The human volatilome meets cancer diagnostics: past, present, and future of noninvasive applications.

BACKGROUND: Cancer is a significant public health problem, causing dozens of millions of deaths annually. New cancer screening programs are urgently needed for early cancer detection, as this approach can improve treatment outcomes and increase patient survival. The search for affordable, noninvasive, and highly accurate cancer detection methods revealed a valuable source of tumor-derived metabolites in the human metabolome through the exploration of volatile organic compounds (VOCs) in noninvasive biofluids. AIM OF REVIEW: This review discusses volatilomics-based approaches for cancer detection using noninvasive biomatrices (breath, saliva, skin secretions, urine, feces, and earwax). We presented the historical background, the latest approaches, and the required stages for clinical validation of volatilomics-based methods, which are still lacking in terms of making noninvasive methods available and widespread to the population. Furthermore, insights into the usefulness and challenges of volatilomics in clinical implementation steps for each biofluid are highlighted. KEY SCIENTIFIC CONCEPTS OF REVIEW: We outline the methodologies for using noninvasive biomatrices with up-and-coming clinical applications in cancer diagnostics. Several challenges and advantages associated with the use of each biomatrix are discussed, aiming at encouraging the scientific community to strengthen efforts toward the necessary steps to speed up the clinical translation of volatile-based cancer detection methods, as well as discussing in favor of (i) hybrid applications (i.e., using more than one biomatrix) to describe metabolite modulations that can be "cancer volatile fingerprints" and (ii) in multi-omics approaches integrating genomics, transcriptomics, and proteomics into the volatilomic data, which might be a breakthrough for diagnostic purposes, onco-pathway assessment, and biomarker validations.

Actividades psicoterapéuticas dirigidas a la atención hospitalaria de los pacientes pediátricos oncológicos

El cáncer es una de las causas de muerte más habitual por enfermedad en menores. Debido a los grandes avances en la investigación médica y los tratamientos, una gran tasa de niños la supera, de ahí que la promoción, prevención y tratamiento constituye un reto necesario a asumir a partir del análisis de sus dimensiones. El objetivo del trabajo es diseñar un sistema de actividades psicoterapéuticas para el perfeccionamiento de la atención a los pacientes oncológicos en el Hospital Provincial Pediátrico de Camagüey. La metodología empleada fue la cuanticualitativa (análisis de documentos, entrevista, encuestas, observación, entre otros). Se fundamentan teóricamente los elementos conceptuales, se exponen los asuntos psicosociales y didácticos de su diseño, así como la valoración por especialistas. Los resultados introducidos en la práctica desde la Sala de Oncología fueron apreciados favorablemente por los pacientes y familiares en 10 sesiones que incluyeron temas como la autoestima y asertividad.

Cancer is one of the most common causes of death due to illness in children. Due to the great advances in medical research and treatments, a large percentage of children overcome it, hence promotion, prevention and treatment constitute a necessary challenge to assume based on the analysis of its dimensions. The objective of the work is to design a system of psychconapeutic activities to improve care for oncological patients at the Provincial Pediatric Hospital of Camagüey. The methodology used was quantitative (document analysis, interview, surveys, observation, among cons). The conceptual elements are theoretically based, the psychosocial and didactic issues of its design are exposed, as well as the assessment by specialists. The results introduced into practice from the Oncology Ward were favorably appreciated by patients and family members in 10 sessions that included topics such as self-esteem and assertiveness.

Riesgo de mortalidad en infecciones invasoras por Fusarium spp en niños con enfermedades hemato-oncológicas: una revisión sistemática de la literatura / Risk of mortality in invasive infections by Fusarium spp in children with hematooncological diseases: a literature systematic review

INTRODUCCIÓN: Los estudios sobre la infección fúngica invasora (IFI) por Fusarium spp en pacientes pediátricos con patología hemato-oncológica, son escasos, correspondiendo en general a series clínicas descriptas en forma retrospectiva, lo que dificulta conocer en profundidad sus características y evolución. OBJETIVO: Analizar la evolución fatal de la IFI causada por Fusarium spp en pacientes pediátricos con patología hemato-oncológica, llevándose a cabo una revisión sistemática. MATERIAL Y MÉTODOS: La búsqueda bibliográfica se realizó con fecha 23 de marzo de 2023, en las principales bases de datos (Medline (a través de PubMed), Embase (a través de Embase-Elsevier), The Cochrane Library (a través de Wiley), Cinahl (a través de EbscoHOST), SCI-EXPANDED y Scielo (a través de la WOS) y Scopus (a través de Scopus-Elsevier) y libre (mediante el motor Google) y revisando las citas de los artículos incluidos. RESULTADOS: Se rescataron 1.341 artículos, de los cuales se descartaron 931 por diversas razones. Mediante el análisis de los textos completos, finalmente se incluyeron 11 estudios. Todos los estudios eran de nivel 4 (serie de casos). Se detectó una notoria heterogeneidad (p < 0,008) entre los mismos. La mediana de la frecuencia de muerte observada implicó a un tercio de los afectados (Md 33 %; Q1:22,7-Q4:75). CONCLUSIONES: La mortalidad por IFI por Fusarium spp fue alta en niños con patología hemato-oncológica, en especial en aquellos con neutropenia profunda y mala respuesta al tratamiento de su enfermedad de base

BACKGROUND: Studies on invasive fungal infection (IFI) by Fusarium spp in pediatric patients with hemato-oncological pathology are scarce and limited and a few series of cases described retrospectively, which makes it difficult to fully understand their characteristics and outcome. With the aim of analyzing the fatal evolution of these patients, this systematic review was carried out. METHODS: The literature search was performed up to March 23, 2023, in the main databases, as Medline (through PubMed), Embase (through Embase-Elsevier), The Cochrane Library (through Wiley), Cinahl (through EbscoHOST), SCI-EXPANDED and Scielo (through WOS) and Scopus (through Scopus-Elsevier) and free (through the Google engine) and reviewing the citations of the included articles. RESULTS: 1341 articles were retrieved, of which 931 were discarded for various reasons. By analyzing its full texts, 11 studies were finally included. It was observed that heterogeneity among them was relevant (p < 0.008). Median frequency of death involved one third of those affected (Md 33%; Q1:22,7-Q4:75). CONCLUSIONS: Mortality due to IFI due to Fusarium spp was high in children with hemato-oncological pathology, especially in those with severe neutropenia and poor response to treatment of their underlying disease.

Cytarabine and Ferric Carboxymaltose (Fe+3) Increase Oxidative Damage and Alter Serotonergic Metabolism in Brain.

BACKGROUND & OBJECTIVE: The purpose of this study was to measure the effect on brain biomarkers after treatment with anticancer compounds - cytarabine (CT) and ferric carboxymaltose (FC) (Fe+3) in Wistar rats. METHODS: The Wistar rats were treated as follows: group 1 (control), NaCl 0.9%; group 2, CT (25 mg/k), group 3, FC(Fe+3) (50 mg/k) and group 4, CT + FC(Fe+3). The animals were sacrificed and their brains were obtained and used to measure lipoperoxidation (TBARS), H2O2, Na+, K+ ATPase, glutathione (GSH), serotonin metabolite (5-HIAA) and dopamine. The results indicated an enhancement of lipid peroxidation in the cortex and striatum of groups treated with FC(Fe+3) and CT, while GSH decreased in the cortex of group treated with CT + FC(Fe+3). Dopamine decreased in the cortex of the rats that received CT, while in the striatum, 5HIAA increased in all groups. RESULTS & CONCLUSION: These results suggest that the treatment with CT and FC(Fe+3) boosted oxidative stress and led to an alteration in momoamine concentrations in the brain.

Análisis de la mortalidad en enfermedades hemato-oncológicas malignas en pediatría: estudio multicéntrico en 14 hospitales públicos argentinos / Study of mortality due to hemato-oncological malignancies during childhood: multicenter study in 14 public hospitals in Argentina

INTRODUCCION: La mortalidad producida de forma temprana y durante diferentes fases del tratamiento de los niños con enfermedades hemato-oncológicas malignan es una de las causas de fracaso de los tratamientos actuales. Las tasas de mortalidad y sus causas no han sido estudiadas en Argentina.OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en 14 centros públicos desde enero de 2000 a diciembre de 2010.METODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en 14 centros identificados en el Registro Onco-Hematológico Argentino y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de muerte, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de co-morbilidad y las demoras en el diagnóstico y tratamiento, así como las particularidades de cada centro.RESULTADOS: En 13 centros se analizó exitosamente un promedio >70% de los óbitos, y en el restante se obtuvieron datos del 35%. La tasa de mortalidad fue >40% en 3 centros, ≥30% en 7 y 30% de mortalidad en los primeros 5 años analizados, la tasa disminuyó a 20% de los pacientes fallecidos. La principal causa de muerte en las etapas tempranas del diagnóstico y tratamiento correspondió a infecciones severas.CONCLUSIONES: Es indispensable desarrollar políticas de salud para revertir la elevada mortalidad en niños con cáncer en Argentina. Para ello, se deben aplicar programas que incluyan reformas estructurales, formación de recursos humanos y equipamiento, además de un trabajo colaborativo continuo y eficiente.

INTRODUCTION:The early mortality occurred at different stages of the treatment agains hemato-oncological malignancies during childhood is one of the causes of failure of modern therapies. In Argentina, the mortality rates and their causes have not been studied yet.OBJECTIVE: To analyze mortality rates, causes and moment of death in children with malignant diseases in 14 public centers from January 2000 until December 2010.METHODS: The analysis was conducted in clinical records of patients who died due to malignant diseases in 14 centers. The cases were identified by the national register for hematology and oncology diseases (ROHA) and by different registers belonging to hemato-oncological departments. Causes were classified according to the phase of therapy when the event occurred and the relationship of death with the treatment or underlying disease. Causes of co-morbility, delays in diagnosis/during treatment and particular features of the centers were also analyzed.RESULTS: In 13 centers, more than 70% of the deaths were successfully analyzed, while there was information of 35% for the remaining one. The mortality rate was >40% in 3 centers, ≥30% in 7 and 30% of mortality during the first 5 years of the analyzed period, the rate decreased to <25% as a hemato-oncologist joined the medical staff. The access to information was difficult in all the centers. In 5 of them there were delays during the diagnostic evaluation and treatment in about 20% of the dead patients. The main cause of death during early phases of diagnosis and treatment was related to severe infectious complications.CONCLUSIONS: It is fundamental to develop appropriate health policies in order to decrease mortality rates among children with cancer in Argentina. They should include programs for structural reform, human resource development and equipment supply, as well as continuous cooperative work.

Análisis de la mortalidad en enfermedades hemato-oncológicas malignas en pediatría: estudio multicéntrico en 14 hospitales públicos argentinos / Study of mortality due to hemato-oncological malignancies during childhood: multicenter study in 14 public hospitals in Argentina

INTRODUCCION: La mortalidad producida de forma temprana y durante diferentes fases del tratamiento de los niños con enfermedades hemato-oncológicas malignan es una de las causas de fracaso de los tratamientos actuales. Las tasas de mortalidad y sus causas no han sido estudiadas en Argentina.OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en 14 centros públicos desde enero de 2000 a diciembre de 2010.METODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en 14 centros identificados en el Registro Onco-Hematológico Argentino y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de muerte, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de co-morbilidad y las demoras en el diagnóstico y tratamiento, así como las particularidades de cada centro.RESULTADOS: En 13 centros se analizó exitosamente un promedio >70% de los óbitos, y en el restante se obtuvieron datos del 35%. La tasa de mortalidad fue >40% en 3 centros, ≥30% en 7 y <25% en 4. En un centro con >30% de mortalidad en los primeros 5 años analizados, la tasa disminuyó a <25% con la incorporación de una hemato-oncóloga. El acceso a los datos fue dificultoso en todos los centros. En 5 de ellos, hubo demoras en el diagnóstico y/o tratamiento en >20% de los pacientes fallecidos. La principal causa de muerte en las etapas tempranas del diagnóstico y tratamiento correspondió a infecciones severas.CONCLUSIONES: Es indispensable desarrollar políticas de salud para revertir la elevada mortalidad en niños con cáncer en Argentina. Para ello, se deben aplicar programas que incluyan reformas estructurales, formación de recursos humanos y equipamiento, además de un trabajo colaborativo continuo y eficiente.

INTRODUCTION:The early mortality occurred at different stages of the treatment agains hemato-oncological malignancies during childhood is one of the causes of failure of modern therapies. In Argentina, the mortality rates and their causes have not been studied yet.OBJECTIVE: To analyze mortality rates, causes and moment of death in children with malignant diseases in 14 public centers from January 2000 until December 2010.METHODS: The analysis was conducted in clinical records of patients who died due to malignant diseases in 14 centers. The cases were identified by the national register for hematology and oncology diseases (ROHA) and by different registers belonging to hemato-oncological departments. Causes were classified according to the phase of therapy when the event occurred and the relationship of death with the treatment or underlying disease. Causes of co-morbility, delays in diagnosis/during treatment and particular features of the centers were also analyzed.RESULTS: In 13 centers, more than 70% of the deaths were successfully analyzed, while there was information of 35% for the remaining one. The mortality rate was >40% in 3 centers, ≥30% in 7 and <25% in 4. At a center which had >30% of mortality during the first 5 years of the analyzed period, the rate decreased to <25% as a hemato-oncologist joined the medical staff. The access to information was difficult in all the centers. In 5 of them there were delays during the diagnostic evaluation and treatment in about 20% of the dead patients. The main cause of death during early phases of diagnosis and treatment was related to severe infectious complications.CONCLUSIONS: It is fundamental to develop appropriate health policies in order to decrease mortality rates among children with cancer in Argentina. They should include programs for structural reform, human resource development and equipment supply, as well as continuous cooperative work.

Estudio de Infecciones diseminadas por candida en pacientes con neutropenia febril asociada a enfermedades hemato-oncológicas / Study disseminated Candida infections in patients with febrile neutropenia associated with hemato-oncological diseases

Mundialmente, en las últimas dos décadas se ha observado un incremento en la frecuencia de las infecciones micóticas diseminadas, con alta morbi-mortalidad, particularmente importante en las infecciones por Candida. El objetivo es determinar la frecuencia de candidiasis diseminada, en pacientes con enfermedades hemato-oncológicas o aplasia medular que ingresaron a los servicios de medicina interna del hospital universitario de caracas, con fiebre y neutropenia, entre enero y septiembre de 2010, realizándose evaluación exhaustiva y tomándose muestras de sangre, además de otras muestras en caso de presencia de lesiones, para el diagnóstico micológico. Se evaluaron 48 pacientes en el período del estudio, diagnósticandose 21 casos (43,75%) de micosis diseminadas, catalogadas como infecciones probadas en 13 y probables en 8 casos. De las infecciones probadas 8 (38%) correspondieron a infecciones por Candida: en uno se aisló Candida albicans y en 7, Candida no albicans: 2 pacientes con candida tropicalis, 2 con candida glabatra y uno con candida guillermondii. Dos cepas fueron informadas como candida spp, y 5 por otros hongos. Las infecciones micóticas diseminadas contribuyen sustancialmente a la morbimortalidad de los pacientes con neutropenia, por lo tanto es fundamental la sospecha y diagnóstico temprano de estas entidades en los pacientes con cáncer de origen hematológico y aplasia medular.

Wordwide, there has been an increase in the incidence of disseminated fungal diseases during the last two decades, with high morbidity and mortality particularly importante in Candida infections. To determine the frequency of disseminated candidiasis in patients with hemato-oncological diseases or bone marrow aplasia and febrile neutropenia. A descriptive, prospective and analytical study was conducted. Patients with hemato-oncological diseases or bone marrow aplasia who were hospitalized at the internal medicine service of the hospital universitrio de caracas, with fever and neutropenia, between january and september, 2010 were included, making torough assessment and taking blook samples as well as other clinical specimen when other lesions were present, for mycological diagnosis. During the study period, 48 patients were evaluated. Twenty one cases were diagnosed (43.75%) as disseminated fungal disease. They were classified as proven in 13 cases and probable in 8. From the proven diseases, 8 (38%) corresponded to Candida infections: in one, Candida albicans was isolated and in 7, Candida non-albicans: 2 patients with Candida tropicalis were found, 2 with Candida glabrata and one with Candida guillermondii. Two were reported as Candida spp. In 5 patients other fungi were found. Dissemiated fungal infections substantially contribute to morbidity and mortality in neutropenic patients. For this reason, awareness and early diagnosis of this disease are crucial are crucial in patients with hematological cancer and bone marrow aplasis.