Publications by authors named "M Alejandra Sanchez"

4,345 Publications

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The role of multimorbidity in short-term mortality of lung cancer patients in Spain: a population-based cohort study.

BMC Cancer 2021 Sep 24;21(1):1048. Epub 2021 Sep 24.

Department of Non-Communicable Disease Epidemiology, Inequalities in Cancer Outcomes Network, London School of Hygiene and Tropical Medicine, London, UK.

Aim: Chronic diseases often occur simultaneously and tend to be associated with adverse health outcomes, but limited research has been undertaken to understand their role in lung cancer mortality. Therefore, this study aims to describe the prevalence and patterns of having one (comorbidity) or ≥ 2 chronic diseases (multimorbidity) among lung cancer patients in Spain, and to examine the association between comorbidity or multimorbidity and short-term mortality risk at six months after cancer diagnosis.

Methods: In this population-based cohort study, data were drawn from two Spanish population-based cancer registries, Girona and Granada, and electronic health records. We identified 1259 adult lung cancer patients, diagnosed from 1st January 2011 to 31st December 2012. We identified the most common patterns of individual comorbidities and their pairwise correlations. We used a flexible parametric modelling approach to assess the overall short-term mortality risk 6 months after cancer diagnosis by levels of comorbidity after adjusting for age, sex, smoking status, province of residence, surgery, cancer stage, histology, and body mass index.

Results: We found high prevalence of comorbidity in lung cancer patients, especially among the elderly, men, those diagnosed with advanced-stage tumours, smokers, and obese patients. The most frequent comorbidities were chronic obstructive pulmonary disease (36.6%), diabetes (20.7%) and heart failure (16.8%). The strongest pairwise correlation was the combination of heart failure with renal disease (r = 0.20, p < 0.01), and heart failure with diabetes (r = 0.16, p < 0.01). Patients with either one or two or more comorbidities had 40% higher overall mortality risk than those without comorbidities (aHR for comorbidity: 1.4, 95%CI: 1.1-1.7; aHR for multimorbidity: 1.4, 95%CI: 1.1-1.8), when relevant confounding factors were considered.

Conclusions: The presence of comorbid diseases, rather than the number of comorbidities, was associated with increasing the risk of short-term lung cancer mortality in Spain. Comorbidity was a consistent and independent predictor of mortality among lung cancer patients, six months after diagnosis. The most common comorbid conditions were age-, obesity- and tobacco-related diseases. Our findings highlight the need to develop targeted preventive interventions and more personalised clinical guidelines to address the needs of lung cancer patients with one or more comorbidities in Spain.
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http://dx.doi.org/10.1186/s12885-021-08801-9DOI Listing
September 2021

Metastatic carcinoma in human remains from TT110, Luxor, Egypt (ancient Thebes).

Homo 2021 Sep 22. Epub 2021 Sep 22.

Englewood Hospital. New Jersey. USA.

Commingled human remains were discovered in TT110 (Djehuty tomb; Dynasty XVIII), located in El Sheikh Abd el Qurna, Luxor, Egypt. The tomb had been reused over a long period of time (1570-332 BCE). In a small area distinct from the comingled remains, an incomplete skull and two fragments, consistent with that of a young adult female, between 25 and 40 years of age were found. A detailed macroscopic and radiologic analysis was performed at the tomb site. The three bone fragments showed abundant small to medium sized osteolytic lesions compatible with a diagnosis of late stage metastatic carcinoma or, less likely, multiple myeloma. The age and sex of the individual favors the possibility of breast cancer as the primary making this one of the oldest cases of metastases reported from ancient Egypt.
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http://dx.doi.org/10.1127/homo/2021/1477DOI Listing
September 2021

Student-Authored Scientist Spotlights: Investigating the Impacts of Engaging Undergraduates as Developers of Inclusive Curriculum through a Service-Learning Course.

CBE Life Sci Educ 2021 Dec;20(4):ar55

Department of Biology, San Francisco State University, San Francisco, CA 94132.

Scientist Spotlights-curricular materials that employ the personal and professional stories of scientists from diverse backgrounds-have previously been shown to positively influence undergraduate students' relatability to and perceptions of scientists. We hypothesized that engaging students in authoring Scientist Spotlights might produce curricular materials of similar impact, as well as provide a mechanism for student involvement as partners in science education reform. To test this idea and investigate the impact of student-authored Scientist Spotlights, we developed a service-learning course in which teams of biology students partnered with an instructor to develop and implement Scientist Spotlights in a biology course. Results revealed that exposure to three or four student-authored Scientist Spotlights significantly shifted peers' perceptions of scientists in all partner courses. Interestingly, student-authored Scientist Spotlights shifted peers' relatability to scientists similarly among both white students and students of color. Further, student authors themselves showed increases in their relatability to scientists. Finally, a department-wide survey demonstrated significant differences in students' perceptions of scientist representation between courses with and without student-authored Spotlights. Results suggest that engaging students as authors of inclusive curricular materials and partners in reform is a promising approach to promoting inclusion and addressing representation in science.
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http://dx.doi.org/10.1187/cbe.21-03-0060DOI Listing
December 2021

[Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units].

Med Intensiva 2021 Sep 16. Epub 2021 Sep 16.

Medicina Intensiva, Hospital QuirónSalud Tenerife, Tenerife, Spain.

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients.
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http://dx.doi.org/10.1016/j.medin.2021.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443328PMC
September 2021

Chronic opioid use is associated with obstructive and spastic disorders in the esophagus.

Neurogastroenterol Motil 2021 Sep 16:e14233. Epub 2021 Sep 16.

Department of Medicine, Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.

Background And Aims: Chronic opioid effects on the esophagus are poorly understood. We investigated whether opioids were associated with increased prevalence of esophageal motility disorders.

Methods: A retrospective study of all patients undergoing high-resolution manometry (HREM) at the Yale Gastrointestinal Motility Lab between January 2014 and August 2019. Data were extracted from the electronic medical record after studies were reviewed by two motility specialists using the Chicago Classification v.3.0. We compared the manometric results of patients who use opioids to those who do not and adjusted for type and dose of opioids using a 24 h Morphine Milligram Equivalents (MME) scale to compare patients taking low or high amounts of opioids.

Results: Four manometric abnormalities were significantly different between the opioid and non-opioid users. Achalasia type III, esophagogastric junction outflow obstruction (EGJOO), and distal esophageal spasm (DES) (p < 0.005, p < 0.01, and p < 0.005, respectively) were common among opioid users, whereas ineffective esophageal motility (IEM) was more common among non-opioid users (p < 0.01). The incidence of EGJOO was significantly higher in opioid users compared to non-opioid users (p < 0.001). Lastly, IRP, DCI, and distal latency were significantly different between the two groups. Patients in the high MME group had significantly greater IRP, DCI, and lower distal latency than non-opioids (p < 0.001). Also, achalasia type III and DES were more common in the high but not the low MME group.

Conclusions: Opioid use is associated with multiple abnormalities on esophageal motility and these effects may be dose-dependent.
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http://dx.doi.org/10.1111/nmo.14233DOI Listing
September 2021
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