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Hospital de Órbigo, Spain

Casals C.,University of Granada | Casals Sanchez J.L.,Hospital Clinico de Malaga
Semergen | Year: 2011

The implementation of physical activity on a regular basis is essential to maintain physical and mental health, and is a mainstay in the treatment of several diseases. In patients with fibromyalgia physical activity should be routinely included in the treatment plan, and we must optimise the prescription to obtain the maximum benefit. © 2010 Elsevier España, S.L. y SEMERGEN.

Objective: To determine the influence of dysfunctional thoughts and their relationship on the burden of caregivers. Method: Descriptive study conducted in the San Andrés Torcal Health Centre, Malaga, Spain, in 2010. Subjects: A random sample was selected from dependent person caregivers of the centre. Those patients who were receiving palliative care and those cases where the care was less than 6 weeks were excluded.We used the Dysfunctional Thoughts Questionnaire (DTQ) and the short Zarit questionnaire was used on the caregivers. Sociodemographic variables of the caregiver and variables related to care (presence of support, duration of care, and if applicable, the type of help received by them), were collected. Sociodemographic variables of the patients, as well as the Barthel index and presence or absence of dementia were recorded. Analysis used: descriptive analysis, Pearson correlation coefficient to assess the association between quantitative variables and Kolmogorov-Smirnov test. Results: The mean DTQ score was 49.94 (95% CI; 42.0 - 49.8). The burden measured by Zarit test and dysfunctional thoughts were positively associated (Pearson correlation coefficient 0.57, P < .001). Conclusions: Dysfunctional thoughts have a high impact on our population of caregivers and may be a contributing factor to the onset of fatigue in the caregiver role.There is a positive association between stress of caregivers and dysfunctional thoughts, and is more intensive in caregivers of patients without dementia. © 2011 Elsevier España, S.L.

Mateos M.-V.,University of Salamanca | Orio A.,ICO | Rosino L.,Institute Dinvestigasions Biomediques August Pi I Sunyer Idibaps | Arriba F.D.,Hospital Morales Messeguer | And 17 more authors.
Haematologica | Year: 2015

Bendamustine is a bifunctional alkylating agent with proven activity in myeloma. In this study 60 newly diagnosed myeloma patients were given bendamustine plus bortezomib and prednisone in a regimen consisting of one cycle of bortezomib twice weekly for 6 weeks (1.3 mg/m2 on days 1, 4, 8, 11, 22, 25, 29, and 32), plus bendamustine (90 mg/m2 on days 1 and 4) and prednisone. The following cycles included bortezomib once weekly. Patients who were transplant candidates proceeded to stem cell collection after four cycles and the transplant was performed after six cycles. Patients who were not candidates for transplantation received up to nine cycles. Forty-two patients were transplant candidates and after six cycles, 50% achieved at least a very good partial response, with 24% having complete responses; 35 proceeded to a transplant, and the complete response rate was 54%. Seventeen patients continued up to nine cycles, and 57% achieved at least a very good partial response, including 26% with complete responses. The 2-year progression-free survival and overall survival rates were 62% and 86%, respectively. The safety profile was manageable, but stem cell mobilization was compromised in 35% of patients. In summary, this combination is effective in untreated patients, with an acceptable toxicity profile, but given the introduction of second-generation novel agents and monoclonal antibodies, the combination will probably be better reserved for relapsing patients, in whom stem cell collection is not needed, while cost-effective combinations with non-cross-resistant drugs continue to represent a medical need. This trial was registered with ClinicalTrials.gov, number NCT01376401. © 2015 Ferrata Storti Foundation.

Guisado A.M.,Hospital Torrecardenas | Munoz A.S.,Hospital Clinico de Malaga | De La Cabeza Lomas Garrido M.,Hospital Medico Quirurgico Ciudad de Jaen | Borrego M.R.,Hospital Universitario Virgen Del Rocio | And 5 more authors.
Advances in Therapy | Year: 2011

The introduction of aromatase inhibitors (AI) has resulted in practice change approaches in the treatment of early breast cancer. In this paper, we analyze the most relevant studies including the ATAC, BIG 1-98, TEAM, MA-17, NSABP B-33, and ABSCG-6 studies. Postmenopausal patients with hormone receptor-positive early breast cancer should be treated with AI for 5 years. For patients who have been initiated with tamoxifen (TAM), switching to an AI to complete 5 years of treatment is also recommended. The results of the extended adjuvant therapy studies recommend the use of an AI (anastrozole, letrozole, or exemestane) after the completion of standard TAM treatment. With regards to premenopausal women, TAM is the recommended adjuvant hormonal treatment for pre- and perimenopausal women. There is no indication for the use of AI in these subgroups of patients. Finally, determination of CYP2D6 polymorphisms could be considered when choosing the best adjuvant hormonal treatment option. © © Springer Healthcare 2011.

Chillon M.C.,University of Salamanca | Gomez-Casares M.T.,Universitario Of Gran Canaria Dr Negrin | Lopez-Jorge C.E.,Universitario Of Gran Canaria Dr Negrin | Rodriguez-Medina C.,Universitario Of Gran Canaria Dr Negrin | And 14 more authors.
Leukemia | Year: 2012

There is barely any information about the prognostic significance of FLT3 expression and mutational status in cytogenetically distinct subgroups of acute lymphoblastic leukemia (ALL). We analyzed the presence of FLT3-tyrosine kinase domain (TKD) and FLT3-internal tandem duplication (ITD) mutations as well as FLT3 expression levels in 54 newly diagnosed patients with B-ALL (n49) or T-ALL (n5). All B/T-ALL samples tested negative for the presence of FLT3-TKD or FLT3-ITD. None of the T-ALL and E2A-PBX1 B-ALL overexpressed FLT3. In contrast, mainly MLL-AF4 B-ALL but also ETV6-RUNX1, BCR-ABL or B-ALL displaying normal cytogenetics exhibited significantly higher FLT3 expression levels than normal bone marrow, supporting that aberrantly increased transcription of FLT3, rather than activating FLT3 mutations, contributes to the pathogenesis of these B-ALL. Using the median FLT3 expression as cut-off value we found that high-level FLT3 expression is associated with an extremely poor 1-year overall survival (OS; 0 vs 71%; P0.002) and disease-free survival (DFS; 0 vs 43%; P0.03) in MLL-AF4 B-ALL but not in MLL-germline B-ALL. Cox regression analysis with OS/DFS as end points showed that age>14 years and high-level FLT3 expression were independent prognostic factors when all ALL patients were analyzed together. Importantly, when the MLL-AF4 B-ALL subgroup was analyzed separately, high-level FLT3 expression was the only independent prognostic factor for OS and treatment outcome. These findings indicate that high FLT3 expression identifies MLL-AF4 ALL patients at very high risk of treatment failure and poor survival, emphasizing the value of ongoing/future clinical trials for FLT3 inhibitors. © 2012 Macmillan Publishers Limited. All rights reserved.

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