteo menor o mayor de 30,000/µL, determinándose: sensibilidad, especificidad, valor de predicción positiva (VVP) y valor de predicción negativa (VPN). Resultados. La edad gestacional en recién nacidos prematuros fue de 33ñ2.4 semanas y de 39ñ0.6 semanas en los de término (p<0.001); el peso fue de 1,963ñ746 y 3,180ñ400g respectivamente (P<0.001), el CCL para los prematuros fue de 86,931ñ104,676/µL y de 103,086ñ44,346/µL para los de término (no significativo). De toda la muestra se encontró 4 niños con EMH y CCL menor de 30,000/µL, determinando una sensibilidad del 80 por ciento, especificidad 100 por ciento, VPP cien por ciento y VPN 97.56. De las madres que recibieron esteroides prenatales ningún niño prematuro desarrolló EMH, en cambio de 10 madres que no los recibieron 6 niños la presentaron (P<0.5). Conclusión. Se recomienda el CCL como examen para determinar madurez pulmonar fetal, que no es afectado por contaminación de sangre y/o meconio y es de realización rápida (menos de 5 minutos); posible de hacer en todo hospital del país que tenga aparato de conteo de células sanguíneas, haciéndolo por el canal de plaquetas. No es costoso (cuesta menos que una biometría hemática completa), y es confiable para descartar EMH si el conteo es mayor de 30,000/µL