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Protocolo diagnóstico y terapéutico de los síndromes paraneoplásicos del cáncer de pulmón
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.006
G. González, S. Roa, M. García-Pardo, Y. Lage, A. Barril, J.C. Calvo, M.E. Olmedo, V. Alía, P. Garrido, J. Chamorro
{"title":"Protocolo diagnóstico y terapéutico de los síndromes paraneoplásicos del cáncer de pulmón","authors":"G. González,&nbsp;S. Roa,&nbsp;M. García-Pardo,&nbsp;Y. Lage,&nbsp;A. Barril,&nbsp;J.C. Calvo,&nbsp;M.E. Olmedo,&nbsp;V. Alía,&nbsp;P. Garrido,&nbsp;J. Chamorro","doi":"10.1016/j.med.2025.03.006","DOIUrl":"10.1016/j.med.2025.03.006","url":null,"abstract":"<div><div>Paraneoplastic syndromes are a set of signs and symptoms that appear in sites distant from the primary tumor or its metastases in relation to the secretion of substances produced by the neoplasm itself or by antibodies targeted against tumor antigens that generate a cross-reaction with other tissues. Lung cancer is one of the neoplasms in which this type of syndrome most frequently develops.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1614-1617"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mesotelioma pleural maligno
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.003
V. Alía, M.E. Olmedo, G. González, Y. Lage, M. García-Pardo, S. Roa, J.C. Calvo, A. Barrill, P. Garrido, J. Chamorro
{"title":"Mesotelioma pleural maligno","authors":"V. Alía,&nbsp;M.E. Olmedo,&nbsp;G. González,&nbsp;Y. Lage,&nbsp;M. García-Pardo,&nbsp;S. Roa,&nbsp;J.C. Calvo,&nbsp;A. Barrill,&nbsp;P. Garrido,&nbsp;J. Chamorro","doi":"10.1016/j.med.2025.03.003","DOIUrl":"10.1016/j.med.2025.03.003","url":null,"abstract":"<div><div>Malignant pleural mesothelioma is an aggressive and rare neoplasm associated with asbestos exposure. Its incidence is increasing in developing countries. It has a poor prognosis, with a median survival time of about one year. The treatments currently available offer limited benefits. Based on the available evidence, the role of radical surgery is controversial because of the high perioperative morbidity and mortality and the tendency for disease recurrence. Platinum- and pemetrexed-based chemotherapy was the cornerstone of the treatment of unresectable disease in patients with good functional reserve. Immunotherapy with nivolumab and ipilimumab has recently emerged as a new standard option, improving survival figures and with manageable toxicity, especially in the non-epithelioid histologic subtype. Pleural effusion and trapped lung are common complications in this disease, so techniques aimed at controlling symptoms are fundamental. It is necessary to conduct new clinical trials and translational research in order to improve survival and quality of life expectations for patients with pleural mesothelioma.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1595-1602"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tráfico leucocitario: mecanismos e impacto clínico
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.014
D. De León-Oliva , D. Liviu Boaru , P. De Castro-Martínez , R. Díaz-Pedrero , L. López-González , M. Álvarez-Mon , M.A. Ortega
{"title":"Tráfico leucocitario: mecanismos e impacto clínico","authors":"D. De León-Oliva ,&nbsp;D. Liviu Boaru ,&nbsp;P. De Castro-Martínez ,&nbsp;R. Díaz-Pedrero ,&nbsp;L. López-González ,&nbsp;M. Álvarez-Mon ,&nbsp;M.A. Ortega","doi":"10.1016/j.med.2025.03.014","DOIUrl":"10.1016/j.med.2025.03.014","url":null,"abstract":"<div><div>Leukocyte trafficking is the highly regulated process by which immune cells migrate between the vascular system and tissues. They perform immune surveillance functions under conditions of homeostasis and facilitate inflammatory responses in the event of injury or infection, promoting the elimination of harmful agents and contributing to tissue repair. The regulation of this traffic depends on local signals that induce changes in the capillary system, facilitating leukocyte adhesion and extravasation through the leukocyte adhesion cascade, which is mediated by adhesion molecules on the cell surface of leukocytes and vascular cells. This update will review the set of chemotactic signals that attract leukocytes to the site of injury and the pathological implications of leukocyte trafficking dysregulation as well as provide an update regarding their relationship to aging and the pharmacological treatments that regulate it.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 28","pages":"Pages 1688-1697"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indicaciones e interpretación de las pruebas alérgicas cutáneas y serológicas
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.04.005
C. Vidal Pan , I. Roibás Veiga , P. Méndez Brea , T. González Vidal
{"title":"Indicaciones e interpretación de las pruebas alérgicas cutáneas y serológicas","authors":"C. Vidal Pan ,&nbsp;I. Roibás Veiga ,&nbsp;P. Méndez Brea ,&nbsp;T. González Vidal","doi":"10.1016/j.med.2025.04.005","DOIUrl":"10.1016/j.med.2025.04.005","url":null,"abstract":"<div><div>Protocols for in vivo and in vitro tests used in the study of allergic reactions are presented with special emphasis on the former. In vivo tests include the identification of specific IgE by intraepidermal and intradermal immediate hypersensitivity testing as well as the identification of sensitised T-lymphocytes in delayed hypersensitivity skin tests. Among the in vitro tests, the methods used for the quantification of allergen-specific IgE are described.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1757-1762"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inmunidad innata y adaptativa
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.015
A. Prieto Martín, D. Díaz Martín, L. Muñoz Zamarrón y J. Monserrat Sanz
{"title":"Inmunidad innata y adaptativa","authors":"A. Prieto Martín,&nbsp;D. Díaz Martín,&nbsp;L. Muñoz Zamarrón y J. Monserrat Sanz","doi":"10.1016/j.med.2025.03.015","DOIUrl":"10.1016/j.med.2025.03.015","url":null,"abstract":"<div><div>Immune responses are divided into innate and adaptive. Innate immunity is rapid and non-specific, acting against a broad spectrum of pathogens using receptors that recognize pathogen-associated molecular patterns (PAMPs) or damage-associated molecular patterns (DAMPs). Adaptive immunity recognizes specific antigens through a diverse repertoire of antigen-specific T and B lymphocytes. This system requires time for antigen-specific cells to activate and proliferate. This response generates effector and memory T cell clones that enable a potent, effective, rapid, and specific response in future exposures to the same pathogen. The interaction between both systems is essential for the efficient defense of the organism. The antigen-presenting cells of the innate system inform the adaptive cells about the nature of the pathogens detected and polarize the adaptive response so that it is more effective against the type of pathogen being confronted. Innate immunity can generate a trained memory that enhances its response to subsequent exposures.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 28","pages":"Pages 1698-1711"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manejo de las toxicidades inmunomediadas por fármacos anti-PD-1/PD-L1
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.007
A. Barrill, J.C. Calvo, M.E. Olmedo, V. Alía, S. Roa, G. González, M. García-Pardo, Y. Lage, P. Garrido, J. Chamorro
{"title":"Manejo de las toxicidades inmunomediadas por fármacos anti-PD-1/PD-L1","authors":"A. Barrill,&nbsp;J.C. Calvo,&nbsp;M.E. Olmedo,&nbsp;V. Alía,&nbsp;S. Roa,&nbsp;G. González,&nbsp;M. García-Pardo,&nbsp;Y. Lage,&nbsp;P. Garrido,&nbsp;J. Chamorro","doi":"10.1016/j.med.2025.03.007","DOIUrl":"10.1016/j.med.2025.03.007","url":null,"abstract":"<div><div>The era of immunotherapy has changed the prognosis and quality of life of a large number of patients with lung neoplasms. In general, the treatment of choice has become immunotherapy associated with chemotherapy in multiple scenarios. However, with their emergence, new toxicities have arisen that require rapid identification to achieve optimal control because, although infrequent, they can be life-threatening. Usually, starting treatment with oral or intravenous corticotherapy will be proposed and, depending on the severity of the symptoms, hospitalization and the temporary or definitive suspension of immunotherapy will be considered. In refractory cases, the use of immunomodulatory drugs may be necessary. This protocol aims to summarize the characteristics and general management of these adverse effects.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1618-1621"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biomarcadores predictivos en el cáncer de pulmón. Implicaciones terapéuticas
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.005
M.E. Olmedo, Y. Lage, M. García-Pardo, S. Roa, J.C. Calvo, V. Alía, A. Barril, G. González, P. Garrido y J. Chamorro
{"title":"Biomarcadores predictivos en el cáncer de pulmón. Implicaciones terapéuticas","authors":"M.E. Olmedo,&nbsp;Y. Lage,&nbsp;M. García-Pardo,&nbsp;S. Roa,&nbsp;J.C. Calvo,&nbsp;V. Alía,&nbsp;A. Barril,&nbsp;G. González,&nbsp;P. Garrido y J. Chamorro","doi":"10.1016/j.med.2025.03.005","DOIUrl":"10.1016/j.med.2025.03.005","url":null,"abstract":"<div><div>Targeted and immune checkpoint inhibitor therapies have changed the prognosis and quality of life for subgroups of lung cancer patients. The 2004 discovery of epidermal growth factor receptor (EGFR) mutations followed by rearrangements in the anaplastic lymphoma kinase (ALK) gene facilitated the development of targeted drugs for patients with advanced non-small cell lung cancer (NSCLC). In recent years, other therapeutic targets have been identified in patients with adenocarcinoma that are being incorporated into clinical practice. To date, the only predictive biomarker of immunotherapy efficacy approved in patients with NSCLC is the immunohistochemical (IHC) determination of PD-L1 (Programmed death-ligand-1) in the tumor. This protocol aims to summarize the predictive biomarkers of treatment efficacy used in routine clinical practice.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1610-1613"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cáncer de cabeza y cuello
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.004
S. Roa, V. Alía, A. Barrill, Y. Lage, M. García-Pardo, M.E. Olmedo, J.C. Calvo, G. González, P. Garrido y J. Chamorro
{"title":"Cáncer de cabeza y cuello","authors":"S. Roa,&nbsp;V. Alía,&nbsp;A. Barrill,&nbsp;Y. Lage,&nbsp;M. García-Pardo,&nbsp;M.E. Olmedo,&nbsp;J.C. Calvo,&nbsp;G. González,&nbsp;P. Garrido y J. Chamorro","doi":"10.1016/j.med.2025.03.004","DOIUrl":"10.1016/j.med.2025.03.004","url":null,"abstract":"<div><div>Head and neck tumors encompass neoplasms of the upper aerodigestive tract, including the salivary glands. They are rare tumors with a very heterogeneous population and geographic distribution. Its location in an anatomically complex area conditions the different therapeutic strategies aimed at minimizing comorbidities and optimizing patients’ organ functionality and quality of life. Multiple environmental (toxic, dietary, viral infections, etc.) and genetic risk factors related to the disease have been described; some are prognostic factors of the disease. A systematic study of the neck should be performed through a physical examination, fibroendoscopy, imaging test, and biopsy. A molecular study on the sample should be ordered in order to determine possible therapeutic targets. Likewise, a multidisciplinary approach must also be proposed in order to individualize and establish the best treatment option in each case: surgery, radiotherapy, or systemic treatment (chemotherapy, immunotherapy, targeted therapy).</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 27","pages":"Pages 1603-1609"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143591724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Funciones efectoras de los linfocitos T
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.03.011
D. Díaz Martín , A. Prieto Martín , L. Muñoz Zamarrón , M. Álvarez-Mon
{"title":"Funciones efectoras de los linfocitos T","authors":"D. Díaz Martín ,&nbsp;A. Prieto Martín ,&nbsp;L. Muñoz Zamarrón ,&nbsp;M. Álvarez-Mon","doi":"10.1016/j.med.2025.03.011","DOIUrl":"10.1016/j.med.2025.03.011","url":null,"abstract":"<div><div>T lymphocytes are an essential part of the antigen-specific adaptive immune response. This update will explore the concept, functions, and main characteristics of these lymphocytes, the particularities of their receptor, and subpopulations based on their receptor. It will analyze the functional states based on the antigenic encounter, what signals are necessary for their activation, and how they differentiate after encountering an antigen. Attention will be paid to the effector functions of helper and cytotoxic T cells, as well as their differentiation into subpopulations such as Th1, Th2, Th17, and Treg. In addition, it will examine other polarizations described for T lymphocytes, including Tfh, Th9, and Th22. It will also address the study of Tγδ lymphocytes, NKT cells, and cytotoxic CD4 T cells, as well as tissue-resident memory T cells. Lastly, it will analyze how the immunological memory of T lymphocytes is generated and how their exhaustion occurs.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 28","pages":"Pages 1643-1659"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indicación de vacunación-inmunoterapia en las enfermedades alérgicas
Medicine - Programa de Formación Médica Continuada Acreditado Pub Date : 2025-03-01 DOI: 10.1016/j.med.2025.04.006
P. Méndez Brea , I. Roibás Veiga , T. González Vidal , C. Vidal Pan
{"title":"Indicación de vacunación-inmunoterapia en las enfermedades alérgicas","authors":"P. Méndez Brea ,&nbsp;I. Roibás Veiga ,&nbsp;T. González Vidal ,&nbsp;C. Vidal Pan","doi":"10.1016/j.med.2025.04.006","DOIUrl":"10.1016/j.med.2025.04.006","url":null,"abstract":"<div><div>Allergen immunotherapy or vaccination is the only etiological treatment for allergic diseases such as rhinitis, asthma, and allergy to hymenoptera venoms. Its efficacy has been fully demonstrated in double-blind, placebo-controlled studies and in meta-analyses. Immunotherapy should only be used in diseases in which an IgE-mediated allergy mechanism has been shown to be central to its pathogenesis. Vaccination consists of the administration of repeated doses of an allergenic extract to which the patient is sensitized in order to improve the symptoms associated with subsequent exposure to that allergen. The main indications and contraindications for specific immunotherapy with allergens and the most frequently used routes of administration are described.</div></div>","PeriodicalId":100912,"journal":{"name":"Medicine - Programa de Formación Médica Continuada Acreditado","volume":"14 29","pages":"Pages 1763-1768"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143817297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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