Miastenia grave asociada a nivolumab / Myasthenia gravis associated with nivolumab

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[Social inequality and changes in quality of life among the elderly in rural areas of the Province of Cuenca (Spain) between 1994 and 2002]. / Desigualdades sociales y cambios en la calidad de vida de los ancianos en el medio rural de Cuenca entre 1994 y 2002.

OBJECTIVE: To evaluate changes in quality of life (QoL) in a sample of elderly community-dwelling individuals. Overall QoL was evaluated, in addition to the dimensions of physical health (PH), mental health (MH), activities of daily living (ADL), economic resources (ER) and social resources (SR). MATERIALS AND METHODS: Of a sample of 918 persons aged more than 64 years old in the Province of Cuenca (Spain), QoL was measured in 519 in 1994 by means of the Quality of Life for the Elderly (QLE) questionnaire, developed from the OARS-MFAQ Older Americans Resources and Services Multidimensional Functional Assesment Questionaire. In 2002, with a 3.6% loss, the QLE was administered again in all participants that were still alive and non-institutionalized. The results were compared for the two periods and the factors associated with variation in QoL were estimated by means of multiple regression analysis. RESULTS: Of the 519 participants at baseline, 130 died (25%) and 14 (12.7%) were institutionalised. Elderly individuals who were still alive in 2002 showed a general worsening in their overall QoL, specifically in the variables of ADL, PH and MH. However, after adjusting for age, we found that overall QoL was better in 2002 than in 1994. Logistic regression revealed that the factors associated with a lesser decrease in QoL were education, being male, lower age, and being widowed. CONCLUSIONS: QoL in community-dwelling elderly individuals in the Province of Cuenca improved between 1994 and 2002.

Desigualdades sociales y cambios en la calidad de vida de los ancianos en el medio rural de Cuenca entre 1994 y 2002 / Social inequality and changes in quality of life among the elderly in rural areas of the province of Cuenca (Spain) between 1994 and 2002

Objetivo: valorar los cambios en la calidad de vida de una muestra de ancianos que viven en la comunidad, tanto de forma global (IGCV), como en las dimensiones de salud física (SF), salud mental (SM), actividades de la vida diaria (AVD), recursos económicos (RE) y recursos sociales (RS).Material y métodos: de una muestra de 918 individuos mayores de 64 años de la provincia de Cuenca, se midió, en 1994, la calidad de vida de 519, mediante el cuestionario de calidad de vida en ancianos (CVA) desarrollado a partir del OARS-MFAQ (Older Americans Resources and Services Multidimensional FunctionalAssesment Questionaire). En 2002, con un 3,6% de pérdidas, se administró de nuevo el CVA a aquellos que permanecían vivos y no institucionalizados. Se compararon los resultados en los dos períodos de estudio, y mediante análisis de regresión múltiple seestiman los factores asociados a la variación de la calidad de vida.Resultados: de los 519 participantes del estudio, 130 (25%) fallecieron y 14 (2,7%) fueron institucionali-zados. Los ancianos que permanecían vivos en 2002 empeoraron su CV en general y, más concretamente, en las dimensiones de AVD, SF y SM. Sin embargo, ajustando por edad, el IGCV mejoró en 2002 respecto a 1994. Mediante regresión logística encontramos asociados a unmenor empeoramiento en la CV tener estudios, ser varón, tener una edad inferior y estar viudo.Conclusiones: la calidad de vida de los ancianos no institucionalizados de Cuenca mejoró entre los años 1994 y 2002

Objective: to evaluate changes in quality of life (QoL) in a sample of elderly community-dwelling individuals. Overall QoL was evaluated, in addition to the dimensions of physical health (PH), mental health (MH), activities of daily living (ADL), economic resources (ER) and social resources (SR).Materials and methods: of a sample of 918 persons aged more than 64 years old in the Province of Cuenca (Spain), QoL was measured in 519 in 1994 by means of the Quality of Life for the Elderly (QLE) questionnaire, developed from the OARS-MFAQ Older Americans Resources and Services Multidimensional Functional Assesment Questionaire. In 2002, with a 3.6% loss, the QLE was administered again in all participants that were stillalive and non-institutionalized. The results were compared for the two periods and the factors associated with variation in QoL were estimated by means of multiple regression analysis.Results: of the 519 participants at baseline, 130 died (25%) and 14 (12.7%) were institutionalised. Elderly individuals who were still alive in 2002 showed a general worsening in their overall QoL, specifically in the variables of ADL, PH and MH. However, afteradjusting for age, we found that overall QoL was better in 2002 than in 1994. Logistic regression revealed that the factors associated with a lesser decrease in QoL were education, being male, lower age, and being widowed.Conclusiones: QoL in community-dwelling elderly individuals in the Province of Cuenca improved between 1994 and 2002

Pro-gastrin-releasing peptide (proGRP) in patients with benign and malignant diseases: comparison with CEA, SCC, CYFRA 21-1 and NSE in patients with lung cancer.

We studied the specificity and sensitivity of progastrin releasing peptide (ProGRP) in 37 healthy subjects and 195 patients with benign and 149 with malignant diseases other than lung cancer. Likewise, we compared the ProGRP with other tumor markers used in lung cancer (CEA, SCC, CYFRA and NSE) in 187 patients with NSCLC and in 66 SCLC patients. We considered 50 pg/ml, 5 ng/ml, 2 ng/ml, 3.3 ng/ml and 20 ng/ml as the upper limits of normality for ProGRP, CEA, SCC, CYFRA 21-1 and NSE, respectively. Abnormal ProGRP serum levels were found in 10% of patients with benign diseases and in 13% of patients with malignancies other than lung. Renal failure was the main source of false-positive results (51.6%). Slightly raised ProGRP serum levels, excluding renal failure, were found in 4.1% of patients with benign diseases (<80 pg/ml) and in 5% of patients with malignancies other than lung cancer or neuroendocrine tumors (<120 pg/ml). Abnormal levels of ProGRP, NSE, CEA, CYFRA and SCC were found in 30%, 22.5%, 55.6%, 65.2% and 26.7% of NSCLC and in 73%, 64%, 53%, 46% and 4.5% of SCLC, respectively. Tumor marker serum levels were related to histological type and tumor extension, with ProGRP being the most sensitive marker in SCLC, CEA in adenocarcinomas and CYFRA 21-1 in squamous tumors. The most sensitive combinations of tumor markers were ProGRP and NSE in SCLC (88%), and CEA plus CYFRA in NSCLC (82%). In summary, ProGRP is the tumor marker of choice in SCLC and NSE is a complementary tumor marker in this histological type.