Malestar emocional y percepción de amenazaen familiares de personas afectadas por COVID-19 / Emotional distress and threat perception of COVID-19 in relatives of affected people

Los familiares de personas afectadas por la COVID-19 pudieron experimentar mayor impacto emocional durante el confinamiento, más aún si se tenía una imagen muy amenazante del COVID-19. El objetivo fue analizar la relación entre la psicopatología y la percepción de amenaza en familiares de personas afectadas por COVID-19. Participaron 50 familiares de personas afectadas por COVID-19 (84% mujeres), de entre 20 y 63 años (M=36,88; DT=12,73). Se evaluó la psicopatología (SCL-90-R; Derogatis, Lipman y Covi, 1973) y la percepción de amenaza del COVID (BIP-Q5; Pérez-Fuentes, Molero, Oropesa et al., 2020). Observamos una afectación emocional y una percepción de amenaza moderadas. Quienes tenían enfermedades físicas y psicológicas mostraron menos percepción de amenaza, pero más psicopatología. Mayor percepción de amenaza se asoció con mayor psicopatología. Concluimos que la familia es una parte activa en el proceso de enfermedad, por lo que puede sufrir un gran impacto emocional que debe ser atendido (AU)

Relatives of people affected by COVID-19 were able to experience greater emotional impact during confinement, even more so if they had a very threatening image of COVID-19. The aim was to analyse the relationship between psychopathology and the perception of threat in relatives of people affected by COVID-19. Fifty relatives of people affected by COVID-19 (84% women), aged between 20 and 63 years (M=36.88; SD=12.73) participated. Psycho-pathology (SCL-90-R; Derogatis et al., 1973) and perceived threat of COVID (BIP-Q5; Pérez-Fuentes et al., 2020) were assessed. We observed moderate emotional distress and threat perception. Those with physical and psychological illnesses showed less threat perception but more psychopathology. Higher threat perception was associated with higher psychopathology. We conclude that the family is an active part of the disease process and may suffer a great emotional impact that needs to be addressed (AU)

Dolor neuropático en pacientes oncológicos en tratamiento con bortezomib / Neurpathic pain in cancer patients treated with bortezomib

Introducción: El dolor neuropático es el problema más habitual en la neuropatía inducida por quimioterapia (NIQ) y el que más interfiere en la calidad de vida de los pacientes. Su detección precoz resulta fundamental para reducir o eliminar los problemas que de este se derivan. Los objetivos de este estudio eran: 1) determinar la incidencia y las características de NIQ y dolor neuropático en pacientes con mieloma múltiple (MM) tratados con bortezomib, y 2) evaluar el impacto del dolor neuropático en las actividades de la vida diaria (AVD). Método: Todos los pacientes diagnosticados de MM candidatos a tratamiento con bortezomib atendidos en el Hospital Joan XXIII durante 2013, participaron. Los participantes eran entrevistados individualmente e informaban sobre la presencia, las características y el impacto del dolor, así como de los efectos adversos del bortezomib. Resultados: Participaron 22 personas, de las cuales la mitad presentaron NIQ, siendo el grado 2 el predominante. La localización más habitual del dolor neuropático era manos y pies; aparecía de manera espontánea y progresiva empeorando en reposo y durante la noche, con predominio de síntomas positivos. El impacto del dolor se reflejó en todas las AVD. La limitación principal fue la incapacidad para disfrutar de la vida. La neuropatía periférica ocupó el primer lugar en orden de importancia subjetiva para el paciente seguido de la fatiga y el estreñimiento. Conclusiones: Una adecuada evaluación y detección precoz del dolor neuropático es fundamental para minimizar su impacto en la calidad de vida del paciente (AU)

Introduction: The neuropathic pain is the most habitual problem in the neuropathy induced by chemotherapy (NIQ) and the one that more interferes in the quality of life of the patients. His precocious detection turns out to be fundamental to reduce or to eliminate the problems that from this one stem. The aims of this study were: 1) determine the incident and NIQ's characteristics and neuropathic pain in patients with mieloma multiple (MM) treated with bortezomib, and 2) to evaluate the impact of the neuropathic pain in the activities of the daily life (AVD). Method: All the patients diagnosed of MM candidates for treatment with bortezomib attended in the Hospital Joan XXIII during 2013, took part. The participants were interviewed individually and were reporting on the presence, the characteristics and the impact of the pain, as well as of the adverse effects of the bortezomib. Results: There took part 22 persons, of which NIQ presented the half, being the degree 2 the predominant one. The most habitual location of the neuropathic pain was hands and feet; it was appearing in a spontaneous and progressive way deteriorating in rest and during the night, with predominance of positive symptoms. The impact of the pain was reflected in all the AVD. The principal limitation was the disability to enjoy the life. The peripheral neuropathy occupied the first place in order of subjective importance for the patient followed by the fatigue and the constipation. Conclusions: A proper assessment and early detection of neuropathic pain is critical to minimizing its impact on the quality of life of patients (AU)

Neuropathic pain in cancer patients treated with bortezomib. / Dolor neuropático en pacientes oncológicos en tratamiento con bortezomib.

INTRODUCTION: The neuropathic pain is the most habitual problem in the neuropathy induced by chemotherapy (NIQ) and the one that more interferes in the quality of life of the patients. His precocious detection turns out to be fundamental to reduce or to eliminate the problems that from this one stem. The aims of this study were: 1) determine the incident and NIQ's characteristics and neuropathic pain in patients with mieloma multiple (MM) treated with bortezomib, and 2) to evaluate the impact of the neuropathic pain in the activities of the daily life (AVD). METHOD: All the patients diagnosed of MM candidates for treatment with bortezomib attended in the Hospital Joan XXIII during 2013, took part. The participants were interviewed individually and were reporting on the presence, the characteristics and the impact of the pain, as well as of the adverse effects of the bortezomib. RESULTS: There took part 22 persons, of which NIQ presented the half, being the degree 2 the predominant one. The most habitual location of the neuropathic pain was hands and feet; it was appearing in a spontaneous and progressive way deteriorating in rest and during the night, with predominance of positive symptoms. The impact of the pain was reflected in all the AVD. The principal limitation was the disability to enjoy the life. The peripheral neuropathy occupied the first place in order of subjective importance for the patient followed by the fatigue and the constipation. CONCLUSIONS: A proper assessment and early detection of neuropathic pain is critical to minimizing its impact on the quality of life of patients.

Influence of Mitochondrial Genetics on the Mitochondrial Toxicity of Linezolid in Blood Cells and Skin Nerve Fibers.

The antibiotic linezolid is a ribosomal inhibitor with excellent efficacy. Although the administration period has been reduced to 28 days, side effects, usually of hematologic or neuropathic origin, are still reported due to secondary inhibition of mitochondrial protein synthesis. Susceptibility to linezolid toxicity remains unknown. Therefore, the objective of this study was to gain an understanding of clinical heterogeneity in response to identical linezolid exposures through exhaustive examination of the molecular basis of tissue-dependent mitotoxicity, consequent cell dysfunction, and the association of mitochondrial genetics with adverse effects of linezolid administered for the recommended period. Peripheral blood mononuclear cells (PBMC) and skin nerve fibers from 19 and 6 patients, respectively, were evaluated before and after a 28-day linezolid treatment in order to assess toxic effects on mitochondria and cells. Mitochondrial DNA haplotypes and single nucleotide polymorphisms (SNPs) in ribosomal sequences where linezolid binds to mitochondrial ribosomes were also analyzed to investigate their genetic contributions. We found that linezolid reduced mitochondrial protein levels, complex IV activity, and mitochondrial mass in PBMC and was associated with a trend toward an increase in the rate of apoptosis. In skin tissue, mitochondrial mass increased within nerve fibers, accompanied by subclinical axonal swelling. Mitochondrial haplogroup U, mutations in 12S rRNA, and the m.2706A→G, m.3197T→C, and m.3010G→A polymorphisms in 16S rRNA showed a trend toward an association with increased mitochondrial and clinical adverse effects. We conclude that even when linezolid is administered for a shorter time than formerly, adverse effects are reported by 63% of patients. Linezolid exerts tissue-dependent mitotoxicity that is responsible for downstream cellular consequences (blood cell death and nerve fiber swelling), leading to adverse hematologic and peripheral nervous side effects. Multicentric studies should confirm genetic susceptibility in larger cohorts.

Morphometry of dermal nerve fibers in human skin.

OBJECTIVE: We aimed to assess the innervation density of dermal nerves in human skin biopsies by bright-field immunohistochemistry. METHODS: The size of dermal area where nerve length was quantified was validated in 30 skin biopsy sections (5 controls and 5 patients with small-fiber neuropathy [SFN]). It was obtained dividing an area of 200-µm depth from the dermal-epidermal junction into 4 equal portions. The length of dermal nerves (DNFL) was measured into 150 sections (25 controls and 25 patients with SFN) and values per millimeter of epidermis (DNFL/mm) and dermal area (DNFL/mm2) were obtained. Age- and gender-matched normative values of intraepidermal nerve fiber (IENF) density were used as gold standard to calculate the performance of dermal nerve morphometry. RESULTS: Patients showed significantly lower DNFL (1.96 mm ± 0.96 SD), DNFL/mm (0.65 ± 0.29 SD), and DNFL/mm2 (3.75 ± 1.7 SD) than controls (DNFL 3.52 mm ± 1.31 SD, 5th percentile 2.05; DNFL/mm 1.25 ± 0.39, 5th percentile 0.71; DNFL/mm2 7.07 ± 2.41 SD, 5th percentile 3.95). Sensitivity, specificity, and percentage of individuals correctly classified were 75.8%, 73.9%, and 74.8% for DNFL, 75%, 80%, and 77.7% for DNFL/mm, and 75.8%, 80.2%, and 78.1% for DNFL/mm2. Receiver operator characteristic area analysis confirmed the excellent discrimination (0.8-0.9) between patients and controls. Dermal nerve morphometry significantly correlated with IENF density. Spearman rank correlation demonstrated good agreement for interobserver analysis (0.87-0.89), and between DNFL and IENF densities (0.71-0.73; p < 0.0001). CONCLUSIONS: We provided a reliable method to quantify the innervation density of dermal nerves that might improve the diagnostic yield of skin biopsy.

PONTO. Un sistema de información para la gestión de los servicios de oncología radioterápica / PONTO. An information system for the management of the departments of Radiation Therapy Oncology

Introducción: La gestión clínica se comenzó a generalizar en nuestro país a finales del siglo pasadocon la intención de conseguir un sistema sanitario más eficiente. La información, que ha sidofundamental en el avance de la ciencia y en el desarrollo económico social, es ahora decisiva en lastransformaciones que se están produciendo en el sistema sanitario.Material y métodos: El objetivo del presente trabajo es mostrar un sistema de obtención de información,que sirve para la gestión clínica de los servicios de Oncología Radioterápica, con el fin deoptimizar los tratamientos de los pacientes, complementar la información facilitada por el servicio decontrol de gestión de nuestro centro y por otra suministrar los datos por éste requeridos. Este sistemade información contempla la descripción del proceso radioterápico publicado en el Real Decreto,1566/1998 de 17 de julio, por el que se establecen los criterios de calidad en radioterapia. La metodologíade desarrollo utilizada ha sido Métrica 3 adecuada a las características del proyecto, siendo losprocesos de Análisis y Diseño del sistema desarrollados de forma completa. Se ha conseguido la totalimplicación en el proyecto, tanto de la dirección del centro, como del jefe del servicio y de todo el personalperteneciente al servicio de Oncología Radioterápica.Resultados: El proceso de funcionamiento de la aplicación PONTO se basa en la gestión integralde la propuesta que se abre a los pacientes en el momento de su llegada al servicio de Oncología Radioterápica.PONTO se ha estructurado en los siguientes módulos o bloques: Propuestas; Citación;Primeras Consultas; Comités; Sesión Clínica; Simulación-TAC; Planificación; Moldes; Sesión Dosimétrica;Tratamientos; Consulta de Tratamiento; Alta y Consultas Sucesivas.Conclusión: PONTO es un sistema de información propio para un Servicio de Oncología Radioterápicaque permite su gestión clínica. Está cuidadosamente diseñado y organizado con una finalidadclaramente especificada y útil

Introduction: The clinical management began to spread in our country at the end of the lastcentury, aiming to obtain a more efficient health system. Information has been fundamental for theadvancement of science and the socio-economic development, becoming decisive nowadays due to thechanges taking place in the health system.Material and methods: The objective of the present work is to describe an information systemuseful for the clinical management of the departments of Radiation Therapy Oncology, whose purposeis the patients' treatment optimization, complementing the information given by the managementcontrol service of our centre, providing at the same time some data that this could require. Thisinformation system considers the description of the radiotherapy process published in the “RoyalDecree”, 1566/1998 of July 17, setting up the quality criteria in radiotherapy. The methodology usedwas Metric 3, adapted to the characteristics of the project, with a complete development of theAnalysis and Design processes of the system.Results: The PONTO process application is based on the integral management proposals openedto the patients when they arrive at the Radiation Therapy Oncology service. PONTO was structured inthe following modules or blocks: Proposals, Appointments, First Consultation, Committees, ClinicalSession, CT-scanning Simulation, Planning, Moulds, Dosimetric Session, Treatments, TreatmentConsultation, Hospital Discharge, and Successive Consultations.Conclusions: PONTO is an information system suitable for the departments of RadiationTherapy Oncology allowing the clinical management. It is carefully designed and organized with aclear, useful and specific purpose

[Oligoastrocytoma with signet-ring cell differentiation. A morphological, ultrastructural and immunohistochemical study]. / Oligoastrocitoma con diferenciación en células en anillo de sello. Estudio morfológico, ultraestructrural e inmunohistoquímico.

We present a case of a mixed glial tumor (oligoastrocytoma) with signet-ring cells. This cellular feature is a rare differentiation in glial tumors of the central nervous system. Histological, immunohistochemical and ultrastructural findings have been analyzed. Signet-ring cells showed intense expression with GFAP, S-100 and vimentin. A differential diagnosis with other primary brain tumors and cerebral metástases with signet-ring cell differentiation was discussed.

Oligoastrocitoma con diferenciación en células en anillo de sello. Estudio morfológico, ultraestructural e inmunohistoquímico / Oligoastrocytoma with signet-ring cell differentiation. A morphological, ultrastructural and immunohistoche-mical study

Presentamos un caso de tumor glial mixto (oli-goastrocitoma) con células en anillo de sello. Esta diferenciación celular es rara en tumores gliales del sistema nervioso central. En este estudio analizamos las características morfológicas, ultraestructurales e inmunohistoquímicas del tumor. Las células neoplásicas con características morfológicas en anillo de sello mostraban expresión de GFAP, S-100 y vimentina. En la discusión consideramos el diagnóstico diferencial con otros tumores primarios del sistema nervioso central, así como con metástasis cerebrales de neoplasias con diferenciación en células en anillo de sello (AU)