5 results on '"Cristina Perna"'
Search Results
2. Building up user participation: councils and conferences in the Brazilian Health System
- Author
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Soraya Maria Vargas Cortes and Cristina Perna
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participação dos usuários ,conselhos de saúde ,conferências de saúde ,Sociology (General) ,HM401-1281 - Abstract
The article discusses the literature that states that creating channels of participation in developing countries in general, and in Latin America in particular, is too difficult, due to the weakness of both the political institutions and the civil society. In the field of health, the initiatives to promote user participation would have supposedly resulted in failure. However, the Brazilian experience with health councils and conferences does not confirm such statements. The article also examines the historical origins, the creation of these fora and the politico-institutional role they play in the context of the Brazilian health system reform. Finally, the article analyzes the factors that determine the success of a participatory process in health councils and conferences.
3. Sección de Psicosomática y Psiquiatría de Enlace
- Author
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Ignacio Gómez-Reino Rodríguez, Iris Tolosa, Gemma Mestre-Bach, and Cristina Pernas Pereiro
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Cáncer ,Cribado de detección ,Atención primaria ,Síntomas somáticos persistentes (PSS) ,Antipsicótico ,Enfermedad hepática ,Psychology ,BF1-990 ,Psychiatry ,RC435-571 - Abstract
Si desea acceso libre a la versión electrónica de la monografía "Psiquiatría psicosomática y de enlace", dirigida por el profesor Lobo, puede hacerlo clicando: https://www.psiquiatriapsicologia-dexeus.com/IMAGES_12/psiquiatria-psicosomatica-y-de-enlace-web.pdf
- Published
- 2023
- Full Text
- View/download PDF
4. Multiplatform plasma fingerprinting in cancer cachexia: a pilot observational and translational study
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Mónica Patricia Cala, María Teresa Agulló‐Ortuño, Elena Prieto‐García, Carolina González‐Riano, Lucía Parrilla‐Rubio, Coral Barbas, Carmen Vanesa Díaz‐García, Antonia García, Cristina Pernaut, Jorge Adeva, María Carmen Riesco, Francisco Javier Rupérez, and Jose Antonio Lopez‐Martin
- Subjects
Cancer ,Cachexia ,Metabolomics ,Biomarkers ,Diseases of the musculoskeletal system ,RC925-935 ,Human anatomy ,QM1-695 - Abstract
Abstract Background Cachexia is a metabolic syndrome that affects up to 50–80% of cancer patients. The pathophysiology is characterized by a variable combination of reduced food intake and abnormal metabolism, including systemic inflammation and negative protein and energy balance. Despite its high clinical significance, defined diagnostic criteria and established therapeutic strategies are lacking. The ‘omics’ technologies provide a global view of biological systems. We hypothesize that blood‐based metabolomics might identify findings in cachectic patients that could provide clues to gain knowledge on its pathophysiology, and eventually postulate new therapeutic strategies. Methods This is a cross‐sectional observational study in two cohorts of cancer patients, with and without cachexia. Patients were consecutively recruited from routine clinical practice of a General Oncology Department at ‘12 de Octubre’ University Hospital. Selected clinical and biochemical features were collected. Blood metabolite fingerprinting was performed using three analytical platforms, gas chromatography coupled to mass spectrometry (GC–MS), capillary electrophoresis coupled to mass spectrometry (CE–MS), and liquid chromatography coupled to mass spectrometry (LC–MS). Besides, we performed pathway‐based metabolite analyses to obtain more information on biological functions. Results A total of 15 subjects were included in this study, 8 cachectic and 7 non‐cachectic patients. Metabolomic analyses were able to correctly classify their samples in 80% (GC–MS), 97% (CE–MS), 96% [LC–MS (positive mode)], and 89% [LC–MS (negative mode)] of the cases. The most prominent metabolic alteration in plasma of cachectic patients was the decrease of amino acids and derivatives [especially arginine, tryptophan, indolelactic acid, and threonine, with 0.4‐fold change (FC) compared with non‐cachectic patients], along with the reduction of glycerophospholipids [mainly lysophosphatidylcholines(O‐16:0) and lysophosphatidylcholines(20:3) sn‐1, FC = 0.1] and sphingolipids [SM(d30:0), FC = 0.5]. The metabolite with the highest increase was cortisol (FC = 1.6). Such alterations suggest a role of the following metabolic pathways in the pathophysiology of cancer cachexia: arginine and proline metabolism; alanine, aspartate, and glutamate metabolism; phenylalanine metabolism; lysine degradation; aminoacyl‐tRNA biosynthesis; fatty acid elongation in mitochondria; tricarboxylic acids cycle; among others. Conclusions These findings suggest that plasma amino acids and lipids profiling has great potential to find the mechanisms involved in the pathogenesis of cachexia. Metabolic profiling of plasma from cancer patients show differences between cachexia and non‐cachexia in amino acids and lipids that might be related to mechanisms involved in its pathophysiology. A better understanding of these mechanisms might identify novel therapeutic approaches to palliate this unmet medical condition.
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- 2018
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5. Polymorphisms associated with everolimus pharmacokinetics, toxicity and survival in metastatic breast cancer.
- Author
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Tomas Pascual, María Apellániz-Ruiz, Cristina Pernaut, Cecilia Cueto-Felgueroso, Pablo Villalba, Carlos Álvarez, Luis Manso, Lucia Inglada-Pérez, Mercedes Robledo, Cristina Rodríguez-Antona, and Eva Ciruelos
- Subjects
Medicine ,Science - Abstract
Metastatic breast cancer (MBC) progressing after endocrine therapy frequently activates PI3K/AKT/mTOR pathway. The BOLERO-2 trial showed that everolimus-exemestane achieves increased progression free survival (PFS) compared with exemestane. However, there is great inter-patient variability in toxicity and response to exemestane-everolimus treatment. The objective of this study was to perform an exploratory study analyzing the implication of single nucleotide polymorphisms (SNPs) on outcomes from this treatment through a pharmacogenetic analysis.Blood was collected from 90 postmenopausal women with hormone receptor-positive, HER2-negative MBC treated with exemestane-everolimus following progression after prior treatment with a non-steroidal aromatase inhibitor. Everolimus pharmacokinetics was measured in 37 patients. Twelve SNPs in genes involved in everolimus pharmacokinetics and pharmacodynamics were genotyped and associations assessed with drug plasma levels, clinically relevant toxicities (non-infectious pneumonitis, mucositis, hyperglycemia and hematological toxicities), dose reductions or treatment suspensions due to toxicity, progression free survival (PFS) and overall survival.We found that CYP3A4 rs35599367 variant (CYP3A4*22 allele) carriers had higher everolimus blood concentration compared to wild type patients (P = 0.019). ABCB1 rs1045642 was associated with risk of mucositis (P = 0.031), while PIK3R1 rs10515074 and RAPTOR rs9906827 were associated with hyperglycemia and non-infectious pneumonitis (P = 0.016 and 0.024, respectively). Furthermore, RAPTOR rs9906827 was associated with PFS (P = 0.006).CYP3A4*22 allele influenced plasma concentration of everolimus and several SNPs in PI3K/AKT/mTOR pathway genes were associated with treatment toxicities and prognosis. These results require replication, but suggest that germline variation could influence everolimus outcomes in MBC.
- Published
- 2017
- Full Text
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