Search Results (29)

Introduction: Surgical resection is the most effective therapy for patients with early non-small cell lung cancer (NSCLC). Impact on quality of life (QoL) includes a period until return to work, perioperative complications and development of physical sequelae. Lobectomy is the standard procedure. However, sublobar resections have shown similar oncological outcomes preserving healthy parenchyma. We analyze if sublobar resection is associated wiht less deterioration of QoL. Methods: We performed a retrospective analysis of patients undergoing surgical resection for NSCLC between 2017 and 2019. Cases were classified according to type of resection (sublobar vs lobectomies, bilobectomies and pneumonectomies). A survey with questions related to outcomes and QoL and occupational issues was performed. Results: A total of 169 answered the survey and were followed for 36 months. Segmentectomy was performed in 69 patients (40.9%). Lobectomy was the main type of resection (56.2%). Fatigue during walking was less common in patients undergoing sublobar resections (55.1% vs 72.7%; p = 0.02). No other differences were detected in temrs of QoL between both groups. Changes in familiar relationship after surgery were higher in patients under 70 years old. Most patients had not resume their work activities at the time of consultation. Conclusion: Feeling of fatigue while walking was lower in patients undergoing sublobar resections. Changes in familiar relationship were higher in younger patients. QoL was similar in both groups. Full article

Background/objectives: Second primary lung cancer frequently manifests in individuals who have survived head and neck cancer, with this occurrence often being attributed to shared risk factors. The objective of the present study is to compare the prognosis, in terms of survival rate, of patients who presented isolated bronchogenic carcinoma (BC) with that of patients who presented with a personal history of BC and associated oropharyngeal and oral cancer (OAOC). Methods: A retrospective longitudinal study was conducted, including all consecutive patients who underwent surgical resection with curative intent for BC in Hospital Clínico San Carlos (HCSC), Madrid, Spain, between December 1989 and December 2024. The survival rate was calculated and compared in two groups of patients: Group 1: 1594 patients with isolated BC and Group 2: 97 patients with BC and OAOC. Results: Group 2 did not show a significant difference in their 60-month survival rate in comparison to Group 1 (HR = 1.23, CI 95% 0.9–1.6) p = 0.14. But when comparing the 120-month survival rate, Group 1 showed a significantly higher survival rate (36.4%, CI 95% 33.9–39%) compared to Group 2, (25.54%, CI 95% 17.78–36.7%) HR= 1.28 (CI 95% 1–1.6), p = 0.04. Disease-free survival showed a non-significant trend of greater severity among patients with a previous history of OAOC. Conclusions: Lung cancer patients who presented with OAOC had worse overall survival compared to patients who presented with isolated lung cancer, and a significant difference was observed at 120 months of follow-up. Full article

We report the photocatalytic (PC) response of titanium oxide (TiO_x) films grown by reactive DC magnetron sputtering under oblique-angle-deposition (OAD) and subjected to post-deposition flash-lamp-annealing (FLA). Under ballistic growth conditions, OAD yields TiO_x films with either compact or inclined columnar structure as the deposition incidence angle (α) with respect to the substrate normal varies from zero to grazing. On the one hand, films produced for α ≤ 45° display a compact and opaque structure comprising the formation of nanocrystalline cubic titanium monoxide (c-TiO) phase. On the other hand, films grown at larger α (≥60°) display tilted columns with amorphous structure, yielding highly porous films and an increased transparency for α > 75°. For TiO_x films grown at large α, FLA induces phase transformation to nanocrystalline anatase from the amorphous state. In contrast to as-grown samples, FLA samples display PC activity as assessed by bleaching of methyl orange dye. The best PC performance is attained for an intermediate situation (α = 60–75°) between compact and columnar structures. The obtained photoactivity is discussed in terms of the different microstructures obtained by OAD and posterior phase formation upon FLA. Full article

Background: Person-centredness, a global movement in healthcare, is consistent with international developments in healthcare policy. It is important to have instruments to measure person-centred care. The Person-Centred Practice Inventory-Staff (PCPI-S) is an internationally recognized instrument that aims to measure how healthcare staff experience person-centred practice. Aim: To perform the cultural adaptation and psychometric testing of a Spanish version of the PCPI-S (PCPI-S (Sp)). Method: A two-stage research design was implemented as follows: (1) the translation and cultural adaptation of the PCPI-S from English to Spanish using the “Translation and Cultural Adaptation of Patient Reported Outcomes Measures-Principles of Good Practice”; (2) a quantitative cross-sectional survey for the psychometric evaluation of the PCPI-S. Test–retest reliability was evaluated using the Kendall tau concordance coefficient, internal reliability was assessed through the ordinal theta (OT) coefficient, and confirmatory factor analysis was performed to examine the theoretical measurement model. Results: A Spanish version of the PCPI-S was obtained. There were no significant difficulties in the translation process or the consulting sessions. A sample of 287 healthcare professionals participated in the study at least once. All the items showed at least a fair level of test–retest reliability. The OT scores were adequate (>0.69). The model showed good to adequate levels of fit: CFI = 0.89, SRMR = 0.068; RMSEA = 0.060 with CI90% (0.056–0.063). Conclusions: The Spanish translation of the PCPI-S was psychometrically valid when tested with Spanish healthcare professionals. This instrument will help identify professionals’ perceptions of person-centred practice, track the evolution of this practice over time, and assess interventions aimed at improving person-centred practice. Full article

Several factors have been associated with the occurrence of immune-related adverse events (irAEs) induced by immune checkpoint inhibitor (ICI) therapy. Despite their availability, the predictive value of circulating blood cell parameters remains underexplored. Our aim was to investigate whether baseline values of and early changes in absolute neutrophil count (ANC), absolute lymphocyte count (ALC), other blood cell counts, and lymphocyte-related ratios can predict irAEs and whether sex may differentially influence this potential predictive ability. Of the 145 patients included, 52 patients (35.8%) experienced at least one irAE, with a 1-year cumulative incidence of 41.6%. Using Fine and Gray competing risk models, we identified female sex (hazard ratio (HR) = 2.17, 95% confidence interval (CI) = 1.20–3.85), high ALC before ICI initiation (HR = 1.63, 95% CI = 1.09–2.45), and low ANC after ICI initiation (HR = 0.81, 95% CI = 0.69–0.96) as predictors of irAEs. However, ALC and ANC may only have an impact on the risk of irAEs in women (stratified for female sex, ALC-related HR = 2.61, 95% CI = 1.40–4.86 and ANC-related HR = 0.57, 95% CI = 0.41–0.81). Priority should be given to developing models to predict ICI-related toxicity and their validation in various settings, and such models should assess the impact of patient sex on the risk of toxicity. Full article

Interstitial lung diseases (ILDs) constitute a group of more than 200 disorders, with idiopathic pulmonary fibrosis (IPF) being one of the most frequent. Telomere length (TL) shortening causes loss of function of the lung parenchyma. However, little is known about its role as a prognostic factor in ILD patients. With the aim of investigating the role of TL and telomerase activity in the prognosis of patients affected by ILDs, we analysed lung tissue samples from 61 patients. We measured relative TL and telomerase activity by conventional procedures. Both clinical and molecular parameters were associated with overall survival by the Kaplan–Meier method. Patients with IPF had poorer prognosis than patients with other ILDs (p = 0.034). When patients were classified according to TL, those with shortened telomeres reported lower overall survival (p = 0.085); differences reached statistical significance after excluding ILD patients who developed cancer (p = 0.021). In a Cox regression analysis, TL behaved as a risk-modifying variable for death associated with rheumatic disease (RD) co-occurrence (p = 0.029). Also, in patients without cancer, ferritin was significantly increased in cases with RD and IPF co-occurrence (p = 0.032). In relation to telomerase activity, no significant differences were detected. In conclusion, TL in lung tissue emerges as a prognostic factor in ILD patients. Specifically, in cases with RD and IPF co-occurrence, TL can be considered as a risk-modifying variable for death. Full article

Postoperative pulmonary complications (PPCs) increase the hospital length of stay (LOS) and the cost of healthcare associated with surgical procedures. Strategies to reduce PPCs begin before surgery and continue in the postoperative period. Fissios App© is a smartphone application that contains perioperative medical advice and a structured respiratory physiotherapy program. The objective was to implement the use of this app in a group of patients scheduled for a thoracic surgical procedure and determine its efficacy in reducing PPCs. This was a quasi-experimental study in which all patients attended a face-to-face respiratory physiotherapy program, and the intervention group used Fissios App© as a complement. We prospectively recorded the postoperative evolution of both groups, analyzed the categorical differences and quantitative variables, and created a binary logistic regression model. We recruited 393 patients (131 intervention and 262 control). The intervention group had a lower incidence of PPCs (12.2% versus 24% in the control group, p = 0.006), a shorter LOS (a median of 3 days (IQR = 2–5) versus 4 days (IQR = 3–6, p = 0.001) in the control group), and a reduction in the risk of developing PPCs by 63.5% (OR: 0.365, 95% CI: 0.17–0.78). The use of Fissios App© improved the clinical outcomes after surgery and reduced the probability of developing PPCs. Full article

Immune-checkpoint inhibitors (ICIs) are antagonists of inhibitory receptors in the immune system, such as the cytotoxic T-lymphocyte-associated antigen-4, the programmed cell death protein-1 and its ligand PD-L1, and they are increasingly used in cancer treatment. By blocking certain suppressive pathways, ICIs promote T-cell activation and antitumor activity but may induce so-called immune-related adverse events (irAEs), which mimic traditional autoimmune disorders. With the approval of more ICIs, irAE prediction has become a key factor in improving patient survival and quality of life. Several biomarkers have been described as potential irAE predictors, some of them are already available for clinical use and others are under development; examples include circulating blood cell counts and ratios, T-cell expansion and diversification, cytokines, autoantibodies and autoantigens, serum and other biological fluid proteins, human leucocyte antigen genotypes, genetic variations and gene profiles, microRNAs, and the gastrointestinal microbiome. Nevertheless, it is difficult to generalize the application of irAE biomarkers based on the current evidence because most studies have been retrospective, time-limited and restricted to a specific type of cancer, irAE or ICI. Long-term prospective cohorts and real-life studies are needed to assess the predictive capacity of different potential irAE biomarkers, regardless of the ICI type, organ involved or cancer site. Full article

Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC. Full article

The efficacy of cognitive stimulation programs for the elderly is sufficiently documented. However, few studies have addressed the effectiveness of language stimulation programs by cognitive levels in this population. This randomized controlled trial was conducted on 308 participants from a primary care center and followed the CONSORT guidelines. A stratified randomization was carried out. The primary variable was the MEC-35, validated Spanish version of the Mini-Mental State Examination (MMSE). The secondary outcome variable was set-test, which evaluates verbal fluency in four categories. These tests were assessed for all outcome measures at baseline, at 10 weeks, at 6 months, and 1 year after the intervention. The intervention consisted of 10 sessions of 45 min/week for 10 weeks through mental activation notebooks that comprehensively work on the different cognitive functions. The results show that the comparisons between the control and intervention group turn out to be significant (p < 0.05) at the three time points. The comprehensive cognitive stimulation program has made it possible to improve the global aspects of cognition, language proficiency, and verbal fluency. To optimize and maintain these results, it is necessary to consider other clinical, functional, psychological, and occupational aspects, as well as related educational aspects, which prevent mild cognitive impairment. Full article

Objective: To analyse the overall effectiveness and cost-efficiency of a mobile application (APP) as a community health asset (HA) with recommendations and recovery exercises created bearing in mind the main symptoms presented by patients in order to improve their quality of life, as well as other secondary variables, such as the number and severity of ongoing symptoms, physical and cognitive functions, affective state, and sleep quality. Methods: The first step was to design and develop the technologic community resource, the APP, following the steps involved in the process of recommending health assets (RHA). After this, a protocol of a randomised clinical trial for analysing its effectiveness and cost-efficiency as a HA was developed. The participants will be assigned to: (1st) usual treatment by the primary care practitioner (TAU), as a control group; and (2nd) TAU + use of the APP as a HA and adjuvant treatment in their recovery + three motivational interviews (MI), as an interventional group. An evaluation will be carried out at baseline with further assessments three and six months following the end of the intervention. Discussion: Although research and care for these patients are still in their initial stages, it is necessary to equip patients and health care practitioners with tools to assist in their recovery. Furthermore, enhanced motivation can be achieved through telerehabilitation (TR). Full article

The aim of this study was to systematically review the scientific evidence related to the physiotherapy interventions in neurorehabilitation that utilize virtual reality (VR) for balance training and risk of falls in people with multiple sclerosis (MS). A search was conducted in Medline (PubMed), PEDro, and Google Scholar to identify all the relevant studies. Clinical trials assessing the effects of VR in people with MS were included. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and PEDro scale. Qualitative analysis was performed according to the GRADE. In total, 16 studies (n = 663) were included. The meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for balance, with a moderate clinical effect in eight studies (SMD: 0.63; 95% CI 0.34–0.92; p < 0.05). In addition, the meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for risk of falls, with a small clinical effect in six studies (SMD: −0.55; 95% CI −1.07–0.04; p < 0.05). VR-based treatments are more effective than non-intervention in improving balance and fall risk in people with MS, with a very low certainty of evidence. In addition, they also show to be more effective than conventional rehabilitation, with a very low certainty of evidence. Full article

Introduction: Acute Otitis Media (AOM) is the most commonly-occurring bacterial complication in childhood. After making certain corrections to the patients’ dietary habits, which we found to be excessively high in animal-based and industrially-processed foods, we observed a significant reduction in recurrent colds and their bacterial complications. We promote an original way of treating these diseases, since until now the conventional treatment is based on pharmacological and surgical treatment. From our point of view, the mucosa that covers the entire ENT area is in a pro-inflammatory and hyper-reactive state, as a consequence of the alterations produced by an inadequate diet. For us there is no difference in the nutritional treatment of the different mucous membranes that cover the ENT area. The purpose of the study was to assess the effects of the Traditional Mediterranean Diet (TMD) on patients diagnosed with Recurring Acute Otitis Media (RAOM). Methods: prospective pre-postest comparison study with 48 girls and 42 boys aged 1–5 years, each of whom had been and included on the 1-year programme “Learning to eat the Mediterranean Way”, designed to encourage the adoption of the TMD. We studied clinical and therapeutic variables and various anthropometric parameters. Results: all the symptomatic indicators studied (number and intensity of episodes of otitis and emergency admissions) showed a positive and statistically significant evolution in RAOM. By the end of the study, none of the patients met the criteria for classification as RAOM, and 60% percent of patients did not present any further episodes of AOM. In line with the above, the use of anti-microbial drugs and symptomatic treatments reduced considerably; the use of antibiotics dropped from 4.30 occasions/patient/year, to 0.66 (p < 0.001), and the used of symptomatic treatments dropped from 7.63 to 2.75 (p < 0.001). The level of family satisfaction was very high. Conclusions: the adoption of the Traditional Mediterranean Diet has been demonstrated to significantly reduce occurrence of acute otitis media and may contribute to the treatment of patients diagnosed with recurrent acute otitis media. Full article

Leptin is involved in the modulation of insulin signaling in peripheral tissues, being closely associated with changes in lipid metabolism. This adipokine modifies inflammatory pathways that can interact with insulin targets in peripheral organs; however, the mechanisms remain unclear. Inflammatory and insulin signaling targets, cytokines, adiponectin, irisin and non-esterified fatty acid (NEFA) levels and enzymes of fatty acid anabolism were studied in the gastrocnemius of chronic centrally infused leptin (L), pair-fed and control rats. The phosphorylation of signal transducer and activator of transcription 3 (STAT3) and c-Jun N-terminal kinase (JNK) was reduced in L rats (59% and 58%, respectively). The phosphorylation of the insulin receptor and Akt and adiponectin and irisin content was increased in L rats (154%, 157%, 308% and 329%, respectively). The levels of glucose-6-phosphate dehydrogenase, the mRNA content of acetyl Co-A carboxylase and NEFA concentrations were diminished in the muscles of L rats (59%, 50% and 61%, respectively). The activation of JNK correlated positively with STAT3 phosphorylation, tumoral necrosis factor-α and NEFA and negatively with irisin and Akt phosphorylation. These data suggest that the activation of insulin signaling targets and a decrease in NEFA content are associated with a reduction in muscle inflammation parameters, suggesting that leptin may integrate these pathways. Full article

Bacillus clausii is a probiotic that benefits human health. Its key characteristics include the ability to form spores; the resulting tolerance to heat, acid, and salt ensures safe passage through the human gastrointestinal tract with no loss of cells. Although B. clausii has been widely used for many decades, the beneficial properties of other probiotics, such as Lactobacillus spp. and Bifidobacterium spp., are better disseminated in the literature. In this review, we summarize the physiological, antimicrobial, and immunomodulatory properties of probiotic B. clausii strains. We also describe findings from studies that have investigated B. clausii probiotics from the perspective of quality and safety. We highlight innovative properties based on biochemical investigations of non-probiotic strains of B. clausii, revealing that B. clausii may have further health benefits in other therapeutic areas. Full article