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Mexico City, Mexico

Avila-Montiel D.,Direccion de Investigacion | Ortega-Martin V.,Direccion de Investigacion | Ruiz-Cano J.,Direccion de Investigacion | Dorantes-Acosta E.,Servicio de Hemato Oncologia | And 3 more authors.
Boletin Medico del Hospital Infantil de Mexico | Year: 2013

Background. When a family member is admitted to the hospital, this represents a complex social and cultural phenomenon. Little research about caregivers and their basic needs such as nutrition has been carried out. The aim of this study is to assess the diet of caregivers of pediatric patients with cancer and to qualitatively describe the conditions associated with eating during hospitalization of a family member. Methods. Fifty three caregivers of hospitalized patients in the Oncology Department at the Hospital Infantil de México Federico Gomez were surveyed. The 24-h reminder was used every day throughout the process of hospitalization. Finally, surveys were conducted in order to qualitatively describe food intake of caregivers during the feeding process in a hospitalization period. Results. Women caregivers outnumbered men (n = 43, 81%). Body mass index (BMI) at the beginning of the study was 25.5 ± 5 kg/m2 (X ± SD). Caloric intake per day of caregivers at the beginning of the hospitalization period was lower than medical recommendations for the Mexican population (2500 kcal). In the qualitative description, it was found that most caregivers eat breakfast (86%) and only a third have dinner (32%). Although 71% of caregivers ate something from the patients' food tray, the most common way to obtain food was by purchase. Conclusions. Study subjects were overweight according to their BMI (≥ 25 kg/m2). Despite caloric intake being lower than recommended, intake distribution was acceptable according to the macronutrient distribution. Half of the caregivers studied had three meals but often experienced long periods of fasting.

Moreno L.,Hospital Infantil Universitario Nino Jesus | Garcia Ariza M.A.,Servicio de Oncologia Pediatrica | Cruz O.,Servicio de Hemato Oncologia | Calvo C.,Servicio de Oncologia Pediatrica | And 6 more authors.
Anales de Pediatria | Year: 2016

Leptomeningeal dissemination in paediatric central nervous system (CNS) tumours is associated with a poor outcome, and new therapeutic strategies are desperately needed. One of the main difficulties in the treatment of CNS tumours is blood brain barrier penetration. Intrathecal therapy has shown to be effective in several paediatric tumours. The aim of this article is to review the data available on the use of liposomal cytarabine for paediatric patients with leptomeningeal dissemination of CNS tumours, including the pharmacology, administration route, safety and efficacy data. © 2016 Asociación Española de Pediatría.

Bonifaz L.C.,Hospital Of Especialidades Centro Medico Nacional Xxi | Zapata-Tarres M.,Servicio de Hemato Oncologia | Sadowinski-Pine S.,Servicio de Patologia | Cabrera-Munoz M.L.,Servicio de Patologia
Boletin Medico del Hospital Infantil de Mexico | Year: 2014

Background: Lymphomas are B and/or T cell clonal neoplasms in various states of differentiation, characteristically compromising lymph nodes. They are constituted by B and T lymphocytes that reach the node by chemokine-mediated recruitment including CXCL13. Hypoxia-inducible transcription factor (HIF-1α) plays a role in cellular adaptation to oxygen concentration changes. It also regulates expression of chemokines such as CXCL12, CCL20, and CCL5 as well as some of their receptors such as CCR7 and CXCR4. Methods: We performed in silico analysis of the CXCL13 promoter, pharmacologic modulation of HIF-1α activity and, using reporter plasmids, site-directed mutation and DNA-protein interaction analysis we analyzed the relation between HIF-1α activity and CXCL13 expression. Moreover, we did tissue microarray and immunohistochemistry to see the expression of HIF-1α and CXCL13. Results: This study detected three possible HIF-1α binding sites suggesting that this chemokine may be regulated by the CXCL13 transcription factor. We showed that CXCL13 expression is directly dependent, whereby an increase in HIF-1α activity increases CXCL13 expression and decreased HIF-1α activity in turn decreases CXCL13 expression. We proved that HIF-1α transcriptionally regulates the expression of CXCL13 in a direct manner. We established that HIF-1α and CXCL13 are greatly overexpressed in the most aggressive pediatric lymphomas. Conclusions: For the first time, this study showed that HIF-1α directly regulates transcriptional CXCL13 and that both proteins are overexpressed in the most aggressive forms of pediatric lymphoma. This suggests that they may play a significant role in the pathogenesis of pediatric non-Hodgkin's lymphoma. © 2013, Boletín Médico del Hospital Infantil de México.

Vega J.,University of Valparaiso | Goecke H.,University of Valparaiso | Carrasco A.,Servicio de Medicina | Escobar C.,Servicio de Urologia | And 4 more authors.
Clinical and Experimental Nephrology | Year: 2011

A 31-year-old woman with nephronophthisis received a cadaveric kidney transplant, and was immunosuppressed with cyclosporine, azathioprine and steroids. Twelve days after transplant a biopsy showed acute rejection with vascular damage. She was treated with 3 pulses of methylprednisolone and change of immunosuppression to mycophenolate mofetil and tacrolimus, without improving graft function. At day 21, a second biopsy showed accentuation of interstitial and vascular rejection. Antibodymediated rejection was suspected and plasmapheresis and rituximab were prescribed. Graft function improved rapidly. Staining for C4d was negative and there were no circulating antibodies against the donor. In the interstitial infiltrate there were clusters of B lymphocytes that accounted for 40% of cells, which was thought to be an ominous sign, as it has been associated with poor graft outcome. Acute T-cell-mediated rejection grade III (Banff 07) was diagnosed. Thirty-nine months after transplant her kidney function is stable with no other complication. This clinical case generates the hypothesis that rituximab may have a beneficial role in the therapy of acute cellular rejection when there are clusters of B lymphocytes in the infiltrate and a good response has not been obtained to conventional anti-rejection therapy. © Japanese Society of Nephrology 2010.

Sevilla J.,Servicio de Hemato Oncologia | Sevilla J.,Hospital Infantil Universitario Nino Jesus | Guillen M.,Servicio de Hemato Oncologia | Guillen M.,Hospital Infantil Universitario Nino Jesus | And 10 more authors.
Cytotherapy | Year: 2013

The definition of poor mobilizers is not clear in pediatric patients undergoing autologous peripheral blood hematopoietic progenitor cell (HPC) mobilization. Most studies conducted in children define those variables related to the collection of HPC after leukapheresis, but the information regarding exclusively the mobilization process is scarce. In our experience, most children (92.2%) reach the target CD34+ cell dose for autologous peripheral blood progenitor cell transplantation if CD34+ cell count was higher than 10/mL. No differences were observed between those with >20 CD34 + cells/mL and 11e20 CD34+ cells/mL. In this study, we analyzed the variables that influence CD34+ cell count; we found that prior use of radiotherapy was the main variable related to poor mobilization. Patients diagnosed with Ewing sarcoma, treated with radiotherapy and mobilized with standard doses of granulocyte colony-stimulating factor (G-CSF) were also at a high risk of mobilization failure. In these patients, we should consider mobilization with high dose G-CSF and be prepared with new mobilization agents to avoid delay on their course of chemotherapy. © 2013, International Society for Cellular Therapy.

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