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Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors.

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INTRODUCCIÓN: La tetralogía de Fallot representa la cardiopatía congénita cianógena más frecuente después del primer año de vida, ocurre aproximadamente en 1 de cada 3 500 nacimientos y representa el 7 al 10% de todas las Enfermedades Cardiacas Congénitas. Su variante extrema que se acompaña de atresia pulmonar representa el 1 a 2% de las cardiopatías congénitas. Presentamos una Tetralogía de Fallot Extrema Ductus Dependiente de manejo complejo. CASO CLÍNICO: Se trata de un neonato a término de 12 días de vida, adecuado para la edad gestacional, sin factores de riesgo prenatales, ni antecedentes patológicos familiares, el cual es diagnosticado de Tetralogía de Fallot Extrema por ecocardiograma. EVOLUCIÓN: Paciente inicialmente tratado con infusión de prostaglandina E1. Posteriormente mediante fístula Blalock-Taussig izquierda. CONCLUSIONES: Para mejorar el pronóstico y sobrevida de un paciente con Tetralogía de Fallot Extrema el diagnóstico prenatal oportuno y el tratamiento apropiado es de vital importancia, sin embargo el tratamiento definitivo con derivaciones pulmonares sistémicas representan complicaciones con riesgo de mortalidad. El presente caso tuvo un desenlace desfavorable.

BACKGROUND: The Tetralogy of Fallot represents the most common cyanogenic heart disease after the first year of life. It occurs in 1 of 3 500 live births and accounts as 7 to 10% of all Congenital Heart Diseases. Its extreme variant is accompanied by pulmonary atresia and accounts 1 to 2% of the Congenital Heart Diseases. We present an Extreme Tetralogy of Fallot­ Ductus Dependent of complex management. CLINICAL CASE: A full term 12 day neonate, adequate for gestational age, without prenatal risk factors or pathologic family antecedents, is diagnosed with Extreme Tetralogy of Fallot by echocardiogram. EVOLUTION: The patient was treated initially with an infusion of prostaglandin E1. Then, a left Blalock-Taussig shunt was performed. CONCLUSIONS: To improve the prognosis and survival rates of patients with Extreme Tetralogy of Fallot , a timely diagnosis and treatment are of vital importance. Definitive treatment with systemic pulmonary shunts carries high risk complications. The present case had an unfavorable evolution.

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Resumen Este estudio tiene como objetivo analizar las relaciones entre las actitudes sexistas, los pensamientos distorsionados sobre la mujer y el uso de la violencia y los comportamientos de violencia con la pareja, en universitarios ecuatorianos de ramas relacionas con el bienestar y la salud. La muestra está conformada por 646 alumnos de tres universidades (424 alumnas y 222 alumnos). Se aplicaron los siguientes instrumentos: Versión modificada de la Escala de Tácticas para los Conflictos, Inventario de Sexismo Ambivalente, Inventario de Pensamientos Distorsionados y Escala de Deseabilidad Social. Para la detección de diferencias estadísticamente significativas, se aplicó el test de Mann Whitney y el test de Kruskal Wallis. Para estimar el efecto de la deseabilidad social en las respuestas, se realizaron diferentes regresiones lineales. Los resultados identifican un alto nivel de sexismo y de violencia ejercida y sufrida en la muestra de universitarios, aunque estos parecen estar influidos por la deseabilidad social. Este hecho cobra especial relevancia debido al papel que juegan estos profesionales en la detección y tratamiento de violencia en la pareja. Los resultados obtenidos indican la oportunidad de trabajar en intervenciones educativas en población universitaria para minimizar los pensamientos sexistas que pueden ser fundamento de la violencia de género.

Abstract This study aims to analyze the relationships between sexist attitudes, distorted thoughts about women, the use of violence and violent behaviors in couples. The study was carried out in Ecuadorian universities with students related to Welfare and Health studies. There were 646 students from three universities (424 men and 222 women). The following tests were applied: Modified version of the Scale Conflict Tactics, Ambivalent Sexism Inventory, Inventory of Distorted Thoughts and Social Desirability Scale. The Mann-Whitney and Kruskal Wallis tests were applied to detect statistically significant differences. In order to estimate the effect of social desirability on responses it was performed different linear regressions. The results identify high levels of sexism and perpetrated and suffered violence, although these results seemed to be influenced by social desirability. This becomes especially important due to the role played by these professionals in the detection and treatment of intimate partner violence. The results show the importance to work on educational interventions in universities to minimize sexist thoughts that cause violence against women.

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